PATIENT EDUCAITON AND EXPECTATIONS FOR COLORECTAL SURGERY
Riley Brian*1, Milos Jovanovic3, Neil Hyman2, Benjamin D. Shogan2
1Pritzker School of Medicine, University of Chicago, Chicago, IL; 2Department of Surgery, University of Chicago, Chicago, IL; 3Chicago College of Osteopathic Medicine, Midwestern University, Downer's Grove, IL
Background:
Patients often present with preconceived notions regarding their recovery after an operation. Here we aimed to study how preoperative education at the time of surgical consultation influenced patient expectations for length of stay and postoperative eating. We also aimed to study the association between those expectations and actual length of stay and postoperative eating.
Methods:
We performed a prospective study on patients undergoing colon or rectal resection at a tertiary care academic center between July 1, 2018 and December 31, 2018. Patients were included in our standardized enhanced recovery program that includes preoperative education by the clinic nurse and surgeon. Patients completed a survey after their preoperative visit assessing expectations. The electronic medical record was queried prospectively for demographic information.
Results:
We recruited 26 consecutive patients of whom 25 (96%) were enrolled. Twenty-four of these patients (96%) completed the preoperative survey. Despite being educated that their expected length of stay would be three to four days or less, 13 of 24 patients (54.2%) indicated that their hospital stay would be five days or longer. Eight of 13 patients (61.5%) who expected a longer length of stay than counselled preoperatively were discharged earlier than they expected. There was no significant association between expected length of stay and actual length of stay. We found no association between patient income, education, and family support and patients' expected or actual length or stay.
In addition, despite being educated that they would begin eating on the night of their operation or the day following their operation, 11 of 24 patients (45.8%) indicated that they would not be allowed to eat until two or more days after surgery. Nine of 11 patients (81.8%) who expected not being allowed to eat until later than they were counselled preoperatively began eating earlier than they expected. There was no significant association between expected postoperative eating and actual postoperative eating.
Conclusions:
Preoperative education in the setting of an enhanced recovery program did not reliably set up patient expectations for length of stay or postoperative eating. Patients whose expectations differed from their preoperative education did not recover differently than other patients.
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