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C.K. Pager, P.J. McCluskey; Great Expectations: Randomized Controlled Trial of Preoperative Information to Improve Postoperative Patient Satisfaction in Day-stay Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):782.
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Purpose: Patient satisfaction has come to be embraced as a significant health outcome in its own right. Satisfaction is often explained by concordance between expectation and experience, and inadequate information is an important determinant of patient dissatisfaction. However, many patients do not wish to receive additional information despite a level of understanding below requirements for informed consent. The objective of this randomized controlled trial is to investigate the effects of an informational video on patient expectations and satisfaction with day-stay cataract surgery. Methods:141 patients undergoing day-stay cataract surgery were randomized into one of two video groups, explaining either what to expect from the cataract surgery or the anatomy & physiology of cataract. Patients were surveyed as to their expectations for visual outcome, anxiety, risk and discomfort resulting from the surgery. After the operation, patients were again asked to rate their experience of anxiety, discomfort, risk, comprehension, overall satisfaction and comparison with expectations. Results: 84% of patients already felt the received enough or too much information. The expectations video group expected the surgery to be more risky and uncomfortable than the anatomy video group. Yet, after the surgery, the expectations video group were significantly more satisfied, understood better what was happening to them, and felt less anxious. There was no difference in the degree of discomfort or risk actually experienced, or the expected visual outcomes. Patients with prior cataract surgery experience expected less anxiety and discomfort, and found the surgery closer to their expectations than did first-time cataract patients. However, there was no interaction between past experience with cataract surgery and effect of video group allocation. Conclusions: This study has demonstrated that a simple, inexpensive videotape showing patients what to expect from cataract surgery resulted in strongly significant increases in patient understanding of and satisfaction with the cataract surgery, as well as a decrease in anxiety. These effects were independent of patients' expected visual outcomes or previous experience with cataract surgery, and despite the fact that patients generally felt they had already received enough information.
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