BACKGROUND Orthopaedic trauma patients may experience poor recall regarding their injury and treatment, impairing postoperative outcomes. We sought to evaluate the impact of a standardized postoperative educational protocol on patient recall, adherence to the treatment plan, and satisfaction. METHODS Two hundred and twenty adult, English-speaking patients with surgically treated lower-extremity fractures were prospectively included. One hundred and ten patients in the educational intervention cohort met with a non-physician study member after surgery but before hospital discharge. They were given a written questionnaire evaluating knowledge of key aspects of their injury and treatment plan. For incorrectly answered questions, the study team member told the patient the correct answer (e.g., "No, you broke your tibia."). Immediately after, the patient was verbally asked the question again (e.g., "Which bone did you break?"), repeating the process until the answer was correct. The 110 patients in the control cohort did not receive this "teach-back" protocol. During their first postoperative appointment, all 220 patients completed a follow-up questionnaire assessing recall, adherence to the treatment plan, and satisfaction. RESULTS The control cohort correctly answered 64% of recall-oriented questions versus 89% in the intervention cohort (p < 0.001). Eighty-two percent of control patients versus 89% patients in the intervention cohort adhered to postoperative weight-bearing restrictions (p = 0.09). Eighty-four percent of controls adhered to their deep venous thrombosis prophylaxis regimen versus 99% of the intervention cohort (p < 0.001). On a 5-point Likert scale, controls were less satisfied with their overall orthopaedic care compared with patients in the intervention cohort (mean of 4.38 ± 0.84 versus 4.54 ± 0.63 points; p = 0.02), although this difference was less than the minimal clinically relevant difference of 10% that was defined at study onset. On propensity score-weighted multivariable analysis, receipt of the postoperative educational intervention was the only modifiable factor associated with improvement in patient recall (26% improvement [95% confidence interval, 20% to 31%]; p < 0.001). CONCLUSIONS Some orthopaedic trauma patients' nonadherence to surgeon recommendations and dissatisfaction with care may be mitigated by postoperative education. This standardized postoperative educational protocol improves orthopaedic trauma patients' recall, adherence to their treatment plan, and satisfaction in a manner requiring minimal time. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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改善手术骨科创伤后的患者回忆。


背景骨科创伤患者可能对其受伤和治疗记忆不佳，从而损害术后结果。我们试图评估标准化术后教育方案对患者回忆、治疗计划依从性和满意度的影响。方法 前瞻性纳入 220 名接受手术治疗下肢骨折的英语成人患者。教育干预队列中的 110 名患者在手术后出院前会见了一名非医生研究成员。他们收到了一份书面调查问卷，评估他们对伤害和治疗计划的关键方面的了解。对于回答错误的问题，研究小组成员告诉患者正确的答案（例如，“不，你打破了你的胫骨。”）。紧接着，患者再次被口头询问这个问题（例如，“你骨折了哪根骨头？”），重复该过程直到答案正确。对照组的 110 名患者没有接受这种“回授”方案。在第一次术后预约期间，所有 220 名患者都完成了一份随访调查问卷，评估回忆、对治疗计划的遵守情况和满意度。结果 对照组正确回答了 64% 的回忆型问题，而干预组的正确回答率为 89% (p < 0.001)。 82% 的对照患者与 89% 的干预组患者遵守术后负重限制 (p = 0.09)。 84% 的对照者坚持深静脉血栓形成预防方案，而干预组的这一比例为 99% (p < 0.001)。 在 5 点李克特量表中，与干预队列中的患者相比，对照组对其整体骨科护理不太满意（平均值为 4.38 ± 0.84 分 vs 4.54 ± 0.63 分；p = 0.02），尽管这种差异小于临床上的最小差异。研究开始时定义的相关差异为 10%。在倾向评分加权多变量分析中，接受术后教育干预是与患者回忆改善相关的唯一可修改因素（26% 改善 [95% 置信区间，20% 至 31%]；p < 0.001）。结论 术后教育可以缓解一些骨科创伤患者不遵守外科医生建议和对护理不满意的情况。这种标准化的术后教育方案以最短的时间提高了骨科创伤患者的记忆力、对治疗计划的依从性和满意度。证据级别 预后 II 级。有关证据级别的完整描述，请参阅作者须知。