Issues of importance to patients seeking care from members of the AOFAS: a preliminary report of the outcomes committee of the AOFAS.
BACKGROUND
The purpose of this multi-center study was to examine the outcomes of importance for patients seeking treatment for foot and ankle disorders. An improved understanding of patient outcome preferences will assist surgeons in improving patient satisfaction.


METHODS
An open-ended priority function questionnaire was administered to 235 patients presenting as new patients to five different outpatient locations. The questionnaire was designed to identify activities of importance to patients and was based on the McMaster Toronto Arthritis (MACTAR) patient preference disability questionnaire. Subjects were asked to list the specific activities that were limited by their condition. Open-ended answers were written on five blank spaces and then ranked as to their importance. The visual analog pain scale was recorded as a measure of the severity of the patient's symptoms at the time the response was made. The outpatient settings were two university hospitals, two private offices with academic affiliation, and one private office. Two hundred thirty-five surveys were collected between September and November of 2000; 227 surveys were acceptable for analysis. The respondents included 132 females (58.1%), 94 males (41.4%) and one patient who did not specify his gender (0.4%). The mean age was 45.8 (range 18 to 83) years.


RESULTS
Average pain at the time of assessment was 2.7 on a scale of 0 to 9 and was reported to increase to 4.8 in a typical day. The most frequently ranked limitations were difficulty with walking (159), running (73), standing (55), and exercise (54). Walking also was the issue ranked as the highest priority (77 of 159), while running (11 of 73), standing (10 of 55) and exercise (3 of 54) were assigned lesser priority values. Only 68 of 227 respondents failed to list walking as an issue. Work, sleep, and social activities were not commonly cited as issues of importance.


CONCLUSIONS
Patients presenting to office practices identified as specializing in foot and ankle disorders are predominantly middle-aged women in mild to moderate pain. Walking is the function most frequently identified as a problem and ranked as the highest priority for improvement. Social limitations were unlikely to be named as a limitation in this population.
Sangeorzan
Bruce J
BJ
Orthopaedics and Sports Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA.
Beskin
James L
JL
Britt
Sarah M
SM
Brage
Michael
M
Holt
Sarah
S
Kadel
Nancy J
NJ
Legro
Marcia W
MW
Sands
Andrew K
AK
SooHoo
Nelson F
NF
Stroud
Chris C
CC
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005534:Foot Diseases / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D011998:Recreation; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D016138:Walking