Feasibility of Online Multimedia Animations as Preoperative Guides for Urgent Abdominal Surgeries in a Public Hospital in Brazil

Abstract

Introduction: Preoperative education helps patients feel less anxious and improve self-care while decreasing hospitalization time and demand for postoperative analgesia. Health literacy, culture and language play vital roles in patients’ understanding of health issues and may influence treatment outcomes. Obstacles are more evident in low- and middle-income countries (LMICs), where inadequate patient education levels are higher and hospital resources lower. Methodology: A prospective pilot study assessing the feasibility of online preoperative multimedia animations as guides for surgical patients in an LMIC was performed. They are in the local language with a holistic focus on surgical patient education. Patients admitted to a public hospital in Brazil for acute cholecystitis or appendicitis were included. Feasibility was represented by acceptability rate and ease of integration with department protocols. Results: Thirty-four patients were included in the study. Twenty-six patients concluded the intervention (acceptability rate of 76.5%). Demographic factors seemed to affect results, indicated by higher acceptability from those with lower education levels, from younger patients and from women. No issues were reported regarding integration to local protocols. Discussion: Few studies have evaluated use of multimedia resources for preoperative patients. No studies assessed the use of animations and none analyzed digital patient education resources in an LMIC. This study demonstrated that the use of animations for patient education in LMICs is feasible. A step-based protocol approach is proposed by this study to aid the implementation of patient education digital interventions. Conclusion: The use of online multimedia animations in local language as preoperative guides in LMICs is feasible. It may help improve patient education in these contexts and promote beneficial clinical outcomes for surgical patients. This positive feasibility study opens the way for future randomized trials to assess the tool’s clinical impacts. Funding: None to declare. Declaration of Interest: Gabriel Schnitman is an intern for Mitacs Accelerate program. No other conflicts of interest to declare. Ethical Approval: This study was approved by the Institutional Review Board at McGill University in Canada and in the Research Ethics Board in the University of Sao Paulo (USP) in Brazil, where certificates of ethical approval were obtained.