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

• E-mail
• Print
• Link

Phase one. The purpose of the first phase of the study was to assess the psychometric evidence for a scale meant to examine the nature and scope of preoperative teaching received and valued by same day surgery patients. The 73-item PTQ was modified for use with day surgery patients. (24) Previous studies demonstrated sound psychometric evidence for the PTQ when used with inpatients undergoing surgery.

The 73 items of the PTQ form five teaching domains:

* situational/procedural information,

* sensation/discomfort information,

* patient role information,

* skills training, and

* psychosocial support.

For each PTQ item, patients are asked to indicate whether they received specific teaching and to rate its value.

Situational/procedural information refers to events expected to be experienced during the surgical procedure, including nursing care activities and application and use of medical equipment and technology. This domain also includes information on the timing and sequence of events. Sensation/discomfort information describes what patients may feel, see, or hear in relation to the surgical procedure. Patient role information relates to the behavior expected of patients as active partners in achieving treatment goals and recovery. Skills training encompasses an explanation of specific skills and provides an opportunity for patients to practice those skills before surgery as a means of aiding postoperative recovery. Psychosocial support pertains to the interaction between patients and care providers, which is aimed at helping patients deal with anxiety, concerns, and fears about surgery.

Nine content experts were enlisted to develop content validity evidence for an abbreviated version of the PTQ for use with same day surgery patients. The experts' perioperative nursing experience ranged from 10 to 30 years, with the exception of one nurse who had five years of perioperative experience. Academic credentials of content experts included one nurse with a doctorate in nursing, three with master's degrees in nursing, three with bachelor's degrees, and two with associate's degrees.

The content experts were instructed to read each of the 73 items of the PTQ and select only those items judged to be essential information for patients undergoing same day surgery. Each item was rated using a five-point Likert-type scale ranging from zero (ie, not important) to four (ie, very important). Using a criterion of a three or four rating from 80% of the content experts, 26 items remained and were named the preoperative teaching interview guide (PTIG) (Table 1). Like the original PTQ, the 26 items of the PTIG are categorized into five subscales or domains of teaching. Eleven of the PTIG items address situational/procedural information; six address psychosocial support; four address sensation/discomfort information; four address patient role information; and one addresses skills training.

Rating scales for the PTIG. The 26 items of the PTIG are rated on two different scales. A three-level rating scale is used to determine whether patients received preoperative teaching. The response "no" is assigned a weight of zero; "not sure" is weighted 0.5; and "yes" is weighted one. A five-point Likert-type scale ranging from zero (ie, not important) to four (ie, very important) is used to determine the value patients place on preoperative teaching.