Purpose
Nonspecific upper extremity illnesses (eg,. wrist pain, forearm pain)—where no objectively
verifiable pathology is detectable—are common and usually self-limiting. For some
patients, a nonspecific diagnosis can contribute to mistrust and disappointment.
Methods
This study tested the primary null hypothesis that there is no difference in mean
overall satisfaction between patients given a specific compared with a nonspecific
diagnosis. Second, we assessed factors associated with satisfaction and with nonspecific
upper extremity diagnosis.
Results
There was no significant difference between mean satisfaction with nonspecific and
specific diagnoses in bivariate analysis. However, when treated as a categorical variable,
22% of the patients with a nonspecific diagnosis had a satisfaction score of 8 or
lower compared with 11% of the patients given a specific diagnosis. First visit and
greater pain intensity were significantly associated with a nonspecific diagnosis
in bivariate analysis. In the multivariable models, no factors were independently
associated with satisfaction or with nonspecific diagnoses.
Conclusions
Although nonspecific diagnoses can sometimes be frustrating for both physician and
patient, in this small study using a satisfaction measure with a strong ceiling effect,
they were no less satisfying to patients on average and corresponded with slightly
greater pain intensity than specific diagnoses.
Clinical relevance
The degree to which nonspecific diagnoses (perhaps in combination with compassionate
care and incremental monitoring) can be part of a satisfying treatment experience
merits additional investigation.
Key words
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Article info
Publication history
Published online: November 27, 2018
Accepted:
October 15,
2018
Received:
March 27,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
