1
|
Gamst-Jensen H, Villumsen BR, Nielsen AH, Egerod I, Brix LD. "What matters to you" on the day of surgery: Protocol for a mixed methods study. Acta Anaesthesiol Scand 2024; 68:1101-1106. [PMID: 38660741 DOI: 10.1111/aas.14430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The anticipation of anesthesia and surgery is the source of fear and anxiety in millions of patients worldwide. Although patients' fear and anxiety are recognized, more knowledge is needed to address patient responses and needs. Understanding the needs of the patients are important, and asking patients directly is the first step towards addressing these needs. This again might help reducing medications such as anesthetics and postoperative pain relief. The aim of this study protocol is to describe how we will investigate what matters to patients on the day of surgery, as well as their degree-of-worry and surgical fear. METHODS Using a convergent mixed methods design with equal weighting of the qualitative and quantitative data strand we take advantage of the international "What Matters To You" Day on June 6, 2024 to conduct a flash mob study. We will approach perioperative departments around Denmark to participate and eligible patients arriving to the perioperative department for surgery will be invited to participate. Consenting patients are asked to complete a survey in three parts regarding (1) what matters to you, (2) degree-of-worry, and (3) surgical fear. We will use qualitative analysis for the first part and descriptive statistics for second and third parts. The data strands will be analyzed separately followed by integrated analysis and joint displays.
Collapse
Affiliation(s)
- H Gamst-Jensen
- Department of Anesthesia, Centre of Head and Orthopedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - B R Villumsen
- Department of Anaesthesiology and Intensive Care, Gødstrup Hospital, Herning, Denmark
| | - A H Nielsen
- Department of Anaesthesiology and Intensive Care, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - I Egerod
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - L D Brix
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Anaesthesiology and Intensive Care, Horsens Hospital, Horsens, Denmark
| |
Collapse
|
2
|
Ali Z, Ahsan Z, Liaqat N, Din IU. Bridging the gap: evaluation of preoperative patients' education by comparing expectations and real-perioperative surgical experiences: a mixed-methods descriptive cross-sectional study. BMC Health Serv Res 2024; 24:964. [PMID: 39169337 PMCID: PMC11337772 DOI: 10.1186/s12913-024-11388-z] [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: 07/08/2024] [Accepted: 08/01/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Educating patients regarding surgery is an important aspect of the preoperative process. It helps individuals answer their queries, reduce anxiety, and improve overall satisfaction with the surgical experience. OBJECTIVE To compare patients' expectations with their real-perioperative surgical experiences. Also, to evaluate the effectiveness of preoperative education and, thus, improve the doctor-patient relationship. METHODOLOGY Through consecutive sampling, 65 adult patients were selected from the ENT department of Khyber Teaching Hospital. Preoperative education was provided to all the subjects using a 25-point pro-forma, and their queries were addressed. Postoperatively, all participants were interviewed regarding their expectations and real perioperative surgical experiences. The gaps were noted, and participants were asked about their preferences for addressing such gaps in future interactions. Postoperatively, patients were asked to give comments on how a certain part of preoperative education could have been better delivered. RESULTS Among the 65 patients, 28 (43.1%) were male, and 37 (56.9%) were female. The majority (38.5%) had a primary/secondary school education. Eight (12.3%) patients had ear surgery, 19 (29.2%) had nose surgery, and 38 (58.5%) had throat surgery. Almost 39 (60%) patients had preoperative fear/anxiety. After preoperative education, 17 (26.2%) patients experienced perioperative fear/anxiety, which was a significant reduction (p = 0.001). Preoperative anxiety was greater in females (M: F = 8:13, p = 0.00), while perioperative anxiety was comparable among both genders after patient education (M: F = 5:12, p = 0.18). The greatest dissatisfaction was noted regarding the surgical schedule (33.8%), range of motion (16.9%), deep breathing exercises (13.8%), and preoperative fasting (12.3%). Most importantly, patients' comments were noted, when they were asked to suggest a better way to educate preoperatively in their respective area of dissatisfaction. Patients appreciated detailed explanations with practical demonstrations for range of motion exercises. One patient complained about no clear instructions on postoperative resumption of snuff. CONCLUSION Preoperative patient education should be a two-way process involving active participation and continuous feedback. By educating patients properly through a multidisciplinary approach, healthcare providers can further enhance patient satisfaction, alleviate anxiety, and improve the overall quality of care.
Collapse
Affiliation(s)
- Zeeshan Ali
- Hayatabad Medical Complex, Peshawar, Khyber Pakhtunkhwa (KPK), Pakistan
| | - Zainab Ahsan
- Khyber Medical University, Peshawar, Khyber Pakhtunkhwa (KPK), Pakistan
| | - Nazneen Liaqat
- Department of Otorhinolaryngology, Head and Neck Surgery, Khyber Teaching Hospital Medical Teaching Institute, Peshawar, Khyber Pakhtunkhwa (KPK), Pakistan.
| | - Israr Ud Din
- Department of Otorhinolaryngology, Head and Neck Surgery, Khyber Teaching Hospital, Medical Teaching Institute, Peshawar, Khyber Pakhtunkhwa (KPK), Pakistan
| |
Collapse
|
3
|
El-Gabalawy R, Sommer JL, Hebbard P, Reynolds K, Logan GS, Smith MSD, Mutter TC, Mutch WA, Mota N, Proulx C, Gagnon Shaigetz V, Maples-Keller JL, Arora RC, Perrin D, Benedictson J, Jacobsohn E. An Immersive Virtual Reality Intervention for Preoperative Anxiety and Distress Among Adults Undergoing Oncological Surgery: Protocol for a 3-Phase Development and Feasibility Trial. JMIR Res Protoc 2024; 13:e55692. [PMID: 38743939 PMCID: PMC11134251 DOI: 10.2196/55692] [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: 12/21/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Preoperative state anxiety (PSA) is distress and anxiety directly associated with perioperative events. PSA is associated with negative postoperative outcomes such as longer hospital length of stay, increased pain and opioid use, and higher rates of rehospitalization. Psychological prehabilitation, such as education, exposure to hospital environments, and relaxation strategies, has been shown to mitigate PSA; however, there are limited skilled personnel to deliver such interventions in clinical practice. Immersive virtual reality (VR) has the potential for greater accessibility and enhanced integration into an immersive and interactive experience. VR is rarely used in the preoperative setting, but similar forms of stress inoculation training involving exposure to stressful events have improved psychological preparation in contexts such as military deployment. OBJECTIVE This study seeks to develop and investigate a targeted PSA intervention in patients undergoing oncological surgery using a single preoperative VR exposure. The primary objectives are to (1) develop a novel VR program for patients undergoing oncological surgery with general anesthesia; (2) assess the feasibility, including acceptability, of a single exposure to this intervention; (3) assess the feasibility, including acceptability, of outcome measures of PSA; and (4) use these results to refine the VR content and outcome measures for a larger trial. A secondary objective is to preliminarily assess the clinical utility of the intervention for PSA. METHODS This study comprises 3 phases. Phase 1 (completed) involved the development of a VR prototype targeting PSA, using multidisciplinary iterative input. Phase 2 (data collection completed) involves examining the feasibility aspects of the VR intervention. This randomized feasibility trial involves assessing the novel VR preoperative intervention compared to a VR control (ie, nature trek) condition and a treatment-as-usual group among patients undergoing breast cancer surgery. Phase 3 will involve refining the prototype based on feasibility findings and input from people with lived experience for a future clinical trial, using focus groups with participants from phase 2. RESULTS This study was funded in March 2019. Phase 1 was completed in April 2020. Phase 2 data collection was completed in January 2024 and data analysis is ongoing. Focus groups were completed in February 2024. Both the feasibility study and focus groups will contribute to further refinement of the initial VR prototype (phase 3), with the final simulation to be completed by mid-2024. CONCLUSIONS The findings from this work will contribute to the limited body of research examining feasible and broadly accessible interventions for PSA. Knowledge gained from this research will contribute to the final development of a novel VR intervention to be tested in a large population of patients with cancer before surgery in a randomized clinical trial. TRIAL REGISTRATION ClinicalTrials.gov NCT04544618; https://www.clinicaltrials.gov/study/NCT04544618. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55692.
Collapse
Affiliation(s)
- Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Hebbard
- CancerCare Manitoba, Winnipeg, MB, Canada
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Gabrielle S Logan
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Thomas C Mutter
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - W Alan Mutch
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Rakesh C Arora
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States
| | - David Perrin
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Surgery, Section of Orthopedic Surgery, University of Manitoba, Winnipeg, MB, Canada
| | - Jada Benedictson
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Eric Jacobsohn
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
4
|
Kreca SM, Albers IS, Musters SCW, van Dijkum EJMN, Tuinman PR, Eskes AM. The effect of family-centered care on unplanned emergency room visits, hospital readmissions and intensive care admissions after surgery: a root cause analysis from a prospective multicenter study in the Netherlands. Patient Saf Surg 2024; 18:14. [PMID: 38689336 PMCID: PMC11061973 DOI: 10.1186/s13037-024-00399-8] [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: 02/28/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Optimizing transitional care by practicing family-centered care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients' healthcare also has negative consequences for patient safety. This study assessed the safety of family involvement in patients' healthcare by examining the cause of unplanned events in patients who participated in a family involvement program (FIP) after major abdominal cancer surgery. METHODS This is a secondary analysis focusing on the intervention group of a prospective cohort study conducted in the Netherlands. Data were collected from April 2019 to May 2022. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analyzed, and root causes were identified using the medical version of a prevention- and recovery-information system for monitoring and analysis (PRISMA) that analyses unintended events in healthcare. Unplanned events were compared between patients who received care from family caregivers and patients who received professional at-home care after discharge. A Mann-Whitney U test was used to analyze data. RESULTS Of the 152 FIP participants, 68 experienced an unplanned event and were included. 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1-2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge. CONCLUSION Based on the insights from the root-cause analysis in this prospective multicenter study, it appears that unplanned emergency room visits and hospital readmissions are not related to the active involvement of family caregivers in surgical follow-up care. Moreover, surgical follow-up care by trained family caregivers during hospitalization was not associated with increased rates of unplanned adverse events. Hence, the concept of active family involvement by proficiently trained family caregivers in postoperative care appears safe and feasible for patients undergoing major abdominal surgery.
Collapse
Affiliation(s)
- Sani Marijke Kreca
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Treatment and quality of life, Meibergdeef 9, 1105 AZ, Amsterdam, the Netherlands.
| | - Iris Sophie Albers
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Anesthesiology, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Selma Clazina Wilhelmina Musters
- Cancer Center Amsterdam, Treatment and quality of life, Meibergdeef 9, 1105 AZ, Amsterdam, the Netherlands
- Amsterdam UMC location University of Amsterdam, Department of Surgery, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Els Jaqueline Maria Nieveen van Dijkum
- Department of Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and quality of life, Meibergdeef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Pieter Roel Tuinman
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, G01 2.03 Gold Coast campus Griffith University, Gold Coast, QLD, 4222, Australia
- Department of Intensive Care Amsterdam cardiovascular Sciences Amsterdam institute for Infection and Immunity, Amsterdam UMC location Vrije Universiteit Amsterdam NL, Amsterdam, The Netherlands
| | - Anne Maria Eskes
- Cancer Center Amsterdam, Treatment and quality of life, Meibergdeef 9, 1105 AZ, Amsterdam, the Netherlands.
- Amsterdam UMC location University of Amsterdam, Department of Surgery, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, G01 2.03 Gold Coast campus Griffith University, Gold Coast, QLD, 4222, Australia.
- Intensive Care, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, 1081HV, The Netherlands.
- Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
| |
Collapse
|
5
|
Dawod MS, Alswerki MN, Al Ja'ar SM, Keilani DZ, Keilani LZ, Alani MA, Saimeh TH, Al-Tamimi S, Al-Shibly SM, Saimeh ZH, Al-Juboori MA, Alelaumi A, Alsheikh FT, Kamal TW, Khanfar A. Optimizing Recovery After Carpal Tunnel Syndrome Release Surgery: The Role of Counseling in Pain Management and Perioperative Functional Enhancement. J Multidiscip Healthc 2024; 17:971-980. [PMID: 38465327 PMCID: PMC10921890 DOI: 10.2147/jmdh.s451008] [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: 11/26/2023] [Accepted: 02/26/2024] [Indexed: 03/12/2024] Open
Abstract
Background Preoperative patient education is pivotal in improving patient outcomes during the perioperative phase, involving a thorough explanation of what patients can expect. This enhances adherence and reduces perioperative anxiety. In orthopedics, carpal tunnel syndrome, a common and painful hand condition, is effectively managed through surgical release under local anesthesia. Inadequate counseling before such procedures may intensify intraoperative anxiety and increase pain responses. Thus, this research aims to investigate the effects of comprehensive preoperative counseling on various parameters in carpal tunnel release surgery. Methods A case-control study design was adopted for this study. A retrospective analysis of patients who underwent carpal tunnel release surgery was performed. These patients were categorized into two distinct groups: one group received comprehensive counseling during their clinic visits, while the other group reported receiving less effective counseling. Evaluation encompassed patient-related factors, disease-related aspects, and perioperative variables for both groups. Results The study comprised 681 participants, with 526 (77.2%) being females, 421 (61.8%) undergoing surgery on the right side, and 519 (76.2%) employed in non-manual occupations. Moreover, 559 (82.1%) were non-smokers, while approximately two-thirds of the cohort had both diabetes and hypertension. The average age of participants was 52 years, and they reported a mean functional disability score of 7.2 out of 10. The comprehensive preoperative counseling group consisted of 333 patients, while the other group included 348 patients. The analysis revealed statistically significant differences between the two groups, including reduced intra-procedural anxiety (p = 0.043), decreased intraoperative pain (p = 0.005), lower rates of wound complications (p = 0.022), and improved self-reported pain relief (p = 0.3). Conclusion Our study emphasizes the crucial role of preoperative counseling in improving patient experiences during perioperative care, leading to reduced anxiety, milder pain responses, fewer complications, decreased reliance on postoperative pain medication, and increased self-reported pain relief. Level of Evidence Level III, Case-control retrospective study.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Sulaf Moh Al-Shibly
- Jordan University of Science and Technology School of Medicine, Irbid, Jordan
| | | | | | - Ahmad Alelaumi
- Jordan University Hospital, Orthopedic Department, Amman, Jordan
| | | | | | - Aws Khanfar
- Upper limb & Orthopedic Surgery Consultant, Jordan University Hospital, Amman, Jordan
| |
Collapse
|
6
|
Bur JA, Wilson NJ, Lewis PR, Missen K. Patient experiences during the planned perioperative care pathway: An integrative review. J Adv Nurs 2024. [PMID: 38294089 DOI: 10.1111/jan.16071] [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: 07/25/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
AIMS This integrative review aimed to synthesize evidence about the patients' experiences during the planned perioperative care pathway. DESIGN Integrative review. DATA SOURCES Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline Ovid, Scopus, and American Psychological Association (APA) PsychINFO. Original, peer-reviewed studies published in English between 2012 and 2023 exploring patient experiences during the planned perioperative care pathway were reviewed. METHODS This review was guided by the Whittemore and Knafl method and followed PRISMA guidelines to search the literature. Twenty-two articles were selected for the final study. RESULTS Three themes emerged: Sharing of information is empowering; interpersonal relationships are valued by patients, and hospital systems and care co-ordination influence the patient experience. CONCLUSIONS The quality and consistency of the information patients receive can both support and undermine patient confidence in health professionals. The quality of relationships that participants experience and effective communication with health professionals can support or compromise the quality of the patients' perioperative experience. The nature of the hospital systems and care co-ordination in hospital has implications for the quality of recovery from surgery. IMPACT This review evaluates whether national and international health services and organizations, adhering to the WHO guidelines, have developed and implemented intentionally focused perioperative care with the aims to achieving effective and sustainable surgical outcomes through increased patient satisfaction. NO PATIENT OR PUBLIC CONTRIBUTION This article is an integrative review and does not include patient or public contribution.
Collapse
Affiliation(s)
- J A Bur
- School of Nursing and Midwifery, Western Sydney University, Richmond, New South Wales, Australia
| | - N J Wilson
- School of Nursing and Midwifery, Western Sydney University, Richmond, New South Wales, Australia
| | - P R Lewis
- School of Nursing and Midwifery, Western Sydney University, Richmond, New South Wales, Australia
| | - K Missen
- School of Healthcare, Federation University, Churchill, Victoria, Australia
| |
Collapse
|
7
|
Wu M, Dai S, Wang R, Yang S. The relationship between uncertainty and acute procedure anxiety among surgical patients in Chinese mainland: the mediating role of resilience. BMC Psychiatry 2023; 23:796. [PMID: 37915033 PMCID: PMC10619271 DOI: 10.1186/s12888-023-05315-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Surgery, as one of the main diagnostic and treatment methods, is a routine work in medical settings. Patients undergoing surgery often experience acute procedure anxiety due to uncertainty. There is ample evidence showing that uncertainty is a risk factor for the acute procedure anxiety in surgical patients. However, little is known about the psychological processes mediating this relationship. Therefore, this study aims to evaluate resilience as a mediator of the association between uncertainty and anxiety. METHODS A population-based cross-sectional survey with a convenience sampling method was conducted, involving 243 surgical patients in Jiaxing, Zhejiang province of China was carried out. Relevant data were collected by self-reporting questionnaires, including demographic characteristics questionnaire, Amsterdam Preoperative Anxiety and Information Scale (APAIS-C), Mishel's Illness Uncertainty Scale (MUIS), Connor-Davidson Resilience Scale (CD-RISC). Pearson correlation analysis was employed to examine correlations between various variables. A path model was used to assess the mediation effect of resilience with respect to uncertainty and acute procedure anxiety. RESULTS In the path model, uncertainty have an indirect effect on acute procedure anxiety through resilience. The results suggest that resilience has a mediating role in uncertainty and acute procedure anxiety among surgical patients. CONCLUSIONS These findings call for the development of interventions targeting the role of resilience in effectively predicting and preventing acute procedure anxiety and uncertainty among surgical patients.
Collapse
Affiliation(s)
- Min Wu
- The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China
- The graduate school of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Suwan Dai
- The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China
- The graduate school of Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Rong Wang
- The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
| | - Silan Yang
- The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
| |
Collapse
|
8
|
Xing J, Gong C, Wu B, Li Y, Liu L, Yang P, Wang T, Hei Z, Zhou S, Chen C. Effect of an educational video about ERAS on reducing preoperative anxiety and promoting recovery. Heliyon 2023; 9:e20536. [PMID: 37842611 PMCID: PMC10568319 DOI: 10.1016/j.heliyon.2023.e20536] [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: 09/10/2022] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/17/2023] Open
Abstract
Video propaganda is reported effectively improving patients' understanding of operation. However, whether a video introducing patients' most concerns can reduce preoperative anxiety and promote recovery stays unsealed. In this study, we investigated the effects of complementary therapy of educational video during preoperative visit. The results showed that thirty-five (23.2%) parents in Group Control were diagnosed as anxiety according to SAS, and nineteen (12.3%) patients were diagnosed after video intervention. The APAIs anxiety score and APAIs information score in Group Video were lower than those in Group Control. Compared with Group Control, video visit helped to increase the first-attempt pass rate of the knowledge retention exam and solve the patient's most worried concerns, and decrease incidence of emergence agitation, total cost of hospitalization and length of hospital stay. Moreover, video visit improved satisfaction degrees of patients and their main family members. Briefly, our study demonstrated video visit can improve patients' knowledge of anesthesia and decrease their preoperative anxiety, which may represent an important complementary therapy to routine preoperative visits.
Collapse
Affiliation(s)
- Jibin Xing
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chulian Gong
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bin Wu
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, China
| | - Yanting Li
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liling Liu
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, China
| | - Panyang Yang
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Tienan Wang
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ziqing Hei
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shaoli Zhou
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chaojin Chen
- Department of Anaesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
9
|
Ju X, Feng J, Yang J, Ge L, Liu X. Factors influencing the preoperative anxiety in lung cancer patients undergoing video-assisted thoracoscopic surgery: The role of information needs, illness perception and patient trust. J Psychosom Res 2023; 172:111374. [PMID: 37302380 DOI: 10.1016/j.jpsychores.2023.111374] [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: 02/20/2023] [Revised: 04/14/2023] [Accepted: 05/10/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to investigate preoperative anxiety in patients with lung cancer scheduled for video-assisted thoracoscopic surgery (VATS) and explore the influence of demographic factors, information needs, illness perception, and patient trust in preoperative anxiety. METHODS This cross-sectional study was conducted at a tertiary referral center in China from August 14 to December 1, 2022. Patients with lung cancer (N = 308) scheduled for VATS were evaluated using the Amsterdam Anxiety and Information Scale (APAIS), Brief Illness Perception Questionnaire (BIPQ), and Wake Forest Physician Trust Scale (WFPTS). Multivariate linear regression was employed to determine the independent predictors of preoperative anxiety. RESULTS The average total APAIS anxiety score was (10.6 ± 4.2). Of the sample, 48.4% reported high preoperative anxiety (APAIS-A: ≥10). Multivariate linear regression analysis showed that preoperative anxiety was higher in women (B = 0.860); and that preoperative length of stay ≥24 h (B = 0.016), more information needs (B = 0.988), more severe illness perceptions (B = 0.101) and more patient trust (B = -0.078) may lead to higher preoperative anxiety levels. CONCLUSIONS Preoperative anxiety is common in patients with lung cancer scheduled for VATS. Therefore, more attention should be paid to women and patients with a preoperative length of stay of ≥24 h. Meeting information needs, transforming positive disease perceptions, and strengthening the doctor-patient trusting relationship are key protective factors for preoperative anxiety.
Collapse
Affiliation(s)
- Xinxing Ju
- Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jing Feng
- Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jie Yang
- Department of Day Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Ling Ge
- Department of Day Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xiaoxin Liu
- Nursing Department, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China.
| |
Collapse
|
10
|
Shen H, Masingboon K, Samartkit N. Factors related to preoperative uncertainty among patients with breast cancer in Wenzhou, China: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:236-243. [PMID: 37492757 PMCID: PMC10363974 DOI: 10.33546/bnj.2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/30/2023] [Accepted: 06/02/2023] [Indexed: 07/27/2023] Open
Abstract
Background One of the most prevalent psychological signs of breast cancer is uncertainty, which is more prevalent in Chinese patients during the preoperative period. Despite the numerous factors contributing to preoperative uncertainty, there is limited relevant research conducted in China. Objective This study aimed to describe the current state of preoperative uncertainty and to investigate the relationship between anxiety, illness perception, social support, and preoperative uncertainty in patients with breast cancer in Wenzhou, China. Methods This cross-sectional research used a simple random sampling technique to select 122 participants from a university hospital in Wenzhou, China, from July 2022 to December 2022, employing validated instruments. Descriptive statistics and Pearson's correlation coefficient were utilized to analyze the data. Results The average preoperative uncertainty scores of the patients fell within a moderate range (M = 61.92, SD = 7.51). Significant correlations were found between anxiety (r = 0.638, p <0.01), illness perception (r = 0.704, p <0.01), social support (r = -0.481, p <0.01), and preoperative uncertainty. Conclusions The results can assist healthcare professionals, especially nurses, in recognizing the factors contributing to uncertainty before surgery in patients with breast cancer. This knowledge enables them to promptly address and minimize this issue, leading to improved outcomes.
Collapse
Affiliation(s)
- Huaiyu Shen
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | | | | |
Collapse
|
11
|
Garcia De Avila MA, Prata RA, Jacob FLDS, Nóbrega FMDO, De Barros GR, Sugiura BMG. Educational intervention through a comic book for preoperative anxiety in children, adolescents, and their parents: A randomized clinical trial. J Pediatr Nurs 2022; 67:e208-e214. [PMID: 35871148 DOI: 10.1016/j.pedn.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Reducing preoperative anxiety can help optimize surgical care. AIM To analyze the effectiveness of verbal guidance by nurses versus verbal guidance combined with a comic book on preoperative anxiety in children and their parents. METHODS We conducted a randomized parallel, two-group controlled clinical trial in the pediatric ward and a blinded anxiety assessment in the operating room of a Brazilian hospital. Individuals aged 6-14 years undergoing surgical procedures of up to 4 h for the first time were included in the study. Parents who were adults, literate, and able to communicate verbally were included. The primary outcome was the children's anxiety, measured by the Children Anxiety Questionnaire (CAQ), Visual Analog Scale (VAS), and the modified Yale Preoperative Anxiety Scale (mYPAS); the secondary outcome was the parents' anxiety, assessed by the Hamilton Anxiety Rating Scale. Participants were divided into the intervention (IG; n = 60) and control (CG; n = 60) groups. FINDINGS The two groups were homogeneous. The median age of the children was 8 years. No significant differences were observed in the CAQ and VAS scores between the two assessment time points or in the mYPAS scores between the IG and CG. However, parents' anxiety significantly decreased in both groups. APPLICATION TO PRACTICE Preoperative guidance by nurses, either verbal only or verbal information with a comic book proved beneficial in reducing parental anxiety. However, both interventions, performed on the day of surgery, failed to reduce preoperative anxiety in children and adolescents upon admission to the operating room. We recommended the process of preparing the child should begin after scheduling the surgery.
Collapse
Affiliation(s)
| | - Rafaela Aparecida Prata
- Department of Nursing, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, Brazil
| | | | | | | | | |
Collapse
|
12
|
Ng CH, Lim WH, Chin YH, Yong JN, Zeng RW, Chan KE, Tan DJH, Fu CE, Tang ASP, Goh LH, Devi K, Chew NWS, Mak LYL, Tamaki N, Huang DQ, Noureddin M, Siddiqui MS, Loomba R, Sanyal AJ, Muthiah M. Living in the non-alcoholic fatty liver disease silent epidemic: a qualitative systematic review of patients' perspectives. Aliment Pharmacol Ther 2022; 56:570-579. [PMID: 35791632 DOI: 10.1111/apt.17121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/04/2022] [Accepted: 06/22/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) affects one-fourth of the global population. Yet, the care of these patients is limited and awareness of NAFLD remains low in the general public. Investigations into the lives of these patients are often forgotten and traditional quantitative studies only paint part of the picture. AIM To assess the first-hand accounts of these individuals and their perspective on living with NAFLD. METHODS A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO and Web of Science database for qualitative literature regarding patients' perspectives on NAFLD. An inductive thematic analysis was conducted to generate themes and supportive subthemes. RESULTS We incuded eight articles in the review. There were three major themes including the impact on the quality of life, knowledge and information, and attitudes and perceptions on care. The impact of the quality of life details the emotional and physical distress of NAFLD. Knowledge and information include the lack of sufficient communication between healthcare providers and patients with a distinct knowledge gap. Attitudes and perceptions on care extrapolate the current active participation of patients and needs of the patients and the future care that they desire. CONCLUSION This review synthesises first-hand accounts of individuals with NAFLD. With the growing burden of NAFLD, future public interventions must consider individual views for success to be found. The identified themes serve as a forefront for consideration for public policies. Ultimately, NAFLD is a multisystem disease, which must be managed by a multidisciplinary team.
Collapse
Affiliation(s)
- Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jie Ning Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Darren Jun Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Clarissa Elysia Fu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ansel Shao Pin Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lay Hoon Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kamala Devi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas W S Chew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore
| | - Lung-Yi Loey Mak
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Nobuharu Tamaki
- NAFLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California at San Diego, San Diego, California, USA.,Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Daniel Q Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore.,National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Mazen Noureddin
- Cedars-Sinai Fatty Liver Program, Division of Digestive and Liver Diseases, Department of Medicine, Comprehensive Transplant Center, Cedars-Sinai Medical Centre, Los Angeles, California, USA
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California at San Diego, San Diego, California, USA
| | - Arun J Sanyal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mark Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore.,National University Centre for Organ Transplantation, National University Health System, Singapore
| |
Collapse
|
13
|
Novel Patient-Reported Outcome Measures for the Assessment of Patient Satisfaction and Health-Related Quality of Life Following Postmastectomy Breast Reconstruction. Aesthetic Plast Surg 2022; 46:1588-1599. [PMID: 35879476 DOI: 10.1007/s00266-022-02985-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 06/04/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) have become an integral part of the evaluation of reconstruction surgery outcomes. However, there are limitations in current PROMs when it comes to the assessment of well-being during inpatient stay, patient perception of health, relationship with partner, and vitality (i.e., mood and ability to work and pursue hobbies, carry out daily tasks, and sleep) following breast reconstructive surgery. The aim was to develop a novel set of measures to compare patient satisfaction and health-related quality of life following different types of postmastectomy breast reconstruction. METHODS A novel questionnaire was created and refined through cognitive interviews with patients and expert feedback. A field test study was conducted, including patients who had undergone delayed postmastectomy breast reconstruction with implant, autologous tissue, or combination of implant and autologous tissue. Based on the results, confirmatory factor analysis and examination of reliability of the questionnaire were conducted. Results of patient responses were analyzed using Chi-square test, Kruskal-Wallis test, and Mann-Whitney U test. RESULTS Confirmatory factor analysis showed good model fit, and Cronbach's alpha indicated high internal consistency of the questionnaire. Besides that, patients with combination reconstruction reported significantly lower vitality than patients with implant and autologous reconstruction (p = 0.048). CONCLUSIONS This novel questionnaire expands the current knowledge base of postmastectomy breast reconstruction PROMs. Results of the field test study showed that combination reconstruction was associated with lower patient vitality than other reconstruction types. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
|
14
|
Petrescu M, Popa F, Purcărea VL. How could perioperative anxiety be addressed via surgical team communication approaches? Findings from a scoping review. Hosp Pract (1995) 2022; 50:159-169. [PMID: 35345958 DOI: 10.1080/21548331.2022.2059979] [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: 10/18/2022]
Abstract
OBJECTIVES Surgical patients and their families experience high rates of perioperative anxiety, which determine a negative impact on their surgery-related outcomes. Understanding what communicational aspects positively impact perioperative anxiety may help promote more efficient, patient-centered communication approaches which could address this issue. The aim of this scoping review was to synthesize published research on communication between surgical employees and adult patients and their relatives, and its role in managing perioperative anxiety. METHODS A scoping review approach was used across four international databases to search for publications detailing communicational interventions and approaches employed in surgical contexts and their impact on surgical patients' and their caregivers' perioperative anxiety levels. Results were narratively synthesized. RESULTS Twenty-two studies were included in this scoping review, which were grouped according to their communication intervention into one of five categories: technology-assisted interventions, interpersonal communication, educational programs, tools for facilitating exchange of information and theory-derived communication strategies. Records reported mixed results in terms of reducing perioperative anxiety. Facilitating and hindering factors in interpersonal communication in this context were further synthesized. CONCLUSION A multitude of communicational approaches and their effect on anxiety have been investigated within surgical settings, with varying results. Existing evidence suggests that it is vital to address surgical patients' anxiety through personalized empathetic communication, tailored to an individual's case, preferences, and needs. Key aspects of patient-healthcare professional communication which may impact perioperative anxiety were identified and may be utilized in future trainings for communication skills among surgical teams.
Collapse
Affiliation(s)
- Mariana Petrescu
- Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Florian Popa
- Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | | |
Collapse
|