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Sharif-Nia H, Froelicher ES, Hoseinzadeh E, Kaveh O, Fatehi R, Nowrozi P. Assessing the validity and reliability of the 10-item Persian version of the perceived stress scale in post-surgery patients. Front Psychiatry 2024; 15:1402122. [PMID: 38895033 PMCID: PMC11184503 DOI: 10.3389/fpsyt.2024.1402122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction The 10-item Perceived Stress Scale (PSS-10) is commonly used to measure stress levels in postoperative patients, as research shows that high levels of stress can affect postoperative outcomes. By using the PSS-10, healthcare providers can understand patients' psychological well-being before and after surgery, helping improve recovery and overall health. This study focuses on assessing the reliability and validity of the 10-item Persian version of the PSS (PSS-10-P) in postoperative patients. Methods In a methodological study conducted between October to December 2023, a sample of 400 patients who had undergone surgery in 17 Shahrivar Hospital, Amol, Iran were selected using a convenience sampling method. The PSS-10 scale utilized in the study was translated, and its psychometric properties were evaluated through assessments of construct validity, including exploratory (n = 200) and confirmatory (n = 200) factor analysis, convergent validity, and discriminant validity. Furthermore, the study examined the internal consistency of the scale to ensure its reliability. Results The mean age of the participants was 44.38 (SD= 13.49) years. The results of exploratory factor analysis with Promax rotation extracted two factors accounting for 83.82% of the variance comprising 10 items. After necessary modifications during CFA, the final model was approved. As for reliability, the Cronbach's alpha, CR, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. Conclusion According to these results, the Persian version of PSS-10 has a valid structure and acceptable reliability. This scale can be used by health professionals in many ways.
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Affiliation(s)
- Hamid Sharif-Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, School of Nursing, and Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Esmail Hoseinzadeh
- Department of Nursing, Faculty of Medical Sciences, Gorgan Branch, Islamic Azad University, Gorgan, Iran
| | - Omolhoda Kaveh
- Department of Nursing, Sari Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Fatehi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Poorya Nowrozi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Machado PT, Lecoultre C, Courbon C. Cross-sectional and Correlational Examination of Patients' Preoperative Anxiety, Information Need, and Health Literacy in a Presurgical Consultation. J Perianesth Nurs 2024:S1089-9472(24)00039-X. [PMID: 38762807 DOI: 10.1016/j.jopan.2024.01.020] [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: 10/19/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE This study elucidates the preoperative anxiety (PA), information need (IN), and health literacy (HL) levels of an elective preoperative sample in Switzerland and examines the possible associations between PA and the patients' characteristics. By knowing these patient dimensions, which can influence perioperative outcomes, one can tailor individualized nursing interventions to improve patients' surgical experience. DESIGN This was a cross-sectional and correlational study. METHODS The sample consisted of 88 patients who underwent a preoperative consultation at a Swiss tertiary hosptial. Patients' PA and IN were assessed using the Anxiety Preoperative and Information Scale, and their HL was measured using the Functional, Communicative, and Critical Health Literacy Scale. Data on other patient characteristics were collected from the patients, physicians, and electronic patient records. Association tests, as well as univariate regressions, were performed on PA, IN, HL, and patient characteristics. FINDINGS Among participants, 40.91%, 78.41%, and 59% reported having PA, IN, and low HL, respectively. Finally, PA was associated with IN, HL, solitary living, and the American Society of Anesthesiology score. CONCLUSIONS A high proportion of patients scheduled for presurgical consultation were found to be anxious. They presented high IN and low HL. An examination of patients' PA-associated characteristics can help improve their surgical experience. More studies should examine PA-associated characteristics.
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Affiliation(s)
| | - Claudia Lecoultre
- Department of Surgery and Vascular Cardiology Services, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Cécile Courbon
- Department of Surgery and Vascular Cardiology Services, Lausanne University Hospital, Lausanne, Vaud, Switzerland
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Kuroda F, Urban CA, Dória M, Rabinovich Í, Spautz C, Lima R, Schunemann E, Furlan KA, Nissen L, Fornazari AC, Soares I, Sobreiro B, Lourenço M, Loureiro M. Three-dimensional Simulation on Patient-reported Outcomes Following Oncoplastic and Reconstructive Surgery of the Breast: A Randomized Trial. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5804. [PMID: 38752215 PMCID: PMC11095956 DOI: 10.1097/gox.0000000000005804] [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: 10/29/2023] [Accepted: 03/13/2024] [Indexed: 05/18/2024]
Abstract
Background Three-dimensional (3D) imaging using computer simulations is an evolving technology. There is a lack of strong data on the use of this technology for oncoplastic (OP) and reconstructive surgery. Methods A prospective, randomized, single-center trial including breast cancer patients undergoing OP or mastectomy with immediate breast reconstruction with implant (IBR) enrolled from November 2019 to October 2021 at the Hospital Nossa Senhora das Graças, Breast Unit in Curitiba, Brazil. Both patients undergoing OP and those in the IBR group were randomized to undergo 3D imaging and simulation of postoperative results (intervention group) or 3D imaging without simulation (control group). All patients were invited to complete a patient-reported outcome (BREAST-Q) expectations module and breast reconstruction or reduction/mastopexy module before and 6 months after surgery. Results A total of 96 patients were enrolled. Sixty-nine patients (45 OP and 24 IBR) completed the pre- and postoperative questionnaires and were randomized for the simulation. Women in the OP group had higher expectations for breast appearance when clothed than those in the IBR implant group (93.4 ± 16.3 versus 82.9 ± 26.5; P = 0.03). The intervention group was more satisfied with information than the control group (P = 0.021). Both patients who underwent OP and IBR believed that the 3D simulation helped them understand the surgical process (86.6% and 75%, respectively). Conclusions Preoperative 3D simulation significantly improved patient's satisfaction with information and did not decrease postoperative satisfaction with the outcomes. The incorporation of preoperative 3D simulation may be a valuable tool in breast reconstruction.
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Affiliation(s)
- Flávia Kuroda
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
- Post-graduation Program in Biotechnology, Universidade Positivo, Curitiba, Brazil
| | - Cícero A. Urban
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
| | - Maíra Dória
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
| | - Íris Rabinovich
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
| | - Cleverton Spautz
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
| | - Rubens Lima
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
| | - Eduardo Schunemann
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
| | - Karina Anselmi Furlan
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
- Post-graduation Program in Biotechnology, Universidade Positivo, Curitiba, Brazil
| | - Leonardo Nissen
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
| | | | - Isabela Soares
- From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil
| | | | - Mateus Lourenço
- Department of Medicine, Evangélica Mackenzie University, Curitiba, Brazil
| | - Marcelo Loureiro
- Post-graduation Program in Biotechnology, Universidade Positivo, Curitiba, Brazil
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Profit DD. Describing and Predicting Preprocedural Anxiety in Patients Scheduled for Advanced Gastrointestinal Endoscopy During the COVID-19 Pandemic. Gastroenterol Nurs 2023; 46:475-488. [PMID: 37639614 DOI: 10.1097/sga.0000000000000766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/26/2023] [Indexed: 08/31/2023] Open
Abstract
Advanced gastrointestinal endoscopy includes a group of specialized procedures and interventions that are being performed more frequently, with little attention given to a patient's preprocedural anxiety issues. Compounding this concern, in 2020 the COVID-19 pandemic resulted in the delay of many endoscopy cases. It is unknown how this affected the anxiety of patients preparing for advanced endoscopy procedures. Patients with higher anxiety require higher doses of anesthetic medications, and experience increased pain and decreased satisfaction. The purpose of this study was to describe the biological, psychological, and social attributes of patients and identify whether social support, COVID-19-related anxiety, delay of procedure, patient's physical status, and procedural indication category were predictors of state anxiety levels in patients undergoing advanced gastrointestinal endoscopy during the COVID-19 pandemic. The research study was a cross-sectional descriptive design with 90 patients. Patients were classified into low state and high state anxiety groups. Fifty-eight percent of patients had high state anxiety scores. Using logistic regression, social support was identified as a predictor of preprocedural anxiety (odds ratio [OR] = 0.318 [95% confidence interval, CI = 0.170, 0.597, p < .001]) as less social support was associated with higher anxiety. It is imperative that strategies to maximize social support are reinforced.
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Affiliation(s)
- Dawn Donahue Profit
- Dawn Donahue Profit, PhD, RN, is Staff Development Specialist, Nursing Staff Development, UK HealthCare, Lexington, Kentucky
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Zhuo Q, Ma F, Cui C, Bai Y, Hu Q, Hanum AL, Wei W, Liang H. Effects of pre-operative education tailored to information-seeking styles on pre-operative anxiety and depression among patients undergoing percutaneous coronary intervention: A randomized controlled trial. Int J Nurs Sci 2023; 10:174-181. [PMID: 37128491 PMCID: PMC10148264 DOI: 10.1016/j.ijnss.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/06/2023] [Accepted: 03/19/2023] [Indexed: 05/03/2023] Open
Abstract
Objective This study aimed to evaluate the impact of pre-operative education tailored to percutaneous coronary intervention (PCI) patients' information-seeking styles on pre-operative anxiety and depression. Methods A single-blind randomized control trial was conducted. A total of 114 participants were recruited from the cardiology department in a tertiary hospital in Kunming, Southwest China from April to September 2020 and randomly allocated to the intervention group (n = 57) or control group (n = 57). All patients received oral pre-operative education as well as printed pre-operative education manuals and divided into monitors or blunters by the Chinese Version of the Monitoring Subscale of the Miller Behavioral Style Scale (C-MMBSS). The intervention group received pre-operative education tailored to information-seeking styles, while the control group received routine education. Anxiety and depression were measured at baseline and 1 h before the operation. Satisfaction with pre-operative education and length of stay were assessed at discharge. Results A total of 104 participants completed the study (52 participants in each group). Pre-operative education tailored to information-seeking styles was beneficial for reducing pre-operative anxiety (P < 0.01), reducing pre-operative depression (P < 0.01), and improving satisfaction with pre-operative education (P < 0.01) compared with routine education. There was no significant difference in length of stay between the intervention and control groups (P = 0.209). Conversely, pre-operative anxiety of patients was increased (P = 0.017) after pre-operative education in the control group. Conclusion This study confirmed that pre-operative education tailored to information-seeking styles effectively reduces pre-operative anxiety and depression and improves satisfaction with preoperative education.
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Affiliation(s)
- Qiqi Zhuo
- Oncology Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Changsheng Cui
- Department of Pharmacy, Army Medical Center of PLA, Chongqing, China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Qiulan Hu
- ICU in Geriatric Department, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Ardani Latifah Hanum
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Wei Wei
- Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
| | - Hongmin Liang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Yunnan, China
- Corresponding author.
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Perioperative safety determinants in ethnic patient groups. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2023. [DOI: 10.1177/25160435231151545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background In a Dutch hospital, unexpectedly, safer perioperative care was found in non-western ethnic minority patients compared to Dutch ethnic majority patients undergoing high-risk surgery with a mortality risk >1%. We explored determinants in order to find tools for nurses and physicians to improve patients’ safety and safety experience during the perioperative period. Methods A qualitative grounded theory design was applied to understand patients’ perspective on their needs and safety in the perioperative period we interviewed patients ( n = 17). Results Three themes emerged: ‘Nurse & physician behaviour’, ‘Team performance’, and ‘Patient behaviour’. In the first theme ‘Nurse and physicians’ behaviour’, positive determinants related to an attitude of experienced professionals that provide patients with trust. On the other hand, negative determinants provide patients with experiences of unsafety. In the second theme ‘Team performance’, positive determinants involved effective communication and coordinated care of the nurses and physicians. Negative determinants related to visible disagreement about the treatment. In the third theme ‘Patient behaviour’, positive determinants related to seeking support from nurses, physicians, and family to recover and to endure an anxious period. Negative determinants related to missing appointments or not consulting the information provided. Conclusion and practice implications ‘Nurse & physician behaviour’ and ‘Team performance’ are relevant determinants that contribute to patients’ experiences of safe care. Stimulating an active attitude of patients in seeking support may contribute to experiences of safe care. These results can be used to improve patients’ experience of safe care in an uncertain and vulnerable perioperative period.
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van der Linde-van den Bor M, Frans-Rensen SA, Slond F, Liesdek OC, de Heer LM, Suyker WJ, Jaarsma T, Weldam SW. Patients' voices in the development of pre-surgical patient education using virtual reality: A qualitative study. PEC INNOVATION 2022; 1:100015. [PMID: 37213731 PMCID: PMC10194275 DOI: 10.1016/j.pecinn.2021.100015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 05/23/2023]
Abstract
Objective To identify the information needs and perceptions of patients regarding the application of virtual reality in pre-surgical patient education. Methods A qualitative study was conducted between March and July 2020. The study population consisted of a purposive sample of patients scheduled for cardiac surgery from a single institution. Semi-structured individual interviews (n=19) were conducted and analysed using thematic analysis. Results Patient perceptions regarding virtual reality and information needs related to hospitalisation and surgery could be categorised into three themes: Creating familiarity, contents to explore and challenges and preconditions. Conclusions Virtual reality technology is a promising tool that can enhance conventional patient education to improve understanding and to potentially reduce concerns and anxieties. The virtual reality environment creates an opportunity for patients to be in control of the timing, quantity, depth and frequency of patient education. A virtual reality education tool should not be a substitute for personal contact with the physician. Innovation Patient information needs were identified profoundly to the further development of a virtual reality intervention. This intervention aims to educate patients prior to elective cardiac surgery.
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Affiliation(s)
| | - Sarah A. Frans-Rensen
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Fiona Slond
- Utrecht University Medical Centre, Centre for Education, Department of Technology Enhanced Learning, Utrecht, The Netherlands
| | - Omayra C.D. Liesdek
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Linda M. de Heer
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Willem J.L. Suyker
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Tiny Jaarsma
- Utrecht University Medical Centre, Julius Centre for Health Sciences and Primary Care, Utrecht, The Netherlands
- Linkoping University, Department of Health, Medicine and Caring Services, Linkoping, Sweden
| | - Saskia W.M. Weldam
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
- Corresponding author at: Heart and Lung Department, Utrecht University Medical Centre (UMC Utrecht), Internal PO E03.511, PO Box 85500, 3508 GA Utrecht, The Netherlands.
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Favre-Félix J, Laurent V, Branche P, Huissoud C, Raffin M, Pradat P, Aubrun F, Dziadzko M. Auricular Acupuncture for Preoperative Anxiety in Parturient Women with Scheduled Cesarean Section: A Randomized Placebo-Controlled Blind Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:569-578. [PMID: 35394895 DOI: 10.1089/jicm.2021.0346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Preoperative anxiety before cesarean section is a major issue. Nonpharmacologic anxiety control is believed to be more suitable in pregnant women. Auricular acupuncture (AA) is an inexpensive, easy-to-use, and validated intervention to reduce anxiety in different surgical settings. We evaluated the effect of AA on preoperative cesarean section anxiety. Methods: In a prospective, blind, controlled trial, pregnant women with a scheduled cesarean section under spinal anesthesia were randomized to receive AA with needle, AA without needle (sham), or usual care (no intervention). Anxiety level was assessed by using a visual analogue scale for anxiety (VAS-A; 0-minimal anxiety, 100-maximal anxiety) at three time points: inclusion (pre-induction room-T0), when entering the operating room (T1), and before incision (T2). The primary outcome was the VAS-A variation (percentage changes) between T0 and T1 in the AAe group compared with that in the sham AA group. The secondary outcomes were the VAS-A variation between T0 and T1 in the AA group compared with that in the control group, and the variation between T0 and T2 compared between the three groups, the effect of AA on parasympathetic tone, and the incidence of adverse effects. Results: In women immediately before anesthesia for cesarean section, the AA produced a 19% decrease of anxiety, compared with a 21% anxiety increase in sham AA, which is significantly different. The effect of AA was more present in women with low initial anxiety. The proportion of patients reaching clinically significant anxiety reduction (>33% from the initial level) was 2.5 times higher in the AA group (p = 0.02) compared with the sham group. No differences in anxiety variations were found compared with the no-intervention group. No effect of AA was noted on parasympathetic tone. Conclusion: Compared with sham, AA decreased maternal anxiety level when arriving in the operation room and just before the beginning of the cesarean section, with a trend toward improvement compared with usual care.
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Affiliation(s)
- Jeremy Favre-Félix
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Virginie Laurent
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Patricia Branche
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Cyril Huissoud
- Service de Gynécologie-Obstétrique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Stem Cell and Brain Research Institute, U846-INSERM, Bron, France
| | - Mahé Raffin
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Pierre Pradat
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Frederic Aubrun
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Research on Healthcare Performance (RESHAPE), U1290-INSERM et Université Claude Bernard Lyon 1, Lyon, France
| | - Mikhail Dziadzko
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Research on Healthcare Performance (RESHAPE), U1290-INSERM et Université Claude Bernard Lyon 1, Lyon, France
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Chase CL, Yashar BM, Swope C, Albin RL, Uhlmann WR. Searching for Answers: Information-Seeking by Young People At-Risk for Huntington's Disease. J Huntingtons Dis 2022; 11:337-346. [PMID: 35570496 PMCID: PMC9484118 DOI: 10.3233/jhd-210523] [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] [Indexed: 11/23/2022]
Abstract
Background: Health information-seeking is a coping strategy used globally by individuals with a personal or family history of a medical condition, including Huntington’s disease (HD). Objective: We sought to ascertain information-seeking practices of young people who grew up at-risk for HD. Methods: Participants ages 18–25 were recruited from HD support organizations. An online 96-item survey assessed information-seeking motivations and timing as well as information topics accessed, sources, and needs. Results: Fifty young adults (mean age 22.2 years) who grew up at-risk for HD responded. HD had been generally kept a secret (35.4%) or talked about but difficult to bring up (43.8%) in many families. Most (78.0%) became aware of HD in their family before age 15. Few (7.1%) received information resources at the time of disclosure. Most (68.1%) first sought information independently online, half within a week of disclosure. Respondents were motivated to understand the potential impact of HD on their personal lives and family members, obtain general information about the condition, and learn about treatments and research. Most sought information on clinical features and inheritance with > 80% interested in information on symptoms and personal risk and > 70% about having children. Conclusion: Limited information is provided to young people when first informed about HD in their families leading to independent, mostly online information-seeking. Information is used to build knowledge about HD to facilitate coping and life planning. Healthcare providers can direct young people to reliable resources and guide parents in talking with children to ensure that information needs are met.
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Affiliation(s)
- Colby L Chase
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Beverly M Yashar
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Chandler Swope
- Huntington's Disease Youth Organization.,Cystic Fibrosis Foundation
| | - Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.,Geriatric Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Wendy R Uhlmann
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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10
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Arfasa N, Nega Kassa R, Girma Legesse T. Preoperative anxiety and its associated factors among patients undergoing cardiac catheterization at saint peter Specialized Hospital and Addis Cardiac Center, Addis Ababa, Ethiopia. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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11
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Brylev L, Fominykh V, Chernenkaia V, Chernenkiy I, Gorbachev K, Ataulina A, Izvekov A, Monakhov M, Olenichev A, Orlov S, Turin I, Loginov M, Rautbart S, Baymukanov A, Parshikov V, Demeshonok V, Yakovlev A, Druzhkova T, Guekht A, Gulyaeva N. Stress load and neurodegeneration after gastrostomy tube placement in amyotrophic lateral sclerosis patients. Metab Brain Dis 2021; 36:2473-2482. [PMID: 34559375 DOI: 10.1007/s11011-021-00837-x] [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: 12/13/2020] [Accepted: 09/02/2021] [Indexed: 11/29/2022]
Abstract
Dysphagia and progressive swallowing problems due to motoneuron death is one of amyotrophic lateral sclerosis (ALS) symptoms. Malnutrition and body weight loss result in immunological disturbances, fatigability and increase risk of secondary complications in ALS patients, percutaneous endoscopic gastrostomy tube (PEG) placement representing a well-recognized method for malnutrition correction and potentially increasing life expectancy. However, despite nutritional correction, occasional rapid neurological deterioration may develop after PEG placement. We have hypothesized that this decline can be a result of exteroceptive stress during PEG placement and promote neurodegeneration in ALS patients. Intravenous sedation may decrease stress during invasive procedures and it is safe during PEG placement in ALS patients. The aim of the study was comparing different PEG placement protocols of anesthesia (local anesthesia or local anesthesia plus intravenous sedation) in ALS from perspectives of stress load and neurological deterioration profile. During 1.5 years 94 ALS patients were admitted; gastrostomy was performed in 79 patients. After screening according to inclusion and exclusion criteria, 30 patients were included in the prospective consecutive study. All patients were divided in two groups, with local anesthesia and with combination of local anesthesia and intravenous sedation. Routine biochemical indices, neurodegeneration and stress markers were measured. The age of ALS patients was 61 ± 10 years; 20 patients were included at stage 4A and 10 at stage 4B (King's College staging). PEG was placed at average14 months after the diagnosis and 2.2 years after first symptoms. Mean ALS Functional Rating Scale-Revised was 27.8, mean forced vital capacity of lung 46.3% (19-91%). After one year of observation only 8 patients survived. Mean life duration after PEG was 5 months (5 days-20 months). Comparison of two PEG placement protocols did not reveal differences in survival time, stress load and inflammation level. Higher saliva cortisol levels, serum cortisol, glucose, C-reactive protein and interleukin-6 were detected after PEG placement, confirming considerable stress response. PEG is a stressful factor for ALS patients, PEG placement representing a natural model of exteroceptive stress. Stress response was detected as increased cortisol, C-reactive protein, interleukin-6, and glucose levels. Intravenous sedation did not increase the risk of PEG placement procedure, however, sedation protocol did not affect stress load.
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Affiliation(s)
- L Brylev
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
- "Live Now" Charity Foundation for supporting people with ALS and other neuromuscular disorders, Moscow, Russia
| | - V Fominykh
- Bujanov Moscow City Clinical Hospital, Moscow, Russia.
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia.
| | - V Chernenkaia
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - I Chernenkiy
- Bauman Moscow State Technical University, Moscow, Russia
| | - K Gorbachev
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - A Ataulina
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - A Izvekov
- Mukhin Moscow City Clinical Hospital, Moscow, Russia
| | - M Monakhov
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - A Olenichev
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - S Orlov
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - I Turin
- Moscow City Clinical Hospital №40, Moscow, Russia
| | - M Loginov
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - S Rautbart
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - A Baymukanov
- Bujanov Moscow City Clinical Hospital, Moscow, Russia
| | - V Parshikov
- "Live Now" Charity Foundation for supporting people with ALS and other neuromuscular disorders, Moscow, Russia
| | - V Demeshonok
- "Live Now" Charity Foundation for supporting people with ALS and other neuromuscular disorders, Moscow, Russia
| | - A Yakovlev
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - T Druzhkova
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - A Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N Gulyaeva
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
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Tsai HP, Compeau DR. Understanding and measuring formal communication quality for technology implementation: A test during the anticipation stage. JOURNAL OF STRATEGIC INFORMATION SYSTEMS 2021. [DOI: 10.1016/j.jsis.2021.101669] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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McCrorie AD, Begley AM, Chen JJ, McCorry NK, Paget G, McIntosh SA. Improving preparedness prior to reconstructive breast surgery via inclusion of 3D images during pre-operative counselling: a qualitative analysis. BMC Womens Health 2021; 21:323. [PMID: 34465323 PMCID: PMC8408958 DOI: 10.1186/s12905-021-01463-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND A proportion of women undergoing mastectomy for breast cancer choose to undergo breast reconstruction. Evidence suggests that women's preparedness for this surgery is low and that this may contribute to feelings of unmatched expectations and anxiety. There is substantial interest in decision-aids to remedy this. This study explores the incorporation of digitally rendered three-dimensional images into pre-operative counselling sessions as a means of enhancing patient preparedness. METHODS A database of three-dimensional images was produced showing both optimal and sub-optimal aesthetic outcome, matched to participant on the basis of type of surgical reconstruction, body habitus, and skin tone. Women undergoing mastectomy for breast cancer followed by immediate reconstruction were targeted for inclusion. Participants interacted with image software during pre-operative counselling sessions by viewing, rotating, and zooming in/out to gain a more in-depth appreciation of post-operative aesthetic outcome. Semi-structured face-to-face interviews followed thereafter. Interviews were audio-recorded, transcribed, coded, and themes identified. RESULTS Eight semi-structured interviews took place. The major emergent theme was 'increased preparedness' with subthemes including 'expectation management', 'software interaction', and 'enhanced realism'. There were no prohibitively negative emotions after interacting with images. Women reported gaining 'more of a perspective' and feeling 'more informed' after viewing images. They also valued the enhanced interactivity and better appreciation of reconstructed breast symmetry that viewing three-dimensional images offered when compared to viewing two-dimensional photographs. Finally, women also commented that three-dimensional images were more realistic. CONCLUSIONS Results suggest that incorporation of three-dimensional images into pre-operative counselling sessions prior to breast reconstruction, is a fairly simple yet effective method of enhancing patient preparedness prior to surgery. Women particularly valued the ability to use the software to generate a more realistic idea of what to expect after their operation. Future work should focus on better understanding any quantifiable benefit from incorporating three-dimensional images routinely into pre-operative decision-making.
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Affiliation(s)
- Alan D. McCrorie
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7AE N.Ireland UK
| | - Aislinn M. Begley
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7AE N.Ireland UK
| | - Jingwen J. Chen
- The Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7BL N.Ireland UK
| | - Noleen K. McCorry
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA N.Ireland UK
| | - Glenda Paget
- Belfast City Hospital, Belfast Health and Social Care Trust, 51 Lisburn Road, Belfast, BT9 7AB N.Ireland UK
| | - Stuart A. McIntosh
- The Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7AE N.Ireland UK
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Guerrier G, Abdoul H, Jilet L, Rothschild PR, Baillard C. Efficacy of a Web App-Based Music Intervention During Cataract Surgery: A Randomized Clinical Trial. JAMA Ophthalmol 2021; 139:1007-1013. [PMID: 34323929 DOI: 10.1001/jamaophthalmol.2021.2767] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Importance Hypertensive events during cataract surgery may induce complications. Information and communication technologies applied to health are popular, but clinical evidence of its usefulness is rare and limited to treating anxiety without specific analysis. Recent publications have described the potential effects of personalized music choices as mobile-based intervention on pain but not on anxiety. Objective To demonstrate the effects of a web app-based music intervention on the incidence of hypertension in participants during cataract surgery performed under local anesthesia. Design, Setting, and Participants This randomized, single masked, controlled clinical trial was composed of 2 arms and took place at a single center at Cochin Hospital in Paris, France. A total of 313 participants were screened between February 2017 and July 2018. Among these, 311 participants undergoing a phacoemulsification procedure for elective surgery for their first eye cataract under local anesthesia were enrolled. Analysis was intention to treat and began in September 2018 and ended November 2018. Interventions Participants requiring cataract surgery were assigned randomly to either the experimental arm (web app-based music listening intervention delivered via headphones) or control arm (noise-canceling headphones without music) for 20 minutes before surgery. Main Outcomes and Measures The occurrence of at least 1 hypertensive event during surgery. Results A total of 310 participants were randomized in the study (155 to each arm) and 309 were analyzed (1 participant in the music arm had already undergone cataract surgery to the other eye). The mean (SD) age of the participants was 68.9 (10.8) years, and there were 176 female individuals (57%). On the primary end point, the incidence of hypertension was significantly lower in the music arm (21 [13.6%]) than in the control arm (82 [52.9%]), with a difference between the 2 arms of 39.3% (95% CI, 21.4%-48.9%; P < .001). Regarding the secondary end points, the mean (SD) visual measure of anxiety was lower in the music arm (1.4 [2.0]) than in the control arm (3.1 [2.4]), with a difference of 1.5 (95% CI, 1.0-2.1; P = .005). The mean (SD) number of sedative drug injections required during surgery was 0.04 (0.24) vs 0.54 (0.74) in the music vs control arms, respectively, with a difference of 0.50 (95% CI, 0.43-0.57; P < .001). Conclusions and Relevance For participants similar to those enrolled in this study, the trial suggests that a web app-based personalized music intervention before cataract surgery may be considered to lower anxiety levels and hypertension or reduce the need for sedative medication. Trial Registration ClinicalTrials.gov Identifier: NCT02892825.
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Affiliation(s)
- Gilles Guerrier
- Department of Anesthesia and Intensive Care, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.,INSERM U1138 Team 17, Centre de Recherche des Cordeliers (CRC), Paris, France
| | - Hendy Abdoul
- Unité de Recherche Clinique-Centre d'Investigation Clinique Paris Descartes Necker/Cochin, Hôpital Tarnier, Paris, France
| | - Lea Jilet
- Unité de Recherche Clinique-Centre d'Investigation Clinique Paris Descartes Necker/Cochin, Hôpital Tarnier, Paris, France
| | - Pierre-Raphaël Rothschild
- INSERM U1138 Team 17, Centre de Recherche des Cordeliers (CRC), Paris, France.,Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christophe Baillard
- Department of Anesthesia and Intensive Care, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
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Akbolat M, Amarat M, Ünal Ö, Şantaş G. A survey of health information seeking by cancer patients indicates some problems over medical explanations and terminology. Health Info Libr J 2021; 40:29-41. [PMID: 34297458 DOI: 10.1111/hir.12387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 06/07/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cancer patients may experience stress because of insufficient information about their illness, health condition, or treatment, but some may fear what the information reveals. OBJECTIVE This study aims to determine health information-seeking behaviour, the attitudes of cancer patients, the barriers they face in seeking health information and their sociodemographic and disease characteristics. METHODS A survey was conducted with 84 cancer patients in Turkey. Descriptive statistics were performed to determine the characteristics of information seeking and barriers found. RESULTS Cancer patients are likely to seek health information, often confident about finding resources easily. The main problems are as follows: (1) insufficient information from health care providers; (2) understanding medical terminology; and (3) lack of help from health care providers to explain information retrieved. DISCUSSION The information-seeking behaviour of cancer patients in this sample in Turkey resembles studies elsewhere, with (overall) evidence of monitoring behaviour (wanting to find out more about the disease, treatment and effects on lived experience). CONCLUSIONS The cancer patients in this survey were generally willing and confident in their information seeking to find out more about the disease, treatment and effects on lifestyle. The main barriers were medical terminology, insufficient explanations and information from healthcare providers.
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Affiliation(s)
- Mahmut Akbolat
- Sakarya University-Healthcare Management, Sakarya, Turkey
| | - Mustafa Amarat
- Sakarya University-Healthcare Management, Sakarya, Turkey
| | - Özgün Ünal
- Sakarya University-Healthcare Management, Sakarya, Turkey
| | - Gülcan Şantaş
- Yozgat Bozok University-Healthcare Management, Yozgat, Turkey
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Zhang C, Liu X, Hu T, Zhang F, Pan L, Luo Y, Wang Z. Development and psychometric validity of the perioperative anxiety scale-7 (PAS-7). BMC Psychiatry 2021; 21:358. [PMID: 34271896 PMCID: PMC8284006 DOI: 10.1186/s12888-021-03365-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Preoperative anxiety is a common psychological reaction in perioperative patients. The absence of a valid measurement tool hinders the evaluation of interventions to treat preoperative anxiety in China. This study aims to develop the Perioperative Anxiety Scale-7 (PAS-7) and test its reliability, validity, and cut-off value. METHODS A total of 280 patients over 16 years old (M = 55.1, SD = 14.3) who were undergoing elective surgery were recruited to complete the PAS-7 and the Generalized Anxiety Disorder-7 scale (GAD-7) one day before surgery. RESULTS The PAS-7 included seven items divided into two dimensions: mental anxiety and somatic anxiety. These two dimensions could explain 74.294% of the population variance. The internal consistency of each dimension ranged from 0.761-0.933. The confirmatory factor analysis showed that the model fit of the scale was good (χ2= 34.798, df = 13, χ2/df = 2.677, CFI = 0.949, TLI = 0.918, SRMR = 0.057, RMSEA = 0.115). The correlations between the GAD-7 and each dimension and the scale's total score were significant (0.711-0.789). A cut-off score of 8, maximizing the Youden Index, yielded a sensitivity of 75% and a specificity of 84.6% (95% CI: 0.88 ~ 0.97). CONCLUSIONS The PAS-7 had good reliability and validity and could be used as an effective tool to evaluate preoperative anxiety.
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Affiliation(s)
- Chengjiao Zhang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xitong Liu
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianran Hu
- grid.412277.50000 0004 1760 6738Department of Anesthesia and Pain Management, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Zhang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lingyi Pan
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Luo
- grid.412277.50000 0004 1760 6738Department of Anesthesia and Pain Management, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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17
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Fischbeck S, Petrowski K, Renovanz M, Nesbigall R, Haaf J, Ringel F. Anxiety is associated with unfulfilled information needs and pain at the informed consent consultation of spine surgery patients: a longitudinal study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:2360-2367. [PMID: 34089353 DOI: 10.1007/s00586-021-06824-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 02/18/2021] [Accepted: 03/20/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Meeting the information needs of patients adequately is of high importance in informed consent consultations in surgery. However, information needs often remain unmet in the informed consent consultation. The aim of this study was to assess anxiety and pain in relation to the patients' information needs fulfillment perioperatively. METHODS We applied a question prompt list (QPL) for patients undergoing spine surgery (SN-QPL) before (t1) and a question answering list (SN-QAL) after (t2) the informed consent consultation. The patients additionally completed the "State-Trait Anxiety Operation Inventory" (STOA, cognitive and affective scale) at t1, as well as a pain numerical rating scale (NRS) at t2 and postoperative (t3). We analyzed (1) the association between anxiety, information needs and pain and (2) anxiety and pain scores regarding information needs fulfillment after the consent consultation. RESULTS A total of n = 118 patients was included. Affective and cognitive state anxiety was only reduced postoperatively (affective p < .001, cognitive p < .05). The higher trait anxiety was, the more patients longed for information at t1-t3 (t1: r = .58/r = .74, each p < .001), (t2: r = .38/r = .49, each p < .001) and (t3: r = .29, p < .01/r = 34, p < .001). Higher grades of trait anxiety resulted in lower information needs fulfilment. Higher state anxiety levels were associated with higher pain levels. Information needs more often remained unfulfilled in high trait and state anxiety patients. CONCLUSION Patients' anxiety was associated with (un)fulfilled information needs. Meeting information needs should be optimized in the process of surgeon-patient communication. Adapting the information to the patients' anxiety levels seem to be an effective way to reduce anxiety.
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Affiliation(s)
- Sabine Fischbeck
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany.
| | - Katja Petrowski
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany
| | - Mirjam Renovanz
- Interdisziplinäre Sektion Neuroonkologie, Zentrum für Neurologie & Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Hertie-Institut für Klinische Hirnforschung, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Rebecca Nesbigall
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany
| | - Julian Haaf
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany
| | - Florian Ringel
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
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Li X, Qiao XF, Sun L, Wang GP, Bai YH. Application of situational adaptation training combined with childlike nursing for children undergoing tonsillectomy or adenoidectomy. Int J Pediatr Otorhinolaryngol 2021; 145:110707. [PMID: 33887548 DOI: 10.1016/j.ijporl.2021.110707] [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: 12/14/2020] [Revised: 03/22/2021] [Accepted: 04/03/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study aimed to investigate the clinical effect of situational adaptation training combined with child-friendly nursing in relieving the preoperative anxiety of children undergoing tonsillectomy or adenoidectomy. METHODS A total of 160 children undergoing tonsillectomy or adenoidectomy were randomly divided into two groups: a control group and a test group. In addition to the routine operating room nursing in the control group, children in the test group underwent situational adaptation training one day before surgery and child-friendly nursing on the day of surgery. The heart rates and differences in average dynamic pressure were compared between groups, both preoperatively and during anesthesia induction. The cooperativeness with anesthesia was also assessed. The anxiety states of children and their family members after the interventions were scored using the anxiety visual analog scale (VAS). The postoperative satisfaction with nursing was assessed and compared between groups. RESULTS The heart rates, differences in average dynamic pressure, cooperativeness with anesthesia, and VAS scores were significantly lower in the test group than in the control group. The VAS scores of family members were significantly lower in the test group than in the control group. The satisfaction degrees with nursing were significantly higher in the test group than in the control group. CONCLUSION Situational adaptation training combined with child-friendly nursing can significantly relieve the preoperative anxiety of children undergoing tonsillectomy or adenoidectomy and their family members. This treatment improves child cooperativeness during therapy, significantly reduces the amplitude of physiological stress response during surgery, and increases the satisfaction with nursing. Thus, situational adaptation training combined with child-friendly nursing is worthy of application in clinics.
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Affiliation(s)
- Xin Li
- Department of Surgery, Children's Hospital of Shanxi Province, Taiyuan, 030001, China
| | - Xiao-Feng Qiao
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, 030001, China.
| | - Lu Sun
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, 030001, China
| | - Guo-Ping Wang
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, 030001, China
| | - Yin-Huan Bai
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, 030001, China
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Salzmann S, Rienmüller S, Kampmann S, Euteneuer F, Rüsch D. Preoperative anxiety and its association with patients' desire for support - an observational study in adults. BMC Anesthesiol 2021; 21:149. [PMID: 34000986 PMCID: PMC8127269 DOI: 10.1186/s12871-021-01361-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022] Open
Abstract
Background Preoperative anxiety is prevalent and has harmful effects on postoperative outcomes. However, to date, it is still unclear (i) to what extent patients perceive preoperative anxiety as emotionally distressful, (ii) whether patients would welcome support from anesthesiologists in coping with their anxiety, and (iii) whether anxiety scores are useful for everyday clinical practice to determine patients’ need for support. Methods: 1082 patients scheduled to undergo elective procedures under general anesthesia were eligible for this cross-sectional study carried out at a university hospital. Preoperative anxiety, resulting in emotional distress, and patients’ desire for anesthesiologists’ support in coping with their anxiety were assessed dichotomously (no vs. yes) and analyzed descriptively. The intensity of anxiety was evaluated using the Amsterdam Preoperative Anxiety and Information Scale (range 4–20). Associations between the intensity of anxiety and the resulting desire for support were analyzed using logistic regression. Receiver operating characteristic analyses were performed to identify anxiety levels that best predict desire for support. Results Among the 1000 (537 female; M (SD) 57 (18) years) subjects evaluated, 493 (318 (65 %) female) reported anxiety. Anxiety was associated with emotional distress in 320 (65 %) and desire for support in 291 (59 %) patients. Increased preoperative anxiety levels were associated with higher rates of desire for support (B= 0.270; odds ratio 1.31 [95 % CI 1.22–1.41]). An anxiety score > 9 was best to predict a desire for support (sensitivity 0.861, specificity 0.724). However, desire for support was even present in some patients with lowest anxiety scores (5 or 6). Conclusions All patients undergoing surgery should be screened for preoperative anxiety and the resulting desire for support to be able to determine who would welcome support. Anxiety scoring tools do not seem to be useful to identify these patients. By helping patients experience less preoperative anxiety, anesthesiologists may not only reduce patients’ emotional distress but also have a positive impact on postoperative outcome. Trial registration German Clinical Trials Register (DRKS 00013319, 23 November 2017). Supplementary Information The online version contains supplementary material available at 10.1186/s12871-021-01361-2.
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Affiliation(s)
- Stefan Salzmann
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany
| | | | - Stefan Kampmann
- Philipps-University Marburg, Biegenstraße 10, 35037, Marburg, Germany
| | - Frank Euteneuer
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany.,Department of Psychology, Clinical Psychology and Psychotherapy, Medical School Berlin, Calandrellistrasse 1-9, 12247, Berlin, Germany
| | - Dirk Rüsch
- Philipps-University Marburg, Biegenstraße 10, 35037, Marburg, Germany. .,Department of Anesthesia and Intensive Care, University Hospital Giessen-Marburg (Marburg Campus), Baldingerstrasse, 35043, Marburg, Germany.
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20
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The Impact of Preoperative Education on Patients Undergoing Elective Total Hip and Knee Arthroplasty. Orthop Nurs 2020; 39:218-224. [DOI: 10.1097/nor.0000000000000674] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Plamann K, McCarthy Veach P, LeRoy BS, MacFarlane IM, Petzel SV, Zierhut HA. Effects of monitoring versus blunting on the public's preferences for information in a hypothetical cancer diagnosis scenario. J Genet Couns 2020; 30:132-143. [PMID: 32583486 DOI: 10.1002/jgc4.1302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Monitoring and blunting are coping styles that characterize how people respond when faced with personally threatening situations. High monitors tend to pay more attention to, scan for, and amplify threatening cues; high blunters tend to avoid information and seek distractions when faced with a threatening event. This study sought to investigate possible differential effects of monitoring and blunting coping styles on information preferences in a hypothetical cancer diagnosis scenario in the adult general public of Minnesota. In a survey administered at a large public venue (2016 Minnesota State Fair), participants were asked to imagine they carried a gene mutation and were diagnosed with colon cancer. They indicated their information preference [modified Cassileth Information Styles Questionnaire (MCISQ)], completed two coping style measures [Miller Behavioral Style Scale (MBSS) and Threatening Medical Situations Inventory (TMSI)], rated their perceived severity of colon cancer (low, moderate, high), and answered demographic questions. Eight hundred fifty-five individuals provided usable data. Participants classified as monitors on the TMSI had significantly higher MCISQ scores (i.e., preferred more information) than those classified as blunters (p = .004). Those scoring high on monitoring and low on blunting on the MBSS preferred significantly more information than those scoring high on both monitoring and blunting (p = .04). Linear regression analysis revealed being a monitor (TMSI), scoring high on monitoring (MBSS), rating colon cancer as more severe, and having a higher education level were significant positive predictors of MCISQ scores. Results suggest individual differences in coping style, perceived severity, and education level affect desire for information. Genetic counselors should consider these patient characteristics (e.g., asking patients about their information preferences) and tailor their approaches accordingly.
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Affiliation(s)
- Katie Plamann
- Department of Clinical Genomics, Mayo Clinic Health System, Eau Claire, WI, USA
| | - Patricia McCarthy Veach
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Bonnie S LeRoy
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Ian M MacFarlane
- Department of Psychology, Elizabethtown College, Elizabethtown, PA, USA
| | - Sue V Petzel
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota Medical Center - Fairview, Minneapolis, MN, USA
| | - Heather A Zierhut
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
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Eberhart L, Aust H, Schuster M, Sturm T, Gehling M, Euteneuer F, Rüsch D. Preoperative anxiety in adults - a cross-sectional study on specific fears and risk factors. BMC Psychiatry 2020; 20:140. [PMID: 32228525 PMCID: PMC7106568 DOI: 10.1186/s12888-020-02552-w] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 03/17/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Preoperative anxiety comprising anesthesia and surgery related anxiety is common and perceived by many patients as the worst aspect of the surgical episode. The aim of this study was to identify independent predictors of these three anxieties dimensions and to quantify the relevance of specific fears particularly associated with anesthesia. METHODS This study was part of a cross-sectional survey in patients scheduled to undergo elective surgery. Anxiety levels were measured with the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Modified numeric rating scales (mNRS, range 0-10) were used to assess the severity of eight selected specific fears which were predominantly analyzed descriptively. Multivariate stepwise linear regression was applied to determine independent predictors of all three anxiety dimensions (APAIS anxiety subscales). RESULTS 3087 of the 3200 enrolled patients were analyzed. Mean (SD) total preoperative anxiety (APAIS-A-T, range 4-20) was 9.9 (3.6). High anxiety (APAIS-A-T > 10) was reported by 40.5% of subjects. Mean (SD) levels of concern regarding the eight studied specific fears ranged from 3.9 (3.08) concerning "Anesthesiologist error" to 2.4 (2.29) concerning "Fatigue and drowsiness" with an average of 3.2 (2.84) concerning all specific fears. Ranking of all specific fears according to mean mNRS scores was almost identical in patients with high versus those with low anxiety. Among nine independent predictors of anxiety, only 3 variables (female gender, negative and positive anesthetic experience) independently predicted all three APAIS anxiety subscales. Other variables had a selective impact on one or two APAIS anxiety subscales only. Female gender had the strongest impact on all three APAIS anxiety subscales. Adjusted r2 values of the three models were all below 13%. CONCLUSIONS The high variability of importance assigned to all specific fears suggests an individualized approach is advisable when support of anxious patients is intended. Considering independent predictors of anxiety to estimate each patient's anxiety level is of limited use given the very low predictive capacity of all three models. The clinical benefit of dividing patients into those with high and low anxiety is questionable. TRIAL REGISTRATION German Registry of Clinical Trials (DRKS00016725), retrospectively registered.
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Affiliation(s)
- Leopold Eberhart
- grid.10253.350000 0004 1936 9756Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany ,Department of Anesthesia and Intensive Care, University Hospital Giessen-Marburg, Marburg Campus, Baldingerstraße, 35033 Marburg, Germany
| | - Hansjörg Aust
- grid.10253.350000 0004 1936 9756Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany ,Department of Anesthesia and Intensive Care, University Hospital Giessen-Marburg, Marburg Campus, Baldingerstraße, 35033 Marburg, Germany
| | - Maike Schuster
- grid.10253.350000 0004 1936 9756Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany
| | - Theresa Sturm
- grid.10253.350000 0004 1936 9756Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany
| | - Markus Gehling
- grid.10253.350000 0004 1936 9756Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany
| | - Frank Euteneuer
- grid.466457.20000 0004 1794 7698Department of Psychology, Medical School Berlin, Berlin, Germany ,grid.10253.350000 0004 1936 9756Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Dirk Rüsch
- Philipps-University Marburg, Biegenstraße 10, 35037, Marburg, Germany. .,Department of Anesthesia and Intensive Care, University Hospital Giessen-Marburg, Marburg Campus, Baldingerstraße, 35033, Marburg, Germany.
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Wu H, Zhao X, Chu S, Xu F, Song J, Ma Z, Gu X. Validation of the Chinese version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Health Qual Life Outcomes 2020; 18:66. [PMID: 32160883 PMCID: PMC7065348 DOI: 10.1186/s12955-020-01294-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 02/12/2020] [Indexed: 12/19/2022] Open
Abstract
Background Preoperative anxiety is an unpleasant state of tension that may impact patients’ post-operative pain and satisfaction. The level of preoperative anxiety should be routinely identified. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-reported questionnaire that is used to quickly assess preoperative anxiety and information needs with good psychometric properties. Objectives To validate the Chinese version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and to explore coping strategies used by patients in dealing with surgery and anesthetic. Methods The cross-cultural validation of APAIS involved the translation of a Chinese version of APAIS and an investigation of its psychometric properties and clinical applicability. Forward-back translation and a pilot study were performed to produce a Chinese adaptation of APAIS. The inpatients of the orthopedic, otolaryngology, and general surgery department scheduled for general anesthesia surgery were enrolled to complete psychometric testing. The reliability was assessed using Cronbach’s alpha. Exploratory factor analysis and confirmatory factor analysis were calculated to assess construct validity. The criteria validity was analyzed using the correlation between APAIS and State-trait anxiety inventory-state (STAI-S) and Visual analogue scale-anxiety (VAS-A). Coping styles were evaluated using the Medical Coping Modes Questionnaire (MCMQ) score that covered three domains: confrontation, avoidance, and resignation. The impact of different coping styles on patients’ anxiety was explored. Results A total of 204 valid questionnaires were collected the day before surgery. Cronbach’s alpha coefficients were 0.862 for the anxiety scale and 0.830 for the information scale. Exploratory factor analysis with oblique rotation revealed two factors that explained 76.45% of the total variances. A confirmatory factor analysis showed a two-factor model with an adequate model fit (root mean square error of approximation: 0.073, goodness-of-fit: 0.966). The APAIS anxiety score significantly correlated with STAI-S (r = 0.717, P < 0.01) and VAS-A (r = 0.720, P < 0.01). For the three coping strategies, preoperative anxiety had a low correlation with confrontation (r = 0.33, P < 0.01) and resignation (r = 0.22, P < 0.05). Conclusions The Chinese version of APAIS is a valid and reliable instrument for assessing preoperative anxiety. Use of this measurement tool for Chinese patients is feasible and shows promising results.
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Affiliation(s)
- Hao Wu
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhong Shan Road, Nanjing, Jiangsu, 210008, People's Republic of China
| | - Xin Zhao
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhong Shan Road, Nanjing, Jiangsu, 210008, People's Republic of China
| | - Shuaishuai Chu
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhong Shan Road, Nanjing, Jiangsu, 210008, People's Republic of China
| | - Fangxia Xu
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhong Shan Road, Nanjing, Jiangsu, 210008, People's Republic of China
| | - Jia Song
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhong Shan Road, Nanjing, Jiangsu, 210008, People's Republic of China
| | - Zhengliang Ma
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhong Shan Road, Nanjing, Jiangsu, 210008, People's Republic of China.
| | - Xiaoping Gu
- Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhong Shan Road, Nanjing, Jiangsu, 210008, People's Republic of China.
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Lemaître S, González-Candial M. Evaluation of anxiety and pain in eyelid surgery patients: a pilot study. Can J Ophthalmol 2019; 54:723-726. [DOI: 10.1016/j.jcjo.2019.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 02/07/2019] [Accepted: 02/10/2019] [Indexed: 11/27/2022]
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Kietaibl AT, Kietaibl S. [Anesthesiological perspectives on perioperative management in continuous subcutaneous insulin infusion (CSII): stop or continue?]. Wien Med Wochenschr 2019; 170:155-167. [PMID: 31654155 DOI: 10.1007/s10354-019-00711-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Perioperative handling of insulin pumps (CSII) is inconsistent. The aims of this study were a literature search addressing this clinical question, analysis of data found and a proposal for perioperative management recommendations for clinical practice. METHODS A systematic search was conducted in PubMed and Clinical Research Network. RESULTS AND DISCUSSION A total of 11 publications on CSII in perioperative medicine were identified. According to the evidence CSII guarantees perioperative glycemic stability under certain clinical situations. The use of CSII could be continued in patients undergoing elective non-cardiac minor surgery with fasting for up to one meal only. International guidelines on surgery in diabetes do not address the use of perioperative CSII. There is no nationwide register data for CSII, the use of which could be around 18%. Based on the search results, a hospital internal protocol for perioperative management with CSII and patient information material were designed. CONCLUSION Growing evidence for improved patient outcome with perioperative CSII usage warrants interdisciplinary transfer of knowledge and experiences on intensified insulin therapy and patient empowerment.
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Affiliation(s)
| | - Sibylle Kietaibl
- Abteilung für Anästhesie und Intensivmedizin, Evangelisches Krankenhaus Wien und Sigmund Freud Privatuniversität Wien, Hans-Sachs-Gasse 10-12, 1180, Wien, Österreich.
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Kizilkaya T, Gul A. Parameters that Affect the Comfort Level of Pregnant Women Before Cesarean Section: Fasting and Anxiety. J Perianesth Nurs 2019; 34:1265-1273. [PMID: 31474518 DOI: 10.1016/j.jopan.2019.05.135] [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: 02/07/2019] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to investigate whether fasting time and anxiety parameters affect pregnant women's preoperative comfort levels. DESIGN Cross-sectional descriptive study. METHODS Data were collected from pregnant women using the State-Trait Anxiety Inventory (STAI), General Comfort Questionnaire (GCQ), and Numerical Rating Scale. FINDINGS The mean age of the participants was 29.15 ± 4.54 years, and the spinal anesthesia rate was 65.5%. The mean fasting time was 13.16 ± 2.38 hours for solid food and 10.57 ± 2.91 hours for liquid food. The mean GCQ score was 129.82 ± 12.66, while the mean STAI subscale scores were 46.72 ± 9.37 and 43.65 ± 7.95. Moderately negative correlation was found between the total GCQ and STAI scores, while weak positive correlation was observed between the STAI score and the thirst sensation and mouth dryness. CONCLUSIONS The preoperative process negatively affects comfort levels of pregnant women. Interventions that reduce the fasting time and anxiety level of pregnant women will increase comfort.
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Yang JH, Ryu JJ, Nam E, Lee HS, Lee JK. Effects of Preoperative Virtual Reality Magnetic Resonance Imaging on Preoperative Anxiety in Patients Undergoing Arthroscopic Knee Surgery: A Randomized Controlled Study. Arthroscopy 2019; 35:2394-2399. [PMID: 31395176 DOI: 10.1016/j.arthro.2019.02.037] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the effect of a preoperative virtual reality (VR) experience of 3-dimensional (3D) reconstructed magnetic resonance images (MRIs) on anxiety reduction in patients undergoing arthroscopic knee surgery. METHODS Patients in the VR group watched a 3D model of their own MRI through a VR headset describing the anatomy of the knee as well as their own lesion of interest for an arthroscopic procedure. Patients in the non-VR (NR) group received standard preoperative information about their MRI. The primary outcome for analysis was the Amsterdam Preoperative Anxiety and Information Scale score to measure level of anxiety and the need for information in patients undergoing arthroscopic knee surgery. Secondary outcomes were rated with visual analog scale (VAS) scores measuring patient pain, preparedness, satisfaction, and stress. RESULTS Regarding the Amsterdam Preoperative Anxiety and Information Scale score, the sum S (surgery-related anxiety) and sum C (combined anxiety component) subscales showed significantly better outcomes in the VR group (median [interquartile range] for sum S = 2.0 [2.0-4.0], median [quartile 1-quartile 3] sum C = 4.0 [4.0-8.5]) than in the NR group (median [interquartile range] for sum S = 4.9 [3.0-5.0], median [quartile 1-quartile 3] sum C = 8.0 [5.3-9.8]) (P = .014 and P = .005, respectively). Regarding VAS scores, preoperative measures showed significantly better outcomes in satisfaction among VR group patients (95 [90.0-100.0]) in comparison to NR group patients (85 [70.0-96.0]) (P = .010). For postoperative VAS measures, the VR group (satisfaction score = 95 [90.0-100.0], stress score = 15 [2.5-37.5]) showed significantly better outcomes in satisfaction and stress in comparison to the NR group (satisfaction score = 85 [70.0-97.5], stress score = 30 [30.0-50.0]). CONCLUSIONS Application of preoperative VR experience of 3D reconstructed knee MRIs in patients undergoing arthroscopic knee surgery reduces anxiety around surgical encounters. The VR patient group was more satisfied overall and less stressed postoperatively. However, perioperative pain and preparedness were not affected by VR exposure. LEVEL OF EVIDENCE Level I, randomized controlled trial.
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Affiliation(s)
- Jae-Hyuk Yang
- Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Guri, Gyeonggi-do, Republic of Korea
| | - Jae Joon Ryu
- Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, Republic of Korea
| | - Eunwoo Nam
- Biostatistical Consulting and Research Laboratory, Hanyang University College of Medicine, Seoul, Republic of Korea
| | | | - Jin Kyu Lee
- Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, Republic of Korea.
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Brooks JK, Warburton G, Clark BC. Takotsubo Syndrome After Surgical and Nonsurgical Oral and Maxillofacial Events: Review of Published Cases. J Oral Maxillofac Surg 2018; 77:478-488. [PMID: 30326229 DOI: 10.1016/j.joms.2018.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE Takotsubo syndrome (TS) is an acute and potentially serious cardiac disorder that is often attributed to an exuberant catecholaminergic response to a severely physical or emotional event. As there is a paucity of information in the dental literature on TS, this article will provide an overview of this uncommon syndrome, including clinical presentation, demographic characteristics, etiopathogenesis, diagnosis, management, and recovery, particularly emphasizing its occurrence with oral and maxillofacial procedures. PATIENTS AND METHODS A PubMed search with the keyword "takotsubo" for publications from 1991 through May 2018 yielded 3,778 articles. Case reports and case series of TS associated with surgical and nonsurgical procedures in the oral and maxillofacial region were reviewed. Other cases were identified using a defined search strategy. RESULTS The literature search identified 28 documented episodes of TS that occurred with head and neck surgical procedures, mostly sinus, carotid, nasal, and cancer reconstruction surgical procedures, and notably, 3 cases occurred concurrently with dental extractions. In all of the featured patients, some degree of cardiovascular impairment developed and phenotypic overlap with acute occlusive coronary disease was shown. Most patients recovered within 2 weeks, and recovery in the remainder extended up to 3 months. CONCLUSIONS On rare occasions, TS has been reported in association with oral and maxillofacial procedures. As stress appears to be a precipitating factor in the development of TS, perioperative efforts should be instituted to reduce an adrenergic cascade.
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Affiliation(s)
- John K Brooks
- Clinical Professor, Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD.
| | - Gary Warburton
- Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, University of Maryland School of Dentistry, Baltimore, MD
| | - Brian C Clark
- Chief Cardiovascular Medicine Fellow, Department of Cardiology, University of Maryland Medical Center, and Baltimore Veterans Affairs Medical Center, Baltimore, MD
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Goebel S, Mehdorn HM. Breaking Bad News to Patients with Intracranial Tumors: The Patients' Perspective. World Neurosurg 2018; 118:e254-e262. [DOI: 10.1016/j.wneu.2018.06.168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
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Garcia ACM, Simão-Miranda TP, Carvalho AMP, Elias PCL, Pereira MDG, de Carvalho EC. The effect of therapeutic listening on anxiety and fear among surgical patients: randomized controlled trial. Rev Lat Am Enfermagem 2018; 26:e3027. [PMID: 30110103 PMCID: PMC6091387 DOI: 10.1590/1518-8345.2438.3027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 05/06/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To investigate the effect of therapeutic listening on state anxiety and surgical fears in preoperative colorectal cancer patients. METHOD A randomized controlled trial with 50 patients randomly allocated in the intervention group (therapeutic listening) (n = 25) or in the control group (n = 25). The study evaluated the changes in the variables state anxiety, surgical fears and physiological variables (salivary alpha-amylase, salivary cortisol, heart rate, respiratory rate and blood pressure). RESULTS In the comparison of the variables in the control and intervention groups in pre- and post-intervention, differences between the two periods for the variables cortisol (p=0.043), heart rate (p=0.034) and surgical fears (p=0.030) were found in the control group, which presented reduction in the values of these variables. CONCLUSION There was no reduction in the levels of the variables state anxiety and surgical fears resulting from the therapeutic listening intervention, either through the physiological or psychological indicators. However, the contact with the researcher during data collection, without stimulus to reflect on the situation, may have generated the results of the control group. Clinical Trial Registration: NCT02455128.
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Affiliation(s)
| | - Talita Prado Simão-Miranda
- Doctoral student, Escola de Enfermagem de Ribeirão Preto,
Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research
Development, Ribeirão Preto, SP, Brazil. Scholarship holder at Conselho Nacional de
Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Ana Maria Pimenta Carvalho
- PhD, Senior Professor, Escola de Enfermagem de Ribeirão Preto,
Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research
Development, Ribeirão Preto, SP, Brazil
| | - Paula Condé Lamparelli Elias
- PhD, Physician, Hospital das Clínicas, Faculdade de Medicina de
Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Emilia Campos de Carvalho
- PhD, Senior Professor, Escola de Enfermagem de Ribeirão Preto,
Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research
Development, Ribeirão Preto, SP, Brazil
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Aust H, Eberhart L, Sturm T, Schuster M, Nestoriuc Y, Brehm F, Rüsch D. A cross-sectional study on preoperative anxiety in adults. J Psychosom Res 2018; 111:133-139. [PMID: 29935747 DOI: 10.1016/j.jpsychores.2018.05.012] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE The main objective of this study was a detailed comparison of the level of anxiety about surgery and anesthesia. Other objectives included the assessment of the prevalence and intensity of preoperative anxiety. METHODS This cross-sectional single-center survey used the validated Amsterdam anxiety and information scale (APAIS) and a modified numeric rating scale (mNRS) to assess preoperative anxiety, anxiety about surgery and anxiety about anesthesia. Prevalences and intensities of anxieties were predominantly analyzed descriptively. RESULTS 3200 patients were enrolled and 3087 (57% females) were analyzed. 92.6% reported preoperative anxiety according to APAIS scores. The average total APAIS anxiety score (APAIS-A-T) was 9.9 (SD 3.6). 40.5% reported high anxiety (defined as APAIS-A-T > 10). Mean anxiety about surgery (APAIS-A-Su) was higher than mean anxiety about anesthesia (APAIS-A-An): 5.5 (SD 2.1) vs. 4.3 (SD 1.9), p < 0.0001. Accordingly, more patients were substantially more afraid (score difference > 2) of surgery (642, 20.8%, 95% CI 19.4-22.3) than of anesthesia (48, 1.6%, 95% CI 1.2-2.1). CONCLUSION Preoperative anxiety is still very common among adult patients scheduled to undergo an elective procedure. Therefore, it should be evaluated routinely. Anxiety about surgery and anxiety about anesthesia differ in many patients. For this reason, anxiety about surgery and anxiety about anesthesia should be assessed separately. This would allow providing a more individualized support of patients to cope with their anxiety and could require particular attention by the surgeon or the anesthetist.
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Affiliation(s)
- H Aust
- University Hospital Giessen-Marburg, Department of Anesthesia and Intensive Care, Marburg Campus, Baldingerstrasse, 35033 Marburg, Germany
| | - L Eberhart
- University Hospital Giessen-Marburg, Department of Anesthesia and Intensive Care, Marburg Campus, Baldingerstrasse, 35033 Marburg, Germany
| | - T Sturm
- Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany
| | - M Schuster
- Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany
| | - Y Nestoriuc
- Institute and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; Schön Clinic Hamburg-Eilbek, Dehnheide120, 20081 Hamburg, Germany
| | - F Brehm
- Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany
| | - D Rüsch
- University Hospital Giessen-Marburg, Department of Anesthesia and Intensive Care, Marburg Campus, Baldingerstrasse, 35033 Marburg, Germany.
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Goebel S, Mederer D, Mehdorn HM. Surgery-Related Coping in Surgery Patients with Intracranial Tumors. World Neurosurg 2018; 116:e775-e782. [DOI: 10.1016/j.wneu.2018.05.091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 01/10/2023]
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Goebel S, Mehdorn HM. Assessment of preoperative anxiety in neurosurgical patients: Comparison of widely used measures and recommendations for clinic and research. Clin Neurol Neurosurg 2018; 172:62-68. [PMID: 29986197 DOI: 10.1016/j.clineuro.2018.06.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/08/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Preoperative anxiety is frequent in neurosurgical patients and of high clinical relevance (e. g., associated with anestesiological requirements and surgery outcome). Little however is known about the quality of instruments for assessment of preoperative anxiety in this specific patient group and setting. This paper therefore focused on the psychometric properties of widely used questionnaires. Aim of this study was thus to enable both the clinician and the researcher to select appropriate instruments for assessment of surgery-related anxiety. PATIENTS AND METHODS The following instruments for assessment of preoperative anxiety were administered in a pseudo-randomized order one day prior to surgery in sample of 158 neurosurgical patients: The State Trait Operation Anxiety Inventory (STOA) - state scale, the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the one-item visual analogue scale (VAS). The questionnaires were psychometrically tested according to classical test theory (validity, reliability, diagnostic accuracy). RESULTS Construct validity was supported in all applied measures (convergent and divergent validity, known-group comparisons). For the STOA state, we found a one factor scale structure and thus no support for the proposed subscales covering cognitive and affective anxiety. The proposed scale structure of the APAIS, measuring anxiety and information requirement, was replicated. Internal consistency as indicator for reliability of the STOA and the APAIS was excellent (Cronbach's alpha = 0.937/0.868). All instruments showed adequate diagnostic accuracy with the most favourable results of the STOA. CONCLUSIONS All instruments included in this study can be recommended for assessment of surgery-related anxiety in neurosurgical patients with regard to their psychometric properties. Each instrument offers distinct advantages. Thus, clinicians and researchers can base their individual choice on specific aims and available resources.
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Affiliation(s)
- Simone Goebel
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology - Christian-Albrechts University, Olshausenstraße 62, 24118 Kiel, Germany.
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[Assessment of the therapeutic communication in order to improve the welcoming of patients in the operating room: impact study]. Can J Anaesth 2018; 65:1138-1146. [PMID: 29949092 DOI: 10.1007/s12630-018-1167-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/18/2018] [Accepted: 03/27/2018] [Indexed: 10/14/2022] Open
Abstract
PURPOSE We wanted to assess the awareness of the nursing staff to therapeutic communications on improving the welcoming experience of patients in the operating room for outpatient surgery. METHODS This was a single centre prospective impact study performed in an outpatient surgery clinic. In a first phase, a questionnaire was administered by the anesthetist nurse upon arrival of the patient to assess the patient's comfort (NRSc) and satisfaction on a simple numeric scale, and calculate a negative communication score ('NC'). In the second phase, the awareness of the nursing staff on therapeutic communication was emphasized on listening, empathy and the use of positive wording, using educational videos. In the third phase, after the staff awareness-raising period, the questionnaire was repeated. Quantitative variables (primary outcome criterion made of the number of patients with a NC score ≥ 5, NRSc, satisfaction), and qualitative variables before and after the awareness raising phase to therapeutic communications were compared. RESULTS A total of 234 patients were included (109 before and 125 after). Following the staff awareness session to therapeutic communication, the NC score ≥ 5 decreased significantly from 20% to 6% as well as the median NRSc [P25-P75] before (8 [8-9] vs 8 [7-8]) and after (8 [8-9] vs 8 [7-8]) anesthesia. The proportion of less anxious patients before the initiation of anesthesia was significantly higher after the therapeutic communication (32% vs 17%). Satisfaction significantly increased after the awareness phase (8 [7-10] vs (9 [8-10]). CONCLUSION This preliminary study shows a mild improvement of the patients' comfort and satisfaction after therapeutic communication. A controlled randomized trial is needed to confirm those results.
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Duarte-Rodrigues L, Miranda EFP, Souza TO, de Paiva HN, Falci SGM, Galvão EL. Third molar removal and its impact on quality of life: systematic review and meta-analysis. Qual Life Res 2018; 27:2477-2489. [PMID: 29797177 DOI: 10.1007/s11136-018-1889-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to assess the impact of third molar removal on patient's quality of life. METHODS To address the study purpose, investigators designed and implemented a systematic review. The primary outcome variable was the quality of life after third molar extraction. An electronic search was conducted through March, 2017, on the PUBMED, Virtual Health Library (VHL), Web of Science, and OVID, to identify relevant literatures. Research studies (randomized or non-randomized clinical trials) were included that evaluated the quality of life in individuals before and after third molar extraction, using validated measures of oral health-related quality of life with quantitative approach, besides procedures performed under local anesthesia. The R software was used to measure the mean difference on the quality of life between the preoperative period and follow-up days. RESULTS A total of 1141 studies were identified. Of this total, 13 articles were selected in the present systematic review, of which six studies were included in the meta-analysis. All of these 13 articles used the OHIP-14, and 4 of this 13 used OHQoLUK-16 to evaluate the quality of life. Regarding quality assessment, four of the 13 included studies in this review received a maximum score of 9 points, according to the Newcastle-Ottawa (NOS). The OHIP-14 mean score on the first postoperative day was 17.57 (95% CI 11.84-23.30, I2 = 96%) higher than the preoperative period. On the seventh postoperative day, the quality of life assessed by OHIP-14 got worse again. CONCLUSION This systematic review revealed that the highest negative impact on quality of life of individuals submitted to third molar surgery was observed on the first postoperative day, decreasing over the follow-up period.
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Affiliation(s)
- Lucas Duarte-Rodrigues
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Ednele Fabyene Primo Miranda
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Taiane Oliveira Souza
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Haroldo Neves de Paiva
- Department of General Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Saulo Gabriel Moreira Falci
- Department of Oral and Maxillofacial Surgery, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil.
| | - Endi Lanza Galvão
- René Rachou Institute, Fundação Oswaldo Cruz, Av. Augusto de Lima, 1715 - Barro Preto, Belo Horizonte, MG, 30190-002, Brazil
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Maurice-Szamburski A. Preoperative virtual reality experience may improve patient satisfaction and reduce anxiety. Evid Based Nurs 2018; 21:14. [PMID: 29175963 DOI: 10.1136/eb-2017-102780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 06/07/2023]
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Bruckenthal P, Simpson MH. The Role of the Perioperative Nurse in Improving Surgical Patients' Clinical Outcomes and Satisfaction: Beyond Medication. AORN J 2017; 104:S17-S22. [PMID: 27884219 DOI: 10.1016/j.aorn.2016.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/19/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
For the perioperative nurse, the management of postsurgical pain includes various responsibilities, such as performing postsurgical pain assessments as an essential first step, facilitating recovery from surgery, and maximizing patient satisfaction during the postsurgical period. In addition, nurses are responsible for providing patient education regarding pain management, the quality of which may strongly influence patient satisfaction. External and internal challenges exist in perioperative care processes, however, and addressing these challenges will promote the overall goal of providing high-quality care.
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Rahnama M, Shahdadi H, Bagheri S, Moghadam MP, Absalan A. The Relationship between Anxiety and Coping Strategies in Family Caregivers of Patients with Trauma. J Clin Diagn Res 2017; 11:IC06-IC09. [PMID: 28571166 DOI: 10.7860/jcdr/2017/25951.9673] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 02/01/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Traumatic events are of high incidence and affect not only the patient but also their family members, causing psychological problems such as stress and anxiety for caregivers of these patients. Therefore, the application of appropriate coping strategies by them seems necessary in order to promote mental health. AIM To study the relationship of anxiety with coping strategies in family caregivers of trauma patients. MATERIALS AND METHODS The present research was a descriptive-correlational study which was carried out on 127 family caregivers of patients with trauma in intensive care unit, surgery ward and emergency unit of Amir al-Mu'minin Hospital of Zabol, Sistan and Baluchestan Province. The respondents were selected based on the convenience sampling method. Demographics questionnaire, DASS-21, and Coping Strategies questionnaire were used for data collection. The obtained data were statistically analysed using descriptive statistics, Analysis of Variance (ANOVA), t-test, and Pearson correlation coefficient in statistical package for the Social Sciences (SPSS) version 21.0. RESULTS Based on the results, 89.9% of family caregivers suffer from mild to severe anxiety. The most common type of coping strategy used by the respondents was emotion-focused. The results showed no relationship between anxiety and emotion-centrism, but an inverse relationship was found between problem-centrism and anxiety. CONCLUSION The majority of family caregivers had anxiety. Given, the inverse relationship between the level of anxiety and the use of problem-based coping strategy, in addition to identifying and reducing the causes of anxiety in caregivers. It is recommended that appropriate coping strategies should be trained to them.
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Affiliation(s)
- Mozhgan Rahnama
- Assistant Professor, Department of Nursing, Zabol University of Medical Science, Zabol, Sistanvbalouchistan, Iran
| | - Hosien Shahdadi
- Instructor, Department of Nursing, Zabol University of Medical Science, Zabol, Sistanvbalouchistan, Iran
| | - Somyeh Bagheri
- Instructor, Department of Biostatistics, Zabol University of Medical Science, Zabol, Sistanvbalouchistan, Iran
| | - Mahdieh Poodineh Moghadam
- Instructor, Department of Nursing, Zabol University of Medical Science, Zabol, Sistanvbalouchistan, Iran
| | - Ahmad Absalan
- Student, Department of Nursing, Zabol University of Medical Science, Zabol, Sistanvbalouchistan, Iran
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