Videoassistierte anästhesiologische Patientenaufklärung

Zusammenfassung

Hintergrund

Studien über videoassistierte Patientenaufklärung (ViPA) in der Anästhesie konnten zeigen, dass dieses Verfahren hinsichtlich Wissenstransfer und Patientenzufriedenheit der konventionellen Stufenaufklärung überlegen ist und die Patienten nicht zusätzlich verängstigt.

Ziel der Arbeit

Erstmals wird versucht zu klären, wie Ärzte, die ViPA anwenden, diese Methode beurteilen.

Methode

An 22 Anästhesieabteilungen wurden 122 Fragebogen verschickt, von denen 81 (66 %) ausgefüllt zurückgesandt wurden.

Ergebnisse

Der Aussage, ViPA sei eine Hilfe beim Aufklärungsgespräch, stimmten 97,5 % der Befragten zu. Dass die Patienten nach ViPA besser informiert zum Aufklärungsgespräch kommen, wurde von 96 % der Befragten bejaht, dass mit ViPA Zeit eingespart wird, von 92,5 %. Eine zusätzliche Verängstigung der Patienten durch die Videos wurde von 54 % verneint, von 46 % bejaht.

Der Aussage, dass die ViPA ein besseres Eingehen auf das individuelle Risikoprofil erlaube, wurde von jeweils der Hälfte der Befragten zugestimmt bzw. widersprochen.

Die Frage nach den 3 Hauptvorteilen der ViPA ergab folgende Rangfolge:

1. bessere Information der Patienten, 2. Zeiteinsparung, 3. Arbeitserleichterung.

Die Bereitschaft zur Weiterempfehlung der ViPA an Kollegen wurde von 82,5 % der Befragten mit „ja“ beantwortet, von 17,5 % mit „bedingt“.

Diskussion

Bezüglich Wissenstransfer und Zeiteinsparung stimmt die Einschätzung der befragten Ärzte mit der Mehrzahl der bei Patienten erhobenen Befunde überein. Die angstauslösende Wirkung von Videos scheint jedoch von ärztlicher Seite überschätzt zu werden.

Die ViPA wird von der überwiegenden Mehrheit der Befragten als willkommene Hilfe betrachtet, die an Kollegen, die sie bisher nicht anwenden, weiterempfohlen wird.

Abstract

Background

Video-assisted patient education (VaPE) has in the past been a subject of many studies. Compared to conventional methods, most authors reported a better transfer of information, some found increased patient satisfaction and a time-sparing effect. There was no increase in anxiety caused by VaPE. Some authors even found a reduction of anxiety levels before anesthesia. All publications to date have focused on the patient’s point of view. There have been no reports on how anesthetists as users assess VaPE.

Methods

In this study 22 anesthesia departments using VaPE were contacted. A total of 122 anesthetists were sent questionnaires of which 81 (66%) were completed and returned. The anesthetists were first questioned about the characteristics of the workplace, the frequency of preanesthesia patient contacts, the content of the videos, the technique of video presentation and their own professional experience. After this the anesthetists were asked to assess five statements concerning: usefulness of VaPE, economy of time, transfer of knowledge, induction of anxiety and influence on the quality of the consent interview. In each category there were 4 choices: fully agree, partly agree, partly disagree and fully disagree. The first two choices were evaluated as positive and the second two as negative answers. The anesthetists were also asked to state the most valued characteristics of VaPE. Out of eight given options they were to select the most favored three. A final question was whether in their opinion VaPE could be recommended to non-users.

Results

Of the anesthetists 97.5% stated that disclosure interviews predominantly took place in the preoperative anesthetic clinic and 73% performed 15 or more patient interviews per day. Videos about general anesthesia were applied by 70%, about non-obstetric regional anesthesia by 56% and about obstetric epidural anesthesia by 59%. The videos were presented to groups of patients via large screens by 27%, individually with CD players or tablet computers by 51% or with both methods (22%). Of the anesthetists 69% had 5 years or more professional experience, 97.5% found VaPE useful for patients education, 92.5% observed a time-saving effect for the following interview and 96% stated that after watching the video patients were better informed. An increase of anxiety caused by VaPE was noted by 46% whereas 54% found no such effect. As to the quality of interview 50% reported an advantage in focusing on the patient’s individual risk profile and the other 50% reported no advantage. The ranking of the main advantages was 1) better patient information, 2) time-saving effect, 3) helpful for patient education, followed by 4) increased patient satisfaction, 5) better understanding of anesthesiology, 6) individualization of the interview and 7) helpful in questions of legal liability. The answer option “no advantage” was not chosen at all. Of the participants 82.5% would recommend VaPE unconditionally (fully agree), 17.5% would give a conditional recommendation to colleagues and no one would not recommend VaPE.

Conclusion

This survey among anesthetists confirmed most results obtained from patient-based studies: medical users attributed to VaPE a better information transfer and a time-sparing effect. Furthermore, users regarded VaPE as helpful for the preanesthesia interview. As compared to the patient-based results, however, many anesthetists seem to overrate the anxiety, caused by disclosure videos. From the users’ point of view, VaPE is a highly appreciated method for patient education which can be recommended to colleagues.