Knowledge and attitude of candidates to gastroplasty about perioperative: randomized clinical trial

Barros, Lívia Moreira; Gomes, Francisca Antônia do Vale; Carneiro, Flávio Neves; Galindo Neto, Nelson Miguel; Frota, Natasha Marques; Caetano, Joselany Áfio

doi:10.1590/0034-7167-2018-0869

Brasil

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (6) • 2020 • https://doi.org/10.1590/0034-7167-2018-0869 linkcopy

Knowledge and attitude of candidates to gastroplasty about perioperative: randomized clinical trial

Conocimiento y actitud de candidatos a la gastroplastia sobre perioperatorio: ensayo clínico aleatorizado

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives: to evaluate the effectiveness of educational intervention in the knowledge and attitude of candidates for gastroplasty.

Methods: randomized controlled clinical trial with 56 preoperative patients (intervention=28; control=28). The control group received routine care from the health institution and the intervention group participated in a book-mediated educational intervention. Forms were used for clinical-epidemiological characterization and evaluation of knowledge/attitude about bariatric surgery, which were reapplied seven weeks after intervention. RBR-297fzx.

Results: in the pre-test there was no significant difference between the groups (p=0.254). In the post-test, the group that received verbal guidance had a mean score of 19.5 (± 6.17) and the group reading the booklet averaged 31.1 (± 2.96), p=0.000. The attitude is adequate, especially for care such as vitamin supplement intake, water intake and physical activity practice.

Conclusions: the educational intervention mediated by booklet was effective in improving knowledge and attitude when compared to verbal guidance. Thus, it can be replicated during the preoperative preparation.

Descriptors: Obesity; Bariatric Surgery; Educational Technology; Knowledge; Perioperative Nursing

Questions: Surgery and preoperative	M0		p ^† † Mann Whitney test for comparison between groups.	M2		p ^† † Mann Whitney test for comparison between groups.
	CG	IG		CG	IG
	Correct answer	Correct answer		Correct answer	Correct answer
	% (n)	% (n)		% (n)	% (n)
1. Benefits of surgery.	28 (93.3)	30 (100)	0.154	28 (100.0)	28 (100)	1
2. Family support for surgery.	18 (60.0)	23 (76.7)	0.169	20 (71.4)	24 (85.7)	0.197
3. Attempt to lose weight with conventional treatments.	25 (83.3)	28 (93.3)	0.232	20 (71.4)	26 (92.9)	0.038
4. Preoperative objective (clinical assessment and education).	26 (86.7)	24 (80.0)	0.492	23 (82.1)	28 (100)	0.020
5. Smoking and alcohol cessation.	29 (96.7)	29 (96.7)	1	28 (100)	28 (100)	1
6. Equal preparation time before surgery for all patients.	14 (46.7)	13 (43.3)	0.797	12 (42.9)	21 (75.0)	0.015

Questions: Hospitalization and hospital postoperative	M0		p ^† † Mann Whitney test for comparison between groups.	M2		p ^† † Mann Whitney test for comparison between groups.
	CG	IG		CG	IG
	Correct answer	Correct answer		Correct answer	Correct answer
	% (n)	% (n)		% (n)	% (n)
7. Fasting before surgery.	16 (53.3)	20 (66.7)	0.296	17 (60.7)	28 (100.0)	0.000
8. Medication to prevent blood clots.	14 (46.7)	18 (60.0)	0.305	16 (57.1)	28 (100.0)	0.000
9. Transfer to the room immediately after surgery.	9 (30.0)	15 (50.0)	0.117	11 (39.3)	22 (78.6)	0.003
10. Risks and complications related to surgery.	16 (53.3)	18 (60.0)	0.605	16 (57.1)	24 (85.7)	0.019
11. Possible fall out of stitches and staples, leading to infection.	6 (20.0)	8 (26.7)	0.545	6 (21.4)	23 (82.1)	0.000
12. Need for reoperation after complications.	9 (30.0)	16 (53.3)	0.069	16 (57.1)	24 (85.7)	0.019
13. Bed rest throughout hospitalization.	11 (36.7)	14 (46.7)	0.436	8 (28.6)	26 (92.9)	0.000
14. Beginning of the liquid diet without the doctor's consent.	17 (56.7)	20 (66.7)	0.430	14 (50.0)	25 (89.3)	0.002
15. Benefits of walking and compression stockings.	22 (73.3)	19 (63.3)	0.409	20 (71.4)	28 (100.0)	0.317
16. Lung improvement with breathing exercises.	28 (93.3)	28 (93.3)	1.000	27 (96.4)	28 (100.0)	0.000
17. Edema, heat, and redness in the surgical wound.	5 (16.7)	12 (40.0)	0.047	4 (14.3)	20 (71.4)	0.000

Questions: Postoperative at home	M0		p ^† † Mann Whitney test for comparison between groups.	M2		p ^† † Mann Whitney test for comparison between groups.
	CG	IG		CG	IG
	Correct answer	Correct answer		Correct answer	Correct answer
	% (n)	% (n)		% (n)	% (n)
18. Cleaning the surgical wound.	15 (50.0)	17 (56.7)	0.608	14 (50.0)	27 (96.4)	0.000
19. Progression of the diet through adaptation and correct chewing.	17 (56.7)	23 (76.7)	0.103	16 (57.1)	27 (96.4)	0.000
20. Regular postoperative nausea and vomiting.	1 (3.3)	2 (6.7)	0.557	1 (3.6)	13 (46.4)	0.000
21. Restriction of sweets, soda, and high-calorie drinks in the first six months.	27 (90.0)	27 (90.0)	1.000	25 (89.3)	27 (96.4)	0.304
22. Drinking water only when you feel thirsty.	5 (16.7)	4 (13.3)	0.720	4 (14.3)	12 (42.9)	0.190
23. Daily intake of vitamin supplements.	22 (73.3)	21 (70.0)	0.776	21 (75.0)	27 (96.4)	0.023
24. Pain when swallowing, vomiting or esophageal stricture if chewing is not done properly.	22 (73.3)	22 (73.3)	1.000	20 (71.4)	24 (85.7)	0.197
25. Brushing teeth after vomiting.	3 (10.0)	5 (16.7)	0.451	4 (14.3)	26 (92.9)	0.000
26. Chance of psychological disorders or compulsions in the postoperative period.	12 (40.0)	16 (53.3)	0.305	8 (28.6)	25 (89.3)	0.000
27. Return to consultations only in the first year after surgery.	14 (46.7)	23 (76.7)	0.018	10 (35.7)	24 (85.7)	0.000
28. Search for health professionals if doubts or health problems.	23 (76.7)	27 (90.0)	0.169	24 (85.7)	27 (96.4)	0.164
29. Greater weight loss (first six months) by controlled eating and physical activity.	26 (86.7)	19 (63.3)	0.038	23 (82.1)	28 (100.0)	0.020
30. Maintenance of weight loss.	19 (63.3)	19 (63.3)	1.000	23 (82.1)	28 (100.0)	0.020
31. Changes in smell, taste, and feces odor.	13 (43.3)	12 (40.0)	0.795	11 (39.3)	26 (92.9)	0.000
32. Discontinuing of medications, after the improvement of clinical conditions without medical permission.	7 (23.3)	5 (16.7)	0.522	5 (17.9)	16 (57.1)	0.003
33. Dumping syndrome (concept and symptoms).	15 (50.0)	13 (43.3)	0.608	14 (50.0)	27 (96.4)	0.000
34. Alcohol consumption after three months and effects of alcohol.	21 (70.0)	24 (80.0)	0.375	20 (71.4)	28 (100.0)	0.002
35. Hair loss, brittle nails, and dry skin due to nutritional deficiencies.	21 (70.0)	18 (60.0)	0.421	18 (64.3)	27 (96.4)	0.003

Attitude	M0		p ^† † Pearson's chi-square.	M2		p ^† † Pearson's chi-square.
	CG	IG		CG	IG
	% (n)	% (n)		% (n)	% (n)
Follow the nutritionist's guidelines
Suitable	30 (100)	29 (96.7)	0.313	28 (93.3)	27 (90.0)	0.313
Take the vitamin supplement daily
Suitable	26 (86.7)	24 (80.0)	0.488	26 (86.7)	26 (86.7)	-
Drink at least two liters of water a day
Suitable	30 (100)	29 (96.7)	0.313	28 (93.3)	28 (93.3)	-
Chew food before swallowing
Suitable	30 (100)	29 (96.7)	0.313	28 (93.3)	28 (93.3)	-
Physical activities practice
Suitable	29 (96.7)	29 (96.7)	1.000	28 (93.3)	28 (93.3)	-
Follow-up with a psychologist
Suitable	29 (96.7)	30 (100)	0.313	28 (93.3)	28 (93.3)	-
Return to postoperative consultations
Suitable	30 (100)	29 (96.7)	0.321	28 (93.3)	28 (93.3)	-

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[TFN1] Note: M0 - Baseline moment; M2 - Moment 2; CG - Control Group; IG - Intervention Group;

[TFN2] ^†
Mann Whitney test for comparison between groups.