Preoperative teaching received and valued in a day surgery setting

AORN Journal,  March, 2003  by Mary Jane Bernier,  Dolora C. Sanares,  Steven V. Owen,  Patricia L. Newhouse

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One researcher used a patient satisfaction questionnaire to survey same day surgery patients' ability to cope with postoperative symptoms, ability to return to activities of daily living, and rate of hospital readmission. (18) Patient satisfaction and clinical outcomes were related to the delivery of patient-specific information tailored to individual circumstances. Patients viewed thorough and clear information about possible complications as an important part of improving day surgery services.

Another study investigating stress and coping in day surgery patients revealed that patients demonstrating a high preference for information had significantly lower levels of preoperative stress. (19) Another researcher found no correlation between preference for information and the beliefs individuals may have about their ability or inability to control events and situations that affect their lives. (20) A study describing day surgery patients' perceptions of nurses' caring behaviors indicated that nurses' level of knowledge, demonstration of kindness, and consideration for patients ranked highest. (21) Caring behaviors that ranked equally in second place included regarding each patient as an individual, closely monitoring patient conditions, and providing reassurance. In a related study, the influence of nursing presence and caring behaviors on postoperative recovery was examined in 100 adult day surgery patients. (22) Patients who perceived caring behaviors from recovery room nurses experienced less symptom distress and a higher level of functional status postoperatively.

The use of a phenomenological approach in examining the nature of discharge needs after same day surgery revealed patient preference for the inclusion of discharge information with preadmission teaching. (23) The narrative descriptions of participants' (n = 4) postoperative experience revealed that they had more pain and for a longer duration than anticipated. Greater emphasis on postoperative management of discomfort and realistic expectations about the time frame for recovery should be included in preoperative teaching.

In summary, studies exploring the nature and methods of preoperative preparation of patients undergoing same day surgery indicate that the topic is of increasing interest to nurses and other health care providers. From patients' perspective, there is a need for better preparation regarding pain management after discharge. The most favorable patient outcomes were associated with nursing care that included preoperative teaching and acknowledged the uniqueness of patients and their situations. Of interest to this study is the finding that nurses and patients do not always concur on the topics that are of most interest to patients.

METHODS

This study was conducted in two phases. The first phase involved constructing an instrument to measure the nature and value of preoperative teaching for patients undergoing same day surgery. The second phase involved exploring the teaching that patients received before same day surgery and the value they placed on the information.