Effects of a structured web-based educational program on health education literacy compared to self-directed online information seeking in patients undergoing carpal tunnel release surgery: a non-randomized, controlled study (Preprint)
Authors: Seel Mariella , Mihalic Julian Alexander , Froschauer Stefan Mathias , Holzner Berhard , Meier Jens , Gotterbarm Tobias , Holzbauer Matthias 
Published: August 2024

BACKGROUND

With advancements in anesthesiologic and surgical techniques, many surgeries are now performed as day-surgery procedures, requiring greater responsibilities for self-management from patients during the perioperative process. This shift increases the demand for comprehensive patient education to ensure effective self-management. Online health information often lacks reliability and comprehensibility, posing risks for patients with low health literacy. Carpal tunnel release (CTR) surgery, a common day surgery procedure, necessitates effective patient education for optimal recovery and self-management.

OBJECTIVE

This study introduces the CTS Academy, a web-based education program designed for patients undergoing CTR day surgery. The study aims to evaluate the CTS Academy's impact on patients’ health education literacy (HEL) compared to self-directed online information seeking.

METHODS

In a non-randomized controlled study, 60 patients scheduled for CTR were assigned to two groups based on the patients’ preferences: the test group used the CTS Academy, while the control group performed self-directed online searches. HEL was assessed using the Health Education Literacy of Patients with chronic musculoskeletal diseases (HELP) questionnaire, focusing on comprehension (COMPR), application (APPLY), and communicative competence (COMM). Secondary outcomes included content comprehensibility, patient preferences, platform usability, and clinical CTS-related parameters.

RESULTS

Each 18 patients could be included in the assessment of the test and the control group. The test group showed significant improvements in APPLY (P=.006) and COMM (P=.017) after using the CTS Academy in a longitudinal analysis, while no significant changes were observed in the control group. In a comparison between groups, the test group had significantly higher APPLY scores at follow-up (P=.044) and fewer comprehension issues at baseline (P=.029). The CTS-related knowledge assessment yielded 92% vs. 90% correct answers in the test and control cohort.
The test group rated the CTS Academy highly in usability and utility. Preferences leaned towards using CTS Academy alongside doctor consultations and over self-directed searches. No significant differences were found in CTS-related symptoms between groups.

CONCLUSIONS

The CTS Academy effectively enhanced patients' health education literacy, especially in applying and communicating medical information. The platform's usability and utility were rated favorably, and patients preferred it over independent online information seeking. This suggests that structured, web-based education enhances patient self-management during the day surgery process. Further research is recommended to further individualize the content presented based on the individual patient’s needs and to explore long-term impacts and scalability.

CLINICALTRIAL

This study was approved and registered the institutional Review Board (EK1212-2021)