Preoperative Education Program on Gastrointestinal Quality of Life in Cholecystectomy Patients

This clinical trial aims to explore the effectiveness of a preoperative health education program on knowledge and quality of life for patients undergoing cholecystectomy in surgical wards at public teaching hospitals in Erbil City, Iraq. Gallstone disease (GSD) is one of the most common leading causes of morbidity and biliary tract diseases worldwide. Gallstones constitute a significant health problem in developed societies, affecting 10% to 15% of the adult population, and are associated with a significant health and financial burden. Inadequate health education and the absence of structured preoperative counseling programs have contributed to inconsistent knowledge among patients and variable recovery outcomes following the cholecystectomy procedure.

This study will evaluate whether equipping patients who are undergoing cholecystectomy with comprehensive preoperative education enhances the postoperative quality of life and postoperative outcomes.

The study will involve two groups of patients with confirmed cholelithiasis who are undergoing cholecystectomy

Intervention group: patients receiving a comprehensive preoperative educational program will cover:

• General information about the gallbladder included nine questions covered (physiological function of GB, positive indicator signs and symptoms of gallstones, laboratory test indicators for gallstones, which gender and age groups are at higher risk of developing gallstones, common diagnostic tools, and standard methods of treatment for symptomatic patients).
• Patient information about cholecystectomy surgery included five questions covered (number of small incisions in the laparoscopic method, advantages of the laparoscopic method, absolute contraindications of cholecystectomy, situation of operation conversion from laparoscopic to open, and contraindications of both types of open and laparoscopic cholecystectomy).
• Patient's information about preoperative preparations included nine questions covering essential investigations and diagnostic tests before operation, informed consent concerning the reason for fasting before surgery, skin preparation (operative site), the appropriate type of soap for skin preparation, cosmetic use before operation, the type of medication the patients must stop before surgery, personal item removal, and the type of clothes recommended for surgery.
• Postoperative care included eight questions covered (position after surgery, postoperative complications avoided by early ambulation, gastrointestinal symptoms after surgery, normal period, can the patients return to work and daily activities, postoperative exercises such as deep breathing and coughing, leg and ankle pump exercises, ankle circle exercises, and changing position).
• Patients' information about discharge guidelines included six questions covering steps of keeping the wound area clean after surgery, the importance of avoiding soaking in pools or showers for a long time after surgery, eating times per day after surgery, nutrients recommended after surgery, signs and symptoms of wound infection, and situations that need immediate calling or visiting the physician.

The primary outcome will be the change and improvement in postoperative quality of life score and patients' outcomes over a specific period. Secondary outcomes will include patient knowledge and practice measured through a pre- and post-intervention structured questionnaire.

The participants, after one month, will attend follow-up visits where the quality of life will be assessed, and patients will be assessed for their knowledge and understanding of the preoperative educational guidance provided. Data on patients will also be collected and analyzed.

Inclusion criteria

• An adult patient.
• Both genders
• Individuals' interest in participating in the study.
• Patients who were diagnosed with cholelithiasis requiring a cholecystectomy operation confirmed by ultrasound and physical examination
• Ability to attend the educational program
• Conscious patient able to communicate
• Being elective candidates for cholecystectomy

Exclusion criteria

• Who had participated in a previous education program regarding open and laparoscopic cholecystectomy
• Patients who refuse to complete the post-test.
• Those with professional health qualifications
• Patients with mental disabilities and mental illnesses.
• People who changed their opinion about participating in the study or missed consecutive educational intervention sessions for any reason.
• The procedure is done other than standard laparoscopic and open cholecystectomy.