Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 4818
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents 
ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 12  |  Page : 6183-6185  

Patients concerns about spinal surgery in Hafr Al Batin, Saudi Arabia


1 Department of Medicine, Majmaah University, Al Majmaah, Kingdom of Saudi Arabia
2 Department of Medicine, Taif University, Taif, Kingdom of Saudi Arabia
3 King Abdullah International Medical Research Center, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia

Date of Submission07-Jun-2019
Date of Decision21-Jul-2020
Date of Acceptance29-Jul-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Dr. Alwaleed Mohammed Alyamani
King Abdullah International Medical Research Center, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh
Kingdom of Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_450_19

Rights and Permissions
  Abstract 


Background: The aim of the research to study the concerns about spine surgery in patients who attending to neurosurgery clinic in Central Hospital and King Khalid General Hospital in hafar Al-Batin. Objective: The objective is to determine the concern of patients about spine surgery and to detect the reasons of rejection of the surgery with tying to compare the concerns with the social factors and to know the source of their knowledge. Material and Method: A cross-sectional study on sample of 91 from the patients who attending neurosurgery clinic who could be suffering from any spinal diseases such as tumors, degenerative, and trauma. A standardized survey questionnaire distributed manually and responses were collected and analyzed. Results: The majority of the survey respondents were suffering from trauma (48.4%). The satisfaction rate among persons undergone spine surgery was 20.9%. A negative correlation between age and level of education; rejection of spine surgery or exploring for alternative treatment because of risk of surgery was observed. The patient feedback revealed that if advised for spine operation was 46.2% will accept, 29.7% will delay surgery and looking to alternatives, while 23.1% will reject because of concerns. Conclusion: It is recommended that awareness campaigns are required about the importance of spine surgery and to provide the correct information about the complications of spine surgery and finally give more attention to the correct diagnosis.

Keywords: Patients concerns about spinal surgery, rejection of the spine surgery, source of patients knowledge


How to cite this article:
Mohammed ZA, Almutairi AA, Almutairi AS, Alghamdi AW, Mashhur RA, Alyamani AM. Patients concerns about spinal surgery in Hafr Al Batin, Saudi Arabia. J Family Med Prim Care 2020;9:6183-5

How to cite this URL:
Mohammed ZA, Almutairi AA, Almutairi AS, Alghamdi AW, Mashhur RA, Alyamani AM. Patients concerns about spinal surgery in Hafr Al Batin, Saudi Arabia. J Family Med Prim Care [serial online] 2020 [cited 2021 May 14];9:6183-5. Available from: https://www.jfmpc.com/text.asp?2020/9/12/6183/305623




  Introduction Top


In the recent years, there is a tremendous development in neurosurgery techniques for the treatment of spinal diseases;[1] these include new tools like; micro endoscope.[2] However, even with all of these techniques and improvement of surgery, patients of neurosurgery have concerns regarding spinal operations and its benefits, thus leading to increase rate of rejection of surgery and delay of treatment.[3],[4] For that the outcomes of spinal surgery still have some of limitations and not all patients report satisfactory recovery.[5],[6] A Chinese study done in October 2014–January 2015 analyzed the preoperative concerns of 94 Chinese patients suffering from spinal degenerative disease. The result was the “recurrence of symptoms following operation” (41/94) as most concerned, followed by “clinical outcome” (35/94) and “postoperative rehabilitation and daily activity” (30/94).[7]

And another preliminary study done among 100 patients in Turkey, for whom spinal operations were recommended for several reasons, and who had not accepted surgery. Forty-six patients stated they had distrust of surgery, and 54 patients did not want to be operated on for personal reasons. After comparing the two groups, they found that neurosurgical operations and the history of dissatisfaction of the patient or an acquaintance was significantly higher in the first group (P < 0.001) and 40% of all the patients (n = 40) had a past unpleasant neurosurgical experience that was either personal or relevant.[4]

Because there is a lack of literature on this aspect, and in our population in KSA especially in Hafar Al-Batin, patients often have second thoughts about spine surgery. Therefore, this study was planned to analyze the concerns of spinal patient about the spinal surgeries and why they refused the surgery when it recommends for them.

The purpose of the research was to address these concerns by educate patient and community about surgery with videos in Arabic distribute in social media, as time is a critical factor in neurosurgical patients.

Method and analysis

Cross-sectional study

A questionnaire survey of patients attending neurosurgery clinic at central hospital King Khalid General Hospital in hafar Al-Batin, Saudi Arabia, was done. This cross-sectional study has included a survey questionnaire distributed manually to record their demographic data (age, gender, and occupation), most common concerns and their information Source. Based on the nature of the research and the objectives, it sought to achieve, the data were analyzed using the IBM Statistical Package for Social Sciences (SPSS) version 21.0 and the results were extracted. The results of the frequency tables were analyzed and the standard deviation was determined. The correlation coefficients were analyzed using the Pearson correlation coefficient to establish correlation between the variables related to age, occupation, level of education and rejection of surgery, or search for alternatives treatment or belief in serious injuries. The Alpha Cronbach criterion was used to determine the consistency criterion for questionnaire questions.


  Results and Discussion Top


Reliability

Cronbach's Alpha was used to measure Reliability but it needs improvements to reach 0.6. Scale: All variables.

Frequencies

Homogeneity is noted at the samples pecifications according to gender, ages, and heterogeneity according to occupation, level of education, and diagnosis.

Frequency table

The majority of our sample from males with rate 59.3% and 40.7% females.

The characteristics of the sample according to age 49.5% from 20:40 years old, 37.4% from 41:60, 61 and above 12.1%.

According to occupation 26.4% from the sample homemaker, 18.7% office job and the same percentage military, 12.1% retired, 16.5% others.

The majority suffers from trauma with rate 48.4%, 20.9% degenerative spine disease, 12.1% tumors, 14.3% others.

According to education level 34.1% university, 22% illiterate, 16.5% secondary, 13.3% intermediate, 13.2% primary.

A homogeneity is noted at the sample opinion according to undergone spine operation, satisfaction on spine surgery and heterogeneity according to dissatisfaction on spine surgery, response at the need of spine surgery, response at the searching for other treatment alternatives or rejection of spine surgery, thoughts about surgery and information sources.

Frequency table

25.3% from the sample have undergone spine operation in the past, 72.5% did not.

The satisfaction rate among who undergone spine operation was in a high level as 20.9% from 25% who already get into this surgery was satisfied with surgery outcome, only 6.6% were not satisfied.

The reasons of not satisfaction mostly were recurrence of symptoms, no improvement, pain after surgery, and other.

About the patient feedback upon his/her reaction if they need spine operation the majority with 46.2% will accept that but 29.7% will delay surgery and looking to alternatives, 23.1% will reject because of concerns.

Reasons for not accepting the spine surgery and search for alternative were following: life risk, limb paralysis, possibility of failed surgery, recurrence of pain, postoperative rehabilitation, hospitalization exposure, fear of loss job, and existence of a systemic disease.

About the thoughts on spine surgery, the majority with 34.1% opinioned that there is risk to lose function, e.g., I cannot walk or difficulties in bathroom, 22% think it causes limb paralysis, 20.9% other, 13.2 thought may be the symptoms recurrence again, 8.8% thought of no benefit from it or expectation of small improvement.

The information source for the patients were 45.1% the relatives, 25.3% doctors, 15.4% internet, 12.1% Social media and 2.2% others.

Correlation

A negative correlation was found between age and level of education and occupation and rejection of spine surgery or searching for alternative treatment and thinking of risk to lose function, e.g., or cannot walk or difficulties in bathroom.


  Results and Discussion Top


The total sample consisted of 59.3% males and 40.7% females. 49.5% from the age group of 20–40 years, 37.4% from 41 to 60, and 12.1% were above 60 years. Looking at the occupation, 26.4% were homemakers, 18.7% had office job and the same percentage had the military background, 12.1% retired, 16.5% others, According to education level, 34.1% university educated, 22% were illiterate, 16.5% were secondary, 13.3% were intermediate, and 13.2% were only primary educated. The majority suffers from trauma with rate 48.4%, 20.9% degenerative spine disease, 12.1% from tumors, and 14.3% others. We note homogeneity at the sample opinion according to undergone spine operation as 25.3% from the sample have undergone spine operation in the past, 72.5% did not. We found a negative correlation between age and level of education and employment status.

The satisfaction rate among who undergone spine operation was in a high level as 20.9% from 25% who already get into this surgery and was satisfied with surgery outcome, only 6.6% was not satisfied which confirms the results of Yoon JP, Oh JH, Min WK, Kim JW, Jeong WJ, Lee HJ study and Brandt MG, Rotenberg BW, Yeung JC, Franklin JH, Doyle PC study as not all patients report satisfactory recovery, only who get through reported that and who did not still confirms there concerns we can add from our study that The reasons of not satisfaction mostly was recurrence of symptoms, no improvement, pain after surgery and other.

Regarding need of spine surgery, it was found the majority with 46.2% will accept that but 29.7% will delay surgery and looking to alternatives, 23.1% will reject because of concerns, a finding which is similar to the Turkish study which applied on 100 patients results as 54 patients did not want to be operated on for personal reasons. This study examines the reasons for as it was-life risk, limb paralysis, possibility of failed surgery, recurrence of pain, Other, clinical outcome, postoperative rehabilitation, hospitalization exposure, fear of loss job, and existence of a systemic disease. We found also according to the thoughts about spine surgery the majority with 34.1% think that there is risk to lose function, for example, I cannot walk or difficulties in bathroom, 22% think it causes limb paralysis, 20.9% other, 13.2% stating the symptoms might recurrence again, 8.8% stated no benefit from it, which is different from Chun-Xiao Luo, * Yang Yang, et al. study.

We found that the information source for the patients were 45.1% close relatives, 25.3% doctors, 15.4% internet, 12.1% from social media, In comparison with Durdag E1, Labara S, et al. results as 40% of all the patients (n = 40) had a past unpleasant neurological experience that was either personal or relevant reject immediately acceptance of spine surgery if it needed based on relatives and unpleased experience

Recommendations

  1. Need of awareness campaigns about the importance of spine surgery in case of need to correct perception of patients
  2. Due attention should be given to correct diagnosis
  3. Provide the correct information about the complications of spine surgery if needed to dispel the false perceptions about major concerns that may be largely untrue and delay treatment and thus deteriorate health condition
  4. Because there is a large proportion of the cause of injury to accidents, prefer to need of training courses to address the risk of injury and how to deal with injury at the beginning.



  Conclusion Top


There are concerns in a wide range of patients suffering from spine problems requiring surgical intervention, despite the great progress in these surgeries. Patients continue to rely on their opinions on previous unpleased experiences, as well as the experiences of relatives in the absence of clear awareness. It is known that delay in surgery or receiving proper treatment may cause the deterioration of some cases, which requires a clear intervention and awareness of the real necessities such as surgery. Further diagnosis needs to be taken care to prevent complications and reduce negative outcomes.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Arnold PM, Anderson KK, McGuire RA Jr., The lateral transposes approach to the lumbar and thoracic spine: A review. Surg Neurol Int. 2012;3:S198-215.  Back to cited text no. 1
    
2.
Wu H, Yu WD, Jiang R, Gao ZL. Treatment of multilevel degenerative lumbar spinal stenosis with spondylolisthesis using a combination of micro endoscopic discectomy and minimally invasive transforaminal lumbar interbody fusion. Exp Ther Med. 2013;5:567-71.  Back to cited text no. 2
    
3.
D'Angelo C, Mirijello A, Ferrulli A, Leggio L, Berardi A, Icolaro N, et al. Role of trait anxiety in persistent radicular pain after surgery for lumbar disc herniation: A 1-year longitudinal study. Neurosurgery 2010;67:265-71.  Back to cited text no. 3
    
4.
Durdag E, Albayrak S, Ayden O, Atci IB, Bitlisli H, Kara D, et al. Why do the patients reject spinal operations? A preliminary study, Elazig training and research hospital, department of neurosurgery. Turkish Neurosurgery J 2015:25(3) 389-93 [doi: 10.5137/1019-A51Q4193.  Back to cited text no. 4
    
5.
Yoon JP, Oh JH, Min WK, Kim JW, Jeong WJ, Lee HJ. What do the patients want and worry in Korean patients who undergo arthroscopic rotator cuff surgery? Clin Orthop Surg 2012;4:278-83.  Back to cited text no. 5
    
6.
Brandt MG, Rotenberg BW, Yeung JC, Franklin JH, Doyle PC. Prospective evaluation of preoperative concern among patients considering endoscopic sinus surgery: Initial validation. Int Forum Allergy Rhinol 2011;1:219-24.  Back to cited text no. 6
    
7.
Luo CX, Yang Y, Rong LM, Liu B, Xie PG, Zhang LM, et al. Prospective evaluation of preoperative concerns for Chinese patients with spinal degenerative disease. Int J Clin Exp Med 2015:8(10):18523-27  Back to cited text no. 7
    




 

Top
   
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
   Abstract
  Introduction
   Results and Disc...
   Results and Disc...
  Conclusion
   References

 Article Access Statistics
    Viewed382    
    Printed2    
    Emailed0    
    PDF Downloaded33    
    Comments [Add]    

Recommend this journal