Table 2 Main characteristics, evaluated interventions, and conclusions of studies exclusively addressing foot and ankle surgery
From: Preoperative education in patients undergoing foot and ankle surgery: a scoping review
Speirs (2008) [35] | Selvan (2013) [34] | Schafer (2017) [32] | Thomas (2022) [36] | |
|---|---|---|---|---|
Journal | The foot | Foot and ankle surgery | International Journal of Health professions | The foot |
Study design | Observational | Observational (cross-sectional) | Controlled before and after | Observational |
Language | English | English | German | English |
Country | UK | UK | Germany | UK |
Number of participants | 161 | NR | 56 | 130 (62 attended foot school) |
Inclusion criteria | Patients over 18 years undergoing elective foot and/or ankle surgery under local or general anesthesia, at the West Middlesex University Hospital | All foot and ankle elective patients attending for their operative intervention at Aintree University Hospital from Jan to March of 2007–2011 | Patients of any age undergoing elective foot and ankle surgeries | Patients undergoing elective foot and ankle procedures from Jan 2019 to Jan 2020 |
Exclusion criteria | Revision surgery cases, pediatric cases, and patients who had insufficient understanding of English | NR | Revision surgeries and urgent surgeries | Patients who stayed overnight at the hospital due to anesthetic complications such as low blood pressure and uncontrolled pain. Insufficient data of the patient |
Diagnosis of participants | Hallux limitus, hallux valgus, lesser toes pathology, lesser metatarsals pathology | NR | NR | NR |
Indicated surgery | “Implant,” cheilectomy, sesamoidectomy, Lapidus procedure, osteotomies, arthroplasty, arthrodesis, Weil osteotomy, neurectomy, hemiphalangectomy, syndactylization | Only indicates if there was a forefoot, midfoot, hindfoot, ankle, fore and midfoot, or hindfoot and ankle surgery | NR | Scarf-Akin, Morton’s neuroma, Achilles-tendon lengthening, Lapidus, first MTPJ fusion, multiple toes surgery, lesser toes, calcaneal surgery |
Description of preoperative education | Preoperative information sheets | An educative session dictated by a nurse and a physiotherapist | Training course of 2 and a half hours, with a multidisciplinary team. Introduction (10 min); education (90 min) on foot surgery, anesthesia, nursing, social services, and physical therapy care at the hospital in the treatment phase, postoperative follow-up and aid provision. “Kiosk” (60 min) practical walking exercises, physiotherapy, and social service | Group session with a physiotherapist, lead discharge nurse and providing educational material (booklets specific to their surgical procedure) |
Timing of education and number of sessions | At the moment of informed consent | Three weeks before surgery. One session | “Before surgery.” Not detailed. One session | Within 2 weeks of surgery. One session per week |
Outcomes | Rating of the procedure information sheet, readability of sheets | Length of stay (hours) | Increase in knowledge, satisfaction, and preoperative anxiety | Length of stay (hours) |
Main conclusions | PILs used for foot surgery were well received by patients. The audit highlighted the areas “recovery, level of pain, and work return.” There were differences between men and women and between patients aged more and less than 60 years old | The intervention group had reduced inpatient stays, increase in day-case surgery rates with significant cost savings | The training increased the knowledge of the participants and the personal gain. The patients reported a high level of satisfaction with the process. The efficacy and profitability have to be proved in a controlled study yet to recommend the implementation | Preoperative education results in significantly shorter postoperative hospital stay, thereby saving hospital costs per procedure. Patients should, therefore, be encouraged to attend foot school before their surgical procedure |