Yoeri Bemelmans

Chapter 2 26 P1: “Of course, you could have a video, or you could download a mobile app. But maybe that’s for a few years later. Because now I saw almost all older people who, like me, don’t really like apps. You wouldn’t fulfill their needs, I guess.” Discussion Themost important finding of this study is that the overall experiences on the provided patient information were positive. Patients were satisfied with the given information regarding their KA surgery. Patient expectation management holds an important role in KA surgery, unmet expectations after surgery can result in dissatisfaction [5,10,14]. To prepare patients before surgery, information regarding the procedure and expectations after surgery can be done by providing oral and written content, with a possible addition of face- to-face contacts (e.g. physical therapy sessions, preoperative information classes, so- called ‘joint-schools’). Besides providing written content, patients had several face-to- face contacts in the current study; the orthopaedic surgeon provided oral information, patients received information from the OR planner regarding practical considerations (e.g. date of surgery), had a preoperative consultation by the anaesthesiologist/nurse and underwent a physical education session by the physiotherapist. The combination of preoperative educational programs with written information has been examined before [11,16,2]. These papers concluded that this strategy did not (positively) affect postoperative outcomes in terms of safety (e.g. complication rates, length of hospital stay). When analysing other outcomes, a multimodal educational approach (verbal and written information) on opioid consumption and pain resulted in reduced usage of opioids after surgery [16]. The authors stated further that information solely on patients’ expectations after surgery did not reduce pain scores, indicating that a multimodal educational approach is desirable. This is in line with another study reporting no effect of preoperative education alone on postoperative pain scores [3]. Another proposed advantage of patient education is reduced preoperative anxiety. As anxiety is strongly related to poorer postoperative outcomes (in terms of patients satisfaction after KA), it is of major importance to address this anxiety prior to surgery [1]. Aydin et al. [2] reported a reduction of preoperative anxiety after implementation of preoperative patient education. In addition, Tong et al. [19] reported psychological interventions prior to surgery to be beneficial in the reduction of anxiety and mental components of quality of life on the long term. This addresses the need for patient specific and targeted preoperative patient information.