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Southern Online Journal
of Nursing Research www.snrs.org |
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Utility
of Video Modeling as an Adjunct
to Preoperative Education
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ABSTRACT |
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Helene
J. Krouse, PhD, APRN,BC, CORLN Professor Wayne
State University Detroit,
Michigan
Jo
Ann Fisher, MSN, ARNP Family
Nurse Practitioner Satellite
Beach, Florida
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This experimental study investigated the effectiveness of nursing-based videotaped instruction in increasing knowledge, improving self-care practices, and facilitating postoperative recovery among patients (N=52) undergoing nasal surgery. Patient participants were randomly assigned to one of two treatment groups: 1) standard preoperative education and 2) standard preoperative education plus videotaped instructions. Symptom management, quality of life, knowledge level, and importance of specific treatments were assessed preoperatively and at one and four weeks postoperatively. Analysis of variance was used to compare group differences and changes with time. Several significant findings were noted over time, however no significant differences were found between the two groups. Knowledge scores significantly increased for both groups from preoperative to postoperative assessments. Values on the quality of life scale significantly improved on one-month follow-up for all patients. Significant increase in knowledge, improved quality of life, and symptom management indicate positive postoperative outcomes for patients. Adequate patient teaching prior to surgery has beneficial effects over the postoperative period. Nursing-designed patient videotaped instruction in place of individualized nurse-patient teaching could be a cost effective method of preoperative education. Key Words: Videotape, Modeling, Patient Education, Postoperative Outcomes, Self Care |
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Utility
of Video Modeling as an Adjunct
to
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1Manoukian,
P.D., Wyatt, J.R., Leopold, D.A.,
& Bass, E.B. (1997). Recent
trends in utilization of procedures
in otolaryngology-head and neck
surgery. Laryngoscope, 107, 472-475.
2Lindsey,
A. M. (1997). Nursing scholarship:
Accountability for outcome. Image: Journal of Nursing Scholarship,
29, 224. |
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Changes
in the delivery of health care services
resulting from technological advances,
innovative surgical techniques,
and economic and political pressures
have promoted an increase in outpatient
surgical procedures.1
Many procedures once performed in
traditional hospital settings are
now done in ambulatory surgical
centers. This transformation in
surgical care setting allows only
minimal patient-nurse contact time
prior to discharge from the facility
postoperatively, requiring patients
to assume greater responsibility
for their own care. Therefore, it
is imperative that non-professional
caregivers are effectively educated
to provide care for themselves or
family members so that desired treatment
outcomes are achieved.2 The purpose of
this study was to investigate the
efficacy of nursing-based “video
modeling” materials for patients
undergoing nasal and sinus surgery
in increasing patient knowledge,
improving self-care practices with
postoperative care regimens, and
facilitating postoperative healing. |
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3Lisko,
S. A.(1995). Development and use
of videotaped instruction for preoperative
education of the ambulatory gynecological
patient. Journal
of Post Anesthesia Nursing, 10,
324-328.
4Courtney,
R. & Rice, C. (1997). Investigation
of nurse practitioner-patient interactions:
Using the nurse practitioner rating
form. Nurse
Practitioner, 22(2), 46-48;
54-57; 60; 65. 5
Yale, E. (1993). Preoperative teaching
strategy: Videotapes for home viewing.
AORN
Journal, 57, 901-908.
6Gagliano,
M. E. (1988). A literature review
on the efficiency of video in patient
education. Journal
of Medical Education, 63, 785-792.
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Educational
materials designed to facilitate
information acquisition and practice
for patients and caregivers are
a priority in nursing care.3 The current popularity
of multimedia presentations suggests
that nursing-based videotaped instructional
materials utilizing “video modeling”
can empower patients in self-care
practices, thereby improving compliance
with postoperative treatment regimens.
Video instruction developed by nurses,
for use in the office and home,
can be an effective method of educating
non-professional caregivers in specific
practices necessary for self-care
or home-care of a family member.4 Yale5
found when videotaped instruction
is provided in the patient’s home,
it can be an economical, effective,
and convenient way to motivate learning
and enhance desired outcomes. Nursing-designed
patient educational materials can
be powerful tools for enabling patients
in performing self-care activities.
Video instruction, which combines
elements of visualization and video
modeling techniques, can be effectively
incorporated by nurses to further
enhance patient teaching for achieving
desired outcomes.6
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7Manoukian,
1997.
8Kennedy,
D. W., Shaman, P., Han, W., Selman,
H., Deems, D. A., & Lanza, D.
C. (1994). Complications
of ethmoidectomy: A survey of fellows
of the American Academy of Otolaryngology-Head
and Neck Surgery. Otolaryngology-Head
and Neck Surgery, 111, 589-599. |
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The
advancement of endoscopic surgery
in many surgical specialties has
helped to significantly reduce hospitalizations
and increase same day surgery.7
One class of surgery that is now
predominately performed on an outpatient
basis is nasal and sinus surgery.
Sinus surgical procedures are among
the most common operations performed
in the United States, with over
200,000 cases completed yearly.8 |
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9Krouse,
H. J., Krouse, J. H., & Christmas,
D.A. (1997). Endoscopic sinus surgery
in otorhinolaryngology nursing using
powered instrumentation. ORL-Head
and Neck Nursing, 15 (2), 22-26. 10Schapira,
M. M., Meade, C., & Nattinger,
A. B. (1997). Enhanced decision-making:
The use of a videotape decision-aid
for patients with prostate cancer.
Patient
Education and Counseling, 30,
119-127. 11Robertson,
C., Gatchel, R. J., & Fowler,
C. (1991). Effectiveness of a videotaped
behavioral intervention in reducing
anxiety in emergency oral surgery
patients. Behavioral
Medicine, 17(2), 77-85. 12Deane,
F. P., Spicer, J., & Leathem,
J. (1992). Effects of videotaped
preparatory information on expectations,
anxiety, and psychotherapy outcomes.
Journal of Consulting and
Clinical Psychology, 60, 980-984. 13Streiff,
L. D. (1986). Can clients understand
our instructions? Image:
Journal of Nursing Scholarship,
18, 48-52. |
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For patients
undergoing nasal and/or sinus surgery,
standard patient education involves
the use of verbal instructions by
physicians and nurses, often delivered
during a brief session prior to
the day of surgery.9
Patient memory of these instructions
is often inadequate due to anxiety
and feelings of uncertainty. Videotapes
for patient education have enhanced
assimilation of information and
short-term knowledge.10 Educational videotapes
have also been useful in decreasing
patients’ anxiety prior to procedures
and psychotherapy.11,12 Instructional
material can be standardized by
using videotapes, assuring the same
content for all patients. Patients
may also require reinforcement of
information and can view the tape
on multiple occasions. Patient instructional
sheets or pamphlets are frequently
used but are often written at a
reading level that manyindividuals
cannot comprehend.13 An important benefit
of using videotaped instructions
preoperatively, therefore, is the
enhancement of learning in patients
with low literacy skills and in
elderly patients who have visual
difficulties in |
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reading small
printed documents.14 Use of nurse-developed
videotaped instruction can also
be beneficial and cost effective
in delivering standardized information
to more patients in a timely manner. |
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Patients who
adhere to prescribed postoperative
regimens of medical and nursing
therapies following nasal and sinus
surgery may have better outcomes
and therefore more positive long-term
benefits related to their quality
of life than patients who fail to
follow these recommendations. Adherence
to these protocols can be less than
optimal, especially as the period
of time following surgery lengthens.
Since failure to continue these
treatments and prescription medications
can lead to decreased symptomatic
relief and the need for recurrent
surgical intervention, strategies
that increase patient adherence
would have both short-term and long-term
implications in improving patient |
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15Larsen,
K. & Tos, M. (1994). Clinical
course of patients with primary
nasal polyps. Acta
Otolaryngologica, 114, 556-559.
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care.15 |
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Theoretical
Framework |
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Bandura’s Social
Cognitive Theory provides a framework
for understanding the use of video
modeling to improve specific postoperative
behaviors by patients. According
to social cognitive theory, behavioral
competencies, social competencies,
and cognitive skills, are acquired
through observational learning.
The individual observes the
modeled event and forms a cognitive
construct, which shapes future behavior.
Through the representation
of the model, the individual observes
benefits of the modeled procedure
and is motivated to match behavior
to that of the |
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16Bandura,
A. (1986). Social
Foundations of Thought and Action:
A Social Cognitive Theory. Englewood
Cliffs, New Jersey: Prentice-Hall. |
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observed individual.16 |
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17
Bandura, A. (1997). Self-Efficacy: The Exercise of Control.
New York: W.H. Freeman.
18ibid,
p.91 |
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Learning through
vicarious experiences, such as modeling,
can promote feelings of self-efficacy
regarding these specific behaviors.17
Desired skills and acquisition of
knowledge can be effectively taught
through observation of proficient
models demonstrating these behaviors.18
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Video
modeling |
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One of the strongest
benefits of videotaped presentations
is the process of “behavioral modeling”
or “video modeling." This “video
modeling” involves demonstrating
desired behaviors, outcomes, and
attitudes through |
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19Gagliano,
1988
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active, visual
representations.19
Video modeling allows the viewer
to identify with the model performing
the activity, as well as perceiving
that one is also capable of effectively
engaging in |
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20ibid. |
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similar behaviors.
According to Gagliano,20
video modeling is one of the strongest
benefits in using videotaped presentations. |
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Incorporation
of “video modeling” into postoperative
nursing care for patient use at
home can prepare patients to effectively
care for themselves in order to
decrease complications and promote
healing after surgery. Patients
requiring additional reinforcement
of information can view the tape
on multiple occasions at their own |
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21Minton,
P. N. (1983). Videotape instruction:
An effective way to learn. Rehabilitation Nursing, 8 (3),
15-17. 22Courtney,
1997 |
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convenience.21
Video instruction developed by practitioners
has been shown to be effective in
reinforcing patient teaching.22
A quasi-experimental study conducted
on patients undergoing total knee
arthroplasty revealed that patients
receiving videotaped postoperative
exercises performed these exercises
more regularly and with greater
accuracy than a |
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23Lin,
P. C., Lin, L. C., & Lin, J.
J. (1997). Comparing the effectiveness
of different educational programs
for patients with total knee arthroplasty.
Orthopaedic Nursing, 16, 43-49. 24McDaniel,
R.W. &
Rhodes, V. A. (1998). Development
of a preparatory sensory information
videotape for women receiving chemotherapy
for breast cancer. Cancer
Nursing, 21,143-148. |
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non-video control
group.23
In another study, coping skills
and self care behaviors demonstrated
on videotapes were found to be effective
in assisting patients to anticipate
and manage sensations associated
with chemotherapy.24 |
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25Krouse,
H. J. (2001). Video modelling to
educate patients. Journal
of Advanced Nursing, 33,748-757.
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An integrative
research review on video modeling
and patient education concluded
that video modeling can be an effective
way to educate patients in several
ways.25
Videotapes were useful in educating
individuals about the various risks
and benefits of specific treatment
options.
Preparatory videotapes using
video modeling were also beneficial
in reducing anxiety and physiological
arousal prior to medical procedures.
Video modeling was also effective
in increasing the rate of performing
specific self-care practices and |
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26ibid. |
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desired behaviors.26
Videotapes incorporating video modeling
behaviors should facilitate patient
acquisition of specific behaviors
in order to perform postoperative
care regimens with greater proficiency
and consistency. The ultimate goal
of postoperative care and performance
of desired behaviors is to improve
surgical outcomes, |
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27Krouse,
H. J. (1997). Nursing care of the
patient undergoing powered endoscopic
sinus surgery. In J.
H. Krouse & D. A. Christmas
(Eds.). Powered
endoscopic sinus surgery (pp.111-121).
Baltimore: Williams & Wilkins.
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reduce complications,
and promote healing,27
thereby enhancing one’s quality
of life. |
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The
following hypotheses were tested
in this study: Patients
receiving the nursing-based videotape
instruction at home in combination
with standard preoperative patient
teaching: H1:
demonstrate greater knowledge
of postoperative care following
nasal and sinus surgery than patients
receiving only standard preoperative
instruction; H2:
indicate greater perception
of the importance of elements of
the postoperative regimen of care
following nasal and sinus surgery
than patients receiving only standard
preoperative instruction; H3:
perceive less disability
and have better scores on a quality
of life scale following nasal and
sinus surgery than patients receiving
only standard preoperative instruction;
H4:
experience better postoperative
healing than patients receiving
only standard preoperative instruction.
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Methods |
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Design The study involved a two-group experimental design. Patients undergoing nasal or sinus surgery were randomly assigned to one of two treatment groups. The control group received standard preoperative teaching in the office prior to surgery. The experimental group received the standard preoperative teaching plus a videotape demonstrating specific postoperative care measures. Subjects completed several questionnaires preoperatively and postoperatively during week one and week four. |
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Sample The
final sample consisted of 52 patients
undergoing nasal or sinus surgery.
Twenty-eight subjects were
in the experimental group and twenty-four
were in the control group.
Initially 60 subjects were
enrolled and randomly assigned to
one of the two treatment groups.
A total of eight subjects, four
in each group, did not return for
the final one-month follow-up, even
after being contacted several times
by the nurse, and were therefore
excluded from final data analysis.
Patients in a private otolaryngology
practice, who were undergoing nasal
and/or sinus surgery between September
1998 through June 1999, were invited
to participate in the study. The
researcher invited all eligible
patients to participate in the study
at the time of their preoperative
visit. None of the patients who
were asked to participate declined
and each person was enrolled in
the study. All subjects enrolled
in the study indicated that they
had access to a VCR player at home.
The
sample consisted of 32 men and 20
women ranging in age from 18 to
86 years (M=53.9;
SD=17.3) with similar distributions
in both groups. Of these subjects,
27% had undergone previous nasal
or sinus surgery and only 17% were
smokers. A third of the subjects
indicated that they had a positive
history for allergies.
There were no significant
differences on demographic characteristics
between the two groups
as illustrated in Table
1.
Instruments Collection of
demographic information on each
subject involved completion of standard
health history and allergy history
forms currently in use in the office.
A tool to measure knowledge level
(Knowledge
Index) concerning postoperative
practices and care was developed
by the investigator based on standard
preoperative teaching materials.
This instrument consists of 20 true-false
questions about the postoperative
recovery period and related care.
It assesses a person’s understanding
of what normally occurs postoperatively,
how to care for the surgical area,
and “Do’s and Don’ts.” Scores on
the Knowledge
Index are computed as the sum
of the number of correct answers
on the tool. An initial pool of
60 questions was developed by the
researcher based on the standard
preoperative instruction for |
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patients
undergoing nasal and sinus surgery.
Three experienced otolaryngology nurses
then independently selected the 30
items they felt best represent elements
of the postoperative knowledge base
for surgical patients. The 20 items
that consistently reflected the opinions
of these three nurses were then included
as the final Knowledge
Index. A Cronbach Alpha coefficient
of the Knowledge Index was computed
to estimate the internal consistency
of this instrument. An a coefficient
of 0.74 was obtained. This initial
test of reliability suggests that
the instrument has good initial internal
consistency. |
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28Krouse,
H. J. & Krouse, J. H. (1999).
Complementary therapeutic practices
in patients with chronic sinusitis.
Clinical
Excellence for Nurse Practitioners,
3(6), 346-352. |
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The Sinus
Treatment Follow-Up Scale (STFS),
an instrument developed by Krouse
& Krouse,28
consists of a 20-item self-report
questionnaire in which subjects
are asked to rate the importance
of various practices and treatments
that they used during their postoperative
recovery period. The STFS is an
interval scale that utilizes a four-point
rating ranging from 0 – 3, with
0 meaning “not important” to 3 meaning
“very important.” Mean scores can
be computed based upon rated importance
given to each item. An outside practitioner
in the field of otolaryngology reviewed
items included on the tool. Previous
use of the scale with a population
of sinusitis patients and normal
individuals revealed that it was
able to |
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29ibid. |
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discriminate
between these groups.29 |
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30Benninger,
M. S. & Senior, B. A. (1997).
The development of the Rhinosinusitis
Disability Index. Archives
of Otolaryngology-Head and
Neck Surgery, 123, 1175-1179. |
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The Rhinosinusitis
Disability Index (RSDI), developed
by Benninger and Senior,30
is a global quality-of-life measurement
tool for patients with sinusitis
consisting of 30 items which are
self-rated by patients. It has been
validated as an instrument in measuring
not only the physical component
of nasal and sinus disease, but
the functional and emotional impact
of the diseases as well.
Factor analytic procedures
were used to extract three subscales—physical,
emotional, and functional—with good
utility as an index of the construct
validity of the tool. The RSDI has
been shown to discriminate well
between patients and controls, with
a significance of .01 or less, also
an |
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31ibid. |
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indicator of
its validity.31 |
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Healing was
assessed through an examination
of the surgical site in the nasal
and sinus cavities by the surgeon,
who was blind to the subject’s assigned
treatment group. The endoscopic
rating involved an objective assessment
of the nasal cavity on four separate
factors: nasal discharge, nasal
edema, nasal crusting, and nasal
obstruction. Each of the four factors
was graded by an experienced otolaryngologist
with scores ranging from 1 – 4,
with 1 signifying the absence of
any pathology and 4 signifying severe
pathology. Procedure Subjects were
randomly assigned to one of two
treatment groups: (1) the control
group received standard preoperative
education by the nurse, including
verbal and written instruction;
and (2) the experimental group received
standard preoperative education
plus a nursing-based videotape on
postoperative care following nasal
and sinus surgery. This videotape
is approximately 10 minutes in length.
The entire study protocol and consent
form were reviewed and approved
by the University of Florida Institutional
Review Board.
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At
the preoperative visit, each subject
underwent an evaluation by the surgeon,
which also included rating the subject’s
nasal and sinus cavities. Following
this examination each subject completed
the RSDI and the Knowledge Index
prior to initiation of preoperative
teaching by the nurse. Standard
preoperative instruction, with the
same otorhinolaryngology nurse,
was conducted in the office usually
within one week of the surgery.
All subjects received written materials
that outlined the steps involved
in proper nasal irrigation techniques
and the “do’s and don’ts” following
surgery. One instructional sheet
also provided several diagrams illustrating
the proper technique for performing
nasal irrigations. These written
instructional sheets are standard
teaching materials |
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32Sigler,
B. A. & Schuring, L. T. (1993).
Ear,
Nose, and Throat Disorders.
St. Louis: Mosby.
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and
used widely in the field of otolaryngology.32 |
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Following
this standard preoperative education,
an office staff member randomly
assigned the subject to one of the
two treatment groups and maintained
a list of the subjects in each group.
This information was not shared
with the researcher or the surgeon
during the study period. Based on
this random group assignment, the
subject either left the office with
written materials or stayed to watch
the videotape. The experimental
group received a 10-minute videotape,
developed by the researcher that
showed three models performing the
desired behaviors, a middle-aged
woman, a middle-aged man, and a
young woman. These individuals demonstrated
specific postoperative practices
with the objective that viewers
would see people similar to themselves
performing these activities successfully
and see themselves as capable of
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33Bandura,
1997. p. 87 |
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performing
their own postoperative care.33
Prior to using the videotape in
this study, several patients previewed
the tape and were asked questions
regarding its content to assess
appropriateness and level of information.
No difficulties were noted in use
of the videotape in this outpatient
setting. After viewing the videotape
in the office, subjects in the experimental
group were given a copy of the videotape,
by the staff member, to view at
home along with standard written
materials. To reduce any biases
the nurse who provided preoperative
instruction and the surgeon were
blind as to the subject’s treatment
group.
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The
first postoperative visit was conducted
within one week following surgery.
At this visit, subjects took a post-test
to re-assess their knowledge about
their postoperative recovery period
and completed the Sinus Treatment
Follow-up Scale (STFS) to assess
the importance of various components
of their postoperative care. The
surgeon also rated the physical
appearance and cleanliness of the
surgical site on degree of crusting,
edema, drainage, and obstruction.
At the one-month postoperative visit,
the surgeon once again rated the
appearance and cleanliness of the
surgical site as an indicator of
postoperative healing. Subjects
completed the RSDI to assess any
changes in their symptoms and quality
of life scores
from preoperative scores (Diagram
1). |
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Results |
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All
subjects in the experimental group
viewed the videotape first in the
office; 75% stated that they had
viewed the video at least one additional
time at home. Hypothesis 1 was tested
using a two-way repeated measures
analysis of variance (ANOVA) to
compare pre- and post-test Knowledge
Index scores between groups. There
was a significant improvement in
knowledge score for both groups
following preoperative instruction
over time, F(1, 50)= 25.43 (p<.0001),
however group x time interaction
was not significant.
Mean
scores of the rated importance of
each of the items on the Sinus
Treatment Follow-Up Scale during
the postoperative period were computed
and compared between the two groups
using a two-way ANOVA (Hypothesis
2).
Of the 20 items rated on
the scale, eight items were rated
as important self-care practices
by subjects and
depicted in Table
2. Both
groups rated nasal irrigation and
use of saline sprays as the two
most important self-care measures
practiced during the postoperative
period. The percentage of subjects
who rated the practice of nasal
irrigation as important in relieving
symptoms postoperatively was 96%
for the experimental group and 100%
for the control group. One hundred
percent of subjects in both groups
rated saline sprays as important
in their postoperative care. Both
the experimental and control groups
also rated most medications including
antihistamines, decongestants, and
over-the-counter medications as
least important to their postoperative
care. Use of antibiotics was important
in the first week postoperatively
since subjects received prescriptions
for perioperative antibiotics but
were no longer taking these medications
by the one-month follow-up. A comparison
of differences in perceived importance
of specific postoperative measures
between the groups yielded no significant
differences. The
third hypothesis compared the two
treatment groups on their severity
of symptoms, perceived limitations,
and quality of life related to their
sinus disease. The three subscale
scores of the RSDI—physical, functional,
and emotional—were computed separately
for each group and compared preoperative
scores to one-month postoperative
scores. Means and standard deviations
for the three scales are depicted
on Table 3.
Two-way repeated measures ANOVA
was calculated to compare effects
over time as well as group x time
interaction. Higher scores signified
poorer adjustment and lower scores
corresponded to perceptions that
are more positive. Over time, there
was a significant decrease in the
mean scores on the three quality
of life subscale scores in both
groups. Scores on the RSDI Physical
subscale significantly improved
at the one month follow-up for both
groups, F(1,50)=11.06
(p<0.002).
The RSDI Emotional and Functional
subscale scores at one month follow
up also showed significant improvement
from preoperative scores across
both groups. The time effect for
the RSDI Emotional subscale was
F(1,50)=11.14
(p<0.0016),
and F(1,50)=9.21 (p<0.0038),
for the Functional subscale.
Assessment
of postoperative healing (Hypothesis
4) was based on the surgeon’s evaluation
of the surgical site for crusting,
edema, discharge, and obstruction
at the one week and one month postoperative
visits. Significant improvements
in the surgical area were noted
in both groups over time with no
significant differences between
the two groups using a two-way repeated
measures ANOVA, treating individual
ratings as discrete interval data
points. The greater amount of crusting
noted at one month in comparison
to the preoperative assessment reflects
the observation that complete healing
is often not appreciated until six
to eight weeks following surgery.
These results
are presented in Table
4. |
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Discussion |
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This
experimental study compared the
effectiveness of standard preoperative
patient instruction to preoperative
instruction using a nurse-based
videotape in conjunction with standard
preoperative teaching for patients
undergoing nasal and sinus surgery.
The two treatment groups were followed
preoperatively through one month
follow up and compared on level
of knowledge related to postoperative
care, perceived importance of self-care
practices, complications and healing,
and perceived quality of life related
to their sinus disease. The use
of specific postoperative care measures
that patients perform at home following
surgery is designed to reduce the
risk of complications, promote healing,
and optimize desired treatment outcomes. Because
the majority of surgical procedures
are performed on an outpatient basis,
greater responsibility for postoperative
care is placed on patients and families.
Therefore, the role of adequate
patient instruction prior to surgery
has become even more important in
facilitating optimal outcomes.
Both
treatment groups received extensive
preoperative instruction, with a
registered nurse specialized in
otolaryngology nursing, prior to
undergoing nasal and sinus surgery.
The addition of a nurse-based instructional
videotape viewed by patients at
the office and at home was designed
to reinforce information and demonstrate
specific self-care practices that
patients were to engage in at home.
Results of this study revealed several
significant findings. Subjects in
both the experimental and control
groups scored significantly higher
on the Knowledge
Index questionnaire following
surgery even though level of knowledge
was not reassessed until one week
after surgery. The majority of patients
received preoperative instructions
up to one week before surgery and
still retained a significant amount
of information about appropriate
care measures when re-tested at
their first postoperative visit.
This indicates that most patients
understand and retain preoperative
information independent of the educational
method. Instructions that occur
up to one week preoperatively still
promote adequate knowledge acquisition
and retention of information over
the postoperative period. Steinberg,
Diercks, |
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34Steinberg,
T. G., Diercks, M. J., & Millspaugh,
J. (1996). An evaluation of the
effectiveness of a videotape for
discharge teaching of organ transplant
recipients. Journal
of Transplant Coordination, 6(2),
59-63.
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and Millspaugh,34
found that a videotape used in conjunction
with other educational methods is
an effective strategy for teaching
discharge planning to transplant
patients. Since the videotape was
used in addition to an individual
session with the transplant nurse,
similar to this study design, one
cannot determine whether videotaped
instructions used alone would be
an effective method of instruction.
The use of illustrative drawings
as part of the standard preoperative
educational materials may have provided
visual cues of specific self care
behaviors, similar to those portrayed
in the videotape, thus assisting
subjects in performing these activities. |
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