Disease knowledge and patient education are key players for a better quality of life in vascular surgery patients

Abstract

Background The aim of this prospective investigation was to determine factors that influence the verbal disease knowledge level of the patient after the informed consent (IC) talk and to assess whether it can be improved by additional education. Furthermore, the factors underlying quality of life (QoL) after treatment, among them knowledge, education, and ambulatory care, were investigated. Methods Consecutive patients who had undergone vascular surgical intervention for abdominal aortic aneurysm (AAA), thrombendarteriectomy (TEA) of the femoral bifurcation, or digital subtraction angiography (DSA) with or without endovascular intervention for arterial occlusive disease (AOD) were included over a defined study time period. They were divided randomly into (i) standard IC talk, (ii) extended IC talk with a PowerPoint lecture (PP; Microsoft Inc., Redmond, WA, USA), and (iii) extended IC talk with a walking diary (WD). The patients filled out questionnaires before and after treatment and a RAND36 Health Survey during follow-up. The disease knowledge level was quantified by six verbal items. Group comparisons were performed by matched-pair analysis (MPA) and factor analysis by multiple regression analysis and multivariate analysis of variance (MANOVA). Results From January 2015 until November 2016, n= 198 patients were enrolled. Remembrance and comprehension rates were in general low and did not improve significantly with additional PP or WD. Age was inversely associated with disease knowledge. Age was also inversely andWD/PP and knowledge level directly associated with mid-term QoL. However, other factors such as care provision and social status were important as well. Conclusion Communication with and education of vascular surgery patients is one of the mainstays of treatment and should be continued beyond the legal and formal requirements during treatment and after discharge from hospital in order to keep the QoL as high as possible.