[Patients' need for information before surgery]. / Aufklärungsbedürfnisse chirurgischer Patienten.

Frequently, prior to surgery, patients are provided with information in order to meet legal and hospital requirements, but without taking their psychological needs into consideration. In order to learn how to improve this situation, the present study was performed. By means of a semi-structured interview including a newly constructed card system, that avoids giving patients undemanded and possibly harmful implicit information, the need for information of 60 patients before hip- or knee-replacement surgery were investigated in great detail. The results show that 83.3% of the patients want to be prepared by the surgeon, preferably by means of an oral communication (75.0%). Most frequently the day when decision for surgery is made and the day of hospitalization were preferred as point of time for preparation (30% each). Patients were more interested in information about the operation and recovery (43.3% each) than about risks (33.3%). Only 11.7% wanted to get psychological preparation prior to surgery. We conclude that coming into contact and establishing a trustful relationship with the surgeon who does the operation is the most crucial need of surgical patients. He should give presurgical information according to the patient's needs, which often do not focus on the risks, as legal regulations do. By providing psychological preparation for the small number of patients in need, psychological specialists may contribute to improve satisfaction and outcome of surgical patients.

21. The National Center for Health Statistics; long-term care surveys.

The NCHS has been conducting ad hoc surveys of nursing homes and other long-stay institutions since 1963. Growing public concern about the quality of care in nursing homes has provided the support to expand these data collection activities and establish a biennial program, commencing with the 1973-74 Nursing Home Survey. Based on a national probability sample, the new program collects a wide range of data about the health status and demographic characteristics of residents, availability of personnel and services, facility characteristics, costs, charges, and sources of payment. Among the problems common to these surveys are the difficulties of measuring quality of care, assessing the actual cost of services or episodes of illness, classifying long-term care establishments, and adapting survey methods to measure longitudinal changes in health status of residents and the corresponding provision of services.