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Kocaturk S, Gur ZB, Gursoytrak B. Can Verbal Interview Decrease Preoperative Anxiety and Postoperative Discomfort in Oral and Maxillofacial Surgery Patients?: A Randomized Clinical Trial. J Oral Maxillofac Surg 2024:S0278-2391(24)00588-3. [PMID: 39009060 DOI: 10.1016/j.joms.2024.06.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 06/25/2024] [Accepted: 06/25/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Preoperative anxiety is a condition that can be seen frequently in oral and maxillofacial surgery patients and affects the recovery process. PURPOSE The aim of this study was to determine the effect of preoperative educational or informative interviews on preoperative anxiety levels and postoperative discomfort in patients undergoing oral and maxillofacial surgery. STUDY DESIGN, SETTING, AND SAMPLE This prospective randomized clinical trial involved patients who underwent oral and maxillofacial surgery at Aydın-Adnan-Menderes University, Oral and Maxillofacial Surgery Hospital. Patients with neurological or psychological disorders, a history of previous psychiatric drug use, those who used anxiolytic or sedative drugs before surgery, those who required postoperative anxiolytic and opioid administration, or patients who underwent nonstandard surgical and anesthesia protocols were excluded. EXPOSURE VARIABLE Preoperative educational or informative interview is the exposure variable. Subjects were randomly assigned to the intervention and control groups. MAIN OUTCOME VARIABLES The primary outcome variable was preoperative anxiety measured by the Spielberger State-Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information scale (APAIS). The secondary outcome variables were postoperative pain measured by visual analog scale at the first and sixth hours, postoperative nausea (repeated gagging or spitting), and postoperative vomiting (active vomiting) were observed within 6 hours following general anaesthesia. COVARIATES The study's covariates were age, weight, sex, American Society of Anesthesiologists Physical Status Classification System score, marital status, edicational background, surgery procedure, anesthesia procedure, duration of surgery, and recovery time. ANALYSES The χ2 and student t-tests were used to compare primary predictor and covariates against outcome variables. A P value <.05 was considered significant. RESULTS A total of 92 patients were included in this study, with 46 randomized to intervention group and 46 to control group. The mean age (37.78 ± 13.94 years vs 33.34 ± 15.17 years, P = .16) and sex differences (female/male: 16/30(34.8/65.2) versus 26/20(56.5/43.5), P = .06) were comparable between groups. While higher values were recorded in the average anxiety scores in the control group than in the study group, statistically significant differences were found [Spielberger State-Trait Anxiety Inventory-S (37.36 ± 10.87 vs 52.39 ± 12.13) (P < .01), APAIS-T (15.82 ± 5.35 vs 21.39 ± 6.69) (P < .01), APAIS-A (4.17 ± 2.12 vs 6.47 ± 2.15) (P < .01), APAIS-B (5.76 ± 2.03 vs 7.65 ± 2.60) (P < .01), and APAIS-C (6.04 ± 2.47 vs 7.21 ± 2.38), (P < .05)]. At the same time, there was also a significant difference in terms of early postoperative pain [(2.08 ± 2.77 vs 3.43 ± 2.86), (P = .02)] and postoperative nausea [12/34 (26.1/73.9) versus 25/21(54.3/45.7), (P = .01)]. CONCLUSIONS AND RELEVANCE Oral and maxillofacial surgery causes significant situational anxiety. This study showed that preoperative educational or informative interviews reduced preoperative anxiety levels and postoperative discomfort, such as early postoperative pain, nausea, and vomiting.
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Affiliation(s)
- Selin Kocaturk
- Student, TAKEV High School, (accredited by the German Science Association- MINT Zukunft Schaffen), Izmir, Turkey; Research Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey; Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey
| | - Zeynep Busra Gur
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey.
| | - Burcu Gursoytrak
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey; Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey
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Shreya A, Rath DP, Parida S, Munuswamy H, Prasad S, Padmanabhan R. Evaluation of Postoperative Pain After Cardiothoracic Surgery in Patients With and Without Significant Preoperative Anxiety: A Prospective Observational Study. Ann Card Anaesth 2024; 27:121-127. [PMID: 38607875 PMCID: PMC11095785 DOI: 10.4103/aca.aca_175_23] [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: 10/31/2023] [Revised: 01/13/2024] [Accepted: 01/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND AND AIMS Anxiety plays a distressing role in cardiothoracic operations. It may trigger hemodynamic instability, increased morbidity, and very crucially, postoperative pain and analgesic use. Our aim is to look at the association between anxiety, postoperative pain, and analgesic use. MATERIALS AND METHODS One hundred and twenty-two patients scheduled for cardiothoracic surgeries were asked questions according to the Amsterdam Preoperative Anxiety and Information Scale (APAIS), the evening prior to the surgery. Different factors that could affect anxiety perioperatively were recorded through the patient's hospital records. The visual analog score (VAS) was recorded at arrival in the ICU after surgery. Paracetamol (1 g) and Inj Tramadol (1 mg/kg) were administered as postoperative analgesia. Additional fentanyl boluses (1 mcg/kg) were administered whenever the VAS exceeded 4. Analgesic doses were documented. All the data were then analyzed statistically. RESULTS Preoperative anxiety was recorded in 63.9% of the 122 subjects included in the study, with younger patients and patients with very low socioeconomic status being the majority. VAS, at 20 and 24 hrs of assessment, was higher in both groups, and there was a statistically significant difference, with patients that were preoperatively anxious, recording higher VAS scores. Postoperative analgesic doses were also significantly higher for patients with anxiety. CONCLUSIONS This clinical trial demonstrated that greater than 60% of the participants presented with preoperative anxiety, the majority being young participants. Lower socioeconomic status is also a risk factor for preoperative anxiety. Patients who suffered from preoperative anxiety are more likely to have greater pain scores and analgesic needs during postsurgical assessment.
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Affiliation(s)
- Agarwal Shreya
- Department of Cardio Thoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Durga P. Rath
- Department of Cardio Thoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Satyen Parida
- Department of Anaesthesiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Hemachandren Munuswamy
- Department of Cardio Thoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Sreevathsa Prasad
- Department of Cardio Thoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Ramsankar Padmanabhan
- Department of Cardio Thoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Khadka B, Sharma A, Bhattarai PR, Rayamajhi B, Adhikari H. Role of pre-operative counseling with NSQIP surgical risk calculator in the surgical patients. Surg Open Sci 2024; 18:11-16. [PMID: 38312306 PMCID: PMC10831096 DOI: 10.1016/j.sopen.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/31/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
Introduction Patient satisfaction is important tool to monitor health care performance and quality of health plans, emphasizing effective counseling and consent processes. The objective of the study is to assess patient satisfaction and anxiety with the use of NSQIP surgical risk calculator in comparison to standardized questionnaires. Methodology This is an interventional prospective randomized study. Difference in patient satisfaction is assessed by a 7-point Likert scale and anxiety assessment by 5-point Likert scale of Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire written in Nepalese. Satisfaction scores were compared using analysis of variance (ANOVA), or the Kruskal-Wallis test. P- value <0.05 was considered statistically significant. Results Satisfaction score regarding comfort during counseling and consent process was similar with and without use of NSQIP surgical risk calculator (83.3 % and 76.9 %, respectively). Satisfaction score regarding plan of anesthesia was 63.33 % with the use of NSQIP and 53.8 % without NSQIP tool. 30.76 % of patients with high school education developed negative feelings following counseling when NSQIP tool was not used (p value 0.002). NSQIP usage increased anxiety about anesthesia and surgery and led to higher continual thinking about the procedure.Duration of counseling was 12 min with NSQIP tool use in comparison to 9.67 min following conventional counseling (p value 0.047). Conclusion NSQIP surgical risk calculator is a reliable tool that can be used alongside conventional methods during preoperative period for decision-making and counseling with similar satisfaction scores but a higher incidence of anxiety and continual thinking about procedures.
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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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Bello C, Romero CS, Heinimann J, Lederer M, Luedi MM. Ambulatory anesthesia: restructuring for success. Curr Opin Anaesthesiol 2023; 36:611-616. [PMID: 37724621 DOI: 10.1097/aco.0000000000001311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
PURPOSE OF REVIEW We review current evidence about organizational structures, patient selection criteria, safety measures, economic considerations, quality management, and staffing challenges in ambulatory anesthesia. The focus is on the facilitators and barriers related to the peri-interventional period and the potential concepts and innovations for the future development of ambulatory anesthesia services. RECENT FINDINGS Recent findings shed light on organizational structures in ambulatory anesthesia, including hospital-based centers, freestanding ambulatory centers, and office-based practices. Patient selection for ambulatory anesthesia involves a two-step process, considering both surgical and anesthetic factors. Safety measures, such as standardized guidelines and scoring systems, aim to ensure patient well being during the perioperative course. Economic considerations pose challenges due to the complexities of managing operating room efficiency and the variations in reimbursement systems. Quality management in ambulatory anesthesia emphasizes the need for outcome studies and patient-centered quality indicators. Staffing requirements necessitate highly skilled professionals with both technical and nontechnical skills, and structured education and training are essential. SUMMARY Ambulatory anesthesia is gaining importance due to advancements in surgical techniques and peri-interventional care. The review highlights the need for addressing challenges related to organizational structures, patient selection, patient safety, economic considerations, quality management, and staffing in ambulatory anesthesia. Understanding and addressing these factors are crucial for promoting the further development and improvement of ambulatory anesthesia services.
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Affiliation(s)
- Corina Bello
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Carolina S Romero
- Anesthesia, Critical care and Pain Department, Hospital General Universitario De Valencia, Universidad Europea de Valencia, Valencia, Spain
| | - Jonathan Heinimann
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Inselspital, Bern University Hospital, Bern
| | - Melanie Lederer
- Department of Anaesthesiology, Cantonal Hospital of St. Gallen, St. Gallen
| | - Markus M Luedi
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Li M, Guo J, Gao J, Wang L, Ding Y. Qualitative study of the perceived experiences and needs coping of primary caregivers of patients with breast cancer during operation in central China. BMJ Open 2023; 13:e072932. [PMID: 37914299 PMCID: PMC10626842 DOI: 10.1136/bmjopen-2023-072932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023] Open
Abstract
PURPOSE The purpose of this study is to gain an in-depth understanding of the intraoperative waiting period experience and needs response of primary caregivers of patients with breast cancer. METHOD Using a purposive sampling method, 16 primary caregivers of patients with breast cancer admitted to the Department of Breast Surgery of Shanxi Bethune Hospital from January to May 2022 were selected as study subjects. Semistructured in-depth interviews were conducted using a qualitative research method. RESULTS Five themes were extracted from the levels of safety and security, information transfer, emotion management, psychological adjustment and role adaptation: safety first and intraoperative care, lack of information and misdirection, negative emotions and tired of coping, ineffective worry and overthinking, and role multiplicity and bearing alone, respectively. CONCLUSION The intraoperative waiting period for primary caregivers of patients with breast cancer felt multidimensional and had less than optimal needs satisfaction. Healthcare professionals should use the existing needs as an entry point to give appropriate interventions to enhance the coping ability of caregivers of patients with breast cancer.
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Affiliation(s)
- Min Li
- Nursing College, Shanxi Medical University, Taiyuan, Shanxi, China
- General Surgery Department, Shanxi Bethune Hospital, Taiyuan, China
| | - Jun Guo
- General Surgery Department, Shanxi Bethune Hospital, Taiyuan, China
| | - Jinnan Gao
- General Surgery Department, Shanxi Bethune Hospital, Taiyuan, China
| | - Linying Wang
- General Surgery Department, Shanxi Bethune Hospital, Taiyuan, China
| | - Yongxia Ding
- Nursing College, Shanxi Medical University, Taiyuan, Shanxi, China
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Bello C, Nuebling M, Koster KL, Heidegger T. Patient-reported perioperative anaesthesia-related anxiety is associated with impaired patient satisfaction: a secondary analysis from a prospective observational study in Switzerland. Sci Rep 2023; 13:16301. [PMID: 37770524 PMCID: PMC10539284 DOI: 10.1038/s41598-023-43447-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/24/2023] [Indexed: 09/30/2023] Open
Abstract
Perioperative anxiety is common. The relationship between anxiety and patient satisfaction with anaesthesia is still under debate. We assessed the prevalence and different causes of anaesthesia-related fears leading to perioperative anxiety and its association with patient satisfaction. A multiple-time validated, psychometrically developed questionnaire assessing the presence of anxiety, causes of fear, and different dimensions of patient satisfaction was sent to patients after discharge. The clinical data were obtained from a previous study. The sample size was calculated to recruit a minimum of 300 completed questionnaires. Statistical analyses included multivariate logistic regression models. Complete data were available for 474 of the 600 patients recruited for the study (response rate: 79%). A total of 141 patients (30%) reported anxiety regarding anaesthesia before hospital admission. The prevalence of anxiety was significantly associated with patient age (< 54 years: n = 196, prevalence = 37%; > 54 years: n = 263, prevalence = 24%; p = 0.002), female sex (female: n = 242, prevalence 39%; male: n = 223, prevalence 20%; p < 0.001), and surgical speciality (gynaecology (n = 61, prevalence = 49%), otolaryngology (n = 56, prevalence = 46%); p < 0.001). Fear of not awakening from anaesthesia (n = 44, prevalence = 32%, SD 45.8) and developing postoperative nausea or vomiting (n = 42, prevalence = 30%, SD 46.0) were the most reported anaesthesia-related causes of fear. Anxiety was associated with impaired overall patient satisfaction (mean dissatisfaction score 15%, versus 23%, SD 16.3 in the anxious group, SD 16.3, p < 0.001), especially regarding the dimensions "information and involvement in decision-making" (14% of deficits stated in the non-anxious group compared to 23% in the anxious group, p < 0.001), "respect and trust" (2% vs 6.26%, p < 0.001) and "continuity of care" (50% vs 57%, p < 0.015). Patient-reported anaesthesia-related anxiety is common and may affect important outcome parameters such as patient satisfaction. Abstract presented in e-poster format at Euroanaesthesia 2023, June 3-5, Glasgow.
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Affiliation(s)
- Corina Bello
- Department of Anaesthesiology Spital Grabs, Spitalregion Rheintal Werdenberg Sarganserland, Grabs, Switzerland.
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
| | | | - Kira-Lee Koster
- Department of Medical Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Thomas Heidegger
- Department of Anaesthesiology Spital Grabs, Spitalregion Rheintal Werdenberg Sarganserland, Grabs, Switzerland
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
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Jafarian AA, Khatibi A, Mesbah Kiaei M, Alebouyeh MR, Alimian M, Habibi A, Amniati S. Comparison of Effects of Stress and Midazolam on Retrograde and Anterograde Amnesia in Patients Undergoing General Anesthesia. Anesth Pain Med 2023; 13:e134300. [PMID: 37404263 PMCID: PMC10317029 DOI: 10.5812/aapm-134300] [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: 12/18/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 07/20/2023] Open
Abstract
Background The identification of different factors affecting anesthesia and physiological changes during anesthesia can be effective in improving the quality of anesthesia. Midazolam is a benzodiazepine that has been used for many years for sedation under anesthesia. Stress is also an important factor affecting memory and other physiological changes, such as blood pressure and heart rate. Objectives his study aimed to investigate the effects of stress on retrograde and anterograde amnesia among patients undergoing general anesthesia. Methods This multi-center, parallel, stratified, randomized controlled trial was performed on patients undergoing non-emergency abdominal laparotomy. The patients were divided into high- and low-stress groups according to the Amsterdam Preoperative Anxiety and Information Scale. Then, both groups were randomly divided into three subgroups receiving 0, 0.02, or 0.04 mg/kg of midazolam. Recall cards were shown to patients at 4 minutes, 2 minutes, and immediately before injection to determine retrograde amnesia and at 2 minutes, 4 minutes, and 6 minutes after injection to determine anterograde amnesia. Hemodynamic changes were recorded during intubation. The chi-square and multiple regression tests were used to analyze the data. Results Midazolam injection was associated with the development of anterograde amnesia in all groups (P < 0.05); however, it had no effect on the development of retrograde amnesia (P < 0.05). Midazolam could decrease the systolic and diastolic blood pressure and heart rate during intubation (P < 0.05). Stress also caused retrograde amnesia in patients (P < 0.05); nevertheless, it had no effect on anterograde amnesia (P > 0.05). Stress and midazolam injection could not affect the oxygen levels during intubation. Conclusions The results showed that midazolam injection could induce anterograde amnesia, hypotension, and heart rate; nonetheless, it had no effect on retrograde amnesia. Stress was associated with retrograde amnesia and increased heart rate; however, it was not associated with anterograde amnesia.
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Affiliation(s)
- Ali Akbar Jafarian
- Department of Anesthesiology and Pain Medicine, Motahari Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Khatibi
- Firouzgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Mesbah Kiaei
- Department of Anesthesiology and Pain Medicine, Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmood-Reza Alebouyeh
- Department of Anesthesiology and Pain Medicine, Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mahzad Alimian
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Habibi
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saied Amniati
- Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Öztürk E, Yikilmaz TN, Hamidi N, Selvi İ, Başar H. Scheduled or immediate cystoscopy: Which option reduces pain and anxiety? Int Urol Nephrol 2023; 55:37-41. [PMID: 36125620 DOI: 10.1007/s11255-022-03364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/10/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Office-based flexible cystoscopy is a common outpatient procedure in daily urology practice. Sometimes, cystoscopy procedures are performed on the initial day or scheduled on the following days. We designed this study to compare immediate versus scheduled cystoscopy in terms of anxiety and pain. METHODS In this study, 160 patients were prospectively randomized to undergo office-based flexible cystoscopy by the same urologist between November 2017 and January 2018. Participants were grouped as scheduled for a cystoscopy on the third day of their application (group 1) and immediate cystoscopy on the same day of the application (group 2). A visual analog scale (VAS), State-Trait Anxiety Inventory (STAI) and Beck Anxiety Inventory (BAI) were completed by the patients. RESULTS Among men, immediate cystoscopy group experienced an increased state anxiety score compared to scheduled group (51.21 ± 8.108 vs 35.29 ± 10.553; p < 0.001). BAI scores were 16.51 ± 8.078 for group1 vs 31.92 ± 8.403 for group2 (p < 0.001). The mean VAS score was 3 ± 1.183 and 4.55 ± 1.155 in group1 and group2, respectively (p < 0.001). Among women, both the trait anxiety score and state anxiety score were found significantly low in scheduled group (mean trait anxiety scores 44.71 ± 6.051 and 49.3 ± 6.670, mean state anxiety scores were 33.71 ± 8.776 and 44.15 ± 7 in group1 and 2, respectively; p < 0.0001). BAI scores were also low in scheduled group (19.02 ± 7.786 vs 34.13 ± 8.367). Additionally, the mean VAS score was significantly high in immediate cystoscopy group compared to scheduled cystoscopy group (3.50 ± 0.784 vs 2.61 ± 0.919; p < 0.001). CONCLUSION To reduce anxiety and pain, informing patients properly about the cystoscopy and scheduling the procedure would be helpful for a better cooperation of the patient.
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Affiliation(s)
- Erdem Öztürk
- Urology Department, Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Training and Research Hospital, Vatan Street No:91, Yenimahalle, 06200, Ankara, Turkey.
| | - Taha Numan Yikilmaz
- Urology Department, Department of Urology, Denizli Egekent Hospital, Denizli, Turkey
| | - Nurullah Hamidi
- Urology Department, Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Training and Research Hospital, Vatan Street No:91, Yenimahalle, 06200, Ankara, Turkey
| | - İsmail Selvi
- Urology Department, Department of Urology, Başakşehir Çam and Sakura Hospital, Istanbul, Turkey
| | - Halil Başar
- Urology Department, Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Training and Research Hospital, Vatan Street No:91, Yenimahalle, 06200, Ankara, Turkey
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Asiri S, Guilhermino M, Duff J. The effectiveness of using virtual reality technology for perioperative anxiety among adults undergoing elective surgery: a randomised controlled trial protocol. Trials 2022; 23:972. [PMID: 36461040 PMCID: PMC9716760 DOI: 10.1186/s13063-022-06908-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND More than 2.5 million people are admitted for surgery in Australia each year, and between 40 to 80% will experience moderate to high preoperative anxiety. Elevated levels of preoperative anxiety can increase the risk of postoperative complications such as pain, delayed wound healing, infection, prolonged recovery, and longer hospitalisation. Limited previous research on Virtual Reality (VR) indicates a positive impact on surgery-related anxiety and suggests that the intervention potentially leads to reduce postoperative complications. OBJECTIVE To evaluate the effectiveness of using VR technology for perioperative anxiety among adults undergoing elective surgery. METHOD A two-group parallel randomised controlled trial (RCT) will be conducted, including 150 adult patients (aged 18 years and over) undergoing elective surgery and requiring an overnight stay at a major metropolitan hospital. Eligible participants will be screened for anxiety via the Amsterdam Preoperative Anxiety and Information score (APAIS). Those with moderate to severe anxiety will be randomly allocated to receive the VR session or usual care, in the preoperative holding area. Intervention participants will use a head-mounted VR device to watch and listen to a nature scene for 10 minutes. STUDY OUTCOMES The primary outcome is perioperative anxiety measured using the visual analogue scale for anxiety (VAS-A). Secondary outcomes include stress levels (measured by saliva cortisol level and heart rate), postoperative pain, patient satisfaction with perioperative care, hospital length of stay, and VR-associated adverse events. CONCLUSION This study will help evaluate if a brief preoperative VR session can reduce perioperative anxiety for adult elective surgical patients. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001350910.
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Affiliation(s)
- Salihah Asiri
- grid.412832.e0000 0000 9137 6644School of Nursing, Umm Al-Qura University, Makkah, Saudi Arabia ,grid.1024.70000000089150953School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia ,Australian College of Perioperative Nurses (ACORN), QLD, Australia ,grid.416100.20000 0001 0688 4634Nursing & Midwifery Research Centre, Centre for Clinical Nursing, Royal Brisbane & Women’s Hospital, Building 34, Level 5, Herston, QLD 4029 Australia
| | - Michelle Guilhermino
- grid.266842.c0000 0000 8831 109XSchool of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia ,grid.414724.00000 0004 0577 6676John Hunter Hospital – Intensive care Services, Newcastle, Australia
| | - Jed Duff
- grid.1024.70000000089150953School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia ,Australian College of Perioperative Nurses (ACORN), QLD, Australia
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Jacofsky MC, Auran RL, Williams A, Mauro S, Sietsema D. Exposure-Related Anxiety and Improving Patient Satisfaction with Medical Undergarments During Surgery: A Randomized Controlled Trial. J Bone Joint Surg Am 2022; 104:1380-1385. [PMID: 35726887 DOI: 10.2106/jbjs.22.00126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The standard of care for patients undergoing a surgical procedure is to have patients remove all clothing and don a hospital-provided gown. A growing number of patients have anxiety when exposing their bodies in a medical setting, which increases stress for those patients. METHODS This study prospectively enrolled patients at a single orthopaedic specialty hospital into 1 of 2 garment groups in a block-randomized design. Patients were asked to remove all clothing; 100 patients received the standard-of-care gown only, and 100 patients received the standard-of-care gown plus a single-use undergarment designed with retractable panels and a releasable waistband. Patients completed surveys evaluating their levels of anxiety with regard to exposing their bodies in a medical setting. RESULTS There were 181 subjects (91%) who completed the preoperative surveys and 166 subjects (83%) who completed the post-discharge surveys. Fifty-seven subjects (31%) reported being uncomfortable exposing their private, intimate parts in a medical setting, and 39 subjects (22%) reported experiencing stress and/or anxiety related to body exposure. Ninety-seven patients (54%) agreed or strongly agreed that protecting their personal modesty is important when undergoing a medical procedure. More patients in the undergarment group agreed or strongly agreed that the garments provided by the hospital met their expectation for privacy (80 patients [87%]), compared with the standard-of-care group (65 patients [73%]) (p = 0.025). Patients in the undergarment group (36 patients [39%]) were more likely than those in the standard-of-care group (16 patients [18%]) to strongly agree that they were satisfied with the hospital-provided garments (p = 0.028). When asked if the hospital-provided garments would influence their choice of hospital, patients in the undergarment group agreed or strongly agreed 3 times as often (19%) as the standard-of-care group (6.6%) (p = 0.06). CONCLUSIONS Exposure-related stress and/or anxiety are experienced by a substantial percentage of surgical patients, and the majority consider protection of their personal modesty in a medical setting to be important. The use of medical undergarments to protect modesty significantly increased levels of patient satisfaction. LEVEL OF EVIDENCE Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Marc C Jacofsky
- Musculoskeletal-Orthopedic Research and Education (MORE) Foundation, Phoenix, Arizona.,The CORE Institute, Phoenix, Arizona.,School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona
| | | | - Alyse Williams
- Musculoskeletal-Orthopedic Research and Education (MORE) Foundation, Phoenix, Arizona
| | - Susan Mauro
- Musculoskeletal-Orthopedic Research and Education (MORE) Foundation, Phoenix, Arizona
| | - Debra Sietsema
- Musculoskeletal-Orthopedic Research and Education (MORE) Foundation, Phoenix, Arizona.,The CORE Institute, Phoenix, Arizona
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Bagheri M, Maleki M, Mardani A, Momen MH, Daliri S, Rezaie S. The effect of video training and intraoperative progress report on the anxiety of family caregivers waiting for relatives undergoing surgery. Heliyon 2022; 8:e10065. [PMID: 35992003 PMCID: PMC9382265 DOI: 10.1016/j.heliyon.2022.e10065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/24/2022] [Accepted: 07/19/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose This study aimed to examine the effect of video training and intraoperative progress report on the anxiety of family caregivers awaiting relatives undergoing surgery. Methods A three-armed randomized controlled design was used. One hundred and two participants were enrolled and randomly assigned to three groups: the video training group (n = 34), the intraoperative progress report group (n = 34), and the control group (n = 34). Interventions were performed when the relatives of the participants were undergoing surgery. The participants in the video training group received video training containing images of the operating room environment and animations related to the patient’s surgical procedure, postoperative care, and possible complications from the surgery. In the intraoperative progress report group, information regarding the patient’s general condition, the percentage of surgical progress, and the approximate time of the patient’s transfer from the operating room were provided. The control group received routine care. A demographic data questionnaire and the Spielberger State-Trait Anxiety Inventory (STAI) was used for data collection. Results It was found a statistically significant decrease in the state anxiety in the video training (p < 0.001) and intraoperative progress report (p < 0.001) group after the intervention when compared to before the intervention. It was found no significant difference among the study groups in terms of the level of state and trait anxiety after the intervention (p > 0.05). Conclusions This study found that both video training and intraoperative progress report are effective in reducing the state anxiety of family caregivers awaiting relatives undergoing surgery.
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Dziadzko M, Mazard T, Bonhomme M, Raffin M, Pradat P, Forcione JM, Minjard R, Aubrun F. Preoperative Anxiety in the Surgical Transfer and Waiting Area: A Cross-Sectional Mixed Method Study. J Clin Med 2022; 11:jcm11092668. [PMID: 35566793 PMCID: PMC9100941 DOI: 10.3390/jcm11092668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/04/2022] [Accepted: 05/07/2022] [Indexed: 02/04/2023] Open
Abstract
Severe preoperative anxiety (SPA) in surgical patients may have clinical consequences and worsen satisfaction. Some institutions have a surgical transfer and waiting area (TWA) for patient reception/dispatch to operating rooms. We measured the frequency of SPA, investigated predicting factors, and quantified the effect of the TWA stay on anxiety levels in a single centre cross-sectional study. Preoperative anxiety was assessed using three scales. Patients’ perceptions/suggestions were studied by a psychoanalyst. A total of 933 adult patients, undergoing elective procedures, were interviewed. SPA was detected in 24.7%, non-modified by anxiolytic premedication. Patients’ median stay was 9 min, and anxiety level was decreasing in those with SPA. In multivariable analysis, female sex, inpatient settings, and pain before the procedure were predictive for SPA. Previous operating room experience, and a supine arrival position were associated with less SPA. Patients complained about a lack of information, and an uncomfortable environment in the waiting area. To reduce anxiety, they mainly asked for warm blankets/music (physical/sound barriers), and extra sedative agents. The holding area may be a place to measure patients’ anxiety by paramedical staff, and to apply simple non-pharmacological interventions. The psychological concept of psychical envelopes may be useful for the development and investigation of such interventions in improving patients’ experience.
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Affiliation(s)
- Mikhail Dziadzko
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
- INSERM U1290 RESHAPE, Université Claude Bernard Lyon 1, 69622 Lyon, France
- Consultation Douleur, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69005 Lyon, France;
- Correspondence: ; Tel.: +33-4-2610-9325
| | - Tessa Mazard
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
| | - Myriam Bonhomme
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
| | - Mahé Raffin
- Centre de Recherche Clinique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (M.R.); (P.P.)
| | - Pierre Pradat
- Centre de Recherche Clinique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (M.R.); (P.P.)
| | - Jean-Marc Forcione
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
| | - Raphael Minjard
- Consultation Douleur, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69005 Lyon, France;
- Centre de Recherche en Psychopathologie et Psychologie Clinique, Université Lumière Lyon-II, 69500 Bron, France
| | - Frederic Aubrun
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
- INSERM U1290 RESHAPE, Université Claude Bernard Lyon 1, 69622 Lyon, France
- Consultation Douleur, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69005 Lyon, France;
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Vallejo FA, Eichberg DG, Morell AA, Shah AH, Di L, Berry K, Luther E, Lu VM, Patel NV, Ivan ME, Komotar RJ. Same-day discharge after brain tumor resection: a prospective pilot study. J Neurooncol 2022; 157:345-353. [PMID: 35192136 PMCID: PMC8861287 DOI: 10.1007/s11060-022-03969-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 11/28/2022]
Abstract
Purpose Outpatient brain surgery has many advantages for the psychological and physical wellbeing of patients, as well as reduced costs to the health care system. Compared with inpatient admissions, same day discharges reduce patient exposure to nosocomial infection, thromboembolic complications, and medical error. We aim to establish a prospectively collected quality outcomes database to examine the outcomes of patients that undergo brain tumor resection and are discharged home the same day as surgery. Methods We have established a prospectively collected quality outcomes database to examine the outcomes of all patients that underwent brain tumor resection by a single neurosurgeon (R.J.K) at our institution from August 2020 to August 2021 and were discharged home the same day as surgery. Results Over the one-year period this study was conducted, 37 of 334 patients met inclusion criteria for the outpatient protocol. Thirty-two patients were discharged on the same day as surgery. Five patients (14%) were considered eligible for outpatient surgery but were ultimately admitted to the hospital postoperatively and were discharged after an overnight observation. No postoperative complications were noted at two-week postoperative follow-up. Conclusion In select patients undergoing brain tumor surgery, same day discharge should be considered. Establishing a multidisciplinary team of physicians, nurses, radiologists, and physical therapists is critical to achieving this aim. Physicians should have a low threshold to admit a patient with concerning exam findings, complications, or complicated past medical history. Once discharged, open communication with the patient and their family is critical to detect complications that should trigger rehospitalization and intervention.
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Affiliation(s)
- Frederic A Vallejo
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA.
| | - Daniel G Eichberg
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Alexis A Morell
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Ashish H Shah
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Long Di
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Katherine Berry
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Evan Luther
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Victor M Lu
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Nitesh V Patel
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Michael E Ivan
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
| | - Ricardo J Komotar
- Department of Neurosurgery, University of Miami Miller School of Medicine Lois Pope Life Center, 1095 14th Terrace, Miami, FL, 33136, USA
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Wang XQ, Li H, Li XN, Yuan CH, Zhao H. Gut-Brain Axis: Possible Role of Gut Microbiota in Perioperative Neurocognitive Disorders. Front Aging Neurosci 2022; 13:745774. [PMID: 35002672 PMCID: PMC8727913 DOI: 10.3389/fnagi.2021.745774] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/03/2021] [Indexed: 12/19/2022] Open
Abstract
Aging is becoming a severe social phenomenon globally, and the improvements in health care and increased health awareness among the elderly have led to a dramatic increase in the number of surgical procedures. Because of the degenerative changes in the brain structure and function in the elderly, the incidence of perioperative neurocognitive disorders (PND) is much higher in elderly patients than in young people following anesthesia/surgery. PND is attracting more and more attention, though the exact mechanisms remain unknown. A growing body of evidence has shown that the gut microbiota is likely involved. Recent studies have indicated that the gut microbiota may affect postoperative cognitive function via the gut-brain axis. Nonetheless, understanding of the mechanistic associations between the gut microbiota and the brain during PND progression remains very limited. In this review, we begin by providing an overview of the latest progress concerning the gut-brain axis and PND, and then we summarize the influence of perioperative factors on the gut microbiota. Next, we review the literature on the relationship between gut microbiota and PND and discuss how gut microbiota affects cognitive function during the perioperative period. Finally, we explore effective early interventions for PND to provide new ideas for related clinical research.
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Affiliation(s)
- Xiao-Qing Wang
- Department of Anesthesiology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
| | - He Li
- Department of Anesthesiology, Affiliated Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Nan Li
- Department of Anesthesiology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
| | - Cong-Hu Yuan
- Department of Anesthesiology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
| | - Hang Zhao
- Department of Anesthesiology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China
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Parikh HB, Gagliardi AG, Carry PM, Albright JC, Mandler TN. How Do We Best Educate Our Patients' Caregivers? Comparing the Efficacy of Print Versus Media-based Education Materials in Peripheral Nerve Catheter and Pain Pump Education. J Pediatr Orthop 2022; 42:35-39. [PMID: 34723897 DOI: 10.1097/bpo.0000000000001997] [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] [Indexed: 02/07/2023]
Abstract
BACKGROUND Media-based educational materials (EMs) are becoming prominent. The purpose of this study was to compare print versus media-based EMs given to caregivers of pediatric and young adult patients undergoing surgery. We aimed to see whether print or media-based EMs lead to greater caregiver satisfaction, comfort, and preparedness for outpatient peripheral nerve catheter and pain pump management. We also assessed caregiver preference for EM modality. HYPOTHESIS We hypothesized that media-based EMs would demonstrate greater overall efficacy and thus generate higher caregiver preference. STUDY DESIGN Randomized control trial. METHODS After IRB approval, clinicaltrials.gov registration (17-0638), and informed consent, caregivers were randomized to either media or print-based EM groups. Caregivers reviewed their assigned EM and completed a standardized assessment of their comprehension. We assessed caregiver satisfaction, preparedness, and comfort level with the content on a 5-point Likert scale. On postoperative days 1 to 2, caregivers reported satisfaction, comfort, and preference for EM modality. An intent-to-treat analysis was used to compare the 2 groups. RESULTS From our final cohort of 135 caregivers, we found no difference [P>0.05] in satisfaction, comfort level, level of preparedness, or discharge readiness scores between groups. After the caregivers were given both EMs, they were evenly split in their preference for print (49.6%) versus video (50.4%) based methods. CONCLUSIONS We did not detect a significant difference in caregiver preference or feelings of preparedness between groups. Interestingly, a significant proportion of caregivers (25%) did not feel comfortable managing the peripheral nerve catheter and its pain pump at home. Future studies should work to improve caregiver comfort with educational content before patient discharge. CLINICAL RELEVANCE Providers and institutions should feel comfortable providing both print and media-based patient and caregiver education. Caregiver education may be best suited based on caregiver preference of one EM modality versus the other. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Harin B Parikh
- Departments of Pediatric Anesthesiology
- Pediatric Orthopedic Surgery, Children's Hospital Colorado, Aurora, CO
| | | | | | | | - Tessa N Mandler
- Pediatric Orthopedic Surgery, Children's Hospital Colorado, Aurora, CO
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Samalea Suarez N, Hallet C, Lois F, Joris J, Brichant J. Effect of walking to the operating room on preoperative anxiety in patients scheduled for outpatient laser therapy for venous insufficiency. A monocentric randomized study. ACTA ANAESTHESIOLOGICA BELGICA 2021. [DOI: 10.56126/72.4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Preoperative anxiety in day surgery is associated with a higher incidence of post-operative complications such as postoperative nausea and vomiting, pain or unplanned admission.
Objectives: To evaluate the effect of walking to the operating room (OR) on anxiety in ambulatory patients undergoing minimal invasive laser therapy for venous insufficiency.
Design and setting: Randomized study in a tertiary hospital between May and November 2019.
Methods: 100 patients scheduled for ambulatory laser therapy for venous insufficiency were included. Patients were randomized to walk to the OR (study group, n=50) on even weeks or to lie in a bed to the OR (control group, n=50) on odd weeks.
Main outcome measures: Baseline anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and Numerical Rating Scale of anxiety (anxiety-NRS) from 0 to 10 when prepared for departure to OR. Preoperative anxiety-NRS assessment was performed upon arrival in the OR.
Results: Patients’ characteristics were similar in both groups. Baseline anxiety-NRS was significantly lower in the study group than in the control group: 2 (1-3) vs. 4 (2-6.5) (p=.013) respectively. No difference was observed between the groups for preoperative anxiety-NRS. A significant reduction in anxiety-NRS on arrival at the OR was observed in the control group compared with the study group (p=.019).
Conclusion: Walking to the OR does not reduce anxiety in ambulatory patients undergoing minimal invasive laser therapy for venous insufficiency. But, preparing them to walk to the OR could possibly reduce baseline anxiety while waiting for surgery.
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de Witte M, Kooijmans R, Hermanns M, van Hooren S, Biesmans K, Hermsen M, Stams GJ, Moonen X. Self-Report Stress Measures to Assess Stress in Adults With Mild Intellectual Disabilities-A Scoping Review. Front Psychol 2021; 12:742566. [PMID: 34759870 PMCID: PMC8573329 DOI: 10.3389/fpsyg.2021.742566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022] Open
Abstract
Stress has a major negative impact on the development of psychopathology and contributes to the onset of adverse physical conditions. Timely recognition and monitoring of stress-related problems are therefore important, especially in client populations that are more vulnerable to stress, such as people with mild intellectual disabilities (MID). Recent research on the use of physiological measures to assess stress levels emphasize that, in addition to these measures, self-report instruments are necessary to gain insight into the individual perception and impact of stress on daily life. However, there is no current overview of self-report stress measures that focus on the experience of stress in the present moment or in daily life. To provide an overview of the existing self-report stress measures for clinicians and researchers, a scoping review was conducted. In addition, to advise clinical professionals on the use of self-report measures of stress for people with MID, the results of an expert consultation were used to refine the preliminary findings. A systematic scoping literature search resulted in a total of 13 self-reported stress measures that met the final inclusion criteria, of which three were developed specifically for assessing stress in adults with MID (GAS-ID, LI, and SAS-ID). For each included self-report stress measure, the psychometric quality, assessment procedure, and suitability for adults with MID were reported. These were supplemented by the findings from the expert consultation. Implications for clinical practice on the use of self-report stress measures, particularly for people with MID, are discussed. Recommendations for future research and development are given.
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Affiliation(s)
- Martina de Witte
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
- Faculty of Health and Vitality, HAN University of Applied Sciences, Nijmegen, Netherlands
- KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands
- Stevig, Expert Centre for People With Mild Intellectual Disabilities, Gennep, Netherlands
| | - Roel Kooijmans
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
- Koraal Center of Expertise, Sittard, Netherlands
| | - Maria Hermanns
- Faculty of Health and Vitality, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Susan van Hooren
- KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands
- Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, Netherlands
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, Netherlands
| | - Kim Biesmans
- Stevig, Expert Centre for People With Mild Intellectual Disabilities, Gennep, Netherlands
| | - Maaike Hermsen
- Faculty of Health and Vitality, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Geert Jan Stams
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Xavier Moonen
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
- Koraal Center of Expertise, Sittard, Netherlands
- Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, Netherlands
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BOZDOĞAN YEŞİLOT S, ÇİFTÇİ H, YENER MK. Lipom eksizyonu sırasında stres küpü kullanımının ağrı ve anksiyete üzerine etkisi. EGE TIP DERGISI 2021. [DOI: 10.19161/etd.990564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Anaba P, Anaba EA, Abuosi AA. Patient satisfaction with perioperative nursing care in a tertiary hospital in Ghana. Int J Health Care Qual Assur 2021; ahead-of-print. [PMID: 32897662 DOI: 10.1108/ijhcqa-01-2020-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Promoting patient satisfaction is crucial for healthcare quality improvement. However, literature on patient satisfaction with nursing care in Ghana is limited. The aim of this study was to assess patient satisfaction with perioperative nursing care in Korle-Bu Teaching Hospital, the largest tertiary hospital in Ghana. DESIGN/METHODOLOGY/APPROACH The study was a cross-sectional study. A sample of one hundred (n = 100) in-patients in the surgical department were interviewed. Statistical Package for Social Science (SPSS), version 22, was used to analyze the data. The results were presented using univariate, bivariate and multivariate analyses. FINDINGS It was found that majority of the respondents were males (53%), employed (56%) and insured (85%). It was also found that eight in ten respondents were satisfied with the perioperative nursing care. Overall patient satisfaction with perioperative nursing care was significantly associated with information provision (p < 0.001), nurse-patient relationship (p < 0.001), fear and concern (p < 0.05) and discomfort and need (p < 0.05). At the multivariate level, overall patient satisfaction was significantly influenced by nurse-patient relationship (β = 0.430, p = 0.002). ORIGINALITY/VALUE There is limited literature on nursing care in surgical departments and rarely are patients' views considered in assessing quality of perioperative care, especially in Low- and Middle- Income Countries (LMICs). This study is a modest contribution to the literature on patient satisfaction with perioperative nursing care in Ghana.
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Affiliation(s)
- Priscilla Anaba
- Korle-Bu Peri-operative and Critical Nursing School, Accra, Ghana
| | | | - Aaron Asibi Abuosi
- Department of Public Administration and Health Services Management, University of Ghana, Accra, Ghana
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Dogan S, Ceylan C. The effect of music on state anxiety in patients undergoing extracorporeal shockwave lithotripsy. Int J Clin Pract 2021; 75:e14293. [PMID: 33930234 DOI: 10.1111/ijcp.14293] [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: 01/20/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022] Open
Abstract
AIM Extracorporeal shockwave lithotripsy is a commonly used method to break down kidney stones in urology clinics. This study aims to investigate whether or not listening to music is effective against state anxiety in patients undergoing kidney stone treatment with this method. METHODS A total of 80 patients (50 males, 30 females) undergoing extracorporeal shockwave lithotripsy for the first time at our clinic were included in the study. The first group (24 patients) listened to instrumental classical music through headphones 20 minutes before the procedure, while the second group (28 patients) listened to instrumental classical music during the procedure. The third group (28 patients) was the control group and consisted of patients who did not listen to music before or during the procedure. Patients were administered a state-trait anxiety inventory test to measure state anxiety after the process, and their results were compared. RESULTS While there was a significant difference in state-trait anxiety inventory scores between patients who listened to music before/during the procedure and the control group, there was no significant difference between patients who listened to music before and those who listened to music during the procedure. Assessment of randomisation showed groups achieved homogeneity. CONCLUSION Among the groups homogeneously distributed according to age and gender, significantly lower anxiety scores of groups that listened to music compared with the control group have provided supporting data to be open-minded and exploratory about increasing patient tolerability and comfort during these potentially pain-inducing procedures.
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Affiliation(s)
- Serkan Dogan
- Urology Department, Sancaktepe Sehit Prof Dr Ilhan Varank Education and Research Hospital, Istanbul, Turkey
| | - Cavit Ceylan
- Urology Department, Turkey Yüksek İhtisas Education and Research Hospital, Ankara, Turkey
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Stephanie CJ, Mathieu A, Aurore M, Monique MRT. Outpatients' perception of their preoperative information regarding their health literacy skills and their preoperative anxiety level: Protocol for a prospective multicenter cross-sectional study. Medicine (Baltimore) 2021; 100:e26018. [PMID: 34011104 PMCID: PMC8136983 DOI: 10.1097/md.0000000000026018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/30/2021] [Indexed: 01/05/2023] Open
Abstract
Despite the benefits related to ambulatory surgery such as cost reduction due to lack of accommodation and patient satisfaction due to early home return, it may not lead to these expected benefits. Indeed, this kind of practice can increase responsibility for the person being treated and his or her relatives. It is therefore essential to inform them as well as possible to obtain their adherence to the proposed care protocol. Nevertheless, patients' failures to comply with preoperative instructions or the non-attendance of the patient may result in late cancellation of the scheduled surgery. In order to reduce this kind of dysfunction, the Assistance Publique-Hôpitaux de Paris (APHP) uses a reminder system by Short Message Service (SMS).This study is a descriptive cross-sectional multicenter study that focuses on outpatients' lived experiences of their preoperative preparation and information. It aims to collect patients' perceptions of their ability to follow preoperative instructions received by SMS the day before an operation performed for ambulatory surgery, according to their level of health literacy (HL) and preoperative anxiety. Indeed, poor communication between patients and doctors can contribute to preoperative anxiety, while low health literacy (LHL) can lead to poor understanding of preoperative preparation instructions. Therefore, it seems important to take these 2 criteria into account in this study. This research is designed to interview outpatients undergoing ambulatory surgery in the establishments of APHP. A self-questionnaire will be used for this purpose. The choice of this institution is justified by its decision to use in all care units the reminder of preoperative instructions by SMS.The main outcome is the perception of outpatients with LHL skills regarding preoperative information provided by doctors.French ethics review committee (Comité d'Ethique de la Recherche) of the University of Paris has approved the study protocol (IRB 00012020-14). Results from this study will be disseminated through oral communications and a scientific article in an international peer-reviewed journal.This protocol is registered on researchregistry.com (researchregistry5834). This version number is 1.1 Protocol dated July 22, 2020.
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Affiliation(s)
- Chandler-Jeanville Stephanie
- Sorbonne Paris Nord University, Chaire Recherche Sciences Infirmières, LEPS
- Assistance Publique Hôpitaux de Paris, Avicenne Hospital, Hôpitaux Universitaires Paris Seine-Saint-Denis, Anesthesia Department, Bobigny, France
| | - Ahouah Mathieu
- Sorbonne Paris Nord University, Chaire Recherche Sciences Infirmières, LEPS
| | - Margat Aurore
- Sorbonne Paris Nord University, Chaire Recherche Sciences Infirmières, LEPS
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Stuhlreyer J, Klinger R. Development and Validation of the Pain and State of Health Inventory (PHI): Application for the Perioperative Setting. J Clin Med 2021; 10:1965. [PMID: 34063725 PMCID: PMC8124984 DOI: 10.3390/jcm10091965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022] Open
Abstract
Currently, general measurements and evaluations of the quality of recovery are difficult because no adequate measuring tools are available. Therefore, there is an urgent need for a universal tool that assesses patient-relevant criteria-postoperative pain, state of health, and somatic parameters. For this purpose, a pain and state of health inventory (PHI, Schmerz- und Befindlichkeitsinventar (SBI) in German) has been developed. In this study, we describe its development and validation. The development phase was led by an expert panel and was divided into three subphases: determining the conceptual structure, testing the first editions, and adjusting the inventory for a finalized edition. For the purpose of validation, the PHI was filled in by 132 patients who have undergone total knee replacement and was analyzed using principal component analysis. Construct validity was tested by correlating the items with validated questionnaires. The results showed that the inventory can test pain, state of health, and somatic parameters with great construct validity. Furthermore, the inventory is accepted by patients, map changes, and supports to initiate adequate treatment. In conclusion, the PHI is a universal tool that can be used to assess the quality of recovery in the perioperative setting and allow immediate intervention.
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Affiliation(s)
- Julia Stuhlreyer
- Center for Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany;
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24
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Wingler D, Liston D, Joseph A, Wang Y, Feng H, Martin L. Perioperative anxiety in pediatric surgery: Induction room vs. operating room. Paediatr Anaesth 2021; 31:465-473. [PMID: 33278852 DOI: 10.1111/pan.14098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 11/08/2020] [Accepted: 11/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Perioperative anxiety can have a profound and lasting effect on children and their parents, with up to 70 percent of children undergoing outpatient surgery experiencing significant physiologic and/or psychological manifestations of anxiety throughout the ambulatory surgical process. The physical healthcare environment itself can contribute to these feelings, substantially impacting the level of anxiety experienced by both the child and their parent. OBJECTIVE This study sought to examine whether a difference exists between utilization of an induction room vs. the operating room on child and parent perioperative anxiety for parent present induction. METHODS A single institution multi-site prospective observational study was conducted with a cohort of 51 healthy children aged 6-12 years, receiving an outpatient tonsillectomy and/or adenoidectomy and their parent. The methodological approach utilized for this study was Ecological Momentary Assessment. Two psychological measures of anxiety, (i) momentary and (ii) environmental, and one physiologic measure of anxiety (i) electrodermal activity were used. Data were captured separately for child and parent. RESULTS For children who underwent anesthetic induction in the induction room, all three anxiety responses were significantly lower and exhibited a large positive effect [momentary (P = .0002, d = 1.984, induction room = 3.76, operating room = 7.07), environmental (P = .018, d = 1.160, induction room = 1.72, operating room = 0.85), and electrodermal activity (P = .039, d = 1.007, induction room = 0.76, operating room = 1.51)], as compared to children who were induced in the operating room. Electrodermal activity was also statistically significantly lower, with a large positive effect, in the postoperative environment (P = .004, d = 1.454, induction room = 0.21, operating room = 0.60) for Children who were induced in the induction room, as compared to the operating room cohort. No significant differences were found between parents for momentary and environmental anxiety, and electrodermal anxiety. CONCLUSIONS The nonpharmacological strategy of using an induction room for anesthetic induction of children may be clinically effective in reducing anxiety as compared to an operating room.
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Affiliation(s)
- Deborah Wingler
- The Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
| | - David Liston
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Anjali Joseph
- The Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
| | - Yifan Wang
- Seattle Children's Hospital, Seattle, WA, USA
| | - Haotian Feng
- Statistics and Mathematics Consulting Center, Clemson University, Clemson, SC, USA
| | - Lynn Martin
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
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Christal Vimala TJ, Martin R, Rao A, Joy M. Level of anxiety and factors influencing anxiety among orthopedic surgical patients in a secondary care center in India. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2021. [DOI: 10.4103/cjhr.cjhr_112_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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de Witte M, Pinho ADS, Stams GJ, Moonen X, Bos AER, van Hooren S. Music therapy for stress reduction: a systematic review and meta-analysis. Health Psychol Rev 2020; 16:134-159. [PMID: 33176590 DOI: 10.1080/17437199.2020.1846580] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Music therapy is increasingly being used as an intervention for stress reduction in both medical and mental healthcare settings. Music therapy is characterized by personally tailored music interventions initiated by a trained and qualified music therapist, which distinguishes music therapy from other music interventions, such as 'music medicine', which concerns mainly music listening interventions offered by healthcare professionals. To summarize the growing body of empirical research on music therapy, a multilevel meta-analysis, containing 47 studies, 76 effect sizes and 2.747 participants, was performed to assess the strength of the effects of music therapy on both physiological and psychological stress-related outcomes, and to test potential moderators of the intervention effects. Results showed that music therapy showed an overall medium-to-large effect on stress-related outcomes (d = .723, [.51-.94]). Larger effects were found for clinical controlled trials (CCT) compared to randomized controlled trials (RCT), waiting list controls instead of care as usual (CAU) or other stress-reducing interventions, and for studies conducted in Non-Western countries compared to Western countries. Implications for both music therapy and future research are discussed.
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Affiliation(s)
- Martina de Witte
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,HAN University of Applied Sciences, Nijmegen, Netherlands.,Stevig, Expert Centre for People with Mild Intellectual Disabilities, Gennep, Netherlands.,KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands
| | - Ana da Silva Pinho
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Geert-Jan Stams
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Xavier Moonen
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - Arjan E R Bos
- Faculty of Psychology, Open University, Heerlen, Netherlands
| | - Susan van Hooren
- KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands.,Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, Netherlands.,Faculty of Psychology, Open University, Heerlen, Netherlands
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Milisen K, Van Grootven B, Hermans W, Mouton K, Al Tmimi L, Rex S, Detroyer E. Is preoperative anxiety associated with postoperative delirium in older persons undergoing cardiac surgery? Secondary data analysis of a randomized controlled trial. BMC Geriatr 2020; 20:478. [PMID: 33208091 PMCID: PMC7672929 DOI: 10.1186/s12877-020-01872-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/05/2020] [Indexed: 11/18/2022] Open
Abstract
Background Although many studies have reported numerous risk factors for postoperative delirium, data are scarce about preoperative anxiety as a risk factor. The study aimed to investigate the association between preoperative anxiety and postoperative delirium in older patients undergoing cardiac surgery. Methods Secondary data analysis of a randomized, observer-blind, controlled trial. A total of 190 patients 65 years or older and admitted to the intensive care unit and cardiac surgery unit of a university hospital scheduled for elective on-pump cardiac surgery were included. State anxiety was measured preoperatively using the Amsterdam Preoperative Anxiety and Information Scale and the Visual Analogue Scale for anxiety. Incidence of delirium was measured during the first 5 postoperative days using the Confusion Assessment Method for Intensive Care Unit (when ventilated), or the 3 Minute Diagnostic Interview for Confusion Assessment Method (when extubated) and by daily chart review. Results Preoperative state anxiety was reported by 31% of the patients and 41% had postoperative delirium. A multiple step logistic regression analyses revealed no association between preoperative anxiety and postoperative delirium. Significant risk factors for postoperative delirium were age (OR = 1.10, 95% CI (1.03–1.18)), activities of daily living (0.69, 95% CI (0.50–0.96)), diabetes mellitus (OR = 3.15, 95% CI (1.42–7.00)) and time on cardiopulmonary bypass (OR = 1.01, 95% CI (1.00 to 1.02)). Conclusions No relationship could be found between preoperative anxiety and postoperative delirium.
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Affiliation(s)
- Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium. .,Department of Geriatric Medicine, KU Leuven - University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Bastiaan Van Grootven
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - Wim Hermans
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium
| | - Karen Mouton
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium
| | - Layth Al Tmimi
- Department of Anesthesiology, KU Leuven - University of Leuven, University Hospitals of Leuven, Herestraat 49, B-3000, Leuven, Belgium.,Department of Cardiovascular Sciences, KU Leuven - University of Leuven, B-3000, Leuven, Belgium
| | - Steffen Rex
- Department of Anesthesiology, KU Leuven - University of Leuven, University Hospitals of Leuven, Herestraat 49, B-3000, Leuven, Belgium.,Department of Cardiovascular Sciences, KU Leuven - University of Leuven, B-3000, Leuven, Belgium
| | - Elke Detroyer
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium.,Department of Geriatric Medicine, KU Leuven - University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium
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Carneiro ÉM, Tosta ADM, Antonelli IBS, Soares VM, Oliveira LFA, Borges RMC, da Silva AP, Borges MDF. Effect of Spiritist "Passe" on Preoperative Anxiety of Surgical Patients: A Randomized Controlled Trial, Double-Blind. JOURNAL OF RELIGION AND HEALTH 2020; 59:1728-1739. [PMID: 31119515 DOI: 10.1007/s10943-019-00841-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The objective of this study was to evaluate the preoperative anxiety of hospitalized patients exposed to Spiritist "passe," laying on of hand with the intention of healing (Sham) and without laying on of hand. Other variables as depression, pain, physiological parameters, muscle tension, and well-being were assessed. Patients in the Spiritist "passe" intervention group showed greater reductions in anxiety (p < 0.05) and muscle tension (p < 0.01) and increases in well-being (p < 0.01). More marked reductions in preoperative anxiety and muscle tension and improvement in well-being were observed in patients exposed to Spiritist "passe" compared to Sham or standard medical care.Trial registration: ClinicalTrials.gov Identifier NCT03356691.
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Affiliation(s)
- Élida Mara Carneiro
- Clinics Hospital, Federal University of Triângulo Mineiro (HC-UFTM), 330, Getúlio Guarita Street, Uberaba, MG, Brazil.
- Committee on Religious and Spiritual Assistance (CARE), HC-UFTM, 330 Getúlio Guarita Street, Uberaba, MG, Brazil.
- Department of Rehabilitation, HC-UFTM, 330, Getúlio Guaritá Street, Uberaba, MG, 38025-440, Brazil.
- Medical Spiritist Association of Uberaba, 50, Dr. Thomaz Ulhôa, Uberaba, MG, 38025 050, Brazil.
| | - Ariana de Melo Tosta
- Clinics Hospital, Federal University of Triângulo Mineiro (HC-UFTM), 330, Getúlio Guarita Street, Uberaba, MG, Brazil
- Department of Rehabilitation, HC-UFTM, 330, Getúlio Guaritá Street, Uberaba, MG, 38025-440, Brazil
| | - Izabella Barberato Silva Antonelli
- Clinics Hospital, Federal University of Triângulo Mineiro (HC-UFTM), 330, Getúlio Guarita Street, Uberaba, MG, Brazil
- Department of Rehabilitation, HC-UFTM, 330, Getúlio Guaritá Street, Uberaba, MG, 38025-440, Brazil
| | - Veridiana Mariano Soares
- Clinics Hospital, Federal University of Triângulo Mineiro (HC-UFTM), 330, Getúlio Guarita Street, Uberaba, MG, Brazil
- Department of Rehabilitation, HC-UFTM, 330, Getúlio Guaritá Street, Uberaba, MG, 38025-440, Brazil
| | | | | | - Adriana Paula da Silva
- Clinics Hospital, Federal University of Triângulo Mineiro (HC-UFTM), 330, Getúlio Guarita Street, Uberaba, MG, Brazil
- Medical Spiritist Association of Uberaba, 50, Dr. Thomaz Ulhôa, Uberaba, MG, 38025 050, Brazil
| | - Maria de Fátima Borges
- Clinics Hospital, Federal University of Triângulo Mineiro (HC-UFTM), 330, Getúlio Guarita Street, Uberaba, MG, Brazil
- Committee on Religious and Spiritual Assistance (CARE), HC-UFTM, 330 Getúlio Guarita Street, Uberaba, MG, Brazil
- Medical Spiritist Association of Uberaba, 50, Dr. Thomaz Ulhôa, Uberaba, MG, 38025 050, Brazil
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Lumb AB, Latchford GJ, Bekker HL, Hetmanski AR, Thomas CR, Schofield CE. Investigating the causes of patient anxiety at induction of anaesthesia: A mixed methods study. J Perioper Pract 2020; 31:246-254. [PMID: 32638654 PMCID: PMC8258711 DOI: 10.1177/1750458920936933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim To investigate patient anxiety at anaesthetic induction and whether this is affected by anaesthetic room interventions. Methods A mixed methods study was carried out: pre-induction interventions were directly observed. Patient anxiety was assessed quantitatively with cardiovascular changes, the visual analogue scale and the state-trait anxiety inventory. Interviews allowed qualitative assessment. Results Patient-reported anxiety did not correlate with cardiovascular changes. Anaesthetic room interventions were not predictive of anxiety. Postoperative interviews identified five sources of anxiety, mostly related to preparation for surgery. Staff responses to anxiety were also highlighted. Discussion Patient-reported anxiety and its biological response are not correlated. Pre-induction interventions do not contribute to anxiety. Anxiety levels at induction are similar to or lower than earlier in the preoperative period. Conclusions On induction of anaesthesia, patients have little control over their situation but are actively reassured and distracted by theatre staff. Our data suggest staff are good at this. More could still be done to reduce preoperative sources of anxiety.
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Affiliation(s)
- Andrew B Lumb
- Leeds Institute of Biological and Clinical Sciences, Leeds, UK
| | | | - Hilary L Bekker
- Department of Psychological and Social Medicine, University of Leeds, Leeds, UK
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30
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Sigdel S, Ozaki A, Basnet M, Kobashi Y, Pradhan B, Higuchi A, Uprety A. Anxiety evaluation in Nepalese adult patients awaiting cardiac surgery: A prospective observational study. Medicine (Baltimore) 2020; 99:e19302. [PMID: 32118748 PMCID: PMC7478669 DOI: 10.1097/md.0000000000019302] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Perioperative anxiety could negatively affect surgery outcomes, and cardiac diseases have long been known to be an independent risk factor for anxiety development. However, little is known about preoperative anxiety in Nepalese adult cardiac patients waiting for surgery. The primary objectives of this study were to: (1) clarify the levels of preoperative anxiety in Nepalese adult cardiac patients waiting for open heart surgery; (2) identify factors associated with preoperative anxiety; and (3) evaluate any possible factors associated with patients' desire to obtain information related to their heart surgery.This is a prospective observational study for patients already scheduled for cardiac surgery at a core medical institution in Kathmandu, Nepal. We collected sociodemographic and clinical characteristics of the patients from their medical charts, and assessed their preoperative anxiety using the Amsterdam Preoperative Anxiety and Information Scale. We performed descriptive analyses of the collected data. Further, we employed regression models to assess to the objectives of the study.In total, 140 patients participated, and data of 123 (87.9%) were used for analysis. 58.5% of the participants had preoperative anxiety. Female gender (OR 0.31, 95% CI 0.15-0.65, P < .001) and past anesthesia exposure (OR 2.38, 95% CI 1.01-5.62, P < .05) were identified as risk factors for developing anxiety before cardiac surgery. Further, female gender (IRR 0.80, 95% CI 0.67-0.94, P < .001), higher education levels (IRR 1.18, 95% CI 1.01-1.40, P < .05), and higher preoperative anxiety (IRR 1.44, 95% CI 1.21-1.73, P < .001) could lead to higher levels of desire to acquire information related to the procedure.The study concluded that more than a half of the cardiac surgery patients experiences preoperative anxiety; female gender and having past anesthesia exposure are the risk factors. Anxious patients have more desire to acquire knowledge about the procedure. Thus, the evaluation and adequate management of preoperative anxiety should be proposed in high-risk groups.
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Affiliation(s)
- Shailendra Sigdel
- Department of Cardiothoracic and Vascular Anesthesiology, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - Akihiko Ozaki
- Department of Breast Cancer, Jyoban Hospital of Tokiwa Foundation, Iwaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma
| | - Madindra Basnet
- Department of Cardiothoracic and Vascular Anesthesiology, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - Yurie Kobashi
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima
- Department of Anesthesia, Jyoban Hospital of Tokiwa Foundation, Iwaki
| | - Bishwas Pradhan
- Department of Cardiothoracic and Vascular Anesthesiology, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - Asaka Higuchi
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima
- Medical Governance Research Institute, Tokyo, Japan
| | - Anup Uprety
- Department of Anesthesiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
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Jiwanmall M, Jiwanmall SA, Williams A, Kamakshi S, Sugirtharaj L, Poornima K, Jacob KS. Preoperative Anxiety in Adult Patients Undergoing Day Care Surgery: Prevalence and Associated Factors. Indian J Psychol Med 2020; 42:87-92. [PMID: 31997870 PMCID: PMC6970311 DOI: 10.4103/ijpsym.ijpsym_180_19] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/01/2019] [Accepted: 08/04/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND There is a paucity of data related to anxiety levels in patients undergoing day care surgery in India. METHODS Preoperative anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS) 1 day before surgery and on the day of surgery, and the patients were categorized as cases (APAIS score ≥13) and controls (APAIS score <13). Sociodemographic characteristics, clinical features, and fears associated with anesthesia and surgery were also noted. RESULTS Out of the 399 patients recruited, 58.1% experienced significant preoperative anxiety. The fear of needles (P = 0.002), fear of waking up during the surgery (P < 0.001), and the patient's need of additional information regarding anesthesia and surgery (P < 0.001) were significantly associated with preoperative anxiety. CONCLUSION A significant proportion of patients scheduled for day care surgery have preoperative anxiety. A preanesthetic workup of a patient with adequate clarification about their doubts and fears related to anesthesia and surgery is recommended to bring down the level of anxiety.
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Affiliation(s)
- Meghna Jiwanmall
- Department of Anaesthesiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Stephen A Jiwanmall
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Aparna Williams
- Department of Anaesthesiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - S Kamakshi
- Department of Nursing, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lovisal Sugirtharaj
- Department of Nursing, Christian Medical College, Vellore, Tamil Nadu, India
| | - K Poornima
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
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Nilsson U, Dahlberg K, Jaensson M. Low Preoperative Mental and Physical Health is Associated with Poorer Postoperative Recovery in Patients Undergoing Day Surgery: A Secondary Analysis from a Randomized Controlled Study. World J Surg 2019; 43:1949-1956. [PMID: 30937487 DOI: 10.1007/s00268-019-04995-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Day surgical procedures are increasing both in Sweden and internationally. Day surgery patients prepare for and handle their recovery on their own at home. The aim of this study was to investigate patients' preoperative mental and physical health and its association with the quality of their recovery after day surgery. METHOD This was a secondary analysis of a randomized controlled trial. Data were collected at four-day surgery units in Sweden. Health-related quality of life was measured using the Short Form 36 (SF-36) Health Survey, and postoperative recovery was assessed using the Swedish web version of the Quality of Recovery (SwQoR) scale. RESULT This study included 756-day surgery patients. A low, compared with a high, preoperative mental component score was associated with poorer recovery as shown by responses to 21/24 and 22/24 SwQoR items, respectively, on postoperative days (PODs) 7 and 14. A low compared with a high preoperative physical component score was associated with poorer recovery in 18/24 SwQoR items on POD 7 and 13/24 on POD 14. CONCLUSION A clear message from this study is for surgeons, anaesthetists and nurses to consider the fact that postoperative recovery largely depends on patients' preoperative mental and psychical status. A serious attempt must be made, as a part of the routine preoperative assessment, to assess and document not only the physical but also the mental status of patients undergoing anaesthesia and surgery. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT0249219.
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Affiliation(s)
- Ulrica Nilsson
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, and Perioperative Medicine and Intensive Care, Karolinska University Hospital, 141 83, Huddinge, Stockholm, Sweden.
| | - Karuna Dahlberg
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Maria Jaensson
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Gebhardt V, Kiefer K, Weiss C, Schmittner MD. Influence of anxiolytic premedication on vasovagal reactions and home readiness following outpatient intrathecal anaesthesia-A retrospective analysis. Acta Anaesthesiol Scand 2019; 63:468-474. [PMID: 30511415 DOI: 10.1111/aas.13297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Vasovagal reactions during application of intrathecal anaesthesia (IA) are associated with high anxiety levels. A high percentage of patients undergoing outpatient surgery suffer from anxiety. Anxiolytic premedication in day-surgery is suspected to delay recovery and discharge and is, therefore, not routinely used. The aim of this retrospective analysis was to detect the influence of anxiolytic premedication on the incidence of vasovagal reactions and time until discharge home. METHODS Anaesthesia records of all patients undergoing outpatient surgery under low-dose IA from January 2008 to June 2017 were analysed. Incidences of vasovagal reactions with a decrease in blood pressure and/or heart rate and need for cardiovascular activating medications were documented. Patients were categorised as having received an anxiolytic premedication or not. The time from intrathecal injection of the local anaesthetic until readiness for discharge was recorded. RESULTS The records of 2747 patients were analysed. One thousand two hundred and ninety-one of them received an anxiolytic premedication of 1-2 mg midazolam intravenously. Three hundred and fourteen patients had vasovagal incidents during application of IA (no premedication n = 217 [15.0%], premedication n = 97 [7.5%], P < 0.0001). Premedication did not prolong time to achieve readiness for discharge (mepivacaine: P = 0.5886, chloroprocaine: P = 0.1555). However, in the prilocaine group, premedication led to a significantly earlier achievement of readiness for discharge (P = 0.0002). CONCLUSION Anxiolytic premedication significantly reduces the incidence of vasovagal reactions during the application of IA and does not affect time until readiness for discharge.
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Affiliation(s)
- Volker Gebhardt
- Department of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Centre Mannheim; Ruprecht-Karls-University Heidelberg; Mannheim Germany
| | - Kevin Kiefer
- Department of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Centre Mannheim; Ruprecht-Karls-University Heidelberg; Mannheim Germany
| | - Christel Weiss
- Department of Medical Statistics, University Medical Centre Mannheim, Heinrich-Lanz-Zentrum; Ruprecht-Karls-University Heidelberg; Mannheim Germany
- Medical Faculty; Mannheim of Heidelberg University, Ruprecht-Karls-University Heidelberg; Mannheim Germany
| | - Marc D. Schmittner
- Medical Faculty; Mannheim of Heidelberg University, Ruprecht-Karls-University Heidelberg; Mannheim Germany
- Department of Anaesthesiology, Intensive Care and Pain Medicine; BG Klinikum Unfallkrankenhaus Berlin gGmbH; Berlin Germany
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Afonso AM, Tokita HK, McCormick PJ, Twersky RS. Enhanced Recovery Programs in Outpatient Surgery. Anesthesiol Clin 2019; 37:225-238. [PMID: 31047126 DOI: 10.1016/j.anclin.2019.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Although enhanced recovery pathways were initially implemented in inpatients, their principles are relevant in the ambulatory setting. Opioid minimization and addressing pain and nausea through multimodal analgesia, regional anesthesia, and robust preoperative education programs are integral to the success of ambulatory enhanced recovery programs. Rather than measurements of length of stay as in traditional inpatient programs, the focus of enhanced recovery programs in ambulatory surgery should be on improved quality of recovery, pain management, and early ambulation.
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Affiliation(s)
- Anoushka M Afonso
- Enhanced Recovery Programs (ERP), Department of Anesthesiology & Critical Care Medicine, Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, M-301, New York, NY 10065, USA.
| | - Hanae K Tokita
- Department of Anesthesiology & Critical Care, Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Patrick J McCormick
- Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Rebecca S Twersky
- Department of Anesthesiology & Critical Care Medicine, Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center, 1133 York Avenue, Suite 312, New York, NY 10065, USA
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Günübirlik Cerrahide Hastaların Ameliyat Sonrasına İlişkin Endişelerinin İncelenmesi. JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/gopctd.478417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Factors Associated With Patient-Initiated Communication After Mohs Micrographic Surgery. Dermatol Surg 2019; 45:234-243. [PMID: 30640776 DOI: 10.1097/dss.0000000000001750] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite extensive counseling, patients commonly call with postoperative concerns after Mohs micrographic surgery (MMS). OBJECTIVE We sought to determine the incidence, reasons, and patient and surgical characteristics that lead to patient-initiated communication after MMS. MATERIALS AND METHODS A retrospective chart review of 1,531 patients who underwent MMS during the observational period was conducted. Demographics and perioperative characteristics of patients who initiated communication were compared with a random sample of matched controls. RESULTS Of the 1,531 patients who underwent MMS, 263 patients (17.2%) initiated 412 communication encounters within 90 days of surgery. Top reasons for patient-initiated communication included wound concerns, bleeding, and postoperative pain. Female patients and those with a larger surgical defect size (cm) were more likely to call postoperatively. Patients who underwent second intention healing, grafts, and interpolation flaps were more likely to initiate communication compared to patients repaired with a linear closure. CONCLUSION This study identifies the incidence, reasons, and patient and surgical factors predictive of patient-initiated communication after MMS, which may allow for targeted improvements in postoperative counseling, ameliorating patient anxiety, augmenting patient satisfaction, and improved efficiency for the health care team.
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Burton D, King A, Bartley J, Petrie KJ, Broadbent E. The surgical anxiety questionnaire (SAQ): development and validation. Psychol Health 2018; 34:129-146. [DOI: 10.1080/08870446.2018.1502770] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dominic Burton
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Amy King
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jim Bartley
- Department of Otorhinolaryngology – Head and Neck Surgery, Counties Manukau District Health Board, Otahuhu, Auckland, New Zealand
| | - Keith J. Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Mulugeta H, Ayana M, Sintayehu M, Dessie G, Zewdu T. Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia. BMC Anesthesiol 2018; 18:155. [PMID: 30376809 PMCID: PMC6208029 DOI: 10.1186/s12871-018-0619-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 10/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety during the preoperative period is the most common problem with a number of postoperative complications such as an increase in postoperative pain, delay of healing and prolong the hospital stay. Further, patients with a high level of preoperative anxiety require higher doses of anesthetic agents and recover poorly. Despite its serious health complications, its magnitude and associated factors have been poorly explored in Ethiopia particularly in the selected study areas. OBJECTIVE To assess preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot Referral Hospitals, Northwest Ethiopia. METHOD An institution based cross-sectional study was conducted on 353 patients scheduled for surgery using a systematic random sampling technique. The data were collected using the state version of the state-trait anxiety inventory scale. All collected data were entered into Epi-Data version 3.1 and analysis was done by using SPSS version 20 software. Binary logistic regression was performed to assess the effect of independent variables on the dependent variable. A p-value < 0.05 was considered as statistically significant. RESULTS Overall, 61% (95%CI (55.5-65.7)) patients had significant high level of preoperative anxiety. The most common reported factor responsible for preoperative anxiety was fear of complications 187(52.4%). There was a statistically significant high level of pre-operative anxiety among female patients [AOR 2.19 (95%CI (1.29-3.71))] and patients who lack preoperative information [AOR 2.03(95%CI (1.22-3.39))]. CONCLUSION The prevalence of preoperative anxiety was high. The level of preoperative anxiety significantly associated with sex, preoperative information provision, and previous surgical experience. Preoperative psychosocial assessment should be incorporated into a routine nursing practice and every patient should be provided with preoperative information before surgery.
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Affiliation(s)
- Henok Mulugeta
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Mulatu Ayana
- Department of Public Health, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Mezinew Sintayehu
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Getenet Dessie
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Tesfu Zewdu
- Department of Nursing, College of Health Science, Assosa University, P.O. Box 18, Assosa, Ethiopia
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Alacadag M, Cilingir D. Presurgery Anxiety and Day Surgery Patients' Need for Information. J Perianesth Nurs 2018; 33:658-668. [DOI: 10.1016/j.jopan.2017.06.125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 06/12/2017] [Accepted: 06/27/2017] [Indexed: 10/18/2022]
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Theunissen M, Jonker S, Schepers J, Nicolson NA, Nuijts R, Gramke HF, Marcus MAE, Peters ML. Validity and time course of surgical fear as measured with the Surgical Fear Questionnaire in patients undergoing cataract surgery. PLoS One 2018; 13:e0201511. [PMID: 30092085 PMCID: PMC6084852 DOI: 10.1371/journal.pone.0201511] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 07/17/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The primary aim of the study was to assess the convergent validity of the Surgical Fear Questionnaire (SFQ) with other self-report instruments and biological indices of stress. Secondary aims were the examination of predictors of the level and time course of fear and preferences for fear treatment. METHODS In a prospective observational cohort study SFQ short-term (SFQ-s) and long-term (SFQ-l) scores were assessed one week, one day, and the morning before cataract surgery, together with salivary cortisol and alpha-amylase (sAA) levels, and numeric rating scale (NRS) fear score. SFQ-scores were also assessed before second eye surgery. Expected pain and recovery, and sociodemographic and medico-psychological predictors of fear were assessed at baseline. RESULTS Data of 98 patients were analyzed. Scores of both SFQ-subscales (range 0-40) were generally low, all mean ≤ 9.0. SFQ-s and SFQ-l correlated significantly with the other self-report instruments: NRS fear .83 and .89, expected pain .49 and .54, expected recovery -.27 and -.44. No association was found between SFQ-scores and cortisol or sAA level. Predictors of the level of fear were baseline pain and stress. Additional effects of time were found for subgroups based on educational level, antidepressant use, and presurgical stress (SFQ-l). SFQ-scores were significantly lower before the second cataract surgery than before the first, and higher in patients who would have appreciated treatment of fear. DISCUSSION Convergent validity of the SFQ with other self-report measures is shown. The sensitivity of the SFQ permits the detection of small variations in fear caused by time or other factors.
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Affiliation(s)
- Maurice Theunissen
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, the Netherlands
- * E-mail:
| | - Soraya Jonker
- Department of Ophthalmology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jan Schepers
- Department of Methodology & Statistics, Maastricht University, Maastricht, the Netherlands
| | - Nancy A. Nicolson
- Department of Psychiatry & Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Rudy Nuijts
- Department of Ophthalmology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Hans-Fritz Gramke
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marco A. E. Marcus
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, the Netherlands
- Department of Anesthesia/ICU, Pain & Palliative Care, Hamad Medical Corporation, Doha, Qatar
| | - Madelon L. Peters
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands
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Nielsen E, Wåhlin I, Frisman GH. Evaluating Pictures of Nature and Soft Music on Anxiety and Well-Being During Elective Surgery. Open Nurs J 2018; 12:58-66. [PMID: 29755608 PMCID: PMC5925859 DOI: 10.2174/1874434601812010058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/07/2018] [Accepted: 03/28/2018] [Indexed: 12/16/2022] Open
Abstract
Background: Patients going through surgery being awake often have a sense of anxiety and need support to relax. Objective: The aim of this study was to investigate whether looking at pictures of natural scenery could reduce anxiety and pain and increase relaxation and well-being being awake during the elective surgery. Methods: This three-arm, randomized intervention study consisted of one group viewing pictures of natural scenery, one group listening to soft instrumental music, and one control group without distraction, all adult patients (n=174). The State Trait Anxiety Inventory short form and a visual analogue scale on well-being were used as well as sedation treatment if necessary. Results: No differences related to anxiety after surgery were found among the three groups. When controlling for the effect of sedative treatment, however, patients without sedation had a lower degree of anxiety postoperatively (p=0.014). Younger patients had a higher degree of anxiety and lower degree of postoperative relaxation and well-being.
Conclusion:
Viewing pictures of natural scenery while being awake during elective surgery is as relaxing as listening to soft instrumental music. Offering nature scenery pictures for patients to view could be relaxing during the elective surgery.
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Affiliation(s)
- Elinor Nielsen
- Department of Anesthesiology and Intensive Care, Vrinnevi Hospital Norrköping, Norrköping, Sweden
| | - Ingrid Wåhlin
- Research Section, Kalmar County Council, S-391 85 Kalmar, Sweden and Linnaeus University, Faculty of Health and life Sciences, Växjö, Kalmar, Sweden
| | - Gunilla Hollman Frisman
- Department of Anesthetics, Operations and Speciality Surgery Center and Medical and Health Sciences, Division of Nursing Sciences. Linköping University, 581 85 Linköping, Sweden
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Ekinci M, Gölboyu BE, Dülgeroğlu O, Aksun M, Baysal PK, Çelik EC, Yeksan AN. [The relationship between preoperative anxiety levels and vasovagal incidents during the administration of spinal anesthesia]. Rev Bras Anestesiol 2017; 67:388-394. [PMID: 28412052 DOI: 10.1016/j.bjan.2016.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 07/29/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND It was aimed to investigate the relationship between preoperative anxiety and vasovagal symptoms observed during the administration of spinal anesthesia in patients undergoing surgery in the perianal and inguinal regions. METHODS The study included patients with planned surgery for inguinal hernia repair, anal fissure, hemorrhoid and pilonidal sinus excision. The study included a total of 210 patients of ASA I-II, aged 18-65 years. Patients were evaluated in respect of demographic characteristics, smoking and alcohol consumption, ASA grade and educational level. Correlations were evaluated between the number of attempts at spinal anesthesia and anesthesia history with vasovagal symptoms and educational level, gender, smoking and alcohol consumption and anesthesia history with anxiety scores. The instant (transient) state anxiety inventory part of the Transient State/Trait Anxiety Inventory (State Trait Anxiety Inventory - STAI) was used to determine the anxiety levels of the participants. Clinical findings of peripheral vasodilation, hypotension, bradycardia and asystole observed during the administration of spinal anesthesia were recorded. RESULTS Vasovagal incidences during the administration of spinal anesthesia were seen to increase in cases of high anxiety score, male gender, and an absence of anesthesia history. Educational level and the number of spinal needle punctures were not found to have any effect on vasovagal incidents. CONCLUSION The determination of causes triggering vasovagal incidents seen during the application of spinal anesthesia, better patient information of regional anesthesia implementations and anxiety relief with preoperative anxiolytic treatment will help to eliminate potential vasovagal incidents.
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Affiliation(s)
- Mürsel Ekinci
- Kars State Hospital, Department of Anesthesiology and Reanimation, Kars, Turquia.
| | - Birzat Emre Gölboyu
- Kars State Hospital, Department of Anesthesiology and Reanimation, Kars, Turquia
| | - Onur Dülgeroğlu
- Kars State Hospital, Department of General Surgery, Kars, Turquia
| | - Murat Aksun
- Katip Celebi School of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
| | - Pınar Karaca Baysal
- Kars State Hospital, Department of Anesthesiology and Reanimation, Kars, Turquia
| | - Erkan Cem Çelik
- Palandoken State Hospital, Department of Anesthesiology and Reanimation, Erzurum, Turquia
| | - Ayşe Nur Yeksan
- Kafkas University School of Medicine, Department of Anesthesiology and Reanimation, Kars, Turquia
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de'Angelis N, Menahem B, Compagnon P, Merle JC, Brunetti F, Luciani A, Cherqui D, Laurent A. Minor laparoscopic liver resection: toward 1-day surgery? Surg Endosc 2017; 31:4458-4465. [PMID: 28378083 DOI: 10.1007/s00464-017-5498-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 02/28/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Technical advances in laparoscopy and enhanced recovery after surgery programs have progressively decreased the need for hospitalization. The present study aimed to explore the feasibility and safety of an early discharge protocol after minor laparoscopic liver resection (LLR). METHODS The study sample consisted of patients with both benign and malignant hepatic lesions involving no more than two hepatic segments who underwent minor LLR and were discharged within 24 h. Patients were selected based on their fitness for surgery, proximity to the hospital, and availability of a responsible adult to care for them once discharged. Patients and their accompanying caregiver were instructed about the procedure, its potential complications, and the conditions required for an early discharge. They were also provided with a 24-h dedicated phone number for assistance. RESULTS Twenty-four patients [mean age 48.9 year (SD 14.75); 12 women] with no more than one comorbidity were included. The majority (87.5%) was classified as ASA I or II. Thirteen patients (46%) were operated on for malignant lesions. The median operative time was 90 min, the median pneumoperitoneum time was 60 min, and the estimated blood loss was 50 mL. Mortality was zero. No transfusion, conversion, or pedicule clamping was necessary. No anesthesia-related complications occurred. All patients were discharged at 24 h. Only one patient (4.2%) was readmitted at postoperative day 3 for intolerable abdominal pain due to a wound abscess that was treated by antibiotics. CONCLUSION By applying a standardized protocol for admission, preoperative workup, and anesthesia, early discharge after minor LLR can be successfully carried out in highly selected patients with minimal impact on primary healthcare services.
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Affiliation(s)
- Nicola de'Angelis
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Université Paris Est-UPEC, Address: 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Benjamin Menahem
- UMR INSERM U1086 Cancers et Prevention, Centre François Baclesse, Avenue du Général Harris, 14045, Caen Cedex, France.,UFR de Médecine, 2 rue des Rochambelles, 14033, Caen Cedex, France
| | - Philippe Compagnon
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Université Paris Est-UPEC, Address: 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Jean Claude Merle
- Department of Anesthesiology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Francesco Brunetti
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Université Paris Est-UPEC, Address: 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Alain Luciani
- Department of Radiology, Henri Mondor Hospital, AP-HP, Créteil, France.,INSERM U955, Team 18, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Daniel Cherqui
- Hepatobiliary and Pancreatic Surgery and Liver Transplantation Unit, Paul Brousse Hospital, Paris, France
| | - Alexis Laurent
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Université Paris Est-UPEC, Address: 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France. .,INSERM U955, Team 18, Institut Mondor de Recherche Biomédicale, Créteil, France.
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Sobanko JF, Da Silva D, Chiesa Fuxench ZC, Modi B, Shin TM, Etzkorn JR, Samimi SS, Wanat KA, Miller CJ. Preoperative telephone consultation does not decrease patient anxiety before Mohs micrographic surgery. J Am Acad Dermatol 2017; 76:519-526. [DOI: 10.1016/j.jaad.2016.09.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/06/2016] [Accepted: 09/22/2016] [Indexed: 10/20/2022]
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Kamau A, Mung'ayi V, Yonga G. The effect of a preanaesthesia clinic consultation on adult patient anxiety at a tertiary hospital in Kenya: a cohort study. Afr Health Sci 2017; 17:138-146. [PMID: 29026387 PMCID: PMC5636231 DOI: 10.4314/ahs.v17i1.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Preoperative anxiety is a common perioperative complication seen in approximately 11-80% of adults undergoing surgery. One of the goals of the preanaesthesia clinic is to allay anxiety. A preanaesthesia clinic evaluation has been shown to reduce anxiety however current studies on anxiety and the preanaesthesia clinic have not quantified this reduction. OBJECTIVE To determine the reduction in anxiety in patients evaluated in the clinic versus those evaluated in the ward. METHODS Fifty one adult patients with 28 patients in anaesthesia clinic (AC) group and 23 in the ward (W) group were sequentially recruited from both the surgical, gynaecology and antenatal outpatient clinics and the wards. The patient's State Trait Anxiety Index (STAI) was taken once the patient was booked for theatre. The patients then had a preanaesthesia evaluation either in the preanaesthesia outpatient clinic (PAC) or in the wards. Another STAI score was taken in the preoperative area in theatre on the day of surgery. The difference in the change of STAI scores in both groups was then analysed. RESULTS Fifty one adult patients were recruited with 28 in the AC group and 23 in the W group. The majority of patients were female (n=38). Statistically significant difference was seen in the reduction of the anxiety scores between the clinic group 2.143 (C.I=1.384-2.902) and ward group 0.74(C.I=0.17-1.31) with a p value=0.0051.There was also significant difference in reduction in anxiety scores within ward group in the patients with no prior anaesthetic experience having a greater reduction than those with prior anaesthetic experience. There were no other significant differences between the two groups. CONCLUSION Patients evaluated in the anaesthesia clinic had a greater reduction in their anxiety but it was not as much as hypothesised which may be due to the multi-factorial nature of preoperative anxiety. A larger multicenter study is recommended to increase generalizability to the population.
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Affiliation(s)
- Anthony Kamau
- Department of Anaesthesia, Aga Khan University, East Africa, Nairobi, Kenya
| | - Vitalis Mung'ayi
- Department of Anaesthesia, Aga Khan University, East Africa, Nairobi, Kenya
| | - Gerald Yonga
- Department of Internal Medicine, Aga Khan University, East Africa, Nairobi, Kenya
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Hoorntje A, Koenraadt KLM, Boevé MG, van Geenen RCI. Outpatient unicompartmental knee arthroplasty: who is afraid of outpatient surgery? Knee Surg Sports Traumatol Arthrosc 2017; 25:759-766. [PMID: 28229182 PMCID: PMC5332488 DOI: 10.1007/s00167-017-4440-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/20/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE In recent years, duration of hospitalisation after knee arthroplasty has decreased and fast track and outpatient surgery protocols have been developed. Studies have shown that outpatient surgery is feasible, safe, and cost effective. However, the psychological well-being of patients undergoing outpatient surgery has never been described before. The purpose of this study was to investigate how patients experience outpatient surgery for unicompartmental knee arthroplasty (UKA), examining levels of anxiety and depression, satisfaction, and pain. It was hypothesized that the same-day discharge following UKA would not result in higher levels of anxiety and depression, compared to the standard fast-track surgery. METHODS This case-controlled study included 20 patients undergoing UKA in an outpatient surgery setting and 20 patients undergoing the standard fast-track procedure. The Hospital Anxiety and Depression Scale (HADS, 0-42, lower is better) and numeric rating scales (NRS, 0-10) for pain and satisfaction were collected preoperatively, on the day of surgery, on the first, second, and seventh postoperative days and after 6 and 12 weeks. The Oxford Knee Score (OKS), the KOOS, EuroQoL-5D, and Net Promoter Score (NPS) were collected preoperatively and 3 months postoperatively. RESULTS 90% of patients in the outpatient surgery group were discharged on the day of surgery. At the first postoperative day, the median HADS score was significantly lower in the outpatient surgery group compared to the fast-track group (3 vs. 8, p = 0.02), the median NRS satisfaction score was significantly higher in the outpatient surgery group (8 vs. 5, p = 0.03), and no differences existed between both groups for the NRS pain scores. At 3 month follow-up, no significant differences in improvement scores existed between both groups for the HADS, the NRS scores, and for the OKS, KOOS, EuroQoL-5D, and NPS. CONCLUSION The results of this study emphasize the feasibility of an outpatient surgery pathway in carefully selected UKA patients. The outpatient surgery pathway is safe, and clinical outcome, including levels of anxiety and depression, satisfaction, and pain, was similar in outpatient surgery patients compared to the standard fast-track patients. LEVEL OF EVIDENCE Case-control study, Level III.
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Affiliation(s)
- Alexander Hoorntje
- Department of Orthopaedic Surgery, Foundation FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Postbus 90158, 4800 RK Breda, The Netherlands
| | - Koen L. M. Koenraadt
- Department of Orthopaedic Surgery, Foundation FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Postbus 90158, 4800 RK Breda, The Netherlands
| | - Margreet G. Boevé
- Department of Orthopaedic Surgery, Foundation FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Postbus 90158, 4800 RK Breda, The Netherlands
| | - Rutger C. I. van Geenen
- Department of Orthopaedic Surgery, Foundation FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Postbus 90158, 4800 RK Breda, The Netherlands
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Gürsoy A, Candaş B, Güner Ş, Yılmaz S. Preoperative Stress: An Operating Room Nurse Intervention Assessment. J Perianesth Nurs 2016; 31:495-503. [PMID: 27931701 DOI: 10.1016/j.jopan.2015.08.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 06/08/2015] [Accepted: 08/08/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this research study was to determine the effect of preoperative visits by the operating room (OR) nurse on patient stress levels before undergoing surgery. DESIGN This research was a quasi-experimental study. METHODS The research sample included patients (N = 179) who were hospitalized for surgery during 6 months in the general surgery department of a public hospital in the Eastern Black Sea Region. The OR nurse, part of the medical staff for surgery, visited patients in the experimental group 1 day before surgery. The OR nurse collected information that was consistent with the requirements of the patients. Patients in the control group were provided with preoperative care that was consistent with hospital procedure. Research data were collected using question forms, patient satisfaction scores, and Burford Distress Thermometer scale. Statistical evaluations included t tests and receiver operating characteristic analysis for independent groups. FINDING Most patients stated that they felt stressed because of the impending surgery. Patients made the following most common statements of the factors that caused stress; fear of unknown, anesthesia phobia, and fear of OR environment and complications that may occur during surgery. Patients in both groups experienced a significant decrease in postoperative stress levels. The perceived distress in the experimental group was significantly lower than the control group during the postoperative period. Patients in the experimental group reported that the OR nurse's visit effectively minimized their stress levels. CONCLUSIONS OR nurse visits to patients before surgery contributed to decreased preoperative stress levels.
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Casans Francés R, Ripollés Melchor J, Abad-Gurumeta A, Longás Valién J, Calvo Vecino JM. The role of the anaesthesiologist in enhanced recovery programs. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2016; 63:273-288. [PMID: 26775121 DOI: 10.1016/j.redar.2015.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 11/04/2015] [Accepted: 11/09/2015] [Indexed: 06/05/2023]
Affiliation(s)
- R Casans Francés
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Clínico Universitario «Lozano Blesa», Zaragoza, España; Grupo Español de Rehabilitación Multimodal (GERM/ERAS-Spain), España.
| | - J Ripollés Melchor
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario «Infanta Leonor», Madrid, España; Grupo Español de Rehabilitación Multimodal (GERM/ERAS-Spain), España
| | - A Abad-Gurumeta
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario La Paz, Madrid, España; Grupo Español de Rehabilitación Multimodal (GERM/ERAS-Spain), España
| | - J Longás Valién
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Clínico Universitario «Lozano Blesa», Zaragoza, España; Grupo Español de Rehabilitación Multimodal (GERM/ERAS-Spain), España
| | - J M Calvo Vecino
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario «Infanta Leonor», Madrid, España; Grupo Español de Rehabilitación Multimodal (GERM/ERAS-Spain), España
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Abstract
Postoperative fast-track recovery protocols combine various methods to support immediate care of patients who undergo major surgery. These protocols include control of postoperative pain and early beginning of oral diet and mobilization. The combination of these approaches may reduce the rate of postoperative complications and facilitate hospital discharge. The aim of this study was to evaluate progress and parameters of fast-track recovery after major liver and pancreatic resection. A descriptive bibliographical review from 2001 to 2012 via electronic databases such as MEDLINE, PubMed, and Google Scholar was undertaken. Articles that focused on a fast-track protocol were studied. Reports focusing on the implementation of a fast-track protocol in the postoperative recovery of patients after major hepatectomy or pancreatectomy were selected. Fast-track protocols may be applicable to patients recovering after major liver or pancreatic resection. Future research should be focused on particular parameters of the fast-track protocol separately.
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Hudson BF, Davidson J, Whiteley MS. The impact of hand reflexology on pain, anxiety and satisfaction during minimally invasive surgery under local anaesthetic: a randomised controlled trial. Int J Nurs Stud 2015; 52:1789-97. [PMID: 26294281 DOI: 10.1016/j.ijnurstu.2015.07.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 07/17/2015] [Accepted: 07/17/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Elevated patient anxiety during surgery is linked to a range of suboptimal treatment outcomes. Reflexology has been reported to be effective in reducing pre and post-operative anxiety and post-operative pain. OBJECTIVES To explore whether the addition of hand reflexology to treatment as usual during minimally invasive varicose vein surgery under local anaesthetic impacted upon patient reported anxiety and pain during surgery, and patient satisfaction with treatment. DESIGN Randomised controlled trial. SETTING Private outpatient clinic specialising in venous conditions. PARTICIPANTS 137 participants were assessed for eligibility. One hundred patients were recruited (mean age 47.8 years, 83% female). Participants received endovenous thermal ablation and/or phlebectomy for the treatment of varicose veins. Inclusion criteria included age (between 18 and 80) and receiving endovenous thermal ablation and/or phlebectomy for the treatment of varicose veins under local anaesthetic. Exclusion criteria included the presence of leg ulcers and receiving microsclerotherapy or foam sclerotherapy treatments, being unwilling to enter into the randomisation process and arriving late at the clinic. METHODS Participants were randomly allocated to either treatment as usual (control group) or intra-operative hand reflexology during minimally invasive varicose vein surgery under local anaesthetic. Participants in the reflexology group received a session of intra-operative hand reflexology which began in the operating theatre, prior to analgesic injections and continued until surgery was complete. It was not possible to blind the participants, researchers or theatre staff to group allocation due to the modifications required to the operating theatre for participants in the reflexology group. The researcher could not be blinded due to the role they played in the trial organisation. RESULTS Of the 137 participants screened for eligibility, 7 participants declined to participate and a further 30 did not meet the inclusion criteria, giving a recruitment rate of 93%. Fifty participants were randomised to the reflexology group and fifty participants were randomised to the control group. Intra-operative anxiety was significantly lower in the reflexology group (mean score of 3.24 on an 11-point rating scale) than the control group (mean score of 5.0, p<.001). CONCLUSIONS Intra-operative hand reflexology is a useful adjunct to local anaesthetic varicose vein surgery, with participants in the reflexology group reporting significantly lower intra-operative anxiety and shorter pain duration than participants receiving treatment as usual.
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Affiliation(s)
- Briony F Hudson
- The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey GU2 7RF, UK; School of Psychology, University of Surrey, Guildford, UK
| | - Jade Davidson
- The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey GU2 7RF, UK; Rosey Feet, UK
| | - Mark S Whiteley
- The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey GU2 7RF, UK; Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, UK.
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