Evaluation of patient preparedness for surgery: a randomized controlled trial

Greene, K.A.; Wyman, A.M.; Hart, Stuart; Hoyte, Lennox; Bassaly, Renee

doi:10.1016/j.ajog.2017.04.017

Cited by 29 publications

(39 citation statements)

References 10 publications

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“…A handful of studies in urogynecology have evaluated the efficacy of various interventions at increasing surgical preparedness with limited results. Similar to our study, preparedness was measured in these studies using a single question on 71.1 vs usual care: 68.8%, p = 0.79) [6]. A randomized trial comparing a peer-centered (n = 32) versus a standard physician-centered (n = 30) preoperative counseling video for patients undergoing midurethral sling placement also found no differences in preparedness between groups (peercentered group: 75 vs physician-centered group: 73%, p = 1.00) [7].…”

Section: Discussionsupporting

confidence: 74%

“…Similar to our study, preparedness was measured in these studies using a single question on the PPQ. A randomized trial comparing a preoperative educational video as an adjunct to usual care ( n = 52) versus usual care alone ( n = 48) for patients undergoing a sacrocolpopexy found similar rates of preparedness in the two groups (video: 71.1 vs usual care: 68.8%, p = 0.79) [ 6 ]. A randomized trial comparing a peer-centered ( n = 32) versus a standard physician-centered ( n = 30) preoperative counseling video for patients undergoing midurethral sling placement also found no differences in preparedness between groups (peer-centered group: 75 vs physician-centered group: 73%, p = 1.00) [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The PPQ is an 11-item questionnaire developed by Kenton et al [4]. Although not validated, this survey has been used in several urogynecological studies assessing surgical preparedness with the same cutoff score for question 11 [6][7][8]. Currently, there are no validated measures to assess surgical preparedness in urogynecology.…”

Section: Methodsmentioning

confidence: 99%

“…Despite improved outcomes among women with increased surgical preparedness, most interventions to increase surgical preparedness have not been successful including video education prior to surgery, peer-centered counseling, or peer support groups [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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A telehealth intervention to increase patient preparedness for surgery: a randomized trial

Halder

White

Brown³

et al. 2021

Int Urogynecol J

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Introduction and hypothesis Methods to increase surgical preparedness in urogynecology are lacking. Our objective was to evaluate the impact of a preoperative provider-initiated telehealth call on surgical preparedness. Methods This was a multicenter randomized controlled trial. Women undergoing surgery for pelvic organ prolapse and/or stress urinary incontinence were randomized to either a telehealth call 3 (± 2) days before surgery plus usual preoperative counseling versus usual preoperative counseling alone. Our primary outcome was surgical preparedness, as measured by the Preoperative Prepardeness Questionnaire. The Modified Surgical Pain Scale, Pelvic Floor Distress Inventory-20, Patient Global Impressions of Improvement, Patient Global Impressions of Severity, Satisfaction with Decision Scale, Decision Regret Scale, and Clavien-Dindo scores were obtained at 4-8 weeks postoperatively and comparisons were made between groups. Results Mean telehealth call time was 11.1 ± 4.11 min. Women who received a preoperative telehealth call (n = 63) were significantly more prepared for surgery than those who received usual preoperative counseling alone (n = 69); 82.5 vs 59.4%, p < 0.01). A preoperative telehealth call was associated with greater understanding of surgical alternatives (77.8 vs 59.4%, p = 0.03), complications (69.8 vs 47.8%, p = 0.01), hospital-based catheter care (54 vs 34.8%, p = 0.04) and patient perception that nurses and doctors had spent enough time preparing them for their upcoming surgery (84.1 vs 60.9%, p < 0.01). At 4-8 weeks, no differences in postoperative and patient reported outcomes were observed between groups (all p > 0.05). Conclusions A short preoperative telehealth call improves patient preparedness for urogynecological surgery.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A telehealth intervention to increase patient preparedness for surgery: a randomized trial

Halder

White

Brown³

et al. 2021

Int Urogynecol J

View full text Add to dashboard Cite

show abstract

“…Across studies, evidence suggests that patient characteristics, such as anxiety (Guo, 2014; Lucas, Cox, Perry, & Bridges, 2013; Pereira, Figueiredo‐Braga, & Carvalho, 2016), health literacy (De Oliveira, McCarthy, Wolf, & Holl, 2015; Lin et al, 2014; Ortiz, Wang, Elayda, & Tolpin, 2015), surgical risk (Govender, Spurrett, & Biccard, 2015; Grocott, 2010; Levett, Edwards, Grocott, & Mythen, 2016), and type of surgery (Burkle et al, 2014; Ortiz et al, 2015), influence patient readiness, which in turn can influence surgical outcomes. Related surgical outcomes with a patient focus include perception of pain, postoperative analgesic consumption (Ali et al, 2014; Angioli et al, 2014; Wilson et al, 2015), patient experience or satisfaction (Greene et al, 2017; Guo, 2014), and complications (Ali et al, 2014; De Oliveira et al, 2015; Wilson et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

The mediating role of pre‐operative patient readiness on surgical outcomes: A structural equation model analysis

Torres

Relf

Tuazon

2020

Journal of Advanced Nursing

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Aims:To determine the mediating role of surgical readiness on patient characteristics (surgical risk, type of surgery, pre-operative anxiety, and health literacy) and its influence on surgical outcomes (pain, postoperative complications, and surgical experience).Design: Correlational, theory testing using structural equation modelling. Methods:A total of 376 consecutively selected surgical patients from four tertiary hospitals were recruited and followed-up 48-72 hr postoperatively from May-October 2017. Consenting respondents answered questionnaires measuring basic surgical information, health literacy, anxiety, surgical readiness, pain score, and surgical experience. Further, records review was conducted to identify occurrence of any postoperative complications and use of additional analgesics. Results:A good fit and parsimonious model (χ 2 /df = 0.75, RMSEA = 0.00, GFI = 0.99, CFI = 1.00, PNFI = 0.50) highlighted the mediating effect of pre-operative readiness between patient characteristics and surgical outcomes. The type of surgery (curative) influenced patient readiness, surgical complications, and use of additional postoperative analgesics. Higher health literacy negatively influenced patient readiness; can decrease the use of postoperative analgesics; and lessen postoperative pain. Further, pre-operative anxiety decreased patient readiness and increased postoperative pain and negatively influenced the surgical experience. Conclusion:Patient readiness is beyond the physiological aspect of pre-operative preparation and it is influenced primarily by the mental and emotional state of a patient. Addressing issues such as anxiety and health literacy can improve pre-operative readiness that can enhance pain management and surgical experience. Hence, the mediating role of readiness in improving surgical outcomes emphasizes the need to deliver a patient-centred and individualized approach to patient preparation with a key focus on their readiness for surgery. Impact:This study demonstrates the difference between preparing patients and promoting readiness for surgery. Surgical readiness requires patient-centred approach in promoting a more engaged and confident patient who is capable to use appropriate health information and how it can lead to better surgical outcomes.

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Systematic Review of Preoperative Patient Readiness

Torres¹,

Fernandez²,

Ledbetter³

et al. 2021

AORN Journal

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Preoperative readiness indicates the patient’s capacity to process information, consider possible outcomes, and decide to undergo a surgical procedure. This systematic review examines how the term “patient readiness” is used in the literature and synthesizes how preoperative interventions address readiness. A medical librarian searched five electronic databases to identify articles published between July 1, 2008, and June 30, 2019, that address studies including adult patients scheduled for surgery who participated in programs designed to foster readiness or studies that explored surgical readiness. After extracting 28 studies, the authors assessed the articles for quality and thematically synthesized them to describe actions and indicators of patient readiness according to the Perioperative Patient Focused Model. Readiness can positively influence surgical outcomes (eg, pain, satisfaction); however, there is a paucity of high‐level, quality evidence that discusses surgical readiness for perioperative care. Nurses should use the information in this review to improve patient‐centered preoperative care.

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Evaluation of patient preparedness for surgery: a randomized controlled trial

Cited by 29 publications

References 10 publications

A telehealth intervention to increase patient preparedness for surgery: a randomized trial

A telehealth intervention to increase patient preparedness for surgery: a randomized trial

The mediating role of pre‐operative patient readiness on surgical outcomes: A structural equation model analysis

Systematic Review of Preoperative Patient Readiness

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