Development and evaluation of interdisciplinary preoperative patient education in foot and ankle surgery: immediate effects on knowledge, satisfaction and anxiety / Entwicklung und erste Evaluation eines präoperativen interdisziplinären Schulungskonzeptes für Patienten/-innen der Fußchirurgie: unmittelbare Effekte auf Wissenszuwachs, Zufriedenheit und Angst

Abstract

Background and objective: Foot and ankle surgery is increasing due to demographic and lifestyle changes. Most often, pa-tients are required to unload their foot postoperatively, resulting in significant impairment of activi-ties of daily living without adequate preparation for this situation. The aim of the study was the development and evaluation of a preoperative patient education intervention. Methods: Based on current research, a patient education intervention was developed. To investigate immediate effects, a longitudinal study with two points of measurement before and after the education session was conducted. Outcomes were increase in knowledge, satisfaction and preoperative anxiety, which were measured with a selfdeveloped questionnaire. Additionally, five short interviews were conducted. Results: 56 patients (63% female) with a mean age of 56,7 (SD=14,8) years were included. Patients had a significant increase in knowledge following the intervention from mean 3,93 (SD=1,78) to 5,48 (SD=2,29) correctly answered questions (out of 10). Patients felt that they were better informed and more satisfied with the information provided. Patients evaluated the way of information delivery, the content of information, the group and the location as positive.The expectations of patients relating to postoperative loadbearing capacity and coping with eve-ryday life as well as preoperative anxiety did not change following the intervention. Conclusion:The education intervention could be implemented in the clinical routine and showed positive ef-fects. However, regarding realistic expectations and preoperative anxiety no change was ob-served. Long-term post operative effectivity and efficiency of patient education should be further examined within a randomized controlled trial. Abstract

Preoperative education in patients undergoing foot and ankle surgery: a scoping review

“…This way, 15 studies were included in our review (Fig. 1) [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

“…All but one studies were published in English [25][26][27][28][29][30][31][33][34][35][36][37][38][39], and most of them assessed a broader population than only patients undergoing foot and ankle surgery [25-31, 33, 37-39]. Six of 15 studies were carried out in Europe [32,[34][35][36], five [26][27][28][29]31] in the USA, three [37][38][39] in Asia, and one [30] in Africa. Figure 2 shows the date of publication of studies separated by continent.…”

“…Only four [17,32,[34][35][36] of the 15 studies included patients undergoing foot and ankle surgery exclusively. Three [34][35][36] of these four studies were conducted in the UK and one [32] in Germany. Three [34][35][36] were observational studies, and one [32] had a quasi-experimental design.…”

Prehabilitation for Patients Undergoing Elective Foot and Ankle Surgery: A Contemporary Review

“… 91 Another study from Germany evaluated the effect of a 2½-hour preoperative multidisciplinary training course that included education on the procedure, perioperative expectations, and postoperative protocols followed by an opportunity to practice ambulating with assistive devices. 80 Following intervention, they reported significant improvement in patient knowledge and satisfaction, but no effect on preoperative anxiety. 80 An additional 2 studies from the United Kingdom found that preoperative educational interventions led to significantly reduced length of hospital stay.…”

“… 80 Following intervention, they reported significant improvement in patient knowledge and satisfaction, but no effect on preoperative anxiety. 80 An additional 2 studies from the United Kingdom found that preoperative educational interventions led to significantly reduced length of hospital stay. 81 , 95 Selvan et al 81 set up a single course 3 weeks before surgery led by a nurse who provided education on the procedure and postoperative course and a physical therapist who reviewed postoperative weightbearing restriction, evaluated mobility, and instructed on stair navigation and safe use of crutches.…”