[3-dimensional computer animation--a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study--picture versus text].
BACKGROUND
The rigorous implementation of clear preoperative information is mandatory for the patient's understanding, acceptance and written informed consent to all diagnostic and surgical procedures. In the present study, I evaluated whether new media are suitable for conveying basic information to patients; I analysed the merits of computerized animation to illustrate a difficult treatment process, i.e., the progressive steps of a thyroid operation, in comparison to the use of conventional flyers.


METHODS
3D animation software was employed to illustrate the basic anatomy of the thyroid and the larnyx; the principle of thyroidectomy was explained by visualizing the surgical procedure step by step. Finally, the possible complications that may result from the intraoperative manipulations were also visually explained. Eighty patients entered a prospective randomisation: on the day before surgery, group 1 watched the computer animation, whereas group 2 was given the identical information in a written text (= standard flyer). The evaluation included a questionnaire with scores of 1-5, rating the patients' understanding, subjective and objective knowledge, emotional factors like anxiety and trust, and the willingness to undergo an operation.


RESULTS
Understanding of and subjective knowledge about the surgical procedure and possible complications, the degree of trust in professional treatment, the reduction in anxiety and readiness for the operation were significantly better after watching the computer animation than after reading the text. However, active knowledge did not improve significantly. The interest in the preoperative information was high in both groups. The benefit of computer animation was enhanced in a second inquiry; patients who had only read the text had a significant improvement in parameters after an additional exposure to the video animation.


CONCLUSIONS
Preoperative surgical information can be optimized by presenting the operative procedure via computer animation. Nowadays, several types of new media such as the world wide web, CD, DVD, and digital TV are readily available and--as shown here--suitable for effective visual explanation. Most patients are familiar with acquiring new information by one of these means. An appropriately designed 3D repre-sentation is met with a high level of acceptance, as the present study clearly shows. Modern patient-based information systems are necessary. They can no longer be the sole responsibility of the medical profession, but must be on the agenda of hospital managements and of medical care systems as well.
Hermann
M
M
Chirurgische Abteilung, Kaiserin Elisabeth Spital, Huglgasse 1-3, 1150 Wien, Osterreich. michael@drhermann.at
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001296:Audiovisual Aids; D003194:Computer-Assisted Instruction; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D013965:Thyroidectomy