基于结构化检查表的术前咨询与标准咨询对择期手术后患者报告结局的影响。
Impact of structured checklist-based preoperative counseling versus standard counseling on postoperative patient-reported outcomes after elective surgery.
机构信息
Orthopedic Surgery Department, Faculty of Medicine, Mutah University, Al-Karak, Jordan.
Orthopedic Department, Jordan University Hospital, P.O. Box: (13046), Amman, 11942, Jordan.
出版信息
BMC Health Serv Res. 2024 Nov 14;24(1):1405. doi: 10.1186/s12913-024-11916-x.
INTRODUCTION
Surgery, even on an elective-basis, often induces significant stress in patients, characterized by preoperative anxiety and heightened stress levels due to anticipation of the unknown. However, the primary objective of preoperative counseling is to mitigate these concerns, particularly when delivered in a structured and comprehensive manner. While previous research has highlighted the beneficial impact of preoperative counseling on patient-reported outcomes, none have specifically explored the implementation of a structured checklist-based approach during counseling sessions. To bridge this gap in the literature, our study aims to investigate the effects of implementing a checklist-based structured counseling approach on patient-reported outcomes following elective surgery.
METHODS
In this prospective cohort study conducted over one year from January to December 2023, a total of 600 patients undergoing elective surgery across three specialties-orthopedic surgery, general surgery, and urology-were examined. The patients were divided into two groups: an intervention group consisting of 300 patients and a control group with an equal number of patients. The study evaluated three key outcomes-postoperative pain, anxiety, and satisfaction-at three specific time points following surgery: 24 h, 48 h, and 72 h.
RESULTS
Patients receiving structured checklist counseling showed significantly lower pain scores (24 h: 6.6 vs. 7.03, p = 0.041; 48 h: 5.62 vs. 6.55, p = 0.029; 72 h: 2.54 vs. 2.90, p = 0.035) and anxiety scores (24 h: 8.58 vs. 9.25, p = 0.039; 48 h: 7.50 vs. 8.45, p = 0.030; 72 h: 4.53 vs. 5.98, p = 0.031), as well as higher satisfaction scores (24 h: 5.99 vs. 5.06, p = 0.043; 48 h: 6.99 vs. 6.02, p = 0.033; 72 h: 9.10 vs. 8.20, p = 0.039) compared to controls. These improvements were consistently significant across all three surgical specialties studied (p < 0.05).
CONCLUSION
The structured checklist-based counseling method proves to be effective and essential. This method is associated with reduced postoperative pain and anxiety levels, along with increased patient satisfaction, when compared to the standard approach.
LEVEL OF EVIDENCE
Prospective non-randomized study, Level II.
简介
手术，即使是择期手术，也常常会给患者带来显著的压力，表现为术前焦虑和对未知的预期导致应激水平升高。然而，术前咨询的主要目的是减轻这些担忧，特别是当以结构化和全面的方式提供时。尽管先前的研究已经强调了术前咨询对患者报告结果的有益影响，但没有一项研究专门探讨了在咨询过程中实施基于结构化检查表的方法。为了弥补这一文献空白，我们的研究旨在调查在择期手术后实施基于检查表的结构化咨询方法对患者报告结果的影响。
方法
在这项从 2023 年 1 月到 12 月进行的为期一年的前瞻性队列研究中，我们检查了在三个专业领域（骨科、普通外科和泌尿科）接受择期手术的总共 600 名患者。患者被分为两组：干预组 300 名患者，对照组 300 名患者。该研究评估了术后三个特定时间点的三个关键结果-术后疼痛、焦虑和满意度：24 小时、48 小时和 72 小时。
结果
接受结构化检查表咨询的患者疼痛评分显著降低（24 小时：6.6 与 7.03，p=0.041；48 小时：5.62 与 6.55，p=0.029；72 小时：2.54 与 2.90，p=0.035）和焦虑评分（24 小时：8.58 与 9.25，p=0.039；48 小时：7.50 与 8.45，p=0.030；72 小时：4.53 与 5.98，p=0.031），同时满意度评分更高（24 小时：5.99 与 5.06，p=0.043；48 小时：6.99 与 6.02，p=0.033；72 小时：9.10 与 8.20，p=0.039）与对照组相比。这些改善在所有三个研究的外科专业中均一致显著（p<0.05）。
结论
基于结构化检查表的咨询方法被证明是有效和必要的。与标准方法相比，这种方法与术后疼痛和焦虑水平降低以及患者满意度提高相关。
证据水平
前瞻性非随机研究，二级。
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