NEW YORK (Reuters Health) - A simple paper handout may be just as effective as videos and nurse instruction at educating surgery patients about their procedure, a new study suggests.
Previous work has found that patients are generally very bad at remembering information about the surgery they are about to undergo, despite having received it when they consented to the procedure.
That hints they might have trouble grasping the risks and benefits of the surgery beforehand, setting them up for later disappointment.
The new study tested whether having nurses educate the patients or showing them a video -- both common strategies -- would offer any advantage over a simple paper handout before knee replacement surgery.
"While the recovery from this operation is prolonged, and while complications can be devastating, complications are rare and most patients return to a high level of function with little pain," Dr. James H. Lubowitz, who was not involved in the work, told Reuters Health.
Still, an artificial knee doesn't work the same as a normal knee.
"It is metal and plastic and bone cement (grout). Patients expecting 'normal' may be disappointed, thus emphasizing the importance of preoperative patient education," said Lubowitz, who heads the Taos Orthopaedic Institute in Taos, New Mexico.
For the new study, researchers divided 151 patients about to have a total knee replacement at the Minneapolis Veterans Affairs Medical Center into three groups.
One group filled out a computer-based informed consent called iMedConsent and received a handout about the risks and benefits of the surgery. The second group also watched a video, while a nurse spoke with the third group after they had received the handout and seen the video.
The patients filled out a multiple choice questionnaire about the surgery when they consented to it and on the morning of the surgery and six weeks later.
Overall, they usually scored about 75 to 80 percent correct answers on knowledge about the procedure, and there was no difference between the three groups.
However, those who said they were satisfied with the consent process generally remembered the risks and benefits of the surgery better.
"We expected that the more intense education (video plus nurse) would yield higher scores," said Dr. Terence Gioe of the Minneapolis Veterans Affairs Medical Center, who led the work.
"We may be able to do more with simple handouts that patients can review and refer back to after the initial consultation," told Reuters Health by email.
The findings appear in the journal Arthritis Care and Research.
Gioe and his colleagues suggest standard informed consent and a paper handout may be all patients need to understand what they have in store. But Lubowitz was less convinced.
He said the study was limited by several factors. For instance, the questionnaire may not have been discerning enough to tease out possible differences, and the computer-based informed consent may be more effective than what other hospitals use.
"I would not say that video aids or nurse education are unnecessary, nor would I insist that they are necessary," he said. "In non-VA, high-volume practices, or settings where orthopedic resident 'training knees' (to show to patients) are not available, the use of video or nurse educators could be extremely valuable."
SOURCE: http://bit.ly/jOrYGl Arthritis Care and Research, online April 11, 2011.
No comments:
Post a Comment