Neubauer Paul D, Tabaee Abtin, Schwam Zachary G, Francis Fayanne K, Manes R Peter
Section of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, CT.
Department of Otolaryngology, New York Presbyterian Hospital - Weill Cornell Medical College, New York, NY.
Int Forum Allergy Rhinol. 2016 Sep;6(9):921-5. doi: 10.1002/alr.21763. Epub 2016 Mar 30.
The potential for patient misconceptions about endoscopic sinus surgery (ESS) has implications for the informed consent process. An understanding of patients' baseline knowledge and sources of information regarding ESS would improve surgeons' ability to counsel patients preoperatively and provide effective educational materials.
A prospective patient survey was performed at 2 independent tertiary care medical centers. Patients who were offered ESS as part of routine rhinology care were queried about expectations, knowledge, and sources of information regarding ESS before preoperative counseling.
Of the 30 patients who completed the survey, 70% of patients reported doing research on ESS before the visit. The most common sources of information were friends and family (40%), YouTube (30.0%), and WebMD (26.7%). The most important factors researched included risks (95%), benefits (85%), and recovery related issues (70%). Patients in the younger group used healthcare and physician rating websites whereas none of the patients older than the median age of 44 years reported using them (33.3% vs 0%, p = 0.028). The older group more often relied upon healthcare providers than the younger group (71.5% vs 18.8%, p = 0.011). A range of responses were noted regarding early postoperative symptoms and recovery time.
This study identified a varied understanding of ESS including significant misconceptions about risks, anesthesia, and need for ongoing therapy, among others. Patients obtain their information from a variety of sources including peers, other doctors, and the Internet. Awareness of the gaps in patient knowledge and the sources of information will improve preoperative counseling.
患者对鼻内镜鼻窦手术(ESS)可能存在误解,这会影响知情同意过程。了解患者关于ESS的基线知识和信息来源,将提高外科医生术前为患者提供咨询以及提供有效教育材料的能力。
在2个独立的三级医疗中心进行了一项前瞻性患者调查。对作为常规鼻科护理一部分而接受ESS的患者,在术前咨询前询问他们对ESS的期望、知识和信息来源。
在完成调查的30名患者中,70%的患者报告在就诊前对ESS进行了研究。最常见的信息来源是朋友和家人(40%)、YouTube(30.0%)和WebMD(26.7%)。研究的最重要因素包括风险(95%)、益处(85%)和恢复相关问题(70%)。较年轻组的患者使用医疗保健和医生评级网站,而年龄大于中位数44岁的患者中无人报告使用过这些网站(33.3%对0%,p = 0.028)。较年长组比年轻组更常依赖医疗保健提供者(71.5%对18.8%,p = 0.011)。关于术后早期症状和恢复时间,有一系列不同的回答。
本研究发现患者对ESS的理解各不相同,包括对风险、麻醉和持续治疗需求等存在重大误解。患者从包括同龄人、其他医生和互联网在内的多种来源获取信息。意识到患者知识方面的差距和信息来源,将改善术前咨询。