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Meta-Analysis
. 2014 Feb 28;2014(2):CD009933.
doi: 10.1002/14651858.CD009933.pub2.

Formal education of patients about to undergo laparoscopic cholecystectomy

Kurinchi Selvan Gurusamy, Jessica Vaughan, Brian R Davidson
Meta-Analysis

Formal education of patients about to undergo laparoscopic cholecystectomy

Kurinchi Selvan Gurusamy et al. Cochrane Database Syst Rev. .

Abstract

Background: Generally, before being operated on, patients will be given informal information by the healthcare providers involved in the care of the patients (doctors, nurses, ward clerks, or healthcare assistants). This information can also be provided formally in different formats including written information, formal lectures, or audio-visual recorded information.

Objectives: To compare the benefits and harms of formal preoperative patient education for patients undergoing laparoscopic cholecystectomy.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2013), MEDLINE, EMBASE, and Science Citation Index Expanded to March 2013.

Selection criteria: We included only randomised clinical trials irrespective of language and publication status.

Data collection and analysis: Two review authors independently extracted the data. We planned to calculate the risk ratio with 95% confidence intervals (CI) for dichotomous outcomes, and mean difference (MD) or standardised mean difference (SMD) with 95% CI for continuous outcomes based on intention-to-treat analyses when data were available.

Main results: A total of 431 participants undergoing elective laparoscopic cholecystectomy were randomised to formal patient education (215 participants) versus standard care (216 participants) in four trials. The patient education included verbal education, multimedia DVD programme, computer-based multimedia programme, and Power Point presentation in the four trials. All the trials were of high risk of bias. One trial including 212 patients reported mortality. There was no mortality in either group in this trial. None of the trials reported surgery-related morbidity, quality of life, proportion of patients discharged as day-procedure laparoscopic cholecystectomy, the length of hospital stay, return to work, or the number of unplanned visits to the doctor. There were insufficient details to calculate the mean difference and 95% CI for the difference in pain scores at 9 to 24 hours (1 trial; 93 patients); and we did not identify clear evidence of an effect on patient knowledge (3 trials; 338 participants; SMD 0.19; 95% CI -0.02 to 0.41; very low quality evidence), patient satisfaction (2 trials; 305 patients; SMD 0.48; 95% CI -0.42 to 1.37; very low quality evidence), or patient anxiety (1 trial; 76 participants; SMD -0.37; 95% CI -0.82 to 0.09; very low quality evidence) between the two groups.A total of 173 participants undergoing elective laparoscopic cholecystectomy were randomised to electronic consent with repeat-back (patients repeating back the information provided) (92 participants) versus electronic consent without repeat-back (81 participants) in one trial of high risk of bias. The only outcome reported in this trial was patient knowledge. The effect on patient knowledge between the patient education with repeat-back versus patient education without repeat-back groups was imprecise and based on 1 trial of 173 participants; SMD 0.07; 95% CI -0.22 to 0.37; very low quality evidence).

Authors' conclusions: Due to the very low quality of the current evidence, the effects of formal patient education provided in addition to the standard information provided by doctors to patients compared with standard care remain uncertain. Further well-designed randomised clinical trials of low risk of bias are necessary.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Patient education versus no patient education, Outcome 1 Patient knowledge.
1.2
1.2. Analysis
Comparison 1 Patient education versus no patient education, Outcome 2 Patient satisfaction.
1.3
1.3. Analysis
Comparison 1 Patient education versus no patient education, Outcome 3 Patient anxiety.
1.4
1.4. Analysis
Comparison 1 Patient education versus no patient education, Outcome 4 Calculations for conversion of binary outcome to standardised mean difference (binary outcomes).
1.5
1.5. Analysis
Comparison 1 Patient education versus no patient education, Outcome 5 Calculations for conversion of continuous outcome to standardised mean difference (binary outcomes).
2.1
2.1. Analysis
Comparison 2 Patient education with repeat‐back versus patient education without repeat‐back, Outcome 1 Patient knowledge.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD009933

References

References to studies included in this review

Blay 2005 {published data only}
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Bollschweiler 2008 {published data only}
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