Effects of a Preoperative Patient-Controlled Analgesia Education Program Using Smart Learning in Laparoscopic Cholecystectomy Patients.

Abstract

Background: Patients undergoing laparoscopic cholecystectomy develop severe postoperative pain, and this acute pain often becomes chronic.

Objectives: This study determines the effects of preoperative education on patient-controlled analgesia (PCA) through smart learning in patients using PCA after undergoing laparoscopic cholecystectomies.

Design: We conducted a quasi-experimental study with a nonequivalent control group pretest-posttest design.

Participants: A total of 60 adult patients aged 20-65 years, admitted for laparoscopic cholecystectomy at a hospital in Korea, participated in a smart learning training program.

Methods: The concept of smart learning, which integrates learning content and solutions with the fourth industrial revolution using mobile devices such as smartphones and media tablets was applied in this study. This smart learning training program comprised three phases: (1) prebriefing, where patients accessed PCA knowledge via a program created by researchers and accessible using a mobile web device (e.g., smartphone or an iPad), with training covering pain characteristics, PCA effects, precautions, and usage methods; (2) simulation, where patients learned using PCA with a machine; (3) debriefing, where patients reviewed their knowledge and skills.

Results: Comparing the pain between the experimental and control groups, the pain decreased significantly in both the experimental (Z = -4.40, p < .001) and control groups (Z = -4.41, p < .001), with no significant difference between groups (Z = -1.00, p = .319). Preoperative knowledge significantly increased in both the experimental (Z = -4.74, p < .001) and control groups (Z = -3.55, p < .001), with a significant difference between groups (Z = -6.05, p < .001). Total satisfaction with pain control was higher in the experimental group than in the control group.

Conclusions: A structured educational program on PCA use is an effective nursing intervention. PCA educational programs using smart learning could help patients undergoing laparoscopic cholecystectomy understand postoperative pain, promote efficient PCA use, and enhance their satisfaction with pain control.