Harvard Medical School, Boston, Massachusetts.
Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California.
Semin Thorac Cardiovasc Surg. 2022 Spring;34(1):363-372. doi: 10.1053/j.semtcvs.2021.03.003. Epub 2021 Mar 10.
We sought to develop and evaluate a personalized multimedia education (ME) tool for preoperative patient education to improve patient health knowledge, quality of life and satisfaction with care in thoracic surgery. The ME tool was developed and deployed in outpatient clinic during preoperative teaching for patients undergoing surgical resection for lung cancer for quality improvement. Patients were given an electronic survey prior to preoperative teaching and at initial postoperative visit to assess teaching effectiveness and care satisfaction. Sequential patients received either standard preoperative teaching or teaching using the ME tool. Pre- and postoperative survey responses were compared using independent sample paired t test and multivariable linear regression modeling for adjustment. The final ME tool was an iPad application that incorporated real-time annotations of 3-dimensional, interactive anatomic diagrams. The tool featured video tours of operations, and radiology image import for annotation by the surgeon. Forty-eight patients were included in this pilot study (standard education n = 26; ME, n = 22). ME patients had significantly higher satisfaction scores compared to SE patients with respect to length of education materials, clarity of content, supportiveness of content and willingness to recommend materials to others. There was no difference in length of clinic visit between groups. Both patient and provider input can be used to create an innovative electronic preoperative educational tool that prepares and empowers patients in shared decision-making before surgery. Improvements in health literacy and self-efficacy may be more difficult to achieve but remain important as multimedia teaching tools are further developed.
我们旨在开发和评估一种个性化多媒体教育（ME）工具，用于术前患者教育，以提高胸外科患者的健康知识、生活质量和对护理的满意度。该 ME 工具是在门诊期间为接受肺癌手术切除的患者开发和部署的，旨在进行质量改进。患者在术前教学前和术后首次就诊时接受电子调查，以评估教学效果和护理满意度。连续患者接受标准术前教学或使用 ME 工具进行教学。使用独立样本配对 t 检验和多变量线性回归模型进行调整，比较术前和术后调查的反应。最终的 ME 工具是一个 iPad 应用程序，其中包含实时注释的 3 维交互式解剖图。该工具具有手术视频游览功能，以及放射学图像导入功能，以供外科医生进行注释。这项试点研究纳入了 48 名患者（标准教育组 n=26；ME 组 n=22）。与标准教育组患者相比，ME 组患者对教育材料的长度、内容清晰度、内容支持性和愿意向他人推荐材料的满意度评分显著更高。两组的就诊时间长度没有差异。患者和提供者的反馈都可以用于创建一种创新的电子术前教育工具，在手术前为患者做好准备并增强其在共同决策中的能力。尽管多媒体教学工具进一步发展，但提高健康素养和自我效能感可能更加困难，但仍然很重要。
