Physiotherapy education and training prior to upper abdominal surgery is memorable and has high treatment fidelity: a nested mixed-methods randomised-controlled study

Objective To (1) assess memorability and treatment fidelity of pre-operative physiotherapy education prior to elective upper abdominal surgery and, (2) to explore patient opinions on pre-operative education. Design Mixed-methods analysis of a convenience sample within a larger parallel-group, double-blinded, randomised controlled trial with concealed allocation and intention-to-treat analysis. Setting Tertiary Australian hospital. Participants Twenty-nine patients having upper abdominal surgery attending pre-admission clinic within six-weeks of surgery. Intervention The control group received an information booklet about preventing pulmonary complications with early ambulation andbreathing exercises. The experimental group received an additional face-to-face 30-minute physiotherapy education and training session on pulmonary complications, early ambulation, and breathing exercises. Outcome measures Primary outcome was proportion of participants who remembered the taught breathing exercises following surgery. Secondary outcomes were recall of information sub-items and attainment of early ambulation goals. These were measured using standardised scoring of a semi-scripted digitally-recorded interview on the 5th postoperative day, and the attainment of early ambulation goals over the first two postoperative days. Results Experimental group participants were six-times more likely to remember the breathing exercises (95% CI 1.7 to 22) and 11-timesmore likely (95% CI 1.6 to 70) to report physiotherapy as the most memorable part of pre- admission clinic. Participants reported physiotherapy education content to be detailed, interesting, and of high value. Some participants reported not reading the booklet and professed a preference for face-to-face information delivery. Conclusion Face-to-face pre- operative physiotherapy education and training prior to upper abdominal surgery is memorable and has high treatment fidelity. (c) 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.