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Patient Comprehension of Carpal Tunnel Surgery: an Investigation of Health Literacy
Gregory Waryasz, MD; Joseph A. Gil, MD; Daniel Chiou, MD; Paul Ramos, MD; Jonathan Schiller, MD; Manuel F. DaSilva, MD
Brown University, Providence, RI

Introduction: Health literacy has been suggested to include a set of individual abilities that allow a patient to acquire information about their medical conditions. Previous studies have suggested a lack of patient comprehension in orthopaedic trauma patients. The purpose of this investigation is to determine if elective surgical patients are able to obtain a satisfactory level of comprehension of carpal tunnel syndrome and release.
Methods: Patients with a diagnosis of carpal tunnel syndrome who elected to undergo isolated carpal tunnel release with a single surgeon were enrolled in the study. The patients were informed that they would be asked to complete a questionnaire at the post-operative visit regarding their surgery and post-operative instructions. The questionnaire was created directly from information that was provided through verbal instruction at the preoperative visit and a handout that was provided postoperatively.
Results: 45 patients (13 males, 32 females) were enrolled. 38 (84.4%) patients reported that their age was between 30 to 65 years, 2 (4.4%) patients reported that their age was between 18 to 30 years old, and 5 (11%) patients reported that their age was 66 years or greater. The average percentage of correct answers was 74.9% (95% CI, 69.6%-80.4%). Only 49% (n=22) percent of patients responded that the surgery was performed to decompress the median nerve. 46.7% (n=21) of patients reported that they did not know what nerve is involved, 4% (n=2) reported ulnar nerve, and 2% (n=1) reported axillary nerve. Education level (p=0.3), gender (p=0.29), and age (p=0.36) did not reveal any significant differences.
Conclusion: Although significant efforts to help patients achieve health literacy in carpal tunnel surgery were made, we found that patients continued to lack comprehension of pertinent components of carpal tunnel surgery, particularly understanding the involved anatomy.

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