Ianthe Boden1, Doa El-Ansary2, Nadia Zalucki3, Iain K Robertson4, Laura Browning5, Elizabeth H Skinner6, Linda Denehy7. 1. Physiotherapy Department, Launceston General Hospital, P.O. Box 1963, Launceston, 7250, TAS, Australia; Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Alan Gilbert Building, 161 Barry Street, Carlton, 3053, VIC, Australia; Clifford Craig Foundation, Launceston General Hospital, P.O. Box 1963, Launceston, 7250, TAS, Australia. Electronic address: ianthe.boden@ths.tas.gov.au. 2. Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Alan Gilbert Building, 161 Barry Street, Carlton, 3053, VIC, Australia. Electronic address: d.el-ansary@unimelb.edu.au. 3. Physiotherapy Department, Launceston General Hospital, P.O. Box 1963, Launceston, 7250, TAS, Australia. Electronic address: nadia.zalucki@ths.tas.gov.au. 4. Clifford Craig Foundation, Launceston General Hospital, P.O. Box 1963, Launceston, 7250, TAS, Australia; School of Health Sciences, University of Tasmania, Locked Bag 1320, Launceston, 7250, TAS, Australia. Electronic address: iain.robertson@utas.edu.au. 5. Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Alan Gilbert Building, 161 Barry Street, Carlton, 3053, VIC, Australia; Division of Allied Health, Western Health, Furlong Road, St Albans, 3021, VIC, Australia. Electronic address: laura.browning@wh.org.au. 6. Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Alan Gilbert Building, 161 Barry Street, Carlton, 3053, VIC, Australia. Electronic address: drlizzieskinner@gmail.com. 7. Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Alan Gilbert Building, 161 Barry Street, Carlton, 3053, VIC, Australia. Electronic address: l.denehy@unimelb.edu.au.
Abstract
OBJECTIVES: To (1) assess memorability and treatment fidelity of pre-operative physiotherapy education prior to elective upper abdominal surgery and, (2) to explore patient opinions on pre-operative education. DESIGN: Mixed-methods analysis of a convenience sample within a larger parallel-group, double-blinded, randomised controlled trial with concealed allocation and intention-to-treat analysis. SETTING:Tertiary Australian hospital. PARTICIPANTS: Twenty-nine patients having upper abdominal surgery attending pre-admission clinic within six-weeks of surgery. INTERVENTION: The control group received an information booklet about preventing pulmonary complications with early ambulation and breathing exercises. The experimental group received an additional face-to-face 30-minute physiotherapy education and training session on pulmonary complications, early ambulation, and breathing exercises. OUTCOME MEASURES: Primary outcome was proportion of participants who remembered the taught breathing exercises following surgery. Secondary outcomes were recall of information sub-items and attainment of early ambulation goals. These were measured using standardised scoring of a semi-scripted digitally-recorded interview on the 5th postoperative day, and the attainment of early ambulation goals over the first two postoperative days. RESULTS: Experimental group participants were six-times more likely to remember the breathing exercises (95%CI 1.7 to 22) and 11-times more likely (95%CI 1.6 to 70) to report physiotherapy as the most memorable part of pre-admission clinic. Participants reported physiotherapy education content to be detailed, interesting, and of high value. Some participants reported not reading the booklet and professed a preference for face-to-face information delivery. CONCLUSION: Face-to-face pre-operative physiotherapy education and training prior to upper abdominal surgery is memorable and has high treatment fidelity. TRIAL REGISTRATION: ACTRN-12613000664741.
RCT Entities:
OBJECTIVES: To (1) assess memorability and treatment fidelity of pre-operative physiotherapy education prior to elective upper abdominal surgery and, (2) to explore patient opinions on pre-operative education. DESIGN: Mixed-methods analysis of a convenience sample within a larger parallel-group, double-blinded, randomised controlled trial with concealed allocation and intention-to-treat analysis. SETTING: Tertiary Australian hospital. PARTICIPANTS: Twenty-nine patients having upper abdominal surgery attending pre-admission clinic within six-weeks of surgery. INTERVENTION: The control group received an information booklet about preventing pulmonary complications with early ambulation and breathing exercises. The experimental group received an additional face-to-face 30-minute physiotherapy education and training session on pulmonary complications, early ambulation, and breathing exercises. OUTCOME MEASURES: Primary outcome was proportion of participants who remembered the taught breathing exercises following surgery. Secondary outcomes were recall of information sub-items and attainment of early ambulation goals. These were measured using standardised scoring of a semi-scripted digitally-recorded interview on the 5th postoperative day, and the attainment of early ambulation goals over the first two postoperative days. RESULTS: Experimental group participants were six-times more likely to remember the breathing exercises (95%CI 1.7 to 22) and 11-times more likely (95%CI 1.6 to 70) to report physiotherapy as the most memorable part of pre-admission clinic. Participants reported physiotherapy education content to be detailed, interesting, and of high value. Some participants reported not reading the booklet and professed a preference for face-to-face information delivery. CONCLUSION: Face-to-face pre-operative physiotherapy education and training prior to upper abdominal surgery is memorable and has high treatment fidelity. TRIAL REGISTRATION: ACTRN-12613000664741.
Authors: Ianthe Boden; Elizabeth H Skinner; Laura Browning; Julie Reeve; Lesley Anderson; Cat Hill; Iain K Robertson; David Story; Linda Denehy Journal: BMJ Date: 2018-01-24