title: A qualitative report of patient problems and postoperative instructions.
abstract: OBJECTIVE
  While surgery related stress may interfere with the patient's ability to concentrate on instructions, language difficulty or low health literacy may also impede appropriate doctor/patient communication. The purpose of this study is to understand from a sample of minority patients the types of problems encountered during healing and the level of information regarding elements of postoperative instructions they recalled receiving at an inner-city safety net hospital. We initiated a qualitative study to understand the care sequence process and provision of informed consent and postoperative instruction.
  
  
  METHODS
  African American or Latino patients, 18 years of age or older, who had third molars removed under general anesthesia or received treatment for a mandibular fracture were recruited to participate in a focus group to discuss their treatment. Patients described their problem and any informed consent given about treatment risks and benefits and postoperative information they recalled.
  
  
  RESULTS
  A total of 137 former patients were approached, 57 agreed to participate (42%) and 34 of those (60%) completed the interview. Subjects included 14 females and 20 males. Five categories of patient problems were reported: physical, eating, treatment-related, psychosocial, and other problems. People reported 5 categories of coping strategies: medication use, physical treatments, dietary solutions, rest, and clinical assistance. Twenty people recalled being given informed consent, and 5 participants recalled no elements of informed consent. Overall, 14 participants recalled elements of postoperative instruction.
  
  
  CONCLUSIONS
  Gaps in patient understanding of postoperative care suggest room for improvement in postoperative instructions. Additional research is necessary to design and test high-quality postoperative instructions for surgical treatment and recovery in populations with limited health related literacy.
authors.affiliation: UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA. kathya@dent.ucla.edu
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Atchison
authors.forename: Edward E
authors.initials: EE
authors.lastname: Black
authors.forename: Richard
authors.initials: R
authors.lastname: Leathers
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Belin
authors.forename: Mirna
authors.initials: M
authors.lastname: Abrego
authors.forename: Melanie W
authors.initials: MW
authors.lastname: Gironda
authors.forename: Daniel
authors.initials: D
authors.lastname: Wong
authors.forename: Vivek
authors.initials: V
authors.lastname: Shetty
authors.forename: Claudia
authors.initials: C
authors.lastname: DerMartirosian
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D003144:Communication Barriers; D005260:Female; D017144:Focus Groups; D006630:Hispanic or Latino; D006801:Humans; D007258:Informed Consent; D008297:Male; D008337:Mandibular Fractures / Q000208:ethnology / Q000601:surgery*; D011939:Mental Recall; D008964:Molar, Third / Q000601:surgery*; D011182:Postoperative Care / Q000523:psychology*; D014081:Tooth Extraction