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多媒体支持改善术前患者教育:以根治性前列腺切除术为例的随机对照试验。

Multimedia support for improving preoperative patient education: a randomized controlled trial using the example of radical prostatectomy.

机构信息

Department of Urology, University of Heidelberg, Heidelberg, Germany.

出版信息

Ann Surg Oncol. 2013 Jan;20(1):15-23. doi: 10.1245/s10434-012-2536-7. Epub 2012 Aug 1.

Abstract

BACKGROUND

Growing evidence supports the use of multimedia presentations for informing patients. Therefore, we supported preoperative education by adding a multimedia tool and examined the effects in a randomized controlled trial.

METHODS

We randomized German-speaking patients scheduled for radical prostatectomy at our center to receive either a multimedia-supported (MME) or a standard education (SE). Outcomes were measured in a structured interview. Primary outcome was patient satisfaction. In addition, we applied validated instruments to determine anxiety and measures of decision-making. Results were given by mean and standard deviation. For comparison of groups we used t test and chi-square test. For an explorative analysis we applied multivariate logistic regression.

RESULTS

We randomized 203 patients to receive MME (n=102) or SE (n=101). Complete satisfaction with preoperative education was more frequent in the MME group (69 vs 52%, p=.016) and patients after MME reported more questions (5.7 vs 4.2, p=.018). There was no difference concerning the duration of talks and the number of recalled risks. However, perceived knowledge was higher after MME (1.3 vs 1.6, p=.037). Anxiety and measures of decision-making were comparable. Patients judged the multimedia tool very positive, and 74% of the MME group thought that their preoperative education had been superior to SE.

CONCLUSIONS

Multimedia support should be considered worthwhile for improving the informed consent process before surgery (www.germanctr.de; DRKS00000096).

摘要

背景

越来越多的证据支持使用多媒体演示来为患者提供信息。因此,我们通过添加多媒体工具来支持术前教育,并在一项随机对照试验中检验了其效果。

方法

我们将在我们中心接受根治性前列腺切除术的德语患者随机分为接受多媒体支持(MME)或标准教育(SE)的两组。通过结构化访谈来测量结果。主要结果是患者满意度。此外,我们应用了经过验证的工具来确定焦虑和决策措施。结果以平均值和标准差表示。为了比较两组,我们使用了 t 检验和卡方检验。对于探索性分析,我们应用了多变量逻辑回归。

结果

我们随机分配了 203 名患者接受 MME(n=102)或 SE(n=101)。接受 MME 的患者对术前教育的满意度更高(69%比 52%,p=.016),并且接受 MME 的患者报告了更多的问题(5.7 比 4.2,p=.018)。然而,谈话时间和回忆的风险数量没有差异。但是,接受 MME 的患者认为自己的知识水平更高(1.3 比 1.6,p=.037)。焦虑和决策措施相当。患者对多媒体工具的评价非常积极,74%的 MME 组认为他们的术前教育优于 SE。

结论

多媒体支持应该被认为是改善手术前知情同意过程的有价值的方法(www.germanctr.de;DRKS00000096)。

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