Abstract
Objective
To evaluate patient understanding of risks, benefits, and alternatives (R/B/A) prior
to urological procedures using the teachback method.
Methods
Using a preprocedural phone interview, patients recalled general knowledge and R/B/A
of a scheduled procedure. A scoring system compared patient responses to a standardized
R/B/A list to analyze the level of understanding, graded as incomplete (<25%), partial
(25-75%), or complete (>75%). Following the interview, additional education was provided
if understanding was inadequate, and patients were queried regarding their satisfaction.
Results
Patients (n = 99) comprised 46% women; 32% Spanish speaking; Mean age was 64 ± 10.9 years. Procedures
included were: intravesical botulinum toxin injection (24), mid-urethral sling (9),
colpocleisis (4), prostate biopsy (24), ureteroscopy (16), transurethral resection
prostate (11), transurethral resection bladder tumor (11). Across all procedures,
the average percent of risks identified was 12%, benefits 63%, and alternatives 35%.
No patients had complete understanding, but most had partial (73.7%). Patients had
significantly higher level of understanding if they were female (P = 0.02), underwent the same procedure previously (P < 0.01) or any surgery within a year (P = 0.02), and were undergoing an in-office procedures (P = 0.03). After the teachback interview, most patients (90%) were satisfied with their
understanding.
Conclusion
In our cohort, patient understanding was alarmingly incomplete and there was substantial
benefit in pre-procedural interviews. Our findings highlight the need for improvement
in patient education prior to surgery and offers a potential solution using a teachback-based
telephone interview.
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Article info
Publication history
Published online: September 30, 2022
Accepted:
September 20,
2022
Received:
July 18,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Authors Contributions: AS performed data collection, data analysis, wrote and edited the manuscript, and is the corresponding author. PD and WC wrote and edited the manuscript. JL performed data analysis. JK performed data collection. KW edited the manuscript. NA edited the manuscript, approved the final version, and is the article guarantor.
Funding Support: None.
Conflict of Interest: All Authors have no conflict of interest.
Informed Consent: Verbal informed consent was received prior to initiating the telephone survey.
Prior Presentations: This project was presented at the SWIU clinical mentoring meeting in February 2022, SUFU winter meeting in February 2022, and AUA annual meeting in May 2022.
Identification
Copyright
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