Educating patients about anesthesia: a systematic review of randomized controlled trials of
media-based interventions
Lee A, Chui P T, Gin T
CRD summary
This review evaluated media-based patient education about anaesthesia prior to surgery. The authors concluded that
videos and printed information on the process and risks of anaesthesia increased knowledge and reduced anxiety, but
had no effect on patient satisfaction. This was a well-conducted review but, owing to insufficient information about the
patients studied, it is difficult to determine in whom the intervention is effective.
Authors' objectives
To determine whether media-based patient education about anaesthesia could decrease patient anxiety and increase
knowledge and satisfaction.
Searching
MEDLINE (from 1966 to May 2002), EMBASE (from 1988 to May 2002), PsycINFO (from 1984 to May 2002),
CINAHL (from 1982 to May 2002) and the Cochrane CENTRAL Register were searched for studies in any language;
the search terms were reported. The bibliographies of retrieved studies, review articles and observational studies were
checked. In addition, the authors of RCTs were contacted for further published and unpublished studies.
Study selection
Study designs of evaluations included in the review
Randomised controlled trials (RCTs) were eligible for inclusion. The comparators in each of the included studies could
be either a control group (receiving no intervention or a non-medical intervention) or a different type of media-based
intervention.
Specific interventions included in the review
Studies of media-based interventions (pamphlets, video, booklets, audiotapes, or the Internet) that relayed information
pertaining to general or regional anaesthesia and/or pain management were eligible for inclusion. Studies that compared
the level of risk disclosure were excluded from the review. The interventions were delivered at a pre- admission clinic,
a day prior to surgery, or on the day of surgery.
Participants included in the review
The inclusion criteria for the participants were not explicit. In the included studies, patients or the parents of patients
undergoing anaesthesia received the media-based intervention.
Outcomes assessed in the review
Studies that evaluated anxiety, level of patient knowledge, and patient satisfaction were eligible for inclusion. Anxiety
was assessed using a validated instrument, e.g. Spielberger's State and Trait Anxiety Inventory, a visual analogue scale
(VAS), Amsterdam Preoperative Anxiety and Information Scale, Yale Preoperative Anxiety Scale, and the Children's
Global Mood Score. Patient knowledge was assessed using the Standard Anaesthesia Learning Test or multi-item
knowledge questionnaires, whereas patient satisfaction was as defined by the trialist.
How were decisions on the relevance of primary studies made?
Two reviewers independently assessed the quality of each included study.
Assessment of study quality
Validity was assessed by assigning a grade for the adequacy of allocation concealment to each included study, according
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