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Zhi Z, Liu R, Han W, Cui H, Li X. Quality of life assessment of patients after removal of late-onset infected mesh following open tension-free inguinal hernioplasty: 3-year follow-up. Hernia 2023; 27:1525-1531. [PMID: 37528329 DOI: 10.1007/s10029-023-02845-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/23/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Open tension-free inguinal hernioplasty is one of the common surgical methods used today to treat inguinal hernias due to its simplicity and low recurrence rate. With the widespread use of tension-free inguinal hernia repair, the number of patients with mesh infections is gradually increasing. However, there is a lack of studies assessing the quality of life of patients after the removal of late-onset infected meshes in open inguinal hernias. The aim of this study was to analyse and assess the quality of life, pain severity and anxiety of patients after late-onset infection mesh removal following open inguinal hernioplasty. METHODS Data from 105 patients admitted to our hospital from January 2014 to January 2019 who developed delayed mesh infection after open tension-free inguinal hernia repair were retrospectively analysed. 507 patients without mesh infection after open inguinal hernioplasty were included as cross-sectional controls. The baseline data of the two groups were matched for propensity score matching (PSM) with a caliper value of 0.05 and a matching ratio of 1:1. Patients are followed up by telephone or outpatient consultations for 3 years to assess quality of life, pain and anxiety after removal of the infected mesh. RESULTS The 105 patients who developed late-onset mesh infection after inguinal hernia repair had a mean age of 64.07 ± 12.90 years and a mean body mass index (BMI) of 24.64 ± 2.67 (kg/m2). The mean follow-up time was 58 months and 10.5% (10/105) of the patients were lost to follow-up. At the 3-year follow-up there was one case of hernia recurrence and five cases of mesh reinfection. The patients' quality of life scores, pain scores and anxiety scores improved after surgery compared to the preoperative scores (all p < 0.01). CONCLUSION Patients with late-onset mesh infection after inguinal hernioplasty showed an improvement in quality of life, pain and anxiety compared to preoperative after removal of the infected mesh. Mesh-plug have a higher risk of mesh infection due to their poor histocompatibility and tendency to crumple and shift.
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Affiliation(s)
- Z Zhi
- Yan'an University, Yan'an, 716000, China
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, China
| | - R Liu
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, China
| | - W Han
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, China
| | - H Cui
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, China
| | - X Li
- Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, China.
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Kefelegn R, Tolera A, Ali T, Assebe T. Preoperative anxiety and associated factors among adult surgical patients in public hospitals, eastern Ethiopia. SAGE Open Med 2023; 11:20503121231211648. [PMID: 38020793 PMCID: PMC10655790 DOI: 10.1177/20503121231211648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Objective This study aimed to assess the prevalence of preoperative anxiety and associated factors among adult surgical patients in public hospitals of eastern Ethiopia from 25 April to 26 May 2022. Methods An institutional-based cross-sectional study was undertaken using a systematic sampling technique among 423 participants from patients eligible for elective surgery. The prevalence of preoperative anxiety was assessed using the state and trait anxiety inventory measurement scale. Data were analyzed using SPSS version 26. Descriptive and summary statistics were computed. Binary and multivariable logistic regression were computed. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval and statistical significance was declared at a p-value < 0.05. Results The prevalence of preoperative anxiety among patients scheduled for elective surgery was 51.2%. Being 31-45 aged adult (AOR = 0.36; 95% CI = 0.17, 0.78), having moderate (AOR = 0.46; 95% CI = 0.22, 0.96) and strong social support (AOR = 0.04; 95% CI = 0.02, 0.08), being single (AOR = 0.19; 95% CI = 0.04, 0.89), listening to music (AOR = 0.37; 95% CI = 0.18, 0.74) and finding social and religious support (AOR = 0.15; 95% CI = 0.07, 0.33), and orthopedic surgery (AOR = 0.21; 95% CI = 0.10, 0.43) were significantly associated with lower odds of preoperative anxiety, whereas having fear of death (AOR = 1.16; 95% CI = 0.64, 2.09) was significantly associated with increased odds of preoperative anxiety. Conclusion In the current study, the magnitude of preoperative anxiety was high. Being an older adult and having social and treatment support was associated with lower odds of preoperative anxiety. In contrast, lower psychological readiness (fear of death) was associated with increased odds of preoperative anxiety. Patients should be routinely assessed for anxiety during the preoperative appointment, and the proper coping mechanisms and anxiety-reduction approaches should be used. It is also advisable that appropriate policies and procedures for reducing preoperative anxiety should be devised.
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Affiliation(s)
- Reta Kefelegn
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abebe Tolera
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Ali
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Assebe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Josephs CA, Shaffer VO, Kucera WB. Impact of Mental Health on General Surgery Patients and Strategies to Improve Outcomes. Am Surg 2022:31348221109469. [PMID: 35730505 DOI: 10.1177/00031348221109469] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Mental Health Disorders (MHD) are a growing concern nationwide. The significant impact MHD have on surgical outcomes has only recently started to be understood. This literature review investigated how mental health impacts the outcomes of general surgery patients and what can be done to make improvements. Patients with schizophrenia had the poorest surgical outcomes. Mental health disorders increased post-surgical pain, hospital length of stay, complications, readmissions, and mortality. Mental health disorders decreased wound healing and quality of care. Optimizing outcomes will be best accomplished through integrating more effective perioperative screening tools and interventions. Screenings tools can incorporate artificial intelligence, MHD data, resilience and its biomarkers, and patient mental health questionnaires. Interventions include cognitive behavioral therapy, virtual reality, spirituality, pharmacology, and resilience training.
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Affiliation(s)
- Cooper A Josephs
- 364432Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - Virginia O Shaffer
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Walter B Kucera
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
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Jovanovic K, Kalezic N, Sipetic Grujicic S, Zivaljevic V, Jovanovic M, Kukic B, Trailovic R, Zlatanovic P, Mutavdzic P, Tomic I, Ilic N, Davidovic L. Preoperative Anxiety is Associated With Postoperative Complications in Vascular Surgery: A Cross-Sectional Study. World J Surg 2022; 46:1987-1996. [PMID: 35507076 DOI: 10.1007/s00268-022-06575-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Preoperative anxiety is associated with increased morbidity and/or mortality in surgical patients. This study investigated the incidence, predictors, and association of preoperative anxiety with postoperative complications in vascular surgery. METHODS Consecutive patients undergoing aortic, carotid, and peripheral artery surgery, under general and regional anesthesia, from February until October 2019 were included in a cross-sectional study. Anesthesiologists assessed preoperative anxiety using a validated Serbian version of the Amsterdam Preoperative Anxiety and Information Scale. Patients were divided into groups with low/high anxiety, both anesthesia- and surgery-related. Statistical analysis included multivariate linear logistic regression and point-biserial correlation. RESULTS Of 402 patients interviewed, 16 were excluded and one patient refused to participate (response rate 99.7%). Out of 385 patients included (age range 39-86 years), 62.3% had previous surgery. High-level anesthesia- and surgery-related anxieties were present in 31.2 and 43.4% of patients, respectively. Independent predictors of high-level anesthesia-related anxiety were having no children (OR = 0.443, 95% CI: 0.239-0.821, p = 0.01), personal bad experiences with anesthesia (OR = 2.294, 95% CI: 1.043-5.045, p = 0.039), and time since diagnosis for ≥ 4 months (OR = 1.634, 95% CI: 1.023-5.983, p = 0.04). The female sex independently predicted high-level surgery-related preoperative anxiety (OR = 2.387, 95% CI: 1.432-3.979, p = 0.001). High-level anesthesia-related anxiety correlated with postoperative mental disorders (rpb = 0.193, p = 0.001) and pulmonary complications (rpb = 0.104, p = 0.042). Postoperative nausea (rpb = 0.111, p = 0.03) and postoperative mental disorders (rpb = 0.160, p = 0.002) correlated with high-level surgery-related preoperative anxiety. CONCLUSIONS Since preoperative anxiety affects the postoperative course and almost every third patient experiences anxiety preoperatively, routine screening might be recommended in vascular surgery.
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Affiliation(s)
- Ksenija Jovanovic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia. .,Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Nevena Kalezic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Vladan Zivaljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Center for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan Jovanovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Center for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Biljana Kukic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia
| | - Ranko Trailovic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Zlatanovic
- Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Perica Mutavdzic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ivan Tomic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Lazar Davidovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
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Disceken FM, Kose G. Association of preoperative pain beliefs with postoperative pain levels in abdominal surgery patients. J Clin Nurs 2021; 30:3249-3258. [PMID: 33973286 DOI: 10.1111/jocn.15831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 01/18/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to analyse the association of preoperative pain beliefs with postoperative pain levels in abdominal surgery patients. BACKGROUND Postoperative pain is related to not only clinical and demographic characteristics but also pain beliefs. The perception, intensity and expression of pain as a subjective experience varies among individuals and cultures. Personal beliefs about pain play an important role in pain experiences and responses. DESIGN This cross-sectional study consisted of 126 abdominal surgery patients admitted to the General Surgery and Gynecological Surgery Clinics between September 2018-January 2019. The STROBE (Strengthening The Reporting of Observational Studies in Epidemiology) checklist was used as a guideline for this study. METHODS Data were collected through descriptive information forms, pain characteristics questionnaires, Visual Analogue Scales and pain beliefs questionnaires. One-way variance analysis and Pearson's correlation and t tests were used for data analysis. RESULTS The mean age of the participants was 48.63 ± 14.27 years. A total of 37.3% of the participants experienced moderate pain and 35.7% experienced severe pain at the 8th postoperative hour. Pain intensity significantly decreased at 16, 24 and 32 h postoperatively. In the predischarge interviews, 92.1% of the patients expressed limitations in physical activities due to pain. There was a relationship between 8-16 h postoperatively and sex and pain expectancy. Mean scores obtained from the organic and psychological beliefs subscales of the Pain Belief Questionnaire were 3.12 ± 0.79, and 2.37 ± 1.11, respectively. The psychological beliefs score was negatively associated with the level of education, and the organic beliefs score was higher for those participants who had undergone gynaecological surgery. There was a weak and positive correlation between the organic beliefs and psychological beliefs subscales of the Pain Beliefs Questionnaire. CONCLUSION Patients had moderate to severe postoperative pain, and sex and pain expectations affected the experienced level of pain. Most participants believed that the pain was organic in origin. The level of education exerted a significant impact on pain beliefs. RELEVANCE TO CLINICAL PRACTICE Characteristics and perception of pain and pain beliefs are important factors that should be determined to personalise pain relief care and maintain effective pain management.
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Affiliation(s)
| | - Gulsah Kose
- Department of Nursing, Faculty of Health Sciences, Mugla Sıtkı Kocman University, Mugla, Turkey
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