Constructing information booklets for day-case patients

Effects of an information booklet on patient anxiety and satisfaction with information in magnetic resonance imaging: A randomized, single-blind, placebo-controlled trial

INTRODUCTION

Magnetic resonance imaging (MRI) is an important modality in diagnostics and treatment follow-up. However, MRI can be perceived as unpleasant even though the examination is non-invasive. Patients' knowledge of the MRI procedure is usually scarce, which may enhance patient anxiety at examination. We investigated the effects on anxiety and satisfaction with an information booklet on MRI compared to a placebo booklet delivered to adult patients prior to their first MRI examination.

METHODS

This randomized, single-blind, placebo-controlled trial included 197 patients. The intervention group (n = 95) received a booklet about MRI prior to the examination, whereas the control group (n = 102) received a placebo booklet of the same size and layout but containing general information. The State Trait Anxiety Inventory with supplementary questions from the Quality from the Patient's Perspective questionnaire were used as patient-reported outcome measures.

RESULTS

Anxiety did not differ between the groups, either prior to MRI or during the examination, but those who received the placebo booklet were at higher risk of experiencing high anxiety prior to the MRI examination (odds ratio 2.64; P = 0.029). The intervention group was more satisfied with the information received (P = 0.044), and a majority of participants in both groups (≥87%) considered it important to obtain information on the MRI procedure.

CONCLUSION

Written MRI information decreases the risk of high anxiety levels before MRI and improves patient satisfaction with the information. Further research is needed to investigate whether written information prior to MRI is beneficial not only from the perspective of the patient but may also be cost-effective.

IMPLICATIONS FOR PRACTICE

Written MRI information prior to the examination is recommended in radiography care.

Preoperative Needs-Based Education to Reduce Anxiety, Increase Satisfaction, and Decrease Time Spent in Day Surgery: A Randomized Controlled Trial

BACKGROUND

Too much or too little information during patient education can increase patient anxiety. Needs-based patient education helps to determine the appropriate amount of information required to provide education based on patient needs. This study aimed to compare needs-based patient education with traditional patient education in reducing preoperative anxiety.

METHODS

This was a prospective, multicenter, single-blind, randomized controlled trial with a 1:1 allocation ratio. Patients undergoing day surgery were randomized into a study group (needs-based education) or a control group (traditional education). The primary outcome was patient anxiety. Secondary outcomes were patient satisfaction and time spent in patient education. Patients completed questionnaires to evaluate their anxiety and satisfaction before patient education, after patient education, and after surgery.

RESULTS

In total, 450 patients were randomized and analyzed (study group n = 225, control group n = 225). Comparisons before education, after education, and after surgery showed that there was a significant decrease in patient anxiety and an increase in satisfaction in both groups (p < 0.001). The comparison between needs-based education and traditional education showed a greater decrease in anxiety (7.09 ± 7.02 vs. 5.33 ± 7.70, p = 0.001) and greater increase in satisfaction (21.1 ± 16.0 vs. 16.0 ± 21.6, p < 0.001) in the needs-based group. The needs-based group also had significantly less education time than the traditional group (171.8 ± 87.59 vs. 236.32 ± 101.27 s, p < 0.001).

CONCLUSION

Needs-based patient education is more effective in decreasing anxiety, increasing patient satisfaction, and reducing time spent in education compared with traditional patient education.

TRIAL REGISTRATION

ClinicalTrials.gov, number NCT03003091.

Real-world ethics and nursing research

In this paper I argue that nursing research is losing its way. There are a number of ways in which this is happening; for example, people are spending much more time writing about methodology than getting on with the research itself and the reporting of discovery. Here, I address the extent to which we are debilitating the research enterprise through what passes as ‘ethics’ and ‘governance’.

I will refer to examples from nursing and related research to illustrate the gradual development of greater concern for the well-being of research participants and the prevention of harm. I will go on to illustrate how, in comparison to the search for knowledge in the wider world, the health professions (and in the UK nurses in particular) are making research more difficult to execute than it needs to be. In the development of defensive rules and procedures we have somehow forgotten exactly from what harms we are protecting our patients, students and staff.

For those looking for a theoretical background to my views, they are, in essence, consequential, and I hope to show that with a harms and benefits approach we could bring much common sense to the critical appraisal of previous research and the approval and conduct of nursing research now and in the future.