Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD; Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.
Department of Orthopaedic Surgery, Georgetown Public Hospital, Georgetown, Guyana.
J Arthroplasty. 2020 Sep;35(9):2410-2417. doi: 10.1016/j.arth.2020.04.084. Epub 2020 May 1.
Patient knowledge about arthritis and risks, benefits, and outcomes of joint arthroplasty in developing countries is unknown. We evaluated the effectiveness of a preoperative class on improving knowledge and decreasing anxiety during a surgical mission trip offering total joint arthroplasty.
A team of US health care providers taught a preoperative class to 41 patients selected for total joint arthroplasty during a surgical mission trip to Guyana. Participants completed a 32-point survey about arthritis; indications, risks, and benefits of joint arthroplasty; and postoperative, in-patient rehabilitation expectations. The State-Trait Anxiety Inventory was used to measure participant anxiety. Participants completed identical surveys before and after class. Matched-pairs Student t tests were used to compare means between preclass and postclass surveys. Significance was accepted at P < .05.
Seventy-eight percent of patients (31 of 41) scored less than 12 of 32 possible points (40%) on the preclass knowledge questionnaire. Mean ± standard deviation knowledge scores improved from 14.0 ± 4.5 before the class to 16.5 ± 6.5 after the class (P = .008). Anxiety scores (n = 33) improved from 35 ± 13 before the class to 33 ± 12 after the class (P = .047).
On this surgical mission trip, underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class. Greater understanding of how to educate patients and reduce their anxiety on medical missions is needed.
在发展中国家，患者对关节炎以及关节置换术的风险、益处和结果的了解情况尚不清楚。我们评估了在提供关节置换手术的外科任务旅行中，术前课程对提高知识和降低焦虑的效果。
一组美国医疗保健提供者向在圭亚那进行的外科任务旅行中选择的 41 名接受全关节置换术的患者教授了术前课程。参与者完成了一份关于关节炎的 32 分调查问卷；关节置换术的适应证、风险和益处；以及术后、住院康复的期望。使用状态-特质焦虑量表来衡量参与者的焦虑程度。参与者在课前和课后完成了相同的调查。采用配对学生 t 检验比较课前和课后调查的平均值。P 值小于.05 为差异有统计学意义。
78%的患者（41 名中的 31 名）在课前知识问卷中得分为 32 分中的 12 分以下（40%）。课前的平均知识得分为 14.0 ± 4.5，课后的平均知识得分为 16.5 ± 6.5（P =.008）。焦虑评分（n=33）从课前的 35 ± 13 降至课后的 33 ± 12（P =.047）。
在这次外科任务旅行中，接受服务不足的患者在参加术前课程后，对全关节置换术的了解仅略有增加。需要进一步了解如何在医疗任务中教育患者并减轻他们的焦虑。
