Pre-operative patient education does not necessarily reduce length of stay or pain after spinal surgery

Rapp, Aaron; Sun, Michael; Weissman, Holly; Perez-Cruet, Mick J.; Fahim, Daniel K.

doi:10.1016/j.inat.2020.101044

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…However, our observation is in keeping with another recent observational study of 229 patients listed for spinal surgery where 116 (51%) did not attend an optional, unspecified, preoperative education session. 40 Instead of offering a binary choice of attendance, tailoring psychoeducation by sub-grouping patients depending on their predispositions could enable and affect uptake. For example, joint arthroplasty surgery patients can be categorized into those who desire information to handle uncertainly (monitors) 31 or stress (sensitizers), 41 those who avoid information about surgery (avoiders), 42 those fearful about surgery (anxious), 43 and those who avoid considering unpleasant events (deniers).…”

Section: Discussionmentioning

confidence: 99%

A Preoperative Spinal Education intervention for spinal fusion surgery designed using the Rehabilitation Treatment Specification System is safe and could reduce hospital length of stay, normalize expectations, and reduce anxiety

et al. 2022

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Aims Psychoeducative prehabilitation to optimize surgical outcomes is relatively novel in spinal fusion surgery and, like most rehabilitation treatments, they are rarely well specified. Spinal fusion patients experience anxieties perioperatively about pain and immobility, which might prolong hospital length of stay (LOS). The aim of this prospective cohort study was to determine if a Preoperative Spinal Education (POSE) programme, specified using the Rehabilitation Treatment Specification System (RTSS) and designed to normalize expectations and reduce anxieties, was safe and reduced LOS. Methods POSE was offered to 150 prospective patients over ten months (December 2018 to November 2019) Some chose to attend (Attend-POSE) and some did not attend (DNA-POSE). A third independent retrospective group of 150 patients (mean age 57.9 years (SD 14.8), 50.6% female) received surgery prior to POSE (pre-POSE). POSE consisted of an in-person 60-minute education with accompanying literature, specified using the RTSS as psychoeducative treatment components designed to optimize cognitive/affective representations of thoughts/feelings, and normalize anxieties about surgery and its aftermath. Across-group age, sex, median LOS, perioperative complications, and readmission rates were assessed using appropriate statistical tests. Results In all, 65 (43%) patients (mean age 57.4 years (SD 18.2), 58.8% female) comprised the Attend-POSE, and 85 (57%) DNA-POSE (mean age 54.9 years (SD 15.8), 65.8% female). There were no significant between-group differences in age, sex, surgery type, complications, or readmission rates. Median LOS was statistically different across Pre-POSE (5 days ((interquartile range (IQR) 3 to 7)), Attend-POSE (3 (2 to 5)), and DNA-POSE (4 (3 to 7)), (p = 0.014). Pairwise comparisons showed statistically significant differences between Pre-POSE and Attend-POSE LOS (p = 0.011), but not between any other group comparison. In the Attend-POSE group, there was significant change toward greater surgical preparation, procedural familiarity, and less anxiety. Conclusion POSE was associated with a significant reduction in LOS for patients undergoing spinal fusion surgery. Patients reported being better prepared for, more familiar, and less anxious about their surgery. POSE did not affect complication or readmission rates, meaning its inclusion was safe. However, uptake (43%) was disappointing and future work should explore potential barriers and challenges to attending POSE. Cite this article: Bone Jt Open 2022;3(2):135–144.

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Section: Discussionmentioning

confidence: 99%

A Preoperative Spinal Education intervention for spinal fusion surgery designed using the Rehabilitation Treatment Specification System is safe and could reduce hospital length of stay, normalize expectations, and reduce anxiety

et al. 2022

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Relevance of Preoperative Pain Education To The Cardiac Patients on Their Response To Postoperative Pain Therapy

Khalid

Kausar

Sadiqa

et al. 2022

PBMJ

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To observe the effects of preoperative pain education on Coronary artery bypass graft surgery (CABG) patients on postoperative pain management. Methods: A randomized control trial was performed from April-December 2019, after seeking ethical approval. Patients of Punjab institute of cardiology, Lahore, scheduled for CABG were selected after informed consent. Those with psychiatric illness, chronic pain/opioid addiction, or allergic to opioids, were excluded. The population was divided into control (received routine preoperative care) and interventional (received additional preoperative education via pain management booklet) groups, data was collected postoperatively via questionnaire and analyzed on SPSS. Chi-square was used as a statistical test and p-value <0.05 was significant. Results: Eighty patients with 47 males and 33 females aged 50-80 years (mean=61.05±8.32) were recruited. The interventional group agreed to the significance of instant in-hospital notifying/managing pain and 38(95%) controls agreed to it, 39(98%) interventional patients were willing for a stronger pain-relief medicine if not cured by the initial dose, while 12(30%) controls were willing for it. 38(95%) interventional patients denied the fear of addiction to painkillers, contrarily 5(12.5%) controls negated this fear. All interventional patients rejected the concern of incurable nausea with pain-relief medicine, while 37(92.5%) controls were threatened with this concern. Constipation associated with pain-relief medicine was refused by all interventional patients, 25(62.5%) controls accepted it. All the differences between both groups were significant (p<0.001). Conclusion: A significantly improved postoperative patient compliance/outcome (pain-related) was observed in the interventional group who preoperative received pain education compared to the control.

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A Literature Review Study on the Effectiveness of Pre-operative Education for Post-operative Pain Management

Rafiei,

Ahmadifajr,

Mazalzadeh

2024

J Health Rep Technol

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Context: Post-operative pain (POP) is one of the essential consequences of various surgeries in surgical patients, and various pharmacological and non-pharmacological methods should reduce it. Due to the side effects of medicinal methods, the use of non-medicinal methods has attracted the attention of nurses and health care workers nowadays. Considering this issue, the main goal of this study was to evaluate pre-operative education (POE) on the reduction of POP in surgical patients. Evidence Acquisition: This narrative review evaluated previous research from 1990 to 2024. Accordingly, 184 studies were obtained in the first search stage through advanced search in national and international databases, including Web of Science, Islamic World Science Citation Center (ISC), Scopus, PubMed, Magiran, and Google Scholar, Iran-Doc. Then, considering the inclusion and exclusion criteria, 22 studies were considered for the present review study. Results: Based on the present review, most evaluated studies (approximately 64%) showed that POE positively and significantly affects POP. Previous studies have reported that various parameters play a role in the impact of POE on POP, including the type of surgery, the length of follow-up, the continuity of care, the method of providing training, the quality of the intervention, the patient's awareness of the pain measurement method, with or without the educator's interaction and empathy during education, and the presence or absence of patient anxiety during training. Conclusions: Considering the positive and significant effect of POE on POP, nurses and caregivers of patients who are candidates for surgery should use the appropriate educational content and educational methods to reduce POP in patients according to the type of surgery and other influencing variables. However, before that, the nurses themselves should get enough information about the different methods of POE so that they can convey the educational content to the patients with proper quality and efficiency.

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Pre-operative patient education does not necessarily reduce length of stay or pain after spinal surgery

Cited by 3 publications

References 20 publications

A Preoperative Spinal Education intervention for spinal fusion surgery designed using the Rehabilitation Treatment Specification System is safe and could reduce hospital length of stay, normalize expectations, and reduce anxiety

A Preoperative Spinal Education intervention for spinal fusion surgery designed using the Rehabilitation Treatment Specification System is safe and could reduce hospital length of stay, normalize expectations, and reduce anxiety

Relevance of Preoperative Pain Education To The Cardiac Patients on Their Response To Postoperative Pain Therapy

A Literature Review Study on the Effectiveness of Pre-operative Education for Post-operative Pain Management

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