Abstract
QUESTION
In patients having surgery for inguinal hernia, does postoperative patient education at discharge and a follow-up telephone call reduce pain up to 1 week after surgery?
METHODS
Design: randomised controlled trial.
Allocation: {concealed}.*
Blinding: blinded (data entry operators and data analysts).
Follow-up period: 1, 3, and 7 days after surgery.
Setting: a hospital in Denmark.
Patients: 234 patients .18 years of age having elective, unilateral inguinal hernia surgery. Exclusion criteria were planned laparoscopic or bilateral surgery and inability to complete a pain diary or communicate in Danish.
Intervention: 103 patients were allocated to postoperative patient education (30–60 min), which was delivered by a project nurse at discharge and addressed previous pain experiences, analgesic use, movement and lifting, wound
care, complications, relaxation, prevention of constipation, and return to work. Key points were summarised in a 78-point guide. Patients also received a follow-up telephone call 2 days after surgery. 131 patients were allocated to routine information (5–10 min), which was provided by the ward nurse before discharge and addressed pain, analgesic use, lifting, showering/bathing, suture removal, and laxative use.
Outcomes: included change in patient-reported pain from the day before surgery, assessed at rest (morning, noon, and night) and with movement (noon) (100 mm visual analogue scale [VAS], 0 = no pain and 100 = worst possible pain), and return to work ,7 days after surgery. A sample size of 100 patients per group was calculated to detect a 15% difference in proportion of patients with pain at rest .3 on a Numeric Rating Scale (80% power, a = 0.025).
Patient follow-up: 92% were included in the intention-totreat analysis (mean age 54 y, 93% men).
MAIN RESULTS
The education and routine information groups did not differ for change in pain at rest on days 1, 3, and 7 (data reported only in figures). The education group had greater reductions in pain with movement on day 7 (mean difference in VAS 7 mm, 95% CI 0.7 to 13.1). The groups did not differ for number of patients with pain at rest or with movement on day 7 or return to work before day 7 (table).
CONCLUSION
In patients having surgery for an inguinal hernia, postoperative education did not differ from provision of routine information for pain up to 1 week after surgery
In patients having surgery for inguinal hernia, does postoperative patient education at discharge and a follow-up telephone call reduce pain up to 1 week after surgery?
METHODS
Design: randomised controlled trial.
Allocation: {concealed}.*
Blinding: blinded (data entry operators and data analysts).
Follow-up period: 1, 3, and 7 days after surgery.
Setting: a hospital in Denmark.
Patients: 234 patients .18 years of age having elective, unilateral inguinal hernia surgery. Exclusion criteria were planned laparoscopic or bilateral surgery and inability to complete a pain diary or communicate in Danish.
Intervention: 103 patients were allocated to postoperative patient education (30–60 min), which was delivered by a project nurse at discharge and addressed previous pain experiences, analgesic use, movement and lifting, wound
care, complications, relaxation, prevention of constipation, and return to work. Key points were summarised in a 78-point guide. Patients also received a follow-up telephone call 2 days after surgery. 131 patients were allocated to routine information (5–10 min), which was provided by the ward nurse before discharge and addressed pain, analgesic use, lifting, showering/bathing, suture removal, and laxative use.
Outcomes: included change in patient-reported pain from the day before surgery, assessed at rest (morning, noon, and night) and with movement (noon) (100 mm visual analogue scale [VAS], 0 = no pain and 100 = worst possible pain), and return to work ,7 days after surgery. A sample size of 100 patients per group was calculated to detect a 15% difference in proportion of patients with pain at rest .3 on a Numeric Rating Scale (80% power, a = 0.025).
Patient follow-up: 92% were included in the intention-totreat analysis (mean age 54 y, 93% men).
MAIN RESULTS
The education and routine information groups did not differ for change in pain at rest on days 1, 3, and 7 (data reported only in figures). The education group had greater reductions in pain with movement on day 7 (mean difference in VAS 7 mm, 95% CI 0.7 to 13.1). The groups did not differ for number of patients with pain at rest or with movement on day 7 or return to work before day 7 (table).
CONCLUSION
In patients having surgery for an inguinal hernia, postoperative education did not differ from provision of routine information for pain up to 1 week after surgery
| Original language | English |
|---|---|
| Pages (from-to) | 26 - 26 |
| Number of pages | 0 |
| Journal | Evidence Based Nursing |
| Volume | 11 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Jan 2008 |
Keywords
- inguinal hernia
- post-operative patient education