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Yılmaz Y, Durmayuksel E, Erturk T, Inal FY, Yamac DM, Ersoy A. The Effect of Preoperative Anxiety on Motor and Sensory Block Duration and Effectiveness in Spinal Anesthesia. Anesthesiol Res Pract 2024; 2024:8827780. [PMID: 39188895 PMCID: PMC11347032 DOI: 10.1155/2024/8827780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 07/19/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024] Open
Abstract
Introduction The aim was to evaluate the effect of preoperative anxiety on the sympathetic block that developed after spinal anesthesia and therefore the duration of motor and sensory blockade. Materials and Methods After the approval of the ethics committee, 90 patients between the ages of 18 and 55 years who were to be operated under spinal anesthesia were included in the study. Preoperative anxiety of the patients was evaluated with the Spielberger trait and State Anxiety Scale and Visual Analog Scale (VAS). The Bromage scores of the patients were followed up intermittently. Onset time of sensory block, onset time of motor block, and motor block recovery time were recorded. Cases with bradycardia and hypotension were noted. Results No statistically significant correlation was found between the duration of motor block onset (5.81 ± 4 min), the sensory block onset time (0.89 ± 0.4 min), and the motor block recovery time (92.06 ± 36.9 min) with other variables. VAS (5.81 ± 2.5), STAI-1 (40.4 ± 9.8), and STAI-2 (41.69 ± 8.2) values had a statistically significant effect on the occurrence of bradycardia (14.4%). The variables of VAS, STAI-1, STAI-2, sensory block onset, motor block onset, and motor block recovery time were statistically significantly higher in women (mean 5.24 ± 2.4, 38.97 ± 9.9, 41.43 ± 8.7, 0.89 ± 0.42, 5.64 ± 3.82, and 88.77 ± 38.74 in males and mean 7.15 ± 2.1, 43.74 ± 8.9, 42.30 ± 7.0, 0.88 ± 0.27, 6.20 ± 4.35, and 99.70 ± 31.70 in females, respectively). Conclusion It was observed that preoperative anxiety had no effect on motor and sensory block onset and duration.
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Affiliation(s)
- Yadigar Yılmaz
- Sultan 2. Abdulhamid Han Education and Research HospitalDepartment of Anesthesiology and Reanimation, Istanbul 34668, Türkiye
| | - Esra Durmayuksel
- Bahçeşehir UniversityFaculty of Health SciencesNursing Department, Istanbul, Türkiye
| | - Tuna Erturk
- Sultan 2. Abdulhamid Han Education and Research HospitalDepartment of Anesthesiology and Reanimation, Istanbul 34668, Türkiye
| | - Ferda Yılmaz Inal
- Istanbul Medeniyet UniversityFaculty of MedicineDepartment of Anesthesiology and Reanimation 34722, Istanbul, Türkiye
| | - Dilek Metin Yamac
- Sultan 2. Abdulhamid Han Education and Research HospitalDepartment of Anesthesiology and Reanimation, Istanbul 34668, Türkiye
| | - Aysin Ersoy
- Sultan 2. Abdulhamid Han Education and Research HospitalDepartment of Anesthesiology and Reanimation, Istanbul 34668, Türkiye
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Mitrev LV, Chin GR, Roberts BW, van Helmond N, Trivedi KC, Libraro NJ, Rana DD, Dibato JE, Trzeciak S, Solina AR, Greeson JM. Is the Compassion of Anesthesiologists Associated With Postoperative Pain and Patient Experience? A Prospective Cohort Study. Anesth Analg 2024:00000539-990000000-00880. [PMID: 39058620 DOI: 10.1213/ane.0000000000007026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
BACKGROUND Patient perception of physician compassion may be associated with improved health outcomes, yet it is unclear whether it is associated with postoperative pain reduction or improved patient experience metrics in same-day surgery patients. We hypothesized that higher anesthesiologist compassion during the preanesthesia interview, rated by patients, is associated with lower postoperative pain via the anxiety pathway in same-day surgery patients. We also performed exploratory correlation analysis to assess whether compassion was associated with less opioid consumption and improved patient experience in same-day surgery patients. METHODS We conducted a single-center, prospective, observational cohort study in American Society of Anesthesiologists (ASA) physical status I to III patients scheduled to undergo same-day surgery with anesthesia. Compassion was scored using a validated 5-item tool. State anxiety (SA) and trait anxiety (TA) were measured using the State-Trait Anxiety Inventory. Pain scores were obtained using a 0 to 10 Likert scale. Daily opioid use was recorded. Patient experience was assessed using the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) and the Surgical Care CAHPS. Mediation analysis was used to assess the association between compassion and pain scores via the anxiety pathway. Spearman correlation was performed to test for association between the compassion score and the secondary outcomes. RESULTS A total of 147 subjects completed the study with a median age of 50 years and 81% female. Fifty percent underwent breast surgery, 35% abdominal surgery, and the rest underwent gynecological and urological surgeries. The median (Q1-Q3) postoperative pain scores on postoperative days 0 and 3 days later were 4 (1.5-6) and 3 (1-5), respectively.Mediation analysis results showed a same-day anxiety-mediated effect (95% confidence interval [CI]) of compassion on pain of -0.08 (-0.13 to -0.02), attributing to 9% of the total effect. On postoperative day 0, an increase in compassion was associated with a significant average drop in pain of between 0.02 and 0.13. In addition, higher compassion was correlated with better patient experience metrics (ρ= -0.53 [95% CI, -0.64 to -0.39]). CONCLUSIONS The study results suggest that an anxiety-mediated pathway exists through which compassionate care may help improve the patient's perception of postoperative pain on the day of surgery (before discharge from the hospital). Higher compassion was also associated with better patient experience metrics.
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Affiliation(s)
- Ludmil V Mitrev
- From the Department of Anesthesiology, Cooper University Hospital, Camden, New Jersey
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Gabrielle R Chin
- Department of Psychology, Rowan University, Glassboro, New Jersey
| | - Brian W Roberts
- Cooper Medical School of Rowan University, Camden, New Jersey
- Department of Emergency Medicine, Cooper University Hospital, Camden, New Jersey
| | - Noud van Helmond
- From the Department of Anesthesiology, Cooper University Hospital, Camden, New Jersey
| | - Keyur C Trivedi
- From the Department of Anesthesiology, Cooper University Hospital, Camden, New Jersey
- Cooper Medical School of Rowan University, Camden, New Jersey
| | | | - Dhaval D Rana
- From the Department of Anesthesiology, Cooper University Hospital, Camden, New Jersey
| | - John E Dibato
- Cooper Research Institute, Cooper University Hospital, Camden, New Jersey
| | - Stephen Trzeciak
- Department of Medicine, Cooper University Hospital, Camden, New Jersey; and
| | - Alann R Solina
- From the Department of Anesthesiology, Cooper University Hospital, Camden, New Jersey
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Jeffrey M Greeson
- Department of Psychology, Rowan University, Glassboro, New Jersey
- Center for Humanism, Cooper Medical School of Rowan University, Camden, New Jersey
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Rtbey G, Mihertabe M, Andualem F, Melkam M, Takelle GM, Tinsae T, Fentahun S. Anxiety and associated factors among medical and surgical patients in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0306413. [PMID: 39046996 PMCID: PMC11268606 DOI: 10.1371/journal.pone.0306413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/12/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Individuals diagnosed with chronic medical conditions and patients appointed to undergo surgery face various degrees of anxiety as a result of doubts related to the outcome of surgery, and the psycho-socioeconomic costs of the medical illness. This can affect the treatment process and even the outcome of patients with medical and surgical cases. Though different studies were conducted on anxiety and associated factors among medical and surgical patients in Ethiopia, the findings were found to be inconsistent and had a wide discrepancy. So, this systematic review and meta-analysis estimated the pooled effect size of anxiety among this population and guides to plan appropriate intervention at a national level. METHODS Studies conducted on anxiety and associated factors among medical and surgical patients in Ethiopia were included. Data was extracted using Microsoft Excel and analyzed using STATA version 11. The random-effects model was used to estimate the pooled effect size of anxiety and its determinants with 95% confidence intervals. Funnel plots and Egger's regression tests were employed to check publication bias. Sub-group and sensitivity analyses were also conducted. RESULTS The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be 48.82% with a 95% CI (42.66, 54.99). Being female[OR = 2.84(2.02, 4.01)], fear of death [OR = 2.93(1.57, 5.50)], and history of surgery[OR = 0.42(0.27, 0.065)], among surgical patients and being female[OR = 2.35(1.94, 2.850], having poor social support[OR = 2.22(1.62, 3.05)], perceived stigma[OR = 4.25(1.97, 9.18)] and family history of mental illness[OR = 1.86(1.21, 2.86)] among medical patients were significantly associated with anxiety in this systematic review and meta-analysis. CONCLUSION AND RECOMMENDATION The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be high. Therefore, it would be good for professionals to screen patients for anxiety besides managing their medical or surgical cases to detect them early and address them.
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Affiliation(s)
- Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Milen Mihertabe
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Can O, Bozkurt M, Danış E, Taha Keskin E, Kandemir E, Lutfi Canat H. The effect of informative video before the procedure on anxiety levels in patients who will have ureteral stent removal under local anesthesia. Actas Urol Esp 2024; 48:377-383. [PMID: 38373480 DOI: 10.1016/j.acuroe.2024.02.014] [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: 11/21/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Abstract
OBJECTIVE Our objective was to assess the impact of video-animated information on the anxiety levels of patients undergoing ureteral stent removal under local anesthesia. METHOD The study was designed as a randomized prospective trial. The one group received only verbal and written information before the surgery, while the other group received video-animated information in addition to the written and verbal instructions. The patients' anxiety levels were assessed using the STAI-S and STAI-T questionnaires, while their pain scores were evaluated using VAS scores. Tolerability and satisfaction scores were also evaluated on a 5-point Likert scale. RESULTS The video-group (Group 1) consisted of 74 patients, while the non-video group (Group 2) consisted of 82 patients. The mean pre-information STAI-T score was 34.4 ± 3.7 in Group 1 and 35.2 ± 3 in the Group 2 (p = 0.113). In the video group, pre-information STAI-S scores was 34.8 ± 3.3 and post-information STAI-S scores was 33.8 ± 3 (p < 0.001). In the non-video group, pre-information STAI-S score was 35.6 ± 2.6 and post-information STAI-S score was 35.5 ± 2.7 (p = 0.260). The mean VAS score of Group 1 is 5.7 ± 1.2 and Group 2 is 5.7 ± 1.4 (p = 0.608). The mean tolerability scores of Group 1 and Group 2 were 3.7 ± 0.9 and 2.7 ± 1, respectively. The mean satisfaction scores of Group 1 and Group 2 were 4.1 ± 0.9 and 2.6 ± 1, respectively. Both tolerability score and satisfaction score improved statistically significantly after video information (p < 0.001). CONCLUSION Providing video-animated information in addition to written and verbal information before removing the ureteral stent reduces patients' preoperative anxiety. Furthermore, patient tolerance and satisfaction are higher when informative videos are included.
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Affiliation(s)
- O Can
- Servicio de Urología, Hospital Urbano Basksehir Cam y Sakura, Estambul, Turkey.
| | - M Bozkurt
- Servicio de Urología, Hospital Urbano Prof. Dr. Cemil Tascioglu, Estambul, Turkey
| | - E Danış
- Servicio de Urología, Hospital Urbano Prof. Dr. Cemil Tascioglu, Estambul, Turkey
| | - E Taha Keskin
- Servicio de Urología, Hospital Urbano Basksehir Cam y Sakura, Estambul, Turkey
| | - E Kandemir
- Servicio de Urología, Universidad Karamanoglu Mehmetbey, Karaman, Turkey
| | - H Lutfi Canat
- Servicio de Urología, Hospital Urbano Basksehir Cam y Sakura, Estambul, Turkey
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Machado PT, Lecoultre C, Courbon C. Cross-sectional and Correlational Examination of Patients' Preoperative Anxiety, Information Need, and Health Literacy in a Presurgical Consultation. J Perianesth Nurs 2024:S1089-9472(24)00039-X. [PMID: 38762807 DOI: 10.1016/j.jopan.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE This study elucidates the preoperative anxiety (PA), information need (IN), and health literacy (HL) levels of an elective preoperative sample in Switzerland and examines the possible associations between PA and the patients' characteristics. By knowing these patient dimensions, which can influence perioperative outcomes, one can tailor individualized nursing interventions to improve patients' surgical experience. DESIGN This was a cross-sectional and correlational study. METHODS The sample consisted of 88 patients who underwent a preoperative consultation at a Swiss tertiary hosptial. Patients' PA and IN were assessed using the Anxiety Preoperative and Information Scale, and their HL was measured using the Functional, Communicative, and Critical Health Literacy Scale. Data on other patient characteristics were collected from the patients, physicians, and electronic patient records. Association tests, as well as univariate regressions, were performed on PA, IN, HL, and patient characteristics. FINDINGS Among participants, 40.91%, 78.41%, and 59% reported having PA, IN, and low HL, respectively. Finally, PA was associated with IN, HL, solitary living, and the American Society of Anesthesiology score. CONCLUSIONS A high proportion of patients scheduled for presurgical consultation were found to be anxious. They presented high IN and low HL. An examination of patients' PA-associated characteristics can help improve their surgical experience. More studies should examine PA-associated characteristics.
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Affiliation(s)
| | - Claudia Lecoultre
- Department of Surgery and Vascular Cardiology Services, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Cécile Courbon
- Department of Surgery and Vascular Cardiology Services, Lausanne University Hospital, Lausanne, Vaud, Switzerland
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Gurbuz E, Gurbuz AA. Investigation of the effect of virtual reality distraction in patients undergoing mandibular periodontal surgery: A randomized controlled study. J ESTHET RESTOR DENT 2024; 36:813-822. [PMID: 38314536 DOI: 10.1111/jerd.13203] [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: 11/20/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVE This clinical study aimed to evaluate the effect of virtual reality (VR) technology on anxiety and pain levels in patients undergoing gingivectomy and gingivoplasty procedures. MATERIALS AND METHODS The patients were randomized into test (surgery with VR glasses) and control (surgery without VR glasses) groups. Before the surgery, the anxiety level was measured using the modified dental anxiety scale (MDAS), and anticipated pain (AP) was measured by a visual analog scale (VAS). Immediately after the surgery, the pain and discomfort associated with the surgery (VASP), procedure time (T), and time perception (TP) were evaluated. The patients in the test group were requested to assess the immersion (VASI), satisfaction (VASS), perception of reduced anxiety (VASA), and perceived control (VASC). One week after surgery, MDAS was applied to all patients. RESULTS This trial was conducted with 41 female and 17 male subjects with a mean age of 29.69 ± 12.32. There were no significant differences between the groups in terms of age, sex, preoperative MDAS, or AP. After surgery, MDAS, VASP, T, and TP failed to differ significantly between the groups. The subject age was positively correlated with VASI, VASS, VASA, and VASC (r = 0.60, p = 0.00; r = 0.44, p = 0.02; r = 0.46, p = 0.02; r = 0.50, p = 0.01, respectively) and negatively correlated with VASP (r = 0.47, p = 0.04). CONCLUSIONS VR application did not affect anxiety and pain levels in patients undergoing periodontal surgery. More studies are needed to evaluate VR distraction in periodontal surgeries with diverse age samples and video options. CLINICAL SIGNIFICANCE VR does not affect anxiety and pain levels during gingivectomy and gingivoplasty surgeries in the young adult population. It should be evaluated in older age groups. Trial registration ClinicalTrials.gov Identifier: NCT06092177.
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Affiliation(s)
- Ezgi Gurbuz
- Department of Periodontology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
| | - Ali Aycan Gurbuz
- Department of Cartoon/Animation, Faculty of Fine Arts, Dumlupınar University, Kutahya, Turkey
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Gibas G, Liebisch M, Eichenberg C, Krenn VT, Sallakhi A, Benhebesse SE, Kietaibl S. Preoperative anxiety after face-to-face patient assessment versus preanaesthesia telemedicine (PANTEM) in adults: a randomised clinical trial. Wien Med Wochenschr 2024; 174:133-139. [PMID: 35635622 DOI: 10.1007/s10354-022-00937-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/25/2022] [Indexed: 11/25/2022]
Abstract
Preanaesthesia consultation is performed to assess and optimise patient-specific risk factors before surgery, to inform patients about anaesthesia techniques and to obtain consent. Aside from face-to-face visits, telephone consultation is increasingly being used clinically. Concentration on the content and avoidance of confounding factors could lead to improved patient preparation. We hypothesised that patients receiving a telemedical intervention have less anxiety. Patients scheduled for elective surgery were randomised into two groups according to the consultation performed face-to-face (FTF) or via telephone (TEL). Before consultation (< 48 h) and 1-2 h prior to surgery, both groups had to fill in the State-Trait Anxiety Inventory (STAI). A total of 271 patients were randomised and 130 were analysed. There were no significant intergroup differences in mean state anxiety (STAI-S) before and after the intervention. Patients' positive feedback on telemedical consultation urges future studies on its effect on satisfaction and quality of life.
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Affiliation(s)
- Georg Gibas
- Faculty for Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Martin Liebisch
- Faculty for Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Christiane Eichenberg
- Department of Psychosomatics of the Medical Faculty, Sigmund Freud Private University Vienna, Vienna, Austria
| | - Vincent T Krenn
- Faculty for Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Aria Sallakhi
- Faculty for Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Salah E Benhebesse
- Department of Anaesthesia and Intensive Care Medicine, Evangelical Hospital Vienna, Hans-Sachs-Gasse 10-12, 1180, Vienna, Austria
| | - Sibylle Kietaibl
- Faculty for Medicine, Sigmund Freud Private University, Vienna, Austria.
- Department of Anaesthesia and Intensive Care Medicine, Evangelical Hospital Vienna, Hans-Sachs-Gasse 10-12, 1180, Vienna, Austria.
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Yahagi M, Hiruta R, Miyauchi C, Tanaka S, Taguchi A, Yaguchi Y. Comparison of Conventional Anesthesia Nurse Education and an Artificial Intelligence Chatbot (ChatGPT) Intervention on Preoperative Anxiety: A Randomized Controlled Trial. J Perianesth Nurs 2024:S1089-9472(23)01073-0. [PMID: 38520470 DOI: 10.1016/j.jopan.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 03/25/2024]
Abstract
PURPOSE This study aimed to evaluate the effects of an artificial intelligence (AI) chatbot (ChatGPT-3.5, OpenAI) on preoperative anxiety reduction and patient satisfaction in adult patients undergoing surgery under general anesthesia. DESIGN The study used a single-blind, randomized controlled trial design. METHODS In this study, 100 adult patients were enrolled and divided into two groups: 50 in the control group, in which patients received standard preoperative information from anesthesia nurses, and 50 in the intervention group, in which patients interacted with ChatGPT. The primary outcome, preoperative anxiety reduction, was measured using the Japanese State-Trait Anxiety Inventory (STAI) self-report questionnaire. The secondary endpoints included participant satisfaction (Q1), comprehension of the treatment process (Q2), and the perception of the AI chatbot's responses as more relevant than those of the nurses (Q3). FINDINGS Of the 85 participants who completed the study, the STAI scores in the control group remained stable, whereas those in the intervention group decreased. The mixed-effects model showed significant effects of time and group-time interaction on the STAI scores; however, no main group effect was observed. The secondary endpoints revealed mixed results; some patients found that the chatbot's responses were more relevant, whereas others were dissatisfied or experienced difficulties. CONCLUSIONS The ChatGPT intervention significantly reduced preoperative anxiety compared with the control group; however, no overall difference in the STAI scores was observed. The mixed secondary endpoint results highlight the need for refining chatbot algorithms and knowledge bases to improve performance and satisfaction. AI chatbots should complement, rather than replace, human health care providers. Seamless integration and effective communication among AI chatbots, patients, and health care providers are essential for optimizing patient outcomes.
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Affiliation(s)
- Musashi Yahagi
- Department of Anesthesiology, Hitachi General Hospital, San Francisco, CA.
| | - Rie Hiruta
- Department of Surgery, Hitachi General Hospital, San Francisco, CA
| | - Chisato Miyauchi
- Department of Surgery, Hitachi General Hospital, San Francisco, CA
| | - Shoko Tanaka
- Department of Surgery, Hitachi General Hospital, San Francisco, CA
| | - Aya Taguchi
- Department of Surgery, Hitachi General Hospital, San Francisco, CA
| | - Yuichi Yaguchi
- Department of Anesthesiology, Hitachi General Hospital, San Francisco, CA
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Cakan F, Say MA, Adar A. Intraoperative Takotsubo Cardiomyopathy: A Case Report. J Perianesth Nurs 2024:S1089-9472(23)01103-6. [PMID: 38520468 DOI: 10.1016/j.jopan.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 03/25/2024]
Abstract
Takotsubo cardiomyopathy (TTC) is a rare condition associated with transient akinesia of apical segments and hyperkinesia of basal segments of the heart. Although several mechanisms have been proposed to cause direct and indirect myocardial damage owing to catecholamine excess, the underlying pathophysiology remains unknown. An 18-year-old female was referred to our otorhinolaryngology outpatient clinic for a septorhinoplasty. Apart from the fear of surgery, the patient had no other health issues. After the administration of local anesthesia (lidocaine and epinephrine mix), tachycardia storms occurred and soon ended with cardiac collapse. Further evaluation revealed TTC. TTC should be considered, especially in cases of treatment-resistant hemodynamic problems after cardiac resuscitation, and nurses can play a crucial role during the preanesthetic period in helping the patient cope with the stress factors related to the upcoming surgery.
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Affiliation(s)
- Fahri Cakan
- Cerkezkoy State Hospital, Department of Cardiology, Tekirdag, Turkiye.
| | - Mehmet A Say
- Cerkezkoy State Hospital, Department of Ear-Nose-Throat, Tekirdag, Turkiye
| | - Adem Adar
- Baskent University Alanya Application And Research Hospital, Department of Cardiology, Antalya, Turkiye
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Zhang LH, Ying YF, Yin J, Li N, Cheng Y, Yu RY. Effect of pre-admission "quasi-collective" education on health education for patients with ophthalmic day surgery. Technol Health Care 2024; 32:1177-1184. [PMID: 37899068 DOI: 10.3233/thc-230877] [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] [Indexed: 10/31/2023]
Abstract
BACKGROUND Day surgery is a new surgical model in which patients complete the admission, surgery, and discharge on the same day. OBJECTIVE The present study aimed to explore the effect of pre-admission "quasi-collective" health education for patients with ophthalmic day surgery. METHODS For this study, a total of 200 patients undergoing ophthalmic day surgery from February 2019 to December 2019 were enrolled as the research subjects. The patients were divided randomly into the observation group and the control group, with 100 cases in each group. For the control group, conventional health education was conducted after admission. On the day of admission, the admission education and peri-operative health education were performed. For the observation group, pre-admission health education was provided to the patients, and detailed education on the admission instructions, pre-operative precautions, and simulation of the intra-operative process were given by the medical staff. On the day of admission, the understanding of the education was evaluated, and any weaknesses in the health education were addressed. The anxiety status, method of handwashing, method of administering the drug to the eye, preoperative preparations, intra-operative training, preoperative medication, diet guidance, and postoperative care were compared between the two groups of patients. RESULTS Before discharge, there were significant differences in the anxiety scores, impact, and satisfaction of health education between the two groups of patients, all of which were statistically significant (P< 0.05). CONCLUSION The pre-admission "quasi-collective" health education for patients undergoing day surgery in ophthalmology was better than conventional health education.
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Affiliation(s)
- Li-Hua Zhang
- Outpatient Department, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ya-Fen Ying
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jing Yin
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Na Li
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yan Cheng
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Rong-Yan Yu
- Department of Infectious Disease, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Müller M, Schmucker C, Naumann J, Schlueter N, Huber R, Lederer AK. Acupuncture in management of acute dental pain - A systematic review and meta-analysis. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:114-128. [PMID: 36950225 PMCID: PMC10025006 DOI: 10.1016/j.jdsr.2023.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 03/12/2023] Open
Abstract
Acute dental pain is a common issue leading to dental consultation. Besides causal therapy, patients are treated with acupuncture, but efficacy in acute dental pain is still not clarified. We aimed to evaluate results of recent research to estimate the efficacy of acupuncture compared to pain-relieving approaches in treatment of acute dental pain. A systematic review of controlled trials being published between database inception and 2020 were conducted to evaluate the efficacy of acupuncture (alone or as complementary therapy) compared to local anesthesia or conventional analgesic medications in acute dental pain (intraoperatively and postoperatively) and to clarify whether acupuncture reduces the use of postoperative analgesic medications. Of 1672 publications, 23 publications met the inclusion criteria. From these, 11 randomized controlled trials (n = 668) reported on the efficacy of acupuncture on postoperative acute dental pain. Patients, who received acupuncture, showed lower pain scores postoperatively compared to sham acupuncture (Relative Risk -0.77, 95% Confidence interval -1.52 to -0.03). Overall, the results suggest a potential role of acupuncture in improving acute dental pain intraoperatively and postoperatively as well as improving the efficacy of local anesthesia, but the results are limited due to methodological shortcomings emphasizing the necessity for future high-quality research.
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Affiliation(s)
- Moritz Müller
- Center for Complementary Medicine, Department of Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Christine Schmucker
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Johannes Naumann
- European Institute for Physical Therapy and Balneology (EIPB), 79106 Freiburg, Germany
| | - Nadine Schlueter
- Hannover Medical School (MHH), Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
| | - Roman Huber
- Center for Complementary Medicine, Department of Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Ann-Kathrin Lederer
- Center for Complementary Medicine, Department of Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
- Corresponding author at: Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany.
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Valverde Bernal J, Martínez-Soler F, Berga Congost G, Martínez Pérez J, Asmarats L, Moreno Arroyo C. Impact of a PROgram of Cardiovascular nursE interventionS in a VALVular haEmodynamic Unit (PROCESS-VALVE) on Quality Indicators: A Quasi-Experimental Ambispective Study. Int J Gen Med 2023; 16:4257-4265. [PMID: 37750105 PMCID: PMC10518147 DOI: 10.2147/ijgm.s412369] [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: 03/14/2023] [Accepted: 08/03/2023] [Indexed: 09/27/2023] Open
Abstract
Background The percutaneous treatment of heart valve diseases carried out in the hemodynamic service is constantly growing. After analyzing the mortality, readmissions, success of the procedure, and complications, several studies support this type of percutaneous procedure. The increase in these procedures has required the creation of multidisciplinary teams and new diagnostic and care circuits, such as presurgical consultations and postsurgical follow-ups. Even so, there is little evidence regarding the effect of these consultations on quality indicators. Purpose The objective of this study is to evaluate the impact of a program of presurgical and postsurgical nurse interventions (PROCESS-VALVE) on quality indicators of the health of patients undergoing percutaneous valve procedures. Patients and Methods The influence of presurgical and postsurgical consultations on quality indicators will be evaluated through an ambispective quasi-experimental study. Patients will be recruited at a tertiary-level hospital in Barcelona, Spain. For the control group, data will be collected retrospectively from patients who underwent percutaneous valve procedures but did not receive pre- or postsurgical consultations. The intervention group comprises those patients agreeing to participate in the study and the hemodynamic nurse valve consultation program (PROCESS-VALVE). In addition, we will assess whether a face-to-face postsurgical consultation equally improves quality indicators compared to postsurgical telephone consultation; for this, a sub-study will be carried out comparing face-to-face or telephone postsurgical follow-up by means of a randomized controlled clinical trial with simple blinding in the intervention group. Discussion This study will generate scientific evidence regarding the impact on quality indicators of a nursing intervention via presurgical and postsurgical consultations. In addition, it will allow us to decide the most appropriate follow-up strategy for this type of patient. Trial Registration ClinicalTrials.gov NCT05179278, registration date 01/05/2022.
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Affiliation(s)
| | - Fina Martínez-Soler
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Gemma Berga Congost
- Interventional Cardiology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - José Martínez Pérez
- Interventional Cardiology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lluis Asmarats
- Interventional Cardiology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carmen Moreno Arroyo
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
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Graf S, Feldmann H, Hunold LS, Steinkraus KC, Nasir N, Michalski CW, Dörr-Harim C, Hüttner FJ. Use of virtual reality in port implantation to reduce perioperative anxiety and pain: protocol for a randomised controlled pilot trial at a single German university hospital (VIP-trial; DRKS00028508). BMJ Open 2023; 13:e074738. [PMID: 37709332 PMCID: PMC10503368 DOI: 10.1136/bmjopen-2023-074738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Intravenous access port implantation is commonly performed under local anaesthesia, which offers advantages such as increased patient satisfaction and resource savings compared with general anaesthesia. However, patients may experience increased perioperative stress and anxiety in the operating room setting without general anaesthesia. Virtual reality (VR) distraction or hypnosis during surgery under local anaesthesia may help patients to auditorily and visually separate from their real environment and engage with a virtual environment through hypnorelaxing guidance. Previous studies suggested that VR hypnosedation may reduce the use of sedatives or general anaesthesia, and may offer additional benefits such as reducing postoperative pain and nausea, and promoting faster patient discharge. METHODS AND ANALYSIS The VIP trial is a randomised controlled pilot trial comparing the usage of VR during port implantation with the current standard of care (local anaesthesia and analgosedation if needed). A total of 120 adult patients are included after screening for eligibility and obtaining informed consent. Patients are randomised preoperatively in a 1:1 ratio to the trial groups. The main outcomes are change of perioperative anxiety and pain. Further outcomes include patient satisfaction and tolerability, perioperative analgesia and sedation, occurrence of postoperative nausea, vomiting and VR sickness symptoms, surgeon's satisfaction, procedure duration, postoperative complications until postoperative day 30 and patient willingness to hypothetically undergo port implantation again under the same conditions. ETHICS AND DISSEMINATION The VIP trial has been approved by the Ethics Committee of the Medical Faculty of Ulm University (reference number 03/22). If the intervention demonstrates that VR can effectively reduce perioperative anxiety and pain, it may become a novel standard of care to minimise the need for analgosedation or general anaesthesia in port implantation procedures and improve patient outcomes. The results will be submitted to a peer-reviewed journal in the field and will be presented at applicable conferences to ensure rigorous evaluation and access for the academic community. TRIAL REGISTRATION NUMBER German Clinical Trials Register: DRKS00028508; registration date 15 March 2022; Universal Trial Number: U1111-1275-4995.
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Affiliation(s)
- Sandra Graf
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - Hannah Feldmann
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
| | - Lisa S Hunold
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - Kira C Steinkraus
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Clinical Trial Centre ulmCARES, Department of Surgery, Ulm University Hospital, Ulm, Germany
| | - Nadir Nasir
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Clinical Trial Centre ulmCARES, Department of Surgery, Ulm University Hospital, Ulm, Germany
| | - Christoph W Michalski
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - Colette Dörr-Harim
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Department of General, Visceral and Transplantation Surgery, Heidelberg University, Heidelberg, Germany
| | - Felix J Hüttner
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Clinical Trial Centre ulmCARES, Department of Surgery, Ulm University Hospital, Ulm, Germany
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Arifin J, Mochamat M, Pramadika T, Paramita D, Nurcahyo WI. Effects of Immersive Virtual Reality on Patient Anxiety During Surgery Under Regional Anesthesia: A Randomized Clinical Trial. Anesth Pain Med 2023; 13:e130790. [PMID: 37645005 PMCID: PMC10461385 DOI: 10.5812/aapm-130790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 12/24/2022] [Accepted: 01/22/2023] [Indexed: 08/31/2023] Open
Abstract
Background Surgery and anesthesia are associated with increased patient anxiety. Perioperative anxiety is a common problem in regional anesthesia procedures and has an extensive impact. Immersive virtual reality (IVR) is a potential non-pharmacological distraction method to reduce anxiety. Immersive virtual reality creates a virtual environment that allows patients to interact and immerse in the virtual world, reducing patient anxiety. Objectives This study aimed to examine the effect of IVR on the anxiety of patients undergoing regional anesthetic surgery. Methods A total of 30 participants referred to Dr. Kariadi General Hospital (Indonesia) from October 2021 to December 2021 were enrolled in this randomized, single-blind clinical trial. The patients were divided into virtual reality (VR) and control groups (n = 15 in each group). The control group received midazolam (0.02 mg/kg) as premedication. The VR group received an IVR intervention without premedication. The data of anxiety scores were assessed using the Spielberger State-Trait Anxiety Inventory 6 (STAI-6). This study also collected vital signs, side effects, and patient and surgeon satisfaction level data. Results The average anxiety level during surgery in the operating room decreased in both groups (P < 0.05); the VR group had a lower score (P = 0.04). A significant reduction in perioperative anxiety levels was observed in the VR group compared to the control group. The patient satisfaction level was also significantly higher in the VR group than in the control group (P = 0.024). Both groups had no significant difference in monitored vital signs, side effects, and surgeon satisfaction. Conclusions The IVR intervention could reduce anxiety in patients undergoing surgery under regional anesthesia and improve patient satisfaction.
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Affiliation(s)
- Johan Arifin
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
- Department of Anesthesiology and Intensive Care, Dr. Kariadi General Hospital, Semarang, Indoneisia
| | - Mochamat Mochamat
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
- Department of Anesthesiology and Intensive Care, Dr. Kariadi General Hospital, Semarang, Indoneisia
| | - Taufan Pramadika
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Dina Paramita
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
- Department of Anesthesiology and Intensive Care, Dr. Kariadi General Hospital, Semarang, Indoneisia
| | - Widya Istanto Nurcahyo
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
- Department of Anesthesiology and Intensive Care, Dr. Kariadi General Hospital, Semarang, Indoneisia
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Klein E, Mauri J, Lesserson LS, Nayyar P. Nil per os duration and anxiety: A single center cross-sectional study. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2023. [DOI: 10.1016/j.tacc.2023.101231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Asiri S, Guilhermino M, Duff J. The effectiveness of using virtual reality technology for perioperative anxiety among adults undergoing elective surgery: a randomised controlled trial protocol. Trials 2022; 23:972. [PMID: 36461040 PMCID: PMC9716760 DOI: 10.1186/s13063-022-06908-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND More than 2.5 million people are admitted for surgery in Australia each year, and between 40 to 80% will experience moderate to high preoperative anxiety. Elevated levels of preoperative anxiety can increase the risk of postoperative complications such as pain, delayed wound healing, infection, prolonged recovery, and longer hospitalisation. Limited previous research on Virtual Reality (VR) indicates a positive impact on surgery-related anxiety and suggests that the intervention potentially leads to reduce postoperative complications. OBJECTIVE To evaluate the effectiveness of using VR technology for perioperative anxiety among adults undergoing elective surgery. METHOD A two-group parallel randomised controlled trial (RCT) will be conducted, including 150 adult patients (aged 18 years and over) undergoing elective surgery and requiring an overnight stay at a major metropolitan hospital. Eligible participants will be screened for anxiety via the Amsterdam Preoperative Anxiety and Information score (APAIS). Those with moderate to severe anxiety will be randomly allocated to receive the VR session or usual care, in the preoperative holding area. Intervention participants will use a head-mounted VR device to watch and listen to a nature scene for 10 minutes. STUDY OUTCOMES The primary outcome is perioperative anxiety measured using the visual analogue scale for anxiety (VAS-A). Secondary outcomes include stress levels (measured by saliva cortisol level and heart rate), postoperative pain, patient satisfaction with perioperative care, hospital length of stay, and VR-associated adverse events. CONCLUSION This study will help evaluate if a brief preoperative VR session can reduce perioperative anxiety for adult elective surgical patients. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001350910.
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Affiliation(s)
- Salihah Asiri
- grid.412832.e0000 0000 9137 6644School of Nursing, Umm Al-Qura University, Makkah, Saudi Arabia ,grid.1024.70000000089150953School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia ,Australian College of Perioperative Nurses (ACORN), QLD, Australia ,grid.416100.20000 0001 0688 4634Nursing & Midwifery Research Centre, Centre for Clinical Nursing, Royal Brisbane & Women’s Hospital, Building 34, Level 5, Herston, QLD 4029 Australia
| | - Michelle Guilhermino
- grid.266842.c0000 0000 8831 109XSchool of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia ,grid.414724.00000 0004 0577 6676John Hunter Hospital – Intensive care Services, Newcastle, Australia
| | - Jed Duff
- grid.1024.70000000089150953School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia ,Australian College of Perioperative Nurses (ACORN), QLD, Australia
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Patients’ Fears and Perceptions Associated with Anesthesia. Medicina (B Aires) 2022; 58:medicina58111577. [DOI: 10.3390/medicina58111577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Objectives: It has been suggested that intense feelings of fear/anxiety and significant patient concerns may affect the perioperative course. Those findings emphasize the importance of surgical patients’ preoperative feelings. Still, current knowledge in this area is based on a limited number of studies. Thus, we think that there is a need to further explore patients’ preoperative fears, better characterize risk factors and reasons for their occurrence, and evaluate patients’ perspectives associated with anesthesia. Materials and Methods: A total of 385 patients undergoing vascular surgery were preoperatively interviewed using a questionnaire that included demographics and questions related to patients’ fears and perceptions of anesthesia. Statistical analyses included descriptive statistics, Pearson’s χ2 and McNemar tests, and multivariate ordinal logistic regression. Results: The main causes of patients’ preoperative fear were surgery (53.2%), potential complications (46.5%), and anesthesia (40%). Female sex was a predictor of surgery and anesthesia-related fear (OR = 3.07, p = 0.001; OR = 2.4, p = 0.001, respectively). Previous experience lowered the fear of current surgery (OR = 0.65, p = 0.031) and anesthesia (OR = 0.6, p = 0.017). Type of surgery, type of anesthesia, educational and socioeconomic status, and personal knowledge of an anesthesiologist affected specific anesthesia-related fears. Over 25% of patients did not know that an anesthesiologist is a physician, and only 17.7% knew where anesthesiologists work. Level of education and place of residence influenced patients’ perceptions of anesthesia. Conclusions: Anesthesia-related fears are affected by the type of surgery/anesthesia, experience with previous surgery, and personal knowledge of an anesthesiologist. Women, patients with lower education levels, and patients with poorer socioeconomic status are at higher risk of developing those fears. The perception of anesthesiologists is inadequate, and knowledge of anesthesia is poor. Promotion of patient education regarding anesthesia is needed to alleviate those fears and increase understanding of anesthesia.
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LEARNS Model as Perioperative Education Strategy for Patients with Laryngeal Tumors. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3360966. [PMID: 36276849 PMCID: PMC9581709 DOI: 10.1155/2022/3360966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/17/2022] [Indexed: 11/05/2022]
Abstract
Objective To evaluate LEARNS model as a perioperative strategy for health education and nursing supervision of patients with laryngeal tumors. Methods LEARNS scheme based on the best practice guidelines was applied to patients in the observation group: (1) analyze the needs of patients (Listen_L); (2) establish therapeutic partnership (Establish_E); (3) adopt intentional intervention (Adopt_A); (4) reinforce health awareness (Reinforce_R); (5) implement feedback assessment of knowledge (Name_N); (6) strengthen self-management based on community resources (Strengthen_S). In the control group, traditional medical care instructions were provided to the patients by medical staff. Parameters such as anxiety status, treatment compliance, nursing satisfaction, self-care ability, and life quality were compared between the observation and control groups. Results Upon admission, there was no significant difference in self-care ability and anxiety level between two groups. However, the anxiety level of observation group was significantly lower than that of the control group 1 day before operation and 7 days after operation. Postoperative treatment compliance and nursing satisfaction were also improved in the observation group. In addition, self-care ability and life quality in the observation group were significantly enhanced as compared to the control group. Conclusion As a mutual learning process between nurses and patients, LEARNS model motivates nurses to assess the needs of patients voluntarily. Furthermore, evidence-based education reinforces the self-care ability and health awareness of the patients. Our data suggests that LEARNS model is of great value in improving the life quality of the patients with laryngeal tumors and nursing satisfaction.
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Ji W, Sang C, Zhang X, Zhu K, Bo L. Personality, Preoperative Anxiety, and Postoperative Outcomes: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12162. [PMID: 36231463 PMCID: PMC9565184 DOI: 10.3390/ijerph191912162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Research has shown that personality is associated with anxiety levels in the general population. However, little is known about the relationship between personality and preoperative anxiety and the subsequent health outcomes in patients undergoing surgery. Therefore, this review aimed to identify studies that explored the relationship between personality traits and preoperative anxiety, as well as their association with postoperative outcomes. Existing literature shows that anxiety may play an intermediary role in the relationship between personality and postoperative outcomes. Severe anxiety may partially explain the adverse effects of certain personality traits, such as neuroticism, on postoperative outcomes. However, the relationship between personality traits, preoperative anxiety, and postoperative outcomes remains unclear. Interventions such as clinical evaluation, preoperative counseling, and management strategies can be of great value in identifying and resolving patients' anxiety and negative emotions to improve postoperative outcomes.
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Affiliation(s)
- Wentao Ji
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Chao Sang
- Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
| | - Xiaoting Zhang
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Keming Zhu
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Lulong Bo
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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Septorinoplasti hastalarında perioperatif anksiyete. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2022. [DOI: 10.21673/anadoluklin.1158712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aim: Septorhinoplasty is a frequently performed surgery in otolaryngology clinics. Although perioperative anxiety is considered a normal part of the surgical experience, it has some negative consequences. The aim of this study was to evaluate the perioperative depression, anxiety and postoperative pain scores of the patients that underwent septorhinoplasty.
Methods: A total of 46 patients that underwent septorhinoplasty (SRP) between 2019-2021 years were included in this prospective study. HADS (Hospital anxiety depression scale) was used to measure anxiety and depression scores, and visual analog scale (VAS) was used to measure postoperative pain scores (POP) of the patients.
Results: Preoperative and first postoperative day HADS-A scores were compared and there was a significant decrease between the scores (p=.001). HADS-A and HADS-D scores decreased significantly after internal nasal splints were removed(p
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Benzy M, Venkatesh R, Vellam Ramakrishnan V, Odayar VS. Effect of Video Counselling Versus Verbal Counselling on Patient's experience during phacoemulsification under topical anaesthesia. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100050. [PMID: 37846388 PMCID: PMC10577861 DOI: 10.1016/j.aopr.2022.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/23/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2023]
Abstract
Purpose To evaluate the impact of video and verbal counselling on patients' undergoing phacoemulsification under topical anaesthesia. Methods This is a prospective randomized controlled trial conducted at Aravind Eye Care System, Pondicherry, India. All patients had a 15 min one-on-one verbal counselling covering surgical technique, implant options, anaesthesia and payment options one day prior to surgery. On the day of surgery, patients were randomized into two groups; in the first group, patients were provided with video counselling and in the second group, patients were given verbal counselling prior to undergoing phacoemulsification under topical anaesthesia. Measurements of blood pressure, heart rate, respiration rate, and the Likert-scale anxiety rating were collected at preoperative, perioperative, and postoperative time points. Results A group of 186 patients (aged 45-70 years) were provided video counselling via portable iPad before first-time phacoemulsification, and a second group of 186 patients underwent surgery with verbal counselling. Systolic and diastolic blood pressure measurements were lower in both the video and verbally counselled groups during the intraoperative time point. Furthermore, during the intraoperative period, 123 (66.1%) video counselled patients felt relaxed compared to 119 (64%) patients who were provided verbal counselling (P = 0.6636). Patient cooperation during surgery was excellent in 76(40.9%) video counselled patients and 67(36%) verbally counselled patients (P = 0.3374). 25.8% and 21% (P = 0.2703) of patients experienced no pain during surgery in the video and verbal counselled groups respectively. Conclusions Although measures such as pulse rate, respiratory rate and feelings of relaxation did not show significant differences among the two groups of video and verbal counselling, patients marked cooperation during surgery and furthermore, the level of anxiety is most reassuring.
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Affiliation(s)
- Merlin Benzy
- Department of Cataract and IOL Services, Aravind Eye Hospital, Pondicherry, India
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Shewangzaw Engda A, Belay Yigzaw H, Alemnew Engdaw N, Admasu Basha E, Adem A, Dargie Wubetu A, Misganaw Kebede W, Atinafu BT, Nigussie Tarekegn F, Abate Belew M. Magnitude of Preoperative Anxiety and Associated Factors Among Adult Surgical Patients in Debre Berhan Comprehensive Specialized Hospital. Int J Gen Med 2022; 15:5999-6007. [PMID: 35818581 PMCID: PMC9270893 DOI: 10.2147/ijgm.s369921] [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: 04/08/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Anxiety is an un-pleasurable emotional state associated with psychophysiological changes in response to an intra-psychic conflict. The perioperative period is one of the worrying events for most surgical patients. Despite preoperative anxiety having many negative consequences on post-operative physical and mental health, no adequate information on the degree to which the preoperative period exposed clients to preoperative anxiety and its associated factors. Objective To assess the prevalence of preoperative anxiety and associated factors among adult surgical patients in Debre Berhan Comprehensive Specialized Hospital, Ethiopia. Methods Institution-based cross-sectional study was conducted from June 1, 2020, to August 30, 2020. State-Trait Anxiety Inventory Scale (S-STAI) was used to measure the level of pre-operative anxiety. A systematic random sampling technique was employed to collect the data. The data were entered to Epi-Data version 4.6 and exported to SPSS version 25 for data analysis. A statistically significant association was declared at a p-value less than 0.05. Results A total of 330 patients were enrolled in the study with a response rate of 93.2%. The prevalence of a high level of preoperative anxiety was 53.6% (95% CI (49.6-58.7)). Being female 3.2 (2.19, 3.71) illiterate 4.1 (2.01, 15.39), fear of death 2.12 (1.30, 3.44), results of operation 2.60 (1.75, 4.18), postoperative pain 2.35 (1.37, 4.02), and surgical complication 1.9 (1.03, 12.13) were statistically significant factors. Conclusion Preoperative anxiety affects more than half of surgical patients which is a high and serious health burden. Additionally, this study revealed that being female, illiterate, fear of death, having a history of surgical complications and fear of complications, and fear of postoperative pain were significantly associated with preoperative anxiety. Assessing during the preoperative period helps to detect and ameliorate the problem. Preoperative counseling and informed consent taken as a prerequisite for surgery will help in reducing preoperative anxiety.
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Affiliation(s)
- Abayneh Shewangzaw Engda
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Hailu Belay Yigzaw
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigus Alemnew Engdaw
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Elyas Admasu Basha
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Ahmed Adem
- Department of Nursing, Psychiatry Unit, College of Health Sciences and Medicine, Samara University, Samara, Ethiopia
| | - Abate Dargie Wubetu
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Worku Misganaw Kebede
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bantealem Tilaye Atinafu
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Fetene Nigussie Tarekegn
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Makda Abate Belew
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
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Pestana-Santos M, Pestana-Santos A, Cabral IE, Santos MR, Lomba L. Nurses’ Views on How to Best Design a Program to Prevent Adolescents’ Anxiety in the Perioperative Period. A Qualitative Study. J Perianesth Nurs 2022; 37:458-466. [DOI: 10.1016/j.jopan.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/08/2021] [Accepted: 10/03/2021] [Indexed: 11/29/2022]
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Bedaso A, Mekonnen N, Duko B. Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Open 2022; 12:e058187. [PMID: 35277412 PMCID: PMC8919464 DOI: 10.1136/bmjopen-2021-058187] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/15/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES This review aimed to determine the pooled prevalence of preoperative anxiety and its associated factors among patients undergoing surgery in low/middle-income countries (LMICs). METHODS We searched PubMed, SCOPUS, CINAHL, Embase and PsychINFO to identify peer-reviewed studies on the prevalence and factors associated with preoperative anxiety among patients undergoing surgery using predefined eligibility criteria. Studies were pooled to estimate the prevalence of preoperative anxiety using a random-effect meta-analysis model. Heterogeneity was assessed using I² statistics. Funnel plot asymmetry and Egger's regression tests were used to check for publication bias. RESULT Our search identified 2110 studies, of which 27 studies from 12 countries with 5575 participants were included in the final meta-analysis. Of the total 27 studies, 11 used the State-Trait Anxiety Inventory to screen anxiety, followed by the Amsterdam Preoperative Anxiety and Information scale, used by four studies. The pooled prevalence of preoperative anxiety among patients undergoing surgery in LMICs was 55.7% (95% CI 48.60 to 62.93). Our subgroup analysis found that a higher pooled prevalence of preoperative anxiety was found among female surgical patients (59.36%, 95% CI 48.16 to 70.52, I2=95.43, p<0.001) and studies conducted in Asia (62.59%, 95% CI 48.65 to 76.53, I2=97.48, p<0.001). CONCLUSION Our meta-analysis indicated that around one in two patients undergoing surgery in LMICs suffer from preoperative anxiety, which needs due attention. Routine screening of preoperative anxiety symptoms among patients scheduled for surgery is vital. PROSPERO REGISTRATION NUMBER CRD42020161934.
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Affiliation(s)
- Asres Bedaso
- Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Nibretie Mekonnen
- Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia
| | - Bereket Duko
- Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia
- Curtin University, School of Population Health, Department of Public Health, Perth, Western Australia, Australia
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Applications of three-dimensional surgical planning in facial feminization surgery: A systematic review. J Plast Reconstr Aesthet Surg 2022; 75:e1-e14. [PMID: 35400593 DOI: 10.1016/j.bjps.2022.02.073] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/22/2022] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite some reports that have shown an increase in safety, efficiency, and accuracy during feminizing craniofacial procedures utilizing three-dimensional (3D) technology, there are no reports summarizing the available evidence on this matter for facial feminization surgery (FFS). Here, we aimed to systematically review the application of 3D technology on FFS. METHODS We conducted a comprehensive search across PubMed, SCOPUS, Ovid MEDLINE®, Web of Science, and ScienceDirect looking for studies reporting the use of 3D surgical planning in the setting of FFS following the PRISMA guidelines. We extracted data on photographic assessment, imaging, surgical application, and surgical technique and outcomes. RESULTS This review included 10 studies comprising 1473 transgender female patients and 50 cadaveric cranial specimens. Four studies employed virtual surgical planning (VSP) and the concomitant use of prefabricated cutting guides. One study reported the implementation of 3D VSP using a female skull as a reference. One study used computer-aided design cutting guides and custom plates for FFS. Standardized incorporation of 3D printed models allowed for preoperative planning in three studies. Three studies reported VSP using 3D reconstruction of CT images, but without the use of 3D printing. Three studies used 3D photography with specialized camera technology to enrich clinical documentation and provide a comprehensive facial analysis of soft tissue. Accuracy ranged from 85.7% to 97%. Morbidity ranged from 0% to 12.5%. CONCLUSION Based on this data, we believe 3D VSP has promising outcomes in terms of accuracy and low morbidity, encouraging its implementation in FFS. However, further prospective double-arm cohort studies are required.
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Ferede YA, Bizuneh YB, Workie MM, Admass BA. "Prevalence and associated factors of preoperative anxiety among obstetric patients who underwent cesarean section": A cross-sectional study. Ann Med Surg (Lond) 2022; 74:103272. [PMID: 35198163 PMCID: PMC8844776 DOI: 10.1016/j.amsu.2022.103272] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/08/2022] [Accepted: 01/23/2022] [Indexed: 01/26/2023] Open
Abstract
Background Anxiety is the most common problem in the preoperative period. This anxiety increases postoperative pain, delay healing, and prolong the hospital stay. Among the surgical population, a higher level of preoperative anxiety has been seen in obstetric patients. Objective The aim of this study was to assess the prevalence and associated factors of preoperative anxiety among obstetric patients undergoing cesarean section. Methods An institutional-based cross-sectional study was conducted from January 01, 2021, to May 30, 2021. A total of 376 obstetric patients who underwent cesarean sections were included. Descriptive statistics, cross-tabs, and binary logistic regression analysis were performed to identify the association shivering and independent variables. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval and a p-value<0.05 was considered as statistically significant state versions of state-trait anxiety inventory scale (S-STAI) were used for this study. Results The overall prevalence rate of preoperative anxiety was 63% (95% CI: 58.2, 68.1). The patient's preoperative mean anxiety score of STAI was (43.81 ± 8.81). There was a high level of preoperative anxiety in patients undergoing emergency cesarean section as compared to elective patients. Patients' age less than 30 years, level of education, and previous anesthesia and surgery exposure were also highly associated with the dependent variable. Conclusion In this study, fear of complications and fear of death result of operation were the most common factors responsible for preoperative anxiety while few patients were anxious about financial loss and osmotic issues. The prevalence rate of preoperative anxiety was 63% among obstetric patients. Preoperative anxiety was highly related to fear of complications and fear of death. Age, Level of education were significantly associated with preoperative anxiety. Previous anesthesia exposure was also significantly associated with anxiety. Preoperative anesthesia visits are important to reduce anxiety.
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Affiliation(s)
- Yonas Admasu Ferede
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Yosef Belay Bizuneh
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Misganaw Mengie Workie
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Parada-Cabaleiro E, Batliner A, Schedl M. An Exploratory Study on the Acoustic Musical Properties to Decrease Self-Perceived Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:994. [PMID: 35055816 PMCID: PMC8775969 DOI: 10.3390/ijerph19020994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 12/29/2022]
Abstract
Musical listening is broadly used as an inexpensive and safe method to reduce self-perceived anxiety. This strategy is based on the emotivist assumption claiming that emotions are not only recognised in music but induced by it. Yet, the acoustic properties of musical work capable of reducing anxiety are still under-researched. To fill this gap, we explore whether the acoustic parameters relevant in music emotion recognition are also suitable to identify music with relaxing properties. As an anxiety indicator, the positive statements from the six-item Spielberger State-Trait Anxiety Inventory, a self-reported score from 3 to 12, are taken. A user-study with 50 participants assessing the relaxing potential of four musical pieces was conducted; subsequently, the acoustic parameters were evaluated. Our study shows that when using classical Western music to reduce self-perceived anxiety, tonal music should be considered. In addition, it also indicates that harmonicity is a suitable indicator of relaxing music, while the role of scoring and dynamics in reducing non-pathological listener distress should be further investigated.
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Affiliation(s)
- Emilia Parada-Cabaleiro
- Multimedia Mining and Search Group, Institute of Computational Perception, Johannes Kepler University Linz (JKU), 4040 Linz, Austria;
- Human-Centered AI Group, AI Laboratory, Linz Institute of Technology (LIT), 4040 Linz, Austria
| | - Anton Batliner
- Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, 86159 Augsburg, Germany;
| | - Markus Schedl
- Multimedia Mining and Search Group, Institute of Computational Perception, Johannes Kepler University Linz (JKU), 4040 Linz, Austria;
- Human-Centered AI Group, AI Laboratory, Linz Institute of Technology (LIT), 4040 Linz, Austria
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Dippre AT, Quinn KM, Walto M, Mukherjee R, Baliga PK, Abbott AM. The Perioperative Patient Experience During COVID-19. Am Surg 2021; 88:498-506. [PMID: 34965161 PMCID: PMC8859479 DOI: 10.1177/00031348211061100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Access to elective surgical procedures has been impacted by the COVID-19 pandemic. Methods We sought to understand the patient experience by developing and distributing an anonymous online survey to those who underwent non-emergency surgery at a large academic tertiary medical center between March and October 2020. Results The survey was completed by 184 patients; the majority were white (84%), female (74.6%), and ranged from 18 to 88 years old. Patients were likely unaware of case delay as only 23.6% reported a delay, 82% of which agreed with that decision. Conversely, 44% felt that the delay negatively impacted their quality of life. Overall, 82.7% of patients indicated high satisfaction with their care. African American patients more often indicated a “neutral” vs “satisfactory” hospital experience (P < .05) and considered postponing their surgery (P < .01). Interestingly, younger patients (<60) were more likely than older (≥60) patients to note anxiety associated with having surgery during the pandemic (P < .01), feeling unprepared for discharge (P < .02), not being allowed visitors (P < .02), and learning about the spread of COVID-19 from health care providers (P < .02). Discussion These results suggest that patients are resilient and accepting of changes to health care delivery during the current pandemic; however, certain patient populations may have higher levels of anxiety which could be addressed by their care provider. These findings can help inform and guide ongoing and future health care delivery adaptations in response to care disruptions.
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Affiliation(s)
- Andrew T Dippre
- Department of Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Kristen M Quinn
- Department of Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Melinda Walto
- Department of Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Rupak Mukherjee
- Department of Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Prabhakar K Baliga
- Department of Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
| | - Andrea M Abbott
- Department of Surgery, 2345Medical University of South Carolina, Charleston, SC, USA
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Tawa P, Brault N, Luca-Pozner V, Ganry L, Chebbi G, Atlan M, Qassemyar Q. Three-Dimensional Custom-Made Surgical Guides in Facial Feminization Surgery: Prospective Study on Safety and Accuracy. Aesthet Surg J 2021; 41:NP1368-NP1378. [PMID: 33480977 DOI: 10.1093/asj/sjab032] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Facial feminization surgery (FFS) includes several osseous modifications of the forehead, mandible, and chin, procedures that require precision to provide the patient with a satisfactory result. Mispositioned osteotomies can lead to serious complications and poor aesthetic outcomes. Surgical cutting guides are commonly employed in plastic and maxillofacial surgery to improve safety and accuracy. Yet, to our knowledge, there is no report in the literature on the clinical application of cutting guides in FFS. OBJECTIVES The authors sought to assess the safety and accuracy of custom surgical cutting guides in FFS procedures. METHODS A prospective follow-up of 45 patients regarding FFS with preoperative virtual planning and 3-dimensional custom-made surgical guides for anterior frontal sinus wall setback, mandibular angle reduction, and/or osseous genioplasty was conducted. Accuracy (superimposing preoperative data on postoperative data by global registration with a 1-mm margin of error), safety (intradural intrusion for the forehead procedures and injury of the infra alveolar nerve for chin and mandibular angles), and patient satisfaction were assessed. RESULTS A total 133 procedures were documented. There was no cerebrospinal fluid leak on the forehead procedures or any infra alveolar nerve or tooth root injury on both chin and mandibular angle operations (safety, 100%). Accuracy was 90.80% on the forehead (n = 25), 85.72% on the mandibular angles (n = 44), and 96.20% on the chin (n = 26). Overall satisfaction was 94.40%. CONCLUSIONS Custom-made surgical cutting guides could be a safe and accurate tool for forehead, mandibular angles, and chin procedures for FFS. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Pierre Tawa
- Reconstructive and Aesthetic Surgery Department at Tenon Hospital, Sorbonne University, Paris, France
| | - Nicolas Brault
- Reconstructive and Aesthetic Surgery Department at Tenon Hospital, Sorbonne University, Paris, France
| | - Vlad Luca-Pozner
- Department at Trousseau Hospital, Sorbonne University, Paris, France
| | - Laurent Ganry
- Department at Trousseau Hospital, Sorbonne University, Paris, France
| | - Ghassen Chebbi
- Department at Trousseau Hospital, Sorbonne University, Paris, France
| | - Michael Atlan
- Department of Plastic, Reconstructive and Aesthetic Surgery at Tenon Hospital, Sorbonne University, Paris, France
| | - Quentin Qassemyar
- Reconstructive and Aesthetic Surgery Department at Tenon Hospital, Sorbonne University, Paris, France
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Talabi AO, Sowande OA, Mosaku KS, Owojuyigbe AM, Amosu LO, Adejuyigbe O. Effect of parental presence on anxiety during induction of anaesthesia in children undergoing elective day case surgery. ANNALS OF PEDIATRIC SURGERY 2021. [DOI: 10.1186/s43159-021-00106-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Surgical operation and anaesthesia induction are fearful events which may interfere with the smooth conduct of anaesthesia and postoperative recovery in children. Indeed, the fear of needles, syringes and unknown hospital environment often compound their anxiety. Various modalities such as use of clowns, music, low intensity light in the induction room, pharmacological agents and parental presence during induction of anaesthesia have been utilized with the aim of gaining the cooperation of the children during induction. However, their use has yielded conflicting results. This prospective study was conducted among children whose ages were between 2 and 15 years. They were randomized into parental presence and parental absence (un-accompanied) or control groups. The anxiety levels of children and parents in both groups were compared at baseline, separation and during induction of anaesthesia.
Results
The ages of the children ranged between 2 and 15 years with a mean age of 6.78 ± 2.50 years. The mean age of patients in the parental presence at induction (PPIA) was 7.14 ± 3.68 years while in the control group was 6.42 ± 3.31 years. The difference was not statistically significant, p < 0.05. The mean anxiety score of patients in the PPIA at reception, separation and induction of anaesthesia were 26.6 ± 9.2, 38.4 ± 18.3 and 54.1 ± 22.8 compared to 27.3 ± 8.04, 41.4 ± 21.7 and 58.6 ± 23.1 in the control group respectively, p < 0.05. The mean anxiety score of parents in the PPIA at reception, separation and induction of anaesthesia were 52.2 ± 6.7, 51.7 ± 7.8 and 51.9 ± 7.9 compared to 53.0 ± 6.5, 52.4 ± 6.2 and 52.9 ± 7.9 in the control group respectively, p < 0.05. Among the cohort of preschool age group, children in the control group were more anxious at induction compared to the PPIA group, p = 0.01. As the age increases, the anxiety state of the children decreases, t = − 0.398, p < 0.001. The mean score of parental satisfaction in the PPIA and the control groups were comparable, 8.1 ± 7.1 vs 7.3 ± 1.1 respectively, p = 0.395.
Conclusion
The presence of parents during induction of anaesthesia did not influence the anxiety states of children in our study. Anxiety at induction tends to reduce as the age of patients increases.
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Mbamalu O, Bonaconsa C, Nampoothiri V, Surendran S, Veepanattu P, Singh S, Dhar P, Carter V, Boutall A, Pennel T, Hampton M, Holmes A, Mendelson M, Charani E. Patient understanding of and participation in infection-related care across surgical pathways: a scoping review. Int J Infect Dis 2021; 110:123-134. [PMID: 34293491 DOI: 10.1016/j.ijid.2021.07.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/10/2021] [Accepted: 07/14/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To explore the existing evidence on patient understanding of and/or participation in infection-related care in surgical specialties. METHOD A scoping review of the literature was conducted. PubMed, Web of Science, Scopus, and grey literature sources were searched using predefined search criteria for policies, guidelines, and studies in the English language. Data synthesis was done through content and thematic analysis to identify key themes in the included studies. RESULTS The initial search identified 604 studies, of which 41 (36 from high-income and five from low- and middle-income countries) were included in the final review. Most of the included studies focused on measures to engage patients in infection prevention and control (IPC) activities, with few examples of antimicrobial stewardship (AMS) engagement strategies. While patient engagement interventions in infection-related care varied depending on study goals, surgical wound management was the most common intervention. AMS engagement was primarily limited to needs assessment, without follow-up to address such needs. CONCLUSION Existing evidence highlights a gap in patient participation in infection-related care in the surgical pathway. Standardization of patient engagement strategies is challenging, particularly in the context of surgery, where several factors influence how the patient can engage and retain information. Infection-related patient engagement and participation strategies in surgery need to be inclusive and contextually fit.
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Affiliation(s)
- Oluchi Mbamalu
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
| | - Candice Bonaconsa
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Vrinda Nampoothiri
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Surya Surendran
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Pranav Veepanattu
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Sanjeev Singh
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Puneet Dhar
- Department of Gastrointestinal Surgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi (Kerala), India
| | - Vanessa Carter
- e-Patient Scholar and Africa CDC Civil Society Champion for Antimicrobial Resistance; Healthcare Communications and Social Media, South Africa
| | - Adam Boutall
- Colorectal Unit, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Timothy Pennel
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
| | - Mark Hampton
- Dr Matley & Partners Surgical Practice, Cape Town, South Africa
| | - Alison Holmes
- NIHR Health Protection Research Unit in Healthcare Associated infections and Antimicrobial Resistance, Department of Medicine, Imperial College London, UK
| | - Marc Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Esmita Charani
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa; NIHR Health Protection Research Unit in Healthcare Associated infections and Antimicrobial Resistance, Department of Medicine, Imperial College London, UK.
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Perioperative factors associated with persistent post-surgical pain after hysterectomy, cesarean section, prostatectomy, and donor nephrectomy: a systematic review and meta-analysis. Pain 2021; 163:425-435. [PMID: 34121077 DOI: 10.1097/j.pain.0000000000002361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/04/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Persistent postsurgical pain (PPSP) is a common, and often disabling postoperative morbidity, but many questions remain about factors associated with PPSP. This systematic review and meta-analysis aimed to identify preoperative, intraoperative and postoperative factors associated with PPSP after gynecological surgeries, namely hysterectomy and cesarean section (C-section), and urological surgeries, namely prostatectomy and donor nephrectomy. Overall, 18 gynecological surgery studies, 4 prostatectomy studies, and 2 donor nephrectomy studies met the review criteria providing data that could be meta-analyzed. Average (±SD) PPSP occurrence after gynecological surgery was 20±11%; factors associated with increased risk of PPSP included smoking, preoperative abdominal or pelvic pain, preoperative pain elsewhere in the body, longer duration of surgery, more intense acute postoperative pain, and surgical wound infection. The use of neuraxial anesthesia was associated with decreased PPSP risk. Average PPSP occurrence was 20±9% after prostatectomy and 15±2% after donor nephrectomy. For urological procedures, the existing data did not allow for identification of significant factors associated with PPSP, except for laparoscopic and hand assisted laparoscopic approaches that were associated with lower incidence of PPSP for donor nephrectomy, and the use of neuraxial anesthesia which was associated with lower incidence of PPSP after prostatectomy. PPSP after gynecological and urological surgeries is common. This systematic review identified important factors associated with C-section and hysterectomy that can help identify women who are at high risk of PPSP. More high-quality studies with consistent methodology are needed to understand the factors associated with PPSP risk, particularly for surgeries such as prostatectomy and nephrectomy.
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Weisfeld CC, Turner JA, Dunleavy K, Ko A, Bowen JI, Roelk B, Eissa R, Benfield E, Robertson K. Dealing with Anxious Patients: A Systematic Review of the Literature on Nonpharmaceutical Interventions to Reduce Anxiety in Patients Undergoing Medical or Dental Procedures. J Altern Complement Med 2021; 27:717-726. [PMID: 34076531 DOI: 10.1089/acm.2020.0504] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objectives: State (situational) anxiety can create suboptimal outcomes for patients across a variety of health care specializations. While anxiolytic medications reduce anxiety, problematic side effects can compromise outcomes. These challenges have spurred searches for nonpharmaceutical approaches to alleviate patient anxiety. This systematic literature review, largely following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to determine patterns and effectiveness of interventions across medical health care specialty areas, including dentistry. Methods: A systematic review was conducted, using PubMed, CINAHL, and PsycINFO databases, with search terms related to anxiety, specific interventions, and medical or dental procedures. Hand searching for additional citations was performed on the bibliographies of dissertations, meta-analyses, and systematic reviews that met article inclusion criteria. The search process yielded 48,324 articles and 257 dissertations published in English between 1974 and 2018. Each abstract was evaluated for inclusion by two reviewers, yielding 718 articles that were read and evaluated for outcomes, risk of bias, pretest and post-test, controls and quality, using a Critical Appraisal Skills Programme instrument. Of these, 408 articles, describing 501 experimental trials, were accepted for inclusion in this analysis. Results: A total of 50,343 patients were included in these experiments, with an overall success rate of 71% for reducing patient anxiety. Results are summarized by health care specialty area: surgery, oncology, cardiology, obstetrics/gynecology, dentistry, and pain/trauma, and the following diagnostic testing and intervention areas: imaging, colonoscopy, mechanical ventilation, and other. The largest number of experiments (114) was in the surgery category. The types of interventions included music, education, relaxation, cognitive behavioral therapy (CBT), massage, distraction, hypnosis, acupuncture/acupressure, social support, aromatherapy, nature sounds, natural visual stimuli, special garment, and other. The largest numbers of experiments were done with music (143) and education (130). Discussion: The following interventions were most successful, reducing anxiety in over 70% of experiments: music, CBT, relaxation, massage, acupuncture/acupressure, hypnosis, and natural sounds. Confidence in results is limited by publication bias, small sample sizes, and the lack of placebo controls. Directions for future research are discussed.
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Affiliation(s)
- Carol C Weisfeld
- Department of Psychology, and University of Detroit Mercy, Detroit, MI, USA
| | - Jill A Turner
- Libraries/IDS, University of Detroit Mercy, Detroit, MI, USA
| | - Kim Dunleavy
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Arthur Ko
- McAuley School of Nursing, College of Health Professions, University of Detroit Mercy, Detroit, MI, USA
| | | | - Brandi Roelk
- Department of Psychology, and University of Detroit Mercy, Detroit, MI, USA
| | - Reem Eissa
- Department of Psychology, and University of Detroit Mercy, Detroit, MI, USA
| | - Erica Benfield
- Department of Psychology, and University of Detroit Mercy, Detroit, MI, USA
| | - Kristen Robertson
- Orthopedic Physical Therapy Program, Walk the Line Recovery Therapy, Southfield, MI, USA
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Ambler M, Springs S, Garcia D, Born C. Heterogeneity of outcomes for intraoperative music interventions: a scoping review and evidence map. BMJ Evid Based Med 2021; 26:116-117. [PMID: 32816900 DOI: 10.1136/bmjebm-2020-111382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Over the past 30 years, numerous studies have been performed that assess the efficacy of intraoperative music as an adjunctive means to regional and local anaesthesia to improve clinical outcomes. Despite an emerging body of evidence and growing adoption of music in surgical settings, the variety of interventions studied, and the heterogeneity of outcomes and outcome measurement tools applied makes difficult the task of aggregating evidence. OBJECTIVE This study assesses the state of the field of intraoperative musical interventions by documenting and visualising the breadth of outcomes measured in studies. DESIGN Scoping review and evidence map. METHODS Three electronic databases (PubMed, Embase and a music-focussed research database, RILM (International Music Literature Repository)) were searched for full-text articles published between January 1991 and July 2019. Results from these searches were screened and relevant data was extracted from full-text articles on type of music intervention and type of anaesthesia; outcomes measured were recorded in an evidence map in order to identify the current state of the field and assess for trends in outcome measurements. INTERVENTIONS Music administered to adult patients via headphones or speakers under regional or local sedation in during the intraoperative period. RESULTS Twenty-one studies with a total of 2283 patients were included. A total of 42 unique outcomes were measured across the 21 studies, with each measuring an average of 6.41±2.63 outcomes. Systolic blood pressure, diastolic blood pressure, heart rate, anxiety, pain, patient satisfaction, respiratory rate and sedation requirements were the most prevalent outcomes reported. Only 15 outcome measures (36%) were used in more than one study, while the remaining 27 outcome measures (64%) were identified in only one study in our review. CONCLUSIONS Our scoping review identifies that almost two-thirds of studies in this field used >1 outcome measure unique to that study (not also used in other studies), which hinders opportunities to aggregate data across studies and meta-analyse evidence. Future studies should provide clear documentation regarding the intervention and consider using valid and reliable outcome tools. Researchers should consider standardisation when appropriate and adopting the use of core outcome sets for conditions where these sets have been developed.
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Affiliation(s)
- Melanie Ambler
- Brown University Division of Biology and Medicine, Providence, Rhode Island, USA
- Diane Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Stacey Springs
- Center for Evidence Synthesis, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Dioscaris Garcia
- Diane Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Christopher Born
- Diane Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedic Surgery, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
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Schiffmann I, Freund M, Vettorazzi E, Stellmann JP, Heyer-Borchelt S, D'Hooghe M, Häußler V, Rahn AC, Heesen C. Assessing the effect of an evidence-based patient online educational tool for people with multiple sclerosis called UMIMS-understanding magnetic resonance imaging in multiple sclerosis: study protocol for a double-blind, randomized controlled trial. Trials 2020; 21:1008. [PMID: 33298133 PMCID: PMC7724874 DOI: 10.1186/s13063-020-04855-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 11/01/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND While magnetic resonance imaging (MRI) plays a major role in the lives of people with multiple sclerosis (pwMS), studies have shown that MRI-specific knowledge in pwMS is limited. Moreover, poor knowledge was associated with negative feelings towards MRI (e.g. anxiety concerning MRI scan). Because information sources about MRI in MS for pwMS are not available, we designed and evaluated an evidence-based online educational platform about MRI in MS called "Understanding MRI in MS" (UMIMS). Based on a pilot study in n= 79 subjects, an educational intervention was found to be feasible and effective. We hypothesize that MRI-specific knowledge can be increased by using UMIMS and that, subsequently, negative feelings towards MRI will be reduced and shared decision-making competences increased. METHODS This randomized, controlled, double-blinded trial (RCT) will recruit n = 120 pwMS. The intervention group will receive access to UMIMS. The control group will get access to a specifically developed control website, which visually imitates UMIMS and contains the standard information available by several MS self-help organizations. The change in MRI-specific knowledge assessed via the MRI-risk knowledge questionnaire (MRI-RIKNO) after the intervention is the primary endpoint at 2 weeks. Several secondary endpoints will be assessed at different timepoints throughout the study, e.g. emotions towards MRI, autonomy preferences, threat by MS and shared decision-making competences. The study includes a process evaluation. DISCUSSION The aim of this RCT is to prove that access to an education tool on MRI in MS will increase pwMS' MRI-specific knowledge and enhance shared decision-making when discussing decisions involving MRI results during patient-physician encounters. TRIAL REGISTRATION Clinicaltrials.gov NCT03872583 . Registered on 13 March 2019.
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Affiliation(s)
- Insa Schiffmann
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany.
- Department of Neurology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany.
| | - Magalie Freund
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Eik Vettorazzi
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Jan-Patrick Stellmann
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Neurology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
- APHM, Hopital de la Timone, CEMEREM, Marseille, France
- Aix Marseille Université, CNRS, CRMBM, UMR 7339, Marseille, France
| | - Susanne Heyer-Borchelt
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Marie D'Hooghe
- Centre for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
- National MS Centre Melsbroek, Melsbroek, Belgium
| | - Vivien Häußler
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Neurology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anne Christin Rahn
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Christoph Heesen
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Neurology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
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Madsen BK, Zetner D, Møller AM, Rosenberg J. Melatonin for preoperative and postoperative anxiety in adults. Cochrane Database Syst Rev 2020; 12:CD009861. [PMID: 33319916 PMCID: PMC8092422 DOI: 10.1002/14651858.cd009861.pub3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Anxiety in relation to surgery is a well-known problem. Melatonin offers an alternative treatment to benzodiazepines for ameliorating this condition in the preoperative and postoperative periods. OBJECTIVES To assess the effects of melatonin on preoperative and postoperative anxiety compared to placebo or benzodiazepines. SEARCH METHODS We searched the following databases on 10 July 2020: CENTRAL, MEDLINE, Embase, CINAHL, and Web of Science. For ongoing trials and protocols, we searched clinicaltrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform. SELECTION CRITERIA We included randomized, placebo-controlled or standard treatment-controlled (or both) studies that evaluated the effects of preoperatively administered melatonin on preoperative or postoperative anxiety. We included adult patients of both sexes (15 to 90 years of age) undergoing any kind of surgical procedure for which it was necessary to use general, regional, or topical anaesthesia. DATA COLLECTION AND ANALYSIS One review author conducted data extraction in duplicate. Data extracted included information about study design, country of origin, number of participants and demographic details, type of surgery, type of anaesthesia, intervention and dosing regimens, preoperative anxiety outcome measures, and postoperative anxiety outcome measures. MAIN RESULTS We included 27 randomized controlled trials (RCTs), involving 2319 participants, that assessed melatonin for treating preoperative anxiety, postoperative anxiety, or both. Twenty-four studies compared melatonin with placebo. Eleven studies compared melatonin to a benzodiazepine (seven studies with midazolam, three studies with alprazolam, and one study with oxazepam). Other comparators in a small number of studies were gabapentin, clonidine, and pregabalin. No studies were judged to be at low risk of bias for all domains. Most studies were judged to be at unclear risk of bias overall. Eight studies were judged to be at high risk of bias in one or more domain, and thus, to be at high risk of bias overall. Melatonin versus placebo Melatonin probably results in a reduction in preoperative anxiety measured by a visual analogue scale (VAS, 0 to 100 mm) compared to placebo (mean difference (MD) -11.69, 95% confidence interval (CI) -13.80 to -9.59; 18 studies, 1264 participants; moderate-certainty evidence), based on a meta-analysis of 18 studies. Melatonin may reduce immediate postoperative anxiety measured on a 0 to 100 mm VAS compared to placebo (MD -5.04, 95% CI -9.52 to -0.55; 7 studies, 524 participants; low-certainty evidence), and may reduce delayed postoperative anxiety measured six hours after surgery using the State-Trait Anxiety Inventory (STAI) (MD -5.31, 95% CI -8.78 to -1.84; 2 studies; 73 participants; low-certainty evidence). Melatonin versus benzodiazepines (midazolam and alprazolam) Melatonin probably results in little or no difference in preoperative anxiety measured on a 0 to 100 mm VAS (MD 0.78, 95% CI -2.02 to 3.58; 7 studies, 409 participants; moderate-certainty evidence) and there may be little or no difference in immediate postoperative anxiety (MD -2.12, 95% CI -4.61 to 0.36; 3 studies, 176 participants; low-certainty evidence). Adverse events Fourteen studies did not report on adverse events. Six studies specifically reported that no side effects were observed, and the remaining seven studies reported cases of nausea, sleepiness, dizziness, and headache; however, no serious adverse events were reported. Eleven studies measured psychomotor and cognitive function, or both, and in general, these studies found that benzodiazepines impaired psychomotor and cognitive function more than placebo and melatonin. Fourteen studies evaluated sedation and generally found that benzodiazepine caused the highest degree of sedation, but melatonin also showed sedative properties compared to placebo. Several studies did not report on adverse events; therefore, it is not possible to conclude with certainty, from the data on adverse effects collected in this review, that melatonin is better tolerated than benzodiazepines. AUTHORS' CONCLUSIONS When compared with placebo, melatonin given as premedication (as tablets or sublingually) probably reduces preoperative anxiety in adults (measured 50 to 120 minutes after administration), which is potentially clinically relevant. The effect of melatonin on postoperative anxiety compared to placebo (measured in the recovery room and six hours after surgery) was also evident but was much smaller, and the clinical relevance of this finding is uncertain. There was little or no difference in anxiety when melatonin was compared with benzodiazepines. Thus, melatonin may have a similar effect to benzodiazepines in reducing preoperative and postoperative anxiety in adults.
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Affiliation(s)
- Bennedikte K Madsen
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, Denmark
| | - Dennis Zetner
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, Denmark
| | - Ann Merete Møller
- Cochrane Anaesthesia, Critical and Emergency Care Group, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Jacob Rosenberg
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev, Denmark
- Cochrane Colorectal Group, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
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Celik Y, Thunström E, Strollo PJ, Peker Y. Continuous positive airway pressure treatment and anxiety in adults with coronary artery disease and nonsleepy obstructive sleep apnea in the RICCADSA trial. Sleep Med 2020; 77:96-103. [PMID: 33341644 DOI: 10.1016/j.sleep.2020.11.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Anxiety and obstructive sleep apnea (OSA) coexist among adults with coronary artery disease (CAD) following revascularization. Continuous positive airway pressure (CPAP) is the first line treatment of OSA patients with daytime sleepiness. The current study evaluated the effect of CPAP on anxiety in CAD patients with nonsleepy OSA. METHODS Two hundred forty-four revascularized CAD patients with nonsleepy OSA (apnea-hypopnea index ≥15/h, Epworth Sleepiness Scale score <10) were randomly assigned to CPAP or no-CPAP between 2005 and 2010. Zung Self-rating Anxiety Scale (SAS) was administered at baseline and after 3 and 12 months with higher scores suggesting more anxiety. RESULTS A total of 208 patients with complete SAS scores at baseline and 12-month follow-up were included (CPAP, n = 103; no-CPAP, n = 105). In the intention-to-treat analysis, CPAP had no significant effect on the SAS scores. On-treatment analysis revealed a significant increase in the median of delta SAS score (+3.75) after three months among the participants using the device 2.8 h/day or more while there was a decline in the median of delta SAS score (-1.25) in the non-adherent or no-CPAP group (p = 0.031). The increase in the SAS score (+1.25) in the adherent group, and the decline (-1.25 points) in the non-adherent/no-CPAP group remained significant after one year (p = 0.011). Baseline SAS score predicted non-adherence [adjusted odds ratio 1.11; 95% confidence interval (CI) 1.04-1.18; p = 0.003], and there was an association between the increase in the SAS scores and accumulated CPAP hours/day [standardized β = 0.144 (95% CI 0.005-0.695), p = 0.047]. CONCLUSION Our results suggest that anxiety should be considered in the management of CAD patients with nonsleepy OSA following revascularization. CLINICAL TRIAL REGISTRATION NCT00519597.
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Affiliation(s)
- Yeliz Celik
- Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
| | - Erik Thunström
- Dept. of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Patrick J Strollo
- Dept of Clinical Sciences, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Yüksel Peker
- Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey; Dept. of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Dept of Clinical Sciences, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, Lund, Sweden; Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Suarningsih NKA, Kongsuwan W, Kritpracha C. Effect of an education program and traditional music on anxiety in patients with myocardial infarction. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Patient and procedural risk factors for increased postoperative pain after cesarean delivery under neuraxial anesthesia: a retrospective study. Int J Obstet Anesth 2020; 44:60-67. [DOI: 10.1016/j.ijoa.2020.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 07/07/2020] [Accepted: 07/15/2020] [Indexed: 12/17/2022]
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Zhou Z, Wang Y, Niu Y, He Z, Huang M, Zhou Y, Lv W, Hu J. How we assess the perioperative anxiety of surgical patients with pulmonary nodules: the revision of state-trait anxiety inventory. J Cardiothorac Surg 2020; 15:324. [PMID: 33115530 PMCID: PMC7592361 DOI: 10.1186/s13019-020-01338-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 09/22/2020] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The aim of the study was to develop a short form of State-Trait Anxiety Inventory (STAI) and calculate the norms for the assessment of anxiety in surgical patients in mainland China. METHODS Patients who were scheduled to carry out pulmonary surgery in our department were included. The sinicized 40-item STAI Form-Y was used to assess the anxiety on the surgery eve. Then the coefficient of variation, coefficient of correlation, stepwise regression analysis, principal component analysis, and structural equation model were successively to filter the items. The reliability and validity of the revised STAI was estimated and the norms were computed. RESULTS 445 intact replies were collected. A 13-item STAI with 6 items in state subscale and 7 items in trait subscale produced similar scores with the full version of STAI. The Cronbach alpha coefficients for the state and trait subscales were 0.924 and 0.936, respectively. The determinant coefficients were 0.781 and 0.822, respectively. Moreover, the norms of both state subscale and trait subscale are provided according to the age and gender. CONCLUSIONS The revised short form of STAI has good reliability and validity. It is likely to be more acceptable by reducing the fatigue effects, and is suitable for follow-up study on the assessment and intervention of perioperative anxiety of surgical patients with pulmonary nodules.
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Affiliation(s)
- Zhenyu Zhou
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Ying Wang
- Operation Room, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Yuequn Niu
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Zhehao He
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Manli Huang
- Department of Psychiatry, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Yuqiong Zhou
- Operation Room, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Wang Lv
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Jian Hu
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
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Liu Y, Chen J, Pan Y, Cai Y, Ge C, Chu H, Xia C, Song Y, Chen Y, Wu B, Wang L. The effects of video based nursing education on perioperative anxiety and depression in patients with gastric cancer. PSYCHOL HEALTH MED 2020; 26:867-876. [PMID: 33044837 DOI: 10.1080/13548506.2020.1825756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to determine the effect of video-based nursing education on perioperative anxiety and depression. A total of 128 patients scheduled for minimally invasive gastrectomy were randomly divided into intervention (n = 64) and control (n = 64) group. The. The anxiety and depression scores, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed before the intervention, 1 h before surgery and 24 h after surgery. And the cortisol levels were measured before the intervention and 1 h before surgery. No significant difference was observed in baseline anxiety score, depression score, vital signs and cortisol level (P > 0.05). The anxiety level, depression level, SBP, DBP and HR of patients in intervention group was significantly lower than that in control group at 1 h before surgery and 24 hs after surgery (P < 0.05). The serum cortisol in the intervention group was also significantly lower than that in the control group 1 h before surgery (p < 0.001). Video-based nursing education was effective in decreasing the perioperative anxiety and depression of patients undergoing minimally invasive gastrectomy. It could also keep vital signs and serum cortisol levels in normal limits.
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Affiliation(s)
- Yan Liu
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Jin Chen
- Department of Surgery, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yajuan Pan
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yihong Cai
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Chunyan Ge
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Hongmei Chu
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Chunxiang Xia
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yan Song
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yan Chen
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Bin Wu
- Department of Nursing, The Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Ling Wang
- Department of Nursing, The Second Hospital of Nanjing, Nanjing, Jiangsu, Province, China
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Forsberg A. Associations between ASA classification, self-estimated physical health, psychological wellbeing and anxiety among Swedish orthopaedic patients. Int J Orthop Trauma Nurs 2020; 39:100769. [PMID: 32622556 DOI: 10.1016/j.ijotn.2020.100769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/17/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND The evaluation of one's physical health and psychological wellbeing may be subjective. Aspects of functional capacity, including the patients' own estimation of physical health and wellbeing, have been shown to be strong predictors of postoperative outcomes and should be the focus of further research. AIM This study aimed to explore the associations between ASA classification, self-estimated physical health, psychological wellbeing and anxiety among orthopaedic patients. METHODS This was a longitudinal study using a quantitative approach. SETTINGS A central county hospital in northern Sweden. RESULTS A high ASA classification rated by anaesthetists was not associated with physical health and psychological wellbeing self-estimated as less than good. A high ASA classification was significantly associated with self-estimated anxiety prior to surgery. Three days and one month post-surgery, the situation was reversed, and the ASA I/II group, to a significantly higher extent, rated that they felt anxiety. CONCLUSION Preoperative screening systems for orthopaedic patients should not only focus on the medical and objective physical issues but also include the patients' own estimation of their physical health and psychological wellbeing. It is essential that orthopaedic patients receive relevant information that provides a realistic outlook, as well as an honest and optimistic future view.
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Affiliation(s)
- Angelica Forsberg
- Division of Nursing Department of Health Science, Luleå University of Technology, Luleå, Sweden; Intensive Care Unit 57, Sunderby Hospital, SE-971 80, Luleå, Sweden.
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Khalil H, Shajrawi A, Dweik G, Zaghmouri A, Henker R. The impact of preoperative pain-related psychological factors on pain intensity post-surgery in Jordan. J Health Psychol 2020; 26:2876-2885. [PMID: 32597221 DOI: 10.1177/1359105320937067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
This study aimed to investigate the impact of preoperative psychological factors on postoperative pain. We included 300 postoperative patients who underwent open reduction and internal fixation surgery. Pain Scale, Pain Catastrophizing Scale, and Depression, Anxiety, and Stress Scale were completed by patients preoperatively and at 24 hours after surgery. Clinical characteristics were obtained from medical records. Data were analyzed using multiple linear regression. Postoperative pain was predicted by pain catastrophizing and anxiety symptoms. High preoperative catastrophizing and anxiety levels were associated with increased pain postoperatively. However, the relationships between preoperative depressive and stress symptoms and postoperative pain were not significant.
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Clair C, Engström Å, Strömbäck U. Strategies to Relieve Patients' Preoperative Anxiety Before Anesthesia: Experiences of Nurse Anesthetists. J Perianesth Nurs 2020; 35:314-320. [DOI: 10.1016/j.jopan.2019.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/13/2019] [Accepted: 10/20/2019] [Indexed: 10/25/2022]
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Alsabban W, Alhadithi A, Alhumaidi FS, Al Khudhair AM, Altheeb S, Badri AS. Assessing needs of patients and families during the perioperative period at King Abdullah Medical City. Perioper Med (Lond) 2020; 9:10. [PMID: 32280457 PMCID: PMC7137296 DOI: 10.1186/s13741-020-00141-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background This paper explores elective surgery patients' and family members' needs during the perioperative period, in a specialized hospital in Saudi Arabia. Needs are influenced by context and could differ from a setting to another. Methods Two questionnaires, one for the patient group and the other for the family member group, were adopted from a previous similar study. The participants were asked to rate the importance of each need and how much it was satisfied. Data were collected in 5 weeks. Descriptive statistics were used to determine the average rate and standard deviation of each item. Results Patients highly rated the need for adequate symptom management in the recovery area. Family members highly rated the importance of being informed if the surgical procedure is taking more time than expected and communicating with the surgeon after the procedure. Conclusion Systematically involving the family member in the perioperative care of the patient is advantageous. However, interventions and extent of involvement of the family member to the care of the patient would have to be adapted according to the cultural context.
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Affiliation(s)
- Wid Alsabban
- 1Perioperative Medicine Administration, King Abdullah Medical City-Makkah, Makkah, Saudi Arabia
| | - Ahmed Alhadithi
- 2College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | - Saeed Altheeb
- 2College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Saad Badri
- 3College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia
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Pasyar N, Rambod M, Araghi F. The effect of bergamot orange essence on anxiety, salivary cortisol, and alpha amylase in patients prior to laparoscopic cholecystectomy: A controlled trial study. Complement Ther Clin Pract 2020; 39:101153. [PMID: 32379683 DOI: 10.1016/j.ctcp.2020.101153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 03/15/2020] [Accepted: 03/18/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND PURPOSE This study aimed to determine the effect of bergamot orange essence on anxiety, salivary cortisol, and alpha amylase in patients prior to laparoscopic cholecystectomy. MATERIAL AND METHODS This clinical trial with pre-post design was conducted on 60 candidates for cholecystectomy. The participants were randomly divided into an intervention and a control group. The intervention group participants underwent aromatherapy using two drops of 3% bergamot orange essence, while the control group ones inhaled two drops of odourless grape seed oil. Anxiety mean score and salivary cortisol and alpha amylase levels were measured before and after the intervention. RESULTS A significant difference was found between the groups regarding anxiety (F = 9.00, p = 0.004) and alpha amylase level (F = 9.46, p = 0.003) after the intervention. CONCLUSION Bergamot orange essence decreased anxiety and salivary alpha amylase level. Therefore, this method can be used as a complementary technique to reduce patients' anxiety prior to laparoscopic cholecystectomy surgery. IRCT REGISTRATION NUMBER IRCT20171113037428N2. It is available in following website: https://www.irct.ir/trial/27696 REGISTRATION DATE: 03/25/2018.
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Affiliation(s)
- Nilofar Pasyar
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Rambod
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fatemeh Araghi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Sharif F, Bakhtiari S, Rakhshan M, Shahriari M. Perspective and Experience of Operating Room Personnel on Ethical Behaviors. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2020. [DOI: 10.29333/ejgm/7821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Osseous Transformation with Facial Feminization Surgery: Improved Anatomical Accuracy with Virtual Planning. Plast Reconstr Surg 2020; 144:1159-1168. [PMID: 31397786 DOI: 10.1097/prs.0000000000006166] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Facial feminization surgery entails a series of surgical procedures that help the transwoman pass as their affirmed gender. Although virtual surgical planning, with intraoperative cutting guides, and custom plates have been shown to be helpful for craniomaxillofacial reconstruction, they have not yet been studied for facial feminization surgery. The authors used cadaveric analysis for morphologic typing and to demonstrate the utility of virtual surgical planning in facial feminization surgery procedures. METHODS Male cadaveric heads underwent morphologic typing analysis of the frontal brow, lateral brow, mandibular angle, and chin regions (n = 50). Subsequently, the cadavers were split into two groups: (1) virtual surgical planning intraoperative cutting guides and (2) no preoperative planning. Both groups underwent (1) anterior frontal sinus wall setback, (2) lateral supraorbital recontouring, (3) mandibular angle reduction, and (4) osseous genioplasty narrowing. Efficiency (measured as operative time), safety (determined by dural or nerve injury), and accuracy (scored with three-dimensional computed tomographic preoperative plan versus postoperative result) were compared between groups, with significance being p < 0.05. RESULTS For frontal brow and lateral lower face, morphologic type 3 (severe) predominated; for lateral brow and chin, type 2 (moderate) predominated. For frontal sinus wall setback, virtual surgical planning improved efficiency (19 minutes versus 44 minutes; p < 0.05), safety (100 percent versus 88 percent; p < 0.05; less intracranial entry), and accuracy (97 percent versus 79 percent; p < 0.05) compared with no preoperative planning. For mandibular angle reduction, virtual surgical planning improved safety (100 percent versus 88 percent; p < 0.05; less inferior alveolar nerve injury) and accuracy (95 percent versus 58 percent; p < 0.05). CONCLUSIONS Preoperative planning for facial feminization surgery is helpful to determine morphologic typing. Virtual surgical planning with the use of cutting guides/custom plates improved efficiency, safety, and accuracy when performing four key craniofacial techniques for facial feminization.
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A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery. Ann Gen Psychiatry 2020; 19:46. [PMID: 32817752 PMCID: PMC7425359 DOI: 10.1186/s12991-020-00296-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 08/07/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study investigated the effects of Islamic religious and breathing techniques with heart rate variability (HRV) biofeedback therapies on HRV and psycho-physiologic coherence (resonance frequency), depression and anxiety in coronary artery bypass graft surgery (CABG) patients. METHODS Sixty CABG patients were chosen and randomly assigned to religious, breathing techniques and control groups. The experimental groups received 8 weeks of treatments; a 2-h session with home works in each week. The control group received only their normal hospital interventions. The groups' depression, anxiety, HRV and psycho-physiologic coherence levels were assessed before and after the interventions by DASS-21 for depression and anxiety, and em-wave desktop software for HRV and psycho-physiologic coherence. The data were analyzed using ANCOVA with Bonferroni Comparison test and descriptive tests in SPSS software. RESULTS The findings showed that there were significant differences in psycho-physiologic coherence (HRV), depression and anxiety scores among the three groups in the post-tests. In fact, depression and anxiety were reduced more in the religious group, while psycho-physiologic coherence raised more in the breathing with the HRV feedback group. CONCLUSION The results showed that both Islamic religious and breathing techniques with HRV biofeedback therapies can be used in rehabilitation programs for CABG patients in clinics and hospitals.
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Jiang M, Bo J, Lei Y, Hu F, Xia Z, Liu Y, Lu C, Sun Y, Hou B, Ni K, Ma Z, Gu X. Anxiety-induced hyperalgesia in female rats is mediated by cholecystokinin 2 receptor in rostral ventromedial medulla and spinal 5-hydroxytryptamine 2B receptor. J Pain Res 2019; 12:2009-2026. [PMID: 31308730 PMCID: PMC6613357 DOI: 10.2147/jpr.s187715] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 05/29/2019] [Indexed: 12/18/2022] Open
Abstract
Background Preoperative anxiety is associated with postoperative hyperalgesia; however, few studies have investigated the mechanism underlying this association in female surgical patients. Research has suggested that ON cells in the rostral ventromedial medulla (RVM) receive nerve impulses via cholecystokinin 2 (CCK2) receptors, facilitating hyperalgesia. Additionally, the downstream serotonergic projection system from the RVM to the spinal cord has a dual regulating effect on pain responses, and the 5-hydoxytryptophan 2B (5-HT2B) receptor in spinal dorsal horn neurons is critically involved in mechanical allodynia. Methods Ovariectomized rats were treated with estrogen replacement, single prolonged stress (SPS), and plantar incision. Various receptor agonists and antagonists were then administered into the RVM and spinal cord to study the mechanism underlying postoperative hyperalgesia caused by preoperative anxiety in female rats. Results Behavioral testing revealed that preoperative SPS induced postoperative hyperalgesia, as well as the expression of the CCK2 receptor in the RVM and the expression of the 5-HT2B receptor, protein kinase Cγ (PKCγ), and phosphorylation of the N-methyl-d-aspartate receptor1 (p-NR1) in the spinal cord increased confirmed by Western blot. RVM microinjection of the CCK2 receptor agonist CCK-8 and intrathecal injection of the 5-HT2B receptor agonist BW723C86 both produced hyperalgesia in female rats after plantar incision, whereas the CCK2 receptor antagonist YM022, the 5-HT2B receptor antagonist RS127445, and the PKCγ inhibitor C37H65N9O13 decreased the rats’ sensitivity to the same stimulus. Additionally, electrophysiological analysis suggested that activation of the 5-HT2B receptor increased the whole-cell current (IBa) in superficial dorsal horn neurons through the PKCγ pathway. Conclusion Our study demonstrated that preoperative anxiety-induced postoperative hyperalgesia in female rats is associated with descending pain pathways. The CCK2 receptor in the RVM and spinal 5-HT2B receptor may play a role in this hyperalgesic effect.
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Affiliation(s)
- Ming Jiang
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Jinhua Bo
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Yishan Lei
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Fan Hu
- Department of Basic Medicine, Analytical & Testing Center, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China
| | - Zhengrong Xia
- Department of Basic Medicine, Analytical & Testing Center, Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China
| | - Yue Liu
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Cui'e Lu
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Yu'e Sun
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Bailing Hou
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Kun Ni
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Zhengliang Ma
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
| | - Xiaoping Gu
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, People's Republic of China
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