Elcil KAYA BİÇER, Semih AYDOĞDU, Hakkı SUR

RADYOAKTİF SİNOVEKTOMİNİN NONHEMOFİLİK SİNOVİTLERDE HASTA MEMNUNİYETİ ÜZERİNE ETKİSİ

Amaç: Radyoaktif sinovektomi (RAS) uygulanmış hemofili dışı sinovit hastalarında memnuniyet düzeyinin ve bunu etkileyen etmenlerin değerlendirilmesiGereç ve Yöntem: 2002-2013 arasında RAS uygulanmış hemofili dışı sinovit hastalarından ulaşılabilen ve telefon anketine katılmayı kabul eden 21 hasta çalışmaya dahil edildi. Hastaların 16’sında romatizmal hastalık vardı; 21 hastanın 25’i diz, ikisi dirsek ve üçü ayak bileği eklemi olmak üzere 30 eklemine 41 enjeksiyon yapılmıştı. Yirmi altı ekleme cerrahi sinovektomi yapılmıştı. Telefon anketinde temel yakınma, her enjeksiyon için hastanın yararlanım algısı, şişlikte gerileme ya da tekrarlama ve memnuniyetleri sorgulandı. Ağrı ve işlevsellik için telefonla diz değerlendirme formu dolduruldu. Bulgular: Temel yakınma eklemlerin 23 tanesinde (%76,7) şişlikti. Birinci enjeksiyon 14 eklemde (%46,7) yararlı, dört eklemde (%13,3) kısmen yararlı, 12 eklemdeyse (%40) faydasız olarak değerlendirildi. On dokuz eklemde (%63,3) şişlik tamamen, üç eklemde (%10) kısmen geriledi; 10 eklemdeyse (%33,3) tekrarladı. Hastalar, eklemlerin 20’sinin (%66,7) klinik sonucundan memnundu. Dizin ağrı ve işlev skorlarının medyan değeri 80’di; iki skor bakımından memnun olan ve olmayanlar arasında anlamlı fark saptanmadı. Spesifik bir romatizmal hastalığı olmayanlarda ağrı skoru anlamlı olarak daha iyi bulundu (p=0.031); bu hastalar uygulanan girişimden daha memnundu (p=0.045). Şişliğin devam etmesi, tekrarlaması ve yürüme güçlüğü olması hasta memnuniyetini olumsuz etkileyen etmenler olarak değerlendirildi.Sonuç: Romatizmal hastalığı olmayanlarda memnuniyet oranının daha yüksek olması, sistemik hastalığı olanlarda uzun süreli tatminkar sonuç elde edebilmenin zorluğuyla ilişkili görünmektedir. Memnuniyet üzerinde en etkili faktör şişliktir. Yüksek nüks riski varlığında ve çok sayıda cerrahi girişimden kaçınmak için RAS uygun bir seçenektir. Anahtar Sözcükler: Radyoaktif sinovektomi; sinovit; hasta memnuniyeti.

Anahtar Kelimeler:

Radyoaktif sinovektomi, sinovit, hasta memnuniyeti

PATIENT SATISFACTION FOLLOWING RADIOACTIVE SYNOVECTOMY IN NONHEMOPHILIC SYNOVITIS

Objective: To evaluate satisfaction rates of nonhemophilic synovitis patients who underwent radioactive synovectomy (RAS), to outline the factors influencing patient satisfaction.Material and Methods: RAS was performed to 31 nonhemophilic patients between 2002 and 2013; 21 patients were reached and agreed to make an interview on the phone. Twenty five of 30 joints were knee, two were elbow, and three were ankle; 41 injections were performed. Twenty six joints had surgical synovectomy. Primary complaints before and after RAS, patients’ perception of benefits, subsidence and recurrence of swelling and patient satisfaction were questioned. An over the phone knee evaluation form was filled which scored pain and functionality.Results: Swelling was the primary complaint in 23 joints (76.7%). First RAS injection was beneficial for 14 joints (46.7%), partially beneficial for four (13.3%), and not beneficial for 12 (40%). Swelling subsided completely in 19 joints (63.3%), partially in three (10%); recurred in 10 joints (33.3%). Satisfaction rate was 66.7%. Median values for pain and function scores were both 80. The ones without a specific rheumatic disease had significantly better pain scores (p=0.031), and were more satisfied with the procedure (p=0.045). Patient satisfaction was influenced by persistence and recurrence of swelling and restriction of walking. Conclusion: Satisfaction rate of patients without a rheumatic disease was significantly higher. In case of systemic diseases, obtaining durable successful outcomes is more challenging. Swelling was the most influential factor on satisfaction. In cases of high recurrence risk, RAS is an alternative to avoid multiple operations.Key words: Radioactive synovectomy; synovitis; patient satisfaction.

Keywords:

Radioactive synovectomy, synovitis, patient satisfaction,

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