Effect of preoperative education and ICU tour on patient and family satisfaction and anxiety in the intensive care unit after elective cardiac surgery: a randomised controlled trial

BACKGROUND: Preoperative education may help participants to psychologically prepare themselves for surgery, but the outcomes of such preparation have rarely been assessed in patients requiring postoperative care in the intensive care unit (ICU) as well as in family members. OBJECTIVE: To assess the effect of a preoperative multifaceted education intervention on patient and family satisfaction levels in the ICU and measures of perioperative patients' anxiety and depression. TRIAL DESIGN: Single-centre, two-armed, parallel, superiority, randomised controlled trial. Healthcare professionals in ICU and outcome assessor were blinded to treatment allocation. PARTICIPANTS: 100 elective coronary artery bypass grafting±valve surgery patients and their family members. INTERVENTIONS: Preoperative education comprising of a video and ICU tour in addition to standard care (treatment), versus standard care (control). OUTCOMES: Patient and family satisfaction levels with ICU using validated PS-ICU23 and FS-ICU24 questionnaires (0-100), respectively; change in perioperative anxiety and depression scores between 1 day presurgery and 3 days postsurgery. RESULTS: Among 100 (50 treatment, 50 control) patients and 98 (49 treatment, 49 control) family members, 94 (48 treatment, 46 control) patients and 94 (47 treatment, 47 control) family members completed the trial. Preoperative education was associated with higher overall patient (mean difference (MD) 6.7, 95% CI 0.2 to 13.2) and family (MD 10.0, 95% CI 3.8 to 16.3) satisfaction scores. There was a weak association between preoperative education and a reduction in patient's anxiety scores over time (MD -1.7, 95% CI -3.5 to 0.0). However, there was no evidence of a treatment effect on patient's depression scores over time (MD -0.6, 95% CI -2.3 to 1.2). CONCLUSION: Providing comprehensive preoperative information about ICU to elective cardiac surgical patients improved patient and family satisfaction levels and may decrease patients' anxiety levels. TRIAL REGISTRATION NUMBER: ChiCTR-IOR-15006971.