Validation of an educational booklet targeted to patients candidate for total knee arthroplasty

SummaryBackgroundKnee osteoarthritis is a highly prevalent condition and the leading reason for total knee arthroplasty (TKA). No consensus exists about the optimal content of preoperative patient information and, to the best of our knowledge, no validated information document is available. Our objective here was to obtain validation by healthcare professionals and patients of an educational booklet for patients awaiting TKA.Materials and methodsThe booklet was developed and validated in six phases: systematic literature review, drafting of the first version, critical revision by a panel of experts, modification of the booklet, validation by a multidisciplinary panel of experts, and validation by two groups of patients, one composed of patients awaiting TKA and the other of patients in the immediate post-TKA period. We assessed the impact of the booklet based on knowledge and belief scores before and 2 days after receiving the booklet.ResultsCritical revision of the first draft led to changes to meet the concerns voiced by the experts. Knowledge improved only in the patient group given the booklet preoperatively (from 6/10 to 9/10, P=0.005). The booklet did not modify beliefs in either patient group.DiscussionWe used a rigorous methodology to develop and validate the contents of an educational booklet. Receiving this document before TKA resulted in improved patient knowledge but had no impact on beliefs.Level of evidenceLevel IV

Frequency and Interrelations of Risk Factors for Chronic Low Back Pain in a Primary Care Setting

INTRODUCTION: Many risk factors have been identified for chronic low back pain (cLBP), but only one study evaluated their interrelations. We aimed to investigate the frequency of cLBP risk factors and their interrelations in patients consulting their general practitioners (GPs) for cLBP. METHODS: A cross-sectional, descriptive, national survey was performed. 3000 GPs randomly selected were asked to include at least one patient consulting for cLBP. Demographic, clinical characteristics and the presence of cLBP risk factors were recorded. The frequency of each cLBP risk factor was calculated and multiple correspondence analysis (MCA) was performed to study their interrelations. RESULTS: A total of 2068 GPs (68.9%) included at least 1 patient, for 4522 questionnaires analyzed. In the whole sample of patients, the 2 risk factors most commonly observed were history of recurrent LBP (72.1%) and initial limitation of activities of daily living (66.4%). For working patients, common professional risk factors were beliefs, that LBP was due to maintaining a specific posture at work (79.0%) and frequent heavy lifting at work (65.5%). On MCA, we identified 3 risk-factor dimensions (axes) for working and nonworking patients. The main dimension for working patients involved professional risk factors and among these factors, patients' job satisfaction and job recognition largely contribute to this dimension. DISCUSSION: Our results shed in light for the first time the interrelation and the respective contribution of several previously identified cLBP risk factors. They suggest that risk factors representing a "work-related" dimension are the most important cLBP risk factors in the working population