Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial

Abstract

BackgroundObtaining informed consent is an essential step in the surgical pathway. Providing adequate patient education to enable informed decision making is a continued challenge of contemporary surgical practice. This study investigates whether the use of a patient information website, to augment patient education and informed consent for elective orthopaedic procedures is an effective measure.MethodsA randomised controlled trial was conducted comparing the quality of informed consent provided by a standard discussion with the treating surgeon compared to augmentation of this discussion with an online education resource (www.orthoanswer.org). Participants were recruited from orthopaedic outpatient clinics. Patients undergoing five common orthopaedic procedures were eligible to participate in the trial. The primary outcome measure was knowledge about their operation. Satisfaction with their informed consent and anxiety relating to their operation were the secondary outcome measures.ResultsThere was a statistically significant increase in patient knowledge for the intervention arm as compared to the control arm (p < 0.01). Patients in the intervention arm, had an average score of 69.25% (SD 14.91) correct answers as compared to 47.38% (SD 17.77) in the control arm. Satisfaction was also improved in the intervention arm (p = 0.043). There was no statistically significant difference between the control and intervention arm relating to their anxiety scores (p = 0.195).ConclusionsThe use of a patient education website as an augment to informed consent improves patient knowledge about their planned operation as well as satisfaction with the consent process whilst not increasing their anxiety levels. We recommend that all patients be directed to web based education tools to augment their consent.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614001058662.

Informação Como Instrumento Da Assistência Ao Paciente Submetido a Cirurgia Ortopédica

“…Várias informações fundamentais relacionadas ao período pré-operatório não foram citadas pelos indivíduos pesquisados, tais como: informações sobre tipo e tempo de manutenção da prótese; risco da cirurgia e possíveis complicações; restrições e limitações relacionadas à cirurgia; consentimento para a cirurgia; problemas e intervenções relacionados com ansiedade, medo, distúrbios do sono; estímulo ao autocuidado dentro das limitações do paciente; cuidados gerais de Enfermagem e de prevenção da síndrome do desuso; medicamentos específicos para problemas identificados e alterações de esquemas terapêuticos cotidianos; realização de exames laboratoriais e por imagem; avaliação pré-operatória pelo enfermeiro do Centro Cirúrgico (6,(13)(14)(15)(16)(17)(18)(19)(20) .…”

“…Além desses, também foram omitidos: riscos relacionados à anestesia; informações sobre o protocolo de cirurgia segura; necessidade de suporte social; cuidados e restrições durante a recuperação pós-anestésica e após o retorno à unidade de internação; limitações no pós-operatório hospitalar e após a alta; cuidados após a alta; adaptações e modificações da residência; presença e controle da dor pré e pós-operatória; necessidade de transfusão de sangue; evolução e tratamento das comorbidades; necessidade de ser encaminhado à Unidade de Terapia Intensiva no pós-operatório; e, medicamentos pré-anestésicos e encaminhamento ao Centro Cirúrgico (6,(13)(14)(15)(16)(17)(18)(19)(20) .…”

Empowering knowledge and Quality of Recovery after hip or knee replacement

“…Positive effects have been found in the level of knowledge and independency on activities in daily living, and patients' also experienced fewer problems (Demir & Erdil 2013), and shorter hospital stays (Yoon et al 2010). Some interventions had both positive and negative outcomes, such as improving patients' knowledge but with no difference in anxiety levels (Fraval et al 2015, Heikkinen et al 2012a, Heikkinen et al 2012b). In another study, patients were better prepared for surgery and to control postoperative pain, but no differences in factors such as length of hospital stay, level of pain or complication rate were found (Kearney et al 2011).…”

Digital vs face‐to‐face information provision in patient counselling for prenatal screening: A noninferiority randomized controlled trial

“…There is yet another evolving area of innovation, which is the use of interactive electronic media to facilitate teaching and learning . Better educated patients tend to be healthier, and e‐learning contributes to increased knowledge, improves satisfaction with the consent process and consultation, and is shown to be effective in improving both physical and mental health outcomes . It is unknown whether digital information provision (instructional video with or without interactivity) can be as satisfying as information provided face to face in prenatal counselling during screening for prenatal testing.…”