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Teixeira MR, Oliveira GDS, Andrade CEMC, Schmidt RL, Teodoro VA, Pedrão PG, Baiocchi G, Paiva CE, Dos Reis R. Impact of Preoperative Counseling and Education on Decreasing Anxiety in Patients With Gynecologic Tumors: A Randomized Clinical Trial. J Surg Oncol 2024. [PMID: 39380202 DOI: 10.1002/jso.27942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 09/16/2024] [Indexed: 10/10/2024]
Abstract
OBJECTIVE To evaluate the impact of counseling and preoperative education on reducing anxiety in patients undergoing surgery for gynecologic cancer. METHODS In this randomized clinical trial, patients with gynecological tumors undergoing surgical treatment between 15 and 60 days preoperatively, were included. The group was randomized to receive preoperative routine orientation plus preoperative counseling and education by nursing (experimental group [EG]) or receive preoperative routine orientation only (control group [CG]). We stratified the groups by surgical approach: open, laparoscopy, and robotic. We excluded patients treated in another service and with the need for an intensive care unit after surgery. We used the Hospital Anxiety and Depression Scale (HADS) to evaluate symptoms of anxiety and depression. The severity of symptoms was evaluated using the Edmonton Symptom Assessment System (ESAS-Br). RESULTS We analyzed 54 women (CG 27, EG 27). No significant differences were observed regarding ESAS scores (total, physical, emotional, well-being, and anxiety) between preoperative and postoperative evaluation. However, in the EG, comparing the preoperative versus postoperative moments, there was a significant reduction in total, emotional, and anxiety scores of ESAS (p = 0.012; p = 0.003; p = 0.001). No difference in anxiety symptoms by HADS scale was noted between the two groups, comparing preoperative and postoperative moments, CG (40.7% and 22.2%) and EG (37.0% and 25.9%) (p = 0.78; p = 0.75), respectively. Also, in depression symptoms (HADS scale), we found no difference comparing preoperative and postoperative moments (p = 0.34; p > 0.99). When we stratified by surgical approach or time between intervention and surgery ( ≤ 15, > 15 to ≤ 30, and > 30 days), no difference was observed in the anxiety and depression symptoms evaluation, in both groups. CONCLUSIONS The preoperative education by nurse orientation reduced the total, emotional, and anxiety symptoms of ESAS score between preoperative and postoperative moments. However, by the HADS scale, there was no difference in anxiety and depression symptoms.
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Affiliation(s)
| | - Gabriela da Silva Oliveira
- Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Researcher Support Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Research and Teaching Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | - Ronaldo Luis Schmidt
- Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Valiana Alves Teodoro
- Division of Epidemiology and Biostatistics, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Priscila Grecca Pedrão
- HPV Research Group, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo, Brazil
| | - Glauco Baiocchi
- Department of Gynecologic Oncology, AC Camargo Cancer Center, São Paulo, Brazil
| | - Carlos Eduardo Paiva
- Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Ricardo Dos Reis
- Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- HPV Research Group, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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Giordano NA, Und Aspang JS, Baker J, Holder C, Cantu N, Checo G, Rice CW, Barrell B, Wallace M, Steck AR, Schenker ML. Can Patient-centered Education and Pain Management Delivered by Coaches Improve Pain Outcomes After Orthopaedic Trauma? A Randomized Trial. Clin Orthop Relat Res 2024; 482:1858-1869. [PMID: 38843502 PMCID: PMC11419535 DOI: 10.1097/corr.0000000000003121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 04/19/2024] [Indexed: 09/25/2024]
Abstract
BACKGROUND Pain after orthopaedic trauma is complex, and many patients who have experienced orthopaedic trauma are at increased risk for prolonged opioid utilization after the injury. Patient-centered interventions capable of delivering enhanced education and opioid-sparing pain management approaches must be implemented and evaluated in trauma care settings to improve pain outcomes and minimize opioid-related risks. QUESTIONS/PURPOSES Does personalized pain education and management delivered by coaches (1) improve pain-related outcomes, (2) reduce opioid consumption, and (3) improve patient-reported outcome measures (Patient-Reported Outcomes Measurement Information System [PROMIS] scores) compared to written discharge instructions on pain management and opioid safety? METHODS This clinical trial aimed to examine the effect of a personalized pain education and management intervention, delivered by paraprofessional coaches, on pain-related outcomes and opioid consumption compared with usual care (written discharge instructions on pain management and opioid safety). Between February 2021 and September 2022, 212 patients were randomized to the intervention (49% [104]) or control group (51% [108]). A total of 31% (32 of 104) and 47% (51 of 108) in those groups, respectively, were lost before the minimum study follow-up of 12 weeks or had incomplete datasets, leaving 69% (72 of 104) and 53% (57 of 108) for analysis in the intervention and control group, respectively. Patients randomized to the intervention worked with the paraprofessional coaches throughout hospitalization after their orthopaedic injury and at their 2-, 6-, and 12-week visits with the surgical team after discharge to implement mindfulness-based practices and nonpharmacological interventions. Most participants in the final sample of 129 identified as Black (73% [94 of 129]) and women (56% [72 of 129]), the mean Injury Severity score was 8 ± 4, and one-third of participants were at medium to high risk for an opioid-use disorder based on the Opioid Risk Tool. Participants completed surveys during hospitalization and at the 2-, 6-, and 12-week follow-up visits. Surveys included average pain intensity scores over the past 24 hours measured on the pain numeric rating scale from 0 to 10 and PROMIS measures (physical functioning, pain interference, sleep disturbance). Opioid utilization, measured as daily morphine milligram equivalents, was collected from the electronic health record, and demographic and clinical characteristics were collected from self-report surveys. Groups were compared in terms of mean pain scores at the 12-week follow-up, daily morphine milligram equivalents both during inpatient and at discharge, and mean PROMIS scores at 12 weeks of follow-up. Additionally, differences in the proportion of participants in each group achieving minimum clinically important differences (MCID) on pain and PROMIS scores were examined. For pain scores, an MCID of 2 points on the pain numeric rating scale assessing past 24-hour pain intensity was utilized. RESULTS We found no difference between the intervention and control in terms of mean pain score at 12 weeks nor in the proportions of patients who achieved the MCID of 2 points for 24-hour average pain scores (85% [61 of 72] versus 72% [41 of 57], respectively, OR 2.2 [95% confidence interval (CI) 0.9 to 5.3]; p = 0.08). No differences were noted in daily morphine milligram equivalents utilized between the intervention and control groups during hospitalization, at discharge, or in prescription refills. Similarly, we observed no differences in the proportions of patients in the intervention and control groups who achieved the MCID on PROMIS Physical Function (81% [58 of 72] versus 63% [36 of 57], respectively, OR 2.2 [95% CI 0.9 to 5.2]; p = 0.06). We saw no differences in the proportions of patients who achieved the MCID on PROMIS Sleep Disturbance between the intervention and control groups (58% [42 of 72] versus 47% [27 of 57], respectively, OR 1.4 [95% CI 0.7 to 3.0]; p = 0.31). The proportion of patients who achieved the MCID on PROMIS Pain Interference scores did not differ between the intervention and the control groups (39% [28 of 72] versus 37% [21 of 57], respectively, OR 1.1 [95% CI 0.5 to 2.1]; p = 0.95). CONCLUSION In this trial, we observed no differences between the intervention and control groups in terms of pain outcomes, opioid medication utilization, or patient-reported outcomes after orthopaedic trauma. However, future targeted research with diverse samples of patients at increased risk for poor postoperative outcomes is warranted to ascertain a potentially meaningful patient perceived effect on pain outcomes after working with coaches. Other investigators interested in this interventional approach may consider the coach program as a framework at their institutions to increase access to evidence-based nonpharmacological interventions among patients who are at increased risk for poor postoperative pain outcomes. Smaller, more focused programs connecting patients to coaches to learn about nonpharmacological pain management interventions may deliver a larger impact on patient's recovery and outcomes. LEVEL OF EVIDENCE Level I, therapeutic study.
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Affiliation(s)
| | | | - J’Lynn Baker
- Mercer University School of Medicine, Macon, GA, USA
| | - Carter Holder
- Christopher Wolf Crusade, Atlanta, GA, USA
- Grady Memorial Hospital, Atlanta, GA, USA
| | - Nicholas Cantu
- Department of Orthopaedics, School of Medicine, Emory University, Atlanta, GA, USA
| | - Grace Checo
- Department of Orthopaedics, School of Medicine, Emory University, Atlanta, GA, USA
| | | | - Bailey Barrell
- Christopher Wolf Crusade, Atlanta, GA, USA
- Grady Memorial Hospital, Atlanta, GA, USA
| | | | - Alaina R. Steck
- Grady Memorial Hospital, Atlanta, GA, USA
- Department of Emergency Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Mara L. Schenker
- Department of Orthopaedics, School of Medicine, Emory University, Atlanta, GA, USA
- Grady Memorial Hospital, Atlanta, GA, USA
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Wasim AS, Choudri MJ, Saidani Z, Khan AM, Siddiqui RS, Ridha A, Ahmed KS, Ali U. The effect of video-assisted learning on pre-operative knowledge and satisfaction for total knee arthroplasty surgery: a randomised-controlled study. J Orthop Surg Res 2024; 19:592. [PMID: 39342315 PMCID: PMC11438008 DOI: 10.1186/s13018-024-04974-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/03/2024] [Indexed: 10/01/2024] Open
Abstract
INTRODUCTION Traditionally, surgical procedures are explained through consultations between the surgeon and the patient to ensure informed consent. Patient education enhances engagement and knowledge, aiding informed decision-making. This study aimed to assess the effect of an educational video on preoperative patient knowledge and satisfaction in the context of total knee arthroplasty (TKA) as an adjunct to the consent process. METHODS A prospective randomized controlled study involving 100 patients in dedicated elective orthopedic units in UK-based hospitals was conducted. After consultation with a dedicated knee surgeon and a preoperative education day for TKA run by dedicated orthopedic nurse specialists, patients were randomized into one of two limbs (video vs no video) at a 1:1 ratio. The treatment group (video group) was shown a video about the principles and steps of the procedure, including the recovery time. Following this, a 10-point knowledge test was completed, and patients rated their satisfaction with the preoperative education on a scale of 0-10. RESULTS Patients in the video limb group had a significantly greater mean knowledge score and greater satisfaction with preoperative education than patients who did not view the video. The video group (n = 49) had a mean knowledge score of 8.73 +/- 0.159 compared to 7.68 +/- 0.281 for the nonvideo limb (n = 50) (p < 0.05). The video group had a mean satisfaction score of 9.00 +/- 0.123 compared to 8.40 +/- 0.121 for the nonvideo limb group (p < 0.05). CONCLUSION Video-assisted consent in total knee arthroplasty improves preoperative knowledge and patient satisfaction when used as an adjunct in the consent process. A simple, standardized video, either pre- or post-consultation could reinforce information that the patient receives in a simple effective manner, allowing for true informed consent.
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Affiliation(s)
- Abdus Samee Wasim
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| | | | - Zakaria Saidani
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | | | - Ali Ridha
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Usman Ali
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
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Amprachim SE, Vlamis J, Nikolaou VS, Pneumaticos SG. Role of Preoperative Information and Education of Patients Undergoing Total Hip Arthroplasty: A Narrative Review of the Literature. Cureus 2024; 16:e66094. [PMID: 39224727 PMCID: PMC11368389 DOI: 10.7759/cureus.66094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Total hip arthroplasty (THA) is a common and highly effective surgical procedure used to relieve pain and improve function in patients with severe hip arthritis and other hip disorders. While the surgical techniques and implants used in THA have advanced significantly, the importance of preoperative information and education cannot be overstated. The aim of this narrative review is to explore the effect of preoperative information and education on the outcome of THA. Key components of preoperative education and information include detailed information about the operation itself, the preoperative preparation, the postoperative pain management and rehabilitation, the possibility of postoperative complications, psychosocial support, and answers to frequently asked questions. The results of the study have confirmed the contradictory findings found in the literature concerning the impact of preoperative education on THA clinical outcomes, including pain, anxiety, functionality, postoperative rehabilitation, duration of hospitalization, and rate of complications. While, theoretically, preoperative education should have a positive effect on clinical outcomes, a plethora of studies have failed to support this hypothesis. Thus, there is a great need for properly designed, prospective, randomized, and controlled studies that have sufficient power in order to fully elucidate the role of preoperative education and information on THA outcomes.
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Affiliation(s)
- Sara Eleni Amprachim
- 3rd Department of Orthopaedics, National and Kapodistrian University of Athens, KAT Attica General Hospital, Athens, GRC
| | - John Vlamis
- 3rd Department of Orthopaedics, National and Kapodistrian University of Athens, KAT Attica General Hospital, Athens, GRC
| | - Vasileios S Nikolaou
- 2nd Department of Orthopaedics, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Spyros G Pneumaticos
- 3rd Department of Orthopaedics, National and Kapodistrian University of Athens, KAT Attica General Hospital, Athens, GRC
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Roberts R, Burdall O, Bohr C, Kennard H, Lewis S, Harris L, Cusick E. Are we informing our patients correctly? Evaluation of perioperative counselling for paediatric intestinal stoma formation: a national study. Pediatr Surg Int 2024; 40:189. [PMID: 39008127 DOI: 10.1007/s00383-024-05756-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE Adequate preoperative information is known to improve patient outcomes. We aimed to evaluate perioperative education for paediatric patients and families undergoing intestinal stoma formation. METHODS UK paediatric surgery centres were invited to recruit patients aged 6-16 years with a stoma in situ or reversed within the last 2 years. Patient and parent questionnaires were posted for potential participants. RESULTS Eighty-three patient/parent dyads returned questionnaires. Median age was 11.5 years (range 4.1-17.8), with 48% (n = 40) formed electively. Parents rated how well-informed they felt perioperatively out of 10 (0 poorly, 10 highly informed). Parents were better informed about surgical issues and stoma care than psychological and social impacts (7.45 vs 6.11; p < 0.0001). 54% reported surgical complications but significantly fewer patients listed these amongst the worst things about having a stoma (24.4%) when compared with psychosocial issues: distress from bag leaks (90.8%; p < 0.0001), self-consciousness (54.1%; p = 0.0001), and restricted activity (40.2%; p = 0.03). CONCLUSION Parents felt well-informed for medical and practical aspects but less well-informed of psychological and lifestyle impacts of having a stoma. Surgical complications were less important to patients than the impact on daily life. Increased psychosocial information would enable families to be better prepared for life with a stoma.
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Affiliation(s)
- Rebecca Roberts
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK.
| | - Oliver Burdall
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Claire Bohr
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Hilary Kennard
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Sophie Lewis
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Lauren Harris
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Eleri Cusick
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
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Karpinski K, Plachel F, Gerhardt C, Saier T, Tauber M, Auffarth A, Paksoy A, Akgün D, Moroder P. Comparison of Patients' and Surgeons' Expectations before Shoulder Arthroplasty. J Clin Med 2024; 13:3489. [PMID: 38930018 PMCID: PMC11204657 DOI: 10.3390/jcm13123489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/20/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Patients suffering from osteoarthritis particularly complain about pain during day and night as well as loss of function. This consequently leads to impaired quality of life and therefore psychological stress. The surgical therapy of choice is joint replacement. Regarding the outcome after operation, expectations might differ between the patient and the surgeon. This can lead to dissatisfaction on both sides. This study aimed to document patients' expectations of a planned shoulder joint replacement. The results were compared with assessments made by shoulder surgeons. Methods: In total, 50 patients scheduled for operative shoulder joint replacement were included in this study, as well as 10 shoulder surgeons. Patients were requested to fill out questionnaires preoperatively to provide sociodemographic data, PROMS (Patient-Reported Outcome Measures) with regard to the pathology and their expectations about surgery in terms of pain relief, gain of range of motion, strength as well as the impact on activities of daily and professional life and sports. In addition, surgeons were asked what they thought their patients expect. Results: The most important goal to achieve for patients was to relieve daytime pain, followed by improvement of self-care and the ability to reach above shoulder level. The most important factors for patients to achieve after operation were 'pain relief' in first place, 'movement' in second and 'strength' in third. This also applied to shoulder surgeons, who ranked 'pain relief' first, followed by 'movement' and 'strength'. When patients where asked what is most important when it comes to choosing their surgeon, 68% voted for 'surgical skills', 28% for 'age/experience', followed by 'empathy', 'sympathy' and 'appearance'. For surgeons, 'age/experience' obtained rank one, 'surgical skills' was ranked second, followed by 'sympathy', 'empathy' and 'appearance'. Surgeons significantly underrated the factor 'empathy' in favor of 'sympathy'. Conclusions: This study shows that patients' expectations for shoulder joint replacement and surgeons' assessments do not differ significantly. Relief from pain and better shoulder movement were crucial for patients to achieve after operation, which was in line with surgeons' expectations. The most important factor for choosing the surgeon was 'surgical skills' for patients, while surgeons thought they would care more about 'age and experience'. This underlines that patients' expectations should be taken into account within the preoperative medical interview. This might allow an optimization of compliance of the patients and lead to a better satisfaction on both sides.
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Affiliation(s)
- Katrin Karpinski
- Centrum für Muskuloskeletale Chirurgie, Klinik für Schulter- und Ellenbogenchirurgie, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany (A.P.); (P.M.)
| | - Fabian Plachel
- Centrum für Muskuloskeletale Chirurgie, Klinik für Schulter- und Ellenbogenchirurgie, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany (A.P.); (P.M.)
| | | | - Tim Saier
- BG Unfallklinik Murnau, 82418 Murnau am Staffelsee, Germany
| | | | - Alexander Auffarth
- Universitätsklinik für Orthopädie und Traumatologie, Universitätsklinikum Salzburg, A-5020 Salzburg, Austria;
| | - Alp Paksoy
- Centrum für Muskuloskeletale Chirurgie, Klinik für Schulter- und Ellenbogenchirurgie, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany (A.P.); (P.M.)
| | - Doruk Akgün
- Centrum für Muskuloskeletale Chirurgie, Klinik für Schulter- und Ellenbogenchirurgie, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany (A.P.); (P.M.)
| | - Philipp Moroder
- Centrum für Muskuloskeletale Chirurgie, Klinik für Schulter- und Ellenbogenchirurgie, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany (A.P.); (P.M.)
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Akkaya H, Ayhan H. The effect of in-bed turning and mobilization training given to patients who undergo lumbar disk surgery on postoperative first mobility level: A single-blind, randomized controlled trial. Int J Orthop Trauma Nurs 2023; 50:101022. [PMID: 37441868 DOI: 10.1016/j.ijotn.2023.101022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/29/2023] [Accepted: 05/08/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE This study was conducted to investigate the effects of mobilization and in-bed turning training given through the role-playing technique to patients to undergo lumbar disk surgery on the patient's pain, strain and dependence level during the first postoperative mobilization (turning, sitting, standing and walking). METHODS Patients who would undergo a lumbar disk hernia surgery were recruited from a neurosurgery clinic in Turkey. Patients who met inclusion criteria and agreed to participate (n = 40) in the study were randomly assigned to an intervention group (in-bed turning and mobilization training simulated with the role-playing technique, n = 19) and a control group (usual clinical care, n = 21). The outcome of the study was patient mobility and observer mobility scale scores. RESULTS Postoperative scores obtained from the patient mobility and observer mobility scale were lower in the intervention group than the scores of the control group, and the difference between the groups was found statistically significant (p < 0.05). The anxiety levels of the intervention group before (38.00 ± 6.59, p < 0.001) and after mobilization (31.63 ± 4.57, p = 0.032) were significantly lower. CONCLUSION The findings indicate training improves patient care outcomes for first postoperative mobility. It is recommended that structured training for in-bed turning and mobilization should be integrated into routine clinical care in the preoperative period for patients to undergo lumbar disk hernia surgery. PRACTICE IMPLICATIONS Preoperative training increases the patient's willingness to be mobilized and decreases the anxiety level and perceived pain and strain.
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Affiliation(s)
- Hatice Akkaya
- Kutahya Vocational School, Kutahya University of Health Sciences, Kutahya, Turkey
| | - Hatice Ayhan
- Department of Surgical Nursing, Gulhane Faculty of Nursing, University of Health Sciences Turkey, Ankara, Turkey.
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8
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Kim TW, Kim SH. Effectiveness of patient education on total knee arthroplasty: A systematic review and meta-analysis. J Clin Nurs 2023; 32:2383-2398. [PMID: 35429079 DOI: 10.1111/jocn.16324] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/06/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES This study was designed to examine the contents and methods of patient educational interventions about total knee arthroplasty (TKA) and their effectiveness in reducing postoperative pain and enhancing range of motion (ROM) in the literature. BACKGROUND Patient education has been provided to facilitate recovery after TKA; however, little is known about the contents and methods of the interventions and their effectiveness in reducing postoperative pain and enhancing ROM. DESIGN This is a systematic review and meta-analysis of randomised controlled trials (RCTs). METHODS Published studies from June 1998-June 2021 were identified from electronic databases. Two independent investigators assessed the quality of the studies by using the revised Cochrane risk-of-bias tool. Meta-analyses with random-effects models were conducted to assess the effectiveness of the interventions using the Comprehensive Meta-Analysis Software. The study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. RESULTS Among 12 articles that met the inclusion criteria, three interventions provided education on pain management and mobility/exercises. The most common educational methods were the combinations of oral explanation, written materials, and audiovisual materials, group discussion, while four studies used information technology (IT) devices. The meta-analysis demonstrated that the educational interventions using IT devices were effective in improving pain and ROM, but not the interventions that did not use IT devices. CONCLUSION Structured education for pain management, communication and/or exercise support programs utilising diverse methods have been provided to patients undergoing TKA. Using IT devices could successfully enhance the effectiveness of educational interventions for patients undergoing TKA. RELEVANCE TO CLINICAL PRACTICE Integration of postoperative pain management and mobility/exercises with the use of IT devices should be actively considered in providing patient education in clinical nursing practice.
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Affiliation(s)
- Tae Woo Kim
- Kyungpook National University Hospital, Daegu, South Korea
| | - Su Hyun Kim
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
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Toci GR, Filtes P, Lau V, Imbergamo C, Varghese B, Tawfik A, Sirch F, Fletcher D, Katt BM. Patient Comprehension of Trigger Finger Concepts Based on Distribution Format: A Randomized Controlled Trial of Handout Versus Video. Hand (N Y) 2023; 18:562-567. [PMID: 34969311 PMCID: PMC10233629 DOI: 10.1177/15589447211058816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patient comprehension is an essential part of optimizing medical outcomes. It is unknown which format is most effective in delivering this information. In addition to a face-to-face conversation, a paper handout is often given as an educational supplement at the conclusion of a visit. Secondary to advances in technology and the ubiquity of the Internet, medical videos have gained popularity. The purpose of this randomized controlled trial was to determine whether the educational material format (paper handout vs video) resulted in a difference in either comprehension of the condition or satisfaction with the delivery of the information. METHODS Patients aged ≥18 years with a diagnosis of trigger finger were prospectively enrolled and randomized to receive either a paper handout or video link with information regarding the pathophysiology, diagnosis, and treatment of trigger finger. Survey assessments were then distributed, consisting of 7 questions related to trigger finger and 1 question related to patient satisfaction. Continuous data were compared using 2-sample t tests, and categorical data were compared with χ2 tests. Alpha was 0.05. RESULTS Seventy-one patients were enrolled, and 60 completed their survey (response rate: 85%). The video group had significantly higher comprehension scores (82% vs 71%, P = .04) and significantly higher satisfaction scores (9.4 vs 8.6, P = .02). CONCLUSIONS Those who received their educational material in a video format had greater comprehension of their condition and higher satisfaction compared with those receiving a paper handout. Medical providers should consider using video formats to provide supplemental educational materials to their patients.
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Affiliation(s)
| | - Peter Filtes
- Rutgers Robert Wood Johnson Medical
School, New Brunswick, NJ, USA
| | - Vincent Lau
- Rowan University School of Osteopathic
Medicine, Stratford, NJ, USA
| | - Casey Imbergamo
- Rutgers Robert Wood Johnson Medical
School, New Brunswick, NJ, USA
| | - Bobby Varghese
- Rutgers Robert Wood Johnson Medical
School, New Brunswick, NJ, USA
| | - Amr Tawfik
- Thomas Jefferson University,
Philadelphia, PA, USA
| | | | | | - Brian M. Katt
- Rutgers Robert Wood Johnson Medical
School, New Brunswick, NJ, USA
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Fender Z, Bleicher J, Johnson JE, Phan K, Powers D, Stoddard G, Brooke BS, Huang LC. Improving pain management and safe opioid use after surgery: A DMAIC-based quality intervention. Surg Open Sci 2023; 13:27-34. [PMID: 37351188 PMCID: PMC10282558 DOI: 10.1016/j.sopen.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/16/2023] [Accepted: 04/10/2023] [Indexed: 06/24/2023] Open
Abstract
Background Multimodal perioperative patient education and expectation-setting can reduce post-operative opioid use while maintaining pain control and satisfaction. As part of a quality-improvement project, we developed a standardized model for perioperative education built upon the American College of Surgeons (ACS) Safe and Effective Pain Control After Surgery (SEPCAS) brochure to improve perioperative education regarding opioid use and pain control. Material and methods Our study was designed within the Define, Measure, Analyze, Improve, Control (DMAIC) quality-improvement framework. Patients were surveyed about the adequacy of their perioperative education regarding pain control and use of prescription opioid medication. After gathering baseline data, a multimodal educational intervention based on the SEPCAS brochure was implemented. Survey responses were then compared between groups. Results Twenty-seven subjects were included from the pre-intervention period, and thirty-nine were included from the post-intervention period (n = 66). Those in the post-intervention period were more likely to report receiving the appropriate amount of education regarding recognizing the signs of opioid overdose and how to safely store and dispose of opioid medications. The majority of patients who received the SEPCAS brochure reported that it was useful in their post-operative recovery and that it should be given to every patient undergoing surgery. Conclusions The ACS SEPCAS brochure is an effective tool for improving patient preparation to safely store and dispose of their opioid medication and recognize the signs of opioid overdose. The brochure was also well received by patients and perceived as an effective educational material.
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Affiliation(s)
- Zachary Fender
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Josh Bleicher
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | | | - Kathy Phan
- Division of Pharmacy, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | - Damien Powers
- Division of Pharmacy, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | - Gregory Stoddard
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Lyen C. Huang
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
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Grünwald L, Schröter S, Dickschas J, Harrer J, Minzlaff P, Hinterwimmer S, Saier T, Pattappa G, Angele P. Patient response to osteotomy around the knee joint at one year post-operation-fulfilment of expectations and current health status. Arch Orthop Trauma Surg 2022:10.1007/s00402-022-04660-6. [PMID: 36344785 DOI: 10.1007/s00402-022-04660-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The aim of this study was to investigate patient satisfaction and fulfilment of expectations after osteotomy around the knee at one year postoperatively, using patient-related outcome measures. MATERIALS AND METHODS From the initial sample of 264 patients, a total of 132 patients (age 48y ± 11) were enrolled in this prospective study (response rate 49.3%). Data were collected using the Hospital For Special Surgery-Knee Surgery Expectations Survey (HFSS-KSES), items for satisfaction and the Knee injury and Osteoarthritis Outcome Score (KOOS) measures. At one year postoperative follow-up, an individualized questionnaire asked whether the specific person-related expectations had been fulfilled. RESULTS Satisfaction was high with 83.2% of all participants at one year after surgery. A total of 78% of patients stated they would decide to do the surgery again. This decision was significantly associated with satisfaction, younger age and better KOOS scores scales before surgery for pain, activity and sports. We found high correlations between satisfaction and fulfilment of expectations for the HFES-KSES. Fulfilment of expectations one year after surgery was significantly associated with significant improvements in KOOS scales at one year post-operation. Expectations (1) "to get the knee back to normal status", (2) "improve ability to squat", (3) "improve ability to run", (4) "improve ability to kneel" had been fulfilled worst. A multiple linear regression model for satisfaction had an R2 = 0.797 of the variance. The most influential was the variable fulfilment of "maintain health" that had 70.7% of variance. CONCLUSIONS The fulfilled expectation concerning an improvement of the ability to maintain health was the most influential parameter for satisfaction at one year post-osteotomy. Patients with better health status of the knee and younger age rated the surgery to be more positive and were also more likely to do the surgery again. This provides an indication for an earlier intervention, before the knee and overall health status becomes more detrimental. LEVEL OF EVIDENCE Level II (Therapeutic study).
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Affiliation(s)
- Leonard Grünwald
- Department of Traumatology and Reconstructive Surgery, BG Traumacenter Tübingen, University of Tübingen, Tübingen, Germany.
- Osteotomy Committee of the German Knee Society (DKG), Ismaninger Str. 22, 81675, München, Germany.
| | - Steffen Schröter
- Department of Orthopedics and Reconstructive Surgery, Diakonie Klinikum GmbH Jung-Stilling-Krankenhaus, Siegen, Germany
- Osteotomy Committee of the German Knee Society (DKG), Ismaninger Str. 22, 81675, München, Germany
| | - Jörg Dickschas
- Klinik für Orthopädie und Unfallchirurgie, Klinikum Bamberg, Buger Strasse 80, 96049, Bamberg, Germany
- Klinik für Unfallchirugie und Orthopädische Chirurgie, Universitätsklinikum Erlangen, Friedrich Alexander Universität Erlange, Maximilianspl. 2, 91054, Erlangen, Germany
| | - Jörg Harrer
- Department of Orthopedics and Traumatology, Helmut-G.-Walther Klinikum, Prof.-Arneth-Straße 2B, 96215, Lichtenfels, Germany
- Osteotomy Committee of the German Knee Society (DKG), Ismaninger Str. 22, 81675, München, Germany
| | - Philipp Minzlaff
- Orthoclinic Agatharied, Krankenhaus Agatharied GmbH, Norbert-Kerkel-Platz, 83734, Hausham, Germany
- Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany
| | | | - Tim Saier
- Berufsgenossenschaftliche Unfallklinik Murnau, Prof-Küntscher-Str. 8, 82418, Murnau, Germany
| | - Girish Pattappa
- Department of Experimental Trauma Surgery, University of Regensburg Medical Centre, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Peter Angele
- Department of Experimental Trauma Surgery, University of Regensburg Medical Centre, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
- Sporthopaedicum Regensburg, Hildegard-Von Bingen-Str. 1, 93053, Regensburg, Germany
- Klinik für Trauma und Wiederherstellungschirurgie, Universitätsklinikum Regensburg, Franz Josef Strauss Allee 11, 93042, Regensburg, Germany
- Osteotomy Committee of the German Knee Society (DKG), Ismaninger Str. 22, 81675, München, Germany
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Streith LD, Yip SJY, Brown CJ, Karimuddin AA, Raval MJ, Phang PT, Ghuman A. Effectiveness of a rectal cancer education video on patient expectations. Colorectal Dis 2022; 24:1040-1046. [PMID: 35396809 DOI: 10.1111/codi.16143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022]
Abstract
AIM Discrepancy between patient expectations and outcomes can negatively affect patient satisfaction and quality of life. We aimed to assess patient expectations of bowel, urinary, and sexual function after rectal cancer treatments, and whether a preoperative education video changed expectations. METHODS A total of 45 patients were assessed between January 2018 and January 2021 in a tertiary care hospital in Vancouver, Canada. Patients included were rectal cancer patients who had neoadjuvant chemoradiation and were listed for low anterior resection but had not yet had surgery. Following surgical consultation but before surgery, a questionnaire assessing expectations of lifestyle after treatments was administered. Patients then watched an educational video and repeated the questionnaire to assess for changes in expectations. RESULTS Patient scores indicated expectation that control of bowel movements, urination, and sexual function would sometimes be problematic, but had a range from occasionally problematic to good function. Significant change after the video was seen in the expectation of needing medications for bowel control, and 44%-69% of individual patient answers changed from prevideo to post-video, depending on the question. The education video was scored as helpful or very helpful by 82% of patients. CONCLUSIONS Patients have varying expectations of problematic control of bowel, urinary, and sexual function following rectal cancer treatments. A pretreatment education video resulted in a trend toward changed expectations for functional outcomes in most patients. Further educational modalities for patients may provide more uniform expectations of function and increase patient satisfaction after rectal cancer treatments.
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Affiliation(s)
- Lucas D Streith
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Silas J Y Yip
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carl J Brown
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Ahmer A Karimuddin
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Manoj J Raval
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - P Terry Phang
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Amandeep Ghuman
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
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Preoperative Patient Education Programs for Orthopaedic Surgery: What Do the Programs Include? How Are They Delivered? What Are the Knowledge Gaps? A Scoping Review of 46 Studies. J Orthop Sports Phys Ther 2022; 52:572-585. [PMID: 35802819 DOI: 10.2519/jospt.2022.10614] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To (1) describe the nature and content of the current literature on preoperative education programs for patients preparing for orthopaedic surgery, (2) assess the completeness of reporting program descriptions, and (3) report gaps within the literature. DESIGN Scoping review. LITERATURE SEARCH We searched the CINAHL, Embase, PubMed, Cochrane Reviews, PsycINFO, Web of Science, and Google Scholar databases for studies that (1) addressed preoperative education in elective orthopaedic surgery or (2) provided descriptions or evaluations of a preoperative program, including the content or outcomes of the program. STUDY SELECTION CRITERIA Articles were included if they addressed preoperative patient education focused on an elective orthopaedic surgery and any of the (1) descriptions of an education program including any theoretical frameworks, content, or delivery, or (2) evaluations of the process of a preoperative educational program. Studies were excluded if they were treatment programs with the goal of resolving the problem occurring prior to surgery (eg, rehabilitation or pain management prior to surgery). DATA SYNTHESIS We used the template for intervention description and replication (TIDieR) checklist and guide to assess the completeness of reporting of the content of educational programs. Content was synthesized descriptively and by intervention mapping. The results informed of a draft operational definition of preoperative education that we refined based on expert consultation. RESULTS Forty-six articles were included. There was variation in study designs, target populations, and intervention content. Preoperative education was defined in 1 out of 5 studies. Thirteen studies used a platform of video-based modules to deliver their program; 3 studies implemented virtual platforms. Results from the TIDieR checklist indicated that 30% of studies tracked adherence to and fidelity of their programs. A definition and conceptual map indicated that the length of stay, functional abilities, patient knowledge, and satisfaction were expected benefits. CONCLUSION Poor reporting of content, rationale, and frameworks for preoperative programs in orthopedics may explain why systematic reviews have not found support for their value. Future trials must improve rigor in design and reporting. J Orthop Sports Phys Ther 2022;52(9):572-585. Epub: 9 July 2022. doi:10.2519/jospt.2022.10614.
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Montes D, Beamish C, Waheed S, Osman F, Maursetter L. What happens after the kidney biopsy? The findings nephrologists should know. BMC Nephrol 2022; 23:265. [PMID: 35879695 PMCID: PMC9316327 DOI: 10.1186/s12882-022-02881-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background Percutaneous kidney biopsies are important tools for the diagnosis of kidney diseases. Nephrologists must be familiar with the expected complications of the procedure to provide an adequate informed consent. Here, we present a quality improvement analysis that reviews the complication rate of percutaneous kidney biopsies performed over a 2-year period by nephrologists at a single center, and that tabulates the nature and timing of these events. Methods From a single center cohort, pre- and post-biopsy anthropomorphic and clinical measurements were collected. Post-biopsy complications were tracked and sorted into either major or minor complications. Statistical tests were used to analyze complication incidence across the pre- and post-biopsy measurements obtained. Results Of the 154 nephrologist-performed percutaneous native kidney biopsies, 2 biopsies (1.3%) were found to result in a major complication. Both major complications were detected within 4 hours of the biopsy. Analysis of the pre-biopsy and post-biopsy measurements found that the proportion of complications was higher in patients with hematuria prior to biopsy. It was also found that patients with complications were statistically younger and had fewer comorbidities. Under univariable analysis, older age was associated with a lower incidence rate ratio for complications. However, no pre-or-post biopsy measurement or characteristic had a statistically significant change in incidence rate ratio under multivariable analysis. Conclusions Percutaneous kidney biopsies were found to be low risk when performed by nephrologists in this single center cohort. Consistent with past literature, life threatening major complications rarely occurred and were reliably identified within 4 hours of biopsy, suggesting that centers can consider reduced observation times without compromising patient safety. Minor complications, such as pain, were more likely to occur in younger, healthier patients, and in those with hematuria prior to biopsy. This extensive tabulation of all biopsy adverse events is the first of its kind and will be beneficial for nephrologists to inform discussions with patients about expectations and risk-benefit of this procedure.
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Affiliation(s)
- Daniel Montes
- School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave, Madison, WI, 53705, USA.
| | - Claire Beamish
- School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave, Madison, WI, 53705, USA
| | - Sana Waheed
- Piedmont Nephrology and Internal Medicine, Atlanta, USA
| | - Fauzia Osman
- School of Medicine and Public Health, Department of Medicine, University of Wisconsin, Madison, USA
| | - Laura Maursetter
- School of Medicine and Public Health, Department of Medicine, Division of Nephrology, University of Wisconsin, Madison, USA
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Abdullah Y, Alokozai A, O'Connell S, Mulcahey MK. Online Patient Education Materials for Common Sports Injuries Are Written at Too-High of a Reading Level: A Systematic Review. Arthrosc Sports Med Rehabil 2022; 4:e861-e875. [PMID: 35747648 PMCID: PMC9210373 DOI: 10.1016/j.asmr.2021.12.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/16/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose To determine the readability of online patient information for common sports injuries. Methods A systematic search of the literature using PubMed/MEDLINE, Embase, and the CINAHL databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Studies were included if they (1) were published between 2000 and September 2020, (2) were English-language publications and complete studies from peer-reviewed journals, (3) evaluated online information directed toward patients with common sports injuries. Results Eleven studies met inclusion criteria and were included. The mean Flesch-Kincaid Grade Level for online education information was 10.5, whereas the mean Flesch Reading Ease was 51.2, indicating existing health resources are written above the recommended readability grade level (no greater than a sixth-grade reading level). The mean DISCERN score was 41.5, indicating that the quality of information accessible to patients was fair. The accuracy of health content determined by the ACL-Specific Score was reported as moderate level (mean 8.85). Conclusions This study demonstrates that online patient information regarding common sports injuries the does not match the readability recommendations of the American Medical Association and National Institutes of health. Clinical Relevance Future health-related information should be written by qualified experts at a level that can be easily understood by patients of all health literacy levels. Surgeons should be more attentive to where patients get their information from and how they interpret it. Accurate, easy to understand educational tools can improve efforts to help patients identify misconceptions about treatment options, and to guide patients to choices that are consistent with their values.
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Dziadzko M, Bouteleux A, Minjard R, Harich J, Joubert F, Pradat P, Pantel S, Aubrun F. Preoperative Education for Less Outpatient Pain after Surgery (PELOPS trial) in orthopedic patients-study protocol for a randomized controlled trial. Trials 2022; 23:422. [PMID: 35598000 PMCID: PMC9123724 DOI: 10.1186/s13063-022-06387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
Background Successful pain management after outpatient surgery requires proper education leading to correct decisions on the analgesics use at home. Despite different strategies adopted, up to ½ of patients receive little or no information about the treatment of postoperative pain, 1/3 of them are not able to follow postoperative analgesia instructions. This leads to higher rates of unmet needs in pain treatment, post-discharge emergency calls, and readmissions. Structured educational interventions using psychological empowering techniques may improve postoperative pain management. We hypothesize that preoperative education on use of an improved pain scale to make correct pain management decisions will improve the quality of post-operative pain management at home and reduce analgesics-related side effects. Methods A total of 414 patients scheduled for an outpatient orthopedic surgery (knee/shoulder arthroscopic interventions) are included in this randomized (1:1) controlled trial. Patients in the control arm receive standard information on post-discharge pain management. Patients in the experimental arm receive structured educational intervention based on the rational perception of postoperative pain and discomfort (anchoring and improved pain scale), and the proper use of analgesics. There is no difference in post-discharge analgesics regimen in both arms. Patients are followed for 30 days post-discharge, with the primary outcome expressed as total pain relief score at 5 days. Secondary outcomes include the incidence of severe pain during 30 days, changes in sleep quality (Pittsburg Sleep Quality Assessment), and patients’ perception of postoperative pain management assessed with the International Pain Outcomes questionnaire at day 30 post-discharge. Discussion The developed intervention, based on an improved pain scale, offers the advantages of being non-surgery-specific, is easily administered in a short amount of time, and can be delivered individually or in-group, by physicians or nurses. Trial registration ClinicalTrials.govNCT03754699. Registered on November 27, 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06387-6.
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Affiliation(s)
- Mikhail Dziadzko
- Department of Anesthesiology and Intensive Care Medicine, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France. .,RESHAPE Lab, U1920, INSERM and Claude Bernard Lyon 1 University, Lyon, France. .,Department of Pain treatment, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Axelle Bouteleux
- Department of Anesthesiology and Intensive Care Medicine, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France
| | - Raphael Minjard
- Department of Pain treatment, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.,Center of Research in Clinical Psychopathology and Psychology (CRPPC) University Lumière Lyon 2, Lyon, France
| | - Jack Harich
- BS Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Fanny Joubert
- Center for Clinical Research, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France
| | - Pierre Pradat
- Center for Clinical Research, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France
| | - Solene Pantel
- Center for Clinical Research, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France
| | - Frederic Aubrun
- Department of Anesthesiology and Intensive Care Medicine, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.,RESHAPE Lab, U1920, INSERM and Claude Bernard Lyon 1 University, Lyon, France.,Department of Pain treatment, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France
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Scott EJ, Anthony CA, O'Connor MJ, Lynch TS, Westermann RW. Automated Text-Messaging After Hip Arthroscopy: A Randomized-Controlled Trial of "Post-Op Buddy". Arthroscopy 2022; 38:1488-1495.e5. [PMID: 34655765 DOI: 10.1016/j.arthro.2021.09.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess an automated text-messaging system for patients after hip arthroscopy and its impact at 90 days on the Hip Disability Osteoarthritis Outcome Score Physical Function Short form (HOOS-PS, HOOS-Pain), compliance with rehabilitation guidelines, and patient satisfaction. METHODS One hundred twenty-one participants (average age 29 ± 8.7 years, 52% female) undergoing hip arthroscopy at 2 academic institutions were prospectively enrolled and randomized to receive (1) standard perioperative communication or (2) additional automated mobile phone text messages. Inclusion criteria included ability to communicate in written English and access to a mobile phone with text-messaging capability. Patients undergoing revision surgery or simultaneous femoral or acetabular osteotomy were excluded. HOOS-PS and HOOS-Pain were collected preoperatively, and after surgery an automated mobile phone robot sent participants in the therapeutic arm intermittent text messages for 90 days. At 90 days all participants again completed HOOS-PS, HOOS-Pain, and additional survey questions on satisfaction with their experience (10-point scale), communication from the surgical team (10-point scale) and adherence to physical therapy exercises, weight-bearing guidelines, and brace use, The primary outcome assessed was a statistically significant change in HOOS-PS and HOOS-Pain; secondary outcomes included change in satisfaction, communication, and adherence to physical therapy exercises, weightbearing guidelines, or brace use. Wilcoxon rank sum was used to compare HOOS-PS and HOOS-Pain scores at 0 and 90 days. Demographic characteristics and survey variables were compared using Students t test for continuous variables and χ2 or Fisher exact test for categorical variables as appropriate. RESULTS There were statistically significant and clinically relevant improvements in HOOS-PS and HOOS-Pain in both groups (P < .05). Subjective feedback was strongly positive, with 96% of text message participants reporting they would choose automated messages if it was offered to them again in the future. CONCLUSIONS Ninety days of automated text messaging after hip arthroscopy failed to show a significant difference in HOOS-PS (P = .09), HOOS-Pain (P = .13), patient-reported compliance with postoperative guidelines, or satisfaction with support and communication from the surgical team. LEVEL OF EVIDENCE I, randomized control trial (RCT).
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Affiliation(s)
- Elizabeth J Scott
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A..
| | - Christopher A Anthony
- Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | | | - T Sean Lynch
- Columbia University Medical Center, New York, New York, U.S.A
| | - Robert W Westermann
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A
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Karpinski K, Plachel F, Gerhardt C, Saier T, Tauber M, Auffarth A, Akgün D, Moroder P. Different expectations of patients and surgeons with regard to rotator cuff repair. J Shoulder Elbow Surg 2022; 31:1096-1105. [PMID: 35149203 DOI: 10.1016/j.jse.2021.12.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Rotator cuff lesions are a common shoulder pathology mainly affecting patients aged >50 years. This condition is accompanied by not only pain and loss of function but also impaired quality of life and psychological stress. A frequently employed treatment option is arthroscopic repair. But expectations regarding the outcome after surgery might differ between patients and surgeons and therefore lead to dissatisfaction on both sides. The aim of this study was to document patient expectations of a planned arthroscopic rotator cuff repair and compare the results with the assessment of shoulder surgeons. MATERIALS AND METHODS A total of 303 patients and 25 surgeons were involved in this study. Patients with partial- or full-thickness tear of the rotator cuff scheduled for arthroscopic repair were included in this study. Preoperatively, they were asked to fill out questionnaires inquiring sociodemographic data, scores of the underlying pathology, as well as expectations regarding the operation with regard to pain relief, gain of range of motion and strength, as well as the effect on activities of daily life, work, and sports. Furthermore, 25 surgeons were surveyed on what they think their patients expected using the same standardized questions. RESULTS Among the patients, 43.9% considered gain of range of motion to be the most important goal after rotator cuff repair, followed by pain relief (30.6%) and gain of force (13.7%). Among the surgeons, 72% believed pain relief to be the most important for their patient followed by movement (20%) and strength (8%). When asked which parameter was the most important to achieve after operation, for patients, movement was on first place, pain second, and strength third. For shoulder specialists, the ranking was pain, movement, and strength. Surgeons significantly overrated pain relief when ranking against movement compared with their patients. CONCLUSION The expectations of patients regarding their operation differ from the surgeon's assessment. Whereas gaining range of motion was more important for patients, surgeons clearly voted for pain relief. Different expectations should therefore be discussed within the pretreatment interview and taken into account when planning the right therapy. This might lead to better satisfaction on both sides.
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Affiliation(s)
| | | | | | - Tim Saier
- BG Unfallklinik Murnau, Murnau am Staffelsee, Germany
| | | | | | - Doruk Akgün
- Charité Universitätsmedizin Berlin, Berlin, Germany
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Aardoom JJ, Hilt AD, Woudenberg T, Chavannes NH, Atsma DE. A Preoperative Virtual Reality App for Patients Scheduled for Cardiac Catheterization: Pre–Post Questionnaire Study Examining Feasibility, Usability, and Acceptability. JMIR Cardio 2022; 6:e29473. [PMID: 35191839 PMCID: PMC8905473 DOI: 10.2196/29473] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/30/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background Pre- and postoperative anxiety is a common phenomenon associated with negative postoperative outcomes. Symptoms of posttraumatic stress disorder, such as fear, nightmares, and sleep deprivation, are prevalent in approximately 30% to 50% of patients following discharge from intensive care units after cardiac surgery. Preliminary evidence suggests a promising role of virtual reality (VR) in preventing stress-related reactions using stress inoculation training. Such training enables cognitive preparation of individuals for stressful situations, thereby becoming more tolerant and resistant to stress, subsequently reducing the risk of potential negative psychological consequences. This study investigated a preoperative VR app—Pre-View—aimed at better informing and preparing patients for cardiac catheterization. Objective This study aims to assess the feasibility, usability, and acceptability of Pre-View in patients undergoing cardiac catheterization. Methods Eligible participants were adults scheduled for elective cardiac catheterization. Pre-View comprised an interactive virtual representation of the whole care process related to cardiac catheterization, from entering the hospital for admission to postprocedural stay and discharge. These processes were represented through 360° videos and interactive photos. Self-report questionnaires were completed at baseline (ie, before catheterization and after undergoing the VR experience) and after cardiac catheterization. Outcome measures included user experience and satisfaction, VR presence and immersive tendencies, and user friendliness. The perceived effectiveness was assessed exploratively. Results A total of 8 individuals, with a mean age of 67 (SD 7.5) years, participated in this study. Half of them underwent the VR experience at the hospital and the other half at home. Participants reported high levels of presence in the virtual environment (Presence Questionnaire score: mean 129.1, SD 13.4). The usability of Pre-View was well evaluated (System Usability Scale score: mean 89.1, SD 12.0), and patient satisfaction was high (Client Satisfaction Questionnaire score: mean 27.1, SD 3.2). Usability and satisfaction scores were higher for participants who underwent Pre-View at home versus those who underwent Pre-View at the hospital, although the latter group was significantly older; 72.8 versus 61.3, respectively. All participants reported Pre-View to be effective in terms of feeling better informed about the care process of cardiac catheterization. Most participants (7/8, 88%) reported Pre-View to be effective in terms of feeling better prepared for cardiac catheterization, acknowledging the potential of Pre-View in reducing negative psychological consequences after catheterization. Conclusions The results provide initial support for the feasibility and acceptability of a preoperative VR app, creating a virtual environment that supports patient education and preparation for upcoming cardiac catheterization. More studies are needed to further investigate the effects of VR as a tool to better prepare patients for medical procedures, its effectiveness in reducing negative patient outcomes (eg, anxiety, stress, and postoperative recovery outcomes), and the generalizability of effects across different settings and patient populations.
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Affiliation(s)
- Jiska J Aardoom
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Alexander D Hilt
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Tamar Woudenberg
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Douwe E Atsma
- National eHealth Living Lab, Leiden, Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
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20
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McQueen KS, Powell RK, Keener T, Whalley R, Calfee RP. Role of strengthening during nonoperative treatment of lateral epicondyle tendinopathy. J Hand Ther 2021; 34:619-626. [PMID: 33250396 DOI: 10.1016/j.jht.2020.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/02/2020] [Accepted: 10/09/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Lateral epicondyle tendinopathy (LET) is the most common cause of lateral elbow pain. The literature on rehabilitation of the condition encompasses a plethora of interventions with most current evidence indicating that stretches and some form of strengthening are vital components. However, patient outcomes are infrequently reported further than 12 weeks from the start of therapy and it is unclear which components of a home exercise program are necessary to alleviate symptoms up to one year from the initiation of a therapy program. PURPOSE OF THE STUDY The purpose of the study is to determine if a therapy program with 4 to 6 visits spaced out over 12 weeks focusing on self-management and strengthening is more effective in reducing pain and improving function long term than the same program without strengthening, for individuals with LET. STUDY DESIGN This is a randomized controlled trial. METHODS Ninety-four patients were randomly allocated into two groups: both groups received the interventions of education in pertinent pathoanatomy, stretching, pain management through rest and icing, and activity modification. Group 1 (n = 38) was also provided with a strengthening component to the home exercise program, whereas group 2 did not (n = 21). Our primary outcome measure was pain at rest and pain with activity; our secondary measure was the level of functional impairment as measured by the quick disabilities of arm shoulder and hand. Outcome measurements were assessed at baseline, 6, 12, 24, and 52 weeks after initiation of therapy. RESULTS Both groups demonstrated statistically significant improvement with a moderate to large effect size in pain and function scores when compared with previous time point at 6, 12, and 24 weeks. Pain continued to decrease for both groups from 24 weeks to 52 weeks, but interestingly, there was a significant increase with moderate effect size in the quick disabilities of arm shoulder and hand score at 52 weeks when compared with week 24. No statistically significant difference was found between the two groups at any time point up to 52 weeks from the start of therapy. CONCLUSIONS This study demonstrates that a therapy program consisting of a low number of visits spaced out over 12 weeks based on education, stretches, activity modification, and pain management techniques is effective at reducing pain and increasing function in patients with LET. The addition of strengthening to this program did not improve outcomes. The therapy approach used in this study is consistent with the International Classification of Function guidelines and focuses on engaging patients in self-management of the condition through patient education and self-empowerment.
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Affiliation(s)
- Kathryn S McQueen
- Washington University School of Medicine, Program of Occupational Therapy, Milliken Hand Rehabilitation Center, Saint Louis, MO, USA.
| | - Rhonda K Powell
- Washington University School of Medicine, Program of Occupational Therapy, Milliken Hand Rehabilitation Center, Saint Louis, MO, USA
| | - Tracy Keener
- Washington University School of Medicine, Program of Occupational Therapy, Milliken Hand Rehabilitation Center, Saint Louis, MO, USA
| | - Richard Whalley
- Washington University School of Medicine, Program of Occupational Therapy, Saint Louis, MO, USA
| | - Ryan P Calfee
- Department of Orthopedic Surgery, Washington University School of Medicine, Saint Louis, MO, USA
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21
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Preoperative pain neurophysiology education for lumbar radiculopathy: A randomized-controlled trial. Turk J Phys Med Rehabil 2021; 67:328-335. [PMID: 34870120 PMCID: PMC8607002 DOI: 10.5606/tftrd.2021.5495] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 05/06/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives
This study aims to investigate the postoperative short-term effectiveness of preoperative pain neurophysiology education on pain severity, kinesiophobia, and disability in patients undergoing lumbar surgery for radiculopathy.
Patients and methods
Between April 2019 and August 2019, a total of 41 patients (22 males, 19 females; mean age 52.1±9.5 years; range, 37 to 64 years) scheduled for lumbar radiculopathy surgery were randomized to receive either preoperative routine education only (control group, n=20) or a 70-min pain neurophysiology education in addition to preoperative routine education (intervention group, n=21). The patients were evaluated for the following outcomes prior to surgery (baseline) and at 12 weeks after surgery: low back pain and leg pain using Numeric Pain Rating Scale, disability using Oswestry Disability Index), and kinesiophobia using Tampa Scale for Kinesiophobia.
Results
There were no statistically significant differences in low back pain (p=0.121), leg pain (p=0.142), and the length of stay hospital (p=0.110) between the groups. However, the interaction effects of intervention group were superior to control group regarding disability (p=0.042) and kinesiophobia (p<0.001).
Conclusion
The addition of pain neurophysiology education to routine education following lumbar radiculopathy surgery yields significant improvements for disability and kinesiophobia, although no additional benefits is seen regarding the pain severity and length of stay in hospital in the short-term.
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22
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Oberfeld J, von Hertzberg-Boelch SP, Weissenberger M, Holzapfel BM, Rudert M, Jakuscheit A. Effect of Mobilization on the Day of Surgery After Total Hip Arthroplasty in Elderly, Obese, and Severely Diseased Patients. J Arthroplasty 2021; 36:3686-3691. [PMID: 34284936 DOI: 10.1016/j.arth.2021.06.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Mobilization on the day of surgery after total hip arthroplasty (THA) is widely used. However, elderly, obese and severely diseased patients are often excluded from early mobilization. Therefore, it was our aim to investigate the effect of mobilization on the day of surgery with focus on these patients. METHODS 167 patients underwent THA via direct anterior approach. Exclusion criterion was the use of wound drainage. The patients were randomly allocated to two groups. Day 0 group was mobilized 4 hours after surgery, day 1 group the day after surgery. Primary outcome was the time to readiness for discharge (TRD). Secondary outcome was the occurrence of adverse events (vertigo, nausea, vomiting, severe pain) on the day of surgery. Group comparisons were calculated with respect to elderly (age ≥75 years), obese (BMI ≥30 kg/m2) and severely diseased patients (ASA≥3). RESULTS TRD was shorter in day 0 group (3.25 vs 3.99 days, P < .01). The rate of adverse events on the day of surgery was similar in both groups (0.28 vs 0.25, P = .73). TRD differences were higher within all subgroups (3.85vs4.81; 3.25vs4.39; 4.08vs5.11days) while the rate of immediate adverse events was reduced (0.15vs0.24; 0.25vs0.3; 0.25vs0.33). Within 90 days 3 patients of group 0 underwent revision surgery, none of group 1 (P = .12). CONCLUSION Mobilization on the day of surgery reduces the TRD without increasing the rate of immediate adverse events, regardless of age, BMI and ASA score. Future studies are needed to investigate if early mobility increases the 90-days complication rate.
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Affiliation(s)
- Jan Oberfeld
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Wuerzburg, Germany
| | | | - Manuel Weissenberger
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Wuerzburg, Germany
| | - Boris M Holzapfel
- Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Maximilian Rudert
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Wuerzburg, Germany
| | - Axel Jakuscheit
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Wuerzburg, Germany
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23
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Differences in Patients' and Surgeons' Expectations before Shoulder Stabilization Surgery. J Clin Med 2021; 10:jcm10204661. [PMID: 34682779 PMCID: PMC8538762 DOI: 10.3390/jcm10204661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/10/2021] [Accepted: 10/05/2021] [Indexed: 01/03/2023] Open
Abstract
Purpose: The primary goal of shoulder stabilization procedures is to re-establish stability and many surgeons measure the success after shoulder stabilization surgery only by the absence of re-dislocation. However, patients might also suffer from pain, loss of range of motion and strength as well as anxiety and stigmatization and therefore have other expectations from a stabilization surgery than just a stable shoulder. Purpose of this study was to analyze if surgeons know what their patients typically expect from a shoulder stabilization surgery. Furthermore, the aim was to analyze the influence of various factors on patients’ expectations. Materials and Methods: 204 patients with a diagnosis of shoulder instability scheduled for surgical treatment were included in this prospective multicentric study. Preoperatively, objective and subjective scores were obtained and patients were asked about their postoperative expectations. Additionally, 25 surgeons were interviewed with regard to what they think their patients expect from the surgery using standardized questions. Results: With regard to postoperative expectations surveyed by the Hospital for Special Surgery questionnaire (HSS), the most important goal to achieve for the patients was ‘stopping the shoulder from dislocation’, followed by ‘to improve the ability to exercise or participate in sports’ and ‘being the shoulder to be back the way it was before the issue started’. The ranking of factors for patients was ‘stability’ as the most important to achieve, followed by ‘movement’, ‘strength’, ‘pain’ and ‘cosmetics’. For surgeons, the order was ‘stability’ (p = 0.004 **), ‘movement’ (p = 0.225), ‘pain’ (p = 0.509), ‘strength’ (p = 0.007 **) and ‘cosmetics’ (p = 0.181). There was a significant difference between patients and surgeons with regard to gaining stability at the cost of movement (p = 0.001 **). Conclusion: Patients and surgeons expectations regarding outcome after surgical shoulder stabilization procedures are quite similar with limited topics of disagreement. Generally, surgeons tend to overrate the importance of stability at the costs of other factors.
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24
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Schittek GA, Simonis H, Bornemann-Cimenti H. Pain, nausea, vomiting, thirst, cold, … the challenge of well-being in post-operative patients. Intensive Crit Care Nurs 2021; 66:103090. [PMID: 34119406 DOI: 10.1016/j.iccn.2021.103090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Gregor Alexander Schittek
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
| | - Holger Simonis
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Helmar Bornemann-Cimenti
- Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
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25
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Tong E, Lakhardt K, Wenzel CF, Tong W. A study on the effectiveness of a multidisciplinary class for gender-affirming chest surgery in transmasculine and nonbinary patients and their support persons. J Plast Reconstr Aesthet Surg 2021; 74:3168-3177. [PMID: 34148837 DOI: 10.1016/j.bjps.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 03/18/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Elizabeth Tong
- Department of Radiology, Stanford University, California, United States
| | - Kellyn Lakhardt
- Multi-Specialty Transitions Department, Kaiser Permanente, California, United States
| | - Conrad F Wenzel
- Department of Plastic Surgery, Kaiser Permanente, 1635 Divisadero Street, 6th Floor, San Francisco, CA 94115, United States
| | - Winnie Tong
- Department of Plastic Surgery, Kaiser Permanente, 1635 Divisadero Street, 6th Floor, San Francisco, CA 94115, United States.
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26
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Zhuo Q, Cui C, Liang H, Bai Y, Hu Q, Hanum AL, Yang M, Wang Y, Wei W, Ding L, Ma F. Cross-cultural adaptation, validity and reliability of the Chinese Version of Miller Behavioral Style Scale. Health Qual Life Outcomes 2021; 19:86. [PMID: 33726779 PMCID: PMC7962230 DOI: 10.1186/s12955-021-01717-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/23/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Health education basing on patients' information-seeking styles can improve the effectiveness of health education and patients' health outcomes. The Miller Behavioral Style Scale (MBSS) is widely used to identify individual's information-seeking styles, but the Chinese version is lacking. The study aim was to translate and culturally adapt the MBSS into Chinese version and test the content validity, construct validity and internal consistency reliability of the Chinese version of MBSS (C-MBSS). METHODS The forward-back-translation procedure was adopted in the translation of the MBSS. Content validity was assessed in a panel of experts. In a sample of 1343 individuals including patients, patients' caregivers, university students, and medical staff, reliability and construct validity were assessed using Cronbach's alpha coefficient and factor analysis. The measurement invariance across samples was tested using multigroup confirmatory factor analysis (MGCFA). Floor and ceiling effects were checked. RESULTS The C-MBSS achieved conceptual and semantic equivalence with the original scale. The item-level content validity index (I-CVI) of each item ranged from 0.78 to 1, and the averaging scale-level content validity index (S-CVI/ Ave) was 0.95. The exploratory factor analysis resulted in 2-factor assumption for each hypothetical threat-evoking scenario. Confirmatory factor analysis demonstrated a good fit between theoretical model and data, which provided confirmatory evidence for the second-order factor structure of 2-factor solution (Monitoring and Blunting). The Cronbach's alpha coefficients for the Monitoring and Blunting sub-scales of the C-MBSS were 0.75 and 0.62 respectively. MGCFA results supported the measurement invariance for the Monitoring sub-scale of the C-MBSS across samples. No floor or ceiling effects occurred. CONCLUSIONS This study indicates that the C-MBSS has good content and construct validity. The Monitoring sub-scale of the C-MBSS had acceptable internal consistency reliability while the Blunting sub-scale had unsatisfactory one, which suggest that the Monitoring sub-scale of the C-MBSS can be used to identify individuals' information-seeking styles in Chinese contexts across different populations.
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Affiliation(s)
- Qiqi Zhuo
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, 295#, Yunnan, China
| | - Changsheng Cui
- Pharmacy Department, Zigong First People's Hospital, Zigong, Sichuan, China
| | - Hongmin Liang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, 295#, Yunnan, China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Qiulan Hu
- ICU in Geriatric Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ardani Latifah Hanum
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, 295#, Yunnan, China
| | - Mingfang Yang
- Urology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yanjiao Wang
- Psychiatric Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Wei Wei
- General Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Lan Ding
- Out-Patient Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Xichang Road, Kunming, 295#, Yunnan, China.
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Koivisto JM, Saarinen I, Kaipia A, Puukka P, Kivinen K, Laine KM, Haavisto E. Patient education in relation to informational needs and postoperative complications in surgical patients. Int J Qual Health Care 2020; 32:35-40. [PMID: 31016323 DOI: 10.1093/intqhc/mzz032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/31/2019] [Accepted: 03/01/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To study surgical patients' informational expectations and the level of received knowledge at the time of hospital discharge. To examine if there is an association with postoperative complications and the patient´s level of received knowledge. DESIGN Comparative descriptive design. SETTING The data on patients admitted for non-cardiac surgery were collected in three phases during an eight-month period. PARTICIPANTS 258 in-ward non-cardiac general surgery and orthopedic surgery adult patients. INTERVENTIONS Questionnaires before admission (knowledge expectations) and at discharge (received knowledge). A telephone interview 30 days after discharge. MAIN OUTCOME MEASURES Received knowledge (as much or more / less) compared to expectations, and its association with post-discharge complications. RESULTS There were differences between patient groups in their perception of receiving enough knowledge and they were connected to gender (male vs. female OR 2.67, 95% CI 1.55-4.60, P = 0.0004) and procedure (elective orthopedic implant surgery vs. elective minor orthopedic and hand surgery: OR 3.25, 95% CI 1.72-6.17, P = 0.0003). Patients who received less knowledge than expected had more postoperative complications than those who received sufficient (as much or more than expected) information. CONCLUSIONS Patients differ in terms of informational needs, and preoperative education prepares the patient for the information provided postoperatively. Patient education may have an influence on recovery from surgery.
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Affiliation(s)
| | | | - Antti Kaipia
- Hospital District of Satakunta.,Department of Urology, University of Tampere
| | - Pauli Puukka
- Department of Nursing Science, University of Turku
| | | | | | - Elina Haavisto
- Hospital District of Satakunta.,Department of Nursing Science, University of Turku
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28
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Leino-Kilpi H, Inkeroinen S, Cabrera E, Charalambous A, Fatkulina N, Katajisto J, Sigurðardóttir ÁK, Sourtzi P, Suhonen R, Zabalegui A, Valkeapää K. Instruments for Patient Education: Psychometric Evaluation of the Expected Knowledge (EKhp) and the Received Knowledge of Hospital Patients (RKhp). J Multidiscip Healthc 2020; 13:1481-1505. [PMID: 33204098 PMCID: PMC7667700 DOI: 10.2147/jmdh.s271043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/28/2020] [Indexed: 02/01/2023] Open
Abstract
Purpose In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients’ expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial). Patients and Methods The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language experts. International data collection was performed in 2009–2012 with a total sample of 1,595 orthopedic patients. Orthopedic patients were selected due to the increase in their numbers, and need for educational activities. Here we report the psychometrics of the instruments for potential international use and future development. Results Content validities were confirmed by each participating country. Confirmatory factor analyses supported the original theoretical, six-dimensional structure of the instruments. For some subscales, however, there is a need for further clarification. The summative factors, based on the dimensions, have a satisfactory internal consistency. The results support the use of the instruments in patient education in orthopedic nursing, and preferably also in other fields of surgical nursing care. Conclusion EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted.
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Affiliation(s)
- Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Saija Inkeroinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Esther Cabrera
- School of Health Sciences, TecnoCampus, University Pompeu Fabra, Barcelona, Spain.,Department of Care Management and Social Work, Sechenov University, Moscow, Russia
| | - Andreas Charalambous
- Department of Nursing Science, University of Turku, Turku, Finland.,Nursing Department, Cyprus University of Technology, Limassol, Cyprus
| | - Natalja Fatkulina
- Department of Nursing, Klaipeda University, Klaipėda, Lithuania.,Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Árún K Sigurðardóttir
- School of Health Sciences, University of Akureyri, Akureyri, Iceland.,Akureyri Hospital, Akureyri, Iceland
| | - Panayota Sourtzi
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,Welfare Division, City of Turku, Turku, Finland
| | - Adelaida Zabalegui
- Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Kirsi Valkeapää
- Department of Nursing Science, University of Turku, Turku, Finland.,Human Performance Division, Finnish Defense Research Agency, Järvenpää, Finland
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Li SL, Zhou SH, Lin YJ. The value of continuous nursing in patients after cardiac mechanical valve replacement. J Cardiothorac Surg 2020; 15:299. [PMID: 33023620 PMCID: PMC7541263 DOI: 10.1186/s13019-020-01326-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The purpose of this study was to explore the value of continuous nursing in patients after cardiac valve replacement. METHODS The clinical data of 116 patients after cardiac mechanical valve replacement from January 2017 to January 2018 were analysed retrospectively. According to the nursing mode, the patients were divided into two groups: the continuous nursing group (group A, n = 56) and the conventional nursing group (group B, n = 60). RESULTS The continuous nursing group exhibited significantly decreased SAS and SDS scores 1 year after surgery compared to the preoperative SAS and SDS scores(P < 0.05). The SAS and SDS scores of the continuous nursing group were significantly better than those of the traditional nursing group 1 year after surgery(P < 0.05). There were 4 patients with anticoagulant complications after discharge in the continuous nursing group, and 13 cases of anticoagulant complications in the conventional nursing group. There was a significant difference between the two groups. CONCLUSION Continuous nursing improves patient compliance with treatment and reduces the occurrence of postoperative anticoagulation complications. The patient also receives proper psychological evaluations, which relieve patient anxiety and depression.
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Affiliation(s)
- Sai-Lan Li
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, P. R. China
| | - Sheng-Huo Zhou
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, P. R. China
| | - Yan-Juan Lin
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, Fujian, P. R. China.
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Technical Evidence Review for Emergency Major Abdominal Operation Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery. J Am Coll Surg 2020; 231:743-764.e5. [PMID: 32979468 DOI: 10.1016/j.jamcollsurg.2020.08.772] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023]
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31
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Emotions of Orthopaedic Arthroplasty Patients: A European Survey. Orthop Nurs 2020; 39:315-323. [PMID: 32956273 DOI: 10.1097/nor.0000000000000696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
METHODS This was a pre/post-observational study examining patients' emotions before and during elective knee or hip replacement surgery for osteoarthritis in seven European Union countries to identify factors related to better emotional status at discharge. INSTRUMENTS In addition to demographic data, information was collected on quality of life (EuroQoL five-dimension questionnaire), hospital expectations (Knowledge Expectations of Hospital Patients Scale), symptoms, and experienced emotions. ANALYSIS Total negative emotions scores at baseline and discharge were transformed into median values. Multivariate analysis identified the baseline factors related to better emotional status at discharge. RESULTS Patients (n = 1,590), mean age 66.7 years (SD = 10.6), had a significant reduction in the frequency of total negative emotions at discharge as compared with baseline. The multivariate model showed better health status (odds ratio [OR] = 1.012; p = .004), better emotional status at baseline (≥24 points), and shorter duration of hospital stay (OR = 0.960; p = .011) as independent factors associated with better emotional status at discharge (OR = 4.297; p = .001). CONCLUSIONS Patients undergoing elective knee or hip replacement surgery for osteoarthritis improve their emotional status during hospitalization, with fewer negative emotions at discharge. Good emotional status, feeling of higher health status at baseline, and shorter hospitalization were independently associated with better emotional status at discharge.
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Lee BH, Wu CL. Educating Patients Regarding Pain Management and Safe Opioid Use After Surgery. Anesth Analg 2020; 130:574-581. [DOI: 10.1213/ane.0000000000004436] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Abstract
OBJECTIVES To recognize cancer prehabilitation as a pretreatment regimen to increase functional status for patients requiring cancer treatment. This article presents current evidence addressing the efficacy and benefits of prehabilitation regimens in different cancer survivor populations. DATA SOURCES Studies and case reports in the PubMed database. CONCLUSION Cancer prehabilitation may improve outcomes. Prehabilitation may include targeted or whole-body exercise, nutrition, education, psychologic counseling, and smoking cessation. Opportunities exist to further improve access to and delivery of multimodal prehabilitation, and nurses play a critical role in connecting patients to these services. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses who are knowledgeable of cancer treatment-related effects are poised to assess survivors for existing impairments, advocate for prehabilitation for existing and potential morbidities, and monitor functional status over time. As patient educators, they are key to informing cancer survivors about the role of prehabilitation.
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Dennis J, Wylde V, Gooberman-Hill R, Blom AW, Beswick AD. Effects of presurgical interventions on chronic pain after total knee replacement: a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2020; 10:e033248. [PMID: 31964670 PMCID: PMC7045074 DOI: 10.1136/bmjopen-2019-033248] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Nearly 100 000 primary total knee replacements (TKR) are performed in the UK annually. The primary aim of TKR is pain relief, but 10%-34% of patients report chronic pain. The aim of this systematic review was to evaluate the effectiveness of presurgical interventions in preventing chronic pain after TKR. DESIGN MEDLINE, Embase, CINAHL, The Cochrane Library and PsycINFO were searched from inception to December 2018. Screening and data extraction were performed by two authors. Meta-analysis was conducted using a random effects model. Risk of bias was assessed using the Cochrane tool and quality of evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation. PRIMARY AND SECONDARY OUTCOMES Pain at 6 months or longer; adverse events. INTERVENTIONS Presurgical interventions aimed at improving TKR outcomes. RESULTS Eight randomised controlled trials (RCTs) with data from 960 participants were included. The studies involved nine eligible comparisons. We found moderate-quality evidence of no effect of exercise programmes on chronic pain after TKR, based on a meta-analysis of 6 interventions with 229 participants (standardised mean difference 0.20, 95% CI -0.06 to 0.47, I2=0%). Sensitivity analysis restricted to studies at overall low risk of bias confirmed findings. Another RCT of exercise with no data available for meta-analysis showed no benefit. Studies evaluating combined exercise and education intervention (n=1) and education alone (n=1) suggested similar findings. Adverse event data were reported by most studies, but events were too few to draw conclusions. CONCLUSIONS We found low to moderate-quality evidence to suggest that neither preoperative exercise, education nor a combination of both is effective in preventing chronic pain after TKR. This review also identified a lack of evaluations of other preoperative interventions, such as multimodal pain management, which may improve long-term pain outcomes after TKR. PROSPERO REGISTRATION NUMBER CRD42017041382.
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Affiliation(s)
- Jane Dennis
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Vikki Wylde
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Rachael Gooberman-Hill
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - A W Blom
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Andrew David Beswick
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Bristol, UK
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Hoorntje A, Kuijer PPFM, van Ginneken BT, Koenraadt KLM, van Geenen RCI, Kerkhoffs GMMJ, van Heerwaarden RJ. Predictors of Return to Work After High Tibial Osteotomy: The Importance of Being a Breadwinner. Orthop J Sports Med 2020; 7:2325967119890056. [PMID: 31909053 PMCID: PMC6935877 DOI: 10.1177/2325967119890056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background Limited evidence exists on patient-relevant outcomes after high tibial osteotomy (HTO), including return to work (RTW). Furthermore, prognostic factors for RTW have never been described. Purpose To investigate the extent and timing of RTW in the largest HTO cohort investigated for RTW to date and to identify prognostic factors for RTW after HTO. Study Design Cohort study; Level of evidence, 3. Methods Consecutive patients who underwent HTO between 2012 and 2015 were included. Patients received a questionnaire at a mean follow-up of 3.6 years. Questions were asked pre- and postoperatively regarding work status, job title, working hours, preoperative sick leave, employment status, and whether patients were their family's breadwinner. The validated Work Rehabilitation Questionnaire (WORQ) was used to assess difficulty with knee-demanding activities. Prognostic factors for RTW were analyzed using a logistic regression model. Covariates were selected based on univariate analysis and a directed acyclic graph. Results We identified 402 consecutive patients who underwent HTO, of whom 349 were included. Preoperatively, 299 patients worked, of whom 284 (95%) achieved RTW and 255 (90%) returned within 6 months. Patients reported significant postoperative improvements in performing knee-demanding activities. Being the family's breadwinner was the strongest predictor of RTW (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.27-6.69). In contrast, preoperative sick leave was associated with lower odds of RTW (OR, 0.20; 95% CI, 0.08-0.46). Conclusion After HTO, 95% of patients were able to RTW, of whom 9 of 10 returned within 6 months. Breadwinners were more likely to RTW, and patients with preoperative sick leave were less likely to RTW within 6 months. These findings may be used to improve preoperative counseling and expectation management and thereby enhance work-related outcomes after HTO.
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Affiliation(s)
- Alexander Hoorntje
- Amsterdam Movement Sciences, Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Academic Center for Evidence-Based Sports Medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration on Health & Safety in Sports, AMC/VUmc IOC Research Center, Amsterdam, the Netherlands.,Department of Orthopaedic Surgery, Foundation for Orthopaedic Research Care and Education, Amphia Hospital, Breda, the Netherlands
| | - P Paul F M Kuijer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Berbke T van Ginneken
- Centre for Deformity Correction and Joint Preserving Surgery, Kliniek ViaSana, Mill, the Netherlands
| | - Koen L M Koenraadt
- Department of Orthopaedic Surgery, Foundation for Orthopaedic Research Care and Education, Amphia Hospital, Breda, the Netherlands
| | - Rutger C I van Geenen
- Department of Orthopaedic Surgery, Foundation for Orthopaedic Research Care and Education, Amphia Hospital, Breda, the Netherlands
| | - Gino M M J Kerkhoffs
- Academic Center for Evidence-Based Sports Medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration on Health & Safety in Sports, AMC/VUmc IOC Research Center, Amsterdam, the Netherlands.,Department of Orthopaedic Surgery, Foundation for Orthopaedic Research Care and Education, Amphia Hospital, Breda, the Netherlands
| | - Ronald J van Heerwaarden
- Department of Orthopaedic Surgery, Maartenskliniek Woerden, Woerden, the Netherlands.,Centre for Deformity Correction and Joint Preserving Surgery, Kliniek ViaSana, Mill, the Netherlands
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Kaakinen P, Meriläinen M, Putila P, Kääriäinen M. The quality of counselling in rehabilitation evaluated by orthopaedic surgery patients at a university hospital: A cross sectional study. Int J Orthop Trauma Nurs 2019; 37:100717. [PMID: 31836417 DOI: 10.1016/j.ijotn.2019.100717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 07/03/2019] [Accepted: 09/06/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Pirjo Kaakinen
- University of Oulu, Research unit of Nursing Science and Health Management, Medical Research Center, Oulu, Finland.
| | - Merja Meriläinen
- Oulu University Hospital, Medical Research Center, Oulu, Finland.
| | - Pauliina Putila
- Department of Physical Medicine and Rehabilitation, Oulu University Hospital, Finland.
| | - Maria Kääriäinen
- University of Oulu, Research unit of Nursing Science and Health Management, Medical Research Center, Oulu, University Hospital of Oulu, Finland.
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McDonall J, Hutchinson AF, Redley B, Livingston PM, Botti M. Usability and feasibility of multimedia interventions for engaging patients in their care in the context of acute recovery: A narrative review. Health Expect 2019; 22:1187-1198. [PMID: 31778023 PMCID: PMC6882257 DOI: 10.1111/hex.12957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/02/2019] [Accepted: 08/11/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this narrative review was to examine the usability and feasibility of multimedia intervention as a platform to enable patient participation in the context of acute recovery and to discover what outcomes have been measured. DATA SOURCES A narrative review of primary research articles identified through a search of four electronic databases (MEDLINE, CINAHL, EMBASE and PsycInfo) identified peer-reviewed research evidence published in English language with no limitation placed on time period or publication type. Two authors independently assessed articles for inclusion. From the 277 articles identified through the search, 10 papers reporting the outcomes of seven studies were included in this review. REVIEW METHODS Articles were independently assessed for quality and relevance by two authors. The most appropriate method for data synthesis for this review was a narrative synthesis. RESULTS From the narrative synthesis of study outcomes, two findings emerged as follows: (a) multimedia interventions are feasible and usable in the context of acute care, and (b) multimedia interventions can improve patients' perception of care-related knowledge. Identified gaps included a lack of evidence in relation to the effect of interventions on enhancing patients' ability to participate in their care and the impact on patients' health-related outcomes. CONCLUSIONS In conclusion, there is some evidence of the feasibility and usability of multimedia interventions in acute care. That is, patients can use these types of platforms in this context and are satisfied with doing so. Multimedia platforms have a role in the delivery of information for patients during acute recovery; however, the effectiveness of these platforms to engage and enhance patients' capability to participate in their recovery and the impact on outcomes needs to be rigorously evaluated.
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Affiliation(s)
- Jo McDonall
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
| | - Anastasia F. Hutchinson
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
| | - Bernice Redley
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
| | - Patricia M. Livingston
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
| | - Mari Botti
- Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety ResearchDeakin UniversityGeelongVicAustralia
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Patients' expectations of osteotomies around the knee are high regarding activities of daily living. Knee Surg Sports Traumatol Arthrosc 2019; 27:3022-3031. [PMID: 30542742 DOI: 10.1007/s00167-018-5326-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 12/07/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE This study was conducted to investigate patients' expectations on high tibial osteotomies, distal femur osteotomies, and double-level osteotomies in different health-related domains. It was hypothesized that expectations are high in terms of capacity to work, pain relief, and restoring knee function. METHODS A total of 264 patients (age 47 years ± 11 years) were enrolled in this study from March 2015 until May 2016 in seven specialized orthopaedic surgery departments. Data were collected via the Knee injury and Osteoarthritis Outcome Score, the Hospital for Special Surgery-Knee Surgery Expectations Survey, and a ten-item (non-validated) questionnaire to specifically ask about expectations of osteotomies around the knee 24-48 h prior to surgery. In addition, self-efficacy was assessed. Parametric tests were used to test the hypothesis. RESULTS Knee injury and Osteoarthritis Outcome Score test results showed that all patients suffered because of their knee impairments prior to surgery. All participants had high expectations in all aspects regarding the surgical outcome: on a four-point Likert scale ranging from 1 (very important) to 4 (not important), all mean values were between 1.2 and 1.7. For patients who had a demanding physical work, the ability to keep a stressful working posture was more important than for other patients (i.e. to kneel, to squat). Furthermore, preoperative lower quality of life was associated with higher expectations concerning improving the ability to walk, to achieve improvements in activities of daily living and social well-being. CONCLUSIONS Patients' expectations of osteotomies around the knee are high in terms of capacity to work, pain relief, and restoring functions. The natural course of osteoarthritis and the potential need for conversion to TKA were underestimated by a substantial proportion of the study population. However, the expectation regarding survival rate is in line with the reported literature. The results of this study should assist surgeons in discussing realistic expectations when considering and counselling patients regarding osteotomies around the knee. This may help to clarify realistic expectations preoperatively and ultimately improve patients' satisfaction. LEVEL OF EVIDENCE Therapeutic study, Level II.
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Sun V, Raz DJ, Erhunmwunsee L, Ruel N, Carranza J, Prieto R, Ferrell B, Krouse RS, McCorkle R, Kim JY. Improving family caregiver and patient outcomes in lung cancer surgery: Study protocol for a randomized trial of the multimedia self-management (MSM) intervention. Contemp Clin Trials 2019; 83:88-96. [PMID: 31279090 PMCID: PMC6661176 DOI: 10.1016/j.cct.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To describe the study protocol of the Multimedia Self-Management (MSM) intervention to prepare patients and family caregivers (FCGs) for lung cancer surgery. DESIGN The study is a five-year, single site, randomized controlled trial of 160 lung cancer surgery FCG and patient dyads (320 total participants), comparing intervention and attention control arms. SETTING One National Cancer-Institute (NCI) designated comprehensive cancer center in Southern California. PARTICIPANTS Patients who are scheduled to undergo lung cancer surgery and their FCGs are enrolled as dyads only. INTERVENTION Based on the Chronic Care Self-Management Model (CCM), the intervention is a nurse-led, caregiver-based, multimedia care program for lung cancer surgery. Its primary focus is to help FCGs develop self-management skills related to their caregiving role through goal setting, proactive planning, building problem-solving skills, and accessing family support services. The intervention also supports dyads to prepare for surgery and post-operative recovery at home. It includes videos, print, web-based, and post-discharge telephone support. MAIN OUTCOME MEASURES FCG and patient psychological distress and QOL; FCG burden and preparedness for caregiving; FCG and patient healthcare resource use (in-home nursing care, urgent care/ER visits, readmissions). ANALYSIS Repeated measures ANCOVA statistical design will be used, removing variances prior to examining mean squares for the group by occasion interactions, and co-varying the baseline scores. In addition, structured equation modeling (SEM) will assess whether mediating and moderating factors are associated with outcomes. ClinicalTrials.gov Identifier: NCT03686007.
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Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, United States of America.
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, United States of America
| | | | - Nora Ruel
- Biostatistics and Mathematical Modeling Core City of Hope, Duarte, CA, United States of America
| | - Jacqueline Carranza
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Rosemary Prieto
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Robert S Krouse
- Surgical Services, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States of America; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Ruth McCorkle
- School of Nursing, Yale University, New Haven, CT, United States of America
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, United States of America
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Louw A, Puentedura EJ, Reed J, Zimney K, Grimm D, Landers MR. A controlled clinical trial of preoperative pain neuroscience education for patients about to undergo total knee arthroplasty. Clin Rehabil 2019; 33:1722-1731. [DOI: 10.1177/0269215519857782] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The aim of this study was to determine if a preoperative pain neuroscience education program would result in superior outcomes compared to usual preoperative education for total knee arthroplasty. Design: Controlled clinical trial with alternating allocation. Setting: Community-based hospital. Subjects: Consecutive sample of 120 patients scheduled for total knee arthroplasty. Intervention: Traditional hospital preoperative total knee arthroplasty education program on its own, or with an additional 30-minute group pain neuroscience education session. Main measures: Primary outcomes were measurements at one, three, and six months for pain, function, fear of movement, and pain catastrophization. We also compared opioid usage, healthcare expenses, and patient satisfaction between groups. Results: There were no statistically significant differences in any outcome measures between the two groups over time, except for patient satisfaction. Those in the experimental group had more agreement with statements about “preparation for surgery” ( P = .038), “would do again” ( P = .032), and “met expectations” ( P = .033) compared to those in the control group averaged over the three measurement times. Patients improved in several outcome measures over time regardless of group assignment, with a 34% improvement in pain, 36% improvement in function, 16% improvement in fear of movement, and 23% improvement in pain catastrophization scores. Conclusion: Adding a brief 30-minute pain neuroscience education session to a traditional preoperative total knee arthroplasty education program did not result in any significant improvements, except patient satisfaction.
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Affiliation(s)
- Adriaan Louw
- International Spine Pain Institute, Story City, IA, USA
| | - Emilio J Puentedura
- International Spine Pain Institute, Story City, IA, USA
- Department of Physical Therapy, Baylor University, Waco, TX, USA
| | - Jordan Reed
- Department of Physical Therapy, Spencer Hospital, Spencer, IA, USA
| | - Kory Zimney
- International Spine Pain Institute, Story City, IA, USA
- Department of Physical Therapy, University of South Dakota, Vermillion, SD, USA
| | - Derek Grimm
- Department of Pharmacy Services, Spencer Hospital, Spencer, IA, USA
| | - Merrill R Landers
- Department of Physical Therapy, University of Nevada, Las Vegas, Las Vegas, NV, USA
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«Prehabilitación» en cirugía de columna degenerativa: revisión de la literatura. Neurocirugia (Astur) 2019; 30:124-132. [DOI: 10.1016/j.neucir.2018.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/19/2018] [Indexed: 01/16/2023]
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Bagheri H, Ebrahimi H, Abbasi A, Atashsokhan G, Salmani Z, Zamani M. Effect of Preoperative Visitation by Operating Room Staff on Preoperative Anxiety in Patients Receiving Elective Hernia Surgery. J Perianesth Nurs 2019; 34:272-280. [DOI: 10.1016/j.jopan.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/07/2018] [Accepted: 04/14/2018] [Indexed: 10/28/2022]
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Hounsome J, Lee A, Greenhalgh J, Lewis SR, Schofield-Robinson OJ, Coldwell CH, Smith AF. A systematic review of information format and timing before scheduled adult surgery for peri-operative anxiety. Anaesthesia 2019; 72:1265-1272. [PMID: 28891062 DOI: 10.1111/anae.14018] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 12/28/2022]
Abstract
We included 34 trials with 3742 participants, identified through 6 database and supplementary searches (to May 2017): 29 were randomised; 4 were quasi-randomised and 1 was cluster-randomised. Disparate measurements and outcomes precluded meta-analyses. Blinding was attempted in only 6 out of 34 (18%) trials. A multimedia format, alone or in combination with text or verbal formats, was studied in 20/34 (59%) trials: pre-operative anxiety was unaffected in 10 out of 14 trials and reduced by the multimedia format in three; postoperative anxiety was unaffected in four out of five trials in which formats were compared. Multimedia formats increased knowledge more than text, which in turn increased knowledge more than verbal formats. Other outcomes were unaffected by information format. The timing of information did not affect pre-operative anxiety, postoperative pain or length of stay. In conclusion, the effects of pre-operative information on peri-operative anxiety and other outcomes were affected little by format or timing.
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Affiliation(s)
- J Hounsome
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - A Lee
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong.,Hong Kong Branch of The Chinese Cochrane Centre, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Greenhalgh
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - S R Lewis
- Patient Safety Research Unit, Royal Lancaster Infirmary, Lancaster, UK
| | | | - C H Coldwell
- Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK
| | - A F Smith
- Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK
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Creation and Evaluation of a Preoperative Education Website for Hip and Knee Replacement Patients-A Pilot Study. ACTA ACUST UNITED AC 2019; 55:medicina55020032. [PMID: 30704149 PMCID: PMC6409835 DOI: 10.3390/medicina55020032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/27/2019] [Accepted: 01/28/2019] [Indexed: 11/26/2022]
Abstract
Background and Objectives: There is limited research on the question of whether web-based preoperative education can improve surgical patient outcomes. The purpose of this pilot study was to determine the usability, utility, and feasibility of a website created to increase engagement and improve the quality of the preoperative education that patients having hip and knee arthroplasty surgery receive. Materials and Methods: A website was created, and its appearance was designed with evidence-based “menu-driven” drop-downs to make the screen options age-appropriate to the patient population; the content was supported with video and PDFs of educational material, the same or similar to the usual education provided to patients. The patient-specific outcomes included qualitative data regarding patient knowledge, satisfaction, utilities, and usability. These objectives were assessed based on the perceived health website usability questionnaire online survey. Eighty patients who met inclusion criteria were recruited, ranging in age from 40 to 65 years old. Among them, 52.5% were female, 71.25% were scheduled for knee arthroplasty, and 28.75% hip arthroplasty. The patients were randomly assigned to the paper only or website education cohorts in a 50:50 ratio. However, only 19 from each cohort participated in the survey questionnaire. Results and Conclusions: We hypothesized that findings would show that patients receiving web-based education would feel more knowledgeable about their procedure, have less anxiety, and greater satisfaction with the addition of the website content; and that nurses would report that a website could conserve nursing time and resources. The study revealed no statistically significant differences between the cohorts, with an Alpha level set at 0.05. However, survey results showed that patients using the website rated self-perceived increase in knowledge, and their satisfaction in the time to find and review the information was higher than that of the paper-only cohort. The nursing survey revealed that website education improved workflow, efficiency, and patient education.
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Dore-Smith E, Killingback C. What are the postoperative experiences of patients who have undergone hip and knee joint replacement? A literature review. PHYSICAL THERAPY REVIEWS 2018. [DOI: 10.1080/10833196.2018.1482989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Web App– and Text Message–Based Patient Education in Mohs Micrographic Surgery—A Randomized Controlled Trial. Dermatol Surg 2018; 44:924-932. [DOI: 10.1097/dss.0000000000001489] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effect of an e-Learning Tool on Expectations and Satisfaction Following Total Knee Arthroplasty: A Randomized Controlled Trial. J Arthroplasty 2018; 33:2153-2158. [PMID: 29555496 DOI: 10.1016/j.arth.2018.02.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/31/2018] [Accepted: 02/07/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Orthopedic surgeons recognize patient expectations of total knee arthroplasty (TKA) can be managed through education. E-learning is the application of educational technology. The objective of this study was to evaluate whether an e-learning tool could affect whether patients' expectations were met and they were satisfied 1 year following TKA. METHODS Patients with osteoarthritis from the London Health Sciences Centre, Canada, were randomly assigned to either a control group (n = 207) receiving standard patient education or an intervention group (n = 209) using the e-learning tool in addition to the standard. We used a web-based system with permuted block sizes, stratified by surgeon and first or second TKA. Preoperative measures were completed following the patients' preadmission clinic visit. Postoperative patient-reported outcome measures were completed at 6 weeks, 3 months, and 1 year after TKA. One year after TKA, risk difference was used to determine between-group differences for patient satisfaction and expectations being met. RESULTS One year postoperatively, the risk that expectations of patients were not met was 21.8% in the control group and 21.4% in the intervention group for an adjusted risk difference of 1.3% (95% confidence interval, -7.8% to 10.4%, P = .78). The proportion of patients satisfied with their TKA at 1 year postoperative was 78.6% in the intervention and 78.2% in the control groups. CONCLUSION There was no between-group difference at 1 year between intervention and control groups for either the risk that expectations of patients were not met or the proportion of patients who were dissatisfied with their TKA.
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O' Reilly M, Mohamed K, Foy D, Sheehan E. Educational impact of joint replacement school for patients undergoing total hip and knee arthroplasty: a prospective cohort study. INTERNATIONAL ORTHOPAEDICS 2018; 42:2745-2754. [PMID: 29936539 DOI: 10.1007/s00264-018-4039-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/12/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Enhanced recovery programmes for hip and knee arthroplasty surgery have been shown to decrease length of stay and improve patient outcomes in the elective setting. There are limited studies looking at pre-operative patient education alone and its role, however, more recent studies have demonstrated that it can help reduce length of stay and health care costs. The elective orthopaedic unit at Tullamore Hospital was the first unit in the Irish public health system to have a joint school, pre-operative, educational session, and the aim of this study was to assess our patient understanding of this session to ensure a sustained, high level of patient care, quality assurance and educational standards. METHODS A sample size of n = 51 was calculated to adequately power the study. Final sample size was 57. Data was collected across four joint school sessions. Patients were asked to complete a questionnaire before and after the session. RESULTS Twenty-seven male (47.3%) and 30 female (52.7%) patients completed the surveys. Mean age overall was 64.5 years. All survey questions except those related to anaesthesia and physiotherapy showed a statistically significant improvement after the joint school session. A total knowledge score was calculated and revealed a statistically significant difference between pre- and post-joint school survey answering (P value < 0.001). CONCLUSION Our joint school, pre-operative educational session remains a very effective way of delivering content to patients regarding their surgery. Continuous auditing is paramount to its success and there is potential scope for web-based learning as an adjunct to this validated session.
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Affiliation(s)
- Marc O' Reilly
- Department of Trauma and Orthopaedic Surgery, Tullamore Hospital, Arden Road, Tullamore, Co. Offaly, R35 NY51, Ireland. .,Graduate Entry Medical School, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland.
| | - Khalid Mohamed
- Department of Trauma and Orthopaedic Surgery, Tullamore Hospital, Arden Road, Tullamore, Co. Offaly, R35 NY51, Ireland
| | - Dearbhail Foy
- Department of Trauma and Orthopaedic Surgery, Tullamore Hospital, Arden Road, Tullamore, Co. Offaly, R35 NY51, Ireland
| | - Eoin Sheehan
- Department of Trauma and Orthopaedic Surgery, Tullamore Hospital, Arden Road, Tullamore, Co. Offaly, R35 NY51, Ireland
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Dekkers T, Melles M, Groeneveld BS, de Ridder H. Web-Based Patient Education in Orthopedics: Systematic Review. J Med Internet Res 2018; 20:e143. [PMID: 29685869 PMCID: PMC5938597 DOI: 10.2196/jmir.9013] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/20/2017] [Accepted: 12/23/2017] [Indexed: 12/26/2022] Open
Abstract
Background Patients with orthopedic conditions frequently use the internet to find health information. Patient education that is distributed online may form an easily accessible, time- and cost-effective alternative to education delivered through traditional channels such as one-on-one consultations or booklets. However, no systematic evidence for the comparative effectiveness of Web-based educational interventions exists. Objective The objective of this systematic review was to examine the effects of Web-based patient education interventions for adult orthopedic patients and to compare its effectiveness with generic health information websites and traditional forms of patient education. Methods CINAHL, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, PUBMED, ScienceDirect, Scopus, and Web of Science were searched covering the period from 1995 to 2016. Peer-reviewed English and Dutch studies were included if they delivered patient education via the internet to the adult orthopedic population and assessed its effects in a controlled or observational trial. Results A total of 10 trials reported in 14 studies involving 4172 patients were identified. Nine trials provided evidence for increased patients’ knowledge after Web-based patient education. Seven trials reported increased satisfaction and good evaluations of Web-based patient education. No compelling evidence exists for an effect of Web-based patient education on anxiety, health attitudes and behavior, or clinical outcomes. Conclusions Web-based patient education may be offered as a time- and cost-effective alternative to current educational interventions when the objective is to improve patients’ knowledge and satisfaction. However, these findings may not be representative for the whole orthopedic patient population as most trials included considerably younger, higher-educated, and internet-savvy participants only.
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Affiliation(s)
- Tessa Dekkers
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Marijke Melles
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Bob Sander Groeneveld
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Huib de Ridder
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Louw A, Zimney K, Reed J, Landers M, Puentedura EJ. Immediate preoperative outcomes of pain neuroscience education for patients undergoing total knee arthroplasty: A case series. Physiother Theory Pract 2018; 35:543-553. [PMID: 29589782 DOI: 10.1080/09593985.2018.1455120] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Standard preoperative education for total knee arthroplasty (TKA) has been shown to have no effect on postoperative outcomes. This may be because such education programs fail to educate patients about pain. Pain neuroscience education (PNE) focuses on teaching people more about pain from a neurobiological and neurophysiological perspective. DESIGN AND SETTING Case Series. AIM To determine the immediate effects, if any, of providing PNE before TKA surgery on patient self-report measures. PARTICIPANTS Twelve patients (female = 10) prior to TKA for knee osteoarthritis (OA). INTERVENTION Preoperative educational session by a physical therapist on the neuroscience of pain, accompanied by an evidence-based booklet. MAIN OUTCOME MEASURES Comparison of pre- and post-PNE self-report measures on knee pain (NPRS), Pain Catastrophization Scale (PCS), fear of movement (TSK), and beliefs about TKA; as well as three physical performance measures - knee flexion active range of motion, 40 m self-paced walk, and pressure pain threshold (PPT). RESULTS Immediately following the PNE, patients had statistically significant lower TSK scores, increased PPT, and improved beliefs about their upcoming surgery. There were no significant changes in knee pain, function, or flexion active range of motion. CONCLUSIONS Results appear to suggest that immediately after PNE, patients scheduled for TKA had statistically significant changes in fear of movement, decreased sensitivity to pain and positive shifts in their beliefs about their future knee surgery. Larger trials with control/comparison groups are warranted to determine the true effects of preoperative PNE for patients about to undergo TKA.
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Affiliation(s)
- Adriaan Louw
- a International Spine and Pain Institute , Story City , IA , USA
| | - Kory Zimney
- b Department of Physical Therapy, School of Health Sciences , University of South Dakota , Vermillion , SD , USA
| | - Jordan Reed
- c Rehabilitation Services , Spencer Hospital , Spencer , IA , USA
| | - Merrill Landers
- d Department of Physical Therapy, School of Allied Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA
| | - Emilio J Puentedura
- d Department of Physical Therapy, School of Allied Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA
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