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Effect of preoperative education and ICU tour on patient and family satisfaction and anxiety in the intensive care unit after elective cardiac surgery: a randomised controlled trial
  1. Veronica Ka Wai Lai1,
  2. Ka Man Ho2,
  3. Wai Tat Wong1,
  4. Patricia Leung1,
  5. Charles David Gomersall1,
  6. Malcolm John Underwood3,
  7. Gavin Matthew Joynt1,
  8. Anna Lee1
  1. 1Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
  2. 2Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
  3. 3Division of Cardiothoracic Surgery, Department of Surgery, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
  1. Correspondence to Professor Anna Lee, Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong; annalee{at}cuhk.edu.hk

Abstract

Background Preoperative education may help participants to psychologically prepare themselves for surgery, but the outcomes of such preparation have rarely been assessed in patients requiring postoperative care in the intensive care unit (ICU) as well as in family members.

Objective To assess the effect of a preoperative multifaceted education intervention on patient and family satisfaction levels in the ICU and measures of perioperative patients’ anxiety and depression.

Trial design Single-centre, two-armed, parallel, superiority, randomised controlled trial. Healthcare professionals in ICU and outcome assessor were blinded to treatment allocation.

Participants 100 elective coronary artery bypass grafting±valve surgery patients and their family members.

Interventions Preoperative education comprising of a video and ICU tour in addition to standard care (treatment), versus standard care (control).

Outcomes Patient and family satisfaction levels with ICU using validated PS-ICU23 and FS-ICU24 questionnaires (0–100), respectively; change in perioperative anxiety and depression scores between 1 day presurgery and 3 days postsurgery.

Results Among 100 (50 treatment, 50 control) patients and 98 (49 treatment, 49 control) family members, 94 (48 treatment, 46 control) patients and 94 (47 treatment, 47 control) family members completed the trial. Preoperative education was associated with higher overall patient (mean difference (MD) 6.7, 95% CI 0.2 to 13.2) and family (MD 10.0, 95% CI 3.8 to 16.3) satisfaction scores. There was a weak association between preoperative education and a reduction in patient’s anxiety scores over time (MD −1.7, 95% CI −3.5 to 0.0). However, there was no evidence of a treatment effect on patient’s depression scores over time (MD −0.6, 95% CI −2.3 to 1.2).

Conclusion Providing comprehensive preoperative information about ICU to elective cardiac surgical patients improved patient and family satisfaction levels and may decrease patients’ anxiety levels.

Trial registration number ChiCTR-IOR-15006971.

  • critical care
  • patient education
  • patient satisfaction
  • surgery
  • randomised controlled trial

https://doi.org/10.1136/bmjqs-2019-010667

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    Footnotes

    • Contributors VKWL, KMH and AL conceived the study. VKWL and AL designed the study protocol, with input from PL, KMH, CDG, MJU and GMJ. VKWL, W-TW and PL collected the data. VKWL and AL analysed the data, with input from CDG, MJU and GMJ. VKWL and AL drafted the manuscript and made revisions following critical review by all authors. All authors approved the final version of the manuscript.

    • Funding This study was funded by the Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong (Internal funding).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CRE reference number 2015-308).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. The preoperative education video about postoperative care in the intensive care unit after cardiac surgery is available at: https://www.youtube.com/watch?v=WALZYNfDKWE.