The Effect of Structured Preoperative Teaching On Patients?? Use of Patient- Controlled Analgesia (PC A) And Their Management of Pain

Timmons, Mae E.; Bower, Fay I.

doi:10.1097/00006416-199301000-00007

Cited by 21 publications

(19 citation statements)

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“…The most common teaching method identified in this review was the use of an information pamphlet. Nine published studies examined the effectiveness of specifically designed pamphlets on patient knowledge and compliance to behaviours 6,9 , 17–19,30–33 …”

Section: Resultsmentioning

confidence: 99%

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Knowledge retention from preoperative patient information

Stern

Lockwood

2005

Int J EB Healthcare

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Background Preoperative education is a common feature of the preoperative preparation for many surgical procedures. It is anticipated that this education will result in beneficial outcomes for the patient. Many studies have evaluated the effectiveness of different formats used to deliver the information, and the effect of this information on a variety of outcomes. While there has been substantial research and several meta-analyses undertaken on different aspects of preoperative education, there has been no previous attempt to summarise this body of research to evaluate its impact on knowledge and understanding of patients. Objective The objective of this review was to present the best available evidence related to knowledge retention and/or correct performance of postoperative activities after preoperative patient education. Review method This review considered all studies that included adults in a hospital setting, either as inpatients or same day surgical patients, and who received some form of information and/or instruction before an operative procedure. Interventions were the methods of preoperative patient education, instruction or teaching, and included evaluations of the effectiveness of different presentations such as: • written information; • audio-visual aids; • computer-assisted instruction; • learning packages in either group or individual formats, at either pre-admission or post-admission. The primary outcomes were those associated with the understanding of the information related to the operative or postoperative period that were provided in the intervention and included: 1 increased knowledge; 2 ability to perform postoperative activities; 3 time to teach skills. This review considered randomised controlled trials that evaluated forms of preoperative patient education and their effect on patient understanding, knowledge and ability to perform postoperative activities. Results The findings of this review support the use of pamphlets to inform patients and to improve their skills. The role of videos as a preoperative instruction tool has not been rigorously evaluated. However, existing studies support the use of preoperative videos to improve patient knowledge and skill. The data suggest that the instructional method, the act of educating a patient by delivering directions for actions or behaviour is useful for improving patients' knowledge of their treatment and their ability to perform and comply with required exercises. However, instruction is likely to be more effective if provided before admission. If teaching is to be done after admission, using a group format has been shown to be equally as effective as individual instruction. Conclusions Although numerous studies have been performed on many aspects of preoperative education, little high-quality research has assessed the effectiveness of this information on patient knowledge and ability to perform specific skills such as exercises. Further research is required to examine: (i) the effectiveness of pamphlets and other written material f...

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Section: Resultsmentioning

confidence: 99%

“…Five studies have examined the effect of combinations of information pamphlets and/or patient instruction at pre‐ and post‐admission time period on patient knowledge of their upcoming surgery 6,18 , 19,32 , 33 …”

Section: Resultsmentioning

confidence: 99%

Knowledge retention from preoperative patient information

Stern

Lockwood

2005

Int J EB Healthcare

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“…We consider this unlikely, although the interview group failed to show a significant increase in information, as there had been no change in practice since our initial study [1] and the medical and nursing staff were unaware that a study was being undertaken. It is more likely that pre‐operative information is unable to acutely change patients' behaviour with PCA [2,3]. Long‐held beliefs about addiction and the lack of safety of machines are powerful factors when patients are left to manage their pain relief.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies found little benefit of pre‐operative education on patients' use of PCA [2,3]. However, the nature of the information was determined by the clinical staff, and often failed to address key areas of concern for the patient [4,5].…”

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confidence: 99%

Pre‐operative information and patient‐controlled analgesia: much ado about nothing

Chumbley

Ward²,

Hall

et al. 2004

Anaesthesia

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SummaryWe examined whether pre-operative information benefited patients receiving patient-controlled analgesia (PCA) after major surgery. We investigated whether patients felt better informed about PCA and also whether pre-operative information altered the use of PCA, the adequacy of pain relief, worries about addiction and safety, and knowledge of side-effects. We investigated the effectiveness of information provided in two ways, namely by a patient-determined leaflet or an interview by a trained nurse from the pain team, compared with routine pre-operative information. We studied 225 patients, 75 in each group. Patients in the leaflet group were better informed about PCA, became familiar with using PCA more quickly and were less confused about PCA than the control group. However, there were no effects on pain relief, worries about addiction and safety, and knowledge of side effects. The pre-operative interview resulted in no benefits. Our findings indicate that the detailed provision of pre-operative information failed to improve patients' experiences of PCA. Patient-controlled analgesia (PCA) has been adopted widely for the treatment of postoperative pain. We have argued that the patients' experiences of PCA are paramount in evaluating this transfer of pain relief from medical ⁄ nursing staff to the patient. In an assessment by 200 patients, the response to PCA was favourable overall with good pain relief but with fears of addiction and overdose [1]. These worries affected over a third of patients and restricted the use of PCA in a quarter of patients. Side effects of morphine were common (91% patients experienced at least one unpleasant side-effect) and constrained its use and hence effectiveness in treating patients' pain. However, a feature of this study was the lack of pre-operative information provided for the patients; 40% patients recalled that the information given was inadequate. It is possible therefore that good preoperative information might improve patients' experience of PCA.Previous studies found little benefit of pre-operative education on patients' use of PCA [2,3]. However, the nature of the information was determined by the clinical staff, and often failed to address key areas of concern for the patient [4,5]. We described recently how the content of a patient information leaflet was determined by patients and reflected their needs and worries [6].The aim of the study was to examine whether preoperative information benefited patients. Firstly, we sought to determine whether patients felt better informed about PCA. Second, we examined whether preoperative information helped in other ways: use of PCA, adequacy of pain relief, knowledge of side effects, and worries about overdose and addiction. Third, we compared the effectiveness of information provided in two ways, by a patient-determined leaflet or a trained nurse from the acute pain team, with routine pre-operative information. Ó 2004 Blackwell Publishing Ltd Methods PatientsConsecutive patients, who would receive PCA routinely, were app...

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“…A relatively strong evidence base supports the use of sensory information as educational strategies to impart knowledge and reduce procedural stress (Johnson, 1984;Johnson, Fuller, & Endress, 1976a, 1976bJohnson, Fieler, Wlasowicz, Mitchell, & Jones, 1997;Reuille, 2002;Timmons & Bower, 1993). The authors will briefly review the quality initiative and methodology for development of a DVD to improve the educational preparation of parents whose children are having a VCUG and discuss the results of a pre-and postsurvey on parents' satisfaction, confidence, and anxiety.…”

Section: Introductionmentioning

confidence: 99%