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基于网络的膝关节镜检查前教育可增强患者的知情同意和知识记忆:一项前瞻性、随机对照研究。

Web-Based Education Prior to Knee Arthroscopy Enhances Informed Consent and Patient Knowledge Recall: A Prospective, Randomized Controlled Study.

机构信息

1325 North Rose Drive, Suite 100, Placentia, CA 92870.

Kerlan Jobe Orthopedic Clinic, 6801 Park Terrace, Suite 500, Los Angeles, CA 90045.

出版信息

J Bone Joint Surg Am. 2015 Jun 17;97(12):964-71. doi: 10.2106/JBJS.N.01174.

Abstract

BACKGROUND

Preoperative patient education is an important part of the informed consent process, and a perceived lack of information can lower patient satisfaction. We sought to evaluate the effect of a web-based multimedia patient education tool on the perioperative experience of patients undergoing first-time knee arthroscopy for a meniscal tear.

METHODS

Adult patients undergoing knee arthroscopy for the first time for a primary diagnosis of a meniscal tear were consecutively enrolled into the study from January 2014 through June 2014. Patients were equally randomized to a control group, who received standard preoperative counseling, or the intervention group, who completed a twenty-minute web-based multimedia tutorial in addition to standard counseling. The web-based tutorial covered relevant anatomy, pathology, and general perioperative instructions, and it was completed prior to the preoperative visit. Patients completed surveys that evaluated their preparedness for surgery and knowledge recall at the preoperative visit, on the day of surgery, and after the first postoperative visit.

RESULTS

Sixty-four patients were enrolled, and fifty-five patients (86%; twenty-nine in the control group and twenty-six in the intervention group) with complete data sets were included in the analysis. Preoperatively, the intervention group felt significantly more informed about the surgery and more clearly understood the risks and benefits of, and alternatives to, the surgery (all p < 0.001). Postoperatively, the intervention group reported being significantly more satisfied with the perioperative education that they had received and felt more informed about their surgery and rehabilitation (p ≤ 0.05). Patients in the intervention group were significantly more likely to correctly answer questions regarding their surgical details at the first postoperative visit (p ≤ 0.03).

CONCLUSIONS

Patients who completed the web-based tutorial had improved preoperative knowledge and preparedness as well as enhanced postoperative knowledge recall regarding their surgical procedure. The tutorial received high user satisfaction scores with low user burden scores and was an effective tool for enhancing the patients' perioperative experience.

摘要

背景

术前患者教育是知情同意过程的重要组成部分,而患者感知到的信息不足可能会降低其满意度。我们旨在评估基于网络的多媒体患者教育工具对初次接受膝关节镜半月板撕裂手术患者围手术期体验的影响。

方法

2014 年 1 月至 6 月,连续纳入初次接受膝关节镜半月板撕裂手术的成年患者参与本研究。患者被随机分为对照组(接受标准术前咨询)和干预组(在标准咨询的基础上完成 20 分钟的基于网络的多媒体教程)。该基于网络的教程涵盖了相关的解剖学、病理学和一般围手术期说明,并在术前就诊前完成。患者在术前就诊时、手术当天和首次术后就诊时完成了评估其手术准备情况和知识回忆的调查问卷。

结果

共纳入 64 例患者,其中 55 例(86%;对照组 29 例,干预组 26 例)完成了完整数据集的分析。术前,干预组患者对手术的了解程度显著更高,对手术的风险、收益和替代方案的理解也更清晰(均 p < 0.001)。术后,干预组患者报告称,他们对所接受的围手术期教育的满意度显著更高,对手术和康复的了解也更深入(p ≤ 0.05)。干预组患者在首次术后就诊时正确回答手术细节相关问题的可能性显著更高(p ≤ 0.03)。

结论

完成基于网络的教程的患者术前知识和准备情况得到了改善,对手术过程的术后知识回忆也得到了增强。该教程获得了较高的用户满意度评分和较低的用户负担评分,是增强患者围手术期体验的有效工具。

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