Patient education outcomes in surgery: a systematic review from 2004 to 2010
Article first published online: 23 NOV 2012
© 2012 The Authors. International Journal of Evidence-Based Healthcare © 2012 The Joanna Briggs Institute
International Journal of Evidence-Based Healthcare
Volume 10, Issue 4, pages 309–323, December 2012
How to Cite
Ronco, M., Iona, L., Fabbro, C., Bulfone, G. and Palese, A. (2012), Patient education outcomes in surgery: a systematic review from 2004 to 2010. International Journal of Evidence-Based Healthcare, 10: 309–323. doi: 10.1111/j.1744-1609.2012.00286.x
- Issue published online: 23 NOV 2012
- Article first published online: 23 NOV 2012
- patient education;
- preoperative care;
- systematic review
Rationale and objectives In 2004, Johansson and colleagues, in their systematic review covering the years 1990–2003, documented education interventions and their effectiveness in the treatment of surgical patients. While they provide a review of the state of knowledge until 2003, recent trends in preoperative education and its effects on postoperative patients' outcomes have not been documented in a systematic review. The aim of this study was to describe preoperative educational interventions (including content and delivery time) and postoperative outcomes as considered in studies evaluating the effectiveness for patients undergoing major surgery published from 2004 to 2010.
Methods A systematic review of preoperative education and its effects on postoperative patient outcomes was undertaken. A search was conducted of the PubMed, CINAHL and EBMR databases, including the Cochrane Central Register of Controlled Trials. Randomised controlled trials, or at least clinical trials including pre-/post-test evaluations, with educational interventions performed by nurses preoperatively and outcomes evaluated postoperatively, and written in English, were included.
Results A total of 19 studies involving 3944 patients were retrieved. Of these, 12 were randomised controlled trials. Interventions were based on verbal education, on written/visual education, or both. The content of interventions varied widely. Frequent outcomes evaluated were anxiety, knowledge, pain and length of stay. Objective knowledge (what a patient retains from education) was the only positive outcome influenced by education.
Conclusions Current trends in preoperative education are: scheduling education early; increased frequency of message exposure through several interventions and/or reinforcements; content frequently addressing postoperative management; the measurement of outcomes such as patients' cognitive, experiential and biophysiological aspects. Both the clinical and research implications that emerged from the findings are discussed.