Effects of preoperative education on pain management, anxiety, and preparedness in spine surgery

Abstract

Back pain affects nearly 85% of the population, leading many to seek surgical treatment for their pain (Ramey, Isaac & Alzner, 2017). These patients turn to their providers for education regarding surgical preparation and recovery. A review of the literature supports the use of preoperative patient education in orthopedic spine surgery to reduce perioperative anxiety; however, the impact of preoperative education on pain management, preparedness for surgery, and recovery remains unclear. It is hypothesized that preoperative education will better prepare patients to care for themselves and allow for more realistic expectations of pain control and the recovery process, thereby increasing perceived preparedness and pain management. Malcolm Knowles’ 1973 model of andragogy details key elements of adult learning, which have been used successfully with multiple patient populations. In a quality improvement project based on the Model for Improvement’s Plan-Do-Study-Act framework, Knowles (1973) theory was used to develop a preoperative educational booklet for patients undergoing 1-4 level thoracic or lumbosacral laminectomies with or without lumbar fusions at a regional academic medical center. The booklet’s impact on patient pain management, anxiety, and preparedness were measured via postoperative telephone interview, and scored on a traditional Likert scale of 1-5, with 1 being not helpful, and 5 being extremely helpful. Of the 20 patients enrolled, 12 were included in a final data analysis using descriptive statistics. The mean effectiveness scores of the booklet for preparation, reduction of anxiety, and pain management were 4.39, 4.33, and 3.83, respectively. Keywords: Andragogy, preoperative education, spine surgery, pain, pain management, anxiety, preparedness, orthopedics, orthopaedics