Meta-analysis and systematic review of counselling on surgery

BACKGROUND It was to examine the influence of preoperative doctor-patient communication (D-PC) on surgery, and to improve the postoperative recovery effect of patients via meta-analysis. METHODS Meta-analysis was performed to study the influence of preoperative D-PC on surgery and improve the postoperative recovery effect of patients. Boolean logic search method was adopted, and "Preoperative communication", "psychological counseling", "Surgical effect", and "D-PC" were set as search terms. Literature retrieval of PubMed, Medline, and CNKI from the establishment to the present was conducted. Literatures that performed comparative studies and set group without preoperative communication between doctors and patients as a control were screened. Review Manager (RevMan) was adopted to carry out meta-analysis. RESULTS Fifteen papers were selected in this analysis, most of which were of low-risk bias (medium or high quality). Meta-analysis revealed that there was no statistical heterogeneity in postoperative speech function between control and experimental groups (Chi2 =1.04, I2=0%, P=0.96), and postoperative speech function of experimental group was remarkably better in contrast to control group (Z=4.09, P<0.00001). No statistical heterogeneity was found in the Asiatic aphasia test (AAT) results between two groups (Chi2 =3.77, I2=0%, P=0.44), and there was no considerable difference in AAT test results between groups (Z=1.37, P=0.17). There was statistical heterogeneity in the postoperative quality of life scores between different groups (Chi2 =115.99, I2=97%, P<0.00001), and postoperative quality of life scores of patients in experimental group were greatly superior to the control (Z=1.98, P=0.05). There was statistical heterogeneity in daily communication ability between groups (Chi2 =14.60, I2=73%, P=0.006), and daily communication ability of patients in experimental group was substantially stronger in contrast to the control (Z=7.40, P<0.00001). DISCUSSION Through meta-analysis methods, it was found that preoperative D-PC can effectively improve the postoperative speech function and daily communication ability recovery of patients, the postoperative quality of life, and the postoperative recovery of patients.