Lack of Consensus and Dense Content in Informational Letters on Benign Gynecological Surgery

Preoperative informational letters are often provided to help patients understand their surgery and recovery. Patients who are well informed before undergoing surgery experience reduced stress, increased understanding of the postoperative process, and increased participation in decision-making. A combination of written and oral information is preferred by the patients. Furthermore, written, structured, and comprehensive information is perceived to be valuable.

Although providing patients with written information before gynecological surgery is widely used and assumed important, no study has investigated what information patients truly need. This study maps the contents of departmental informational letters and explores whether the national GynOp letters live up to the patients’ expectations and needs. 

In 2014, all 59 gynecological departments in Sweden were asked to provide the information letter they send to patients before hysterectomy on benign indication. 32 letters were screened and the data were analyzed using frequency analysis. In addition, three focus groups were conducted and these data were submitted to Qualitative Content Analysis.  The focus group discussions (FGD) were digitally recorded and transcribed by a secretary. The material was listened and read through thoroughly by the first, second and fourth author before analysis.

The analysis of the information letters showed great variation and discrepancy in pre-operative information. The analysis of the focus groups resulted in the theme You can’t see the forest for the trees, reflecting that, the women found it very difficult to identify the most important information among the massive amount information received. 

In conclusion, informational letters distributed before benign gynecological surgery do not meet the patient’s needs or expectations. Besides, this study demonstrates the complexity of informing patients in a way that is understandable and fulfills the needs and desires of patients. It seems that patients wanted only the most relevant information in an informational letter; the letters should include the most serious and the most common complications as well as the positive effects of the surgery and nothing more. This study could serve as a foundation for the content of informational letters.

Article by Sofia Widetun, et al, from Umea University, Umea, Sweden.

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