A qualitative report of patient problems and postoperative instructions

Abstract

Purpose-While surgery related stress may interfere with the patient's ability to concentrate on instructions, language difficulty or low health literacy may also impede appropriate doctor/patient communication. The purpose of this study is to understand from a sample of minority patients the types of problems encountered during healing and the level of information regarding elements of postoperative instructions they recalled receiving at an inner-city safety net hospital. We initiated a qualitative study to understand the care sequence process and provision of informed consent and postoperative instruction. Methods-AfricanAmerican or Latino patients, 18 years of age or older, who had third molars removed under general anesthesia or received treatment for a mandibular fracture were recruited to participate in a focus group to discuss their treatment. Patients described their problem and any informed consent given about treatment risks and benefits and postoperative information they recalled.Results-A total of 137 former patients were approached, 57 agreed to participate (42%) and 34 of those (60%) completed the interview. Subjects included 14 females and 20 males. Five categories of patient problems were reported: physical, eating, treatment-related, psychosocial, and other problems. People reported 5 categories of coping strategies: medication use, physical treatments, dietary solutions, rest, and clinical assistance. Twenty people recalled being given The type and level of information that patients may require to make an informed decision in deciding specific treatment types is not well understood. Professional standards state that the health care provider must inform the patient about risks and benefits of each treatment. Nonetheless, the clinician struggles to succinctly and clearly present relevant information to a patient. 7Good communication is also critical in assisting patients to appropriately deal with postoperative management. Studies have shown that adequate postoperative education can improve patient satisfaction and reduce postsurgical morbidity. 8 Malins 5 pointed out that patients from ethnic minorities might need printed instructions in their native language and the services of an interpreter. Moreover, verbal or a combination of verbal and written instructions are preferred by most patients, particularly those with lower education. 3,4,6 However, without written reinforcement the understanding and retention of verbal instructions over a lengthy period of recovery cannot be assured.Alexander 3,9 stated that it is time for dental professionals, particularly those in the surgical specialties, to pay more attention to the phrasing, jargon, and terminology used in their postoperative instruction forms, as well as in their office brochures, informed consent forms, and the like. The purpose of this study was to elicit information from a minority sample about the types of problems encountered following oral surgery, the coping strategies they used to manage the problems, and the level of infor...

The Quality of Patient Education in Day Surgery by Adult Patients

“…56 However, verbal education needs to be comprehensive and consistent with the written material. 11,19 The use of other education methods is lower 34,39 and this research also shows that the use of other educational equipment, such as videos, is not widespread, although previous studies have shown the positive effects of these on the effectiveness of education. Images, various concept maps, brochures and videos can promote the effectiveness of information and increase interest in the information.…”

“…28,38,39,50 However, it must be remembered that even though the hospital routinely provides education to all patients, not all remember receiving adequate instructions. 11 It may be that communication is not always meet between the healthcare staff and patients.…”

“…[6][7][8] However, successful day surgery requires not only surgery, but also successful post-treatment, with patient education having a particularly important role in this. Effective and clear patient education seeks to improve patient knowledge and operational performance, [9][10][11][12][13] optimize patient recovery, shorten hospital stays for patients, improve satisfaction with health care, reduce the risks associated with surgery, [14][15][16][17] as well as help to reduce the pressures on societal health services. 18 Day surgery is an innovative treatment whose popularity and demand is growing all the time.…”

Getting By: Underuse of Interpreters by Resident Physicians

“…Language barriers encountered in the care of patients with limited English proficiency (LEP), a growing segment of the U.S. population 2 , adversely affect healthcare quality. Patients with LEP may have decreased access to acute care and preventive services [3][4][5][6] , decreased satisfaction with care 7,8 , poor understanding of instructions or medications 9,10 , longer hospital stays 11 , and an increased risk of medical errors and misdiagnoses [12][13][14][15][16] .…”

Language-Based Inequity in Health Care: Who Is the “Poor Historian”?

“…They have been consistently shown to receive lower quality care than English-proficient patients on various measures: understanding of treatment plans and disease processes, satisfaction, and incidence of medical errors resulting in physical harm [2][3][4][5][6]. These disparities are rooted in obvious communication barriers but also may reflect cultural differences, clinician biases, and ineffective systems (i.e., structural barriers) [7].…”