目的:虽然临床医生通常使用图形向患者传达信息,使用视觉媒体对手术患者的影响尚不清楚.这篇综述旨在了解当前的研究景观,分析使用视觉辅助与接受手术的患者沟通的影响,以及目前文献中的空白。
方法:在4个数据库中进行了全面的文献检索。搜索词包括:视觉辅助,图表,图形,手术,患者教育,知情同意,和决策。纳入标准是(I)全文,同行评审的英文文章;(ii)非电子视觉辅助的评估;(iii)手术患者人群。
结果:共确定了1402篇文章;21篇符合研究标准。15项为随机对照试验,6项为前瞻性队列研究。视觉媒体评估包括作为知情同意附件的图表(n=6),共享决策对话的图形(n=3),其他术前教育图形(n=8),和术后教育材料(n=4)。患者理解力有统计学上的显着改善,使用插图教育材料(15个中的n=10),客观知识召回率增加(7.8%-29.6%)。其他研究指出满意度增加(6个中的4个),共同决策的改进(4中的n=2),和减少患者的焦虑(6个中的n=3)。对于行为结果,视觉辅助改善术后用药依从性(n=2),降低术后镇痛要求(n=2).
结论:使用视觉辅助来增强患者的手术体验在提高知识保留方面是有希望的。满意,减少焦虑。未来的研究应该考虑视觉辅助格式,和可读性,以及病人的语言,种族,和医疗保健素养。
OBJECTIVE: While graphics are commonly used by clinicians to communicate information to patients, the impact of using visual media on surgical patients is not understood. This
review seeks to understand the current landscape of research analyzing impact of using visual aids to communicate with patients undergoing surgery, as well as gaps in the present literature.
METHODS: A comprehensive literature search was performed across 4 databases. Search terms included: visual aids, diagrams, graphics, surgery, patient education, informed consent, and decision making. Inclusion criteria were (i) full-text, peer-reviewed articles in English; (ii) evaluation of a nonelectronic visual aid(s); and (iii) surgical patient population.
RESULTS: There were 1402 articles identified; 21 met study criteria. Fifteen were randomized control trials and 6 were prospective cohort studies. Visual media assessed comprised of diagrams as informed consent adjuncts (n = 6), graphics for shared decision-making conversations (n = 3), other preoperative educational graphics (n = 8), and postoperative educational materials (n = 4). There was statistically significant improvement in patient comprehension, with an increase in objective knowledge recall (7.8%-29.6%) using illustrated educational materials (n = 10 of 15). Other studies noted increased satisfaction (n = 4 of 6), improvement in shared decision-making (n = 2 of 4), and reduction in patient anxiety (n = 3 of 6). For behavioral outcomes, visual aids improved postoperative medication compliance (n = 2) and lowered postoperative analgesia requirements (n = 2).
CONCLUSIONS: The use of visual aids to enhance the surgical patient experience is promising in improving knowledge retention, satisfaction, and reducing anxiety. Future studies ought to consider visual aid format, and readability, as well as patient language, race, and healthcare literacy.