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Preoperative patient education in vascular surgery
Isabel C Cohen1, Samantha Watson1, Patrick Sweeney2
1Department of Surgery, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Suite 650, Chicago, IL 60611, United States.
Abstract:
This is a systematic review and meta-analysis of preoperative patient education interventions used in vascular surgery and their impact on patient knowledge. Embase, PubMed, and Ovid were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. For inclusion, studies involved an educational intervention for a vascular surgery procedure and patient knowledge was an outcome. Using mean knowledge scores (defined as the percentage of correct responses on knowledge assessments) pre and post education intervention for experimental groups, a forest plot with standardized mean difference (SMD) was generated. Subgroup analyses were performed for abdominal aortic aneurysm (AAA) repair and decision aids. Six studies (654 patients) met inclusion criteria (five randomized controlled trials, one prospective cohort study). Procedures included AAA repair, femoral-popliteal artery bypass, carotid surgery, and endovenous thermal vein ablation. Education interventions included informed consent discussions, decision aids, virtual reality displays, and videos. The pooled SMD was 0.64 (95% confidence interval [CI], 0.48-0.79), suggesting a significant positive effect of education interventions on patient knowledge. For AAA repair and decision aid subgroups (four papers each), the SMD was 0.58 (95% CI, 0.42-0.75) and 0.62 (95% CI, 0.45-0.79), respectively. Preoperative patient education enhances understanding of vascular surgery procedures. Developing procedure-specific and patient-oriented education interventions will help address knowledge gaps among patients with vascular disease.
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