The effect of preoperative education on patient and family satisfaction in cardiac surgery patients

Ph.D. ; Satisfaction with healthcare services is an important patient/family-centred outcome and is a marker for quality of care. Preoperative education in cardiac surgery patients aims to provide patients and their family members with a better understanding of the processes of postoperative care in the intensive care unit (ICU) but its effectiveness is not well understood. ; Four studies are presented in the thesis. In study 1, a systematic review was conducted to examine the effect of preoperative patient education on postoperative anxiety, depression and satisfaction. Five randomized controlled trials (RCTs) and one quasi-experimental study involving 794 participants, showed that preoperative education helped reduced patients’ postoperative anxiety levels (standardized mean difference = -0.52, 95% confidence interval: -0.98 to -0.06; p = 0.01; I2 = 88%, low quality of evidence) but not depression or other clinical outcomes. No RCTs measured patient or family satisfaction levels using valid and reliable instruments. ; In study 2, a two-arm, double-blinded randomized controlled trial (RCT) was conducted to investigate its effectiveness of a preoperative education (15-minute video and ICU tour) in improving patient and family ICU satisfaction and lower anxiety and depression. 94 patients (46 control and 48 intervention) and 94 family members completed the Patient Satisfaction in the Intensive Care Unit questionnaire (PS-ICU) and Family Satisfaction in the Intensive Care Unit questionnaire (FS-ICU) respectively, with scores ranging from 0 to 100; higher scores representing higher satisfaction. The intervention group had higher overall patient satisfaction levels (mean difference (MD) 6.6, 95% CI: 0.3 to 12.9, p = 0.04) and family satisfaction levels (MD 10.0, 95% CI: 3.8 to 16.3, p < 0.01) in the ICU than control group. The intervention may be associated with a reduction in patient’s anxiety (MD -1.7, 95% CI: -3.5 to 0.0, p = 0.06) but not depression levels (MD -0.6, 95% CI: -2.3 to 1.2, p = 0.53). ; In study ...