A comparison of two methods of delivering presurgical instructions.

A 2 x 2 factorial design was employed to test the effects on various indicators of postoperative recovery of surgical patients who had received preoperative instructions. A pamphlet and/or a nurse visit were used as delivery methods. The study population consisted of 50 patients who were scheduled for cholecystectomies. Patients were given information on the expected sequence of events on the day of surgery and instructions in postoperative self-care activities. Findings indicate that a differential effect of providing information was dependent on the patient's level of preoperative fear, with high-fear patients benefiting most from information. Patients in the high preoperative-fear group who received either the pamphlet or the pamphlet and a nurse visit had shorter postoperative hospitalizations, switched from injected to oral medication sooner, scored higher on an index of energy and movement, and rated their appetites as better when compared with patients in either the nurse-visit or control groups. However, among those who scored low in preoperative fear, patients in the control group had better recoveries from surgery than patients who received preoperative information. The study points out the need to perform an educational assessment of patients before information is provided.