Randomized trial of a web-based tool for prolapse: impact on patient understanding and provider counseling
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Introduction and hypothesis
Effective patient/provider communication is important to ensure patient understanding, safety, and satisfaction. Our hypothesis was that interactive patient/provider counseling using a web-based tool (iPad™ application) would have a greater impact on patient satisfaction with understanding prolapse symptoms compared with standard counseling (SC).
Women with complaints of seeing/sensing a vaginal bulge were enrolled in this randomized controlled trial. Participants completed pre- and postvisit Likert scale questionnaires on satisfaction with prolapse knowledge and related anxiety. After new patient histories and physical examinations, study participants were randomized to SC or SC with iPad™. Ninety participants were required to detect a 30 % difference in satisfaction with prolapse knowledge between the two groups.
Ninety women were randomized to SC (n = 44) or SC with iPad™ (n = 46). At baseline, 47 % of women were satisfied with their understanding of bulge symptoms (50 % SC vs. 43.5 % SC with iPad™, p = 0.5). After counseling, 97 % of women reported increased satisfaction with understanding of bulge symptoms (p < 0.0001), with no difference between groups [42/44 (95.5 %) SC vs. 45/46 (97.8 %) SC with iPad™, p = 0.5]. Baseline anxiety was high: 70 % (65.9 % SC vs. 73.9 % SC with iPad™, p = 0.4). After counseling, anxiety decreased to 30 % (p < 0.0001), with improvement in both groups (31.8 % SC vs. 28.3 % SC with iPad™, p = 0.7). Counseling times were similar between groups (9.5 min., SC vs. 8.9 min., SC with iPad, p = 0.4).
Interactive counseling was associated with increased patient satisfaction with understanding bulge symptoms and decreased anxiety whether a web-based tool was used or not.
- Boyles SH, Weber AM, Meyn L (2003) Procedures for pelvic organ prolapse in the United States, 1979–1997. Am J Obstet Gynecol 188(1):108–115. doi:10.1067/mob.2003.101 CrossRef
- Anger JT, Lee UJ, Mittal BM, Pollard ME, Tarnay CM, Maliski S, Rogers RG (2012) Health literacy and disease understanding among aging women with pelvic floor disorders. Female Pelvic Med Reconstr Surg 18(6):340–343. doi:10.1097/SPV.0b013e31826fb8d3 CrossRef
- Heller L, Parker PA, Youssef A, Miller MJ (2008) Interactive digital education aid in breast reconstruction. Plast Reconstr Surg 122(3):717–724. doi:10.1097/PRS.0b013e318180ed06 CrossRef
- Levinson W, Lesser CS, Epstein RM (2010) Developing physician communication skills for patient-centered care. Heal Aff (Millwood) 29(7):1310–1318. doi:10.1377/hlthaff.2009.0450 CrossRef
- Stein T, Frankel RM, Krupat E (2005) Enhancing clinician communication skills in a large healthcare organization: a longitudinal case study. Patient Educ Couns 58(1):4–12. doi:10.1016/j.pec.2005.01.014 CrossRef
- Brody DS, Miller SM, Lerman CE, Smith DG, Lazaro CG, Blum MJ (1989) The relationship between patients' satisfaction with their physicians and perceptions about interventions they desired and received. Med Care 27(11):1027–1035 CrossRef
- Wofford JL, Smith ED, Miller DP (2005) The multimedia computer for office-based patient education: a systematic review. Patient Educ Couns 59(2):148–157. doi:10.1016/j.pec.2004.10.011 CrossRef
- Krishna S, Balas EA, Spencer DC, Griffin JZ, Boren SA (1997) Clinical trials of interactive computerized patient education: implications for family practice. J Fam Pract 45(1):25–33
- Davey HM, Barratt AL, Butow PN, Deeks JJ (2007) A one-item question with a Likert or Visual Analog Scale adequately measured current anxiety. J Clin Epidemiol 60(4):356–360. doi:10.1016/j.jclinepi.2006.07.015 CrossRef
- Customized POP-Q Exercise -- Quick Score Entry (Part 3 of 6) (2011). http://www.youtube.com/watch?v=Zzx1EgekSHw. Accessed 10 Feburary 2012
- Kinnane N, Thompson L (2008) Evaluation of the addition of video-based education for patients receiving standard pre-chemotherapy education. Eur J Cancer Care (Engl) 17(4):328–339 CrossRef
- Randomized trial of a web-based tool for prolapse: impact on patient understanding and provider counseling
International Urogynecology Journal
Volume 25, Issue 8 , pp 1127-1132
- Cover Date
- Print ISSN
- Online ISSN
- Springer London
- Additional Links
- Patient education
- Patient satisfaction
- Industry Sectors
- Author Affiliations
- 1. Department of Obstetrics and Gynecology, University of North Carolina, 3023 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599, USA