Outcomes and Perception of Lung Surgery with Implementation of a Patient Video Education Module: A Prospective Cohort Study

BACKGROUND: Although surgeons are constantly making efforts to improve efficiency of care, it is important to also optimize the patients' understanding and satisfaction with their surgical experience. We investigated the effect of a preoperative educational video on patient outcomes and perception of surgery. STUDY DESIGN: An educational video was developed outlining preoperative, operative, and postoperative expectations for patients undergoing pulmonary resection. A prospective study was conducted with 150 patients undergoing surgery with routine preoperative discussion (control group, January 2008 to June 2009) and 150 patients who were provided a supplemental video module (video or study group, September 2009 to October 2010) in addition to routine discussion. Demographics and outcomes data were recorded. Patients completed a pain survey (McGill Questionnaire) and a standardized patient satisfaction survey at discharge and within 1 month of operation. RESULTS: The groups were similar in sex, age, comorbidities, and forced expiratory volume, 1 second, % predicted. Length of hospital stay (5.19 +/- 7.4 days vs 4.31 +/- 4.3 days; p = 0.2) and hospital readmission rates (12 of 134 [9%] vs 5 of 103 [4.9%]; p = 0.3) were similar for the 2 groups. At discharge, patients in the study group reported less pain at rest (0.98 +/- 0.09) vs controls (1.39 +/- 0.11) (p = 0.01) with no difference in pain with lifting or coughing. Patients in the study group reported better overall satisfaction with their operation (2.14 +/- 0.07 vs 1.85 +/- 0.07; p = 0.02), believed they were better prepared (2.01 +/- 0.07 vs 1.70 +/- 0.06; p = 0.006), and reported less anxiety about the surgical experience (2.79 +/- 0.10 vs 2.24 +/- 0.09; p = 0.0001). CONCLUSIONS: Implementation of a pulmonary resection education module improves patient preparedness, relieves anxiety, and improves pain perception. Additional development and dissemination of a comprehensive education program can improve patients' experience with lung surgery and impact outcomes. (J Am Coll Surg 2012; 214: 816-821. (C) 2012 by the American College of Surgeons)