Preoperative Patient Education Class During an Orthopedic Mission Trip: Effects on Knowledge, Anxiety, and Informed Consent

Mitchell A. Solano, Kaaleswar K. Ramcharran, Lynne C. Jones, Robert S. Sterling, David R. Samaroo, Harpal S. Khanuja

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Patient knowledge about arthritis and risks, benefits, and outcomes of joint arthroplasty in developing countries is unknown. We evaluated the effectiveness of a preoperative class on improving knowledge and decreasing anxiety during a surgical mission trip offering total joint arthroplasty. Methods: A team of US health care providers taught a preoperative class to 41 patients selected for total joint arthroplasty during a surgical mission trip to Guyana. Participants completed a 32-point survey about arthritis; indications, risks, and benefits of joint arthroplasty; and postoperative, in-patient rehabilitation expectations. The State-Trait Anxiety Inventory was used to measure participant anxiety. Participants completed identical surveys before and after class. Matched-pairs Student t tests were used to compare means between preclass and postclass surveys. Significance was accepted at P < .05. Results: Seventy-eight percent of patients (31 of 41) scored less than 12 of 32 possible points (40%) on the preclass knowledge questionnaire. Mean ± standard deviation knowledge scores improved from 14.0 ± 4.5 before the class to 16.5 ± 6.5 after the class (P = .008). Anxiety scores (n = 33) improved from 35 ± 13 before the class to 33 ± 12 after the class (P = .047). Conclusion: On this surgical mission trip, underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class. Greater understanding of how to educate patients and reduce their anxiety on medical missions is needed.

Original languageEnglish (US)
Pages (from-to)2410-2417
Number of pages8
JournalJournal of Arthroplasty
Issue number9
StatePublished - Sep 2020


  • arthroplasty
  • developing country
  • education
  • informed consent
  • orthopedic surgery
  • surgical mission

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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