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Enhanced Consent and Preparedness for Surgery: A Randomized Controlled Trial.

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An audiovisual decision aid (AVDA) for urogynecologic surgery did not improve patient preparedness, regardless of health literacy. Preparedness remained high in both the AVDA and standard consent groups.

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Area of Science:

  • Urogynecology
  • Medical Education
  • Patient Communication

Background:

  • Previous patient decision aids in urogynecology showed no benefit, potentially due to high reading levels.
  • Effective patient communication is crucial for surgical preparedness and satisfaction.

Purpose of the Study:

  • To evaluate if an audiovisual decision aid (AVDA) below an eighth-grade reading level impacts surgical preparedness in urogynecology patients.
  • To assess the correlation between health literacy and preparedness.
  • To measure patient satisfaction with surgical decisions.

Main Methods:

  • A randomized controlled trial compared AVDA use with standard informed consent for pelvic organ prolapse or urinary incontinence surgeries.
  • Preparedness was measured using the "Preoperative Preparedness For Surgery" questionnaire.
  • Health literacy and postoperative satisfaction were also assessed.

Main Results:

  • No significant difference in surgical preparedness was found between the AVDA and standard consent groups (98.7% prepared in both).
  • Preparedness remained high even for patients with low health literacy.
  • High satisfaction with surgical decisions was reported in both groups.

Conclusions:

  • An AVDA written at a lower reading level did not significantly enhance surgical preparedness in urogynecology patients.
  • High levels of preparedness and satisfaction were observed across both intervention and control groups.
  • Future decision aids may need different approaches to demonstrate significant benefits.