Department of Peri-operative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
School of Health Sciences, University of Southampton, Southampton, UK.
Anaesthesia. 2021 Sep;76(9):1207-1211. doi: 10.1111/anae.15393. Epub 2021 Feb 3.
Group pre-operative education has usually been limited to conditioning expectations and providing education. Prehabilitation has highlighted modifiable lifestyle factors that are amenable to change and may improve clinical outcomes. We instituted a pre-operative 'Fit-4-Surgery School' for patients scheduled for major surgery, to educate and promote healthy behaviour. We evaluated patients' views having attended the school, and after surgery we asked how it had changed their behaviour with a lifestyle questionnaire. The school was launched in May 2016 and was attended by 586/1017 (58%) of invited patients. Patients who did not attend: lived further away, median (IQR [range]) 8 (4-19 [0-123]) miles vs. 5 (3-14 [0-172]) miles, p < 0.001; and were more deprived, Index of Multiple Deprivation Rank decile median (IQR [range]), 6 (4-8 [1-10]) vs. 7 (4-9 [1-10]), p = 0.04. Of the 492/586 (84%) participants who completed an evaluation questionnaire, 462 (94%) would recommend the school to a friend having surgery and 296 (60%) planned lifestyle changes. After surgery, 232/586 (40%) completed a behavioural change questionnaire, 106 (46%) of whom reported changing at least one lifestyle factor, most commonly by increasing exercise. The pre-operative school was acceptable to patients.
术前团体教育通常仅限于调整预期和提供教育。术前康复强调了可改变的生活方式因素，这些因素可以改变，可能改善临床结果。我们为计划接受大手术的患者设立了一个术前“适合手术的学校”，以教育和促进健康行为。我们评估了参加学校的患者的观点，手术后我们用生活方式问卷询问它如何改变了他们的行为。该学校于 2016 年 5 月推出，邀请了 1017 名患者中的 586 名（58%）参加。未参加的患者：居住得更远，中位数（IQR[范围]）为 8（4-19[0-123]）英里与 5（3-14[0-172]）英里，p<0.001；而且更贫困，多因素剥夺指数排名中位数（IQR[范围]）为 6（4-8[1-10]）与 7（4-9[1-10]），p=0.04。在 586 名参加评估问卷调查的 492 名患者中，462 名（94%）会向即将接受手术的朋友推荐该学校，296 名（60%）计划改变生活方式。手术后，586 名患者中有 232 名（40%）完成了行为改变问卷调查，其中 106 名（46%）报告至少改变了一个生活方式因素，最常见的是增加锻炼。术前学校受到患者的欢迎。
