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Holzer KJ, Bollepalli H, Carron J, Yaeger LH, Avidan MS, Lenze EJ, Abraham J. The impact of compassion-based interventions on perioperative anxiety and depression: A systematic review and meta-analysis. J Affect Disord 2024; 365:476-491. [PMID: 39182519 DOI: 10.1016/j.jad.2024.08.110] [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: 03/12/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND The perioperative period can be a stressful time for many patients. Concerns for the procedure or fearing potential complications contribute to perioperative anxiety and depression, which significantly impact patient wellbeing and recovery. Understanding the psychological impact of the perioperative period can inform individualized care focused on each patient's unique stressors. Compassion-based interventions are limited but have shown benefits in non-surgical healthcare settings, and can provide support by prioritizing empathy and understanding in the perioperative period. This review evaluates the impact of compassion-based interventions on anxiety and depression among adult surgical patients. METHODS A systematic review of 25 randomized controlled trials was conducted with a meta-analysis of 14 studies for anxiety and 9 studies for depression that provided sufficient information. RESULTS The included studies tested compassion-based interventions that focused on enhanced communication, emotional support, and individualized attention from healthcare professionals. In 72 % of the studies, the interventions decreased anxiety and depression, compared to control groups. These interventions improved health-related outcomes such patient satisfaction and postoperative complications. The meta-analysis indicated a large effect of the compassion-based interventions for anxiety (g = -0.95) and depressive symptoms (g = -0.82). The findings were consistent among various surgeries and patient populations. LIMITATIONS Many of the included studies lacked clarity in their methods and only 14 studies provided sufficient information for the meta-analysis. CONCLUSIONS Given the growing evidence suggesting that compassion-based psychological interventions are feasible and applicable in the perioperative setting, their inclusion in routine care could reduce depression and anxiety around surgery and improve patient outcomes and experiences.
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Affiliation(s)
- Katherine J Holzer
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
| | | | | | - Lauren H Yaeger
- Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael S Avidan
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Joanna Abraham
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA; Institute for Informatics, Data Science and Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
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2
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Rivera PA, Linderman WL, Miguez S, Chow J, DeBroff B, Diaz V. Music during cataract surgery: effect on anxiety. J Cataract Refract Surg 2024; 50:688-692. [PMID: 38499999 DOI: 10.1097/j.jcrs.0000000000001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/13/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE To determine the effect of playing patient-selected music intraoperatively on patient self-reported anxiety and the amount of sedative administered during cataract surgery. SETTING Yale New Haven Hospital health system, New Haven, Connecticut. DESIGN Prospective, randomized, controlled clinical trial. METHODS Patients were randomized to either a music group or a control group, which had no music played. Patients were blinded to the purpose of the study. On postoperative day 1, patients were consented to participate in the study and asked to complete a 6-question Likert-style survey (modified from the State-Trait Anxiety Inventory) assessing anxiety at baseline and during surgery. Patients' intraoperative and postoperative vitals were recorded. The medication, dosage, and number of sedative injections given were also recorded. Paired t tests were used to assess for significant differences between the 2 groups. RESULTS 107 patients (mean age 71.2 years) were enrolled in the study. There was no significant difference in baseline anxiety between the 2 groups. Patients randomized to the music group had significantly lower total self-reported anxiety (mean 5.98) than the control group (mean 7.13, P = .006). Moreover, patients exposed to music felt significantly less frightened, nervous, and confused during surgery ( P = .002, .007, and 0.017, respectively). There was no significant difference between the groups in number and dosage of sedatives given. CONCLUSIONS Playing patient-selected music during cataract surgery is an effective way to decrease anxiety. Music directly affects patient experience and is an inexpensive, low-risk method of reducing patient anxiety during surgery.
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Affiliation(s)
- Paola A Rivera
- From the Department of Ophthalmology and Visual Sciences, Yale University, New Haven, Connecticut (Rivera, Chow, DeBroff, Diaz); Massachusetts Eye and Ear/Harvard Medical School, Boston, Massachusetts (Linderman); School of Medicine, Yale University, New Haven, Connecticut (Miguez)
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Willinge GJA, Spierings JF, Geerdink TH, Twigt BA, Goslings JC, van Veen RN. The effects of a Virtual Fracture Care review protocol on secondary healthcare utilization in trauma patients requiring semi-acute surgery: a retrospective cohort study. Front Digit Health 2024; 6:1362503. [PMID: 38952744 PMCID: PMC11215198 DOI: 10.3389/fdgth.2024.1362503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/21/2024] [Indexed: 07/03/2024] Open
Abstract
Purpose The demand for trauma care in the Netherlands is increasing due to a rising incidence of injuries. To provide adequate trauma care amidst this increasing pressure, a Virtual Fracture Care (VFC) review protocol was introduced for treatment of musculoskeletal injuries to the extremities (MIE). This study aimed to assess the influence of the Dutch VFC review protocol on secondary healthcare utilization (i.e., follow-up appointments and imaging) in adult trauma patients (aged ≥18 years) who underwent semi-acute surgery (2-14 days after initial presentation) for MIE, compared to traditional workflows. We hypothesized utilization of VFC review would lead to reduced secondary healthcare utilization. Methods This retrospective cohort study assessed the influence of VFC review on secondary healthcare utilization in adult trauma patients (aged ≥18 years) who underwent semi-acute surgery for a MIE. Patients treated before VFC review and the COVID-19 pandemic, from 1st of July 2018 to 31st of December 2019, formed a pre-VFC group. Patients treated after VFC review implementation from January 1st 2021 to June 30th 2022, partially during and after the COVID-19 pandemic (including distancing measures), formed a VFC group. Outcomes were follow-up appointments, radiographic imaging, time to surgery, emergency department reattendances, and complications. The study was approved by the local ethical research committee approved this study (WO 23.073). Results In total, 2,682 patients were included, consisting of 1,277 pre-VFC patients, and 1,405 VFC patients. Following VFC review, the total number of follow-up appointments reduced by 21% and a shift from face-to-face towards telephone consultations occurred with 19% of follow-up appointments performed by telephone in the VFC group vs. 4% in the pre-VFC group. Additionally, VFC review resulted in a 7% reduction of radiographs, improved time scheduling of surgery, and a 56% reduction of emergency department reattendances. Registered complication rates remained similar. Conclusion The utilization of VFC review for management of adult patients with a MIE requiring semi-acute surgery improves efficiency compared to traditional workflows. It results in a 21% follow-up appointment reduction, a shift from face-to-face to remote delivery of care, fewer radiographs, improved time scheduling of surgery, and reduces emergency department reattendances by 56%.
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Affiliation(s)
| | - J. F. Spierings
- Department of Trauma Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
| | - T. H. Geerdink
- Department of Trauma Surgery, OLVG Hospital, Amsterdam, Netherlands
| | - B. A. Twigt
- Department of Trauma Surgery, OLVG Hospital, Amsterdam, Netherlands
| | - J. C. Goslings
- Department of Trauma Surgery, OLVG Hospital, Amsterdam, Netherlands
| | - R. N. van Veen
- Department of Trauma Surgery, OLVG Hospital, Amsterdam, Netherlands
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Zijlstra E, van der Zwaag B, Kullak S, Rogers A, Walker D, van Dellen S, Mobach M. A randomized controlled trial of Golden Ratio, Feng Shui, and evidence based design in healthcare. PLoS One 2024; 19:e0303032. [PMID: 38837979 PMCID: PMC11152261 DOI: 10.1371/journal.pone.0303032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/11/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND In a global effort to design better hospital buildings for people and organizations, some design principles are still surrounded by great mystery. The aim of this online study was to compare anxiety in an existing single-bed inpatient hospital room with three redesigns of this room in accordance with the principles of Golden Ratio, Feng Shui, and Evidence-Based Design. METHODS In this online multi-arm parallel-group randomized trial participants were randomly assigned (1:1:1:1) to one of four conditions, namely Golden Ratio condition, Feng Shui condition, Evidence-Based Design condition, or the control condition. The primary outcomes were anxiety, sense of control, social support, positive distraction, and pleasantness of the room. FINDINGS Between June 24, 2022, and August 22, 2022, 558 individuals were randomly assigned to one of the four conditions, 137 participants to the control condition, 138 participants to the Golden Ratio condition, 140 participants to the Feng Shui condition, and 143 participants to the Evidence-Based Design condition. Compared with baseline, participants assigned to the Evidence-Based Design condition experienced less anxiety (mean difference -1.35, 95% CI -2.15 to -0.55, Cohen's d = 0.40, p < 0.001). Results also showed a significant indirect effect of the Feng Shui condition on anxiety through the pleasantness of the room (B = -0.85, CI = -1.29 to -0.45) and social support (B = -0.33, CI = -0.56 to -0.13). Pleasantness of the room and social support were mediators of change in anxiety in the Evidence-Based Design and Feng Shui conditions. In contrast, application of the design principle Golden Ratio showed no effect on anxiety and remains a myth. INTERPRETATION To our knowledge, this is the first randomized controlled trial linking design principles directly to anxiety in hospital rooms. The findings of our study suggest that Feng Shui and Evidence-Based Design hospital rooms can mitigate anxiety by creating a pleasant looking hospital room that fosters access to social support. CLINICAL TRIAL REGISTRATION The trial is registered with ISRCTN, ISRCTN10480033.
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Affiliation(s)
- Emma Zijlstra
- Research Group Facility Management, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Bart van der Zwaag
- Research Group Facility Management, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Sabine Kullak
- International Feng Shui Association, Singapore, Singapore
| | - Ab Rogers
- Ab Rogers Design, London, United Kingdom
| | | | - Sjoukje van Dellen
- Research Group Facility Management, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Mark Mobach
- Research Group Facility Management, Hanze University of Applied Sciences, Groningen, The Netherlands
- Research Group Spatial Environment and the User, The Hague University of Applied Sciences, The Hague, The Netherlands
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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.
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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
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Ghobadi A, Moradpoor H, Sharini H, Khazaie H, Moradpoor P. The effect of virtual reality on reducing patients' anxiety and pain during dental implant surgery. BMC Oral Health 2024; 24:186. [PMID: 38317209 PMCID: PMC10845398 DOI: 10.1186/s12903-024-03904-8] [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: 10/27/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Dental anxiety and pain pose serious problems for both patients and dentists. One of the most stressful and frightening dental procedures for patients is dental implant surgery; that even hearing its name causes them stress. Virtual reality (VR) distraction is an effective intervention used by healthcare professionals to help patients cope with unpleasant procedures. Our aim is to evaluate the use of high-quality VR and natural environments on dental implant patients to determine the effect on reducing pain and anxiety. METHODS Seventy-three patients having two dental implant surgeries participated in a randomized controlled trial. One surgery was with VR, and one was without. Anxiety was measured with the the State-Trait Anxiety Inventory and the Modified Dental Anxiety Scale tests. The pain was measured with the Numerical Rating Scales. Patient satisfaction, surgeon distress, memory vividness, and time perception were evaluated. Physiological data were collected with biofeedback and neurofeedback device. RESULTS VR effectively reduced anxiety and pain compared to no VR. Physiological data validated the questionnaire results. Patient satisfaction increased, with 90.4% willing to reuse VR. VR reduced time perception and memory vividness. CONCLUSION Psychometric and psychophysiological assessments showed that VR successfully reduced patient pain and anxiety. More dental clinicians should use VR technology to manage patient anxiety and pain.
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Affiliation(s)
- Alireza Ghobadi
- Students Research Committee, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hedaiat Moradpoor
- Department of Prosthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Hamid Sharini
- Department of Biomedical Engineering, Faculty of Medicine, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Pooya Moradpoor
- Department of business management, Central Tehran branch, Islamic Azad University, Tehran, Iran
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Sommer JL, Reynolds K, Hebbard P, Smith MSD, Mota N, Mutch WAC, Maples-Keller J, Roos L, El-Gabalawy R. Preoperative Virtual Reality to Expose Patients With Breast Cancer to the Operating Room Environment: Feasibility and Pilot Case Series Study. JMIR Form Res 2024; 8:e46367. [PMID: 38231570 PMCID: PMC10831694 DOI: 10.2196/46367] [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: 02/08/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Clinically elevated preoperative distress and anxiety are common among patients undergoing cancer surgery. Preoperative interventions have been developed to mitigate this distress and anxiety but are inconsistent in efficacy and feasibility for broad implementation. OBJECTIVE This preliminary pilot study aims to assess the feasibility and utility of a newly developed virtual reality (VR) intervention to expose patients awaiting breast cancer surgery to the operating room environment and a simulation of anesthetic induction. METHODS Patients undergoing breast cancer surgery (N=7) were assigned to the VR intervention or control (treatment as usual) group and completed self-report measures of distress and anxiety before surgery, on the day of surgery, and after surgery (5 and 30 d postoperatively). Those in the intervention group trialed the VR simulation 1 to 2 weeks preoperatively and provided qualitative and quantitative feedback. We assessed the feasibility of recruitment capability and study design and evaluated participants' impressions of the intervention using self-report rating scales and open-ended questions. We also descriptively examined distress and anxiety levels throughout the duration of the study. RESULTS Recruitment occurred between December 2021 and December 2022 and progressed slowly (rate: 1 participant/7 wk on average; some hesitancy because of stress and being overwhelmed). All participants who consented to participate completed the entire study. All participants were female and aged 56 (SD 10.56) years on average. In total, 57% (4/7) of the participants were assigned to the intervention group. On average, intervention participants spent 12 minutes engaged in the VR simulation. In general, the intervention was rated favorably (eg, clear information, enjoyable, and attractive presentation; mean% agreement 95.00-96.25, SD 4.79-10.00) and as helpful (mean% agreement 87.50, SD 25.00). Participants described the intervention as realistic (eg, "It was realistic to my past surgical experiences"), impacting their degree of preparedness and expectations for surgery (eg, "The sounds and sights and procedures give you a test run; they prepare you for the actual day"), and having a calming or relaxing effect (eg, "You feel more relaxed for the surgery"). CONCLUSIONS This preoperative VR intervention demonstrated preliminary feasibility among a sample of patients undergoing breast cancer surgery. Results and participant feedback will inform modifications to the VR intervention and the study design of a large-scale randomized controlled trial to examine the efficacy of this intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT04544618; https://clinicaltrials.gov/study/NCT04544618.
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Affiliation(s)
- 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
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Hebbard
- Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
| | | | - Natalie Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - W Alan C Mutch
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jessica Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Leslie Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
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Liu L, Xiao YH, Zhou XH. Effects of humanized nursing care on negative emotions and complications in patients undergoing hysteromyoma surgery. World J Clin Cases 2023; 11:6763-6773. [PMID: 37901016 PMCID: PMC10600858 DOI: 10.12998/wjcc.v11.i28.6763] [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: 06/20/2023] [Revised: 07/13/2023] [Accepted: 08/29/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Uterine fibroids, are prevalent benign tumors affecting women of reproductive age. However, surgical treatment is often necessary for symptomatic hysteromyoma cases. This study examines the impact of humanized nursing care on reducing negative emotions and postoperative complications in patients receiving hysteromyoma surgery. AIM To investigate the impact of humanized nursing care on patients undergoing hysteromyoma surgery. METHODS Among patients who underwent hysteromyoma surgery at the Fudan University Affiliated Obstetrics and Gynecology Hospital, 200 were randomly assigned to either the control group (n = 100) or the humanized nursing care group (n = 100). The control group received traditional nursing care, while the humanized nursing care group received a comprehensive care plan encompassing psychological support, pain management, and tailored rehabilitation programs. In addition, anxiety and depression levels were assessed using the hospital anxiety and depression scale preoperatively and postoperatively. Postoperative complications were evaluated during follow-up assessments and compared between both groups. RESULTS The humanized nursing care group demonstrated a significant decrease in anxiety and depression levels compared to the control group (P < 0.05). The rate of postoperative complications, including infection, bleeding, and deep venous thrombosis, was also markedly lower in the humanized nursing care group (P < 0.05). CONCLUSION Humanized nursing care can effectively alleviate negative emotions and reduce the incidence of postoperative complications in patients undergoing hysteromyoma surgery. This approach should be considered a crucial component of perioperative care for these patients. Further research may be needed to explore additional benefits and long-term outcomes of implementing humanized nursing care in this population.
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Affiliation(s)
- Li Liu
- Operating Room, Fudan University Affiliated Obstetrics and Gynecology Hospital, Shanghai 200092, China
| | - Ya-Hong Xiao
- Operating Room, Cardiovascular Hospital of The Second Affiliated Hospital of Hainan Medical College, Haikou 571199, Hainan Province, China
| | - Xue-Hua Zhou
- Department of Nursing, Chongzuo People's Hospital, Chongzuo 532200, Guangxi Zhuang Autonomous Region, China
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Chiu PL, Li H, Yap KYL, Lam KMC, Yip PLR, Wong CL. Virtual Reality-Based Intervention to Reduce Preoperative Anxiety in Adults Undergoing Elective Surgery: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2340588. [PMID: 37906193 PMCID: PMC10618840 DOI: 10.1001/jamanetworkopen.2023.40588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
IMPORTANCE Preoperative anxiety is common among adult patients undergoing elective surgery and is associated with negative outcomes. Virtual reality (VR)-based interventions have been considered simpler, safer, and more effective for reducing anxiety in patients undergoing surgery than conventional care. OBJECTIVE To examine the effectiveness of a VR-based intervention with preoperative education in reducing preoperative anxiety among adult patients undergoing elective surgery. DESIGN, SETTING, AND PARTICIPANTS An assessor-blinded prospective randomized clinical trial was conducted to recruit adult patients aged 18 years or older who were scheduled for their first elective surgery procedure under general anesthesia within the next 2 to 4 weeks at a preanesthesia assessment clinic in Hong Kong from July to December 2022. INTERVENTIONS Participants were randomly assigned to either an intervention group (an 8-minute immersive 360° VR video tour in the operating theater via a head-mounted display console) or a control group (standard care). MAIN OUTCOMES AND MEASURES The primary outcome of preoperative anxiety was measured using the Amsterdam Preoperative Anxiety and Information Scale (range, 6-30; higher scores indicate greater anxiety), and the secondary outcomes (ie, stress, preparedness, and pain) were assessed by Visual Analog Scale at 3 time points: baseline at beginning of clinical session (T0), at the end of the clinical session immediately after the intervention (T1), and before the surgery (T2). Pain, satisfaction levels, and postoperative length of stay were evaluated after the surgery (T3). Simulation sickness was assessed after the intervention by use of the Simulation Sickness Questionnaire. A generalized estimating equations model was applied to compare changes in outcomes over time. RESULTS A total of 74 participants (mean [SD] age, 46.34 [14.52] years; 38 men [51.4%] and 36 women [48.6%]) were recruited and randomized to the control group (37 participants) and intervention group (37 participants). Compared with the control group, the VR-based intervention group showed significantly decreased preoperative anxiety at T1 (β, -5.46; 95% CI, -7.60 to -3.32; P < .001) and T2 (β, -5.57; 95% CI, -7.73 to -3.41; P < .001), lower stress at T1 (β, -10.68; 95% CI, -16.00 to -5.36; P < .001) and T2 (β, -5.16; 95% CI, -9.87 to -0.45; P = .03), and higher preparedness at T1 (β, 6.60; 95% CI, 0.97 to 12.19; P = .02). Satisfaction levels were significantly increased in the intervention group vs the control group (mean [SD] score, 81.35 [9.24] vs 65.28 [8.16]; difference, 16.07; 95% CI, 12.00 to 20.15; P < .001). No significant differences in pain and postoperative length of stay were found. CONCLUSIONS AND RELEVANCE The findings of this study suggest that a VR-based intervention is a feasible and effective way to reduce preoperative anxiety in adult patients undergoing elective surgery. Given the promising results of this study, further study in the form of large-scale, multicenter, randomized clinical trials with broader implementation is warranted. TRIAL REGISTRATION Chinese Clinical Trial Registry Identifier: ChiCTR2100051690.
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Affiliation(s)
- Pak Lung Chiu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kevin Yi-Lwern Yap
- Department of Pharmacy, Singapore General Hospital, Singapore
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Ka-man Carmen Lam
- Department of Anaesthesia and Operating Theatre Services, Hospital Authority New Territories West Cluster, Hong Kong SAR, China
| | - Pui-ling Renee Yip
- Department of Anaesthesia and Operating Theatre Services, Hospital Authority New Territories West Cluster, Hong Kong SAR, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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10
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Najafali D, Dorafshar AH. Commentary on: Evaluating Chatbot Efficacy for Answering Frequently Asked Questions in Plastic Surgery: A ChatGPT Case Study Focused on Breast Augmentation. Aesthet Surg J 2023; 43:1136-1138. [PMID: 37287210 DOI: 10.1093/asj/sjad186] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/09/2023] Open
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11
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Lagattolla F, Zanchi B, Pietro M, Cormio C, Lorusso V, Diotaiuti S, Fanizzi A, Massafra R, Costanzo S, Caporale F, Rieti E, Romito F. Receptive music therapy versus group music therapy with breast cancer patients hospitalized for surgery. Support Care Cancer 2023; 31:162. [PMID: 36781543 PMCID: PMC9924845 DOI: 10.1007/s00520-023-07624-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
Hospitalization for breast surgery is a distressing experience for women. This study investigated the impact of music therapy (MT), an integrative approach that is characterized by the establishment of a therapeutic relationship between patients and a certified music therapist, through different musical interventions targeted to the specific needs of the patients. The impact of two different MT experiences was compared on anxiety and distressing emotions. METHODS One hundred fifty-one patients during hospitalization for breast surgery were randomly assigned to two music therapy treatment arms: individual/receptive (MTri) vs. group/active-receptive integrated (MTiGrp). Stress, depression, anger, and need for help were measured with the emotion thermometers (ET) and State Trait Anxiety Inventory Y-1 form (STAY-Y1). Data were collected before and after the MT intervention. RESULTS Both types of MT interventions were effective in reducing all the variables: stress, depression, anger, and anxiety (T Student p‹0.01). Patients' perception of help received was correlated with a significant reduction in anxiety and distressing emotions during hospitalization for breast surgery. CONCLUSION Considerations regarding the implementation of MT interventions in clinical practice are discussed. In individual receptive MT, there was a significant decrease in anxiety levels, whereas in the integrated MT group, there was a higher perception of help received and use of inter-individual resources.
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Affiliation(s)
- Fulvia Lagattolla
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Barbara Zanchi
- Department of Music Therapy, Conservatorio Di Musica “Bruno Maderna”, Cesena, Italy
| | - Milella Pietro
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
- Direzione Sanitaria, IRCCS Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Claudia Cormio
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Vito Lorusso
- Unità Operativa Complessa Di Oncologia Medica, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Sergio Diotaiuti
- Unità Operativa Complessa Di Chirurgica Senologica Plastica E Ricostruttiva, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Annarita Fanizzi
- Struttura Semplice Dipartimentale Di Fisica Sanitaria, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Raffaella Massafra
- Struttura Semplice Dipartimentale Di Fisica Sanitaria, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Silvia Costanzo
- Oncologia sperimentale - Centro Studi Tumori Eredo-Familiari, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Francesca Caporale
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Erika Rieti
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Francesca Romito
- Servizio Di Psiconcologia, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
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12
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van der Linde-van den Bor M, Frans-Rensen SA, Slond F, Liesdek OC, de Heer LM, Suyker WJ, Jaarsma T, Weldam SW. Patients' voices in the development of pre-surgical patient education using virtual reality: A qualitative study. PEC INNOVATION 2022; 1:100015. [PMID: 37213731 PMCID: PMC10194275 DOI: 10.1016/j.pecinn.2021.100015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 05/23/2023]
Abstract
Objective To identify the information needs and perceptions of patients regarding the application of virtual reality in pre-surgical patient education. Methods A qualitative study was conducted between March and July 2020. The study population consisted of a purposive sample of patients scheduled for cardiac surgery from a single institution. Semi-structured individual interviews (n=19) were conducted and analysed using thematic analysis. Results Patient perceptions regarding virtual reality and information needs related to hospitalisation and surgery could be categorised into three themes: Creating familiarity, contents to explore and challenges and preconditions. Conclusions Virtual reality technology is a promising tool that can enhance conventional patient education to improve understanding and to potentially reduce concerns and anxieties. The virtual reality environment creates an opportunity for patients to be in control of the timing, quantity, depth and frequency of patient education. A virtual reality education tool should not be a substitute for personal contact with the physician. Innovation Patient information needs were identified profoundly to the further development of a virtual reality intervention. This intervention aims to educate patients prior to elective cardiac surgery.
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Affiliation(s)
| | - Sarah A. Frans-Rensen
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Fiona Slond
- Utrecht University Medical Centre, Centre for Education, Department of Technology Enhanced Learning, Utrecht, The Netherlands
| | - Omayra C.D. Liesdek
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Linda M. de Heer
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Willem J.L. Suyker
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Tiny Jaarsma
- Utrecht University Medical Centre, Julius Centre for Health Sciences and Primary Care, Utrecht, The Netherlands
- Linkoping University, Department of Health, Medicine and Caring Services, Linkoping, Sweden
| | - Saskia W.M. Weldam
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
- Corresponding author at: Heart and Lung Department, Utrecht University Medical Centre (UMC Utrecht), Internal PO E03.511, PO Box 85500, 3508 GA Utrecht, The Netherlands.
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Does virtual reality in the perioperative setting for patient education improve understanding? A scoping review. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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14
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Stoneham S, Coltart GS, Healy E. Does music reduce anxiety for patients undergoing dermatological surgery? A systematic review. Clin Exp Dermatol 2022; 47:1686-1693. [PMID: 35594168 DOI: 10.1111/ced.15264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The incidence of skin cancer is increasing globally, leading to a greater need for dermatologists to perform skin surgery. However, skin surgery can be a potentially stressful experience for patients due to the fear of a possible cancer diagnosis coupled with anxiety related to pain and cosmetic outcomes. AIM To examine whether there is any evidence to support the hypothesis that listening to music during dermatological surgery under local anaesthesia can help reduce patient anxiety. METHODS This systematic review considered all original research published until May 2020. Four relevant studies were identified, comprising a total of 381 patients (three randomized control trials and one case-control trial). RESULTS Two of the four studies showed a significant reduction in perioperative anxiety in patients who had listened to music during surgery. Both of the other studies showed no statistically significant difference between music and no music for patients, although one of these noted reduced anxiety in surgeons. CONCLUSION There is currently limited evidence to support the use of perioperative music in clinical practice to reduce anxiety in skin surgery. However, given the potential benefits and the likely limited costs of this simple intervention, we believe that further research on this topic is warranted.
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Affiliation(s)
- Sophie Stoneham
- Department of Dermatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - George Stewart Coltart
- Department of Dermatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Department of Dermatopharmacology, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Eugene Healy
- Department of Dermatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Department of Dermatopharmacology, Faculty of Medicine, University of Southampton, Southampton, UK
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15
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Evidence from Clinical Studies Related to Dermatologic Surgeries for Skin Cancer. Cancers (Basel) 2022; 14:cancers14153835. [PMID: 35954498 PMCID: PMC9367341 DOI: 10.3390/cancers14153835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/22/2022] [Accepted: 08/03/2022] [Indexed: 01/20/2023] Open
Abstract
Simple Summary Although significant progress in pharmacotherapy for skin cancer has been made in the past several years, surgical removal of primary skin cancer is still the first choice of treatment unless distant metastases are evident. In the surgical treatment of primary skin tumors, the surgical margin is critical not only for reducing the possibility of tumor recurrence but also for minimizing the cosmetic and functional complications associated with wide local excision. In contrast, dermatologic surgeries including lymph node dissection and skin graft can cause various complications, and these complications are frequently associated with significant morbidity and discomfort. In this review, we summarize the evidence from previous clinical studies regarding the optimal surgical margin for skin cancer and the methods for diminishing the complications associated with dermatologic surgery. Abstract Despite the significant progress made in the past several years in pharmacotherapies for skin cancer, such as BRAF/MEK inhibitors, immune checkpoint inhibitors, and Hedgehog pathway inhibitors, surgical removal of primary skin cancer is still the first choice of treatment unless distant metastases are evident. In cases of lymph node metastases with clinically palpable lymphadenopathy, lymph node dissection (LND) is typically performed for most skin cancers. In the surgical treatment of primary skin tumors, the surgical margin is critical not only for reducing the possibility of tumor recurrence but also for minimizing the cosmetic and functional complications associated with wide local excision. In contrast, dermatologic surgery can cause various complications. Although skin graft is frequently used for reconstruction of the surgical defect, extensive graft necrosis may develop if optimal stabilization of the graft is not obtained. LND also sometimes causes complications such as intraoperative or postoperative bleeding and postoperative lymphoceles. Moreover, as in other types of surgery, surgical site infection, intraoperative anxiety, and intraoperative and postoperative pain may also develop. These complications are frequently associated with significant morbidity and discomfort. In this review, we summarize the evidence from previous clinical studies regarding the optimal surgical margin for skin cancer and the methods for diminishing the complications associated with dermatologic surgery.
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16
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Zahraei-Moghaddam SM, Haghighatafshar M, Shekoohi-Shooli F, Miladi S, Farhoudi F. Toward applying a device to reduce motion artifact during imaging: a randomized controlled trial. Expert Rev Med Devices 2022; 19:189-194. [PMID: 35081856 DOI: 10.1080/17434440.2022.2035215] [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] [Indexed: 11/04/2022]
Abstract
OBJECTIVE One of the most critical problems in different types of medical imaging modalities is unwanted patient movement during imaging procedures, which mainly occurs because of stress, anxiety, and restlessness in patients, resulting in poor image quality and decreased diagnostic accuracy. METHODS This prospective, randomized, double-blinded, controlled trial comprised 267 patients who underwent MPI, randomly divided into three groups; Group I: streaming music with a special binaural beat frequency (MBB); Group II: streaming simple music (SM) and Group III: control group. Anxiety level was determined by DASS (Depression Anxiety Stress-Scale) questionnaire and heart rate was monitored. RESULTS Stress and anxiety scores were significantly lower in the MBB group compared with both SM and control group (P˂0.0001). Additionally, a significant decrease in heart rate of patients who were in the MBB group in comparison with the SM (p=0.005) and control group (P=0.018) was observed. The study revealed a significant decrease in motion artifact in the MBB group compared with the SM (P=0.003) and control (P˂0.0001) groups. CONCLUSIONS Using the proposed device capable of streaming special binaural beat frequency embedded music can cause a significant reduction in anxiety level, heart rate, and consequently motion artifact. This method can be useful during the imaging procedure due to several reasons. First, this can cause a significant reduction in motion artifacts. Next, anxiety and stress can be reduced significantly due to the application of special binaural beat frequency embedded music during an imaging procedure. Then, a significant reduction in post-imaging stress and anxiety scores was achieved after using it. Finally, binaural beat frequency embedded music leads to imaging repetition avoidance.
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Affiliation(s)
- Seyed Mohsen Zahraei-Moghaddam
- Nuclear Medicine and Molecular Imaging Research Center, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Haghighatafshar
- Nuclear Medicine and Molecular Imaging Research Center, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Shekoohi-Shooli
- Nuclear Medicine and Molecular Imaging Research Center, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100, Chieti, Italy
| | - Shima Miladi
- Clinical Research Development Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farinaz Farhoudi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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17
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Touil N, Pavlopoulou A, Momeni M, Van Pee B, Barbier O, Sermeus L, Roelants F. Evaluation of virtual reality combining music and a hypnosis session to reduce anxiety before hand surgery under axillary plexus block: A prospective study. Int J Clin Pract 2021; 75:e15008. [PMID: 34811860 DOI: 10.1111/ijcp.15008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/04/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS Preoperative anxiety, which can affect postoperative recovery, is often present in patients undergoing surgery under loco-regional anaesthesia (LRA). Minimising preoperative anxiety with premedication can be effective but results in drug-related side effects. Therefore, the use of non-pharmacological techniques should be encouraged. METHODS We evaluated whether a virtual reality (VR) incorporating music and a hypnosis session, provided during the performance of LRA, can reduce preoperative anxiety. Fifty patients scheduled for elective hand surgery under an axillary plexus block were enrolled (March-June 2019). The primary outcome measure was the change in the Amsterdam Anxiety and Preoperative Information Scale (APAIS) questionnaire 5 min after the VR session as compared to before the VR session. The secondary outcome measures were the visual analog scale (VAS) for anxiety before and 2 h after the surgery and the Evaluation du Vécu de l'ANesthésie-LocoRégionale (EVAN-LR) satisfaction score. RESULTS Data from 48 patients were analysed. The APAIS score as well as VAS for anxiety were significantly reduced after a VR session (p < .001 for both scores). Patients were very satisfied (EVAN-LR: 92 (88, 94)). CONCLUSIONS The use of VR incorporating music and a hypnosis session could be an effective tool in the management of a patient's preoperative anxiety during the performance of an axillary plexus block.
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Affiliation(s)
- Nassim Touil
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Athanasia Pavlopoulou
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Mona Momeni
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Benoît Van Pee
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Olivier Barbier
- Department of Surgery, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Luc Sermeus
- Department of Surgery, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Fabienne Roelants
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
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18
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Muralidharan S, Ichhpujani P, Bhartiya S, Singh RB. Eye-tunes: role of music in ophthalmology and vision sciences. Ther Adv Ophthalmol 2021; 13:25158414211040890. [PMID: 34497975 PMCID: PMC8419534 DOI: 10.1177/25158414211040890] [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: 04/15/2021] [Accepted: 08/03/2021] [Indexed: 11/16/2022] Open
Abstract
Although the healing effect of music has been recognized since time immemorial, there has been a renewed interest in its use in modern medicine. This can be attributed to the increasing focus on holistic healing and on the subjective and objective aspects of well-being. In ophthalmology, this has ranged from using music for patients undergoing diagnostic procedures and surgery, as well as for doctors and the operation theatre staff during surgical procedures. Music has proven to be a potent nonpharmacological sedative and anxiolytic, allaying both the pain and stress of surgery. This review aims to explore the available evidence about the role of music as an adjunct for diagnostic and surgical procedures in current ophthalmic practices.
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Affiliation(s)
- Shruti Muralidharan
- Glaucoma Service, Department of Ophthalmology, Government Medical College & Hospital, Chandigarh, India
| | - Parul Ichhpujani
- Professor, Glaucoma Service, Department of Ophthalmology, Government Medical College & Hospital, Sector 32-A, Chandigarh 160030, India
| | - Shibal Bhartiya
- Glaucoma Facility, Department of Ophthalmology, Fortis Memorial Research Institute, Gurgaon, India
| | - Rohan Bir Singh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Caesar U, Karlsson L, Hamrin Senorski E, Karlsson J, Hansson-Olofsson E. Delayed and cancelled orthopaedic surgery; are there solutions to reduce the complex set of problems? A systematic literature review. Int J Clin Pract 2021; 75:e14092. [PMID: 33590942 DOI: 10.1111/ijcp.14092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 02/12/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Unexpected cancellations of, and delays to, orthopaedic surgery have adverse effects, with a negative impact on hospital performance and undesirable patient outcomes. As cancellations and delays are common, finding measures to prevent them is a matter of urgency. METHODS The present systematic review conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the Cochrane Handbook. Peer-reviewed studies reporting on cancellations or delays in patients requiring emergency orthopaedic or planned orthopaedic surgery that compared care action/intervention with no action or traditional care were included. The Grading of Recommendations Assessment, Development and Evaluation used to assess the quality of evidence of the results from the included studies. The objective of the present study was systematically to search and review the literature for qualitative evidence of factors that might reduce cancellations of and delays to orthopaedic surgical procedures. RESULTS The electronic search yielded 1209 studies and eight articles were included in the performed quality assessment. The heterogeneity of the studies and the lack of calculations and statistics in the studies resulted in no meta-analysis. The result of the quality assessment indicated that the evidence ranked from low to very low across the different outcomes. The main limiting factor, which was the reason for a decrease in quality in some outcomes, was the study designs, which were non-randomised control or retrospective approach. The interventions in the included studies could help to support a reduction in the risk of cancelled and delayed orthopaedic procedures. CONCLUSION This systematic literature review has revealed important evidence to help reduce the risk of cancelled and delayed orthopaedic procedures associated with a variety of care action exposures. They include a fast-track pathway, pre-operative guidelines and telephone contact with patients prior to surgery, as well as careful consideration of additional pre-operative tests.
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Affiliation(s)
- Ulla Caesar
- Department of Orthopaedics, Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Faculty of Caring Sciences Work Life & Social Welfare, Boras University, Boras, Sweden
| | - Louise Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eric Hamrin Senorski
- Department of Health and Rehabilitation, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elisabeth Hansson-Olofsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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Feasibility, Safety, and Satisfaction of Combined Hysterectomy with Bilateral Salpingo-Oophorectomy and Chest Surgery in Transgender and Gender Non-Conforming Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137133. [PMID: 34281069 PMCID: PMC8297260 DOI: 10.3390/ijerph18137133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
The demand for masculinizing breast surgery and hysterectomy with bilateral salpingo-oophorectomy (HBSO) from transmen has increased. With a multidisciplinary approach, these surgeries can be performed in a single session. The objective of this study was to retrospectively evaluate the feasibility, safety, and satisfaction of HBSO and chest surgery in transmen. A cohort of 142 subjects who underwent HBSO alone or combined with chest surgery at Sant’Orsola Hospital was analyzed. Intra and post operation events were evaluated. Subjective post-intervention satisfaction, acceptability, and impact of intervention were assessed via a semi-structured interview. Nineteen transmen underwent HBSO alone and 123 underwent combined surgery. HBSO was performed laparoscopically in 96.5% of transmen (137/142). As expected, length of hospital stay and blood loss were significantly higher in the combined surgery group. A total of 13 intra or post-operative complications occurred in the combined surgery group (10.5%) with thoracic hematoma being the most frequent complication (7.6%). Only one rare complication occurred in the HBSO group (omental herniation through a laparoscopic breach). The overall subjective satisfaction score was 9.9 out of 10 for both groups. Positive changes in all areas of life were reported, with no significant differences. We found that the combined surgery appears to be well tolerated, safe, and feasible in transmen and satisfaction with the combined procedure was high in all subjects.
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Murray N, O’Connor C, Dempsey R, Liew S, Richards H, Brady C, Sweeney P, Hennessey D. Psychological distress in patients undergoing urological surgery: A cross-sectional study. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/20514158211014069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The purpose of this study was to evaluate the psychological distress of urological and uro-oncological patients undergoing surgery. Methods: Patients who presented to Mercy University Hospital from October 2019–May 2020 were consecutively recruited. Demographic and clinical characteristics including age, gender, marital status, type of surgery (uro-oncology or general urology), endoscopy or open surgery were gathered. Mood was evaluated using the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and 6 weeks post-surgery. Results: A total of 118 participants (79.7% male) completed the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and at 6 weeks post-surgery. Forty patients (33.9%) underwent uro-oncology-related surgery. At pre-admission 39 patients (33%) fell into a possible-probable clinical category for anxiety and 15 (12.7%) for depression. Older patients had significantly lower anxiety levels than younger patients ( p⩽0.01). There were no differences between patients undergoing uro-oncology or more general urology surgery and levels of anxiety or depression. Repeated measures analysis of variance with age as a covariate indicated no significant differences in Hospital Anxiety and Depression Scale anxiety scores over time. There was a statistically significant reduction in Hospital Anxiety and Depression Scale depression scores over the three assessment time points ( p=0.004). Conclusion: Over one-third of patients were experiencing moderate to severe levels of psychological distress pre-surgery – higher than levels previously reported in uro-oncological patients. Surprisingly, there was no difference in anxiety and depression scores in uro-oncology and urology patients. Psychological distress in both uro-oncology and more general urology patients should be considered in the surgical setting. Level of evidence Moderate
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Affiliation(s)
- Nuala Murray
- Department of Urology, Mercy University Hospital, Ireland
| | | | - Rhona Dempsey
- Department of Urology, Mercy University Hospital, Ireland
| | - Sean Liew
- Department of Urology, Mercy University Hospital, Ireland
| | - Helen Richards
- Department of Clinical Psychology, Mercy University Hospital, Ireland
| | - Ciaran Brady
- Department of Urology, Mercy University Hospital, Ireland
| | - Paul Sweeney
- Department of Urology, Mercy University Hospital, Ireland
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22
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Fischer S, Seibaek L. Patient perspectives on relatives and significant others in cancer care: An interview study. Eur J Oncol Nurs 2021; 52:101964. [PMID: 33906053 DOI: 10.1016/j.ejon.2021.101964] [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: 07/01/2020] [Revised: 03/19/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE In this study, patient perspectives on their relative's involvement in gynaecological cancer treatment and care are investigated. METHODS In total 17 women participated in two qualitative research interviews each during their treatment period. By applying a phenomenological-hermeneutic text interpretation methodology, the findings were systematically identified, interpreted, and discussed. This process gave rise to two main themes: "Relatives include more than family members" and "Interactions with relatives and significant others". RESULTS The findings showed that, besides family members, in particular neighbours and people who had experienced cancer themselves were an important and valuable support to the patients. Help with daily activities and errands, and providing informal company, represented a substantial support in difficult times, and generated a sense of social belonging and the experience of fellowship. Interactions with relatives were influenced by the patients' personal reflections and experiences and posed several positive as well as negative challenges. Firstly, the patients had many concerns about passing on the news of their cancer disease to their social network. Loneliness, in various representations, was a persistent theme, which reflected various experiences of vulnerability. CONCLUSION Positive family relations represented a unique resource during cancer treatment; however, due to relatives' worries or lack of support, patients could experience strain. This perspective on relatives' involvement - from the patient's point of view - seems to be understudied.
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Affiliation(s)
- Sine Fischer
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark.
| | - Lene Seibaek
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark; Institute for Nursing and Health Research, University of Greenland, Nuuk, Greenland.
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NI CH, WEI L, WU CC, LIN CH, CHOU PY, CHUANG YH, KAO CC. Machine-Based Hand Massage Ameliorates Preoperative Anxiety in Patients Awaiting Ambulatory Surgery. J Nurs Res 2021; 29:e152. [PMID: 33840769 PMCID: PMC8126494 DOI: 10.1097/jnr.0000000000000432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Hand massage therapies have been used to relieve anxiety and pain in various clinical situations. The effects of machine-based hand massage on preoperative anxiety in ambulatory surgery settings have not been evaluated. PURPOSE This prospective study was designed to investigate the effect of machine-based hand massage on preoperative anxiety and vital signs in ambulatory surgery patients. METHODS One hundred ninety-nine patients aged 18 years and older who were scheduled to receive ambulatory surgery were recruited from the Taipei Municipal Wanfang Hospital in Taipei City, Taiwan. The patients were assigned randomly to the experimental group (n = 101), which received presurgical machine-based hand massage therapy, and the control group (n = 98), which received no intervention. The patients in both groups completed the Spielberger State-Trait Anxiety Inventory short form at preintervention (baseline) and postintervention. RESULTS Within-group comparisons of Spielberger State-Trait Anxiety Inventory short form scores showed significant decreases between preintervention and postintervention scores in the experimental group (44.3 ± 11.2 to 37.9 ± 8.7) and no significant change in the control group. Within-group comparisons of vital signs revealed a significant increase in mean respiration rate between baseline and postintervention in both groups (both ps < .05). Blood pressure was found to have decreased significantly only in the control group at postintervention (p < .05). No significant preintervention to postintervention change in pulse was observed in either group. CONCLUSIONS The findings of this study indicate that machine-based hand massage reduces anxiety significantly in patients awaiting ambulatory surgery while not significantly affecting their vital signs.
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Affiliation(s)
- Cheng-Hua NI
- MS, RN, Supervisor, Department of Nursing, Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, and Adjunct Assistant Professor, School of Nursing, College of Nursing, Taipei Medical University, Taiwan, ROC
| | - Li WEI
- MD, PhD, Assistant Professor, Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, and Attending Physician, Division of Neurosurgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taiwan, ROC
| | - Chia-Che WU
- MD, PhD, Assistant Professor, School of Medicine, College of Medicine, Taipei Medical University, and Attending Physician, Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taiwan, ROC
| | - Chueh-Ho LIN
- PhD, PT, Associate Professor, Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taiwan, ROC
| | - Pao-Yu CHOU
- MS, RN, Head Nurse, Department of Nursing, and Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, and Adjunct Instructor, School of Nursing, College of Nursing, Taipei Medical University, Taiwan, ROC
| | - Yeu-Hui CHUANG
- PhD, RN, Professor, School of Nursing, College of Nursing, Taipei Medical University, and Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan, ROC
- Contributed equally as corresponding author
| | - Ching-Chiu KAO
- MS, RN, Executive Director of Community Medicine, Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, and Adjunct Assistant Professor, School of Nursing, College of Nursing, Taipei Medical University, Taiwan, ROC
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Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease: A Meta-Analysis of Mood Effects. Neuropsychol Rev 2021; 31:385-401. [PMID: 33606174 DOI: 10.1007/s11065-020-09467-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 11/22/2020] [Indexed: 12/15/2022]
Abstract
This meta-analysis examines mood changes after bilateral subthalamic deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD). Deep brain stimulation improves motor outcomes in Parkinson's disease but there appears to be conflicting reports as to subsequent mood outcomes. Pubmed, PsychINFO and SCOPUS were searched for studies assessing mood outcomes in PD patients who had undergone STN-DBS published between January 2003 and the end of January 2019. Random effects meta-analyses were conducted for all outcome groups with at least two studies homogenous in design and measure. Forty-eight studies, providing data on negative moods (such as depression, anxiety, apathy, and anger) and positive moods (pleasure and euphoria) were assessed. Results of the meta-analysis suggest that post-DBS, depression and anxiety symptoms improve and there is a reduction in negative affect, an increase in apathy, and in energy level. Although there have been reported cases of mania post-DBS surgery, the meta-analysis suggested no significant changes in symptoms of mania in the broader DBS population. Considerable heterogeneity was found and partially addressed through meta-regression and qualitative assessment of the included STN-DBS controlled studies. The major strengths of this meta-analysis, include attention to outcome validity, heterogeneity, independence of samples, and clinical utility, with the potential to improve post-operative safety through comprehensive consideration of mood and psychological adjustment. It appears that STN-DBS is a relatively safe and, in the case of mood symptomatology, an advantageous treatment of Parkinson's disease.
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Casarin J, Cromi A, Sgobbi B, Di Siena A, Serati M, Bolis ME, Ghezzi F. Music Therapy for Preoperative Anxiety Reduction in Women Undergoing Total Laparoscopic Hysterectomy: A Randomized Controlled Trial. J Minim Invasive Gynecol 2021; 28:1618-1624.e1. [PMID: 33549732 DOI: 10.1016/j.jmig.2021.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 12/23/2022]
Abstract
STUDY OBJECTIVE To assess the superiority of a music therapy intervention (Music) vs usual care (Control) in reducing the preoperative anxiety of patients undergoing total laparoscopic hysterectomy (TLH) with nononcologic indications. DESIGN This was a 1:2 (Music vs Control) randomized controlled study. SETTING A teaching hospital. PATIENTS One hundred patients were available for the analysis: 30 and 70 in the Music and Control arms, respectively. INTERVENTIONS Perioperative music therapy pathway in patients undergoing TLH for benign disease. MEASUREMENTS AND MAIN RESULTS Anxiety was evaluated with the State-Trait Anxiety Inventory Y Form (STAI-Y) at different time points: at baseline and during preoperative, early postoperative, and late postoperative periods. Pathologic anxiety was defined as STAI-Y state >45. Postoperative pain was registered using the visual analog scale. Women in the Music arm experienced lower anxiety levels (median STAI-Y scores 38.0 vs 41.0; p = .002) during the preoperative period. STAI-Y scores did not vary significantly by intervention at each subsequent time point. A significant difference between the groups (Music vs Control) was found in the proportion of women with pathologic anxiety during the preoperative (16.7% vs 37.2%; p = .04) and early postoperative periods (0% vs 12.9%; p = .04), whereas no significant difference between the groups was registered during the late postoperative period (6.6% vs 7.1%; p = .93). Postoperative pain intensity did not significantly differ between the groups at 1, 3, and 6 hours after surgery. CONCLUSIONS Music therapy might be a viable complementary modality to usual surgical care in the gynecologic setting for its ability to significantly decrease preoperative anxiety in women undergoing TLH for benign conditions.
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Affiliation(s)
- Jvan Casarin
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors).
| | - Antonella Cromi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Barbara Sgobbi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Anna Di Siena
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Maurizio Serati
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Maria Elena Bolis
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Fabio Ghezzi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
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Park JS, Han B, Jo SJ, Mun JH. Sleep during Mohs micrographic surgery: A prospective study. Dermatol Ther 2020; 33:e14535. [PMID: 33184964 DOI: 10.1111/dth.14535] [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: 09/07/2020] [Revised: 10/28/2020] [Accepted: 11/06/2020] [Indexed: 11/29/2022]
Abstract
Mohs micrographic surgery (MMS) is a highly specialized technique for treating skin cancer. Drawbacks of MMS are the multi-step procedure and long surgery time. Some patients sleep during surgery and involuntary movements during sleeping can interfere with surgery, which increases the risk of a fall injury. However, to our knowledge, there have been no studies regarding the characteristics of patients' sleep during MMS. This study aimed to investigate the prevalence and characteristics of sleeping patients during MMS. We performed a prospective study and included patients with skin cancers impending MMS. All patients rated their anxiety levels and sleep status using the State-Trait Anxiety Inventory, an anxiety visual analog scale, the Pittsburgh Sleep Quality Index, and the Leeds Sleep Evaluation Questionnaire. Our data showed that 21.9% of patients were asleep during MMS. Multivariable analysis showed that older age (odds ratio [OR], 1.142; p=0.003), lesion size >150 mm2 (OR, 7.904; p=0.031), and multi-stage MMS (OR, 12.201; p=0.011) were significantly associated factors of sleep. This study is the first to report the prevalence and associated factors of sleep during MMS. Physicians should monitor patients with risk factors during MMS to prevent possible medical accidents.
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Affiliation(s)
- Jong Seo Park
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Byeol Han
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Seong-Jin Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, South Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Institute of Human-Environment Interface Biology, Seoul National University, Seoul, South Korea
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Evaluation of Anxiety Levels in Patients Undergoing Intravitreal Injections and Associated Risk Factors Related to the Disease. J Ophthalmol 2020; 2020:4375390. [PMID: 33145102 PMCID: PMC7596427 DOI: 10.1155/2020/4375390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose To analyze patients' anxiety levels using the Visual Analog Scale for Anxiety (VASA), in regard to intravitreal injection treatment and to determine possible associated risk factors related to the disease and treatment characteristics. Methods Cross-sectional observational study with consecutive sampling of patients who were going to receive an intravitreal injection. Subjects completed the VASA prior to the procedure, and afterwards, their data were collected from the electronic medical history. Analysis was performed through a linear regression model. Results Fifty-five men and forty-seven women were enrolled. The mean age was 73.9 ± 12.4 years (mean ± standard deviation (SD)), and the mean ± SD of previous injections was 12.8 ± 12. The most frequent pathologies found were age-related macular degeneration with 46.1% and diabetic macular edema with 36.3%. The median of anxiety levels measured in millimeters (mm) was 16 (interquartile range: 0–48). In univariate models, women presented a mean of 10.8 mm of anxiety more than men (p=0.03). The adjusted multivariate analysis demonstrated that younger patients declared higher anxiety levels (p=0.036). No significant association was found between the best corrected visual acuity (BCVA) on the day of the injection, the change in BCVA since the beginning of the treatment or the number of injections received, and the registered anxiety levels. Conclusions Sex and age may have an influence on anxiety levels. BCVA and the number ofinjections received did not seem to have an influence on our patients anxiety levels.
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Preoperative communication with anesthetists via anesthesia service platform (ASP) helps alleviate patients' preoperative anxiety. Sci Rep 2020; 10:18708. [PMID: 33127967 PMCID: PMC7603311 DOI: 10.1038/s41598-020-74697-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 10/05/2020] [Indexed: 11/12/2022] Open
Abstract
Female gender has been identified as one of the risk factors closely linked to perioperative anxiety and a lower level of satisfaction. A successful preoperative anesthesia education may improve such negative outcomes. The aim of this study was to investigate whether preoperative anesthesia education via an Anesthesia Service Platform (ASP) could reduce the anxiety levels in female patients scheduled for laparoscopic cholecystectomy under general anesthesia, and accelerate rehabilitation. A total of 222 patients scheduled for elective laparoscopic cholecystectomy were randomly assigned to the control group and the ASP group. Patients’ baseline and post-intervention psychological status was measured by the State-Trait Anxiety Inventory and General Well-Being Schedule. Pain management and recovery were assessed by VAS every 12 h for 48 h after surgery; length of stay (LOS) and postoperative analgesic consumption were also assessed. Patients in the control group experienced higher anxiety levels before surgery and had longer LOS than those in the ASP group. Patients in the ASP group had a higher general well-being score; however, they suffered more pain and consumed more analgesics after surgery. ASP is effective for preventing anxiety in female patients before laparoscopic cholecystectomy, improving patients’ general well-being levels, and shortening their LOS, but negatively influences patients’ postoperative pain levels.
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O'Connor K, La Bruno D, Rudderow J, Cannaday S, Yeo CJ, Yeo TP. Preparedness for Surgery: Analyzing a Quality Improvement Project in a Population of Patients Undergoing Hepato-Pancreatico-Biliary Surgery. Clin J Oncol Nurs 2020; 24:E65-E70. [PMID: 32945797 DOI: 10.1188/20.cjon.e65-e70] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Approximately 20% of patients diagnosed with pancreatic cancer will be eligible for hepato-pancreatico-biliary (HPB) surgery. Studies indicate that high-quality patient education is pivotal in reducing anxiety, improving clinical and performance outcomes, and increasing patient satisfaction. OBJECTIVES This quality improvement project sought to determine the perceived level of preparedness for patients undergoing HPB surgery and to identify information and knowledge gaps in preoperative education. METHODS Convenience sampling was used to collect postoperative information via questionnaire from 50 patients regarding areas of importance. FINDINGS Preoperative information gaps for patient and family education were identified. Improving preparedness for HPB surgery has the potential to improve clinical outcomes, increase quality and patient satisfaction, decrease length of stay, and reduce time to adjuvant therapy.
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Clair C, Engström Å, Strömbäck U. Strategies to Relieve Patients' Preoperative Anxiety Before Anesthesia: Experiences of Nurse Anesthetists. J Perianesth Nurs 2020; 35:314-320. [DOI: 10.1016/j.jopan.2019.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/13/2019] [Accepted: 10/20/2019] [Indexed: 10/25/2022]
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Elfering L, van de Grift TC, Bouman MB, van Mello NM, Groenman FA, Huirne JA, Budiman IYW, Goijen LDJ, van Loenen DKG, Mullender MG. Combining total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with subcutaneous mastectomy in trans men: The effect on safety outcomes. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 21:138-146. [PMID: 33015665 PMCID: PMC7430461 DOI: 10.1080/26895269.2020.1751014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background: Masculinizing mastectomy is the most requested gender affirming surgery (GAS) in trans men, followed by genital GAS. Mastectomy and total laparoscopic hysterectomy, with or without bilateral salpingo-oophorectomy (TLH ± BSO), can both be performed in one single operation session. However, data on complication rates of the combined procedure is scarce and no consensus exists on the preferred order of procedures. Aims: To compare safety outcomes between mastectomy performed in a single procedure with those when performed in a combined procedure and assess whether the order of procedures matters when they are combined. Methods: A retrospective chart review was performed of trans men who underwent masculinizing mastectomy with or without TLH ± BSO in a combined session. The effects of the surgical procedure on complication and reoperation rate of the chest were assessed using logistic regression. Results: In total, 480 trans men were included in the study. Of these, 212 patients underwent the combined procedure. The gynecological procedure was performed first in 152 (71.7%) patients. In the total sample, postoperative hematoma of the chest occurred in 11.3%; 16% in the combined versus 7.5% in the single mastectomy group (p = 0.001). Reoperations due to hematoma of the chest were performed in 7.5% of all patients; 10.8% in the combined versus 4.9% in the single mastectomy group (p = 0.017). The order of procedures in the combined group had no significant effect on postoperative hematoma of the chest (p = 0.856), and reoperations (p = 0.689). Conclusion: Combining masculinizing mastectomy with TLH ± BSO in one session was associated with significantly more hematoma and reoperations compared with separately performing mastectomy. This increased risk of complications after a combined procedure should be considered when deciding on surgical options. The order of procedures in a combined procedure did not have an effect on safety outcomes.
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Affiliation(s)
- Lian Elfering
- Department of Plastic Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Tim C. van de Grift
- Department of Plastic Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark-Bram Bouman
- Department of Plastic Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Norah M. van Mello
- Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Freek A. Groenman
- Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Judith A. Huirne
- Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ivo Y. W. Budiman
- Department of Plastic Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
| | - Linde D. J. Goijen
- Department of Plastic Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Margriet G. Mullender
- Department of Plastic Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
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Alsabban W, Alhadithi A, Alhumaidi FS, Al Khudhair AM, Altheeb S, Badri AS. Assessing needs of patients and families during the perioperative period at King Abdullah Medical City. Perioper Med (Lond) 2020; 9:10. [PMID: 32280457 PMCID: PMC7137296 DOI: 10.1186/s13741-020-00141-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background This paper explores elective surgery patients' and family members' needs during the perioperative period, in a specialized hospital in Saudi Arabia. Needs are influenced by context and could differ from a setting to another. Methods Two questionnaires, one for the patient group and the other for the family member group, were adopted from a previous similar study. The participants were asked to rate the importance of each need and how much it was satisfied. Data were collected in 5 weeks. Descriptive statistics were used to determine the average rate and standard deviation of each item. Results Patients highly rated the need for adequate symptom management in the recovery area. Family members highly rated the importance of being informed if the surgical procedure is taking more time than expected and communicating with the surgeon after the procedure. Conclusion Systematically involving the family member in the perioperative care of the patient is advantageous. However, interventions and extent of involvement of the family member to the care of the patient would have to be adapted according to the cultural context.
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Affiliation(s)
- Wid Alsabban
- 1Perioperative Medicine Administration, King Abdullah Medical City-Makkah, Makkah, Saudi Arabia
| | - Ahmed Alhadithi
- 2College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | - Saeed Altheeb
- 2College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Saad Badri
- 3College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia
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Jarmoszewicz K, Nowicka-Sauer K, Zemła A, Beta S. Factors Associated with High Preoperative Anxiety: Results from Cluster Analysis. World J Surg 2020; 44:2162-2169. [DOI: 10.1007/s00268-020-05453-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Packyanathan JS, Lakshmanan R, Jayashri P. Effect of music therapy on anxiety levels on patient undergoing dental extractions. J Family Med Prim Care 2019; 8:3854-3860. [PMID: 31879625 PMCID: PMC6924244 DOI: 10.4103/jfmpc.jfmpc_789_19] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 09/22/2019] [Accepted: 10/14/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND AIMS Dental anxiety has been found to be a significant problem faced by patients undergoing extractions. Anxious patients tend to avoid dental care ultimately leading to complications. Treatment of anxious patients can be very challenging to the dentists, prolonging the treatment duration. There has been various methods to reduce anxiety of which non pharmacological ways include music and aroma therapy. Music has been known to reduce fear, stress and is a form of meditation and relaxation. Hence effect of music on the reduction of anxiety levels for patients undergoing extractions were assessed. The aim of this study is to assess the effect of music therapy on dental anxiety levels of patients undergoing extractions. METHODS 50 patients visiting the outpatient department of Saveetha Dental College for dental extractions were randomly selected and allocated to Test group and Control group. The test group (N = 25) were subjected to music during extractions and Control (N = 25) were not exposed. Dental anxiety levels and hemodynamic changes namely systolic pressure, diastolic pressure and heart rate were assessed before and after extraction. The data was collected and analyzed using SPSS software with Paired t Test. RESULTS The study showed that the control population had elevated hemodynamic changes with regard to systolic, diastolic blood pressure and heart rate, of which the diastolic pressure rise was significant. In the test population, there was fall in the hemodynamic changes with respect to systolic diastolic blood pressure and heart rate, all of which were statistically significant. This was evident in the modified dental anxiety scale as well. CONCLUSION Music seems to be a psychological and spiritual way to calm oneself down. Hence music therapy can be used as an anxiolytic agent for stressful dental procedures.
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Affiliation(s)
- Jerusha S. Packyanathan
- Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Reema Lakshmanan
- Department of Periodontology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - P Jayashri
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Bostancı Ergen E, Akpak YK, Kılıççı Ç, Yayla ÇA, Ayas S. Does minimally invasive surgery reduce anxiety? J Turk Ger Gynecol Assoc 2019; 20:142-146. [PMID: 29983402 PMCID: PMC6751831 DOI: 10.4274/jtgga.galenos.2018.2018.0073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/06/2018] [Indexed: 12/01/2022] Open
Abstract
Objective To evaluate whether there were any differences in preoperative and postoperative anxiety in patients who underwent total laparoscopic hysterectomy (TLH) (n=37) and total abdominal hysterectomy (TAH) (n=37). Material and Methods All premenopausal patients who underwent TLH or TAH because of benign uterine disorders were enrolled. Anxiety status was assessed 6 hours before and after the operation using standardized validated questionnaires: State-Trait Anxiety Inventory. Results In the TAH group, the state anxiety level of the patients significantly increased, whereas there was a significant decrease in the TLH group. For the trait anxiety level, there was a statistically significant increase in the TAH group postoperatively. In the TLH group, trait anxiety levels decreased postoperatively. In the analysis of between-group differences, pre and postoperative the state anxiety level was higher in the TAH group. A statistically significant difference was determined between the groups in respect of the postoperative state anxiety levels (p<0.05), but not in the preoperative state anxiety levels (p>0.05). Statistically significant differences were determined between the groups in respect of education, occupation, and curettage rates (p<0.05). Conclusion Women undergoing TLH for benign uterine disease may have lower levels of preoperative and postoperative anxiety than women undergoing TAH.
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Affiliation(s)
- Evrim Bostancı Ergen
- Clinic of Gynecology Obstetrics and Reproductive Medicine, İstanbul Zeynep Kamil Woman and Child Diseases Training and Research Hospital, İstanbul, Turkey
| | - Yaşam Kemal Akpak
- Clinic of Gynecology Obstetrics and Gynecology, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Çetin Kılıççı
- Clinic of Gynecology Obstetrics and Reproductive Medicine, İstanbul Zeynep Kamil Woman and Child Diseases Training and Research Hospital, İstanbul, Turkey
| | - Çiğdem Abide Yayla
- Clinic of Gynecology Obstetrics and Reproductive Medicine, İstanbul Zeynep Kamil Woman and Child Diseases Training and Research Hospital, İstanbul, Turkey
| | - Selçuk Ayas
- Clinic of Gynecology Obstetrics and Reproductive Medicine, İstanbul Zeynep Kamil Woman and Child Diseases Training and Research Hospital, İstanbul, Turkey
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Yang JH, Ryu JJ, Nam E, Lee HS, Lee JK. Effects of Preoperative Virtual Reality Magnetic Resonance Imaging on Preoperative Anxiety in Patients Undergoing Arthroscopic Knee Surgery: A Randomized Controlled Study. Arthroscopy 2019; 35:2394-2399. [PMID: 31395176 DOI: 10.1016/j.arthro.2019.02.037] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the effect of a preoperative virtual reality (VR) experience of 3-dimensional (3D) reconstructed magnetic resonance images (MRIs) on anxiety reduction in patients undergoing arthroscopic knee surgery. METHODS Patients in the VR group watched a 3D model of their own MRI through a VR headset describing the anatomy of the knee as well as their own lesion of interest for an arthroscopic procedure. Patients in the non-VR (NR) group received standard preoperative information about their MRI. The primary outcome for analysis was the Amsterdam Preoperative Anxiety and Information Scale score to measure level of anxiety and the need for information in patients undergoing arthroscopic knee surgery. Secondary outcomes were rated with visual analog scale (VAS) scores measuring patient pain, preparedness, satisfaction, and stress. RESULTS Regarding the Amsterdam Preoperative Anxiety and Information Scale score, the sum S (surgery-related anxiety) and sum C (combined anxiety component) subscales showed significantly better outcomes in the VR group (median [interquartile range] for sum S = 2.0 [2.0-4.0], median [quartile 1-quartile 3] sum C = 4.0 [4.0-8.5]) than in the NR group (median [interquartile range] for sum S = 4.9 [3.0-5.0], median [quartile 1-quartile 3] sum C = 8.0 [5.3-9.8]) (P = .014 and P = .005, respectively). Regarding VAS scores, preoperative measures showed significantly better outcomes in satisfaction among VR group patients (95 [90.0-100.0]) in comparison to NR group patients (85 [70.0-96.0]) (P = .010). For postoperative VAS measures, the VR group (satisfaction score = 95 [90.0-100.0], stress score = 15 [2.5-37.5]) showed significantly better outcomes in satisfaction and stress in comparison to the NR group (satisfaction score = 85 [70.0-97.5], stress score = 30 [30.0-50.0]). CONCLUSIONS Application of preoperative VR experience of 3D reconstructed knee MRIs in patients undergoing arthroscopic knee surgery reduces anxiety around surgical encounters. The VR patient group was more satisfied overall and less stressed postoperatively. However, perioperative pain and preparedness were not affected by VR exposure. LEVEL OF EVIDENCE Level I, randomized controlled trial.
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Affiliation(s)
- Jae-Hyuk Yang
- Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Gyeonggi-do, Republic of Korea
| | - Jae Joon Ryu
- Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, Republic of Korea
| | - Eunwoo Nam
- Biostatistical Consulting and Research Laboratory, Hanyang University College of Medicine, Seoul, Republic of Korea
| | | | - Jin Kyu Lee
- Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, Republic of Korea.
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Matzner P, Sorski L, Haldar R, Shaashua L, Benbenishty A, Lavon H, Azan Y, Sandbank E, Melamed R, Rosenne E, Ben-Eliyahu S. Deleterious synergistic effects of distress and surgery on cancer metastasis: Abolishment through an integrated perioperative immune-stimulating stress-inflammatory-reducing intervention. Brain Behav Immun 2019; 80:170-178. [PMID: 30851377 DOI: 10.1016/j.bbi.2019.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 02/26/2019] [Accepted: 03/05/2019] [Indexed: 01/21/2023] Open
Abstract
The perioperative period holds disproportionate impact on long-term cancer outcomes. Nevertheless, perioperative interventions to improve long-term cancer outcomes are not clinical routines, including perioperative stress-reducing or immune-stimulating approaches. Here, mimicking the clinical setting of pre-operative distress, followed by surgery, we examined the separate and combined effects of these events on the efficacy of pre-operative immune stimulation in rats and mice, and on post-operative resistance to tumor metastasis of the syngeneic mammary adenocarcinoma MADB106 in F344 rats and the CT26 colon carcinoma in Balb/C mice. The novel immune stimulating agents, GLA-SE or CpG-C (TLR-4 and TLR-9 agonists, respectively), were employed pre-operatively. Sixteen hours of pre-operative behavioral stressors (i) lowered CpG-C induced plasma IL-12 levels, and reduced resistance to MADB106 and CT-26 experimental metastases, and (ii) worsened the deleterious effects of laparotomy on metastasis in both tumor models. In rats, these effects of pre-operative stress were further studied and successfully abolished by the glucocorticoid receptor antagonist RU-486. Additionally, in vitro studies indicated the dampening effect of corticosterone on immune stimulation. Last, we tested a perioperative integrated intervention in the context of pre-operative stress and laparotomy, based on (i) antagonizing the impact of glucocorticoids before surgery, (ii) activating anti-metastatic immunity perioperatively, and (iii) blocking excessive operative and post-operative adrenergic and prostanoid responses. This integrated intervention successfully and completely abolished the deleterious effects of stress and of surgery on post-operative resistance to experimental metastasis. Such and similar integrated approaches can be studied clinically in cancer patients.
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Affiliation(s)
- Pini Matzner
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Liat Sorski
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Rita Haldar
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Lee Shaashua
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Amit Benbenishty
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Hagar Lavon
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Yosi Azan
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Elad Sandbank
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Rivka Melamed
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Ella Rosenne
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Shamgar Ben-Eliyahu
- Neuroimmunology Research Unit, Sagol School of Neuroscience, and The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel.
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Turzáková J, Sollár T, Solgajová A. Faces Anxiety Scale as a screening measure of preoperative anxiety: Validation and diagnostic accuracy study. Int J Nurs Pract 2019; 25:e12758. [DOI: 10.1111/ijn.12758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 12/15/2018] [Accepted: 05/18/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Jana Turzáková
- Institute of Applied Psychology, Faculty of Social Sciences and HealthcareConstantine the Philosopher University in Nitra Nitra Slovakia
| | - Tomáš Sollár
- Institute of Applied Psychology, Faculty of Social Sciences and HealthcareConstantine the Philosopher University in Nitra Nitra Slovakia
| | - Andrea Solgajová
- Department of Nursing, Faculty of Social Sciences and HealthcareConstantine the Philosopher University in Nitra Nitra Slovakia
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Petrowski K, Ritzka D, Fröhner P, Leimert M. Psychosocial Stress Reactivity as Predictor of Operative Outcome in Lumbar Disc Surgery. World Neurosurg 2019; 129:e436-e443. [PMID: 31150852 DOI: 10.1016/j.wneu.2019.05.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND A large proportion of the population suffers from chronic back pain. For optimal treatment, the question arises which patients would benefit from conservative therapy and for whom lumbar disc surgery is most appropriate. It seems reasonable to analyze the impact of paraclinical parameters on the operation outcome to identify patients who would benefit less from surgery or need special pre-/postoperative medical care. MATERIALS AND METHODS From March 2012 to July 2014, 32 patients were treated via microscopically supported interlaminar fenestration and discectomy at the Department of Neurosurgery, University Hospital Carl Gustav Carus Dresden. One day before the operation, a cortisol survey was made during the stress response of the Trier Social Stress Test. At the same time, a survey of relevant questionnaires was conducted by which the postoperative symptom experience was made operational and comparable with the evaluation of the same information thirty days afterwards. RESULTS It could be shown that there is a connection between cortisol reactivity and the pain burden following operations. Patients with a greater cortisol reaction under stress exposition partially experienced more intense postoperative pain than the patients with a lower cortisol reaction. However, this relationship could only be explained by single significant results, whereas further calculations could not produce any significance. CONCLUSIONS Cortisol reactivity seems to be associated with pain development. The inconsistent findings in empiricism as well as in this investigation are indicative of a complex association of postoperative pain and cortisol reactivity, which needs to be examined further.
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Affiliation(s)
- Katja Petrowski
- Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Mainz, Germany; Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany.
| | - Desiree Ritzka
- Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Mainz, Germany; Department of Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Patrick Fröhner
- Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Mainz, Germany
| | - Mario Leimert
- Asklepios Orthopedic Clinic Hohwald, Interdisciplinary Spine Center, Hohwald, Germany
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Strøm J, Nielsen CV, Jørgensen LB, Andersen NT, Laursen M. A web-based platform to accommodate symptoms of anxiety and depression by featuring social interaction and animated information in patients undergoing lumbar spine fusion: a randomized clinical trial. Spine J 2019; 19:827-839. [PMID: 30500464 DOI: 10.1016/j.spinee.2018.11.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Approximately one-third of patients undergoing spine surgery have symptoms of anxiety and depression that correlate with pain, disability, and lower health-related quality of life. The use of web-based informative strategies before surgery and principles from cognitive behavioral therapy, have been applied in other patient groups, facilitating mobility and encouraging beneficial coping behavior. PURPOSE To examine the effect of a web-based Spine Platform featuring Interaction and Information by Animation (w-SPIINA) on symptoms of anxiety and depression, pain, disability, and health-related quality of life. STUDY DESIGN A single-center, two-arm, randomized controlled trial PATIENT SAMPLE: One hundred fourteen consecutive patients scheduled for instrumented lumbar spine fusion due to degenerative disc disease or spondylolisthesis. OUTCOME MEASURES Primary outcome was the change in self-reported Hospital Anxiety and Depression Scale (HADS) scores from baseline to 3-month follow-up. Secondary outcomes were change in HADS 1-day before surgery 2days and 6 months after and changes in self-reported disability measured on the Oswestry disability index (ODI), quality of life (EQ-5D-5L questionnaire), and the low back pain rating scale (LBPRS) 2days and 3 and 6 months after surgery. METHOD Patients were randomized to either a control group receiving a standard information regimen or an intervention group gaining access to w-SPIINA in addition to the standard regimen. The independent charity Helsefonden contributed $45,000, the Health Research Fund of the Regional Hospital Central Jutland contributed $10,000, and the Toyota foundation contributed $10,000 to remunerate a dedicated investigator. The authors have no conflict of interest to declare. RESULTS There was no statistically significant difference within the w-SPIINA group and the control group regarding changes in HADS at 3-month follow-up (p≥.37). Approximately 40% reached minimum clinically important difference (MCID) in the w-SPIINA group on the HADS at 3 months. In the control group 50% reached MCID on anxiety subscale and 35% on the depression subscale at 3 months. No statistically significant differences were found between groups with regard to the overall outcomes at any of the predefined time points. CONCLUSION Providing patients with access to w-SPIINA in addition to a standard information regimen had no additional effect on HADS and patient-reported outcomes1day before, 2days, 3 or 6 months after surgery. However, a high compliance and degree of interaction with w-SPIINA indicates that this mode of web-based support could be applicable in this group of patients.
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Affiliation(s)
- Janni Strøm
- Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark; Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark.
| | - Claus Vinther Nielsen
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark; DEFACTUM, Central Denmark Region, Denmark
| | - Lene Bastrup Jørgensen
- Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark; Department of Clinical Medicine, Section for Public Health, Aarhus University, Aarhus, Denmark
| | - Niels Trolle Andersen
- Department of Biostatistics, Section for Public Health, Aarhus University, Aarhus, Denmark
| | - Malene Laursen
- Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark
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Strickland LH, Kelly L, Hamilton TW, Murray DW, Pandit HG, Jenkinson C. Health Care Professionals' Perceptions of the Arthroplasty Patient Experience: Planning Phase in the Development of a Patient-Reported Outcome Measure. J Perianesth Nurs 2019; 34:376-385. [DOI: 10.1016/j.jopan.2018.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/23/2018] [Accepted: 05/09/2018] [Indexed: 10/28/2022]
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Marks S, Wanner JP, Cobb AS, Swetz KM, Lange GM. Surgery without a surrogate: the low prevalence of healthcare power of attorney documents among preoperative patients. Hosp Pract (1995) 2019; 47:28-33. [PMID: 30328723 DOI: 10.1080/21548331.2019.1537849] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/16/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND There has been little published research regarding the implementation of healthcare power of attorney (HCPOA) documents prior to elective surgery. OBJECTIVES This study aims to determine the prevalence of HCPOA documents incorporated into the electronic medical records (EMR) of patients undergoing elective surgery at four healthcare institutions. A secondary aim is to examine for correlations between HCPOA document implementation and demographic and preoperative clinical predictors. METHODS A retrospective chart review was performed in 2012 on 500 consecutive adult patients undergoing elective surgery that required general anesthesia at four medical centers. A descriptive analysis and multivariate logistic regression analysis were performed to examine for associations between HCPOA implementation and hospital site, age, gender, ASA score, marital status, body mass index, insurance type, and zip code. RESULTS Of 1723 charts reviewed, only 382 had a HCPOA document implemented within the EMR at the time of surgery with significant variance between hospital sites. Female sex, a widowed marital status, and an ASA score greater than 2 were significantly associated with having a HCPOA implemented in the EMR, while BMI, insurance type, and socioeconomic status based on zip code did not significantly correlate with the rate of HCPOA documentation. CONCLUSIONS Less than a quarter (22.2%) of patients undergoing elective surgery requiring general anesthesia had a HCPOA document appropriately identified despite the known morbidity and mortality risks. The mere presence of EMR systems, palliative care consultation teams, and preoperative care teams are likely insufficient in ensuring appropriate surrogate documentation prior to elective surgery.
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Affiliation(s)
- Sean Marks
- a Section of Palliative Care , Medical College of Wisconsin , Milwaukee , WI , USA
| | - John Paul Wanner
- b Department of Orthopedic Surgery , Vanderbilt University , Nashville , TN , USA
| | - Ashley S Cobb
- c Departments of Internal Medicine and Pediatrics , University of Michigan , Ann Arbor , MI , USA
| | - Keith M Swetz
- d Division of Gerontology, Geriatrics, and Palliative Care , University of Alabama Birmingham , Birmingham , AL , USA
| | - George M Lange
- e Internal Medicine, Division of Geriatrics , Columbia St. Mary's Hospital , Wauwatosa , WI , USA
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Deng X, Liang S, Li H, Gouda D, Zhu T, Xiao K. A cross-sectional study to assess the difference in perception of day surgery information between patients and medical staff in China. Patient Prefer Adherence 2019; 13:381-387. [PMID: 30880922 PMCID: PMC6407508 DOI: 10.2147/ppa.s196674] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The development of day surgery in China is still in its infancy. The aim of this study is to examine the difference in perception between patients and medical staff about day surgery and to find out what kind of information should be delivered to patients perioperatively. METHODS The study was designed as a cross-sectional study using survey questionnaires. Patients undergoing day surgery and medical staff working in the day surgery center received a preoperative teaching questionnaire (PTQ). The PTQ consisted of preoperative, operative, postoperative and anesthesia information. Participants were asked to rate accurately what day surgery information they perceived as important on a five-point Likert-type scale that ranged from very important to not important. The main outcome was the value patients and staff place on perioperative information. RESULTS For patients, details of anesthesia (82.6%) was the most important day surgery information, while for medical staff, preoperative (58.1%), postoperative (60.7%) and anesthesia (60.0%) information were of the same importance. Patients ranked surgery effect (83.3%) and pain management (82.5%) as two of the top five most important details about day surgery, but these were not listed in the top 5 rankings of staff. Student's t-test results of mean rankings also showed that patients placed more importance on surgery effect (4.8±0.6, 4.6±0.6, P=0.036) and pain management (4.8±0.5, 4.5±0.5, P=0.031) than the medical staff did. CONCLUSION In China, day surgery is an emerging practice with both patients and medical practitioners still lacking experience, so high-quality perioperative teaching is necessary and important. Our study examining patients and staffs' views on day surgery information should be considered when developing perioperative teaching programs. To increase patient satisfaction of the day surgery experience, delivery of patient-specific information tailored to individual circumstances is necessary.
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Affiliation(s)
- Xiaoqian Deng
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Shuqing Liang
- Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Hui Li
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | | | - Tao Zhu
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Kun Xiao
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China,
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Aagaard K, Rasmussen BS, Sørensen EE, Laursen BS. Patients Scheduled for General Anesthesia: Betwixt and Between Worrying Thoughts and Keeping Focus. J Perianesth Nurs 2018; 33:844-854. [PMID: 30449433 DOI: 10.1016/j.jopan.2016.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 10/04/2016] [Accepted: 10/17/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of the research was to explore the interaction between cancer patients and Registered Nurse Anesthetists (RNAs) before general anesthesia from the patients' perspective. DESIGN Focused ethnography was used as method for data collection. METHODS Surgical patients' interactions with the RNAs were observed during preparations for general anesthesia and further explored during an interview on the first or second postoperative day. Methodological concepts of Grounded Theory structured the analysis. FINDINGS The core variable describes patients being in an intermediate position, not knowing the outcome of the anesthetic and surgical procedures. The core variable is elaborated by subcore variables describing patients' coping strategies and need for care. CONCLUSIONS Patients' experiences of being cared for and supported in their coping strategies by RNAs will substantiate patients' predisposed confidence in the RNA and the anesthetic procedure. This will support patients in keeping focus in a highly technological environment.
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van der Wal- Huisman H, Dons KS, Smilde R, Heineman E, van Leeuwen BL. The effect of music on postoperative recovery in older patients: A systematic review. J Geriatr Oncol 2018; 9:550-559. [DOI: 10.1016/j.jgo.2018.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 02/06/2018] [Accepted: 03/19/2018] [Indexed: 02/06/2023]
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Mackintosh J, Cone G, Harland K, Sriram KB. Music reduces state anxiety scores in patients undergoing pleural procedures: a randomised controlled trial. Intern Med J 2018; 48:1041-1048. [PMID: 29345398 DOI: 10.1111/imj.13738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/04/2017] [Accepted: 12/08/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patient anxiety is an often overlooked complication of pleural diagnostic and therapeutic procedures. Listening to music is effective in reducing patient anxiety in some endoscopy procedures but has not yet been evaluated in pleural procedures. AIM To evaluate the benefits of music therapy during pleural procedures on a patient's anxiety, perceived pain and satisfaction with the procedure. METHODS Consecutive patients undergoing therapeutic pleural procedures were randomised to music and control groups. Participants in the music group listened to self-selected music using ear-bud headphones for the duration of the procedure. State anxiety was assessed before and after the procedure using the State Trait Anxiety Inventory. Physiological parameters were also measured. RESULTS Sixty patients were included in the study. In the music group, a reduction in state anxiety scores were observed post-procedure (34 ± 11 vs 48 ± 13, P < 0.001), while no change was observed in the control group (40 ± 11 vs 42 ± 11, P = 0.51). Participants in the music group had reductions in heart rate (87 ± 17 vs 95 ± 15, P = 0.04), systolic (121 ± 13 vs 130 ± 16, P = 0.02) and diastolic blood pressure (72 ± 8 vs 78 ± 9, P = 0.01) post procedure compared to the pre-procedures values. A similar change was not detected in the control group: heart rate (86 ± 17 vs 85 ± 15, P = 0.73), systolic (133 ± 21 vs 134 ± 20, P = 0.83) and diastolic blood pressure (77 ± 9 vs 79 ± 10, P = 0.30). There was no difference in patient pain scores (P = 0.8), willingness to undergo the procedure again (P= 0.27), satisfaction with the performance of the pleural procedure (P = 0.20) and duration of the procedure (P = 0.68) between the music and control groups. CONCLUSIONS Listening to music appears to be beneficial in reducing anxiety in patients undergoing pleural procedures.
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Affiliation(s)
- John Mackintosh
- Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Grace Cone
- Department of Respiratory Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Kate Harland
- Department of Respiratory Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Krishna B Sriram
- Department of Respiratory Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
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Elkassabany NM, Abraham D, Huang S, Kase B, Pio F, Hume E, Israelite C, Liu J. Patient education and anesthesia choice for total knee arthroplasty. PATIENT EDUCATION AND COUNSELING 2017; 100:1709-1713. [PMID: 28487116 DOI: 10.1016/j.pec.2017.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 04/20/2017] [Accepted: 04/21/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Spinal anesthesia (SA) for Total Knee Arthroplasty (TKA) may be associated with better patients' outcomes. This study aims to assess the association between preoperative education about the advantage of SA over general anesthesia (GA) for TKA and the likelihood of patient choice of NA. METHODS Patients undergoing unilateral primary TKA were identified. Type of anesthesia (GA or SA), attendance of the (joints class), patient demographics, ASA status, anticoagulation status, and diagnosis of back problems were recoded. Regression analysis was used to assess the association between the type of anesthesia and attendance of the joints class. RESULTS 1010 patients were identified to have unilateral primary TKA. 31% of patients attended the joint class. Patients who attended the joints class were more likely to receive SA when compared to those who did not attend (OR=1.7, CI: 1.2-2.5, P=0.004) after adjusting for other variables. CONCLUSION Preoperative education about advantages of SA may be associated with an increase in patients receiving SA for TKA. PRACTICE IMPLICATIONS Increase in patients receiving SA for TKA may improve outcomes.
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Affiliation(s)
- Nabil M Elkassabany
- Department of Anesthesiology and Critical Care, University of Pennsylvania, USA.
| | - Daniel Abraham
- Department of Anesthesiology and Critical Care, University of Pennsylvania, USA.
| | - Stephanie Huang
- Department of Anesthesiology and Critical Care, University of Pennsylvania, USA.
| | - Brandon Kase
- Department of Anesthesiology and Critical Care, University of Pennsylvania, USA.
| | - Finnah Pio
- Department of Orthopedic Surgery, University of Pennsylvania, USA.
| | - Eric Hume
- Department of Orthopedic Surgery, University of Pennsylvania, USA.
| | - Craig Israelite
- Department of Orthopedic Surgery, University of Pennsylvania, USA.
| | - Jiabin Liu
- Department of Anesthesiology and Critical Care, University of Pennsylvania, USA.
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Bhavsar R, Ryhammer PK, Greisen J, Jakobsen CJ. Lower Dose of Sufentanil Does Not Enhance Fast Track Significantly-A Randomized Study. J Cardiothorac Vasc Anesth 2017; 32:731-738. [PMID: 29128486 DOI: 10.1053/j.jvca.2017.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Adjustment in the doses of opioids has been a focus of interest for achieving better fast-track conditions in cardiac anesthesia, but relatively sparse information exists on the potential effect of psychologic and behavioral factors, such as stress, anxiety, and type of personality, on anesthesia requirements and patient turnover in the cardiac recovery unit (CRU); to the authors' knowledge, this particular focus has not been systematically investigated. In this randomized study, the authors tested the hypothesis that low-dose sufentanil, compared with a standard dose, can improve fast-track parameters and the overall quality of recovery. Opioid requirements related to personality type, pain sensitivity, and preoperative stress and anxiety also were assessed. DESIGN A randomized, prospective study. PARTICIPANTS The study comprised 60 patients scheduled for elective coronary artery bypass grafting with or without aortic valve replacement. SETTING A university hospital. INTERVENTIONS Patients were randomly assigned to receive either a standard dose (bolus 0.5 µg/kg) or low dose (bolus 0.25 µg/kg) of sufentanil combined with propofol. MEASUREMENTS AND MAIN RESULTS The primary outcome variables were ventilation time and eligible time to discharge from the CRU. The secondary objective was to evaluate the relationship between opioid requirements and personality type, pain sensitivity, and preoperative stress and anxiety. The groups were comparable in selected demographics and perioperative parameters. There was no difference between groups in ventilation time (low dose: 191 [163-257] v standard dose: 205 [139-279] min; p = 0.405); eligible CRU discharge time (10.3 ± 5.0 v 10.3 ± 4.2 h; p = 0.978); or administration of postoperative morphine (25 [11-34) v 27 [10-39] g; p = 0.790). There was no difference between groups in total sufentanil administration and various preoperative psychologic and behavioral test levels nor in the time to reach bispectral index <50 during induction, except that personality type A demonstrated a longer induction time of 10 (8-12) minutes versus 6 (4-8) minutes in low-score patients. CONCLUSION A lower dose of sufentanil, compared with a standard dose, does not enhance fast-track conditions significantly.
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Affiliation(s)
- Rajesh Bhavsar
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Pia Katarina Ryhammer
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Jacob Greisen
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Carl-Johan Jakobsen
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
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Sander IM, Liepert TT, Doney EL, Leevy WM, Liepert DR. Patient Education for Endoscopic Sinus Surgery: Preliminary Experience Using 3D-Printed Clinical Imaging Data. J Funct Biomater 2017; 8:E13. [PMID: 28387702 PMCID: PMC5491994 DOI: 10.3390/jfb8020013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 03/15/2017] [Accepted: 03/23/2017] [Indexed: 01/17/2023] Open
Abstract
Within the Ear, Nose, and Throat (ENT) medical space, a relatively small fraction of patients follow through with elective surgeries to fix ailments such as a deviated septum or occluded sinus passage. Patient understanding of their diagnosis and treatment plan is integral to compliance, which ultimately yields improved medical outcomes and better quality of life. Here we report the usage of advanced, polyjet 3D printing methods to develop a multimaterial replica of human nasal sinus anatomy, derived from clinical X-ray computed tomography (CT) data, to be used as an educational aid during physician consultation. The final patient education model was developed over several iterations to optimize material properties, anatomical accuracy and overall display. A two-arm, single-center, randomized, prospective study was then performed in which 50 ENT surgical candidates (and an associated control group, n = 50) were given an explanation of their anatomy, disease state, and treatment options using the education model as an aid. Statistically significant improvements in patient ratings of their physician's explanation of their treatment options (p = 0.020), self-rated anatomical understanding (p = 0.043), self-rated understanding of disease state (p = 0.016), and effectiveness of the visualization (p = 0.007) were noted from the population that viewed the 3D education model, indicating it is an effective tool which ENT surgeons may use to educate and interact with patients.
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Affiliation(s)
- Ian M Sander
- Department of Biological Sciences, University of Notre Dame, South Bend, IN 46556, USA.
| | - Taimi T Liepert
- Michiana Sleep Solutions and Allied ENT Speciality Center, South Bend, IN 46635, USA.
| | - Evan L Doney
- Department of Biological Sciences, University of Notre Dame, South Bend, IN 46556, USA.
| | - W Matthew Leevy
- Department of Biological Sciences, University of Notre Dame, South Bend, IN 46556, USA.
| | - Douglas R Liepert
- Department of Biological Sciences, University of Notre Dame, South Bend, IN 46556, USA.
- Michiana Sleep Solutions and Allied ENT Speciality Center, South Bend, IN 46635, USA.
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Enhanced communication performance improvement and patient satisfaction in an endoscopy/ambulatory surgery unit. Gastroenterol Nurs 2017; 38:194-200. [PMID: 26035776 DOI: 10.1097/sga.0000000000000116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A nursing incentive directed toward enhanced communication, performance improvement, patient safety, and patient satisfaction was initiated by the staff nurses in an endoscopy unit of a 714-bed specialized teaching hospital. Data were collected from approximately 1,800 ambulatory patients using a hands-off communication tool. The population was evenly divided between males and females. The goals of the data collection focused on the utilization of a medical questionnaire given to patients prior to elective procedures. The purpose of this initial study was to ascertain whether the questionnaires contributed to patients' communication regarding their health record while facilitating the admission/assessment phase of undergoing an elective endoscopy procedure. The medical questionnaire also served as a patient education tool whereby staff promoted the importance of safe medication administration. The initiative will remain ongoing and future studies will monitor and identify areas needed for performance improvement, patient safety, and enhanced communication. Patient satisfaction is measured using Press Ganey results.
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