1
|
Çalışkan E, Aksoy N. The Relationship Between Preoperative Anxiety Level and Postoperative Pain Outcomes in Total Hip and Knee Replacement Surgery: A Cross-sectional Study. J Perianesth Nurs 2024:S1089-9472(24)00106-0. [PMID: 38980235 DOI: 10.1016/j.jopan.2024.03.010] [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: 12/06/2023] [Revised: 03/03/2024] [Accepted: 03/17/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE Preoperative anxiety is considered a common part of the surgerical experience and can be associated with serious postoperative side effects. This study aims to determine the relationship between preoperative anxiety level and postoperative pain outcomes in patients undergoing total hip replacement (THR) and total knee replacement (TKR). DESIGN The study used a cross-sectional and correlational research method. METHODS The study was conducted with a total of 104 participants, who underwent 17 THR and 87 TKR, at the Orthopedic Clinic of a state hospital in southern Turkey between June 2021 and June 2022. The State-Trait Anxiety Inventory (STAI) was used to determine preoperative anxiety level, and the Visual Analog Scale (VAS) and the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) were used to assess postoperative pain level. FINDINGS The mean preoperative STAI-I and STAI-II scores of the participants who underwent THR and TKR were 53.95 ± 10.51 and 44.20 ± 10.55, respectively. There was a moderate positive correlation between STAI-I scores and VAS pain scores at preoperative and postoperative 6th, 12th, 24th, and 36th hours. There was a moderate positive correlation between STAI-I scores and affective subdimension scores, a moderate positive correlation with pain severity and sleep interference and activity interference, and a weak positive correlation between STAI-II scores and pain severity and sleep interference, activity interference and affective. The factors independently affecting the 6th-hour VAS pain score were determined as male gender, THR procedure, and increasing STAI score. CONCLUSIONS We found that high preoperative state anxiety was associated with early postoperative pain outcomes. State anxiety was associated with pain in the 6th postoperative hour. Considering the multidimensional nature of anxiety, further research is recommended to understand the anxiety domain in surgical patients.
Collapse
Affiliation(s)
| | - Nilgün Aksoy
- Faculty of Nursing, Akdeniz University, Antalya, Turkey.
| |
Collapse
|
2
|
Gamst-Jensen H, Villumsen BR, Nielsen AH, Egerod I, Brix LD. "What matters to you" on the day of surgery: Protocol for a mixed methods study. Acta Anaesthesiol Scand 2024. [PMID: 38660741 DOI: 10.1111/aas.14430] [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: 03/29/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The anticipation of anesthesia and surgery is the source of fear and anxiety in millions of patients worldwide. Although patients' fear and anxiety are recognized, more knowledge is needed to address patient responses and needs. Understanding the needs of the patients are important, and asking patients directly is the first step towards addressing these needs. This again might help reducing medications such as anesthetics and postoperative pain relief. The aim of this study protocol is to describe how we will investigate what matters to patients on the day of surgery, as well as their degree-of-worry and surgical fear. METHODS Using a convergent mixed methods design with equal weighting of the qualitative and quantitative data strand we take advantage of the international "What Matters To You" Day on June 6, 2024 to conduct a flash mob study. We will approach perioperative departments around Denmark to participate and eligible patients arriving to the perioperative department for surgery will be invited to participate. Consenting patients are asked to complete a survey in three parts regarding (1) what matters to you, (2) degree-of-worry, and (3) surgical fear. We will use qualitative analysis for the first part and descriptive statistics for second and third parts. The data strands will be analyzed separately followed by integrated analysis and joint displays.
Collapse
Affiliation(s)
- H Gamst-Jensen
- Department of Anesthesia, Centre of Head and Orthopedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - B R Villumsen
- Department of Anaesthesiology and Intensive Care, Gødstrup Hospital, Herning, Denmark
| | - A H Nielsen
- Department of Anaesthesiology and Intensive Care, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - I Egerod
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - L D Brix
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Anaesthesiology and Intensive Care, Horsens Hospital, Horsens, Denmark
| |
Collapse
|
3
|
Boyce L, Jordan C, Egan T, Sivaprakasam R. Can virtual reality enhance the patient experience during awake invasive procedures? A systematic review of randomized controlled trials. Pain 2024; 165:741-752. [PMID: 37870233 DOI: 10.1097/j.pain.0000000000003086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/16/2023] [Indexed: 10/24/2023]
Abstract
ABSTRACT Procedural anxiety and pain negatively affect surgical outcomes and the patient experience during awake, invasive procedures (AIPs). This systematic review aims to evaluate the effect of using virtual reality (VR) to enhance the intraprocedural patient experience during AIPs. PRISMA, Cochrane, and SWiM Reporting Items guidelines were followed. PubMed, EMBASE, CENTRAL, and medRxiv databases were systematically searched for randomised controlled trials (RCTs) investigating the use of immersive VR headsets to enhance the patient experience in adults undergoing AIPs. Sixteen studies were included. The VR and control groups comprised 685 and 677 patients, respectively. Patients underwent endoscopic procedures in 9 studies ("endoscopic") and interventions that involved a skin incision in 7 studies ("incision"). Eleven (of 13) studies demonstrated a favourable effect on procedural anxiety with VR use compared with standard intraprocedural care (85% [95% CI: 46%-100%], P = 0.011). Ten (of 13) studies demonstrated a favourable effect on pain with VR use (77% [95% CI: 38%-100%], P = 0.046). Seven (of 9) studies demonstrated a favourable VR effect on patient satisfaction (78% (95% CI: 44%-100%), P = 0.070). The effect of VR on physiological markers of anxiety and pain and requirements for additional pro re nata (PRN) analgesia and sedation were not clear. No significant differences in patient experience were identified between the "incision" and "endoscopic" subgroups. This review demonstrates that VR can feasibly be used to enhance the patient experience during AIPs by attenuating subjective perceptions of procedural anxiety and pain. However, further RCTs are required to elucidate the effect of VR on more objective measures of the patient experience.
Collapse
Affiliation(s)
| | | | | | - Rajesh Sivaprakasam
- Nephrology and Renal Transplant, the Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| |
Collapse
|
4
|
Periañez CAH, Castillo-Diaz MA, Barbosa MH, De Mattia AL. Pain Predictors in Patients in the Postanesthesia Care Unit. J Perianesth Nurs 2024:S1089-9472(23)01062-6. [PMID: 38310508 DOI: 10.1016/j.jopan.2023.11.010] [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: 04/12/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE To analyze the effects of pain-predicting factors on patients in the postanesthesia care unit (PACU). DESIGN This is an observational and prospective study. METHODS This study was conducted at a University Hospital in the state of Minas Gerais (Brazil). To collect data on demographic, clinical, and surgical factors, a collection instrument was devised. The verbal numerical scale was employed to measure pain levels before and after surgery in the PACU. A path analysis was used to assess a predictive model. FINDINGS A total of 226 patients were included in this study. The incidence of pain in the PACU was 31.9%. A model with demographic, clinical, and surgical variables was tested. The final model, after including modification indices, obtained results that indicated an acceptable data fit (comparative fit index = 0.996; root mean square error of approximation = 0.08). Age (being young), sex (being a woman), oncological diagnosis as an indication for the surgical procedure, type of surgery (surgery of the digestive system), duration of surgery (longer surgeries), and high intraoperative doses of opioids were predictive variables for pain in the PACU. CONCLUSIONS This study's findings provide support for pain management in the PACU. Furthermore, the results of this research can be used to anticipate the occurrence of acute postoperative pain and personalized perioperative analgesia needs.
Collapse
Affiliation(s)
| | - Marcio Alexander Castillo-Diaz
- Universidad Nacional Autónoma de Honduras, Vicerrectoría de Orientación y Asuntos Estudiantiles. Tegucigalpa, Francisco Morazán, Honduras
| | - Maria Helena Barbosa
- Universidade Federal do Triângulo Mineiro, Departamento de Enfermagem na Assistência Hospitalar. Uberaba, Minas Gerias, Brasil
| | - Ana Lúcia De Mattia
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Básica, Belo Horizonte, Minas Gerais, Brasil
| |
Collapse
|
5
|
Ko SY, Wong EML, Ngan TL, Leung HK, Kwok KTY, Tam HF, Chan CC. Effects of virtual reality on anxiety and pain in adult patients undergoing wound-closure procedures: A pilot randomized controlled trial. Digit Health 2024; 10:20552076241250157. [PMID: 38846363 PMCID: PMC11155349 DOI: 10.1177/20552076241250157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 06/09/2024] Open
Abstract
Background In emergency departments, suturing is a typical procedure for closing lacerated wounds but is invasive and often causes anxiety and pain. Virtual reality (VR) intervention has been reported as a relaxing measure. Objective The study aims to examine the effects of VR intervention on anxiety, pain, physiological parameters, local anesthesia requirements and satisfaction in Chinese adult patients undergoing wound closure in emergency departments in Hong Kong. Methods Adult patients who had lacerated wounds and were undergoing wound closure by suturing can communicate in Chinese and were hemodynamically stable were invited for this trial. Eighty patients were randomly assigned to the VR group, which received VR intervention and standard care, or to the control group, which received standard care only. The primary outcome was anxiety, and the secondary outcomes included pain, blood pressure, pulse rate, satisfactory with pain management, service satisfactory, and extra local analgesia requirement. Outcomes were conducted at baseline, during the procedure and 5 min after the procedure. Results The VR group had a significantly greater reduction in anxiety (p < 0.001), pain (p < 0.001), systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001), pulse rate (p = 0.003) and requested less amount of additional local anesthesia (p = 0.025). The satisfactory level with pain management (p = 0.019) and service (p = 0.002) were significantly higher in participants who received VR intervention. In addition, most participants preferred to have VR in the future, and no major adverse events associated with the use of VR were reported. Conclusion This pilot study provides insight into the use of VR and the direction of future studies. It may effectively improve psychological and physiological outcomes in adult patients during wound-closure procedures in emergency departments.
Collapse
Affiliation(s)
- SY Ko
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - Eliza ML Wong
- School of Nursing, Tung Wah College, Hong Kong, China
| | - TL Ngan
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - HK Leung
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - Kennis TY Kwok
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - HF Tam
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - CC Chan
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| |
Collapse
|
6
|
Demirci H, van der Storm SL, Huizing NJ, Fräser M, Stufkens SAS, Krips R, Kerkhoffs GMMJ, Barsom EZ, Schijven MP. Watching a movie or listening to music is effective in managing perioperative anxiety and pain: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 2023; 31:6069-6079. [PMID: 37897624 PMCID: PMC10719121 DOI: 10.1007/s00167-023-07629-z] [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: 08/02/2023] [Accepted: 10/09/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Despite the use of perioperative anxiolytics and pain medication, surgery can be a stressful and painful experience. Providing patients with distractions using video and/or audio tools in addition to medication may be helpful. To date, no studies have compared different distraction modalities in a same-day surgical setting in adults. This study aims to determine whether audio-visual distraction with video glasses (AVD) is more effective in reducing anxiety and pain compared to audio distraction (AD) in conscious patients undergoing orthopaedic surgery. It was hypothesised that AVD, being the more immersive modality, would be more effective than AD on the outcome parameters. METHODS Fifty patients undergoing orthopaedic surgery with local and/or regional anaesthesia in a clinical day-care setting were randomly assigned to receive either fixed-scenery AVD or patient-choice AD with music. Primary outcome was anxiety, as measured by the Dutch version of the Spielberger State-Trait Anxiety Inventory-6 (STAI-6) prior to and 15 min after the intervention. Secondary outcomes were pain (Numeric Rating Scale Pain [NRS-P]), systolic and diastolic blood pressure, heart rate and patient satisfaction. RESULTS Within each group, there was a significant reduction in anxiety (p = 0.028 for AVD, p < 0.001 for AD). In contrast to our hypothesis, listening to music without watching a video (AD group) reduced anxiety significantly more than experiencing full AVD (p = 0.018). The mean pain score did not change significantly within either user group, nor did pain scores differ between user groups. CONCLUSION In conscious patients undergoing surgery, watching a movie (using video glasses and a headphone set) and listening to music (using only a headphone set) are able to significantly reduce anxiety. AVD, although believed to provide higher levels of distraction, did not prove to be superior to AD. The clinical relevance of this study highlights the potential benefits of AVD or AD modalities in improving the surgical experience for conscious patients. Further research is required to examine the influence of freedom of choice in content on the aforementioned outcomes. To estimate the true value of higher immersion levels, different distraction modalities (e.g. AVD versus virtual reality) featuring the exact same scenery or content need to be compared. LEVEL OF EVIDENCE Level I.
Collapse
Affiliation(s)
- Hafize Demirci
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands.
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands.
| | - Sebastiaan L van der Storm
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| | - Nathalie J Huizing
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Morgianne Fräser
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Sjoerd A S Stufkens
- Amsterdam UMC, Department of Orthopedic Surgery, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Rover Krips
- Department of Orthopaedic Surgery, Flevoziekenhuis, Almere, The Netherlands
| | - Gino M M J Kerkhoffs
- Amsterdam UMC, Department of Orthopedic Surgery, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Esther Z Barsom
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands.
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands.
| |
Collapse
|
7
|
Soydaş D, Makal Orğan E, Yıldız Fındık Ü, Gökce Işıklı A. The relationship between the perception of surgical fear and nursing satisfaction. J Perioper Pract 2023; 33:380-385. [PMID: 36515433 DOI: 10.1177/17504589221137983] [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] [Indexed: 12/15/2022]
Abstract
Since patient satisfaction is considered a criterion in the evaluation of nursing care, it is important and necessary to know the factors associated with satisfaction. The aim of this study is to determine the relationship between surgical fear and satisfaction with nursing care in surgical patients. This descriptive correlational study was conducted with 110 patients who underwent planned major surgical intervention in a university hospital in Turkey. A patient introduction form, the Surgical Fear Questionnaire and Newcastle Satisfaction with Nursing Care Scale were used to collect data, as well as a face to face interview with patients during the pre and postoperative periods. The results showed that the surgical fear levels of the patients were low, their satisfaction with nursing care was high, and a weak correlation existed between the fear and satisfaction levels. We recommend nursing care interventions aimed at keeping the surgical fear levels of patients low and their satisfaction high.
Collapse
Affiliation(s)
- Duygu Soydaş
- Nursing Department, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Esra Makal Orğan
- Nursing Department, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Ümmü Yıldız Fındık
- Nursing Department, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Ayşe Gökce Işıklı
- Health Research and Practice Centre, Thoracic Surgery Department, Trakya University, Edirne, Turkey
| |
Collapse
|
8
|
Üstünel F, Tura İ, Akçam AT, Erden S. The Effect of Preoperative Fear of Pain on Postoperative Pain Levels and the Amount of Analgesic Consumption. Pain Manag Nurs 2023; 24:617-621. [PMID: 37302944 DOI: 10.1016/j.pmn.2023.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 04/20/2023] [Accepted: 04/29/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Preoperative fear of pain can increase the surgical stress response along with anxiety, increasing postoperative pain and the amount of analgesia consumption. AIMS To determine the effect of preoperative fear of pain on postoperative pain level and analgesic consumption. DESIGN A descriptive, cross-sectional design was used. METHODS A total of 532 patients who were scheduled for a variety of surgical procedures in a tertiary hospital were included in the study. Data were collected using Patient Identification Information Form and Fear of Pain Questionnaire-III. RESULTS 86.1% of the patients thought that they would experience postoperative pain, and 70% of the patients reported moderate-to-severe postoperative pain. The examination of the postoperative first 24-hour pain levels indicated that there was a significant positive correlation between patients' pain levels within 0-2 hours and their mean scores on the fear of severe and minor pain sub-dimensions and the total scale and between pain experienced within 3-8 hours and their scores on the fear of severe pain sub-dimension (p <.05). Also, a significant positive correlation was found between patients' mean scores on the total fear of pain scale and the amount of nonopioid (diclofenac sodium) consumption (p <0.05). CONCLUSIONS The fear of pain increased patients' postoperative pain levels, and thus the amount of analgesic consumption. Therefore, patients' fear of pain should be determined in the preoperative period, and pain management practices should be initiated in this period. As a matter of fact, effective pain management will positively affect patient outcomes by reducing the amount of analgesic consumption.
Collapse
Affiliation(s)
- Fatmagül Üstünel
- Cukurova University, Balcalı Hospital Health Practice Center, Nephrology Clinic, Balcalı Campus, Adana, Turkey
| | - İlknur Tura
- Cukurova University, Department of Nursing (RN, MsN)
| | - Atılgan Tolga Akçam
- Cukurova University, Balcalı Hospital Health Practice Center, Surgical Sciences, Department of General Surgery, Balcalı Campus, Adana, Turkey
| | - Sevilay Erden
- Cukurova University, Balcalı Hospital Health Practice Center, Nephrology Clinic, Balcalı Campus, Adana, Turkey.
| |
Collapse
|
9
|
Dibabu AM, Ketema TG, Beyene MM, Belachew DZ, Abocherugn HG, Mohammed AS. Preoperative anxiety and associated factors among women admitted for elective obstetric and gynecologic surgery in public hospitals, Southern Ethiopia: a cross-sectional study. BMC Psychiatry 2023; 23:728. [PMID: 37807071 PMCID: PMC10561508 DOI: 10.1186/s12888-023-05005-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/05/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Preoperative anxiety is a major mental health problem during the preoperative period. Admission of women to surgery is stressful, and a high level of anxiety was associated with increased perioperative morbidity and mortality, poor treatment satisfaction, and bad obstetric outcomes, including long-term cognitive impairment in children. Despite its negative consequences, little is known on this area, particularly in the study area. OBJECTIVE To assess preoperative anxiety and associated factors among women admitted for elective obstetrics and gynecologic surgeries in public hospitals in Southern Ethiopia, 2022. METHODS AND MATERIALS An institution-based cross-sectional study design was conducted among 389 women using structured interviewer-administered samples who were selected by systematic random sampling from May 20th to June 20th, 2022. The Amsterdam preoperative anxiety and information scale (APAIS) was used to assess the level of anxiety. Data were collected electronically using the Open Data Kit version 2022.2.3 and analyzed with the Statistical Package for Social Sciences version 26.0. Bivariate and multivariable logistic regression analyses were done. The strength of the association was declared by using an adjusted odds ratio (AOR) with a 95% confidence interval, and a statistical significance of P < 0.05. RESULTS The magnitude of preoperative anxiety was 57.1% (95% CI = 51.4-61.5), and 48.1% of women required an average amount of information. Being a gynecologic patient (AOR = 2.0, 95% CI = 1.21, 3.32), having previous anesthesia and surgery (AOR = 2.09, 95% CI = 1.10, 3.96), having fear of postoperative pain (AOR = 1.96, 95% CI = 1.08, 3.53), having concern for family (AOR = 2.56, 95% CI = 1.49, 4.37), having poor social support (AOR = 3.75, 95% CI = 1.99, 7.09), and moderate social supports (AOR = 3.27, 95% CI = 1.74, 6.17), and having a high information requirement about anesthesia and surgery (AOR = 4.68, 95%CI = 2.16, 10.13) were statistically associated with preoperative anxiety. CONCLUSION Preoperative anxiety was often high in the region. Associated factors were the type of surgery, previous anesthesia and surgery, fear of postoperative pain, fear for family, social support, and a high information need. So the national and regional health bureau should develop guidelines and implement strategies to reduce women preoperative anxiety as part of midwifery care. The women should be assessed regularly during the preoperative visits; and appropriate anxiety reduction and information regarding surgery, and anesthesia should be provided.
Collapse
Affiliation(s)
- Abera Mamo Dibabu
- Department of Midwifery, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia.
| | - Teklemariam Gultie Ketema
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Maechel Maile Beyene
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Dereje Zeleke Belachew
- Department of Midwifery, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
| | | | - Abdu Seid Mohammed
- Department of Midwifery, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
| |
Collapse
|
10
|
Tam B, Lin M, Castellanos C, Ulloa R, Kokot N, Hur K. Head and Neck Cancer Online Support Groups: Disparities in Participation and Impact on Patients. OTO Open 2023; 7:e87. [PMID: 37933274 PMCID: PMC10625668 DOI: 10.1002/oto2.87] [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: 05/14/2023] [Revised: 08/13/2023] [Accepted: 10/07/2023] [Indexed: 11/08/2023] Open
Abstract
Objective To characterize the users of the head and neck cancer (HNC) online support group (OSG) and describe the perceived benefits of membership. Study Design Cross-sectional. Setting Online. Methods An administered survey with questions asking about demographics, cancer history, treatment choices, and feelings about OSGs was posted on the 5 largest HNC OSGs on Facebook. Results A total of 97 participants completed the survey. Mean age was 57.8 years old (standard deviation = 10.7 years). Most participants were female (50.5%) and Caucasian (92.8%). This cohort was well educated with 65.5% holding at least a college degree. Annual income was high with 41.8% reporting annual income of $100,000 or greater. The most common treatment modality was radiation (88.7%). The most common surgery was neck dissection (46.4%). Most participants preferred OSGs (70.8%) over other support group types. OSGs were heavily utilized with our cohort reporting using the OSG at least several times a week (80.0%). The top reasons for joining the OSG were sharing one's experience of HNC (76.3%) and gaining support from others with HNC (85.6%). OSGs were ranked as the #3 source of medical information for HNC behind otolaryngologists and oncologists. Membership in a HNC OSG had a minimal impact on decision-making. Conclusion HNC OSGs appear to provide a beneficial community for HNC patients. Otolaryngologists should consider incorporating HNC OSG as a possible supplemental resource for their HNC patients.
Collapse
Affiliation(s)
- Benjamin Tam
- Caruso Department of Otolaryngology‐Head and Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Matthew Lin
- Caruso Department of Otolaryngology‐Head and Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Carlos Castellanos
- Caruso Department of Otolaryngology‐Head and Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ruben Ulloa
- Caruso Department of Otolaryngology‐Head and Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Niels Kokot
- Caruso Department of Otolaryngology‐Head and Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Kevin Hur
- Caruso Department of Otolaryngology‐Head and Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| |
Collapse
|
11
|
Topal Hançer A, Köksel P. The Effect of Preoperative Pain Fear on Postoperative Pain, Analgesic Use, and Comfort Level. Pain Manag Nurs 2023; 24:521-527. [PMID: 37481384 DOI: 10.1016/j.pmn.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Preoperative assessment of pain fear could provide essential information for improving perioperative care and could be the first step toward targeted pain management. AIMS The aim of this study is to determine the effect of preoperative pain fear on postoperative pain, analgesic use, and comfort level. METHOD This cross-sectional study was conducted with 201 patients in the general surgery service between January 2022 and March 2022. A sociodemographic questionnaire, Visual Analog Scale (VAS), pain fear, and general comfort scales were used for data collection. Correlation analysis was performed to examine the relationship between scales, and p < .05 was considered statistically significant. RESULTS The mean age of the individuals participating in the study was 51.22±15.89 and 69.2% of them were women. The average score of pain fear was 63.77±21.47, and the average score of the VAS was 7.63±1.82 after the surgery before analgesics and 5.06±1.58 six hours after surgery. The mean comfort level was 132.88±9.26. A significant and positive correlation was detected between the total pain fear and the VAS score, analgesic use, and comfort level (p < .05). CONCLUSIONS In this research, findings demonstrated that as the patients' pain fear increased, postoperative pain severity and amount of analgesia increased. Providing pain management with analgesics increases comfort in patients, but it may cause secondary problems in patients who use high-dose analgesics. Therefore, reducing pain fear, which is one of the main factors in pain, is essential in pain management.
Collapse
Affiliation(s)
- Ayşe Topal Hançer
- From the Faculty of Health Sciences Nursing Department, Sivas Cumhuriyet University, Sivas, Turkey.
| | - Pervin Köksel
- From the Faculty of Health Sciences Nursing Department, Sivas Cumhuriyet University, Sivas, Turkey
| |
Collapse
|
12
|
Xie W, Ye F, Yan X, Cao M, Ho MH, Kwok JYY, Lee JJ. Acupressure can reduce preoperative anxiety in adults with elective surgery: A systematic review and meta-analysis of randomised controlled trials. Int J Nurs Stud 2023; 145:104531. [PMID: 37321140 DOI: 10.1016/j.ijnurstu.2023.104531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/28/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Preoperative anxiety is prevalent amongst adults with elective surgery and is associated with multiple detrimental perioperative physiological effects. Increasing studies support the effectiveness of acupressure in managing preoperative anxiety. However, the magnitude of acupressure's positive association with preoperative anxiety is still unclear due to a lack of rigorous evidence synthesis. OBJECTIVE To estimate the efficacy of acupressure on preoperative anxiety and physiological parameters amongst adults scheduled for elective surgery. DESIGN Systematic review and meta-analysis. DATA SOURCES Search terms were combined for acupressure and preoperative anxiety in PubMed, Cochrane Library, EMBASE, CINAHL, China National Knowledge Infrastructure, and WanFang Data Knowledge Service Platform to search for eligible randomised controlled trials from the inception of each database through September 2022. METHODS Pairs of researchers independently screened and extracted data from included studies. The risk of bias was assessed using the Cochrane risk of bias tool Version 2.0. Meanwhile, random-effects meta-analysis of overall effects and prespecified subgroup (i.e., surgery types, intervention providers, and acupressure stimulation tools) was conducted using Review Manager Software 5.4.1. Meta-regression was performed to explore study-level variables that may contribute to heterogeneity using STATA 16. RESULTS Of 24 eligible randomised controlled trials, there were a total of 2537 participants from 5 countries contributed to this synthesis. When comparing acupressure with usual care or placebo, acupressure showed a large effect size for preoperative anxiety (SMD = -1.30; 95%CI = -1.54 to -1.06; p < 0.001; I2 = 86%). The significant mean reduction of heart rate, and systolic and diastolic blood pressure was -4.58 BPM (95%CI = -6.70 to -2.46; I2 = 89%), -6.05 mmHg (95%CI = -8.73 to -3.37; p < 0.001; I2 = 88%), and -3.18 mmHg (95%CI = -5.09 to -1.27; p = 0.001; I2 = 78%), respectively. Exploratory subgroup analyses showed significant differences in surgery types and acupressure stimulation tools, whilst the intervention providers (i.e., healthcare professionals and self-administered) showed no statistically significant difference for acupressure therapy. None of the predefined participants and study-level characteristics moderated preoperative anxiety through meta-regression. CONCLUSION Acupressure appears efficacious as a therapy for improving preoperative anxiety and physiological parameters amongst adults with elective surgery. Self-administered acupressure, which is effective with a large effect, may be considered as an evidence-based approach to managing preoperative anxiety. Hence, this review aids in the development of acupressure in different types of elective surgeries and the improvement of the rigour of acupressure therapy.
Collapse
Affiliation(s)
- Wenxuan Xie
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Fen Ye
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Xinyi Yan
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Mengyao Cao
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Jojo Yan Yan Kwok
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Jung Jae Lee
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China.
| |
Collapse
|
13
|
Phang SKA, Betzler BK, Dan YR, Bin Abd Razak HR. Current evidence does not support the routine use of cognitive behavioural therapy in total knee arthroplasty: A systematic review. J Clin Orthop Trauma 2023; 42:102204. [PMID: 37449056 PMCID: PMC10336691 DOI: 10.1016/j.jcot.2023.102204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/09/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
Background There is a significant dissatisfaction rate in patients undergoing total knee arthroplasty (TKA), and poor mental health in patients is increasingly recognized as a major contributor to dissatisfaction. The aim was to review the effectiveness of cognitive behavioural therapy (CBT) in improving pain and functional outcomes of patients undergoing TKA and highlight important aspects that may be crucial for improvement. Methods A systematic search was conducted in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies were included if they were randomized control trials that included patients undergoing unilateral or bilateral TKA, with CBT as an intervention compared against usual care, and reported outcomes in pain, knee function and any psychological outcomes as measured. Results Eight RCTs were selected which included 683 participants. The timings of CBT delivery, profiles of therapists, and outcome measures reported varied across the studies. Overall, 3 studies reported significant improvement in pain outcomes, 3 studies reported significant improvement in functional outcomes and 5 studies reported significant improvements in psychological outcomes. Conclusion Current evidence does not support the efficacy of CBT as current literature is too heterogenous. Further studies with homogenous CBT methods are required to further ascertain the true relationship between CBT and postoperative outcomes of TKA. Future studies should consider the points set out in this review, such as the importance of revisiting CBTskills, providing individualized therapy, having a supervisory team to support the fidelity of interventions, and identifying which group of patients would best benefit from CBT.
Collapse
Affiliation(s)
- Sean Kia-Ann Phang
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, 637551, Singapore
| | - Brjan Kaiji Betzler
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, 308232, Singapore
| | - Yuet-Ruh Dan
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, 637551, Singapore
| | - Hamid Rahmatullah Bin Abd Razak
- Department of Orthopaedic Surgery, Sengkang General Hospital, 110 Sengkang East Way, 544886, Singapore
- Musculoskeletal Sciences Academic Clinical Programme, Duke-NUS Medical School, 8 College Road, 169857, Singapore
| |
Collapse
|
14
|
Akutay S, Ceyhan Ö. The relationship between fear of surgery and affecting factors in surgical patients. Perioper Med (Lond) 2023; 12:22. [PMID: 37296486 DOI: 10.1186/s13741-023-00316-0] [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: 11/02/2022] [Accepted: 06/04/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND This study aimed to explain the fear of surgery in surgical patients, the affecting factors, and their relationship. METHODS This study was conducted as a descriptive and cross-sectional study. The study population consists of 300 patients undergoing surgical intervention. Data were collected using the "patient information form" and "Surgical Fear Questionnaire." Parametric and nonparametric tests were used to evaluate the data. The relationship between the fear questionnaire and age, number of previous surgeries, and pre-operative pain was evaluated using Spearman correlation analysis. The relationship with emotional stress was evaluated with multiple linear regression analysis. RESULTS In this study, it was determined that the predictors of the surgical fear level of the patients were age, gender, anesthesia type, and pre-operative pain experience. There was a negative correlation between the age of the patients and the fear of surgery score and a positive correlation between the pre-operative pain severity and the fear of surgery score. It was determined that the factors most associated with pre-operative fear levels were the patients' pre-operative sense of inadequacy (p < 0.001), feeling anxious and unhappy, and confusion about the surgery decision (p < 0.05). CONCLUSION According to the results of this study, it has been determined that the emotional states and fears of the patients before the surgery have significant effects on the fear of surgery. For this, it is recommended to determine the emotional states and fears of the patients before the surgery and to make appropriate interventions, as it will facilitate compliance with the surgical process.
Collapse
Affiliation(s)
- Seda Akutay
- Department of Surgical Diseases Nursing, Erciyes University Faculty of Health Sciences, Kayseri, 38030, Turkey.
| | - Özlem Ceyhan
- Department of Internal Medicine Nursing, Erciyes University Faculty of Health Sciences, Kayseri, 38030, Turkey
| |
Collapse
|
15
|
Quan X. Improving Ambulatory Surgery Environments: The Effects on Patient Preoperative Anxiety, Perception, and Noise. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:73-88. [PMID: 36740908 DOI: 10.1177/19375867221149990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The study aimed to comparatively evaluate three types of preoperative care environment in terms of patient experience outcomes including patient preoperative anxiety, perceived environmental qualities, and noise level. BACKGROUND Preoperative anxiety is a major healthcare problem causing delays, complications, dissatisfaction, and rising healthcare costs. The design of preoperative spaces may play an important role in reducing preoperative anxiety and improving outcomes. METHODS Anonymous questionnaire surveys were conducted with 228 patients in the three types of preoperative bays that varied in terms of bay size and the amount of hard-wall partitions between bays to compare patient self-reported anxiety and perceived environmental qualities. Sound level measurements were conducted throughout the three preoperative care units. RESULTS Female patients in the preoperative unit with largest bays and full hard-wall partitions between bays reported significantly lower levels of subjective anxiety (p's = .002, <.001) and higher levels of perceived environmental qualities on privacy, cleanliness, noise, and pleasantness (p's from <.001 to .017) than patients in the units with smaller bays and no or partial hard-wall partitions. Similar but less clear pattern was found among male patients. The lowest average noise levels were recorded in the unit with largest bays and full hard-wall partitions between bays (2.3-6.1 decibels lower than the other units). CONCLUSIONS The design of preoperative care environment may contribute to the better management of preoperative anxiety. Further efforts in research and design are needed to maximize the benefits in clinical, experiential, and financial outcomes.
Collapse
Affiliation(s)
- Xiaobo Quan
- Christopher C. Gibbs College of Architecture, University of Oklahoma, Norman, OK, USA
| |
Collapse
|
16
|
Sun DJ, You YX, He XJ, Li HT, Zeng XP, Li DZ, Wang W. Effects of light music played by piano intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: A randomized controlled trial. Medicine (Baltimore) 2022; 101:e32339. [PMID: 36595974 PMCID: PMC9803447 DOI: 10.1097/md.0000000000032339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Colonoscopy is the main kind of way to detect and treat diseases about large intestine, but during the examination and preparation, these 2 processes are able to lead abdominal pain, abdominal distention and other discomfort feel, which will cause patients to refuse the examination and become anxious. Painless and sedative endoscopy may reduce discomfort of patients, but there is a risk of adverse effects. Many studies have shown that playing music during colonoscopy can reduce discomfort and increase acceptance of colonoscopy, but the conclusion remains controversial. The 3 approaches of random, single-blind, controlled method were used to investigate the interventions effects of piano light music on satisfaction, anxiety and pain in patients undergoing colonoscopy. METHODS A total of 216 patients were randomly divided into piano music group (n = 112, piano music played during colonoscopy) and control group (n = 104, no music during colonoscopy) to compare patients satisfaction, anxiety score, pain score, vital signs, endoscopic difficulty score, and willingness to undergo colonoscopy again. RESULTS There were no significant differences in vital signs, pre-colonoscopic state anxiety score, and trait anxiety score before and after colonoscopy, and willingness to undergo colonoscopy again between the 2 groups (P > .05). The difficulty of colonoscopy operation and the score of state anxiety after colonoscopy in the piano group were lower than those in the control group (P < .05), and the satisfaction of colonoscopy process, pain management and overall service satisfaction were better than those of the control group (P < .05), and they were more likely to listen to music in the next examination (P < .001). CONCLUSION The light music played by piano can relieve patients' anxiety, improve the satisfaction of colonoscopy process, pain management and service satisfaction, reduce the difficulty of colonoscopy, which have no obvious adverse reactions. Therefore, it is worthy of promotion.
Collapse
Affiliation(s)
- Dong-Jie Sun
- Department of Digestive Diseases, Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Yi-Xiang You
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Jian He
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Hai-Tao Li
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Xiang-Peng Zeng
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Da-Zhou Li
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Wen Wang
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
- * Correspondence: Wen Wang, Department of Digestive Diseases, The Fuzong Clinical Medical College, Fujian Medical University, 156 North Road of West No.2 Ring, Fuzhou 350025, China (e-mails: )
| |
Collapse
|
17
|
Relationship between Postoperative Pain and Sociocultural Level in Major Orthopedic Surgery. Adv Orthop 2022; 2022:7867719. [PMID: 36267670 PMCID: PMC9578872 DOI: 10.1155/2022/7867719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/10/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are associated with moderate to severe postoperative pain (POP). POP is theoretically predictable and may be influenced by sociocultural differences. This study aimed to identify the relationship between POP and the sociocultural level of the patient undergoing THA or TKA. Methods Prospective study, involving informed-consenting adults conducted through consulting patient's clinical processes, preoperative and postoperative questionnaires. Demographic and anthropometric data, type of surgery, ASA classification, sociocultural level of the patient, and POP were assessed. Results 95 patients, all Caucasian and natural from the north of the Portugal, were included. Younger women undergoing TKA reported higher levels of POP. In females, the ASA 3 physical condition was also associated with higher mean pain intensity. Patients with preoperative chronic pain, without depression diagnosis, and unsatisfied with the current profession showed higher levels of reported POP. Retirees, with lower school degree, reported higher levels of minimal pain. Conclusions Job satisfaction, type of surgery, body mass index, presence of chronic pain, and the absence of depression were identified as the main predictors of pain after THA or TKA.
Collapse
|
18
|
Odabaşi G, Küçükakça Çelik G, Aşci Ö. Relationship Between Surgical Fear Level and Postoperative Pain, Nausea–Vomiting, and Sleep Quality in Laparoscopic Sleeve Gastrectomy Patients: A Regression Study. Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2022.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Gülden Küçükakça Çelik
- Nursing Department, Nevşehir Hacı Bektaş Veli University Semra ve Vefa Küçük Faculty of Health Sciences, Nevşehir, Turkey
| | - Özlem Aşci
- Midwifery Department, Niğde Ömer Halis Demir University Nigde Zübeyde Hanım School of Health, Niğde, Turkey
| |
Collapse
|
19
|
Kakar E, van Ruler O, van Straten B, Hoogteijling B, de Graaf EJR, Ista E, Lange JF, Jeekel J, Klimek M. Implementation of music in colorectal perioperative standard care-barriers and facilitators among patients and healthcare professionals. Colorectal Dis 2022; 24:868-875. [PMID: 35194930 PMCID: PMC9544166 DOI: 10.1111/codi.16102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/26/2022] [Accepted: 02/12/2022] [Indexed: 02/08/2023]
Abstract
AIM Perioperative anxiety and pain are still prevalent among patients undergoing surgery. Inflammatory bowel disease and colorectal cancer patients are known to have higher anxiety rates than the general population. Perioperatively applied music intervention has been proven to be effective in reducing perioperative anxiety and pain, resulting in a decrease of intra-operative sedative use, postoperative opioid requirement and neurohormonal stress response. IMPROVE evaluates the adherence to music intervention in colorectal perioperative standard care during systematic implementation. METHOD The Consolidated Framework for Implementation Research (CFIR) was used for implementation in three steps. This study addresses the first step in which barriers and facilitators for implementing perioperative music were identified by surveying patients who underwent colorectal surgery and healthcare professionals involved in perioperative care. Also, perioperative anxiety scores were assessed and data on perioperative pain was collected from the patients' medical records. RESULTS Fifty patients and 69 professionals (response rate 68.3%) were surveyed. For patients, all domains of the CFIR were facilitating implementation. The median reported preoperative and postoperative anxiety scores were 4.5 (1.0-7.0) and 3.0 (1.0-5.75) respectively. The median postoperative pain score on the first postoperative day was 2.8 (2.0-3.7). Also, for professionals most domains were facilitating, except for some factors related to work climate and culture among nurses. CONCLUSIONS In this study it was identified that facilitating factors for implementing music in standard perioperative care were more prominent in both patients and healthcare professionals and therefore successful implementation is probable. Also, this study provides a guideline for assessing facilitators and barriers in other settings.
Collapse
Affiliation(s)
- Ellaha Kakar
- Department of Surgery and Intensive Care UnitErasmus MCUniversity Medical CentreRotterdamThe Netherlands
| | - Oddeke van Ruler
- Department of SurgeryIJsselland HospitalCapelle aan den IJsselThe Netherlands
| | | | - Bas Hoogteijling
- Department of AnesthesiologyIJsselland HospitalCapelle aan den IJsselThe Netherlands
| | | | - Erwin Ista
- Department of Internal MedicineSection Nursing ScienceUniversity Medical CentreErasmus MCRotterdamThe Netherlands
| | - Johan F. Lange
- Department of SurgeryUniversity Medical CentreErasmus MCRotterdamThe Netherlands
| | - Johannes Jeekel
- Department of SurgeryUniversity Medical CentreErasmus MCRotterdamThe Netherlands
| | - Markus Klimek
- Department of AnesthesiologyUniversity Medical CentreErasmus MCRotterdamThe Netherlands
| |
Collapse
|
20
|
Sybil D, Krishna M, Shrivastava PK, Singh S, Khan I. Innovative App (ExoDont) and Other Conventional Methods to Improve Patient Compliance After Minor Oral Surgical Procedures: Pilot, Nonrandomized, and Prospective Comparative Study. JMIR Perioper Med 2022; 5:e35997. [PMID: 35763332 PMCID: PMC9277528 DOI: 10.2196/35997] [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: 12/27/2021] [Revised: 02/26/2022] [Accepted: 06/21/2022] [Indexed: 11/27/2022] Open
Abstract
Background Postoperative care is influenced by various factors such as compliance, comprehension, retention of instructions, and other unaccounted elements. It is imperative that patients adhere to the instructions and prescribed regimen for smooth and placid healing. ExoDont, an Android-based mobile health app, was designed to ensure a smooth postoperative period for patients after a dental extraction. Besides providing postoperative instructions at defined intervals, the app also sends drug reminders as an added advantage over other available, conventional methods. Objective The aim of this study was to compare the compliance rate of individuals with respect to the prescribed regimen and postoperative instructions. Additionally, we aimed to assess any changes in the postoperative complication rate of patients assigned to 3 categories: the verbal, verbal plus written, and ExoDont app-based delivery groups. Methods We conducted a pilot, nonrandomized, and prospective comparative study in which patients after tooth extraction were assigned to 3 groups—verbal (Group A), verbal plus written (Group B), and ExoDont app-based delivery (Group C)—based on the eligibility criteria, and a 1-week follow-up was planned to obtain the responses regarding compliance and postoperative complications from the participants. Results In total, 90 patients were recruited and equally divided into 3 groups. Compliance to prescribed drug was found to be the highest in Group C, where of the 30 participants, 25 (83%) and 28 (93%) followed the entire course of antibiotics and analgesics, respectively. For postoperative instructions, higher compliance was observed in Group C in relation to compliance to diet restrictions (P=.001), not rinsing for 24 hours (P<.001), and warm saline rinses after 24 hours (P=.001). However, the difference was not significant for smoking restrictions (P=.07) and avoiding alcohol (P=.16). Moreover, the difference in postoperative complication rate was not statistically significant among the 3 groups (P=.31). Conclusions As evident from the results, it is anticipated that the ExoDont app will be helpful in circumventing the unaccounted possibilities of missing the prescribed dosage and postoperative instructions and ensuring the smooth recovery of patients after dental extraction. However, future studies are required to establish this app-based method of delivery of postoperative instructions as a viable option in routine clinical practice.
Collapse
Affiliation(s)
- Deborah Sybil
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, Delhi, India
| | | | | | - Shradha Singh
- Faculty of Dentistry, Jamia Millia Islamia, Delhi, India
| | - Imran Khan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, Delhi, India
| |
Collapse
|
21
|
de Andrade ÉV, Haas VJ, de Faria MF, dos Santos Felix MM, Ferreira MBG, Barichello E, da Silva Pires P, Barbosa MH. Effect of listening to music on anxiety, pain, and cardiorespiratory parameters in cardiac surgery: study protocol for a randomized clinical trial. Trials 2022; 23:278. [PMID: 35410256 PMCID: PMC8996225 DOI: 10.1186/s13063-022-06233-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 03/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Preoperative anxiety and postoperative pain are frequent in cardiac surgeries and constitute important stressors for patients, which can cause several complications. One strategy that aims to alleviate these phenomena is listening to music as a non-pharmacological intervention. The aim of this study is to evaluate the effect of listening to music on preoperative state-anxiety, postoperative pain, at rest and when instructed to cough, and cardiorespiratory parameters in patients undergoing cardiac surgery. Methods A randomized, parallel, simple masking clinical trial will be conducted with patients 18 years of age or older who have undergone elective cardiac surgery by sternotomy, who agree to participate in the research and sign a free and informed consent form. Study participants will be randomly divided, in a 1:1 ratio, to one of the two groups: experimental (subjected to listening to music for 20 min in the pre- and postoperative period) or control (standard care in the pre- and postoperative period), using a randomization scheme generated by the Randomization.com website. The sample size calculation was obtained after conducting a pilot study. Discussion The results of the study may contribute to the implementation of non-pharmacological interventions in health services, highlighting the protocols for listening to music, to minimize anxiety and pain in cardiac surgery. Trial registration ReBEC RBR-8mdyhd. Posted on December 10, 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06233-9.
Collapse
|
22
|
Patil JD, Sefen JAN, Fredericks S. Exploring Non-pharmacological Methods for Pre-operative Pain Management. Front Surg 2022; 9:801742. [PMID: 35317192 PMCID: PMC8934410 DOI: 10.3389/fsurg.2022.801742] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/12/2022] [Indexed: 11/15/2022] Open
Abstract
The management of pain is an essential aspect of surgical care, and pain levels in post-operative patients vary case by case. Treating postoperative pain is crucial as it leads to better outcomes and reduces risk of long term pain. While post-operative analgesics has been the mainstay of treatment, this mini-review explores an emerging concept which is preoperative pain management, with promising potential. Such interventions include educating patients on the expected pain outcomes and available pain medications. Non-pharmacological methods such as relaxation exercises have also proven to be effective after abdominal surgery, and educating patients on the existence of such methods pre-operatively encourages them to make use of available therapies. A major area of importance is the pre-operative psychological and emotional wellbeing of patients, as it is a strong predictor of pain and pain prognosis. Cognitive Behavioral Therapy can be effectively used to tackle preoperative anxiety and reduce pain levels. Hypnosis is another developing modality for decreasing stress. Lastly, long term pre-operative opioid use has been linked with higher pain scores and longer pain duration. This provides the basis on which pre-operative opioid weaning can lead to favorable post-operative pain outcomes. While many of these methods have not been experimented on recipients of abdominal surgery in specific, it still paves the path for newer pain control strategies that can eventually be adopted for visceral surgery patients. This review points the reader and researchers to new and developing areas that hold the potential to revolutionize current established pain management guidelines.
Collapse
|
23
|
Kashif M, Hamid M, Raza A. Influence of Preoperative Anxiety Level on Postoperative Pain After Cardiac Surgery. Cureus 2022; 14:e22170. [PMID: 35308773 PMCID: PMC8923043 DOI: 10.7759/cureus.22170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 11/05/2022] Open
|
24
|
Green S, Karunakaran KD, Labadie R, Kussman B, Mizrahi-Arnaud A, Morad AG, Berry D, Zurakowski D, Micheli L, Peng K, Borsook D. fNIRS brain measures of ongoing nociception during surgical incisions under anesthesia. NEUROPHOTONICS 2022; 9:015002. [PMID: 35111876 PMCID: PMC8794294 DOI: 10.1117/1.nph.9.1.015002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
Significance: Functional near-infrared spectroscopy (fNIRS) has evaluated pain in awake and anesthetized states. Aim: We evaluated fNIRS signals under general anesthesia in patients undergoing knee surgery for anterior cruciate ligament repair. Approach: Patients were split into groups: those with regional nerve block (NB) and those without (non-NB). Continuous fNIRS measures came from three regions: the primary somatosensory cortex (S1), known to be involved in evaluation of nociception, the lateral prefrontal cortex (BA9), and the polar frontal cortex (BA10), both involved in higher cortical functions (such as cognition and emotion). Results: Our results show three significant differences in fNIRS signals to incision procedures between groups: (1) NB compared with non-NB was associated with a greater net positive hemodynamic response to pain procedures in S1; (2) dynamic correlation between the prefrontal cortex (PreFC) and S1 within 1 min of painful procedures are anticorrelated in NB while positively correlated in non-NB; and (3) hemodynamic measures of activation were similar at two separate time points during surgery (i.e., first and last incisions) in PreFC and S1 but showed significant differences in their overlap. Comparing pain levels immediately after surgery and during discharge from postoperative care revealed no significant differences in the pain levels between NB and non-NB. Conclusion: Our data suggest multiple pain events that occur during surgery using devised algorithms could potentially give a measure of "pain load." This may allow for evaluation of central sensitization (i.e., a heightened state of the nervous system where noxious and non-noxious stimuli is perceived as painful) to postoperative pain levels and the resulting analgesic consumption. This evaluation could potentially predict postsurgical chronic neuropathic pain.
Collapse
Affiliation(s)
- Stephen Green
- Boston Children’s Hospital, Harvard Medical School, The Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, United States
| | - Keerthana Deepti Karunakaran
- Boston Children’s Hospital, Harvard Medical School, The Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, United States
| | - Robert Labadie
- Boston Children’s Hospital, Harvard Medical School, The Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, United States
| | - Barry Kussman
- Boston Children’s Hospital, Harvard Medical School, Division of Cardiac Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, United States
| | - Arielle Mizrahi-Arnaud
- Boston Children’s Hospital, Harvard Medical School, Division of Perioperative Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, United States
| | - Andrea Gomez Morad
- Boston Children’s Hospital, Harvard Medical School, Division of Perioperative Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, United States
| | - Delany Berry
- Boston Children’s Hospital, Harvard Medical School, The Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, United States
| | - David Zurakowski
- Boston Children’s Hospital, Harvard Medical School, Division of Biostatistics, Department of Anesthesiology, Critical Care and Pain Medicine, Boston, Massachusetts, United States
| | - Lyle Micheli
- Boston Children’s Hospital, Harvard Medical School, Sports Medicine Division, Department of Orthopedic Surgery, Boston, Massachusetts, United States
| | - Ke Peng
- Université de Montréal, Département en Neuroscience, Centre de Recherche du CHUM, Montréal, Quebec, Canada
| | - David Borsook
- Massachusetts General Hospital, Harvard Medical School, Departments of Psychiatry and Radiology, Boston, Massachusetts, United States
| |
Collapse
|
25
|
POEHLMANN JR, STOWE ZN, GODECKER A, XIONG PT, BROMAN AT, ANTONY KM. The impact of pre-existing maternal anxiety on pain and opioid use following cesarean birth: a retrospective cohort study. Am J Obstet Gynecol MFM 2022; 4:100576. [DOI: 10.1016/j.ajogmf.2022.100576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
|
26
|
Ustunel F, Erden S. Evaluation of Fear of Pain Among Surgical Patients in the Preoperative Period. J Perianesth Nurs 2021; 37:188-193. [PMID: 34922831 DOI: 10.1016/j.jopan.2021.02.003] [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: 11/23/2020] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the fear of surgery-related pain of patients in the preoperative period. DESIGN A descriptive, cross-sectional study. METHODS A total of 419 patients who were scheduled for a variety of surgical procedures in a tertiary hospital were included. Data were collected using a Patient Identification Information Form and fear of pain was evaluated using the Fear of Pain Questionnaire-III. FINDINGS 50.8% of the patients were males with a mean age of 49.2 ± 17.3 years. A total of 88.8% patients had a fear of pain after surgery, and 89.3% of them had a moderate to severe fear of pain. 84.5% of female patients, 82.5% of literate patients, and 86.1% of patients who had previously experienced severe pain had a fear of pain of moderate to severe intensity (P < .05). The mean Fear of Pain Questionnaire-III score was 75.1 ± 20.2, and the most commonly identified fears were severe pain (30.64 ± 9.5), and medical pain (24.17 ± 7.7). Patients who had a higher score of fear of severe pain and medical pain were those who had experienced severe pain previously and those who believed that they would experience postoperative pain (P < .05). CONCLUSIONS Almost all patients included in this study had a fear of moderate to severe postoperative pain while in the preoperative period. Nurses should question pain history with each patient, obtain a detailed pain history, and identify the degree of fear of pain in the preoperative period. Fear of pain should be reduced using necessary interventions and pain control should be maintained. Reduced fear of pain in the preoperative period may decrease postoperative pain and yield favorable patient outcomes.
Collapse
Affiliation(s)
- Fatmagul Ustunel
- Cukurova University Institute of Health Sciences, Adana, Turkey.
| | - Sevilay Erden
- Cukurova University Institute of Health Sciences, Adana, Turkey
| |
Collapse
|
27
|
Touil N, Pavlopoulou A, Momeni M, Van Pee B, Barbier O, Sermeus L, Roelants F. Evaluation of virtual reality combining music and a hypnosis session to reduce anxiety before hand surgery under axillary plexus block: A prospective study. Int J Clin Pract 2021; 75:e15008. [PMID: 34811860 DOI: 10.1111/ijcp.15008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/04/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS Preoperative anxiety, which can affect postoperative recovery, is often present in patients undergoing surgery under loco-regional anaesthesia (LRA). Minimising preoperative anxiety with premedication can be effective but results in drug-related side effects. Therefore, the use of non-pharmacological techniques should be encouraged. METHODS We evaluated whether a virtual reality (VR) incorporating music and a hypnosis session, provided during the performance of LRA, can reduce preoperative anxiety. Fifty patients scheduled for elective hand surgery under an axillary plexus block were enrolled (March-June 2019). The primary outcome measure was the change in the Amsterdam Anxiety and Preoperative Information Scale (APAIS) questionnaire 5 min after the VR session as compared to before the VR session. The secondary outcome measures were the visual analog scale (VAS) for anxiety before and 2 h after the surgery and the Evaluation du Vécu de l'ANesthésie-LocoRégionale (EVAN-LR) satisfaction score. RESULTS Data from 48 patients were analysed. The APAIS score as well as VAS for anxiety were significantly reduced after a VR session (p < .001 for both scores). Patients were very satisfied (EVAN-LR: 92 (88, 94)). CONCLUSIONS The use of VR incorporating music and a hypnosis session could be an effective tool in the management of a patient's preoperative anxiety during the performance of an axillary plexus block.
Collapse
Affiliation(s)
- Nassim Touil
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Athanasia Pavlopoulou
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Mona Momeni
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Benoît Van Pee
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Olivier Barbier
- Department of Surgery, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Luc Sermeus
- Department of Surgery, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Fabienne Roelants
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| |
Collapse
|
28
|
Kakar E, Ista E, Klimek M, Jeekel J. Implementation of music in the perioperative standard care of colorectal surgery: study protocol of the IMPROVE Study. BMJ Open 2021; 11:e051878. [PMID: 34711596 PMCID: PMC8557300 DOI: 10.1136/bmjopen-2021-051878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Perioperative music intervention has been proven effective in reducing anxiety, pain, neurohormonal stress response and medication requirement. Unfortunately, there is a gap between new effective interventions and their (interventions) integration in standard care protocols. The aim of this preimplementation and postimplementation study is to investigate the adherence to a music intervention in a tailored, multilevel, systematic implementation strategy and the initial impact of the implementation on postoperative pain in patients undergoing colorectal surgery. METHODS AND DESIGN A monocentre prospective preimplementation and postimplementation study was set up using The Consolidated Framework for Implementation Research to conduct a systematic implementation of music intervention in three phases. Primary outcomes are adherence to the music intervention and the initial impact of the music intervention implementation on postoperative pain scores on the first postoperative day. At least 100 patients will be included in the study. Secondary outcomes include adherence to the implementation strategy, penetration of music intervention in the standard care, assessment of the determinants for implementation, impact of the implemented music intervention on pain during the entire admission, anxiety, medication usage, complications, hospital and intensive care unit (ICU) length of stay. ETHICS AND DISSEMINATION The Medical Ethics Review Board of Erasmus MC University Medical Centre Rotterdam, The Netherlands, has approved this protocol. The study is being conducted in accordance with the Declaration of Helsinki. Results of this trial will be published in peer-reviewed scientific journals and conference presentations. TRIAL REGISTRATION Dutch Trial Register NL8071.
Collapse
Affiliation(s)
- Ellaha Kakar
- General Surgery and Intensive Care Unit, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
- Intensive Care Unit, Erasmus MC, Rotterdam, Netherlands
| | - Erwin Ista
- Intensive Care Unit, Erasmus MC, Rotterdam, Netherlands
- Pediatric surgery, Intensive Care Unit, Internal Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
- Internal Medicine, Erasmus MC, Rotterdam, Netherlands
| | - M Klimek
- Anesthesiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Johannes Jeekel
- General Surgery and Intensive Care Unit, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
- Neuroscience, Erasmus MC, Rotterdam, Netherlands
| |
Collapse
|
29
|
Guerrier G, Bernabei F, Lehmann M, Pellegrini M, Giannaccare G, Rothschild PR. Efficacy of Preoperative Music Intervention on Pain and Anxiety in Patients Undergoing Cataract Surgery. Front Pharmacol 2021; 12:748296. [PMID: 34658886 PMCID: PMC8514945 DOI: 10.3389/fphar.2021.748296] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/15/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of the present study was to investigate the impact of preoperative music exposure on intra- and post-operative pain during cataract surgery. This study was conducted alongside a prospective single-masked randomized controlled trial (ClinicalTrials.gov NCT02892825). Patients undergoing first eye cataract surgery were included and randomly assigned to either the intervention or control group. Patients in the intervention group had a 20-min music session through earphones before surgery, while patients in the control group wore earphones without music. Anxiety level evaluated using the visual analog scale and heart rate were collected before and after music intervention. Pain level was assessed using the Numerical Pain Rating Scale, during the surgical procedure, prior to discharge and 7 days postoperatively. A total of 243 patients were included: 119 in the intervention group and 124 in the control group. No significant differences in baseline characteristics, including age, sex and rate of treated hypertension were found between the 2 groups (all p-values > 0.05). In addition, no significantly differences were found in heart rate and anxiety level before music intervention between the 2 groups (all p-values > 0.05). Conversely, anxiety level was significantly lower in the music group after the intervention (respectively, 1.3 ± 1.1 vs 3.2 ± 2.2; p < 0.05). Patients in the music group reported a lower mean pain level during surgical procedure and before discharge compared with control group (respectively, 1.2 ± 0.5 vs 2.1 ± 1.1, p = 0.03 and 0.23 ± 0.4 vs 0.81 ± 0.7, p = 0.04). No difference was found in pain level 7 days postoperatively (0.1 ± 0.3 vs 0.2 ± 0.4, p = 0.1). A significant correlation was found between anxiety level and intraoperative pain level (R = 0.64, p = 0.02). In conclusion, music intervention was effective in reducing anxiety level and self-reported pain both during surgery and in the early postoperative period. Clinical Trial Registration:https://clinicaltrials.gov/ct2/home, identifier NCT02892825.
Collapse
Affiliation(s)
- Gilles Guerrier
- Anaesthetic and Intensive Care Department, Hôpital Cochin, Paris Descartes University, Paris, France
| | - Federico Bernabei
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mathieu Lehmann
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marco Pellegrini
- Ophthalmology Unit, DIMES, University of Bologna, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Pierre-Raphaël Rothschild
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Centre de Recherche des Cordeliers, INSERM, Paris, France
| |
Collapse
|
30
|
BOZDOĞAN YEŞİLOT S, ÇİFTÇİ H, YENER MK. Lipom eksizyonu sırasında stres küpü kullanımının ağrı ve anksiyete üzerine etkisi. EGE TIP DERGISI 2021. [DOI: 10.19161/etd.990564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
31
|
Goree JH, Srinivasan N, Cucciare MA, Zaller N, Byers L, Boateng B, Hayes CJ. Video-Based, Patient-Focused Opioid Education in the Perioperative Period Increases Self-Perceived Opioid-Related Knowledge: A Pilot Study. J Pain Res 2021; 14:2583-2592. [PMID: 34466026 PMCID: PMC8403019 DOI: 10.2147/jpr.s303850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/21/2021] [Indexed: 11/24/2022] Open
Abstract
Objective The aim of this study was to evaluate whether a video-based, patient-focused opioid education tool delivered in the perioperative period would decrease acute and chronic post-operative opioid prescription dispensations and increase self-rated knowledge about opioids. Methods We enrolled 110 patients with no reported opioid use in the previous 30 days, undergoing ambulatory surgery for breast, orthopedic, gynecologic, or other outpatient procedures for which opioids would be prescribed. Patients were randomized to receive either post-operative opioid education by the surgical team (control arm) or pre-operative education via a novel 5-minute video plus post-operative education by the surgical team (intervention arm). All patients received follow-up phone calls on post-operative day (POD) 7 to assess self-rated knowledge of opioids on a scale of 1 to 10, 10 being most informed, and self-reported opioid use (primary outcome). Arkansas Prescription Drug Monitoring Program (AR PDMP) data were obtained to assess opioid dispensations at POD 90–150 days. Results Seventy-seven percent of participants completed POD7 survey. Participants in the intervention arm rated their knowledge of opioids after surgery significantly higher than those in the control arm (p=0.013). Data from the AR PDMP reveal trends (non-significant) that show increased use of opioids in the control group when compared to the video intervention group at POD 30 (88.7% vs 76%) and POD 90–150 (22.6% vs 10%). Conclusion Video-based, patient-focused opioid education can be effectively implemented in a large university hospital during the perioperative period and is effective for increasing a patient’s perception of opioid-related knowledge. A fully powered, randomized control trial is needed to further explore observed trends and determine if this novel tool can decrease chronic post-operative opioid dispensations.
Collapse
Affiliation(s)
- Johnathan H Goree
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Michael A Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, USA.,Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA
| | - Nickolas Zaller
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Lauren Byers
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Beatrice Boateng
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Corey J Hayes
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR, USA.,Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
32
|
Torabikhah M, Yousefi H, Ansari AHM, Musarezaie A. The Effect of Reducing the Fasting Time on Postoperative Pain in Orthopaedic Patients: A Randomized Controlled Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:310-315. [PMID: 34422610 PMCID: PMC8344633 DOI: 10.4103/ijnmr.ijnmr_291_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/06/2020] [Accepted: 02/08/2021] [Indexed: 11/04/2022]
Abstract
Background Patients undergoing orthopedics surgery experience the most severe postoperative pain. The fasting time is a factor that affects this complication. The aim of this study was to investigate the impact of fasting time reduction by using oral carbohydrate on postoperative pain and analgesic consumption in orthopedic patients. Materials and Methods This randomized control trial was conducted between November 2017 and December 2018. Sixty-four patients were randomly assigned into the intervention (which consumed 200 mL of the 12.50% carbohydrate, 2 h before the surgery) and the control group (which was fasted from midnight). Postoperative pain was measured by visual analog scale; the amount of the consumed analgesics was also recorded. The data were analyzed by using Chi-square and t-test. Results The mean (SD) of the pain scores in the control group immediately and 2, 4, 6, 12 and 24 h after consciousness were 7.19 (2.64), 6.69 (2.17), 6.31 (2.05), 6.16 (2.08), 6.06 (2.24), and 5.38 (1.86), respectively. These scores for the intervention group were 7.44 (1.48), 6.31 (1.25), 5.72 (1.17), 5.59 (1.43), 5.25 (1.13), and 4.97 (1.57). The mean of the pain scores between two groups was not different (p > 0.05). The amount of the consumed morphine (t 61= -2.10, p = 0.039), pethidine (t 62= -2.25, p = 0.028), and diclofenac (t 62= -2.51, p = 0.015) were significantly different between the two groups. Conclusions The pain intensity in the patients with shortened fasting time was lower, but it was not statistically significant. Moreover, reducing fasting time by using carbohydrate significantly reduced the use of analgesics.
Collapse
Affiliation(s)
- Mohsen Torabikhah
- Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hojatollah Yousefi
- Nursing and Midwifery Care Research Center, Adult Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Amir Musarezaie
- Nursing and Midwifery Care Research Center, Adult Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
33
|
Tapar H, Özsoy Z, Balta MG, Daşıran F, Tapar GG, Karaman T. Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study. Braz J Anesthesiol 2021; 72:567-573. [PMID: 34363820 PMCID: PMC9515682 DOI: 10.1016/j.bjane.2021.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 06/29/2021] [Accepted: 07/10/2021] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Patients' postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy. METHODS This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded. RESULTS The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = -0.702, p < 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p < 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p < 0.001; r = 0.556, p < 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (β = 0.597, p < 0.001; β = 0.207, p = 0.036; β = 0.140, p = 0.208; β = 0.624, p < 0.001, respectively). CONCLUSIONS Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.
Collapse
Affiliation(s)
- Hakan Tapar
- Tokat Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turkey.
| | - Zeki Özsoy
- Tokat Gaziosmanpasa University, Medical Faculty, Department of General Surgery, Tokat, Turkey
| | - Mehtap Gürler Balta
- Tokat Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turkey
| | - Fatih Daşıran
- Tokat Gaziosmanpasa University, Medical Faculty, Department of General Surgery, Tokat, Turkey
| | | | - Tuğba Karaman
- Tokat Gaziosmanpasa University, Medical Faculty, Department of Anesthesiology and Reanimation, Tokat, Turkey
| |
Collapse
|
34
|
Schwarm FP, Ott M, Nagl J, Leweke F, Stein M, Uhl E, Maxeiner H, Kolodziej MA. Preoperative Elevated Levels for Depression, Anxiety, and Subjective Mental Stress Have No Influence on Outcome Measures of Peripheral Nerve Field Stimulation for Chronic Low Back Pain-A Prospective Study. Neuromodulation 2021; 24:1042-1050. [PMID: 33522693 DOI: 10.1111/ner.13368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/16/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Peripheral nerve field stimulation (PNFS) is an effective alternative treatment for patients with chronic low back pain. The treatment of low back pain strongly depends on psychological factors like anxiety, depression, and mental stress. The aim of this study was to evaluate the impact of such factors on outcome measures after lead- and implantable pulse generator-implantation. MATERIALS AND METHODS Between 2014 and 2019, a prospective cohort study of 39 patients with chronic lumbar pain was conducted. Hospital Anxiety and Depression Scale (HADS) score was assessed at baseline to measure symptoms of anxiety and depression. Symptom checklist-90 (SCL-90) was used to measure subjective psychopathology. Pain intensity (numeric pain rating scale [NRS]), SF12v2 with Physical Component Summary and Mental Component Summary (MCS) scores, and Oswestry Disability Index (ODI) were assessed pre- and postoperatively as well as three and six months after PNFS implantation. Outcome values were compared to baseline data. Statistical analysis was performed using depending t-test and analysis of variance (ANOVA). A p value <0.05 was considered significant. RESULTS The cohort consisted of 39 patients (18 females, 21 males) with a median age of 61 years (IQR25-75 = 52-67 years). NRS, ODI, and SF12v2 showed significant improvement in the whole follow-up period compared to baseline values (p < 0.05). Elevated HADS scores for anxiety were seen in 64.1%, for depression in 76.9% of the patients at baseline. SCL-90 was pathologic in 71.8% of the cases. A one-way ANOVA revealed no differences between elevated HADS- and SCL-90 values and all outcome measures after PNFS implantation in the whole follow-up period (p > 0.05). CONCLUSION Chronic low back pain is often associated with psychological distress. Our study showed highly elevated levels for anxiety and depression as well as subjective mental stress in patients with chronic low back pain without negative impact on NRS, ODI, and SF12v2 in the whole follow-up after PNFS implantation.
Collapse
Affiliation(s)
- Frank P Schwarm
- Department of Neurosurgery, Justus-Liebig-University Giessen, Giessen, Germany
| | - Marc Ott
- Department of Neurosurgery, Justus-Liebig-University Giessen, Giessen, Germany
| | - Jasmin Nagl
- Department of Neurosurgery, Justus-Liebig-University Giessen, Giessen, Germany
| | - Frank Leweke
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany
| | - Marco Stein
- Department of Neurosurgery, Justus-Liebig-University Giessen, Giessen, Germany
| | - Eberhard Uhl
- Department of Neurosurgery, Justus-Liebig-University Giessen, Giessen, Germany
| | - Hagen Maxeiner
- Department of Anesthesiology, Intensive Care and Pain Therapy, Justus-Liebig-University Giessen, Giessen, Germany
| | | |
Collapse
|
35
|
Katt BM, Tawfik A, Lau V, Padua F, Fletcher D, Stamos B, Aita D, Conte E, Saxena A, Hornstein J. The Planning Fallacy in the Orthopedic Operating Room. Cureus 2021; 13:e12433. [PMID: 33552753 PMCID: PMC7854319 DOI: 10.7759/cureus.12433] [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: 11/05/2022] Open
Abstract
The planning fallacy posits that humans tend to underestimate the amount of time needed to complete a project and that greater complexity results in a larger difference in that estimation. If this phenomenon is present in the orthopedic operating room, it could lead to negative impacts on patients, their families, and physicians themselves. Nine fellowship-trained orthopedic surgeons at one institution were asked to give an estimate of their operative and total room times over the course of three months. Over 759 cases, the surgeons underestimated the total room times by 17.3% (p = 0.034) but did not underestimate their operative times (p = 0.590). The surgeons improved estimation of their operative time for all cases from 13.6 to 10.9 minutes of their actual time (p = 0.031) by comparing the absolute difference for the surgeons' first 25% to the last 25% of cases. Procedures performed at the hospital underestimated operative and total room times by 8.9% and 7.4% compared to the ambulatory center, which overestimated operative times by 6.0% and underestimated total room times by 3.8% (p < 0.001). We found that the planning fallacy does exist in certain situations within the orthopedic operating room.
Collapse
Affiliation(s)
- Brian M Katt
- Hand Surgery, Rothman Orthopaedic Institute, Philadelphia, USA
| | - Amr Tawfik
- Orthopaedics, Rothman Orthopaedic Institute, Philadelphia, USA
| | - Vincent Lau
- Orthopaedics, Rowan School of Osteopathic Medicine, Stratford, USA
| | - Fortunato Padua
- Orthopaedics, Rothman Orthopaedic Institute, Philadelphia, USA
| | - Daniel Fletcher
- Hand Surgery, Rothman Orthopaedic Institute, Philadelphia, USA
| | - Bruce Stamos
- Sports Medicine, Rothman Orthopaedic Institute, Philadelphia, USA
| | - Daren Aita
- Hand Surgery, Rothman Orthopaedic Institute, Philadelphia, USA
| | - Evan Conte
- Sports Medicine, Rothman Orthopaedic Institute, Philadelphia, USA
| | - Arjun Saxena
- Orthopaedics, Rothman Orthopaedic Institute, Philadelphia, USA
| | - Joshua Hornstein
- Sports Medicine, Rothman Orthopaedic Institute, Philadelphia, USA
| |
Collapse
|
36
|
Venkatesan U, Sruthikamal V, Jasmine J. Effectiveness of early ambulation on postoperative anxiety and co-operation among laparotomy surgical patients. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2021. [DOI: 10.4103/jnms.jnms_71_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
37
|
Ferraz MCL, Santana‐Santos E, Pinto JS, Nunes Ribeiro CJ, Santana JFNB, Alves JAB, Ribeiro MDCDO. Analgesic effect of music during wound care among patients with diaphyseal tibial fractures: Randomized controlled trial. Eur J Pain 2020; 25:541-549. [DOI: 10.1002/ejp.1692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 10/28/2020] [Indexed: 11/06/2022]
Affiliation(s)
| | - Eduesley Santana‐Santos
- Graduate Program of Nursing Federal University of Sergipe São Cristóvão Brazil
- Department of Nursing Federal University of Sergipe Lagarto Brazil
| | - Jonas Santana Pinto
- Health Science Graduate Program Federal University of Sergipe Aracaju Brazil
| | | | | | | | - Maria do Carmo de Oliveira Ribeiro
- Graduate Program of Nursing Federal University of Sergipe São Cristóvão Brazil
- Department of Nursing Federal University of Sergipe Aracaju Brazil
| |
Collapse
|
38
|
Khalil H, Shajrawi A, Dweik G, Zaghmouri A, Henker R. The impact of preoperative pain-related psychological factors on pain intensity post-surgery in Jordan. J Health Psychol 2020; 26:2876-2885. [PMID: 32597221 DOI: 10.1177/1359105320937067] [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: 01/04/2023] Open
Abstract
This study aimed to investigate the impact of preoperative psychological factors on postoperative pain. We included 300 postoperative patients who underwent open reduction and internal fixation surgery. Pain Scale, Pain Catastrophizing Scale, and Depression, Anxiety, and Stress Scale were completed by patients preoperatively and at 24 hours after surgery. Clinical characteristics were obtained from medical records. Data were analyzed using multiple linear regression. Postoperative pain was predicted by pain catastrophizing and anxiety symptoms. High preoperative catastrophizing and anxiety levels were associated with increased pain postoperatively. However, the relationships between preoperative depressive and stress symptoms and postoperative pain were not significant.
Collapse
|
39
|
Prevalence of Preoperative Anxiety and Its Relationship with Postoperative Pain in Foot Nail Surgery: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124481. [PMID: 32580413 PMCID: PMC7344875 DOI: 10.3390/ijerph17124481] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 12/19/2022]
Abstract
Preoperative anxiety has been studied in different medical disciplines, but it is unknown in minor surgical procedures such as foot nail surgery. This study aimed to determine the prevalence of preoperative anxiety and postoperative pain in foot nail surgery. The validated Amsterdam preoperative anxiety and information scale (APAIS) was used to evaluate preoperative anxiety and the need for information in 155 patients undergoing foot nail surgery. In addition, a questionnaire was used to collect other variables such as age, sex and educational level. The verbal numeric scale was employed to value the postoperative pain after 24 h. Age and sex influenced (p < 0.05) preoperative anxiety, which had a prevalence of 22.6%. More than 43% of patients needed more information and this was correlated with anxiety (r = 0.629; p < 0.001). There was a significant difference when comparing the total anxiety between the group of participants who had more pain and that who had less pain (p < 0.001). The prevalence of anxiety was high in the participants of this study, being greater in young patients and in women. There was a deficit of information, increasing the level of preoperative anxiety, which in turn was related with greater postoperative pain.
Collapse
|
40
|
The Impact of Preoperative Patient Anxiety on Postoperative Anxiety and Quality of Recovery After Orthopaedic Surgery. J Perianesth Nurs 2020; 35:260-264. [DOI: 10.1016/j.jopan.2019.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/07/2019] [Accepted: 11/25/2019] [Indexed: 12/25/2022]
|
41
|
Wolmeister AS, Schiavo CL, Nazário KCK, Castro SMDJ, de Souza A, Caetani RP, Caumo W, Stefani LC. The Brief Measure of Emotional Preoperative Stress (B-MEPS) as a new predictive tool for postoperative pain: A prospective observational cohort study. PLoS One 2020; 15:e0227441. [PMID: 31914146 PMCID: PMC6948814 DOI: 10.1371/journal.pone.0227441] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/18/2019] [Indexed: 01/01/2023] Open
Abstract
Background Preoperative patients’ vulnerabilities such as physical, social, and psychological are implicated in postoperative pain variability. Nevertheless, it is a challenge to analyze a patient's psychological profile in the preoperative period in a practical and consistent way. Thus, we sought to identify if high preoperative emotional stress, evaluated by the Brief Measure of Emotional Preoperative Stress (B-MEPS) scale is associated with higher postoperative pain levels and poor rehabilitation in patients submitted to intermediate or major surgery. Moreover, the possible neurobiological or neurophysiological mechanisms implicated in high preoperative emotional stress, evaluated through preoperative quantitative sensory pain tests and serum biomarkers BDNF and S100B were investigated. Methods We conducted a prospective, observational, cohort study of ASA 2 and 3 adult patients undergoing major urologic, gynecologic, proctologic and orthopedic surgeries from March 2017 to March 2018. B-MEPS and Central Sensitivity Inventory were evaluated preoperatively, followed by a sequence of experimental pain tests and serum biomarkers collection. Postoperative evaluation carried out within the first 48 hours after surgery comprehended pain at rest and movement-evoked pain, and the consumption of morphine. Quality-of-Recovery was also evaluated in the 3rd postoperative day. Results 23 (15%) out of 150 patients included in the study presented high emotional preoperative stress. Variables significantly related to preoperative stress were: previous psychiatric diagnosis and Central Sensitization Inventory result. Mean movement-evoked pain in the first 12 to 48 hours was 95–105% higher than pain at rest. A mixed model for repeated measures showed a sustainable effect of B-MEPS as a movement-evoked pain predictor. Previous pain, cancer surgery, and preoperative pressure pain tolerance were also independent predictors of postoperative pain. Moderate to severe postoperative movement-evoked pain was predictive of poor rehabilitation in 48 hours after surgery. Conclusion We confirmed that a brief screening method of preoperative emotional states could detect individuals prone to experience severe postoperative pain. Specific interventions considering the stress level may be planned in the future to improve perioperative outcomes.
Collapse
Affiliation(s)
- Anelise Schifino Wolmeister
- Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Carolina Lourenzon Schiavo
- Postgraduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Kahio César Kuntz Nazário
- Anaesthesia and Perioperative Medicine Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | - Andressa de Souza
- Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Rafael Poli Caetani
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Wolnei Caumo
- Department of Surgery, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Luciana Cadore Stefani
- Laboratory of Pain & Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Anaesthesia and Perioperative Medicine Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Department of Surgery, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- * E-mail:
| |
Collapse
|
42
|
Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
43
|
Periañez CAH, Diaz MAC, Bonisson PLV, Simino GPR, Barbosa MH, Mattia ALD. RELATIONSHIP OF ANXIETY AND PREOPERATIVE DEPRESSION WITH POST-OPERATIVE PAIN. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2018-0499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
ABSTRACT Objectiv:e to analyze the relationship of anxiety and depression in the preoperative period with the presence of pain in the postoperative period. Method: cohort study conducted at a university hospital in the state of Minas Gerais (Brazil), between february and July 2017, with 65 patients. A collection instrument was elaborated for the demographic and clinical characteristics. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression; pain intensity was measured using the Verbal Numerical Scale. Data were submitted to descriptive and inferential statistical analysis. Results: according to demographic and clinical characteristics, most patients were female, with a median age of 44 years and surgical specialty of the digestive tract. In the preoperative period, 31 (47.7%) had anxiety, and nine (13.8%), depression. None of the patients reported pain immediately prior to surgery. The incidence of moderate to severe postoperative pain was 32 (49.2%) patients. There was a statistically significant difference in the distribution of patients with postoperative pain in relation to the presence or absence of preoperative anxiety (p value <0.001). There is no statistically significant difference in the distribution of patients with postoperative pain in relation to the presence or absence of preoperative depression (0.733). In multivariate analysis, preoperative anxiety was a predictive factor for postoperative pain. Depression was not a predictive factor of postoperative pain. Conclusion: It was demonstrated that, regardless of the demographic and clinical characteristics of the studied sample, the presence of anxiety in patients in the preoperative period is a predictive factor of postoperative pain.
Collapse
|
44
|
Karišik M, Gligorović Barhanović N, Vulović T, Simić D. POSTOPERATIVE PAIN AND STRESS RESPONSE: DOES CHILD'S GENDER HAVE AN INFLUENCE? Acta Clin Croat 2019; 58:274-280. [PMID: 31819323 PMCID: PMC6884379 DOI: 10.20471/acc.2019.58.02.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Surgical procedure causes multisystem stress response reactions. The aim of this study was to assess whether gender has an impact on the level of neuroendocrine response to surgical stress and intensity of postoperative pain in children undergoing inguinal hernia repair surgery, as well as satisfaction of their parents with preoperative and postoperative care. The study included 60 children aged 3-6 years, all of them the only child in the family. All children included in the study were categorized as American Society of Anesthesiologists PS Class I, and divided into two groups: group 1 composed of 30 boys and group 2 composed of 30 girls. After oral premedication with midazolam, general anesthesia with endotracheal intubation was performed in all patients. Ketorolac, 1 mg.kg-1, was administered for postoperative analgesia. Serum cortisol was measured in all children preoperatively and postoperatively. The quality of postoperative analgesia was evaluated by Wong-Baker (FACES) scale, along with parental satisfaction. Male children who were the only child in the family had stronger neuroendocrine response to surgical stress and stronger intensity of postoperative pain. The parents of the girls expressed greater satisfaction with preoperative and postoperative care.
Collapse
Affiliation(s)
| | - Najdana Gligorović Barhanović
- 1Department of Anesthesiology, Institute for Children's Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro; 2Centre for Clinical Laboratory Diagnostics, Clinical Centre of Montenegro, Podgorica, Montenegro; 3School of Medicine, University of Kragujevac, Kragujevac, Serbia; 4Centre for Anesthesiology and Resuscitation, Clinical Centre Kragujevac, Kragujevac, Serbia; 5School of Medicine, University of Belgrade, Belgrade, Serbia; 6University Children's Hospital, Belgrade, Serbia
| | - Tatjana Vulović
- 1Department of Anesthesiology, Institute for Children's Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro; 2Centre for Clinical Laboratory Diagnostics, Clinical Centre of Montenegro, Podgorica, Montenegro; 3School of Medicine, University of Kragujevac, Kragujevac, Serbia; 4Centre for Anesthesiology and Resuscitation, Clinical Centre Kragujevac, Kragujevac, Serbia; 5School of Medicine, University of Belgrade, Belgrade, Serbia; 6University Children's Hospital, Belgrade, Serbia
| | - Dušica Simić
- 1Department of Anesthesiology, Institute for Children's Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro; 2Centre for Clinical Laboratory Diagnostics, Clinical Centre of Montenegro, Podgorica, Montenegro; 3School of Medicine, University of Kragujevac, Kragujevac, Serbia; 4Centre for Anesthesiology and Resuscitation, Clinical Centre Kragujevac, Kragujevac, Serbia; 5School of Medicine, University of Belgrade, Belgrade, Serbia; 6University Children's Hospital, Belgrade, Serbia
| |
Collapse
|
45
|
Ko SY, Leung DY, Wong EM. Effects of easy listening music intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: a pilot randomized controlled trial. Clin Interv Aging 2019; 14:977-986. [PMID: 31213784 PMCID: PMC6549755 DOI: 10.2147/cia.s207191] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/09/2019] [Indexed: 01/31/2023] Open
Abstract
Purpose: The purpose of this study was to examine the effects of an easy listening music intervention on satisfaction, anxiety, pain, sedative and analgesic medication requirements, and physiological parameters in Chinese adult patients undergoing colonoscopy in Hong Kong. Patients and methods: Patients undergoing colonoscopy, aged 45 or older, able to communicate in Chinese, and hemodynamically stable were invited for the study. A randomized controlled trial was adopted. Eligible patients were randomly assigned either to a music group, which received standard care and additional easy listening music (a series of 15 popular non-rock Chinese songs) through earphones and MP3 for 20 mins before and during the procedure, or to a control group which received standard care only. Standard care comprised of all nursing and medical care provided for patients undergoing colonoscopy. Measures comprised of the State-Trait Anxiety Inventory, visual analog scales of pain level, procedure satisfaction and satisfaction with pain management, the use of sedative and analgesic drugs, heart rate, and blood pressure data were collected at baseline (T0), during (T1) and 30 mins after the procedure (T2). Results: Eighty participants (40 music vs 40 control) completed the study with no attrition. Participants in the music group reported significantly higher levels in both procedure satisfaction (p=0.043) and satisfaction with pain management (p=0.045) than those in the control group. No significant difference was found between groups on anxiety, pain, additional sedative and analgesic use, heart rate, and systolic and diastolic blood pressure (p>0.05). Nevertheless, most participants appreciated the songs provided in MP3 and found it helpful for relaxation during the procedure and would prefer it again (p<0.001). Conclusion: Easy music listening can enhance patients' satisfaction in both procedure and pain management for adults undergoing a colonoscopy procedure.
Collapse
Affiliation(s)
- Shuk Yee Ko
- Accident and Emergency Department, Tuen Mum Hospital, Tuen Mun, NT, Hong Kong
| | - Doris Yp Leung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Eliza Ml Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| |
Collapse
|
46
|
Medina-Garzón M. Effectiveness of a Nursing Intervention to Diminish Preoperative Anxiety in Patients Programmed for Knee Replacement Surgery: Preventive Controlled and Randomized Clinical Trial. INVESTIGACION Y EDUCACION EN ENFERMERIA 2019; 37:e07. [PMID: 31487444 PMCID: PMC7871492 DOI: 10.17533/udea.iee.v37n2e07] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 06/04/2019] [Indexed: 05/02/2023]
Abstract
OBJECTIVES This work was conducted to determine the effectiveness of a nursing intervention, based on the motivational interview, to diminish preoperative anxiety in patients programmed for knee replacement surgery. METHODS Preventive type controlled and randomized clinical trial, on a sample of 56 patients programmed for knee replacement surgery in a clinic in Girardot (Colombia). Random assignment was made: an intervention group (n=28) and a control group (n=28). The six-question Amsterdam Preoperative Anxiety and Information Scale was applied before and after the intervention. The scale has a total score ranging from 5 to 30; the higher the score, the greater the preoperative anxiety. The nursing intervention was conducted in three sessions of motivational interview each lasting 40 min, during the six weeks prior to the surgical procedure; the control group received conventional management of education in the health institution. RESULTS The mean score of preoperative anxiety was equal in the pre-intervention evaluation in both groups (19.76 in the experimental versus 22.02 in the control =22.02; p<0.226), while during the post-intervention, the anxiety score was lower in the intervention group compared with the control group (15.56 and 20.30, respectively; p <0.013). CONCLUSIONS Nursing intervention based on the motivational interview was effective in diminishing preoperative anxiety in patients programmed for knee replacement surgery.
Collapse
|
47
|
Sillero-Sillero A, Zabalegui A. Safety and satisfaction of patients with nurse's care in the perioperative. Rev Lat Am Enfermagem 2019; 27:e3142. [PMID: 31038636 PMCID: PMC6528624 DOI: 10.1590/1518-8345.2646.3142] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 01/27/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE to investigate the safety and satisfaction of patients and their relationship with nurse's care in the perioperative period. METHOD cross-sectional, multi-level, correlational study with 105 nurses in the surgical area and 150 patients operated in a Spanish tertiary hospital. For the nurses the sociodemographic variables, the perception of the work environment, the professional burnout and the satisfaction in the work were collected. For patients, the safety of adverse events and level of satisfaction, through the application of questionnaires. Univariate and multivariate analysis were used. RESULTS job satisfaction, professional commitment, and participation in hospital issues were negative predictors for adverse events related to the patient, while postoperative nurse care was a positive predictor. CONCLUSION there is an increase in adverse events when nurses are dissatisfied at work, less professional commitment and low availability to participate in the subjects of their unit. On the other hand, adverse events decrease when nurses perform the care in the postoperative period. Satisfaction was good and there was no association with the characteristics of nurses' attention. It is recommended to improve these predictors to increase the safety of surgical patients.
Collapse
|
48
|
Yang MMH, Hartley RL, Leung AA, Ronksley PE, Jetté N, Casha S, Riva-Cambrin J. Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis. BMJ Open 2019; 9:e025091. [PMID: 30940757 PMCID: PMC6500309 DOI: 10.1136/bmjopen-2018-025091] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Inadequate postoperative pain control is common and is associated with poor clinical outcomes. This study aimed to identify preoperative predictors of poor postoperative pain control in adults undergoing inpatient surgery. DESIGN Systematic review and meta-analysis DATA SOURCES: MEDLINE, Embase, CINAHL and PsycINFO were searched through October 2017. ELIGIBILITY CRITERIA Studies in any language were included if they evaluated postoperative pain using a validated instrument in adults (≥18 years) and reported a measure of association between poor postoperative pain control (defined by study authors) and at least one preoperative predictor during the hospital stay. DATA EXTRACTION AND SYNTHESIS Two reviewers screened articles, extracted data and assessed study quality. Measures of association for each preoperative predictor were pooled using random effects models. RESULTS Thirty-three studies representing 53 362 patients were included in this review. Significant preoperative predictors of poor postoperative pain control included younger age (OR 1.18 [95% CI 1.05 to 1.32], number of studies, n=14), female sex (OR 1.29 [95% CI 1.17 to 1.43], n=20), smoking (OR 1.33 [95% CI 1.09 to 1.61], n=9), history of depressive symptoms (OR 1.71 [95% CI 1.32 to 2.22], n=8), history of anxiety symptoms (OR 1.22 [95% CI 1.09 to 1.36], n=10), sleep difficulties (OR 2.32 [95% CI 1.46 to 3.69], n=2), higher body mass index (OR 1.02 [95% CI 1.01 to 1.03], n=2), presence of preoperative pain (OR 1.21 [95% CI 1.10 to 1.32], n=13) and use of preoperative analgesia (OR 1.54 [95% CI 1.18 to 2.03], n=6). Pain catastrophising, American Society of Anesthesiologists status, chronic pain, marital status, socioeconomic status, education, surgical history, preoperative pressure pain tolerance and orthopaedic surgery (vs abdominal surgery) were not associated with increased odds of poor pain control. Study quality was generally high, although appropriate blinding of predictor during outcome ascertainment was often limited. CONCLUSIONS Nine predictors of poor postoperative pain control were identified. These should be recognised as potentially important factors when developing discipline-specific clinical care pathways to improve pain outcomes and to guide future surgical pain research. PROSPERO REGISTRATION NUMBER CRD42017080682.
Collapse
Affiliation(s)
- Michael M H Yang
- Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca L Hartley
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Section of Plastic Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Alexander A Leung
- Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul E Ronksley
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Nathalie Jetté
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven Casha
- Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Calgary, Alberta, Canada
| | - Jay Riva-Cambrin
- Department of Clinical Neurosciences, Section of Neurosurgery, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
49
|
Felix MMDS, Ferreira MBG, da Cruz LF, Barbosa MH. Relaxation Therapy with Guided Imagery for Postoperative Pain Management: An Integrative Review. Pain Manag Nurs 2019; 20:3-9. [DOI: 10.1016/j.pmn.2017.10.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 12/29/2022]
|
50
|
The Effect of Foot Massage on Pain Intensity and Anxiety in Patients Having Undergone a Tibial Shaft Fracture Surgery: A Randomized Clinical Trial. J Orthop Trauma 2018; 32:e482-e486. [PMID: 30444801 DOI: 10.1097/bot.0000000000001320] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effect of massage therapy on pain intensity and anxiety in patients who have undergone tibial shaft fracture surgery. DESIGN This study was a randomized clinical trial with a pre-post design. As the study included 2 treatment groups, it was a parallel study. SETTING Khatam-Al-Anbia Hospital in Zahedan, Iran, between July and August 2017. PATIENTS In all, 66 patients who underwent a tibial shaft fracture surgery were enrolled and randomly assigned to intervention and control groups (33 patients each). INTERVENTION The intervention included a 10-minute foot massage (5 minutes per leg) using sweet almond oil, the most common lubricant used in massage therapy. MAIN OUTCOME MEASUREMENTS Data were collected using pain numeric rating scale and Spielberger State-Trait Anxiety Inventory before and after intervention. RESULTS After intervention, the mean scores for pain intensity, and anxiety in the intervention and control groups were 4.72 (0.97) and 5.72 (0.91), and 42.84 (6.50) and 58.36 (10.37), respectively. A significant difference was noted between the intervention and control groups concerning pain intensity and anxiety. CONCLUSIONS The results indicated that massage therapy reduced pain intensity and anxiety in patients who underwent tibial shaft fracture surgery. Therefore, using massage as a noninvasive and acceptable intervention is suggested in orthopaedic surgery, especially after tibial shaft fracture surgeries. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Collapse
|