Assessing the efficacy of preoperative procedural patient education as an intervention to mitigate stress and anxiety among otorhinolaryngology surgery patients: A randomized controlled trial

Background: ENT surgery patients often experience significant physical and psychological stress. While preoperative education's benefits for surgical patients are known, its effectiveness in ENT surgery remains underexplored.

Methods: In a randomized study of 164 inpatient ENT surgery patients under general anesthesia, one group received procedural patient education, while the other followed standard preparation. We assessed perioperative state anxiety (T1: pre-surgery, T2/T3: surgery day, T4: post-surgery) using the State-Trait Operation Anxiety inventory (STOA), along with stress and anxiety via the Numeric Rating Scale for Stress (NRS) and vital signs (blood pressure, respiratory rate, heart rate). User feedback on education's usefulness was collected through an evaluation questionnaire. Perioperative state anxiety was compared using two-tailed t-tests (95% CI). Subjective ratings were correlated with STOA values.

Results: Of 164 participants, 152 completed the trial. Patients receiving preoperative education had significantly lower state anxiety on surgery day (mean difference +2.15, P=0.03) than those without (mean difference 3.09, P=0.04). Those finding education helpful (Helpfulness rating 6 – 10) had lower stress increases (M=+2.80) than the control group (M=+4.04, P=0.05). Vital parameter changes did not significantly differ between groups. Female patients in the education group reported significantly lower postoperative stress (M=-2.95) than controls (M=-2.19; P=0.04), with suggestive but nonsignificant findings in males (P=0.10).

Conclusions: Preoperative education effectively reduces stress and anxiety in ENT surgery patients. Integrating it into routine practice, especially for those valuing it, is advisable, as our study demonstrates substantial benefits.

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