In my experience as a gynaecological surgeon, information pamphlets for patients are useful for compliance to pre-operative preparations and postoperative care. However, as you stated, Catherine, there is a degree of non compliance. I have found that it helps to overcome this problem, by giving patients typed or written information,  signed by the gynaecological surgeon. It also is of great value if the gynaecological surgeon takes the responsibility to explain this information and it's importance to patients. To have the same nursing staff for all your patients, is also of great help, since they then realise the importance of this and help to explain it to patients. Kind regards, Johan (JT) Nel.

Catherine, have you assessed the materials for readability / understandability? In other words have you considered health literacy in preparing the materials? Often times materials that make sense to us as health professionals make less sense to patients. And patients may indicate they understand even when they don't because they're embarrassed to say they don't understand. Make sure the materials are written in plain language; use a list of bulleted points rather than long blocks of text; chunk the information into sections with headings that can help the patient understand, etc.

I think this new text on Health Communication: Principles and Practices can serve to provide some solutions here: https://www.researchgate.net/post/Health_Communication_Principles_and_Practices

Best,

Debra