Preoperative anxiety, coping, and intraoperative adjustment: Are there mediating effects of stress-induced analgesia?

Preparing patients according to their individual coping style improves patient experience of magnetic resonance imaging

MRI-related anxiety is present in 30% of patients and may evoke motion artifacts/failed scans, which impair clinical efficiency. It is unclear how patient anxiety can be countered most effectively. Habitual preferences for coping with stressful situations by focusing or distracting one’s attention thereof (coping style) may play a key role in this context. This study aimed to compare the effectiveness of two patient-preparation videos with informational vs. relaxational content and to determine whether the fit between content and coping style affects effectivity. The sample consisted of 142 patients (M = 48.31 ± 15.81 years). Key outcomes were anxiety, and cortisol as a physiological stress marker. When not considering coping style, neither intervention improved the patients’ reaction; only patient preparation that matched the patients’ coping style was associated with an earlier reduction of anxiety. This suggests that considering individual preferences for patient preparation may be more effective than a one-size-fits-all approach.

Less stress, better success: a scoping review on the effects of anxiety on anesthetic and analgesic consumption

Preoperative anxiety has an incidence of 11-80% in patients undergoing surgical or interventional procedures. Understanding the role of preoperative anxiety on intraoperative anesthetic requirements and postoperative analgesic consumption would allow personalized anesthesia care. Over- or under-anesthetizing patients can lead to complications such as postoperative cognitive dysfunction in elderly patients, or procedural discomfort, respectively. Our scoping review focuses on the current evidence regarding the association between preoperative anxiety and intraoperative anesthetic and/or postoperative analgesic consumption in patients undergoing elective surgical or interventional procedures. Based on 44 studies that met the inclusion criteria, we found that preoperative anxiety has a significant positive correlation effect on intraoperative propofol and postoperative opioid consumption. The analysis of the literature is limited by the heterogeneity of preoperative anxiety tools used, study designs, data analyses, and outcomes. The use of shorter, validated preoperative anxiety assessment tools may help optimize the intraoperative anesthetic and postoperative analgesic regimen. Further research to determine the most feasible and clinically relevant preoperative anxiety tool and subsequent implementation has the potential to optimize perioperative care and improve patient outcomes.

Social Sharing of Emotion in Anticipation of Cardiac Surgery

This study examined associations between social sharing of emotions, social support and preoperative psychological distress. Social sharing was operationalized in terms of quantity and quality. Quantity of social sharing was measured daily using a diary method. Quality of social sharing was measured with the Quality of Sharing Inventory. Participants were 157 hospitalized Greek patients. Hierarchical regression analysis showed that controlling for distress on admission, quality of social sharing was negatively related to distress one day before surgery ( p < .01). No effects were found for quantity of social sharing. Results emphasize the importance of studying qualitative aspects of emotional disclosure.

Predictors of spouses' provided support for patients receiving laparoscopic radical prostatectomy peri-surgery

Close relationships are usually the most important source of social support. But even in close relationships, symptoms of distress in one or both partners may undermine support processes. Seventy-seven patients receiving laparoscopic radical prostatectomy (44-73 years) and their spouses (38-72 years) provided data 1 day prior to surgery as well as 2 days and 2 weeks post-surgery. Our assumption that the commonly found support-eroding potential of receivers' depressive symptoms would not be evident during early stages of an acute crisis situation, such as major tumor surgery, tended to be supported by the data. However, depressive symptoms and degree of patient-reported post-operative pain were associated with a delayed decrease in spousal instrumental support provision 2 weeks after surgery. Spousal depression was largely unrelated to the provision of support. The present findings hint at the limits of a loved-one's capacity to assist in times of need.