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Toraman MM, Gürçayır D. The effect of training given to patients who underwent ureteroscopy with double-J stent placement on anxiety before and after surgery and readiness for discharge. Urolithiasis 2024; 53:9. [PMID: 39680153 DOI: 10.1007/s00240-024-01654-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Accepted: 10/21/2024] [Indexed: 12/17/2024]
Abstract
Patient education is effective in reducing the level of anxiety before and after surgery and increasing the level of readiness for discharge. Patient education provided by nurses can be planned and applied individually. Therefore, this study aims to determine the effect of the education in whom a double J stent after ureteroscopy on their pre- and postoperative anxiety and levels of readiness for discharge. This research study is a randomized controlled trial with control and intervention groups, pre- and posttests. This study was conducted between November 2021 and May 2022 in a university hospital in Turkey. The patients were divided at random into two groups, control (n = 61) and intervention (n = 61). The Personal Information Form, State-Trait Anxiety Inventory (STAI-I, STAI-II), Surgery-Specific Anxiety Scale (SSAS), Readiness for Hospital Discharge Scale for Adult Patients-Short Form (RHDS/SF) and Readiness for Hospital Discharge Scale- Adult-Nurse Assesment Short Form (RN-RHDS/SF) were used to collect the data. The mean SSAS and STAI-I scores on the morning of surgery and before discharge were found to be significantly lower in the intervention group than the control group. The mean RHDS/SF and RN-RHDS/SF scores on the before discharge were found to be significantly higher in the intervention group than the control group. It was concluded that the education provided to the patients in whom a double J stent after ureteroscopy reduced pre- and postoperative anxiety and increased the level of readiness for discharge.
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Affiliation(s)
| | - Dilek Gürçayır
- Faculty of Nursing, Atatürk University, Erzurum, Turkey.
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Dawod MS, Alswerki MN, Alelaumi A, Shaqar MG, Al-Habashneh FM, Alshloul SA, Burghol M, Al-Rawashdah SF, Amir MW, Alkhasawneh MH. Impact of structured checklist-based preoperative counseling versus standard counseling on postoperative patient-reported outcomes after elective surgery. BMC Health Serv Res 2024; 24:1405. [PMID: 39543682 PMCID: PMC11566359 DOI: 10.1186/s12913-024-11916-x] [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: 09/03/2024] [Accepted: 11/11/2024] [Indexed: 11/17/2024] Open
Abstract
INTRODUCTION Surgery, even on an elective-basis, often induces significant stress in patients, characterized by preoperative anxiety and heightened stress levels due to anticipation of the unknown. However, the primary objective of preoperative counseling is to mitigate these concerns, particularly when delivered in a structured and comprehensive manner. While previous research has highlighted the beneficial impact of preoperative counseling on patient-reported outcomes, none have specifically explored the implementation of a structured checklist-based approach during counseling sessions. To bridge this gap in the literature, our study aims to investigate the effects of implementing a checklist-based structured counseling approach on patient-reported outcomes following elective surgery. METHODS In this prospective cohort study conducted over one year from January to December 2023, a total of 600 patients undergoing elective surgery across three specialties-orthopedic surgery, general surgery, and urology-were examined. The patients were divided into two groups: an intervention group consisting of 300 patients and a control group with an equal number of patients. The study evaluated three key outcomes-postoperative pain, anxiety, and satisfaction-at three specific time points following surgery: 24 h, 48 h, and 72 h. RESULTS Patients receiving structured checklist counseling showed significantly lower pain scores (24 h: 6.6 vs. 7.03, p = 0.041; 48 h: 5.62 vs. 6.55, p = 0.029; 72 h: 2.54 vs. 2.90, p = 0.035) and anxiety scores (24 h: 8.58 vs. 9.25, p = 0.039; 48 h: 7.50 vs. 8.45, p = 0.030; 72 h: 4.53 vs. 5.98, p = 0.031), as well as higher satisfaction scores (24 h: 5.99 vs. 5.06, p = 0.043; 48 h: 6.99 vs. 6.02, p = 0.033; 72 h: 9.10 vs. 8.20, p = 0.039) compared to controls. These improvements were consistently significant across all three surgical specialties studied (p < 0.05). CONCLUSION The structured checklist-based counseling method proves to be effective and essential. This method is associated with reduced postoperative pain and anxiety levels, along with increased patient satisfaction, when compared to the standard approach. LEVEL OF EVIDENCE Prospective non-randomized study, Level II.
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Affiliation(s)
- Moh'd S Dawod
- Orthopedic Surgery Department, Faculty of Medicine, Mutah University, Al-Karak, Jordan
| | - Mohammad N Alswerki
- Orthopedic Department, Jordan University Hospital, P.O. Box: (13046), Amman, 11942, Jordan.
| | - Ahmad Alelaumi
- Orthopedic Department, Jordan University Hospital, P.O. Box: (13046), Amman, 11942, Jordan
| | | | | | | | | | | | - Mohammad W Amir
- General Surgery Department, Faculty of Medicine, Mutah University, Al-Karak, Jordan
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Bagherian S, Tehranineshat B, Shahbazi M, Taklif MH. Perceived compassionate care and preoperative anxiety in hospitalized patients. Nurs Ethics 2024; 31:1315-1329. [PMID: 39041777 DOI: 10.1177/09697330231197705] [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: 07/24/2024]
Abstract
BACKGROUND Quality nursing care and ethical responses to patient pain and suffering are very important in the preoperative period. However, few studies have addressed these variables. OBJECTIVE This study aimed to examine the relationship between compassionate care and preoperative anxiety from the perspective of hospitalized patients. METHODS The current study was a cross-sectional descriptive one. The participants were selected using convenience sampling. The data were collected using a demographic questionnaire, Burnell Compassionate Care Tool, and Amsterdam Preoperative Anxiety and Information Scale (APAIS). The collected data were analyzed with SPSS software (version 22) through descriptive and inferential statistics at a significance level of 0.05 (p < .05). PARTICIPANTS AND SETTING This study was conducted on 704 candidates for surgery in the internal and surgical wards of a large teaching hospital located in the south of Iran from December 2022 to March 2023. ETHICAL CONSIDERATIONS The protocol for this study was reviewed and approved by the University Ethics Committee. FINDINGS The patients' average age was 36.61 ± 13.07. The average preoperative anxiety and need for information scores were 13.80 ± 2.66 and 7.44 ± 1.47, respectively. The average score of importance was 3.03 ± 0.19, and the average score of the extent of compassionate care provision was 1.22 ± 0.15. There was a significant relationship between preoperative anxiety with importance and the extent of compassionate care provision (r = 0.68, p < .001), r = -0.72, p < .001, respectively). A comparison of the demographic characteristics, need for information, importance, and provision of compassionate care showed that the extent of compassionate care provision had the greatest contribution in explaining preoperative anxiety (β = 0.50; p < .001). CONCLUSION Even though patients' preoperative anxiety was high and providing compassionate care in the preoperative period had a great role in relieving their anxiety, many participants appear to have received little compassionate care. To this end, nursing managers should pay attention to the quality of compassionate care in the preoperative stage. Besides, healthcare staff should receive the necessary training in compassionate nursing care.
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Teixeira MR, Oliveira GDS, Andrade CEMC, Schmidt RL, Teodoro VA, Pedrão PG, Baiocchi G, Paiva CE, Dos Reis R. Impact of Preoperative Counseling and Education on Decreasing Anxiety in Patients With Gynecologic Tumors: A Randomized Clinical Trial. J Surg Oncol 2024. [PMID: 39380202 DOI: 10.1002/jso.27942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 09/16/2024] [Indexed: 10/10/2024]
Abstract
OBJECTIVE To evaluate the impact of counseling and preoperative education on reducing anxiety in patients undergoing surgery for gynecologic cancer. METHODS In this randomized clinical trial, patients with gynecological tumors undergoing surgical treatment between 15 and 60 days preoperatively, were included. The group was randomized to receive preoperative routine orientation plus preoperative counseling and education by nursing (experimental group [EG]) or receive preoperative routine orientation only (control group [CG]). We stratified the groups by surgical approach: open, laparoscopy, and robotic. We excluded patients treated in another service and with the need for an intensive care unit after surgery. We used the Hospital Anxiety and Depression Scale (HADS) to evaluate symptoms of anxiety and depression. The severity of symptoms was evaluated using the Edmonton Symptom Assessment System (ESAS-Br). RESULTS We analyzed 54 women (CG 27, EG 27). No significant differences were observed regarding ESAS scores (total, physical, emotional, well-being, and anxiety) between preoperative and postoperative evaluation. However, in the EG, comparing the preoperative versus postoperative moments, there was a significant reduction in total, emotional, and anxiety scores of ESAS (p = 0.012; p = 0.003; p = 0.001). No difference in anxiety symptoms by HADS scale was noted between the two groups, comparing preoperative and postoperative moments, CG (40.7% and 22.2%) and EG (37.0% and 25.9%) (p = 0.78; p = 0.75), respectively. Also, in depression symptoms (HADS scale), we found no difference comparing preoperative and postoperative moments (p = 0.34; p > 0.99). When we stratified by surgical approach or time between intervention and surgery ( ≤ 15, > 15 to ≤ 30, and > 30 days), no difference was observed in the anxiety and depression symptoms evaluation, in both groups. CONCLUSIONS The preoperative education by nurse orientation reduced the total, emotional, and anxiety symptoms of ESAS score between preoperative and postoperative moments. However, by the HADS scale, there was no difference in anxiety and depression symptoms.
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Affiliation(s)
| | - Gabriela da Silva Oliveira
- Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Researcher Support Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Research and Teaching Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | - Ronaldo Luis Schmidt
- Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Valiana Alves Teodoro
- Division of Epidemiology and Biostatistics, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Priscila Grecca Pedrão
- HPV Research Group, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo, Brazil
| | - Glauco Baiocchi
- Department of Gynecologic Oncology, AC Camargo Cancer Center, São Paulo, Brazil
| | - Carlos Eduardo Paiva
- Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Ricardo Dos Reis
- Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- HPV Research Group, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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Chen M, Huang Y, Zhang J, Wu Z, Lin C, Zheng B, Chen C, Li W. Impact of preoperative anxiety on postoperative outcomes in patients undergoing minimally invasive thoracoscopic surgery: A prospective cohort study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108605. [PMID: 39151308 DOI: 10.1016/j.ejso.2024.108605] [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: 06/02/2024] [Revised: 08/05/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Preoperative anxiety is a common preoperative psychological state in patients with cancer and associated with worsening perioperative outcomes. However, high-quality prospective studies on preoperative anxiety in patients undergoing lung surgery are scarce. METHODS We conducted a prospective cohort study, enrolling a total of 540 patients. Preoperative anxiety in patients undergoing thoracic surgery was measured using the Hospitalization Anxiety Scale. Patients were grouped according to the Hospitalization Anxiety Scale scores as follows: no anxiety (score <8) and anxiety (score ≥8). The association of preoperative anxiety with postoperative complications and non-complicated adverse events was determined by univariate regression and polynomial regression analyses. RESULTS A total of 121 patients (22.4 %) experienced preoperative anxiety. The anxiety group had a longer average hospital stay (4.33 vs. 3.85 days). Postoperative complications were similar between groups, but the anxiety group reported worse sleep quality (measured by the Athens Insomnia Scale). Regarding postoperative pain, both groups had comparable rates of mild and severe pain on postoperative day 1. However, the anxiety group experienced significantly higher rates of severe pain on postoperative day 2 and mild pain on postoperative day 3. Additionally, the incidence of postoperative nausea and vomiting was significantly higher in the anxiety group on postoperative day 1. CONCLUSIONS Preoperative anxiety may not increase the rates of postoperative complications in patients undergoing lung surgery. However, it may be associated with postoperative sleep disturbances, pain, nausea, and vomiting, as well as prolong the length of postoperative hospitalization.
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Affiliation(s)
- Maohui Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China; National Key Clinical Specialty of Thoracic Surgery, Fuzhou, China
| | - Yizhou Huang
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China; National Key Clinical Specialty of Thoracic Surgery, Fuzhou, China
| | - Jiaoxia Zhang
- Department of Thoracic Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhihui Wu
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China; National Key Clinical Specialty of Thoracic Surgery, Fuzhou, China
| | - Chuanquan Lin
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China; National Key Clinical Specialty of Thoracic Surgery, Fuzhou, China
| | - Bin Zheng
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China; National Key Clinical Specialty of Thoracic Surgery, Fuzhou, China
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China; National Key Clinical Specialty of Thoracic Surgery, Fuzhou, China.
| | - Wei Li
- Department of Thoracic Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China.
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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; 39:767-771. [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] [MESH Headings] [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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Veremci S, Pamuk Cebeci S. The Effect of Providing Education to Patients Undergoing Coronary Angiography on Vital Signs. J Perianesth Nurs 2024; 39:824-830. [PMID: 38775769 DOI: 10.1016/j.jopan.2023.12.017] [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: 05/23/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 10/04/2024]
Abstract
PURPOSE This study was conducted to determine the effect of providing preprocedural education to patients undergoing coronary angiography on their vital signs. DESIGN The study was a randomized controlled experimental study with a pretest/post-test control group design. METHODS The study was conducted in the Cardiology Service of a hospital in Eskişehir between November 2021 and April 2022. Power analysis identified that it was appropriate to include 79 individuals in the experimental group, 79 individuals in the control group, and a total of 158 individuals. The experimental group was trained using the "Structured Education Manual" prepared by the researchers. FINDINGS The education had an influence on the stabilization of vital signs after the procedure compared to preprocedure. When the comparison of vital signs before and after the education was analyzed, systolic blood pressure and diastolic blood pressure differed significantly between 11 measurements in both groups (P < .05). The systolic and diastolic blood pressure of the experimental group measured before the procedure was higher than their other measurements after the procedure. Heart rate, respiratory rate, and saturation value in both groups displayed a statistically significant difference between 11 measurements (P < .05). In the experimental group, heart rate and respiratory rate before the procedure were higher than the postprocedure measurements. The saturation value of the experimental group at 150 minutes after the procedure was higher than the other measurements. CONCLUSIONS Education given to patients before undergoing a coronary angiography procedure had a positive effect on the patients' vital signs. It is recommended that patients undergoing a coronary angiography procedure be provided with audio-visual training by nurses before the procedure.
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Affiliation(s)
- Sefika Veremci
- Eskişehir Osmangazi University/Institute of Health Sciences, Department of Fundamentals of Nursing, Eskişehir, Turkey
| | - Sevil Pamuk Cebeci
- Eskişehir Osmangazi University/Faculty of Health Sciences, Department of Fundamentals of Nursing, Eskişehir, Turkey.
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Ongun P, Oztekin SD, Bugra O, Dolapoglu A. Effect of a preoperative evidence-based care education on postoperative recovery of cardiac surgery patients: A quasi-experimental study. Nurs Crit Care 2024; 29:1151-1161. [PMID: 38699980 DOI: 10.1111/nicc.13082] [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: 11/06/2023] [Revised: 03/24/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Preoperative nursing care affects many factors such as reducing the length of hospital stay of the patients in the perioperative period, the rate of postoperative complications, the duration of the operation, decrease of postoperative pain level and early mobilization. AIM We aimed to determine the effect of preoperative evidence-based care education that given to cardiac surgery clinical nurses on the postoperative recovery of patients. STUDY DESIGN The research was planned as quasi-experimental. Eighty-six patients who underwent cardiovascular surgery were divided into control and intervention groups. First, the ongoing preoperative care practices and patient recovery outcomes of the clinic were recorded for the control group data. Second, education was provided for the clinical nurses about the preoperative evidence-based care list, and a pilot application was implemented. Finally, the evidence-based care list was applied by the nurses to the intervention group, and its effects on patient outcomes were evaluated. The data were collected using the preoperative evidence-based care list, descriptive information form, intraoperative information form and postoperative patient evaluation form. RESULTS The evidence-based care list was applied to the patients in the intervention group, with 100% adherence by the nurses. All pain level measurements in the intervention group were significantly lower in all measurements (p = .00). The body temperature measurements (two measurements) of the intervention group were higher (p = .00). The postoperative hospital stays of the control group and the intervention group were 11.21 ± 8.41 and 9.50 ± 3.61 days. CONCLUSION The presented preoperative evidence-based care list can be used safely in nursing practices for patients. It provides effective normothermia, reduces the level of pain, shortens the hospital stay and reduces the number of postoperative complications. RELEVANCE TO CLINICAL PRACTICE By applying a preoperative evidence-based care to patients undergoing cardiac surgery, pain levels, hospital stays and the number of complications decrease, and it is possible to maintain normothermia. An evidence-based care can be used to ensure rapid postoperative recovery for patients undergoing cardiac surgery.
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Affiliation(s)
- Pinar Ongun
- Faculty of Health Sciences, Department of Nursing, Balikesir University, Balikesir, Turkey
| | - Seher Deniz Oztekin
- School of Health Sciences, Department of Nursing, Dogus University, Istanbul, Turkey
| | - Onursal Bugra
- Faculty of Medicine, Department of Cardiovascular Surgery, Balikesir University, Balikesir, Turkey
| | - Ahmet Dolapoglu
- Faculty of Medicine, Department of Cardiovascular Surgery, Balikesir University, Balikesir, Turkey
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Roberts R, Burdall O, Bohr C, Kennard H, Lewis S, Harris L, Cusick E. Are we informing our patients correctly? Evaluation of perioperative counselling for paediatric intestinal stoma formation: a national study. Pediatr Surg Int 2024; 40:189. [PMID: 39008127 DOI: 10.1007/s00383-024-05756-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE Adequate preoperative information is known to improve patient outcomes. We aimed to evaluate perioperative education for paediatric patients and families undergoing intestinal stoma formation. METHODS UK paediatric surgery centres were invited to recruit patients aged 6-16 years with a stoma in situ or reversed within the last 2 years. Patient and parent questionnaires were posted for potential participants. RESULTS Eighty-three patient/parent dyads returned questionnaires. Median age was 11.5 years (range 4.1-17.8), with 48% (n = 40) formed electively. Parents rated how well-informed they felt perioperatively out of 10 (0 poorly, 10 highly informed). Parents were better informed about surgical issues and stoma care than psychological and social impacts (7.45 vs 6.11; p < 0.0001). 54% reported surgical complications but significantly fewer patients listed these amongst the worst things about having a stoma (24.4%) when compared with psychosocial issues: distress from bag leaks (90.8%; p < 0.0001), self-consciousness (54.1%; p = 0.0001), and restricted activity (40.2%; p = 0.03). CONCLUSION Parents felt well-informed for medical and practical aspects but less well-informed of psychological and lifestyle impacts of having a stoma. Surgical complications were less important to patients than the impact on daily life. Increased psychosocial information would enable families to be better prepared for life with a stoma.
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Affiliation(s)
- Rebecca Roberts
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK.
| | - Oliver Burdall
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Claire Bohr
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Hilary Kennard
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Sophie Lewis
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Lauren Harris
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - Eleri Cusick
- Department of Paediatric Surgery, Bristol Children's Hospital, Upper Maudlin Street, Bristol, BS2 8BJ, UK
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Olgun S, Ozsaker E. The effect of training on coronary artery bypass graft surgery patients. Nurs Crit Care 2024; 29:325-334. [PMID: 36585799 DOI: 10.1111/nicc.12876] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 11/04/2022] [Accepted: 12/10/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND In the pre-operative process, patients who will undergo cardiovascular surgery and their families require planned education and education materials. Education given to patients plays a key role in reducing anxiety, overcoming stress, and accelerating discharge. AIMS This study was conducted to determine the effect of an education booklet in addition to training by nurses on efficacy expectation, pain and anxiety levels in coronary artery bypass grafting (CABG) surgery patients. STUDY DESIGN This quasi-experimental study was conducted in the cardiovascular surgery service of a university hospital in Izmir, Turkey, between June and October 2018 and involved 60 patients. The patients were divided into two groups: control (n = 30) and intervention (n = 30). The intervention group was patients educated before surgery by using the booklet, but the control group only received routine care by nurses. The data were collected using the Mini-Mental Test, Patient Information Form, Visual Analogue Pain Scale, Spielberger State-Trait Anxiety Scale, Barnason Efficacy Expectation Scale, and Education Evaluation Form. RESULTS After the intervention at discharge, there was a significant difference between the mean scores of anxiety, pain, and efficacy expectation among the intervention group which received booklet education with the control group which received routine care (p < .05). CONCLUSION The booklet education given to patients before CABG surgery was found to have potential effects on patients' post-operative pain levels, the efficacy expectation, and satisfaction. RELEVANCE TO CLINICAL PRACTICE In the pre-operative process, the use of booklet education in addition to routine care increases the level of efficacy expectation and decreases pain and anxiety in CABG surgery patients. Therefore, nurses can use booklet education to improve self-efficacy and reduce pain and anxiety in patients who have CABG surgery.
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Affiliation(s)
- Sule Olgun
- Medical Services and Techniques Department, Izmir Kavram Vocational School, Izmir, Turkey
| | - Esma Ozsaker
- Surgical Nursing Department, Ege University Faculty of Nursing, Izmir, Turkey
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Zhou M, Zhou H, Zhang X, Jin X, Su X, Bai Y, Wei W, Zhang Y, Ma F. A qualitative study on patients' and health care professionals' perspectives regarding care delivered during CIED operation. BMC Health Serv Res 2024; 24:73. [PMID: 38225638 PMCID: PMC10789075 DOI: 10.1186/s12913-024-10546-7] [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: 10/17/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Cardiac implantable electronic devices (CIEDs) has proven to be an invaluable tool in the practice of cardiology. Patients who have undergone CIED surgery with local anesthesia may result in fear, insecurity and suffering. Some studies have put efforts on ways to improve intraoperative experience of patients with local anesthesia, but researches concerning experiences of CIED patients during surgery is in its infancy. METHODS Based on semi-structured and in-depth interviews, a qualitative design was conducted in a tertiary general hospital in China from May 2022 to July 2023.Purposeful sampling of 17 patients received CIED surgery and 20 medical staff were interviewed. Thematic analysis with an inductive approach was used to identify dominant themes. RESULTS Four themes emerged from the data: (1) Safety and success is priority; (2) Humanistic Caring is a must yet be lacking; (3) Paradox of surgery information given; (4) Ways to improve surgery experiences in the operation. CONCLUSIONS Intraoperative care is significant for CIED surgery. To improve care experience during surgery, healthcare professionals should pay attention to patients' safety and the factors that affecting humanistic caring in clinical practice. In addition, information support should consider information-seeking styles and personal needs. Besides, the four approaches presented in this study are effective to improve the intraoperative care experience.
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Affiliation(s)
- Min Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
- School of Nursing, Kunming Medical University, Kunming, China
| | - Huilin Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Xiong Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Xiaorong Jin
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Xu Su
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wei Wei
- Digestive Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yimei Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, 650032, Kunming, China.
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Yang WH, Xue FS, Li XT, Tian T. Determining Effects of Preoperative Nursing Visit on Anxiety and Pain Level of Patients After Surgery: The Right Methodology Is Needed. J Perianesth Nurs 2023; 38:836-837. [PMID: 38042578 DOI: 10.1016/j.jopan.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/16/2023] [Indexed: 12/04/2023]
Affiliation(s)
- Wen-He Yang
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fu-Shan Xue
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Xin-Tao Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Tian Tian
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Arpag N, Öztekin SD. The Effect of Visits by Operating Room Nurses Before Cardiac Surgery on Anxiety and Pain Management. J Perianesth Nurs 2023; 38:892-900. [PMID: 37330723 DOI: 10.1016/j.jopan.2023.01.022] [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: 07/23/2022] [Revised: 01/05/2023] [Accepted: 01/21/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Further studies are needed in line with the Enhanced Recovery for Cardiac Surgery (ERCS) protocols with a view to reducing anxiety and opioid use in cardiac surgery patients. The present study investigates the effects of preoperative visits by operating room nurses to patients scheduled for cardiac surgery on postoperative anxiety, pain severity and frequency, and the type and dose of analgesic medication. DESIGN This is a quasi-experimental study with a pretest-posttest control group design involving nonrandomized groups. METHODS The study was conducted in the Department of Cardiovascular Surgery of a Foundation University Hospital in Turkey between August 20, 2020 and April 15, 2021. Included in the study were patients selected based on a nonprobability sampling approach who met the study inclusion criteria (aged 18-75 years, no psychiatric diagnosis or drug use, first cardiovascular surgery experience, scheduled for elective surgery, up to five coronary anastomoses, literate and able to speak and understand Turkish, undergoing cardiovascular surgery with Cardiopulmonary Bypass (CPB)) determined by the researcher. The treatment group was visited preoperatively by operating room nurses, and followed-up for the first 72 hours after surgery. FINDINGS The intervention was effective in reducing postoperative state anxiety levels (P < .05). In the control group, each one-point increase in the preoperative state-anxiety level caused a 9% increase in the length of stay in the intensive care unit (P < .05). Pain severity increased as the preoperative state-anxiety and trait-anxiety levels, and the postoperative state-anxiety levels, increased (P < .05). While there was no significant difference in pain severity, the intervention proved to be effective in reducing pain frequency (P < .05). It was further noted that the intervention reduced the use of opioid and nonopioid analgesics for the first 12 hours (P < .05). The probability of using opioid analgesics increased 1.56 times (P < .05) with each one-point increase in pain severity reported by the patients. CONCLUSIONS The participation of operating room nurses in preoperative patient care can contribute to the management of anxiety and pain and the reduction of opioids. It is recommended that such an approach be implemented as an independent nursing intervention given the potential contribution to ERCS protocols.
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Affiliation(s)
- Nurgül Arpag
- Department of Nursing, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, Turkey.
| | - Seher Deniz Öztekin
- Department of Nursing, School of Health Sciences Director, Doğuş University, Istanbul, Turkey
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Wang SR, Zhou K, Zhang W. Application progress of nursing intervention in cardiac surgery. World J Clin Cases 2023; 11:7943-7950. [DOI: 10.12998/wjcc.v11.i33.7943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/27/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023] Open
Abstract
As a stressor, cardiac surgery affects the physiology and psychology of patients, as well as their postoperative recovery. Patients tend to worry about cognitive deficiency, pain, discomfort, the risk of death, sleep, complications, and other factors, resulting in stress and anxiety. Moreover, serious adverse events, such as circulatory and respiratory dysfunction and infection, tend to occur after cardiac surgery and increase the economic burden on patients. Therefore, appropriate nursing interventions should be selected to strengthen patients’ cognitive levels, compliance, and postoperative practices to accelerate their recovery, reduce complications, and shorten hospital stays so as to contribute to patients’ lives and health.
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Affiliation(s)
- Si-Ru Wang
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Ke Zhou
- Department of Cardiac Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Wei Zhang
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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Vergara-Merino L, Lira MJ, Liquitay CME, González-Kusjanovic N, Morales S. Preoperative education in patients undergoing foot and ankle surgery: a scoping review. Syst Rev 2023; 12:210. [PMID: 37957710 PMCID: PMC10644491 DOI: 10.1186/s13643-023-02375-2] [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: 07/12/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND International guidelines promote preoperative education for patients undergoing orthopedic surgery. However, the evidence sustaining these recommendations comes mainly from studies for hip and knee replacement surgery. Little is known about patients undergoing foot and ankle surgery. We aimed to map and characterize all the available evidence on preoperative education for patients undergoing foot and ankle surgery. METHODS This study complies with the PRISMA-ScR guidelines. We searched eight databases, including MEDLINE, Embase, and CENTRAL. We performed cross-citations and revised the references of included studies. We included studies addressing preoperative education in patients undergoing foot and ankle surgery. We did not exclude studies because of the way of delivering education, the agent that provided it, or the content of the preoperative education addressed in the study. Two independent authors screened the articles and extracted the data. The aggregated data are presented in descriptive tables. RESULTS Of 1596 retrieved records, only 15 fulfilled the inclusion criteria. Four addressed preoperative education on patients undergoing foot and ankle surgery and the remaining 11 addressed a broader population, including patients undergoing foot and ankle surgery but did not provide separate data of them. Two studies reported that preoperative education decreases the length of stay of these patients, another reported that education increased the knowledge of the participants, and the other leaflets were well received by patients. CONCLUSION This scoping review demonstrates that evidence on preoperative education in foot and ankle surgery is scarce. The available evidence supports the implementation of preoperative education in patients undergoing foot and ankle surgery for now. The best method of education and the real impact of this education remain to be determined.
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Affiliation(s)
- Laura Vergara-Merino
- Orthopedic Surgery Department, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
| | - María Jesús Lira
- Orthopedic Surgery Department, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
| | - Camila Micaela Escobar Liquitay
- Research Department, Associate Cochrane Centre, Instituto Universitario Escuela de Medicina del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Nicolás González-Kusjanovic
- Orthopedic Surgery Department, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
| | - Sergio Morales
- Orthopedic Surgery Department, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile.
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Chandrababu R, Ramesh J, Jagadeesh NS, Guo P, Reddy GG, Hayter M. Effects of yoga on anxiety, pain, inflammatory and stress biomarkers in patients undergoing cardiac surgery: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 53:101798. [PMID: 37708834 DOI: 10.1016/j.ctcp.2023.101798] [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: 07/03/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The most common surgical method of managing coronary artery disease is coronary artery bypass grafting (CABG). Stress, anxiety, and pain are commonly identified postoperative symptoms and are closely correlated to patient recovery. OBJECTIVE The purpose of this review was to investigate the effects of yoga interventions on anxiety, pain, inflammatory and stress biomarkers in CABG surgery patients. METHODS and analysis: The databases PUBMED, The Cochrane CENTRAL, EMBASE, CINAHL, Scopus, and Web of Science were comprehensively searched from the inception to December 2022. The quantitative research studies that evaluated the effects of yoga on anxiety, pain, inflammatory and stress biomarkers in CABG patients were included. This systematic review and meta-analysis followed the Cochrane guidelines and is reported using the PRISMA checklist. The RevMan 5.4 software was used for the meta-analysis. RESULTS Seventeen studies met the inclusion criteria, representing 1227 patients with a mean age of 58 years. All studies have reported that yoga interventions significantly reduced anxiety, pain, inflammatory and stress biomarkers in the experimental group compared to the control group. According to the GRADE criteria, moderate quality of evidence was found on effects of yoga intervention in CABG surgery patients. CONCLUSION Yoga has been shown to benefit patients undergoing CABG surgery. It can be used as an adjunctive intervention. However, more rigorous randomized controlled trials are required to generate high-quality evidence for yoga interventions. REGISTRATION PROSPERO CRD42020175833.
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Affiliation(s)
- Ramesh Chandrababu
- Department of Medical Surgical Nursing, Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 600116, India.
| | - Jyothi Ramesh
- Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 600116, India.
| | - Nalini Sirala Jagadeesh
- Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 600116, India.
| | - Ping Guo
- School of Nursing and Midwifery, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
| | - Gajjela Govardhan Reddy
- Division of Yoga, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
| | - Mark Hayter
- Department of Nursing, Manchester Metropolitan University, All Saints Building, Manchester, M15 6BH, United Kingdom.
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Vu T, Smith JA. The pathophysiology and management of depression in cardiac surgery patients. Front Psychiatry 2023; 14:1195028. [PMID: 37928924 PMCID: PMC10623009 DOI: 10.3389/fpsyt.2023.1195028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
Background Depression is common in the cardiac surgery population. This contemporary narrative review aims to explore the main pathophysiological disturbances underpinning depression specifically within the cardiac surgery population. The common non-pharmacological and pharmacological management strategies used to manage depression within the cardiac surgery patient population are also explored. Methods A total of 1291 articles were identified through Ovid Medline and Embase. The findings from 39 studies were included for qualitative analysis in this narrative review. Results Depression is associated with several pathophysiological and behavioral factors which increase the likelihood of developing coronary heart disease which may ultimately require surgical intervention. The main pathophysiological factors contributing to depression are well characterized and include autonomic nervous system dysregulation, excessive inflammation and disruption of the hypothalamic-pituitary-adrenal axis. There are also several behavioral factors in depressed patients associated with the development of coronary heart disease including poor diet, insufficient exercise, poor compliance with medications and reduced adherence to cardiac rehabilitation. The common preventative and management modalities used for depression following cardiac surgery include preoperative and peri-operative education, cardiac rehabilitation, cognitive behavioral therapy, religion/prayer/spirituality, biobehavioral feedback, anti-depressant medications, and statins. Conclusion This contemporary review explores the pathophysiological mechanisms leading to depression following cardiac surgery and the current management modalities. Further studies on the preventative and management strategies for postoperative depression in the cardiac surgery patient population are warranted.
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Affiliation(s)
- Tony Vu
- Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Julian A. Smith
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
- Department of Cardiothoracic Surgery, Monash Health, Melbourne, VIC, Australia
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McCann WD, Hou XY, Stolic S, Ireland MJ. Predictors of Psychological Distress among Post-Operative Cardiac Patients: A Narrative Review. Healthcare (Basel) 2023; 11:2721. [PMID: 37893795 PMCID: PMC10606887 DOI: 10.3390/healthcare11202721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Following surgery, over 50% of cardiac surgery patients report anxiety, stress and/or depression, with at least 10% meeting clinical diagnoses, which can persist for more than a year. Psychological distress predicts post-surgery health outcomes for cardiac patients. Therefore, post-operative distress represents a critical recovery challenge affecting both physical and psychological health. Despite some research identifying key personal, social, and health service correlates of patient distress, a review or synthesis of this evidence remains unavailable. Understanding these factors can facilitate the identification of high-risk patients, develop tailored support resources and interventions to support optimum recovery. This narrative review synthesises evidence from 39 studies that investigate personal, social, and health service predictors of post-surgery psychological distress among cardiac patients. The following factors predicted lower post-operative distress: participation in pre-operative education, cardiac rehabilitation, having a partner, happier marriages, increased physical activity, and greater social interaction. Conversely, increased pain and functional impairment predicted greater distress. The role of age, and sex in predicting distress is inconclusive. Understanding several factors is limited by the inability to carry out experimental manipulations for ethical reasons (e.g., pain). Future research would profit from addressing key methodological limitations and exploring the role of self-efficacy, pre-operative distress, and pre-operative physical activity. It is recommended that cardiac patients be educated pre-surgery and attend cardiac rehabilitation to decrease distress.
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Affiliation(s)
- William D. McCann
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD 4305, Australia;
| | - Xiang-Yu Hou
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD 4067, Australia;
| | - Snezana Stolic
- School of Nursing and Midwifery, University of Southern Queensland, Ipswich, QLD 4305, Australia;
| | - Michael J. Ireland
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD 4305, Australia;
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Maeßen T, Korir N, Van de Velde M, Kennes J, Pogatzki-Zahn E, Joshi GP. Pain management after cardiac surgery via median sternotomy: A systematic review with procedure-specific postoperative pain management (PROSPECT) recommendations. Eur J Anaesthesiol 2023; 40:758-768. [PMID: 37501517 DOI: 10.1097/eja.0000000000001881] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Pain after cardiac surgery via median sternotomy can be difficult to treat, and if inadequately managed can lead to respiratory complications, prolonged hospital stays and chronic pain. OBJECTIVES To evaluate available literature and develop recommendations for optimal pain management after cardiac surgery via median sternotomy. DESIGN A systematic review using PROcedure-SPECific Pain Management (PROSPECT) methodology. ELIGIBILITY CRITERIA Randomised controlled trials and systematic reviews published in the English language until November 2020 assessing postoperative pain after cardiac surgery via median sternotomy using analgesic, anaesthetic or surgical interventions. DATA SOURCES PubMed, Embase and Cochrane Databases. RESULTS Of 319 eligible studies, 209 randomised controlled trials and three systematic reviews were included in the final analysis. Pre-operative, intra-operative and postoperative interventions that reduced postoperative pain included paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), intravenous magnesium, intravenous dexmedetomidine and parasternal block/infiltration. CONCLUSIONS The analgesic regimen for cardiac surgery via sternotomy should include paracetamol and NSAIDs, unless contraindicated, administered intra-operatively and continued postoperatively. Intra-operative magnesium and dexmedetomidine infusions may be considered as adjuncts particularly when basic analgesics are not administered. It is not clear if combining dexmedetomidine and magnesium would provide superior pain relief compared with either drug alone. Parasternal block/surgical site infiltration is also recommended. However, no basic analgesics were used in the studies assessing these interventions. Opioids should be reserved for rescue analgesia. Other interventions, including cyclo-oxygenase-2 specific inhibitors, are not recommended because there was insufficient, inconsistent or no evidence to support their use and/or due to safety concerns.
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Affiliation(s)
- Timo Maeßen
- From the Department of Anaesthesiology, Intensive Care, and Pain Medicine, University Hospital Münster, Münster, Germany (TM, EP-Z), the Department of Cardiovascular Sciences, Section Anaesthesiology, KU Leuven and University Hospital Leuven, Leuven, Belgium (NK, MVdeV, JK), the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Centre, Dallas, Texas, USA (GPJ)
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Hirani S, Sajjad S, Gowani A, James HMS, Gupta A, Kennedy M, Norris CM. Psychosocial interventions and mental health in patients with cardiovascular diseases living in low- and middle-income countries: A systematic review and meta-analysis. J Psychosom Res 2023; 172:111416. [PMID: 37356326 DOI: 10.1016/j.jpsychores.2023.111416] [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: 04/15/2022] [Revised: 02/09/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE Mental health issues are closely associated with symptoms and outcomes of cardiovascular diseases (CVDs). The magnitude of this problem is alarmingly high in low and middle-income countries (LMICs). This systematic review and meta-analysis aimed to examine the effectiveness of psychosocial interventions on mental health outcomes among patients with CVDs living in LMICs. METHODS This review includes Randomized controlled trials (RCTs) and quasi-experimental studies conducted on adult patients who had a CVD and/or hypertension and located in LMICs. Studies published in English between 2010 and March, 2021 and which primarily reported mental health outcomes of resilience, self-efficacy, Quality of life (QoL), depression and anxiety were included. Studies were screened, extracted and critically appraised by two independent reviewers. Meta-analysis was conducted for RCTs and narrative summaries were conducted for all other studies. PRISMA guidelines were followed for reporting review methods and findings. RESULTS 109 studies included in this review reported educational, nursing, behavioral and psychological, spiritual, relaxation, and mindfulness interventions provided by multidisciplinary teams. 14 studies reported self-efficacy, 70 reported QoL, 62 reported one or both of anxiety and depression, and no study was found that reported resilience as an outcome in this population. Pooled analysis showed improvements in self-efficacy and QoL outcomes. The majority of studies showed improvement in outcomes, though the quality of the included studies varied. CONCLUSION Patients with CVDs in LMICs may experience improved mental health through the use of diverse psychosocial interventions. Evaluations are needed to investigate whether the impact of interventions on mental health are sustained over time.
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Affiliation(s)
- Saima Hirani
- School of Nursing, Faculty of Applied Science, The University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
| | - Sehrish Sajjad
- The Aga Khan University, School of Nursing and Midwifery, Karachi, Pakistan
| | - Ambreen Gowani
- The Aga Khan University, School of Nursing and Midwifery, Karachi, Pakistan
| | - Hannah M S James
- Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Aanchel Gupta
- Cumming School of Medicine, University of Calgary, Canada
| | - Megan Kennedy
- Health Sciences Library, University of Alberta, Edmonton, Canada
| | - Colleen M Norris
- Faculty of Nursing, Public Health, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Sibley D, Chen M, West MA, Matthew AG, Santa Mina D, Randall I. Potential mechanisms of multimodal prehabilitation effects on surgical complications: a narrative review. Appl Physiol Nutr Metab 2023; 48:639-656. [PMID: 37224570 DOI: 10.1139/apnm-2022-0272] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Continuous advances in prehabilitation research over the past several decades have clarified its role in improving preoperative risk factors, yet the evidence demonstrating reduced surgical complications remains uncertain. Describing the potential mechanisms underlying prehabilitation and surgical complications represents an important opportunity to establish biological plausibility, develop targeted therapies, generate hypotheses for future research, and contribute to the rationale for implementation into the standard of care. In this narrative review, we discuss and synthesize the current evidence base for the biological plausibility of multimodal prehabilitation to reduce surgical complications. The goal of this review is to improve prehabilitation interventions and measurement by outlining biologically plausible mechanisms of benefit and generating hypotheses for future research. This is accomplished by synthesizing the available evidence for the mechanistic benefit of exercise, nutrition, and psychological interventions for reducing the incidence and severity of surgical complications reported by the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). This review was conducted and reported in accordance with a quality assessment scale for narrative reviews. Findings indicate that prehabilitation has biological plausibility to reduce all complications outlined by NSQIP. Mechanisms for prehabilitation to reduce surgical complications include anti-inflammation, enhanced innate immunity, and attenuation of sympathovagal imbalance. Mechanisms vary depending on the intervention protocol and baseline characteristics of the sample. This review highlights the need for more research in this space while proposing potential mechanisms to be included in future investigations.
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Affiliation(s)
- Daniel Sibley
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Maggie Chen
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Malcolm A West
- Faculty of Medicine, Cancer Sciences, University of Southampton, UK
- NIHR Southampton Biomedical Research Centre, Perioperative and Critical Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andrew G Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Ian Randall
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Zhuo Q, Ma F, Cui C, Bai Y, Hu Q, Hanum AL, Wei W, Liang H. Effects of pre-operative education tailored to information-seeking styles on pre-operative anxiety and depression among patients undergoing percutaneous coronary intervention: A randomized controlled trial. Int J Nurs Sci 2023; 10:174-181. [PMID: 37128491 PMCID: PMC10148264 DOI: 10.1016/j.ijnss.2023.03.015] [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] [Received: 11/08/2022] [Revised: 02/06/2023] [Accepted: 03/19/2023] [Indexed: 05/03/2023] Open
Abstract
Objective This study aimed to evaluate the impact of pre-operative education tailored to percutaneous coronary intervention (PCI) patients' information-seeking styles on pre-operative anxiety and depression. Methods A single-blind randomized control trial was conducted. A total of 114 participants were recruited from the cardiology department in a tertiary hospital in Kunming, Southwest China from April to September 2020 and randomly allocated to the intervention group (n = 57) or control group (n = 57). All patients received oral pre-operative education as well as printed pre-operative education manuals and divided into monitors or blunters by the Chinese Version of the Monitoring Subscale of the Miller Behavioral Style Scale (C-MMBSS). The intervention group received pre-operative education tailored to information-seeking styles, while the control group received routine education. Anxiety and depression were measured at baseline and 1 h before the operation. Satisfaction with pre-operative education and length of stay were assessed at discharge. Results A total of 104 participants completed the study (52 participants in each group). Pre-operative education tailored to information-seeking styles was beneficial for reducing pre-operative anxiety (P < 0.01), reducing pre-operative depression (P < 0.01), and improving satisfaction with pre-operative education (P < 0.01) compared with routine education. There was no significant difference in length of stay between the intervention and control groups (P = 0.209). Conversely, pre-operative anxiety of patients was increased (P = 0.017) after pre-operative education in the control group. Conclusion This study confirmed that pre-operative education tailored to information-seeking styles effectively reduces pre-operative anxiety and depression and improves satisfaction with preoperative education.
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Affiliation(s)
- Qiqi Zhuo
- Oncology Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Changsheng Cui
- Department of Pharmacy, Army Medical Center of PLA, Chongqing, China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Qiulan Hu
- ICU in Geriatric Department, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Ardani Latifah Hanum
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Wei Wei
- Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Hongmin Liang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
- Corresponding author.
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Sinderovsky A, Grosman-Rimon L, Atrash M, Nakhoul A, Saadi H, Rimon J, Birati EY, Carasso S, Kachel E. The Effects of Preoperative Pain Education on Pain Severity in Cardiac Surgery Patients: A Pilot Randomized Control Trial. Pain Manag Nurs 2023:S1524-9042(23)00030-9. [PMID: 36941189 DOI: 10.1016/j.pmn.2023.02.003] [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: 05/08/2022] [Revised: 01/08/2023] [Accepted: 02/06/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND There is minimal research on the effect of individualized preoperative education on postoperative pain and postoperative pain medication intake. AIM The study objective was to assess the effect of individually tailored preoperative education on postoperative pain severity, number of pain breakthroughs, and use of pain medication in participants receiving the intervention compared to controls. METHODS A pilot study with 200 participants was conducted. The experimental group received an informational booklet and discussed their ideas surrounding pain and pain medication with the researcher. Controls received no intervention. Postoperative pain severity was measured by a Numerical Rating System (NRS), which was divided into mild (NRS 1-3), moderate (NRS 4-6), and severe (NRS 7-10). RESULTS In the participant cohort, 68.8% of participants were male, and the average age was 60.48±10.7. Average postoperative 48-hour cumulative pain scores were lower in those who received the intervention compared to controls; 50.0 (IQR 35.8-60.0) vs. 65 (IQR 51.0-73.0; p < .01) participants who received the intervention had less frequent pain breakthroughs when compared to controls (3.0 [IQR 2.0-5.0] vs. 6.0 [IQR 4.0-8.0; p < .01]). There was no significant difference in the amount of pain medication taken by either group. CONCLUSIONS Participants who receive individualized preoperative pain education are more likely to have decreased postoperative pain.
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Affiliation(s)
- Amanda Sinderovsky
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Liza Grosman-Rimon
- Division of Cardiovascular Medicine and Surgery, Tzafon Medical Center, Tiberias, Israel; School of Graduate Studies, The Academic Center Levinsky-Wingate, Wingate Institute, Netanya, Israel
| | - Muhamd Atrash
- Division of Cardiovascular Medicine and Surgery, Tzafon Medical Center, Tiberias, Israel
| | - Aida Nakhoul
- Division of Cardiovascular Medicine and Surgery, Tzafon Medical Center, Tiberias, Israel
| | - Hanadi Saadi
- Division of Cardiovascular Medicine and Surgery, Tzafon Medical Center, Tiberias, Israel
| | - Jordan Rimon
- Faculty of Health, York University, Toronto, Canada
| | - Edo Y Birati
- Division of Cardiovascular Medicine and Surgery, Tzafon Medical Center, Tiberias, Israel; The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
| | - Shemy Carasso
- The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel; The Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem
| | - Erez Kachel
- Division of Cardiovascular Medicine and Surgery, Tzafon Medical Center, Tiberias, Israel; The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel; Department of Cardiac Surgery, Sheba Medical Centre, Tel Hashomer, Israel.
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Hatzl J, Hartmann N, Böckler D, Henning D, Peters A, Meisenbacher K, Uhl C. "Mixed Reality" in patient education prior to abdominal aortic aneurysm repair. VASA 2023; 52:160-168. [PMID: 36891667 DOI: 10.1024/0301-1526/a001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Background: To investigate the usability of Mixed-Reality (MR) during patient education in patients scheduled for abdominal aortic aneurysm (AAA) repair. Patients and methods: Consecutive patients scheduled for elective AAA repair were block-randomized in either the Mixed-Reality group (MR group) or the conventional group (control group). Patients of both groups were educated about open and endovascular repair of their respective AAA. The MR group was educated using a head-mounted display (HMD) demonstrating a three-dimensional virtual reconstruction of the respective patient's vascular anatomy. The control group was educated using a conventional two-dimensional monitor to display the patient's vasculature. Outcomes were informational gain as well as patient satisfaction with the educational process. (DRKS-ID: DRKS00025174). Results: 50 patients were included with 25 patients in either group. Both groups demonstrated improvements in scores in the Informational Gain Questionnaire (IGQ) when comparing pre- and post-education scores. (MR group: 6.5 points (±1.8) versus 7.9 points (±1.5); Control group: 6.2 points (±1.8) versus 7.6 points (±1.6); p<0.01) There was no significant difference between the MR group and the control group either in informational gain (MR group: 1.4±1.8; Control group: 1.4±1.8; p=0.5) nor in patient satisfaction scores (MR group: mean 18.3 of maximum 21 points (±3.7); Control group: mean 17 of 21 points (±3.6); p=0.1) Multiple regression revealed no correlation between the use of MR and informational gain or patient satisfaction. Usability of the system was rated high, and patients' subjective assessment of MR was positive. Conclusions: The use of MR in patient education of AAA patients scheduled for elective repair is feasible. While patients reported positively on the use of MR in education, similar levels of informational gain and patient satisfaction can be achieved with MR and conventional methods.
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Affiliation(s)
- Johannes Hatzl
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Niklas Hartmann
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Dittmar Böckler
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Daniel Henning
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Andreas Peters
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Katrin Meisenbacher
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Christian Uhl
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
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Aydal P, Uslu Y, Ulus B. The Effect of Preoperative Nursing Visit on Anxiety and Pain Level of Patients After Surgery. J Perianesth Nurs 2023; 38:96-101. [PMID: 35970660 DOI: 10.1016/j.jopan.2022.05.086] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE Preoperative education is an important part of surgical preparation. Nursing visits offer nurses the opportunity to provide personalized care. The aim of this study was to determine the effect of nursing visits before laparoscopic surgery on the anxiety and pain levels of patients in the postoperative period. DESIGN Randomized controlled clinical trial. METHODS Data were collected from 135 patients who underwent laparoscopic surgery between March and October 2019 in Istanbul. During the nursing visits, the experimental group (n = 72) was educated by the operating room nurse, while the control group (n = 63) was educated by the service nurse. Data were collected using the State-Trait Anxiety Inventory and the Visual Analog Scale. The CONSORT checklist was followed. FINDINGS The pre-education state anxiety scores of the control and experimental groups were similar and at a moderate level (P > .05). The state anxiety score of the experimental group visited by operating room nurses decreased more than that of the control group after education (P < .001). The postoperative state anxiety and pain scores of the control and experimental groups were found to be similar (P > .05). CONCLUSIONS Visits by operating room nurses before laparoscopic surgery can be an effective method to reduce the anxiety level of patients. Obtaining the opinions of operating room nurses on care integration and organization of in-service education programs may be necessary.
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Affiliation(s)
- Pınar Aydal
- Acibadem Health Group, Acibadem Altunizade Hospital
| | - Yasemin Uslu
- Istanbul University Nursing Faculty Surgical Nursing Department, Istanbul, Turkey.
| | - Bahire Ulus
- Acibadem Mehmet Ali Aydınlar University, Department of Nursing Retired Lecturer, Istanbul, Turkey
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26
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Altinbas BC, Gürsoy A. Nurse-led web-based patient education reduces anxiety in thyroidectomy patients: A randomized controlled study. Int J Nurs Pract 2023:e13131. [PMID: 36691286 DOI: 10.1111/ijn.13131] [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: 03/02/2021] [Revised: 12/20/2022] [Accepted: 12/29/2022] [Indexed: 01/25/2023]
Abstract
AIM The aim of this study was to determine the effect of web-based patient education on anxiety in patients scheduled for thyroid surgery. A secondary aim was to evaluate the patients' postoperative recovery outcomes. DESIGN This study is a randomized controlled trial. METHOD The study was conducted at a university hospital in Turkey between September 2018 and May 2019 with 76 patients scheduled for thyroidectomy surgery and randomly assigned into two groups. Patients in the intervention group received web-based education, while those in the control group were given only routine care. Measurements were performed before surgery, on the day of surgery, and 1 week after discharge. RESULTS On the day of surgery, intervention group anxiety levels were lower than those of the control group, and the majority of early recovery parameters were significantly better in the intervention group than in the control group. One week after discharge, the intervention group patients' anxiety levels were significantly lower. Web-based education had no impact on pain, time in the operating room, readmission to the hospital after discharge, or length of hospitalization. CONCLUSIONS Nurse-led web-based education reduced patients' anxiety regarding surgery. The results also show that it may improve postoperative early recovery.
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Affiliation(s)
- Bahar Candas Altinbas
- Nursing Department, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
| | - Ayla Gürsoy
- Nursing Department, Faculty of Health Sciences, Antalya Bilim University, Antalya, Turkey
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Sriboonlert J, Munkong W, Rintawut S, Paladkhua S, Suwongsa R, Kirisattayakul W. Cananga odorata Aromatherapy Reduces Anxiety in Unexperienced Patients Hospitalized for Interventional Neuroradiology Procedures: A Randomized Control Trial. J Evid Based Integr Med 2023; 28:2515690X221150527. [PMID: 36659818 PMCID: PMC9871980 DOI: 10.1177/2515690x221150527] [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: 01/21/2023] Open
Abstract
The hospitalization and the unfamiliar experiences of patients in interventional radiology procedures cause a moderate to high levels of anxiety. This study was aimed to evaluate the anxiolytic effect of Cananga odorata essential oil (COE) aromatherapy in unexperienced patients hospitalized for interventional neuroradiology (INR) procedures. Forty-four patients admitted for their first INR procedure were randomly divided into COE and placebo control groups. COE or distilled water was dropped onto 2 pieces of mulberry paper and attached to the participant's gown at the shoulder level overnight. The main outcomes were observed from the morning salivary cortisol levels and salivary alpha-amylase activity after intervention. The Thai version of Spielberger State-Trait Anxiety Inventory (STAI) and the vital signs (blood pressure and heart rate) were also assessed before and after COE intervention as the secondary outcome. The demographic and baseline data of both groups did not show any significant difference. After intervention, COE group had a significantly lower salivary alpha-amylase activity than placebo control group. The post-intervention scores of Trait (STAI-T) and State (STAI-S) anxiety were significantly less than those of baseline in both groups. Interestingly, the COE group had a greater percentage reduction on STAI-T after intervention than placebo control group. No significant difference was observed in other outcomes. In addition, the salivary alpha-amylase activity was weak but showed significant correlation with STAI anxiety scores. This study indicates that COE aromatherapy reduces the saliva alpha amylase activity and STAI-T anxiety in unexperienced patients hospitalized for INR procedures.
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Affiliation(s)
- Jetsada Sriboonlert
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Waranon Munkong
- Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Sunantha Rintawut
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Soodjai Paladkhua
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Ratchalita Suwongsa
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Woranan Kirisattayakul
- Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand,Woranan Kirisattayakul, Department of
Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002,
Thailand.
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Jamwal T, Kumar R, Pulle MV, Kumar A, Jain K. Does Structured Patient Education Reduce the Peri-Operative Anxiety and Depression Levels in Elective Chest Surgery Patients? A Double-Blinded Randomized Trial of 300 Patients. J Patient Exp 2023; 10:23743735231151535. [PMID: 36698623 PMCID: PMC9869230 DOI: 10.1177/23743735231151535] [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: 01/19/2023] Open
Abstract
Psychological distress associated with surgery is an emerging issue. The study was conducted to assess the impact of structured patient education viz-a-viz routine patient education on anxiety and depression levels in patients undergoing elective chest surgery. It is a prospective, double-blind randomized study, conducted from February 2019 to February 2020 at a tertiary care center in India, on patients who underwent elective chest surgeries. A total of 300 patients were randomized using a computer-generated randomization sequence, into 2 equal groups (150 subjects each). Study group included patients who underwent structured patient education (Group A), whereas control group included patients who underwent routine patient education (Group B). The 2 groups were compared for anxiety and depression levels at admission as well as discharge using Hospital Anxiety and Depression Scale. Also, at the time of discharge, the groups were compared for the effectiveness of patient education using a validated Questionnaire B. In comparison to routine education, patients receiving structured education showed significantly lesser scores for anxiety and depression at discharge (P < .001). Also, structured patient education proved to be effective in comparison to the routine education in educating the patients in all parameters as determined by the Questionnaire B (P < .05). It can be concluded that structured educational intervention is strongly recommended in patients undergoing chest surgery which can help alleviate perioperative anxiety and depression. Such intervention helps patient get an understanding of the surgical procedure and assist them in facing the condition in a better way.
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Affiliation(s)
- Tilotma Jamwal
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India,Tilotma Jamwal, Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Reena Kumar
- Department of Hospital Administartion, Sir Ganga Ram Hospital, New Delhi, India
| | | | - Arvind Kumar
- Institute for Chest Surgery, Medanta Hospital, Gurugram, India
| | - Kanika Jain
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
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Réhabilitation améliorée après chirurgie cardiaque adulte sous CEC ou à cœur battant 2021. ANESTHÉSIE & RÉANIMATION 2022. [DOI: 10.1016/j.anrea.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Shahmoradi L, Rezaei N, Rezayi S, Zolfaghari M, Manafi B. Educational approaches for patients with heart surgery: a systematic review of main features and effects. BMC Cardiovasc Disord 2022; 22:292. [PMID: 35761186 PMCID: PMC9238074 DOI: 10.1186/s12872-022-02728-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/20/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Patients who undergo heart surgery are exposed to mental and physical difficulties after discharge from hospital. They often need support and follow-up after discharge. The use of educational approaches or solutions before or after heart surgery can increase patients' knowledge on the post-operative complications and self-care. The main purpose of this systematic review is to determine the applications of educational approaches and investigate the effects of these approaches on patients with heart surgery. Method and materiel A thorough search was conducted in Medline (through PubMed), Scopus, ISI web of science to select related articles published between 2011 and May 2022. All of the retrieved papers were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Results A total of 29 articles were obtained from the search, which included in this systematic review after being assessed based on inclusion and exclusion criteria. Most of the articles (n = 10, 34.48%) had been conducted in Canada and Iran, with the most significant number published in 2016. Out of 29 studies, 23 were experimental studies, and six were observational-analytical studies. The number of participants in the studies ranged from 11 to 600 (IQR1: 57.5, median: 88, IQR3: 190). In 28 (96.55%) studies, the educational approaches had a significant effect on clinical, economic or patient-reported outcomes. The greatest effect reported by the studies was related to clinical outcomes such as patient care improvement or change in clinical practice. The most effects in the patient-reported outcomes were related to improving patient satisfaction and patient knowledge. In terms of global rating scores, 17.24% of the included studies were considered as weak, 20.68% as moderate, and 62.06% as strong. Conclusion The results of systematic review showed that the use of educational approaches by patients before and after heart surgery can have significant effects on reducing stress and financial burden, and increasing the quality of care and level of knowledge in patients.
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Affiliation(s)
- Leila Shahmoradi
- Health Information Management Department and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Rezaei
- Medical Library and Information Science, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Medical Library and Information Science, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Sorayya Rezayi
- Health Information Management Department and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mitra Zolfaghari
- Department of eLearning in Medical Education, Virtual School of Tehran University of Medical Sciences, Naderi Street, Keshavarz Blvd, Tehran, Iran
| | - Babak Manafi
- Department of Heart Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Mertes PM, Kindo M, Amour J, Baufreton C, Camilleri L, Caus T, Chatel D, Cholley B, Curtil A, Grimaud JP, Houel R, Kattou F, Fellahi JL, Guidon C, Guinot PG, Lebreton G, Marguerite S, Ouattara A, Provenchère Fruithiot S, Rozec B, Verhoye JP, Vincentelli A, Charbonneau H. Guidelines on enhanced recovery after cardiac surgery under cardiopulmonary bypass or off-pump. Anaesth Crit Care Pain Med 2022; 41:101059. [PMID: 35504126 DOI: 10.1016/j.accpm.2022.101059] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To provide recommendations for enhanced recovery after cardiac surgery (ERACS) based on a multimodal perioperative medicine approach in adult cardiac surgery patients with the aim of improving patient satisfaction, reducing postoperative mortality and morbidity, and reducing the length of hospital stay. DESIGN A consensus committee of 20 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société française d'anesthésie et de réanimation, SFAR) and the French Society of Thoracic and Cardiovascular Surgery (Société française de chirurgie thoracique et cardio-vasculaire, SFCTCV) was convened. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. The entire guideline process was conducted independently of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide the assessment of the quality of evidence. METHODS Six fields were defined: (1) selection of the patient pathway and its information; (2) preoperative management and rehabilitation; (3) anaesthesia and analgesia for cardiac surgery; (4) surgical strategy for cardiac surgery and bypass management; (5) patient blood management; and (6) postoperative enhanced recovery. For each field, the objective of the recommendations was to answer questions formulated according to the PICO model (Population, Intervention, Comparison, Outcome). Based on these questions, an extensive bibliographic search was carried out and analyses were performed using the GRADE approach. The recommendations were formulated according to the GRADE methodology and then voted on by all the experts according to the GRADE grid method. RESULTS The SFAR/SFCTCV guideline panel provided 33 recommendations on the management of patients undergoing cardiac surgery under cardiopulmonary bypass or off-pump. After three rounds of voting and several amendments, a strong agreement was reached for the 33 recommendations. Of these recommendations, 10 have a high level of evidence (7 GRADE 1+ and 3 GRADE 1-); 19 have a moderate level of evidence (15 GRADE 2+ and 4 GRADE 2-); and 4 are expert opinions. Finally, no recommendations were provided for 3 questions. CONCLUSIONS Strong agreement existed among the experts to provide recommendations to optimise the complete perioperative management of patients undergoing cardiac surgery.
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Affiliation(s)
- Paul-Michel Mertes
- Department of Anaesthesia and Intensive Care, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, FMTS de Strasbourg, Strasbourg, France
| | - Michel Kindo
- Department of Cardiac Surgery, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, FMTS de Strasbourg, Strasbourg, France
| | - Julien Amour
- Institut de Perfusion, de Réanimation, d'Anesthésie de Chirurgie Cardiaque Paris Sud, IPRA, Hôpital Privé Jacques Cartier, Massy, France
| | - Christophe Baufreton
- Department of Cardiovascular and Thoracic Surgery, University Hospital, Angers, France; MITOVASC Institute CNRS UMR 6214, INSERM U1083, University, Angers, France
| | - Lionel Camilleri
- Department of Cardiovascular Surgery, CHU Clermont-Ferrand, T.G.I, I.P., CNRS, SIGMA, UCA, UMR 6602, Clermont-Ferrand, France
| | - Thierry Caus
- Department of Cardiac Surgery, UPJV, Amiens University Hospital, Amiens Picardy University Hospital, Amiens, France
| | - Didier Chatel
- Department of Cardiac Surgery (D.C.), Institut du Coeur Saint-Gatien, Nouvelle Clinique Tours Plus, Tours, France
| | - Bernard Cholley
- Anaesthesiology and Intensive Care Medicine, Hôpital Européen Georges-Pompidou, AP-HP, Université de Paris, INSERM, IThEM, Paris, France
| | - Alain Curtil
- Department of Cardiac Surgery, Clinique de la Sauvegarde, Lyon, France
| | | | - Rémi Houel
- Department of Cardiac Surgery, Saint Joseph Hospital, Marseille, France
| | - Fehmi Kattou
- Department of Anaesthesia and Intensive Care, Institut Mutualiste Montsouris, Paris, France
| | - Jean-Luc Fellahi
- Service d'Anesthésie-Réanimation, Hôpital Universitaire Louis Pradel, Hospices Civils de Lyon, Lyon, France; Faculté de Médecine Lyon Est, Université Claude-Bernard Lyon 1, Lyon, France
| | - Catherine Guidon
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Timone, Aix Marseille University, Marseille, France
| | - Pierre-Grégoire Guinot
- Department of Anaesthesiology and Intensive Care, Dijon University Hospital, Dijon, France; University of Bourgogne and Franche-Comté, LNC UMR1231, Dijon, France; INSERM, LNC UMR1231, Dijon, France; FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France
| | - Guillaume Lebreton
- Sorbonne Université, INSERM, Unité mixte de recherche CardioMetabolisme et Nutrition, ICAN, AP-HP, Hôpital Pitié-Salpétrière, Paris, France
| | - Sandrine Marguerite
- Department of Anaesthesia and Intensive Care, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, FMTS de Strasbourg, Strasbourg, France
| | - Alexandre Ouattara
- CHU Bordeaux, Department of Anaesthesia and Critical Care, Magellan Medico-Surgical Centre, F-33000 Bordeaux, France; Univ. Bordeaux, INSERM, UMR 1034, Biology of Cardiovascular Diseases, F-33600 Pessac, France
| | - Sophie Provenchère Fruithiot
- Department of Anaesthesia, Université de Paris, Bichat-Claude Bernard Hospital, Paris, France; Centre d'Investigation Clinique 1425, INSERM, Université de Paris, Paris, France
| | - Bertrand Rozec
- Service d'Anesthésie-Réanimation, Hôpital Laennec, CHU Nantes, Nantes, France; Université de Nantes, CHU Nantes, CNRS, INSERM, Institut duDu Thorax, Nantes, France
| | - Jean-Philippe Verhoye
- Department of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
| | - André Vincentelli
- Department of Cardiac Surgery, University of Lille, CHU Lille, Lille, France
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Arfasa N, Nega Kassa R, Girma Legesse T. Preoperative anxiety and its associated factors among patients undergoing cardiac catheterization at saint peter Specialized Hospital and Addis Cardiac Center, Addis Ababa, Ethiopia. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Goktas S, Tosun Y, Gezginci E, Onuk E, Keğin M. Preoperative Educational Package in Cholecystectomy Patients on Anxiety and Return to Normal Activity—a Randomized Controlled Clinical Trial. Indian J Surg 2022. [DOI: 10.1007/s12262-021-02983-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Topan H, Mucuk S, Yontar Y. The Effect of Patient Education Prior to Rhinoplasty Surgery on Anxiety, Pain, and Satisfaction Levels. J Perianesth Nurs 2022; 37:374-379. [PMID: 35304018 DOI: 10.1016/j.jopan.2021.07.001] [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: 02/18/2021] [Revised: 06/28/2021] [Accepted: 07/03/2021] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to evaluate the effect of education before rhinoplasty surgery on patients' anxiety, pain, and satisfaction levels. DESIGN This was a randomized controlled experimental study. METHODS Of the 90 patients who underwent rhinoplasty surgery at Kayseri City Hospital, Turkey between October 2017 and December 2018, 79 were included in the study. The patients were assigned to an experimental or control group according to a computer-generated randomization list. The experimental group (n = 36) was educated using a rhinoplasty training guide prior to routine plastic surgery procedures. The control group (n = 35) received only routine plastic surgery procedures. A patient identification form, State-Trait Anxiety Inventory, Newcastle Satisfaction with Nursing Care Scale, and Visual Analog Scale were used to collect data. Data analysis included the Shapiro-Wilk normality test, Q-Q plot, two-way analysis of variance, Friedman and Mann-Whitney U tests, and Pearson's chi-square. FINDINGS In the postoperative period, the mean state anxiety inventory score of the experimental group (36.25 ± 9.78) was found to be significantly lower than that of the control group (42.28 ± 9.42) (P < .05). There was no statistically significant difference between the trait anxiety inventory scores of the experimental (39.63 ± 10.20) and control (38.77 ± 6.16) (P > .05) groups. The mean Newcastle Satisfaction with Nursing Care Scale score of the experimental group (71.01 ± 14.65) was significantly higher than the control group (62.93 ± 16.36) (P < .05). There was no significant difference between the pain scores of experimental and control groups postoperatively at 6, 12, and 24 hours (P > .05). CONCLUSIONS Based on the results of our study, we conclude that it would be beneficial to educate patients before rhinoplasty surgery in line with their needs and aesthetic concerns.
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Affiliation(s)
- Handan Topan
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
| | - Salime Mucuk
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey
| | - Yalçın Yontar
- Acıbadem Kayseri Hospital, Plastic, Reconstructive and Aesthetic Surgery Clinic, Kayseri, Turkey
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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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Yang G, Zang X, Ma X, Bai P. Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Chinese Version of the Surgical Fear Questionnaire. J Perianesth Nurs 2022; 37:386-392. [DOI: 10.1016/j.jopan.2021.08.004] [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: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 10/18/2022]
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Aardoom JJ, Hilt AD, Woudenberg T, Chavannes NH, Atsma DE. A Preoperative Virtual Reality App for Patients Scheduled for Cardiac Catheterization: Pre–Post Questionnaire Study Examining Feasibility, Usability, and Acceptability. JMIR Cardio 2022; 6:e29473. [PMID: 35191839 PMCID: PMC8905473 DOI: 10.2196/29473] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/30/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background Pre- and postoperative anxiety is a common phenomenon associated with negative postoperative outcomes. Symptoms of posttraumatic stress disorder, such as fear, nightmares, and sleep deprivation, are prevalent in approximately 30% to 50% of patients following discharge from intensive care units after cardiac surgery. Preliminary evidence suggests a promising role of virtual reality (VR) in preventing stress-related reactions using stress inoculation training. Such training enables cognitive preparation of individuals for stressful situations, thereby becoming more tolerant and resistant to stress, subsequently reducing the risk of potential negative psychological consequences. This study investigated a preoperative VR app—Pre-View—aimed at better informing and preparing patients for cardiac catheterization. Objective This study aims to assess the feasibility, usability, and acceptability of Pre-View in patients undergoing cardiac catheterization. Methods Eligible participants were adults scheduled for elective cardiac catheterization. Pre-View comprised an interactive virtual representation of the whole care process related to cardiac catheterization, from entering the hospital for admission to postprocedural stay and discharge. These processes were represented through 360° videos and interactive photos. Self-report questionnaires were completed at baseline (ie, before catheterization and after undergoing the VR experience) and after cardiac catheterization. Outcome measures included user experience and satisfaction, VR presence and immersive tendencies, and user friendliness. The perceived effectiveness was assessed exploratively. Results A total of 8 individuals, with a mean age of 67 (SD 7.5) years, participated in this study. Half of them underwent the VR experience at the hospital and the other half at home. Participants reported high levels of presence in the virtual environment (Presence Questionnaire score: mean 129.1, SD 13.4). The usability of Pre-View was well evaluated (System Usability Scale score: mean 89.1, SD 12.0), and patient satisfaction was high (Client Satisfaction Questionnaire score: mean 27.1, SD 3.2). Usability and satisfaction scores were higher for participants who underwent Pre-View at home versus those who underwent Pre-View at the hospital, although the latter group was significantly older; 72.8 versus 61.3, respectively. All participants reported Pre-View to be effective in terms of feeling better informed about the care process of cardiac catheterization. Most participants (7/8, 88%) reported Pre-View to be effective in terms of feeling better prepared for cardiac catheterization, acknowledging the potential of Pre-View in reducing negative psychological consequences after catheterization. Conclusions The results provide initial support for the feasibility and acceptability of a preoperative VR app, creating a virtual environment that supports patient education and preparation for upcoming cardiac catheterization. More studies are needed to further investigate the effects of VR as a tool to better prepare patients for medical procedures, its effectiveness in reducing negative patient outcomes (eg, anxiety, stress, and postoperative recovery outcomes), and the generalizability of effects across different settings and patient populations.
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Affiliation(s)
- Jiska J Aardoom
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Alexander D Hilt
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Tamar Woudenberg
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Douwe E Atsma
- National eHealth Living Lab, Leiden, Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
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The Efficacy of Psychological Care and Chinese Herbal Decoction in Postoperative Chemotherapy Patients with Endometrial Cancer. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:5700637. [PMID: 35222888 PMCID: PMC8881117 DOI: 10.1155/2022/5700637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/17/2022]
Abstract
Background. In recent years, the incidence of endometrial cancer (EC) has been on the rise worldwide. The purpose of this study was to investigate the efficacy of psychological care and Chinese herbal decoction in EC patients with postoperative chemotherapy. Methods. 80 EC patients with postoperative chemotherapy were randomly divided into the observation group and control group. The control group was given psychotherapy. The observation group was given psychological care plus Chinese herbal decoction treatment. HE4, CA125, traditional Chinese medicine (TCM) syndrome scores, toxic and side effects, and quality of life scores before and after treatment were observed. Results. After treatment, the total effective rate of the observation group was higher than that of the control group. After treatment, serum HE4 and CA125 levels in the observation group were lower than those in the control group. In addition, CD3+ and CD4+ levels in the observation group were higher than those in the control group. Meanwhile, the CD8+ level in the observation group was lower than that in the control group. Compared with the control group, the quality of life in the observation group was significantly improved, and the incidence of adverse reactions was reduced. Conclusion. Chinese herbal decoction combined with psychological care can improve the clinical symptoms, alleviate the toxic and side effects, and improve the life quality of EC patients with postoperative chemotherapy.
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Ng SX, Wang W, Shen Q, Toh ZA, He HG. The effectiveness of preoperative education interventions on improving perioperative outcomes of adult patients undergoing cardiac surgery: a systematic review and meta-analysis. Eur J Cardiovasc Nurs 2021; 21:521-536. [PMID: 34964470 DOI: 10.1093/eurjcn/zvab123] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/25/2021] [Accepted: 12/09/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cardiac surgeries pose as an emotional experience for patients. Preoperative education is known to positively alter people's perceptions, emotions, and mitigate surgical distress. However, this intervention's effectiveness in improving perioperative outcomes among patients undergoing cardiac surgery lacked rigorous statistical synthesis and remains inconclusive. AIMS The aim was to synthesize the effectiveness of preoperative education on improving perioperative outcomes [anxiety, depression, knowledge, pain intensity, pain interference with daily activities, postoperative complications, length of hospitalization, length of intensive care unit (ICU) stay, satisfaction with the intervention and care, and health-related quality of life] among patients undergoing cardiac surgery. METHODS This systematic review and meta-analysis conducted a comprehensive search of nine electronic databases (PubMed, EMBASE, Scopus, MEDLINE, CINAHL, Cochrane CENTRAL, Web of Science, PsycINFO, and ERIC) and grey literature for randomized controlled trials examining the preoperative educational interventional effects on patients undergoing cardiac surgery from inception to 31 December 2020. The studies' quality was evaluated using Cochrane Risk-of-Bias Tool 1 (RoB1). Meta-analyses via RevMan 5.4 software synthesized interventional effects. RESULTS Twenty-two trials involving 3167 participants were included. Preoperative education had large significant effects on reducing post-intervention preoperative anxiety (P = 0.02), length of ICU stay (P = 0.02), and improving knowledge (P < 0.00001), but small significant effect sizes on lowering postoperative anxiety (P < 0.0001), depression (P = 0.03), and enhancing satisfaction (P = 0.04). CONCLUSIONS This review indicates the feasibility of preoperative education in clinical use to enhance health outcomes of patients undergoing cardiac surgery. Future studies need to explore knowledge outcomes in-depth and more innovative technologies in preoperative education delivery.
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Affiliation(s)
- Si Xian Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.,National University Health System, NUHS Tower Block, 1E Kent Ridge Rd, Singapore 119228, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.,National University Health System, NUHS Tower Block, 1E Kent Ridge Rd, Singapore 119228, Singapore
| | - Qu Shen
- Department of Nursing, School of Medicine, Xiamen University, Room 220, Alice Lee Building, Xiang An South Road, Xiang An District, Xiamen 361102, Fujian Province, China
| | - Zheng An Toh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.,National University Health System, NUHS Tower Block, 1E Kent Ridge Rd, Singapore 119228, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.,National University Health System, NUHS Tower Block, 1E Kent Ridge Rd, Singapore 119228, Singapore
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Liu X, Ghisi GLM, Meng S, Grace SL, Shi W, Zhang L, Gallagher R, Oh P, Aultman C, Sandison N, Ding B, Zhang Y. Establishing a process to translate and adapt health education materials for natives and immigrants: The case of Mandarin adaptations of cardiac rehabilitation education. Heart Lung 2021; 50:794-817. [PMID: 34233218 DOI: 10.1016/j.hrtlng.2021.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/02/2021] [Accepted: 06/05/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cardiac rehabilitation (CR) is a proven model of secondary prevention in which patient education is a core component. OBJECTIVES to translate and culturally-adapt CR patient education for Mandarin-speaking patients living in China as well as immigrants, and offer recommendation for best practices in adaptation for both. METHODS these steps were undertaken in China and Canada: (1) preparation; (2) translation and adaptation; (3) review by healthcare providers based on PEMAT-P; (4) think-aloud review by patients; and (5) finalization. RESULTS Two independent Mandarin translations were undertaken using best practices: one domestic (China) and one international (immigrants). Input by 23 experts instigated revisions. Experts rated the language and content as culturally-appropriate, and perceived the materials would benefit their patients. A revised version was then administered to 36 patients, based on which a few edits were made to optimize understandability. CONCLUSIONS some important differences emerged between translations adapted for native versus immigrant settings.
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Affiliation(s)
- Xia Liu
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Gabriela L M Ghisi
- Cardiovascular Prevention and Rehabilitation Program, KITE-Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 2R6, Canada.
| | - Shu Meng
- Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sherry L Grace
- Cardiovascular Prevention and Rehabilitation Program, KITE-Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 2R6, Canada; Faculty of Health, York University, Toronto, Canada
| | - Wendan Shi
- Charles Perkins Centre, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ling Zhang
- Charles Perkins Centre, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Robyn Gallagher
- Charles Perkins Centre, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, KITE-Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 2R6, Canada
| | - Crystal Aultman
- Cardiovascular Prevention and Rehabilitation Program, KITE-Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 2R6, Canada
| | - Nicole Sandison
- Cardiovascular Prevention and Rehabilitation Program, KITE-Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, Ontario M4G 2R6, Canada
| | - Biao Ding
- Shanghai Sixth People's Hospital, Shanghai, China
| | - Yaqing Zhang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
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Akhlaghi E, Babaei S, Mardani A, Eskandari F. The Effect of the Neuman Systems Model on Anxiety in Patients Undergoing Coronary Artery Bypass Graft: A Randomized Controlled Trial. J Nurs Res 2021; 29:e162. [PMID: 34074963 DOI: 10.1097/jnr.0000000000000436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Coronary artery bypass graft (CABG) surgery is the most commonly used surgical procedure for patients with coronary artery disease. Anxiety is a significant psychological problem associated with CABG surgery that may reduce related treatment outcomes. PURPOSE This study was designed to investigate the effect on anxiety of applying the Neuman Systems Model in patients awaiting and undergoing CABG surgery. METHODS A single-blind, parallel-group randomized controlled trial was conducted on patients scheduled to receive coronary artery bypass surgery in an urban area of Iran. Seventy participants were enrolled using a convenience sampling method and randomly assigned to either the intervention group (n = 35) or the control group (n = 35). Participants in the intervention group received intervention in accordance with the Neuman Systems Model format, including meetings held at three levels of prevention. Patients' anxiety was measured using the State Anxiety Inventory before the intervention, immediately after the intervention, and at discharge time. The chi-square test, Fisher's exact test, independent sample t test, one-way repeated measures analysis of variance test, and Fisher's least significant difference were used to analyze the data. RESULTS No significant difference was found between the mean anxiety scores of the two groups before the intervention (p = .48, t = 0.71). However, the mean anxiety score of the intervention group was significantly lower than that of the control group immediately after the intervention (p = .008, t = 2.73) and at discharge time (p = .007, t = 2.77). CONCLUSIONS The Neuman-based program is an effective and low-cost intervention that may be applied to reduce anxiety in patients awaiting and undergoing CABG surgery. This program may be a good guide in providing healthcare services.
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Affiliation(s)
- Elham Akhlaghi
- RN, Doctoral Candidate, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sima Babaei
- PhD, RN, Assistant Professor, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
| | - Abbas Mardani
- RN, Doctoral Candidate, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Eskandari
- PhD, RN, Support Worker, Psychiatric/Mental Health Nursing, Mental Health Community Making Life Better, Sydney, Australia
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Nilsson O, Stenman M, Letterstål A, Hultgren R. A randomized clinical trial of an eHealth intervention on anxiety in patients undergoing abdominal aortic aneurysm surgery. Br J Surg 2021; 108:917-924. [PMID: 34021309 PMCID: PMC10364917 DOI: 10.1093/bjs/znab151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/10/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The potential benefit of eHealth interventions in patients with abdominal aortic aneurysm (AAA) is uncertain. The primary aim of this study was to investigate the effect of an eHealth intervention on anxiety in patients with AAA undergoing surgery. METHODS A single-centre randomized clinical trial of patients with AAA scheduled for surgical repair was undertaken. The intervention group received an eHealth tool and psychosocial support besides standard care. The control group received standard care. The analysis of treatment effects was performed as intention-to-treat and per protocol analysis. The primary outcome measure was anxiety mean score (Hospital Anxiety and Depression Scale Anxiety (HADS)-A). Secondary outcomes measures were HADS Depression and short-form 12-item health survey mean scores. RESULTS Some 120 participants were randomized. No effect on anxiety mean scores was found in the intention-to-treat analysis (-1.21 versus -0.54, P = 0.330). Among those randomized to the intervention, only 30 of 60 participants used the eHealth tool (application (app) users). The app users were younger and had a higher educational level. A decrease in anxiety mean scores was noted in those who used the app in the per protocol analysis (-2.00 versus -0.54, P = 0.028). The intervention group stated a lower physical-component health-related quality of life (HRQoL) (-4.32 versus -1.16, P = 0.042) but mental-component HRQoL and depressive symptoms were unchanged. CONCLUSIONS Delivery of an eHealth intervention in this RCT did not result in an improvement in anxiety scores in patients awaiting AAA surgery. Uptake of the eHealth tool was low, although it resulted in lower anxiety scores in those participants who actually used it. CLINICAL TRIAL REGISTRATION NUMBER NCT03157973 (http://www.clinicaltrials.gov).
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Affiliation(s)
- O Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - M Stenman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Perioperative Medicine and Intensive Care Function, Karolinska University Hospital, Stockholm, Sweden
| | - A Letterstål
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - R Hultgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden
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Comparison of the Effects of Face-to-Face and Group Education on Awareness and Anxiety of Family Members of Candidates for Coronary Angiography. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2021. [DOI: 10.52547/jgbfnm.18.1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
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Risk Factors for Anastomotic Leakage in Patients with Rectal Tumors Undergoing Anterior Resection within an ERAS Protocol: Results from the Swedish ERAS Database. World J Surg 2021; 45:1630-1641. [PMID: 33733700 PMCID: PMC8093169 DOI: 10.1007/s00268-021-06054-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 01/16/2023]
Abstract
Background Research on risk factors for anastomotic leakage (AL) alone within an Enhanced Recovery After Surgery (ERAS) protocol has not yet been conducted. The aim of this study was to identify risk factors for AL and study short-term outcome after AL in patients operated with anterior resection (AR). Methods All prospectively and consecutively recorded patients operated with AR in the Swedish part of the international ERAS® Interactive Audit System (EIAS) between January 2010 and February 2020 were included. The cohort was evaluated regarding risk factors for AL and short-term outcomes, including uni- and multivariate analysis. Pre-, intra- and postoperative compliance to ERAS®Society guidelines was calculated and evaluated. Results Altogether 1900 patients were included, 155 (8.2%) with AL and 1745 without AL. Male gender, obesity, peritoneal contamination, year of surgery 2016–2020, duration of primary surgery and age remained significant predictors for AL in multivariate analysis. There was no significant difference in overall pre- and intraoperative compliance to ERAS®Society guidelines between groups. Only preadmission patient education remained as a significant ERAS variable associated with less AL. AL was associated with longer length of stay (LOS), higher morbidity rate and higher rate of reoperations. Conclusion Male gender, obesity, peritoneal contamination, duration of surgery, surgery later in study period, age and preadmission patient education were associated with AL in patients operated on with AR. Overall pre- and intraoperative compliance to the ERAS protocol was high in both groups and not associated with AL.
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Toğaç HK, Yılmaz E. Effects of preoperative individualized audiovisual education on anxiety and comfort in patients undergoing laparoscopic cholecystectomy: randomised controlled study. PATIENT EDUCATION AND COUNSELING 2021; 104:603-610. [PMID: 32933794 DOI: 10.1016/j.pec.2020.08.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The study aimed to determine the effects of preoperative individualized audiovisual education for laparoscopic cholecystectomy patients on postoperative anxiety and comfort (pain, nausea, and vomiting). METHOD This study was a randomized clinical trial on 124 patients undergoing laparoscopic cholecystectomy. Patients were randomized into an intervention group (individualized audiovisual education) or a control group (standard education). The primary outcome was change in anxiety and comfort levels between the intervention and control groups at baseline and follow-up. Secondary outcomes were change between groups in Patient Learning Needs Scale scores and vital signs. RESULTS Although the preoperative visual analog scale (VAS)-pain and VAS-nausea scores of the patients in both groups were similar, the postoperative VAS-pain and VAS-nausea levels of the intervention group were significantly lower than that of the control group (p < 0.05). The anxiety levels of the intervention group were also lower both before (42.79 ± 4.29) and after (39.08 ± 3.49) surgery than that of the control group (50.98 ± 5.45 and 44.41 ± 4.77, respectively). CONCLUSION This study showed that preoperative individualized audiovisual education was effective in reducing anxiety and improving patient comfort. PRACTICE IMPLICATIONS Preoperative individualized audiovisual education is crucial for clinical care and can be integrated into other patients because of its positive effects on postoperative recovery outcomes.
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Affiliation(s)
- Hülya Kizil Toğaç
- Manisa Celal Bayar University, Faculty of Health Science Department of Surgical Nursing, Manisa, Turkey
| | - Emel Yılmaz
- Manisa Celal Bayar University, Faculty of Health Science Department of Surgical Nursing, Manisa, Turkey.
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Brescia AA, Piazza JR, Jenkins JN, Heering LK, Ivacko AJ, Piazza JC, Dwyer-White MC, Peters SL, Cepero J, Brown BH, Longi FN, Monaghan KP, Bauer FW, Kathawate VG, Jafri SM, Webster MC, Kasperek AM, Garvey NL, Schwenzer C, Wu X, Lagisetty KH, Osborne NH, Waljee JF, Riba M, Likosky DS, Byrnes ME, Deeb GM. The Impact of Nonpharmacological Interventions on Patient Experience, Opioid Use, and Health Care Utilization in Adult Cardiac Surgery Patients: Protocol for a Mixed Methods Study. JMIR Res Protoc 2021; 10:e21350. [PMID: 33591291 PMCID: PMC7925147 DOI: 10.2196/21350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite pharmacological treatments, patients undergoing cardiac surgery experience severe anxiety and pain, which adversely affect outcomes. Previous work examining pediatric and nonsurgical adult patients has documented the effectiveness of inexpensive, nonpharmacological techniques to reduce anxiety and pain as well as health care costs and length of hospitalization. However, the impact of nonpharmacological interventions administered by a dedicated comfort coach has not been evaluated in an adult surgical setting. OBJECTIVE This trial aims to assess whether nonpharmacological interventions administered by a trained comfort coach affect patient experience, opioid use, and health care utilization compared with usual care in adult cardiac surgery patients. This study has 3 specific aims: assess the effect of a comfort coach on patient experience, measure differences in inpatient and outpatient opioid use and postoperative health care utilization, and qualitatively evaluate the comfort coach intervention. METHODS To address these aims, we will perform a prospective, randomized controlled trial of 154 adult cardiac surgery patients at Michigan Medicine. Opioid-naive patients undergoing first-time, elective cardiac surgery via sternotomy will be randomized to undergo targeted interventions from a comfort coach (intervention) versus usual care (control). The individualized comfort coach interventions will be administered at 6 points: preoperative outpatient clinic, preoperative care unit on the day of surgery, extubation, chest tube removal, hospital discharge, and 30-day clinic follow-up. To address aim 1, we will examine the effect of a comfort coach on perioperative anxiety, self-reported pain, functional status, and patient satisfaction through validated surveys administered at preoperative outpatient clinic, discharge, 30-day follow-up, and 90-day follow-up. For aim 2, we will record inpatient opioid use and collect postdischarge opioid use and pain-related outcomes through an 11-item questionnaire administered at the 30-day follow-up. Hospital length of stay, readmission, number of days in an extended care facility, emergency room, urgent care, and an unplanned doctor's office visit will be recorded as the primary composite endpoint defined as total days spent at home within the first 30 days after surgery. For aim 3, we will perform semistructured interviews with patients in the intervention arm to understand the comfort coach intervention through a thematic analysis. RESULTS This trial, funded by Blue Cross Blue Shield of Michigan Foundation in 2019, is presently enrolling patients with anticipated manuscript submissions from our primary aims targeted for the end of 2020. CONCLUSIONS Data generated from this mixed methods study will highlight effective nonpharmacological techniques and support a multidisciplinary approach to perioperative care during the adult cardiac surgery patient experience. This study's findings may serve as the foundation for a subsequent multicenter trial and broader dissemination of these techniques to other types of surgery. TRIAL REGISTRATION ClinicalTrials.gov NCT04051021; https://clinicaltrials.gov/ct2/show/NCT04051021. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/21350.
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Affiliation(s)
- Alexander A Brescia
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, United States
| | - Julie R Piazza
- Office of Patient Experience, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Jessica N Jenkins
- Department of Child and Family Life, CS Mott Children's Hospital, Michigan Medicine, Ann Arbor, MI, United States
| | - Lindsay K Heering
- Department of Child and Family Life, CS Mott Children's Hospital, Michigan Medicine, Ann Arbor, MI, United States
| | - Alexander J Ivacko
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - James C Piazza
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Molly C Dwyer-White
- Office of Patient Experience, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Stefanie L Peters
- Frankel Cardiovascular Center, Michigan Medicine, Ann Arbor, MI, United States
| | - Jesus Cepero
- Children and Women's Hospital, Michigan Medicine, Ann Arbor, MI, United States
| | - Bailey H Brown
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Faraz N Longi
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Katelyn P Monaghan
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Frederick W Bauer
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Varun G Kathawate
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Sara M Jafri
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, United States
| | - Melissa C Webster
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Amanda M Kasperek
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Nickole L Garvey
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Claudia Schwenzer
- Office of Patient Experience, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Xiaoting Wu
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Kiran H Lagisetty
- Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Nicholas H Osborne
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, United States
- Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Jennifer F Waljee
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, United States
- Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Michelle Riba
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Donald S Likosky
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, United States
| | - Mary E Byrnes
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, United States
- Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - G Michael Deeb
- Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
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Berna P, Quesnel C, Assouad J, Bagan P, Etienne H, Fourdrain A, Le Guen M, Leone M, Lorne E, Nguyen YNL, Pages PB, Roz H, Garnier M. Guidelines on enhanced recovery after pulmonary lobectomy. Anaesth Crit Care Pain Med 2021; 40:100791. [PMID: 33451912 DOI: 10.1016/j.accpm.2020.100791] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To establish recommendations for optimisation of the management of patients undergoing pulmonary lobectomy, particularly Enhanced Recovery After Surgery (ERAS). DESIGN A consensus committee of 13 experts from the French Society of Anaesthesia and Intensive Care Medicine (Soci,t, franOaise d'anesth,sie et de r,animation, SFAR) and the French Society of Thoracic and Cardiovascular Surgery (Soci,t, franOaise de chirurgie thoracique et cardiovasculaire, SFCTCV) was convened. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence. METHODS Five domains were defined: 1) patient pathway and patient information; 2) preoperative management and rehabilitation; 3) anaesthesia and analgesia for lobectomy; 4) surgical strategy for lobectomy; and 5) enhanced recovery after surgery. For each domain, the objective of the recommendations was to address a number of questions formulated according to the PICO model (Population, Intervention, Comparison, Outcome). An extensive literature search on these questions was carried out and analysed using the GRADE® methodology. Recommendations were formulated according to the GRADE® methodology, and were then voted by all experts according to the GRADE grid method. RESULTS The SFAR/SFCTCV guideline panel provided 32 recommendations on the management of patients undergoing pulmonary lobectomy. After two voting rounds and several amendments, a strong consensus was reached for 31 of the 32 recommendations and a moderate consensus was reached for the last recommendation. Seven of these recommendations present a high level of evidence (GRADE 1+), 23 have a moderate level of evidence (18 GRADE 2+ and 5 GRADE 2-), and 2 correspond to expert opinions. Finally, no recommendation was provided for 2 of the questions. CONCLUSIONS A strong consensus was expressed by the experts to provide recommendations to optimise the whole perioperative management of patients undergoing pulmonary lobectomy.
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Affiliation(s)
- Pascal Berna
- Department of Thoracic Surgery, Amiens University Hospital, 80000 Amiens, France
| | - Christophe Quesnel
- Sorbonne Universit,, APHP, DMU DREAM, Service d'Anesth,sie-R,animation et M,decine P,riop,ratoire, H"pital Tenon, 75020 Paris, France
| | - Jalal Assouad
- Department of Thoracic Surgery, Tenon University Hospital, Sorbonne Universit,, 75020 Paris, France
| | - Patrick Bagan
- Department of Thoracic and Vascular Surgery, Victor Dupouy Hospital, 95100 Argenteuil, France
| | - Harry Etienne
- Department of Thoracic Surgery, Tenon University Hospital, Sorbonne Universit,, 75020 Paris, France
| | - Alex Fourdrain
- Department of Thoracic Surgery, Amiens University Hospital, 80000 Amiens, France
| | - Morgan Le Guen
- D,partement d'Anesth,sie, H"pital Foch, Universit, Versailles Saint Quentin, 92150 Suresnes, France; INRA UMR 892 VIM, 78350 Jouy-en-Josas, France
| | - Marc Leone
- Aix Marseille Universit, - Assistance Publique H"pitaux de Marseille - Service d'Anesth,sie et de R,animation - H"pital Nord - 13005 Marseille, France
| | - Emmanuel Lorne
- Departement d'Anesth,sie-R,animation, Clinique du Mill,naire, 34000 Montpellier, France
| | - Y N-Lan Nguyen
- Anaesthesiology and Critical Care Department, APHP Centre, Paris University, 75000 Paris, France
| | - Pierre-Benoit Pages
- Department of Thoracic Surgery, Dijon Burgundy University Hospital, 21000 Dijon, France; INSERM UMR 1231, Dijon Burgundy University Hospital, University of Burgundy, 21000 Dijon, France
| | - Hadrien Roz
- Unit, d'Anesth,sie R,animation Thoracique, H"pital Haut Leveque, CHU de Bordeaux, 33000 Bordeaux, France
| | - Marc Garnier
- Sorbonne Universit,, APHP, DMU DREAM, Service d'Anesth,sie-R,animation et M,decine P,riop,ratoire, H"pital Tenon, 75020 Paris, France.
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Schaefer I, Heneka N, Luckett T, Agar MR, Chambers SK, Currow DC, Halkett G, Disalvo D, Amgarth-Duff I, Anderiesz C, Phillips JL. Quality of online self-management resources for adults living with primary brain cancer, and their carers: a systematic environmental scan. BMC Palliat Care 2021; 20:22. [PMID: 33485331 PMCID: PMC7827995 DOI: 10.1186/s12904-021-00715-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/13/2021] [Indexed: 12/24/2022] Open
Abstract
Background A primary brain cancer diagnosis is a distressing, life changing event. It adversely affects the quality of life for the person living with brain cancer and their families (‘carers’). Timely access to evidence-based information is critical to enabling people living with brain cancer, and their carers, to self-manage the devastating impacts of this disease. Method A systematic environmental scan of web-based resources. A depersonalised search for online English-language resources published from 2009 to December 2019 and designed for adults (> 25 years of age), living with primary brain cancer, was undertaken using the Google search engine. The online information was classified according to: 1) the step on the cancer care continuum; 2) self-management domains (PRISMS taxonomy); 3) basic information disclosure (Silberg criteria); 4) independent quality verification (HonCode); 5) reliability of disease and treatment information (DISCERN Sections 1 and 2); and readability (Flesch-Kincaid reading grade). Results A total of 119 online resources were identified, most originating in England (n = 49); Australia (n = 27); or the USA (n = 27). The majority of resources related to active treatment (n = 76), without addressing recurrence (n = 3), survivorship (n = 1) or palliative care needs (n = 13). Few online resources directly provided self-management advice for adults living with brain cancer or their carers. Just over a fifth (n = 26, 22%) were underpinned by verifiable evidence. Only one quarter of organisations producing resources were HonCode certified (n = 9, 24%). The median resource reliability as measured by Section 1, DISCERN tool, was 56%. A median of 8.8 years of education was required to understand these online resources. Conclusions More targeted online information is needed to provide people affected by brain cancer with practical self-management advice. Resources need to better address patient and carer needs related to: rehabilitation, managing behavioural changes, survivorship and living with uncertainty; recurrence; and transition to palliative care. Developing online resources that don’t require a high level of literacy and/or cognition are also required. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00715-4.
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Affiliation(s)
- Isabelle Schaefer
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Nicole Heneka
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Tim Luckett
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Meera R Agar
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Suzanne K Chambers
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - David C Currow
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Georgia Halkett
- School of Nursing, Midwifery and Paramedicine, Psychology Building, Curtin University, Perth, Western Australia, Australia
| | - Domenica Disalvo
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ingrid Amgarth-Duff
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Cleola Anderiesz
- Australian Brain Cancer Mission, Cancer Australia, Sydney, New South Wales, Australia
| | - Jane L Phillips
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
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Daykan Y, Battino S, Arbib N, Tamir Yaniv R, Schonman R, Klein Z, Pomeranz J, Pomeranz M. Verbal analgesia is as good as oral tramadol prior to intrauterine device (IUD) insertion, among nulliparous women: A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 2020; 258:443-446. [PMID: 33187752 DOI: 10.1016/j.ejogrb.2020.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare two pain management strategies: oral tramadol or a verbal analgesia technique during insertion of an intrauterine device (IUD) among nulliparous women. STUDY DESIGN In this randomized, controlled trial, 54 nulliparous women undergoing insertion of a levonorgestrel-releasing intrauterine device (IUD), from December 2015 to December 2018 were randomized to receive oral tramadol for analgesia or verbal analgesia prior to IUD insertion. Demographic data, clinical symptoms, visual analogue scale (VAS) and complications were reviewed from patient records. RESULTS There was no difference between the two groups regarding gravidity, age, smoking or body mass index. No significant differences were detected between the groups regarding the procedure, including ease of insertion (p = .415), number of insertion attempts (p = .514) and complications during the insertion (p = .150). Mean pain level by VAS was 4.5 ± 1.6 (range 2-8) for the tramadol group and 4.8 ± 2.4 (0-10) for the verbal analgesia group (p = .610). There was no spontaneous ejection of the IUD in either group, and no endometritis or discomfort that resulted in IUD removal. CONCLUSION There was no benefit in using oral tramadol for analgesia prior to IUD insertion among nulliparous women. Verbal analgesia can be a suitable technique for this process and clinicians should become more familiar with its use.
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Affiliation(s)
- Yair Daykan
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Shlomo Battino
- Women's Health Center Clalit Afula, Israel; Galilee Medical Centre, Galilee Faculty of Medicine, Safed, Israel
| | - Nissim Arbib
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rina Tamir Yaniv
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Schonman
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Klein
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Pomeranz
- University of Nicosia Medical School (School of Medicine, University of Nicosia, Nicosia, Cyprus)
| | - Meir Pomeranz
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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50
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Effects of foot massage and patient education in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial. Complement Ther Clin Pract 2020; 40:101215. [PMID: 32891291 DOI: 10.1016/j.ctcp.2020.101215] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Anxiety, pain, and fatigue are common postoperative problems that disturb the recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. These postoperative problems are associated with prolonged recovery and decreased quality of life. This study was aimed at evaluating the combined effects of foot massage and patient education on anxiety, fatigue, pain, self-efficacy, and quality of life in patients undergoing CABG surgery. MATERIAL AND METHODS In this randomized controlled trial (RCT), 130 participants were randomly allocated to experimental (n = 65) and control (n = 65) groups. The experimental group received a combination of foot massage and patient education as interventions and the control group received usual care of the hospital. RESULTS The experimental group had a significant decrease in anxiety (p = 0.001), fatigue (p = 0.001), pain (p = 0.001), and increased self-efficacy (p = 0.001) and quality of life (p = 0.001). CONCLUSION The combined form of foot massage and patient education is effective in decreasing anxiety, fatigue, pain, and increasing self-efficacy and the quality of life. These interventions will support the recovery of patients and reduce their suffering.
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