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Vol 9, No 2 (2007)
Published online: 2007-06-27

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The influence of multimedia patient education on the postoperative course after surgical hernioplasty

Stanisław Pierściński, Jakub Szmytkowski, Stanisław Dąbrowiecki
Chirurgia Polska 2007;9(2):85-91.

Abstract

Background: Patients undergoing surgical treatment under hospital conditions often experience anxiety and uneasiness resulting from their hospital stay, condition and expected postoperative pain. The patients often fail to understand the information they receive on their diagnosis, prognosis and therapy. The above-mentioned undesirable conditions may manifest themselves as, for example, a lowered pain threshold. Education should be the primary tool of reducing the patients’ anxiety towards an upcoming operation. The current standards of medicinal practice rely on conversation while digitally stored multimedia presentations are a new form of patient education.
Material and methods: The course of treatment of a 72-year-old male patient with inguinal hernia was digitally recorded. The surgeon-patient conversations covered the nature of the condition, indications for and methods of surgical repair, possible complications, the course of hospital stay and postoperative recommendations. Subsequent scenes of the film showed the patient being admitted to the Department of Surgery, preparations for surgery, transfer to the operating theater, the postoperative course, including early ambulation, and discharge on the 1st postoperative day. In this paper, the postoperative course in two randomized groups of patients was compared: one group consisted of patients who had undergone traditional preoperative education by medical personnel; in the other group the above-mentioned computer presentation served as the information source. The study subjects were 31 patients undergoing elective surgery for primary uncomplicated unilateral inguinal hernia at the Dept. of General and Endocrine Surgery of the Nicolaus Copernicus University College of Medicine between March 2002 and June 2003. In all of the patients Lichtenstein’s repair was performed under local anesthesia. The following parameters were recorded: pain intensity (VSP, visual pain scale), duration of hospital stay and the number of tramadol tablets required for postoperative pain control.
Results: The postoperative course was similar in both groups. The patients educated by digital means reported lower pain intensity at each assessed interval. The number of tramadol tablets used was similar in both groups. In both cases, statistical analysis showed no significant difference between the two groups.
Conclusions: Our study and a review of the available reports indicate that patient education is a complex problem. Proper education meets the patients’ needs and increases satisfaction with the outcome. However, even when patients are more aware and less anxious after a proper preoperative education, their suffering of pain is similar, and their treatment is neither cheaper nor shorter. Thus far, the attempts to use modern educational means have not increased the effectiveness of patient education and they remain to be perfected.

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Chirurgia Polska (Polish Surgery)