Impact of a Preoperative Video-Based Educational Intervention on Postoperative Outcomes in Elective Major Abdominal Surg
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RESEARCH COMMUNICATION
Impact of a Preoperative Video-Based Educational Intervention on Postoperative Outcomes in Elective Major Abdominal Surgery: a Randomized Controlled Trial Sara Campagna 1 & Marco Clari 1 Alessandro Ferrero 2
&
Cristina Delfino 1 & Monica Rolfo 2 & Alessio Rizzo 2 & Paola Berchialla 3 &
Received: 26 March 2020 / Accepted: 25 May 2020 # 2020 The Society for Surgery of the Alimentary Tract
Introduction Preoperative education may prevent postoperative complications and improve patients’ well-being. Videos may be an effective form of standardized patient education,1 but no evidence is available for patients undergoing major abdominal surgery (MAS). This trial aimed to evaluate the impact of a preoperative, video-based educational intervention on postoperative outcomes in patients undergoing MAS.
Methods Adults scheduled for elective MAS were included, while those that underwent any surgery in the previous 6 months or involved in the ERAS program were excluded. All patients received an informative pamphlet during the pre-admission visit. Patients were randomized at hospital admission. At admission, the intervention group (IG) watched an educational video about the preoperative (e.g., ward structure, preparation for surgery), perioperative (e.g., operating theater setting, awakening), and postoperative period (e.g., devices used, potential complications) and had the opportunity to discuss any doubt arose from the video (n = 97). The control group (CG) received information during routine nursing care at bedside (n = 92). Primary outcomes were preoperative anxiety and * Marco Clari [email protected] 1
Department of Public Health and Pediatrics, University of Torino, via Santena 5 bis, 10126 Torino, Italy
2
Ordine Mauriziano Hospital, via Magellano 1, 10128 Torino, Italy
3
Department of Clinical and Biological Sciences, University of Torino, via Santena 5 bis, 10126 Torino, Italy
postoperative pain. Secondary outcomes were postoperative nausea, vomiting, timing of bowel movements, hospital stay, morbidity, mortality, and quality of life (QoL). Power analysis for primary outcome reduction showed that 78 patients per group were needed to yield a type I error of 5% and a statistical power of 80%. Mann-Whitney U test, chisquare test, or Fisher’s exact test was performed as appropriate for comparison. A generalized regression model was used to ascertain the interaction between groups and time regarding postoperative pain. The effect of the intervention on hospital stay was assessed using a linear regression model. Statistical significance was set at 0.05.
Results One-hundred sixty patients were included in the analyses (80 patients in each group). There were no baseline significant differences between groups. Patients were predominantly female (58.1%), with a mean age of 66.3. Surgery was due to gastrointestinal cancer (90%) and inflammatory bowel diseases (10%). Fifty-five percent of the IC had uppermesocolic surgery, and 52.5% of the CG lower-mesocolic surgery. Mean surgery duration was 28
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