title: Quality and impact of information about interventional rheumatology: a study in 119 patients undergoing fluoroscopy-guided procedures.
abstract: OBJECTIVE
  To evaluate the quality of patient information about fluoroscopy-guided rheumatologic procedures, and to look for an impact on the patient's experience of the procedure.
  
  
  METHODS
  One hundred and nineteen patients completed questionnaires before and after undergoing fluoroscopy-guided interventions. We looked for associations between the information supplied by the rheumatologist who recommended the procedure and pain, anxiety, awareness of potential complications, and the match between patient expectations and actual experience.
  
  
  RESULTS
  62.8% of patients reported receiving information about the procedure. Only 20.5% reported receiving specific information about potential adverse events, although 80.9% felt this information would have been useful. Most patients (74.8%) would have liked to receive additional information. Only 10.1% patients were given written information. Mean (+/-SD) anticipated pain severity as assessed in the waiting room before the procedure on a 0-10 scale was 4.5+/-2.4 in women and 4.2+/-2.3) in men. Actual pain severity during the procedure as assessed on the same scale was 2.7+/-2.6 in women and 2.2+/-1.6 in men. The level of information about the procedure did not influence anticipated or actual pain severity. Anxiety was reported by 59.8% patients and was more common in women (P<0.001), in patients given written information (P=0.05), and in patients undergoing their first intervention (P=0.05). Information was perceived as alleviating anxiety by 69.9% patients, and 77.3% of patients felt they would experience less anxiety if they had the procedure a second time. Only 21.2% patients were able to name a potential adverse event, and this proportion was not influenced by receiving written information. A mismatch between expectations about the procedure or its duration and actual experience was reported by 17 (17/69, 24.6%) and 34 (34/98, 34.7%) patients, respectively, with no significant differences across study subgroups.
  
  
  CONCLUSIONS
  Information about interventional rheumatology procedures is required for ethical principles and legislation. Patients increasingly expect detailed information, which may increase the likelihood that the procedure unfolds smoothly. Our results indicate a need for optimizing patient information. Standardized written material deserves to be evaluated as a means of better meeting the informational needs of patients.
authors.affiliation: Rheumatology Department, Brest Teaching Hospital, CHU de Brest, 29609 Brest, France. xavier.guennoc@chu-brest.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Guennoc
authors.forename: Isabelle
authors.initials: I
authors.lastname: Samjee
authors.forename: Sandrine
authors.initials: S
authors.lastname: Jousse-Joulin
authors.forename: Valérie
authors.initials: V
authors.lastname: Devauchelle
authors.forename: Anne
authors.initials: A
authors.lastname: Roudaut
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000628:therapy*; D016009:Chi-Square Distribution; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005602:France; D019538:Health Care Surveys; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D020380:Needs Assessment; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011786:Quality Control; D012219:Rheumatology / Q000592:standards / Q000639:trends; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents