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Patient education with 3D model before Mohs surgery reduces anxiety

Noelani González

Patient education using a 3D-printed model before Mohs micrographic surgery along with standardized preoperative education improved patient understanding and decreased perioperative anxiety, according to a study.

“The possibility of being able to educate patients with something ‘concrete’ that they can see and touch could be a great addition to patient education,” Noelani González, MD, clinical instructor of dermatology at Mount Sinai Hospital, told Healio Dermatology. “As dermatologists, we tend to be very visual, are always looking at ways to decrease patient anxiety before procedures, and it’s always exciting when something innovative becomes available to aid in our patients’ understanding of procedures.”

Patients scheduled to undergo Mohs micrographic surgery (MMS) were divided into two groups: 42 patients in the 3D-printed model MMS group and 40 in the standard education group. More than half of the patients (52.4%) had not previously undergone MMS.

The 3D-printed MMS model was created as a visual tool to increase understanding of the procedure. “[It] contained two skin layers for simplification, a layer of removed tissue and a residual tumor embedded in the bottom layer of skin,” the researchers wrote.

The educational protocol encompassed 5 minutes of verbal counseling from a script about MMS. The researchers were instructed to read the script and defer procedural questions to the medical team.

The MMS model group underwent verbal counseling and physical demonstration using the 3D-printed MMS model.

To quantify anxiety, researchers employed the Visual Analog Scale (VAS) and State-Trait Anxiety Inventory (STAI). Patients also completed a VAS specific to their comfort level in understanding the MMS procedure. A six-item knowledge assessment was used to assess patient knowledge of MMS.

Patients in the MMS model group reported reductions in VAS anxiety scores from 3 to 1.7 (P ˂ .0001) and the STAI anxiety scores from 32.7 to 27.8 (P ˂ .0001). The VAS scores approached statistical significance, the researchers reported.

The standard education group had decreased VAS anxiety from 2.5 to 2. (P ˂ .04) and STAI anxiety from 33 to 29.7 (P ˂ .03).

In the six-item knowledge assessment, the MMS model averaged higher correct responses than the standard education group (93.25% vs. 85.83%; P ˂ .028).

The goal for patient enrollment was not met and represented a limitation of the study, the researchers wrote. Additionally, the anticipated baseline patients’ anxiety scores may have been overestimated. Also, the lack of a well-validated instrument to gauge patient understanding may have affected the study.

A 3D-printed tool is low-cost, noninvasive and may decrease perioperative anxiety in patients, according to researchers. – by Abigail Sutton

Disclosures: The authors report no relevant financial disclosures.