Preoperative Patient Education Class during an Orthopaedic Mission Trip: Effects on Knowledge, Anxiety, and Informed Consent

Preoperative Patient Education Class during an Orthopaedic Mission Trip: Effects on Knowledge, Anxiety, and Informed Consent
Mitchell A. Solano, Kaaleswar K. Ramcharran, Lynne C. Jones, Robert S. Sterling, David R. Samaroo, Harpal S. Khanuja
The Journal of Arthroplasty, 1 May 2020
Abstract
Background
Patient knowledge about arthritis and risks, benefits, and outcomes of joint replacement in developing countries is unknown. We evaluated the effectiveness of a preoperative class on improving knowledge and decreasing anxiety during a surgical mission trip offering total joint replacement surgery.
Methods
A team of U.S. healthcare providers taught a preoperative class to 41 patients selected for total joint replacement during a surgical mission trip to Guyana. Participants completed a 32-point survey about arthritis; indications, risks, and benefits of joint replacement; and postoperative, in-patient rehabilitation expectations. The State-Trait Anxiety Inventory was used to measure participant anxiety. Participants completed identical surveys before and after class. Matched-pairs Student’s t-tests were used to compare means between pre- and post-class surveys. Significance was accepted at P < .05.
Results
Seventy-eight percent of patients (31/41) scored less than 12 of 32 possible points (40%) on the pre-class knowledge questionnaire. Mean ± standard deviation knowledge scores improved from 14.0 ± 4.5 before the class to 16.5 ± 6.5 after the class (P = .008). Anxiety scores (n = 33) improved from 35 ± 13 before the class to 33 ± 12 after the class (P = .047).
Conclusion
On this surgical mission trip, underserved patients’ knowledge about total joint replacement increased only modestly after taking a preoperative class. Greater understanding of how to educate patients and reduce their anxiety on medical missions is needed.

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