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Kocaturk S, Gur ZB, Gursoytrak B. Can Verbal Interview Decrease Preoperative Anxiety and Postoperative Discomfort in Oral and Maxillofacial Surgery Patients?: A Randomized Clinical Trial. J Oral Maxillofac Surg 2024:S0278-2391(24)00588-3. [PMID: 39009060 DOI: 10.1016/j.joms.2024.06.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 06/25/2024] [Accepted: 06/25/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Preoperative anxiety is a condition that can be seen frequently in oral and maxillofacial surgery patients and affects the recovery process. PURPOSE The aim of this study was to determine the effect of preoperative educational or informative interviews on preoperative anxiety levels and postoperative discomfort in patients undergoing oral and maxillofacial surgery. STUDY DESIGN, SETTING, AND SAMPLE This prospective randomized clinical trial involved patients who underwent oral and maxillofacial surgery at Aydın-Adnan-Menderes University, Oral and Maxillofacial Surgery Hospital. Patients with neurological or psychological disorders, a history of previous psychiatric drug use, those who used anxiolytic or sedative drugs before surgery, those who required postoperative anxiolytic and opioid administration, or patients who underwent nonstandard surgical and anesthesia protocols were excluded. EXPOSURE VARIABLE Preoperative educational or informative interview is the exposure variable. Subjects were randomly assigned to the intervention and control groups. MAIN OUTCOME VARIABLES The primary outcome variable was preoperative anxiety measured by the Spielberger State-Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information scale (APAIS). The secondary outcome variables were postoperative pain measured by visual analog scale at the first and sixth hours, postoperative nausea (repeated gagging or spitting), and postoperative vomiting (active vomiting) were observed within 6 hours following general anaesthesia. COVARIATES The study's covariates were age, weight, sex, American Society of Anesthesiologists Physical Status Classification System score, marital status, edicational background, surgery procedure, anesthesia procedure, duration of surgery, and recovery time. ANALYSES The χ2 and student t-tests were used to compare primary predictor and covariates against outcome variables. A P value <.05 was considered significant. RESULTS A total of 92 patients were included in this study, with 46 randomized to intervention group and 46 to control group. The mean age (37.78 ± 13.94 years vs 33.34 ± 15.17 years, P = .16) and sex differences (female/male: 16/30(34.8/65.2) versus 26/20(56.5/43.5), P = .06) were comparable between groups. While higher values were recorded in the average anxiety scores in the control group than in the study group, statistically significant differences were found [Spielberger State-Trait Anxiety Inventory-S (37.36 ± 10.87 vs 52.39 ± 12.13) (P < .01), APAIS-T (15.82 ± 5.35 vs 21.39 ± 6.69) (P < .01), APAIS-A (4.17 ± 2.12 vs 6.47 ± 2.15) (P < .01), APAIS-B (5.76 ± 2.03 vs 7.65 ± 2.60) (P < .01), and APAIS-C (6.04 ± 2.47 vs 7.21 ± 2.38), (P < .05)]. At the same time, there was also a significant difference in terms of early postoperative pain [(2.08 ± 2.77 vs 3.43 ± 2.86), (P = .02)] and postoperative nausea [12/34 (26.1/73.9) versus 25/21(54.3/45.7), (P = .01)]. CONCLUSIONS AND RELEVANCE Oral and maxillofacial surgery causes significant situational anxiety. This study showed that preoperative educational or informative interviews reduced preoperative anxiety levels and postoperative discomfort, such as early postoperative pain, nausea, and vomiting.
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Affiliation(s)
- Selin Kocaturk
- Student, TAKEV High School, (accredited by the German Science Association- MINT Zukunft Schaffen), Izmir, Turkey; Research Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey; Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey
| | - Zeynep Busra Gur
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey.
| | - Burcu Gursoytrak
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey; Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydın, Turkey
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Xiao X, Zuo YD, Kuang SY, Liu CY, Kun-Shao, Wang H, Yan SY, Yu F, Xu Y, Zhou L, Jiang CL. Effectiveness of WeChat-assisted preoperative education to reduce perioperative anxiety in breast cancer patients: a prospective randomized controlled study protocol. Trials 2024; 25:231. [PMID: 38570855 PMCID: PMC10993457 DOI: 10.1186/s13063-024-08071-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Breast cancer is the most prevalent cancer among women globally, and surgical procedures continue to be the primary treatment. However, over 50% of patients experience preoperative anxiety due to the unknown and fear associated with surgery. Although drug therapy is commonly used to address this anxiety, its side effects have led to a heated debate regarding its effectiveness. Consequently, non-pharmacological therapies, such as preoperative education, have emerged as an alternative approach to alleviate anxiety. WeChat, a widely popular social media platform, offers a public platform that can potentially be utilized for effective preoperative education. This study aims to evaluate the use of WeChat public platform as a tool for preoperative education in patients undergoing breast surgery. METHODS This is a prospective, randomized, and controlled trial will involve 392 adult women scheduled for breast cancer resection. Participants will be randomly assigned to either the WeChat education group or the regular group. In addition to regular preoperative visits, the WeChat education group will also watch science videos through the WeChat public platform. The regular group will only receive education from ward nurses during preoperative visits. The primary outcome measure will be the incidence of preoperative anxiety, defined by scores of the State Anxiety Inventory (SAI) exceeding 40 points. Secondary outcome measures include the incidence of severe anxiety (SAI > 44) on the day before surgery, incidence of anxiety 72 h after surgery, incidence of severe anxiety 72 h after surgery, NRS scores for pain at rest and during activity 24, 48, and 72 h after surgery, incidence of nausea and vomiting within 24 h after surgery, subjective sleep score at 1 week postoperatively, quality of life QoR-15 scores at 1 and 3 months postoperatively, incidence of chronic pain at 3 months postoperatively, bowel function recovery, length of hospital stay, and hospitalization expenses. DISCUSSION This is the first clinical trial to investigate the use of WeChat public platform for delivering preoperative education on perioperative anxiety in breast cancer patients. By utilizing the renowned WeChat public platform, our study aims to improve patient outcomes by providing video education that explains the disease, surgery, and anesthesia in a more accessible manner, thereby reducing the incidence of perioperative anxiety. If our hypothesis is confirmed, this non-pharmacological approach can be universally acknowledged as a cost-effective and practical method in clinical care. Its application can also be extended to other medical fields beyond breast cancer. TRIAL REGISTRATION ClinicalTrials.gov, NCT05291494. Registered on 29 December 2021.
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Affiliation(s)
- Xiao Xiao
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Yi-Ding Zuo
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
- West China Xiamen Hospital of Sichuan University, 361000, Xiamen, China
| | - Shu-Yu Kuang
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Chun-Yuan Liu
- Chongqing Liangping District People's Hospital, Chongqing, 400700, China
| | - Kun-Shao
- Xinxiang Central Hospital, Xinxiang, 453000, China
| | - Heng Wang
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Si-Yu Yan
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Feng Yu
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Yan Xu
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Li Zhou
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Chun-Ling Jiang
- Department of Anesthesiology, The Research Units of West China (2018RU012), West China Hospital, Sichuan University, Chinese Academy of Medical Sciences, Chengdu, 610041, China.
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Chee RM, Capper TS, Muurlink OT. Social media influencers' impact during pregnancy and parenting: A qualitative descriptive study. Res Nurs Health 2024; 47:7-16. [PMID: 37845594 DOI: 10.1002/nur.22350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/26/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023]
Abstract
Pregnant people and parents engage with social media networking sites seeking support and information that is shared in a relatable way. Engaging with social media influencers (SMIs) and their followers, however, may have both affirming and harmful effects. SMIs can facilitate information-sharing, discussion, and supportive behaviors, but engaging with SMIs can lead to negative experiences and exposure to misinformation. To date, little is known about the impacts of following influencers during pregnancy and early parenthood. The aim of this study was to explore how engaging with SMIs impacts pregnant people and parents of children aged 5 or under in Australia. A qualitative descriptive approach was taken. Qualitative data from 85 anonymously completed online written surveys were thematically analyzed using Braun & Clarke's six-step process. Five overarching themes and two subthemes were identified. The first theme, "Comparisons of self," held two subthemes: "Unfavorable comparisons of self to SMIs" and "Favorable comparisons of self to SMIs." Additional themes were "A virtual community of inspiration and togetherness," "Sharing of information, opinions & experiences," "Gatekeeping self-efficacy," and "Credibility." The findings of the study indicated that discordance between influencer-mediated expectations of parenthood and a person's actual experience may affect well-being and perceptions of parental self-efficacy. Information sought from influencers may substitute for face-to-face education by clinicians. Health professionals who are also influencers may possess the ability to provide evidence-based information. This content, however, is not without risk for bias or incompleteness.
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Affiliation(s)
- Rachelle M Chee
- School of Nursing, Midwifery & Social Sciences, CQUniversity Australia, Brisbane, Australia
| | - Tanya S Capper
- School of Nursing, Midwifery & Social Sciences, CQUniversity Australia, Brisbane, Australia
| | - Olav T Muurlink
- School of Business & Law, CQUniversity Australia, Brisbane, Australia
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Lin Y, Luo S, Lu Q, Pan X. The Effects of Implantable Collamer Lens ICL Implantation in High Myopia Patients' Mental Health. Clin Ophthalmol 2024; 18:121-126. [PMID: 38226002 PMCID: PMC10789572 DOI: 10.2147/opth.s447992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/04/2024] [Indexed: 01/17/2024] Open
Abstract
Purpose To investigate the psychological changes in patients pre and post implantable collamer lens (ICL, EVO) implantation surgery in the posterior chamber. Patients and methods Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the mental states of 43 patients who underwent ICL implantation surgery performed by the same surgeon between January 2021 and December 2022. Results Comparing the results before and one week after the operation, there is a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). Similarly, when comparing the pre-operation and one-month post-operation results, there is also a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). However, when comparing the one-week post-operation and one-month post-operation results, there is no significant difference in either the SAS scale (P>0.05) or the SDS scale (P>0.05). Moving on to the comparison between the pre-operation results and the national norm level, there is a significant difference in both the SAS scale (P<0.05) and the SDS scale (P<0.05). When comparing the one-week post-operation results and the national norm level, there is a significant difference in the SAS scale (P<0.05). Similarly, when comparing the one-month post-operation results and the national norm level, there is a significant difference in the SAS scale (P<0.05). Conclusion After undergoing ICL implantation surgery, patients typically experience a notable decrease in anxiety (SAS) and depression (SDS) scales. These improvements gradually stabilize and enhance during the postoperative recovery period. However, it may require a significant amount of time for patients to fully restore their psychological well-being to levels comparable to the national norm, particularly in terms of anxiety levels.
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Affiliation(s)
- Ye Lin
- Department of Ophthalmology, The Second People’s Hospital of Foshan, Foshan, Guangdong Province, People’s Republic of China
| | - Shuke Luo
- Department of Ophthalmology, The Second People’s Hospital of Foshan, Foshan, Guangdong Province, People’s Republic of China
| | - Qiang Lu
- Department of Ophthalmology, The Second People’s Hospital of Foshan, Foshan, Guangdong Province, People’s Republic of China
| | - Xueke Pan
- Department of Ophthalmology, The Second People’s Hospital of Foshan, Foshan, Guangdong Province, People’s Republic of China
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Adhikari SP, Pathak BD, Ghimire B, Baniya S, Joshi P, Kafle P, Adhikari P, Rana A, Regmi L, Dhakal B, Simkhada N, Tandon OP, Pathak ID, Rawal NM. Prevalence of pre-operative anxiety and associated risk factors among patients awaiting elective surgery in a tertiary care hospital. F1000Res 2023; 12:1207. [PMID: 38318155 PMCID: PMC10839854 DOI: 10.12688/f1000research.136320.2] [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] [Accepted: 12/11/2023] [Indexed: 02/07/2024] Open
Abstract
Background Patients undergoing surgery have a fear of anesthesia and surgical procedures that results in anxiety. The global incidence of pre-operative anxiety is estimated at 60-92%. Age, gender, education, marital status, type of family, type of anesthesia and surgery, and history of surgery are the contributing factors. High levels of anxiety during the pre-operative period has negative impacts on surgical outcomes. The main objective of this study was to find out the prevalence of pre-operative anxiety and associated risk factors in a hospital setting of a developing country. Methods This was a single center, analytical, cross-sectional study conducted among the admitted patients scheduled for elective surgeries in a tertiary care hospital. Non-probability convenience sampling was adopted and a total of 205 cases were included. The researchers themselves collected the data on the day before surgery using questionnaires comprised of two parts: semi-structured questionnaires prepared via literature review and Amsterdam Pre-operative Anxiety and Information Scale (APAIS). Data were analyzed in SPSS version 23. Bivariate and multivariate analyses were performed appropriately. Results The prevalence of pre-operative anxiety was 25.85%. The median anaesthesia related, surgery related, and total anxiety scores were 4.00, 5.00 and 9.00 respectively. Likewise, the median score of information desired component scale was 5.00. Different anxiety scores were positively correlated with the information desire component score. The patients living in a nuclear family (adjusted OR, 2.480; 95% CI, 1.272-4.837, p = 0.008) and those without past history of surgery (adjusted OR, 2.451; 95% CI, 1.107-5.424, p = 0.027) had approximately 2.5 times higher risk of having pre-operative anxiety compared to those from a joint family and those having past history of surgery respectively. Those receiving spinal anesthesia had approximately two times lower risk of anxiety (adjusted OR, 0.511; 95% CI, 0.265-0.985, p = 0.045). Conclusions One fourth of the patients had pre-operative anxiety. Type of family, type of anesthesia and past history of surgery were found to be the independent predictors of anxiety.
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Affiliation(s)
- Suman Prasad Adhikari
- Department of Neuropsychiatry, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati province, 10160, Nepal
| | - Bishnu Deep Pathak
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Bhuwan Ghimire
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Sunil Baniya
- Department of Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Lalitpur, Bagmati Province, 26500, Nepal
| | - Prabhas Joshi
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Pooja Kafle
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Prawesh Adhikari
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Aakanksha Rana
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Laxmi Regmi
- Karnali Province Hospital, Birendranagar, Surkhet, 21700, Nepal
| | - Bishal Dhakal
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Nabin Simkhada
- Department of Internal Medicine, Kathmandu University School of Medical Sciences, Kavrepalanchok, Bagmati Province, 45200, Nepal
| | - Om Prakash Tandon
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Indra Dev Pathak
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati Province, 10160, Nepal
| | - Namrata Mahara Rawal
- Department of Neuropsychiatry, Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati province, 10160, Nepal
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Rizzo MG, Costello JP, Luxenburg D, Cohen JL, Alberti N, Kaplan LD. Augmented Reality for Perioperative Anxiety in Patients Undergoing Surgery: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2329310. [PMID: 37589975 PMCID: PMC10436133 DOI: 10.1001/jamanetworkopen.2023.29310] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023] Open
Abstract
Importance Both augmented reality (AR) and virtual reality (VR) have had increasing applications in medicine, including medical training, psychology, physical medicine, rehabilitation, and surgical specialties, such as neurosurgery and orthopedic surgery. There are little data on AR's effect on patients' anxiety and experiences. Objective To determine whether the use of an AR walkthrough effects patient perioperative anxiety. Design, Setting, and Participants This randomized clinical trial was conducted at an outpatient surgery center in 2021 to 2022. All patients undergoing elective orthopedic surgery with the senior author were randomized to the treatment or control group. Analyses were conducted per protocol. Data analysis was performed in November 2022. Intervention AR experience explaining to patients what to expect on their day of surgery and walking them through the surgery space. The control group received the standard educational packet. Main Outcomes and Measures The main outcome was change in State-Trait Anxiety Inventory (STAI) from the screening survey to the preoperative survey. Results A total of 140 patients were eligible, and 45 patients either declined or were excluded. Therefore, 95 patients (63 [66.3%] male; mean [SD] age, 38 [16] years) were recruited for the study and included in the final analysis; 46 patients received the AR intervention, and 49 patients received standard instructions. The AR group experienced a decrease in anxiety from the screening to preoperative survey (mean score change, -2.4 [95% CI, -4.6 to -0.3]), while the standard care group experienced an increase (mean score change, 2.6 [95% CI, 0.2 to 4.9]; P = .01). All patients postoperatively experienced a mean decrease in anxiety score compared with both the screening survey (mean change: AR, -5.4 [95% CI, -7.9 to -2.9]; standard care, -6.9 [95% CI, -11.5 to -2.2]; P = .32) and preoperative survey (mean change: AR, -8.0 [95% CI, -10.3 to -5.7]; standard care, -4.2 [95% CI, -8.6 to 0.2]; P = .19). Of 42 patients in the AR group who completed the postoperative follow-up survey, 30 (71.4%) agreed or strongly agreed that they enjoyed the experience, 29 (69.0%) agreed or strongly agreed that they would recommend the experience, and 28 (66.7%) agreed or strongly agreed that they would use the experience again. No differences were observed in postoperative pain levels or narcotic use. Conclusions and Relevance In this randomized clinical trial, the use of AR decreased preoperative anxiety compared with traditional perioperative education and handouts, but there was no significant effect on postoperative anxiety, pain levels, or narcotic use. These findings suggest that AR may serve as an effective means of decreasing preoperative patient anxiety. Trial Registration ClinicalTrials.gov Identifier: NCT04727697.
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Affiliation(s)
- Michael G. Rizzo
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
| | | | - Dylan Luxenburg
- Miller School of Medicine, University of Miami, Miami, Florida
| | - Jacob L. Cohen
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
| | - Nicolas Alberti
- Center for Computational Science, University of Miami, Miami, Florida
| | - Lee D. Kaplan
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
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Testoni I, Ronconi L, Lampis F, Iacona E, Zammarrelli J, Pompele S, Valle R, Boscolo G, De Leo D. Alternative Means of Informed Consent in Cardiology: Strategies and Effectiveness in a Group of Italian Patients. Behav Sci (Basel) 2023; 13:bs13050430. [PMID: 37232667 DOI: 10.3390/bs13050430] [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: 03/14/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
Informed consent practices in healthcare represent a fundamental element of patient-centred care; however, the traditional use of a written, paper-based description of the medical procedure to obtain informed consent presents many limitations. This research aimed to evaluate the effects of an alternative modality of obtaining informed consent using a brief informative video for patients waiting to undergo a coronary angiography procedure in Italy. The study involved 40 participants-28 males and 12 females (mean age: 68.55, SD = 13.03)-divided equally into two groups: one group received the video-based informed consent and the other received a traditional paper-based form. Each group was asked to fill in two questionnaires; one was created by the researchers to measure the patient's level of understanding of the given information and the perception of usefulness of the informed consent, and the other was the Depression Anxiety Stress Scales-21 (DASS-21), which evaluates levels of anxiety, depression and stress. A comparison of the results of the two groups showed that video-based informed consent allowed participants to better understand the given information, to feel more confident concerning their subjective comprehension of it and to perceive the video-based informed consent as more useful than the traditional one. The video-based informed consent did not lead to higher levels of anxiety, depression or stress among the participants. It can be hypothesized that video-based formats may represent a more useful, understandable and safe alternative to traditional paper-based informed consent in healthcare.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy
- Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
| | - Lucia Ronconi
- IT and Statistical Services, Multifunctional Centre of Psychology, University of Padova, 35122 Padova, Italy
| | - Francesca Lampis
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy
| | - Erika Iacona
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy
- Human Rights Centre Antonio Papisca, University of Padua, 35137 Padova, Italy
| | | | - Sara Pompele
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy
| | - Roberto Valle
- Department of Cardiology, General Hospital, 30015 Chioggia, Italy
| | - Gabriele Boscolo
- Department of Cardiology, General Hospital, 30015 Chioggia, Italy
| | - Diego De Leo
- De Leo Fund, 35137 Padua, Italy
- Slovene Centre for Suicide Research, Primorska University, 6000 Koper, Slovenia
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, QLD 4122, Australia
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Grocott B, Reynolds K, Logan G, Hebbard P, El-Gabalawy R. Breast cancer patient experiences of perioperative distress and anxiety: A qualitative study. Eur J Oncol Nurs 2023; 63:102299. [PMID: 36893576 DOI: 10.1016/j.ejon.2023.102299] [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: 09/27/2022] [Revised: 02/01/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
PURPOSE Distress, often manifesting as anxiety, is common in breast cancer patients and becomes particularly elevated before surgery. This study investigated perspectives of those undergoing breast cancer surgery concerning what enhances and reduces distress and anxiety across the perioperative period (i.e., from diagnostic evaluation to recovery). METHODS The present study conducted qualitative semi-structured individual interviews with 15 adult breast cancer surgery patients within three months post-operation. Quantitative surveys provided background information (e.g., sociodemographics). Individual interviews were analyzed using thematic analysis. Quantitative data were analyzed descriptively. RESULTS Four main themes emerged from qualitative interviews: 1) "fighting an unknown" (sub-themes: uncertainty, health-related knowledge and experience); 2) "the cancer takes away the control" (sub-themes: "living at the whim of others", trusting care providers); 3) person at the centre of the patient (sub-themes: "managing life:" caregiving and work-related stressors, "everybody jumped in to help:" emotional and instrumental support); and 4) physical and emotional impacts of treatment (sub-themes: pain and impacted mobility, "losing a part of yourself"). Breast cancer patients' experiences of surgery-related distress and anxiety were contextualized by broader experiences of care. CONCLUSIONS Our findings illustrate the illness-specific experience of perioperative anxiety and distress in breast cancer patients and inform patient-centered care and intervention.
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Affiliation(s)
- Bronwen Grocott
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Gabrielle Logan
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Pamela Hebbard
- Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; CancerCare Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; CancerCare Manitoba, Canada.
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Aydal P, Uslu Y, Ulus B. The Effect of Preoperative Nursing Visit on Anxiety and Pain Level of Patients After Surgery. J Perianesth Nurs 2023; 38:96-101. [PMID: 35970660 DOI: 10.1016/j.jopan.2022.05.086] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE Preoperative education is an important part of surgical preparation. Nursing visits offer nurses the opportunity to provide personalized care. The aim of this study was to determine the effect of nursing visits before laparoscopic surgery on the anxiety and pain levels of patients in the postoperative period. DESIGN Randomized controlled clinical trial. METHODS Data were collected from 135 patients who underwent laparoscopic surgery between March and October 2019 in Istanbul. During the nursing visits, the experimental group (n = 72) was educated by the operating room nurse, while the control group (n = 63) was educated by the service nurse. Data were collected using the State-Trait Anxiety Inventory and the Visual Analog Scale. The CONSORT checklist was followed. FINDINGS The pre-education state anxiety scores of the control and experimental groups were similar and at a moderate level (P > .05). The state anxiety score of the experimental group visited by operating room nurses decreased more than that of the control group after education (P < .001). The postoperative state anxiety and pain scores of the control and experimental groups were found to be similar (P > .05). CONCLUSIONS Visits by operating room nurses before laparoscopic surgery can be an effective method to reduce the anxiety level of patients. Obtaining the opinions of operating room nurses on care integration and organization of in-service education programs may be necessary.
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Affiliation(s)
- Pınar Aydal
- Acibadem Health Group, Acibadem Altunizade Hospital
| | - Yasemin Uslu
- Istanbul University Nursing Faculty Surgical Nursing Department, Istanbul, Turkey.
| | - Bahire Ulus
- Acibadem Mehmet Ali Aydınlar University, Department of Nursing Retired Lecturer, Istanbul, Turkey
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Relationship between anxiety and internet searches before percutaneous ultrasound-guided diagnostic procedures: A prospective cohort study. PLoS One 2022; 17:e0275200. [PMID: 36194589 PMCID: PMC9531823 DOI: 10.1371/journal.pone.0275200] [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: 08/25/2021] [Accepted: 09/12/2022] [Indexed: 11/19/2022] Open
Abstract
Invasive procedures guided by ultrasound (US) are part of routine medical diagnostic investigation. The lack of knowledge surrounding the technical aspects of such procedures can lead patients to seek complementary information on the Internet, which may in turn trigger anxiety. However, the intersection between the fields of Radiology and Psychology is poorly studied. Here, we identify the profile of an anxious patient before an US-guided intervention. We prospectively studied 133 patients undergoing image-guided procedures. The State-Trait Anxiety Inventory (STAI) was applied for psychometry. Significantly higher anxiety scores were observed in female patients (p = .001), those who believed they had received inadequate information from their referring physician (p = .006), and in patients who considered online information unreliable or difficult to access (p = .007 and p = .001, respectively). Participants who defined themselves as proactive online reported lower anxiety levels (p = .003).
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Septorinoplasti hastalarında perioperatif anksiyete. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2022. [DOI: 10.21673/anadoluklin.1158712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aim: Septorhinoplasty is a frequently performed surgery in otolaryngology clinics. Although perioperative anxiety is considered a normal part of the surgical experience, it has some negative consequences. The aim of this study was to evaluate the perioperative depression, anxiety and postoperative pain scores of the patients that underwent septorhinoplasty.
Methods: A total of 46 patients that underwent septorhinoplasty (SRP) between 2019-2021 years were included in this prospective study. HADS (Hospital anxiety depression scale) was used to measure anxiety and depression scores, and visual analog scale (VAS) was used to measure postoperative pain scores (POP) of the patients.
Results: Preoperative and first postoperative day HADS-A scores were compared and there was a significant decrease between the scores (p=.001). HADS-A and HADS-D scores decreased significantly after internal nasal splints were removed(p
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12
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Animation Supported Consent Before Elective Laparoscopic Cholecystectomy. World J Surg 2022; 46:2350-2354. [PMID: 35763103 PMCID: PMC9244138 DOI: 10.1007/s00268-022-06628-4] [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] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
Background Patient understanding of surgical procedures is often incomplete at the time they are performed, invalidating consent, and exposing healthcare providers to complaints and claims of failure to inform. Remote consultations, language barriers and patient factors can hinder an effective consent pathway. New approaches are needed to support communication and shared decision-making. Methods Multi-language digital animations explaining laparoscopic cholecystectomy were introduced at The Royal London Hospital for patients who attended for elective surgery (www.explainmyprocedure.com/lapchole). Patients completed questionnaires on the day of their procedure both before and after introduction of the animations. We assessed patient-reported understanding of the procedure, its intended benefits, the possible risks, and alternatives to treatment in 72 consecutive patients, 37 before (no animation group) and after 35 after introducing the animations into the consent pathway (animation group). Patient understanding in the two groups was compared. Results The two groups were well matched in respect of age, sex and whether English was their first spoken language. The proportions of patients who reported they completely understood the procedure, its benefits, risks, and alternatives in the no animation group were 54, 57, 38 and 24% and in the animation group, 91, 91, 74 and 77%, respectively; p < 0.01 for each comparison. Conclusion The integration of multi-language laparoscopic cholecystectomy video animations into the patient consent pathway was associated with substantial improvement in reported understanding of the procedure, benefits, risks, and alternatives to treatment. This approach can be applied across all surgical disciplines in a standardised manner in an era of accelerated elective work and remote consultations. Supplementary Information The online version contains supplementary material available at 10.1007/s00268-022-06628-4.
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Applications of three-dimensional surgical planning in facial feminization surgery: A systematic review. J Plast Reconstr Aesthet Surg 2022; 75:e1-e14. [PMID: 35400593 DOI: 10.1016/j.bjps.2022.02.073] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/22/2022] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite some reports that have shown an increase in safety, efficiency, and accuracy during feminizing craniofacial procedures utilizing three-dimensional (3D) technology, there are no reports summarizing the available evidence on this matter for facial feminization surgery (FFS). Here, we aimed to systematically review the application of 3D technology on FFS. METHODS We conducted a comprehensive search across PubMed, SCOPUS, Ovid MEDLINE®, Web of Science, and ScienceDirect looking for studies reporting the use of 3D surgical planning in the setting of FFS following the PRISMA guidelines. We extracted data on photographic assessment, imaging, surgical application, and surgical technique and outcomes. RESULTS This review included 10 studies comprising 1473 transgender female patients and 50 cadaveric cranial specimens. Four studies employed virtual surgical planning (VSP) and the concomitant use of prefabricated cutting guides. One study reported the implementation of 3D VSP using a female skull as a reference. One study used computer-aided design cutting guides and custom plates for FFS. Standardized incorporation of 3D printed models allowed for preoperative planning in three studies. Three studies reported VSP using 3D reconstruction of CT images, but without the use of 3D printing. Three studies used 3D photography with specialized camera technology to enrich clinical documentation and provide a comprehensive facial analysis of soft tissue. Accuracy ranged from 85.7% to 97%. Morbidity ranged from 0% to 12.5%. CONCLUSION Based on this data, we believe 3D VSP has promising outcomes in terms of accuracy and low morbidity, encouraging its implementation in FFS. However, further prospective double-arm cohort studies are required.
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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
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15
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Touil N, Pavlopoulou A, Momeni M, Van Pee B, Barbier O, Sermeus L, Roelants F. Evaluation of virtual reality combining music and a hypnosis session to reduce anxiety before hand surgery under axillary plexus block: A prospective study. Int J Clin Pract 2021; 75:e15008. [PMID: 34811860 DOI: 10.1111/ijcp.15008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/04/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS Preoperative anxiety, which can affect postoperative recovery, is often present in patients undergoing surgery under loco-regional anaesthesia (LRA). Minimising preoperative anxiety with premedication can be effective but results in drug-related side effects. Therefore, the use of non-pharmacological techniques should be encouraged. METHODS We evaluated whether a virtual reality (VR) incorporating music and a hypnosis session, provided during the performance of LRA, can reduce preoperative anxiety. Fifty patients scheduled for elective hand surgery under an axillary plexus block were enrolled (March-June 2019). The primary outcome measure was the change in the Amsterdam Anxiety and Preoperative Information Scale (APAIS) questionnaire 5 min after the VR session as compared to before the VR session. The secondary outcome measures were the visual analog scale (VAS) for anxiety before and 2 h after the surgery and the Evaluation du Vécu de l'ANesthésie-LocoRégionale (EVAN-LR) satisfaction score. RESULTS Data from 48 patients were analysed. The APAIS score as well as VAS for anxiety were significantly reduced after a VR session (p < .001 for both scores). Patients were very satisfied (EVAN-LR: 92 (88, 94)). CONCLUSIONS The use of VR incorporating music and a hypnosis session could be an effective tool in the management of a patient's preoperative anxiety during the performance of an axillary plexus block.
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Affiliation(s)
- Nassim Touil
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Athanasia Pavlopoulou
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Mona Momeni
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Benoît Van Pee
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Olivier Barbier
- Department of Surgery, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Luc Sermeus
- Department of Surgery, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Fabienne Roelants
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
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Heylen J, Antoniou V, Roberts J, Kemp O, Morris J, Vats A. Assessing the quality of consent in elective hip and knee arthroplasty: Do modern orthopaedic surgeons make the cut? J Clin Orthop Trauma 2021; 22:101604. [PMID: 34722146 PMCID: PMC8531839 DOI: 10.1016/j.jcot.2021.101604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Improper consent is a failure of clinical care and also a major cause of litigation within health care authorities. 4% of surgical negligence claims are attributed to improper consenting in the NHS, with an average settlement fee of approximately £40,000 per claim. Improving quality of consenting therefore not only improves patient care but could also reduce healthcare cost. METHOD A retrospective analysis of 100 elective hip and knee arthroplasties at a district general hospital in the South of England. Clinic letters and consent forms were reviewed, using the British Orthopaedic Association (BOA) consent proforma as a comparison standard. Quality of consent was reviewed based upon inclusion of BOA suggested risks. RESULTS 40% of hip arthroplasty clinic letters and 20% of knee arthroplasty clinic letters did not include a risk discussion. Common risks on consent forms when compared to BOA standards were 84.8% compliant in knees and 88.8% in hips. Less common risks on consent forms were 100% compliant in knees and 96% in hips. Rare risks on consent forms were 74.8% compliant in knees and 57.7% in hips. Notably blood clots and infection were consented for in almost all patients. Risk of death meanwhile, was only consented for 62% of the time, across both procedures. CONCLUSION Standard of consenting in this audit falls short of BOA standards. Improvement is needed to improve patient care and avoid medical litigation. An integrated electronic form linking consent process of both outpatient and pre-operative review could be a beneficial intervention.
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Affiliation(s)
| | - Vaki Antoniou
- University Hospital Southampton NHS Trust, Southampton, UK
| | | | - Oliver Kemp
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Amit Vats
- Ashford and St Peter's Hospital's, Chertsey, UK
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Prehabilitation to improve postoperative outcomes in patients with peritoneal carcinomatosis undergoing hyperthermic intraperitoneal chemotherapy (HIPEC): A scoping review. Eur J Surg Oncol 2021; 48:657-665. [PMID: 34702591 DOI: 10.1016/j.ejso.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 09/23/2021] [Accepted: 10/12/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) leads to increased survival rates in patients with peritoneal carcinomatosis, but is associated with considerable morbidity and mortality rates. Prehabilitation, a process to optimize a patient's preoperative functional capacity, has a positive impact on recovery after colorectal surgery. The impact of prehabilitation in patients undergoing HIPEC is scarcely investigated. This scoping review and narrative synthesis aims to summarize and evaluate what is currently reported about the effect of prehabilitation on postoperative outcomes after HIPEC. METHODS A literature search of studies reporting on the effect of prehabilitation on outcomes after HIPEC was performed (August 2020). Study characteristics, patient demographics, composition of prehabilitation programs, and reported outcomes used to quantify the effect of prehabilitation were recorded. RESULTS The literature search did not yield any studies on the effect of prehabilitation programs on outcomes after HIPEC. As an alternative, studies identifying modifiable risk factors for poor postoperative outcomes after HIPEC that can be targeted by prehabilitation were reviewed to evaluate starting points for prehabilitation. Fourteen studies identify the following preoperative factors: poor nutritional status, poor performance status, low health related quality of life and an history of smoking. CONCLUSION No research has been published on the effect of prehabilitation prior to HIPEC. This review demonstrates that preoperative modifiable risk factors for outcomes in patients undergoing HIPEC are multifactorial. A multimodal prehabilitation program prior to HIPEC, including nutritional support, psychical exercise, psychological support and smoking cessation, might therefore be a promising approach to improve postoperative outcomes.
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Assessment of a digital game as a neuropsychological test for postoperative cognitive dysfunction. Braz J Anesthesiol 2021; 72:7-12. [PMID: 34332955 PMCID: PMC9373221 DOI: 10.1016/j.bjane.2021.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/07/2021] [Accepted: 06/20/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Postoperative cognitive dysfunction may result from worsening in a condition of previous impairment. It causes greater difficulty in recovery, longer hospital stays, and consequent delay in returning to work activities. Digital games have a potential neuromodulatory and rehabilitation effect. In this study, a digital game was used as a neuropsychological test to assess postoperative cognitive dysfunction, with preoperative patient performance as control. METHODS It was a non-controlled study, with patients selected among candidates for elective non-cardiac surgery, evaluated in the pre- and postoperative periods. The digital game used has six phases developed to evaluate selective attention, alternating attention, visuoperception, inhibitory control, short-term memory, and long-term memory. The digital game takes about 25 minutes. Scores are the sum of correct answers in each cognitive domain. Statistical analysis compared these cognitive functions pre- and post-surgery using a generalized linear mixed model (ANCOVA). RESULTS Sixty patients were evaluated, 40% male and 60% female, with a mean age of 52.7 ± 13.5 years. Except for visuoperception, a reduction in post-surgery scores was found in all phases of the digital game. CONCLUSION The digital game was able to detect decline in several cognitive functions postoperatively. As its completion is faster than in conventional tests on paper, this digital game may be a potentially recommended tool for assessing patients, especially the elderly and in the early postoperative period.
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19
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Ebrahimi A, Eslami J, Darvishi I, Momeni K, Akbarzadeh M. An overview of the comparison of inhalation aromatherapy on emotional distress of female and male patients in preoperative period. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:111-119. [PMID: 33984876 DOI: 10.1515/jcim-2020-0464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/02/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Many patients experience anxiety and stress before surgery. Anxiety is also different in men and women so that the prevalence of anxiety disorders in women is higher than men. The present study aimed to compare the effect of inhalation aromatherapy on emotional distress of men and women before surgery. METHODS This study conducted as a randomized, single blind, placebo-controlled, prospective and clinical trial. It was performed in hospitals affiliated to Shiraz University of Medical Sciences. 90 patients were selected as candidates for surgery and were divided into two intervention groups and one control group. Patients completed the State-Trait Anxiety Inventory questionnaire before the intervention. Patients completed the State-Trait Anxiety Inventory questionnaire (STAI) after 20 min of intervention. Then the data were analyzed using SPSS software, version 16. The significance level in all testes was set at <0.05. RESULTS Relatively severe anxiety was not observed in men after intervention with lavender and spring orange. In women, relatively severe anxiety was not observed after the intervention with lavender, but in the spring orange group, only in 6.7% of people, relatively severe anxiety and traits were observed, which has decreased compared to before the intervention. In addition, the severity of anxiety in women in the control group increased after placebo intervention (p<0.05). CONCLUSIONS The results showed that inhalation of Citrus aurantium and lavender aroma reduces anxiety in male and female patients.
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Affiliation(s)
- Abed Ebrahimi
- Department of Operating Room, Faculty of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Jamshid Eslami
- Department of Anaesthesia and Surgical Technologists, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University Medical Sciences, Shiraz, Iran
| | - Isan Darvishi
- Department of Operating Room, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Khadijeh Momeni
- Department of Operating Room, Faculty of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Marzieh Akbarzadeh
- Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Abstract
BACKGROUND Since the WHO release of the Safe Surgery Saves Lives Program in 2008, peri-operative checklists minimise errors and improve patient safety worldwide. Anaesthesia professionals are often reluctant to use these checklists in front of patients because they fear causing patients' discomfort before anaesthesia and surgery. OBJECTIVE To assess and compare the subjective level of patient discomfort caused by the use of pre-induction checklists with the patient discomfort estimated by anaesthesia providers. DESIGN Prospective observational study. SETTING The current single-centre trial included 110 anaesthesia providers and 125 nonpremedicated ear, nose and throat or maxillofacial surgery patients in Switzerland from June to August 2016. Inclusion criterion: signed general research consent. EXCLUSION CRITERIA received premedication, less than 18 years old, day-care patients, dementia or other mental illnesses. INTERVENTIONS Anaesthesia healthcare providers and patients before surgery and on the first postoperative day were asked to rate three statements: MAIN OUTCOME MEASURES: All statements were rated on a 100-mm visual analogue scale, where 0 meant no agreement and 100 meant total agreement. RESULTS Patients overwhelmingly agreed that anaesthesia providers should use checklists in front of them. Anaesthesia providers rated the patient discomfort much higher than actually perceived by patients. Both, patients and anaesthesia providers rated the possibility of reducing the risk of errors high. CONCLUSION Patients experience far less discomfort observing the use of pre-induction checklists than anaesthesia providers expect. Patients value the potential safety benefit significantly higher than anaesthesia providers. These results further support the implementation of peri-operative checklists in the operating room environment. TRIAL REGISTRATION The current observational study had no intervention, therefore, was not registered.
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UYMAZ G, KARABAĞ AYDIN A. Ameliyat öncesi anksiyete ile gastrointestinal sistem belirtileri arasındaki ilişki. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.782561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Conway RM, White GZ, Thottam PJ. The burden of laryngomalacia and its effects on caregivers: A support group survey evaluation. Int J Pediatr Otorhinolaryngol 2020; 138:110368. [PMID: 33152962 DOI: 10.1016/j.ijporl.2020.110368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate which factors may affect anxiety and child's health perception of parents with children that have laryngomalacia. STUDY DESIGN Survey Study. SETTING "Coping with Laryngomalacia" - largest online laryngomalacia support group for parents with children who have laryngomalacia. SUBJECTS and Methods: A survey was sent to support group member that gathered information regarding the patient's diagnosis and associated course of treatment and evaluated for parental anxiety and perceived health of their child. Analysis was performed to evaluate which variables are associated with increased parental anxiety and worsened perceived child's health. RESULTS Data was gathered on 434 patients. All caregivers reported some level of anxiety due to the diagnosis and 64% felt completely anxious. Parents who saw an increased number of physicians prior to a pediatric ENT rated their child with poorer health (p < .05). Those that felt their concerns were brushed off initially reported increased anxiety (p < .05). If the child was admitted to the hospital, ICU, required intubation, had feeding troubles, required a feeding tube, or underwent pH monitoring, the patient was rated to have poorer health per the parents (p < .05). CONCLUSION Laryngomalacia causes a significant burden on patients and their families due to the eating problems, feeding problems, hospital stay, and other various conditions associated with the disease. Caregivers should take a more modern and compassionate approach to management and diagnosis.
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Affiliation(s)
- Robert M Conway
- Ascension Macomb-Oakland Hospital, Otolaryngology - Head & Neck Surgery, Madison Heights, M, USA
| | - Gary Z White
- Ascension Borgess Hospital, Otolaryngology - Head & Neck Surgery, Kalamazoo, MI, USA
| | - Prasad John Thottam
- Beaumont Children's Hospital - Pediatric Otolaryngology, Royal Oak, MI, USA.
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O'Connor K, La Bruno D, Rudderow J, Cannaday S, Yeo CJ, Yeo TP. Preparedness for Surgery: Analyzing a Quality Improvement Project in a Population of Patients Undergoing Hepato-Pancreatico-Biliary Surgery. Clin J Oncol Nurs 2020; 24:E65-E70. [PMID: 32945797 DOI: 10.1188/20.cjon.e65-e70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Approximately 20% of patients diagnosed with pancreatic cancer will be eligible for hepato-pancreatico-biliary (HPB) surgery. Studies indicate that high-quality patient education is pivotal in reducing anxiety, improving clinical and performance outcomes, and increasing patient satisfaction. OBJECTIVES This quality improvement project sought to determine the perceived level of preparedness for patients undergoing HPB surgery and to identify information and knowledge gaps in preoperative education. METHODS Convenience sampling was used to collect postoperative information via questionnaire from 50 patients regarding areas of importance. FINDINGS Preoperative information gaps for patient and family education were identified. Improving preparedness for HPB surgery has the potential to improve clinical outcomes, increase quality and patient satisfaction, decrease length of stay, and reduce time to adjuvant therapy.
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Hladkowicz E, Yachnin D, Boland L, Wilson K, McKinnon A, Hawrysh K, Hawrysh T, Bell C, Atkinson K, van Walraven C, Taljaard M, Thavorn K, Stacey D, Yang H, Pysyk C, Moloo H, Manuel D, MacDonald D, Lavallée LT, Gagne S, Forster AJ, Bryson GL, McIsaac DI. Evaluation of a preoperative personalized risk communication tool: a prospective before-and-after study. Can J Anaesth 2020; 67:1749-1760. [PMID: 32929659 DOI: 10.1007/s12630-020-01809-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Patients want personalized information before surgery; most do not receive personalized risk estimates. Inadequate information contributes to poor experience and medicolegal complaints. We hypothesized that exposure to the Personalized Risk Evaluation and Decision Making in Preoperative Clinical Assessment (PREDICT) app, a personalized risk communication tool, would improve patient knowledge and satisfaction after anesthesiology consultations compared with standard care. METHODS We conducted a prospective clinical study (before-after design) and used patient-reported data to calculate personalized risks of morbidity, mortality, and expected length of stay using a locally calibrated National Surgical Quality Improvement Program risk calculator embedded in the PREDICT app. In the standard care (before) phase, the application's materials and output were not available to participants; in the PREDICT app (after) phase, personalized risks were communicated. Our primary outcome was knowledge score after the anesthesiology consultation. Secondary outcomes included patient satisfaction, anxiety, feasibility, and acceptability. RESULTS We included 183 participants (90 before; 93 after). Compared with standard care phase, the PREDICT app phase had higher post-consultation: knowledge of risks (14.3% higher; 95% confidence interval [CI], 6.5 to 22.0; P < 0.001) and satisfaction (0.8 points; 95% CI, 0.1 to 1.4; P = 0.03). Anxiety was unchanged (- 1.9%; 95% CI, - 4.2 to 0.5; P = 0.13). Acceptability was high for patients and anesthesiologists. CONCLUSION Exposure to a patient-facing, personalized risk communication app improved knowledge of personalized risk and increased satisfaction for adults before elective inpatient surgery. TRIAL REGISTRATION www.clinicaltrials.gov (NCT03422133); registered 5 February 2018.
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Affiliation(s)
- Emily Hladkowicz
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,School of Rehabilitation Therapy, Queens' University, Kingston, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - David Yachnin
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Laura Boland
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Health Studies, Western University, London, ON, Canada
| | - Kumanan Wilson
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
| | | | | | | | - Cameron Bell
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Katherine Atkinson
- Department of Public Health Science, Karolinska Institute, Solna, Sweden
| | - Carl van Walraven
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Monica Taljaard
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Dawn Stacey
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Homer Yang
- Department of Anesthesia and Perioperative Medicine, Western University, London, ON, Canada
| | - Christopher Pysyk
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Husein Moloo
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Departments of Surgery, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
| | - Doug Manuel
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada
| | - David MacDonald
- Department of Anesthesiology, Dalhousie University, Halifax, NS, Canada
| | - Luke T Lavallée
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Departments of Surgery, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
| | - Sylvain Gagne
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Alan J Forster
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Gregory L Bryson
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Daniel I McIsaac
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada. .,Ottawa Hospital Research Institute, Ottawa, ON, Canada. .,School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada. .,Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
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Hartlief GA, Niemeijer AS, Lamberts KF, Nieuwenhuis MK. The impact of early information concerning the surgical operations on anxiety in patients with burns. Burns 2020; 47:847-853. [PMID: 32978010 DOI: 10.1016/j.burns.2020.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/10/2020] [Accepted: 08/28/2020] [Indexed: 11/18/2022]
Abstract
AIMS Stress has been linked to poor coping with health-related issues, poor adaptation, a decrease of quality of life, poor recovery and poor wound healing. Therefore, it is important to address patients' uncertainty and feelings of anxiety. The aim of this study was to examine the effect of providing early treatment information based on an LDI-scan to patients with burns on their feelings of anxiety. DESIGN An observational prospective pre-test post-test study. METHODS Patients with intermediate burns (n = 59) admitted to our burn centre in 2016 were evaluated for anxiety using a visual analogue scale (VAS-A) before and after an LDI-scan was made. Two groups were compared: a group that heard whether surgery would or would not be recommended for wound closure (certain group) versus a group that heard to wait and see whether an operation was determined to be helpful (uncertain group). RESULTS Before the LDI-scan was made, both groups showed clinically high levels of anxiety (median VAS scores above 5). After the information gathered with the LDI was discussed with the patient, anxiety dropped significantly (median VAS below 3; p = .001). No significant differences between the groups were observed (p > .05). CONCLUSION In contrast to other studies, anxiety was significantly reduced in all our study groups after information was shared. Early communication of knowledge by health care professionals is important regardless whether it includes treatment uncertainty.
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Affiliation(s)
- Gera A Hartlief
- Martini Hospital, Burn Centre, P.O. Box 30.033, 9700 RM Groningen, The Netherlands.
| | - Anuschka S Niemeijer
- Martini Hospital, Burn Centre, P.O. Box 30.033, 9700 RM Groningen, The Netherlands; Association of Dutch Burn Centres, Martini Hospital, Burn Centre, P.O. Box 30.033, 9700 RM Groningen, The Netherlands; Martini Hospital, Scientific Institute, P.O. Box 30.033, 9700 RM Groningen, The Netherlands
| | - Kirsten F Lamberts
- Martini Hospital, Burn Centre, P.O. Box 30.033, 9700 RM Groningen, The Netherlands
| | - Marianne K Nieuwenhuis
- Martini Hospital, Burn Centre, P.O. Box 30.033, 9700 RM Groningen, The Netherlands; Association of Dutch Burn Centres, Martini Hospital, Burn Centre, P.O. Box 30.033, 9700 RM Groningen, The Netherlands
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Alsabban W, Alhadithi A, Alhumaidi FS, Al Khudhair AM, Altheeb S, Badri AS. Assessing needs of patients and families during the perioperative period at King Abdullah Medical City. Perioper Med (Lond) 2020; 9:10. [PMID: 32280457 PMCID: PMC7137296 DOI: 10.1186/s13741-020-00141-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background This paper explores elective surgery patients' and family members' needs during the perioperative period, in a specialized hospital in Saudi Arabia. Needs are influenced by context and could differ from a setting to another. Methods Two questionnaires, one for the patient group and the other for the family member group, were adopted from a previous similar study. The participants were asked to rate the importance of each need and how much it was satisfied. Data were collected in 5 weeks. Descriptive statistics were used to determine the average rate and standard deviation of each item. Results Patients highly rated the need for adequate symptom management in the recovery area. Family members highly rated the importance of being informed if the surgical procedure is taking more time than expected and communicating with the surgeon after the procedure. Conclusion Systematically involving the family member in the perioperative care of the patient is advantageous. However, interventions and extent of involvement of the family member to the care of the patient would have to be adapted according to the cultural context.
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Affiliation(s)
- Wid Alsabban
- 1Perioperative Medicine Administration, King Abdullah Medical City-Makkah, Makkah, Saudi Arabia
| | - Ahmed Alhadithi
- 2College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | - Saeed Altheeb
- 2College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Saad Badri
- 3College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia
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Osseous Transformation with Facial Feminization Surgery: Improved Anatomical Accuracy with Virtual Planning. Plast Reconstr Surg 2020; 144:1159-1168. [PMID: 31397786 DOI: 10.1097/prs.0000000000006166] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Facial feminization surgery entails a series of surgical procedures that help the transwoman pass as their affirmed gender. Although virtual surgical planning, with intraoperative cutting guides, and custom plates have been shown to be helpful for craniomaxillofacial reconstruction, they have not yet been studied for facial feminization surgery. The authors used cadaveric analysis for morphologic typing and to demonstrate the utility of virtual surgical planning in facial feminization surgery procedures. METHODS Male cadaveric heads underwent morphologic typing analysis of the frontal brow, lateral brow, mandibular angle, and chin regions (n = 50). Subsequently, the cadavers were split into two groups: (1) virtual surgical planning intraoperative cutting guides and (2) no preoperative planning. Both groups underwent (1) anterior frontal sinus wall setback, (2) lateral supraorbital recontouring, (3) mandibular angle reduction, and (4) osseous genioplasty narrowing. Efficiency (measured as operative time), safety (determined by dural or nerve injury), and accuracy (scored with three-dimensional computed tomographic preoperative plan versus postoperative result) were compared between groups, with significance being p < 0.05. RESULTS For frontal brow and lateral lower face, morphologic type 3 (severe) predominated; for lateral brow and chin, type 2 (moderate) predominated. For frontal sinus wall setback, virtual surgical planning improved efficiency (19 minutes versus 44 minutes; p < 0.05), safety (100 percent versus 88 percent; p < 0.05; less intracranial entry), and accuracy (97 percent versus 79 percent; p < 0.05) compared with no preoperative planning. For mandibular angle reduction, virtual surgical planning improved safety (100 percent versus 88 percent; p < 0.05; less inferior alveolar nerve injury) and accuracy (95 percent versus 58 percent; p < 0.05). CONCLUSIONS Preoperative planning for facial feminization surgery is helpful to determine morphologic typing. Virtual surgical planning with the use of cutting guides/custom plates improved efficiency, safety, and accuracy when performing four key craniofacial techniques for facial feminization.
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Jiwanmall M, Jiwanmall SA, Williams A, Kamakshi S, Sugirtharaj L, Poornima K, Jacob KS. Preoperative Anxiety in Adult Patients Undergoing Day Care Surgery: Prevalence and Associated Factors. Indian J Psychol Med 2020; 42:87-92. [PMID: 31997870 PMCID: PMC6970311 DOI: 10.4103/ijpsym.ijpsym_180_19] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/01/2019] [Accepted: 08/04/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND There is a paucity of data related to anxiety levels in patients undergoing day care surgery in India. METHODS Preoperative anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS) 1 day before surgery and on the day of surgery, and the patients were categorized as cases (APAIS score ≥13) and controls (APAIS score <13). Sociodemographic characteristics, clinical features, and fears associated with anesthesia and surgery were also noted. RESULTS Out of the 399 patients recruited, 58.1% experienced significant preoperative anxiety. The fear of needles (P = 0.002), fear of waking up during the surgery (P < 0.001), and the patient's need of additional information regarding anesthesia and surgery (P < 0.001) were significantly associated with preoperative anxiety. CONCLUSION A significant proportion of patients scheduled for day care surgery have preoperative anxiety. A preanesthetic workup of a patient with adequate clarification about their doubts and fears related to anesthesia and surgery is recommended to bring down the level of anxiety.
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Affiliation(s)
- Meghna Jiwanmall
- Department of Anaesthesiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Stephen A Jiwanmall
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Aparna Williams
- Department of Anaesthesiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - S Kamakshi
- Department of Nursing, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lovisal Sugirtharaj
- Department of Nursing, Christian Medical College, Vellore, Tamil Nadu, India
| | - K Poornima
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
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Cetkin HE, Tuna A. How Does Health Education Given to Lung Cancer Patients Before Thoracotomy Affect Pain, Anxiety, and Respiratory Functions? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:966-972. [PMID: 30022377 DOI: 10.1007/s13187-018-1401-1] [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] [Indexed: 06/08/2023]
Abstract
In this study, it was aimed to determine how the postoperative pain level, state-trait anxiety level, and respiratory function were affected by the health education given through a patient education booklet to patients with lung cancer, in comparison with control group, before pulmonary resection through thoracotomy. The 60 patients (n = 60) having pulmonary resection indication because of lung cancer were recruited in the present study. The patients were separated as control (n = 30) and experimental groups (n = 30). The patient education was applied to patients in the experimental groups via the education booklet 24 h before the surgery. Patients in the control groups received only usual clinical nursing information. The pain was evaluated via visual analog scale (VAS). The State-Trait Anxiety Scale (STAS) was used for evaluating the anxiety level. The evaluated pulmonary functions were peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and forced expiratory flow 25-75 (FEF25-75). The pain level of the experimental group was statistically lower than control group (p < 0.05). The state anxiety level of experimental group received education was statistically lower than control group (p < 0.05). There was no any statistical difference in trait anxiety levels between control and experimental groups (p > 0.05). The FEV1 and FEF25-75 values in experimental group were statistically higher than control group. A planned health education applied via the thoracotomy patient education booklet has a positive effect on clinical recovery process by affecting postoperative pain, state anxiety, and FEV1 and FEF25-75 values.
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Affiliation(s)
- Hatice Esra Cetkin
- Department of Nursing, Institute of Health Science, Sanko University, İncilipınar Mah., Gazi Muhtar Pasa Bulv. No:36, 27090, Şehitkamil, Gaziantep, Turkey.
| | - Arzu Tuna
- Department of Nursing, Institute of Health Science, Sanko University, İncilipınar Mah., Gazi Muhtar Pasa Bulv. No:36, 27090, Şehitkamil, Gaziantep, Turkey
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Abstract
BACKGROUND Spine surgery patients have difficulty comprehending the patient education aimed at preparing for surgery. PURPOSE To assess the effect of a specific preoperative education approach (Knowledge Test Feedback Intervention, KTFI) on patients' verbal and visual understanding of their surgery. METHODS In this randomized controlled trial, the intervention group (n = 50) went through the KTFI and routine education, whereas the control group (n = 50) received only routine patient education. Written description of the surgical procedure and drawing of incision were used as outcome measures at baseline, at hospitalization, at discharge, and 3 and 6 months after surgery. RESULTS At baseline, half of the participants showed verbal and visual understanding of their surgery. During follow-up, understanding improved significantly with no statistically significant differences between the groups. CONCLUSION Spinal stenosis patients' understanding of their surgical procedure is imperfect. Patient educators need to ensure patient learning by evaluating comprehension outcomes.
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Prado-Olivares J, Chover-Sierra E. Preoperatory Anxiety in Patients Undergoing Cardiac Surgery. Diseases 2019; 7:E46. [PMID: 31248177 PMCID: PMC6631781 DOI: 10.3390/diseases7020046] [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: 05/12/2019] [Revised: 06/10/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
Anxiety is a feeling of discomfort produced in face of an unknown event, as an impending cardiac surgery, that can lead to inconveniences in the intervention and subsequent recovery. Being the purpose of this research to analyze pre-surgical anxiety, a descriptive cross-sectional study among patients undergoing cardiac surgery was carried out. Data about sociodemographic variables were collected and the level of anxiety prior to surgery was assessed using the STAI-S scale. Subsequently, descriptive data analyses were performed, relationships among variables were analyzed, and a binary logistic regression model was developed in order to analyze the role of the variables involved in the development of preoperative anxiety. Sixty subjects were finally included; more than 80% had a moderate to high level of anxiety. 26.7% underwent valve surgery and 47% underwent coronary artery bypass graft (CABG) surgery, in the latter case presenting higher levels of anxiety. Statistically significant relationships were found among the level of anxiety and (a) level of studies, (b) first surgical intervention, and (c) the rating given to their previous surgical experience. We concluded that preoperative anxiety in people undergoing cardiac surgery is high and yet it is an underestimated phenomenon. The relationship between the received information and their anxiety level is inversely proportional, so that people programmed for cardiac surgery should be provided with all the information they required, through an individualized intervention.
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Affiliation(s)
- José Prado-Olivares
- Internal Medicine Unit. Hospital Universitario de Mostoles, 28935 Madrid, Spain.
| | - Elena Chover-Sierra
- Nursing Department, Facultat d'infermeria i podologia, 46001 Valencia, Spain.
- Internal Medicine Unit. Hospital General Universitario, 46014 Valencia, Spain.
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Günübirlik Cerrahide Hastaların Ameliyat Sonrasına İlişkin Endişelerinin İncelenmesi. JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/gopctd.478417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
STUDY DESIGN This is a cross-sectional study. OBJECTIVE To investigate spine surgeons' attitudes regarding preoperative anxiety measurement, management, and responsibility. SUMMARY OF BACKGROUND DATA The vast majority of patients scheduled for spine surgery experience preoperative anxiety. However, there are currently no consensus guidelines for measure or management of preoperative anxiety in spinal operations. MATERIALS AND METHODS An anonymous questionnaire was sent online to spine surgeons of AO Spine North America to capture their views regarding preoperative anxiety. RESULTS Of 69 complete responses, most respondents were male (n=66, 95.7%), orthopedic surgeons (n=52, 75.4%), and practicing at an academic setting (n=39, 56.5%). Most spine surgeons practiced for at least 20 years (n=52, 75.4%), operated on 100-300 patients per year (n=48, 69.6%), and were attending physicians (n=61, 88.4%). Most did not measure preoperative anxiety (n=46, 66.7%) and would not use a rating scale to measure it (n=38, 55.1%). However, most would discuss it if mentioned by the patient (n=40, 58.0%). Other spine surgeons measured anxiety verbally (n=22, 31.9%) or with a rating scale or survey (n=6, 8.7%). Although preferences for preoperative anxiety management varied, most respondents used patient education (n=54, 78.3%) and permitting family members' presence (n=36, 52.2%) to reduce patient anxieties. Spine surgeons held themselves, anesthesiologists, and patients most responsible to manage preoperative anxiety. CONCLUSIONS The majority of spine surgeons surveyed did not regularly measure preoperative anxiety, but would discuss its management if the subject was broached by the patient. Spine surgeons relied on a variety of methods to manage a patient's anxiety, but most preferred preoperative education and permitting the presence of family members. Responsibility for controlling preoperative anxiety was chiefly allocated to surgeons, anesthesiologists, and patients. Future avenues for research may include developing a preoperative anxiety measurement scale and management protocol specific to spine surgery. LEVEL OF EVIDENCE Level IV.
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Mulugeta H, Ayana M, Sintayehu M, Dessie G, Zewdu T. Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia. BMC Anesthesiol 2018; 18:155. [PMID: 30376809 PMCID: PMC6208029 DOI: 10.1186/s12871-018-0619-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 10/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety during the preoperative period is the most common problem with a number of postoperative complications such as an increase in postoperative pain, delay of healing and prolong the hospital stay. Further, patients with a high level of preoperative anxiety require higher doses of anesthetic agents and recover poorly. Despite its serious health complications, its magnitude and associated factors have been poorly explored in Ethiopia particularly in the selected study areas. OBJECTIVE To assess preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot Referral Hospitals, Northwest Ethiopia. METHOD An institution based cross-sectional study was conducted on 353 patients scheduled for surgery using a systematic random sampling technique. The data were collected using the state version of the state-trait anxiety inventory scale. All collected data were entered into Epi-Data version 3.1 and analysis was done by using SPSS version 20 software. Binary logistic regression was performed to assess the effect of independent variables on the dependent variable. A p-value < 0.05 was considered as statistically significant. RESULTS Overall, 61% (95%CI (55.5-65.7)) patients had significant high level of preoperative anxiety. The most common reported factor responsible for preoperative anxiety was fear of complications 187(52.4%). There was a statistically significant high level of pre-operative anxiety among female patients [AOR 2.19 (95%CI (1.29-3.71))] and patients who lack preoperative information [AOR 2.03(95%CI (1.22-3.39))]. CONCLUSION The prevalence of preoperative anxiety was high. The level of preoperative anxiety significantly associated with sex, preoperative information provision, and previous surgical experience. Preoperative psychosocial assessment should be incorporated into a routine nursing practice and every patient should be provided with preoperative information before surgery.
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Affiliation(s)
- Henok Mulugeta
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Mulatu Ayana
- Department of Public Health, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Mezinew Sintayehu
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Getenet Dessie
- Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Tesfu Zewdu
- Department of Nursing, College of Health Science, Assosa University, P.O. Box 18, Assosa, Ethiopia
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Bakhsha F, Halakou S, Jafari SY, Yousefi Z, Aryaee M. Relationship between knowledge toward anesthesia and Fear of anesthesia in the patients and their Companions in Teaching Hospitals of Golestan University of Medical Sciences , 2017. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2018. [DOI: 10.29252/jgbfnm.15.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Collette AM, Spies C, Eckardt R, Wernecke KD, Schmidt M. Patient Empowerment Reduces Pain in Geriatric Patients After Gynecologic Onco-Surgery: Subgroup Analysis of a Prospective Randomized Controlled Clinical Trial. J Perianesth Nurs 2018; 33:281-289. [PMID: 29784257 DOI: 10.1016/j.jopan.2016.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/21/2016] [Accepted: 10/29/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE This study aimed to determine the effect of patient empowerment on acute postoperative pain. This research was part of the Patient Empowerment and Risk-Assessed Treatment to Improve Outcome in the Elderly After Onco-Surgery Trial. DESIGN This research was a prospective randomized controlled interventional study. METHODS Patients who underwent gynecologic onco-surgery were included in this analysis of demographic data, basic characteristics, pain intensity by numeric rating scale, and mode of pain therapy. The intervention included provision of detailed information booklet and patient diary. FINDINGS Ninety-one patients were enrolled (treatment group, n = 51; control group, n = 40). With the same medications, pain on the first postoperative day was significantly less severe in the treatment group than in the control group (P = .03). On multivariate logistic regression, patient empowerment had a significant effect on pain intensity (odds ratio, 3.46; 95% confidence interval, 1.35 to 8.86; P = .01). The number needed to treat to decrease pain from severe to mild (numeric rating scale, 5 to 10 to 0 to 4) was 4.35. CONCLUSIONS Patient empowerment significantly reduces postoperative pain in elderly patients undergoing gynecologic cancer surgery.
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Tulloch I, Rubin JS. Assessment and Management of Preoperative Anxiety. J Voice 2018; 33:691-696. [PMID: 29753446 DOI: 10.1016/j.jvoice.2018.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/13/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Preoperative anxiety has the potential to alter the dynamics of an elective procedure and has been shown to detrimentally affect patients both cognitively and physiologically. If mismanaged, it can lead to essential procedures being postponed or canceled, delay postoperative recovery, and increase patients' requirements for medical intervention postoperatively. These outcomes have harmful implications both clinically and economically. Our primary objective was to evaluate the levels of anxiety patients experience immediately before elective otorhinolaryngologic procedures. Our secondary outcome was to assess the subjects' views on potential management strategies to tackle their anxiety. METHODS This is an observational cross-sectional project evaluating 53 patients who were selected consecutively from a list of elective otorhinolaryngologic procedures. All procedures were to be completed under general anesthetic, and all patients had received the same preoperative assessment preparation. 29 male and 24 female patients were included, aged between 19 and 76 years (mean 45). The Spielberger State-Trait Anxiety Inventory was used to assess preoperative anxiety directly before the otorhinolaryngologic procedure. The Service Improvement questionnaire was used to assess whether patients would favor the introduction of anxiety-reduction measures. RESULTS There was neither a significant increase in patient anxiety levels preoperatively (P = 0.37) nor a significant increase in anxiety levels preoperatively when results were stratified according to patient gender and age (P = 0.45 and P = 0.27). 54% of the patients felt that their anxiety would have been reduced if they had read a procedural information leaflet, and 22% felt it would have been reduced if they had received preoperative behavioral training. 17% of the patients wanted more information from the surgical team. However, 12% of the patients would have liked less information from the surgical team preoperatively. CONCLUSIONS Patients did not have a significant increase in their anxiety levels preoperatively. On the basis of our findings, we will work to improve the information we provide to patients preoperatively and to identify patient subgroups that require additional preoperative support.
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Affiliation(s)
- Isabel Tulloch
- Neurosurgery, King's College Hospital, London, United Kingdom.
| | - John S Rubin
- The University College London Hospital, University of London, London, United Kingdom
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Y.B. W, G.L. F, H.T. Y, A.G. H. Prevalence and factors associated with preoperative anxiety among elective surgical patients at University of Gondar Hospital. Gondar, Northwest Ethiopia, 2017. A cross-sectional study. INTERNATIONAL JOURNAL OF SURGERY OPEN 2018. [DOI: 10.1016/j.ijso.2017.11.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Schulz CB, Goverdhan SV, Humphry RC. An evaluation of intracameral mydriasis for routine cataract surgery. Br J Ophthalmol 2017; 102:784-789. [PMID: 28903962 DOI: 10.1136/bjophthalmol-2017-310510] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/30/2017] [Accepted: 08/25/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Intracameral Mydrane might facilitate a more streamlined cataract service and improve the patient experience. There is limited 'real-world' evidence of its use in a UK setting. METHODS As part of a local evaluation of cataract surgery using intracameral Mydrane (group 2; n=60), data were collected on intraoperative pupil size and postoperative visual acuity (VA), as well as the rate of mechanical pupil dilation, intraoperative floppy iris syndrome (IFIS) and complications. Preoperative and theatre turnaround time was recorded and patients completed a validated measure of satisfaction postoperatively. Data were compared with a previous cohort subjected to the existing standard regime of preoperative topical mydriatics (group 1; n=60). RESULTS Postoperative VA was comparable between groups (0.09±0.16 vs 0.08±0.15; p=0.59). Pupil size in group 2 was 7.0±1.0 mm prior to capsulorhexis and 6.5±0.29 mm after cortical aspiration, with a smaller pupil in patients on alpha-antagonists (4.7±1.1 mm; p=0.004) at this later time point. Comparing group 2 with group 1, preoperative waiting was less (87 vs 146 min; p<0.0001) and satisfaction was higher (76.0±11.2 vs 66.3±8.6; p<0.0001), although theatre turnaround time was longer (25 min vs 22 min). CONCLUSION Intracameral mydriasis was clinically effective in most patients undergoing cataract surgery and might be associated with an improved patient experience and a more streamlined preoperative flow. Mydrane represents a licensed alternative to the off-label use of other intracameral mydriatic agents, but was not judged to be a cost-effective intervention for routine use in this particular setting.
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Ehwerhemuepha L, Feaster W, Kain Z. Impact of anesthesiologists on parental perioperative satisfaction scores. Paediatr Anaesth 2017; 27:949-954. [PMID: 28675657 DOI: 10.1111/pan.13199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND While the focus on patient experience as an important outcome has significantly increased over the past decade, there is paucity of data on predictive factors associated with parental recommendation of a surgical facility to friends and family. METHODS Data for this report were obtained from a Hospital Information System and Picker Health validated surveys completed by 538 parents whose children underwent outpatient surgery from July 2014 to March 2016. Bivariate, chi-squared, and multivariate logistic regression analysis were carried out using the Picker Health item "Would you recommend this outpatient surgical facility to your friends and family?" as the primary outcome. Demographic data and 53 Picker Health items were used as potential predictors. RESULTS Multivariate logistic regression analysis found the following variables as independent predictors for parental recommendation: quality of perioperative communication by anesthesiologists (odds ratio [95% confidence interval]=0.23 [0.09, 0.58]); provision of information on whom to call for help after discharge (0.22 [0.07, 0.64]); child's perceived baseline health (0.37 [0.15, 0.90]); and ill-informed staff about child's procedure (0.30 [0.21, 0.79]). Variables such as child's pain and child's nausea and vomiting were not predictive for referral pattern. CONCLUSION Parental recommendation of a surgical facility to friends and family depends on a number of variables with the quality of perioperative communication with the anesthesiologist being the most predictive item.
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Affiliation(s)
| | - William Feaster
- Information Systems Department, CHOC Children's Hospital, Orange, CA, USA
| | - Zeev Kain
- Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA, USA.,Department of Pediatrics, CHOC Children's Hospital Orange, Orange, CA, USA.,Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Enhanced recovery after surgery in gastric resections. Cir Esp 2017; 95:73-82. [PMID: 28185641 DOI: 10.1016/j.ciresp.2016.10.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/27/2016] [Accepted: 10/29/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery. METHODS According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery. RESULTS The measures to be applied are divided in a preoperative, perioperative and postoperative stage. This document provides recommendations concerning the appropriate information, limited fasting and administration of carbohydrate drinks 2hours before surgery, specialized anesthetic strategies, minimal invasive surgery, no routine use of drainages and tubes, mobilization and early oral tolerance during the immediate postoperative period, as well as criteria for discharge. CONCLUSIONS The application of a protocol of enhanced recovery after surgery in resective gastric surgery can improve and accelerate the functional recovery of our patients, requiring an appropriate multidisciplinary coordination, the evaluation of obtained results with the application of these measures and the investigation of controversial topics about which we currently have limited evidence.
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Alawadi ZM, Leal IM, Flores JR, Holihan JL, Henchcliffe BE, Mitchell TO, Ko TC, Liang MK, Kao LS. Underserved Patients Seeking Care for Ventral Hernias at a Safety Net Hospital: Impact on Quality of Life and Expectations of Treatment. J Am Coll Surg 2016; 224:26-34.e2. [PMID: 27742485 DOI: 10.1016/j.jamcollsurg.2016.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/19/2016] [Accepted: 09/21/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The purpose of this study was to identify issues important to patients in their decision-making, expectations, and satisfaction when seeking treatment for a ventral hernia. STUDY DESIGN An exploratory qualitative study was conducted of adult patients with ventral hernias seeking care at a safety-net hospital. Two semi-structured interviews were conducted with each patient: before and 6 months after surgical consultation. Interviews were audiotaped, transcribed, and coded using latent content analysis until data saturation was achieved. RESULTS Of patients completing an initial interview (n = 30), 27 (90%) completed follow-up interviews. Half of the patients were Spanish-speaking, one-third had a previous ventral hernia repair, and two-thirds underwent initial nonoperative management after surgical consultation. Patient-described factors guiding management decisions included impact on quality of life, primarily pain and limited function; overwhelming challenges to meeting surgical criteria, primarily obesity; and assuming responsibility to avoid recurrence. Patients were uninformed regarding potential poor outcomes and contributing factors, even among patients with a previous ventral hernia repair, with most attributing recurrence to inadequate self-management. CONCLUSIONS Understanding patients' perspective is crucial to engaging them as stakeholders in their care, addressing their concerns, and improving clinical and patient-centered outcomes. Patient reports suggest how care can be improved through developing more effective strategies for addressing patients' concerns during nonoperative management, preoperative risk reduction strategies that are sensitive to their sociodemographic characteristics, treatment plans that harness patients' willingness for self-management, and patient education and decision-making tools.
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Affiliation(s)
- Zeinab M Alawadi
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX.
| | - Isabel M Leal
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX
| | - Juan R Flores
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX
| | - Julie L Holihan
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX
| | - Blake E Henchcliffe
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX
| | - Thomas O Mitchell
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX
| | - Tien C Ko
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX
| | - Mike K Liang
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX
| | - Lillian S Kao
- Department of Surgery, University of Texas Health Sciences Center, Houston, TX
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de Oliveira P, Mucci S, Silva e Silva V, Leite R, Paglione H, Erbs J, Araújo C, Schirmer J, de Aguiar Roza B. Assessment of Factors Related to Adherence to Treatment in Liver Transplantation Candidates. Transplant Proc 2016; 48:2361-2365. [DOI: 10.1016/j.transproceed.2016.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Woollen J, Prey J, Wilcox L, Sackeim A, Restaino S, Raza ST, Bakken S, Feiner S, Hripcsak G, Vawdrey D. Patient Experiences Using an Inpatient Personal Health Record. Appl Clin Inform 2016; 7:446-60. [PMID: 27437053 PMCID: PMC4941852 DOI: 10.4338/aci-2015-10-ra-0130] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/15/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate patients' experience using an inpatient personal health record (PHR) on a tablet computer to increase engagement in their hospital care. METHODS We performed observations and conducted semi-structured interviews with 14 post-operative cardiac surgical patients and their family members who received an inpatient PHR. Themes were identified using an inductive coding scheme. RESULTS All participants responded favorably to having access to view their clinical information. A majority (85.7%) of participants used the application following an initial training session. Patients reported high satisfaction with being able to view their hospital medications and access educational materials related to their medical conditions. Patients reported a desire to view daily progress reports about their hospital stay and have access to educational information about their post-acute recovery. In addition, patients expressed a common desire to view their diagnoses, laboratory test results, radiology reports, and procedure notes in language that is patient-friendly. CONCLUSION Patients have unmet information needs in the hospital setting. Our findings suggest that for some inpatients and their family members, providing personalized health information through a tablet computer may improve satisfaction, decrease anxiety, increase understanding of their health conditions, and improve safety and quality of care.
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Affiliation(s)
- Janet Woollen
- Department of Biomedical Informatics, Columbia University, New York, NY
| | - Jennifer Prey
- Department of Biomedical Informatics, Columbia University, New York, NY
| | - Lauren Wilcox
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA
| | | | - Susan Restaino
- College of Physicians and Surgeons, Columbia University Medical Center, New York, NY
| | - Syed T. Raza
- College of Physicians and Surgeons, Columbia University Medical Center, New York, NY
| | - Suzanne Bakken
- Department of Biomedical Informatics, Columbia University, New York, NY
- School of Nursing, Columbia University, New York, NY
| | - Steven Feiner
- Department of Computer Science, Columbia University, New York, NY
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University, New York, NY
| | - David Vawdrey
- Department of Biomedical Informatics, Columbia University, New York, NY
- NewYork-Presbyterian Hospital, New York, NY
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Gürsoy A, Candaş B, Güner Ş, Yılmaz S. Preoperative Stress: An Operating Room Nurse Intervention Assessment. J Perianesth Nurs 2016; 31:495-503. [PMID: 27931701 DOI: 10.1016/j.jopan.2015.08.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 06/08/2015] [Accepted: 08/08/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this research study was to determine the effect of preoperative visits by the operating room (OR) nurse on patient stress levels before undergoing surgery. DESIGN This research was a quasi-experimental study. METHODS The research sample included patients (N = 179) who were hospitalized for surgery during 6 months in the general surgery department of a public hospital in the Eastern Black Sea Region. The OR nurse, part of the medical staff for surgery, visited patients in the experimental group 1 day before surgery. The OR nurse collected information that was consistent with the requirements of the patients. Patients in the control group were provided with preoperative care that was consistent with hospital procedure. Research data were collected using question forms, patient satisfaction scores, and Burford Distress Thermometer scale. Statistical evaluations included t tests and receiver operating characteristic analysis for independent groups. FINDING Most patients stated that they felt stressed because of the impending surgery. Patients made the following most common statements of the factors that caused stress; fear of unknown, anesthesia phobia, and fear of OR environment and complications that may occur during surgery. Patients in both groups experienced a significant decrease in postoperative stress levels. The perceived distress in the experimental group was significantly lower than the control group during the postoperative period. Patients in the experimental group reported that the OR nurse's visit effectively minimized their stress levels. CONCLUSIONS OR nurse visits to patients before surgery contributed to decreased preoperative stress levels.
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Pereira L, Figueiredo-Braga M, Carvalho IP. Preoperative anxiety in ambulatory surgery: The impact of an empathic patient-centered approach on psychological and clinical outcomes. PATIENT EDUCATION AND COUNSELING 2016; 99:733-738. [PMID: 26654958 DOI: 10.1016/j.pec.2015.11.016] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/14/2015] [Accepted: 11/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE This study aims to evaluate the influence of an empathic patient-centered approach on preoperative anxiety and surgical outcomes in ambulatory surgery patients. METHODS A sample of 104 patients undergoing general ambulatory surgery was randomly assigned to the intervention (IG) and the control (CG) groups. Before surgery, the IG received personalized information through an empathic patient-centered interview. The CG received standardized information on surgical procedures. Anxiety was assessed before and after the preoperative interview and after the surgery. Wound healing, post-surgical recovery and satisfaction with the quality of preoperative information were assessed after the surgery. RESULTS The two groups were identical at baseline regarding anxiety, socio-demographic and clinical characteristics. After the patient-centered intervention, the IG showed lower levels of preoperative anxiety (p<0.001) and pain (p<0.001), better surgery recovery (p<0.01) and higher levels of daily activity (p<0.001) and of satisfaction with the information received (p<0.01) than the CG. The IG also showed better wound healing (tissue type, p<0.01; local pain, p<0.01). CONCLUSION An empathic patient-centered intervention can reduce preoperative anxiety and increase surgical recovery, wound healing and patient satisfaction. PRACTICE IMPLICATIONS This approach is applicable in pre-surgical interviews and can potentially be used in the routine care of various surgical contexts.
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Affiliation(s)
- Lígia Pereira
- Ambulatory Surgery Unit, Centro Hospitalar do Porto, Porto, Portugal; Department of Clinical Neurosciences and Mental Health, School of Medicine, Oporto University, Porto, Portugal.
| | - Margarida Figueiredo-Braga
- Department of Clinical Neurosciences and Mental Health, School of Medicine, Oporto University, Porto, Portugal
| | - Irene P Carvalho
- Department of Clinical Neurosciences and Mental Health, School of Medicine, Oporto University, Porto, Portugal
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Chen X, Lu L. Depression in Diabetic Retinopathy: A Review and Recommendation for Psychiatric Management. PSYCHOSOMATICS 2016; 57:465-71. [PMID: 27380941 DOI: 10.1016/j.psym.2016.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/17/2016] [Accepted: 04/19/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and one of the main causes of irreversible vision impairment in the working-age population. Multiple studies have demonstrated the significantly high prevalence of depression in patients with DR in recent years. The progression of DR could lead to depression, whereas depressive symptoms often worsen the condition of DR. Therefore, DR is one of the causes of psychosomatic diseases, the treatment for which should combine traditional DR therapy with depression interventions. METHODS We reviewed existing articles that investigated the association between DR and depression in the context of prevalence, risk factors, biological mechanisms, and treatment indications. RESULTS The literature review in this article includes a brief introduction to current studies of depression and DR, followed by a focus on the epidemiology of depression in DR that help doctors better identify potential or existing depression patients upon first diagnosis. The underlying biologic mechanisms between the 2 diseases are briefly reviewed, and potential treatments are addressed. CONCLUSIONS Depression in patients with DR is not uncommon and has a negative effect on the condition of DR. To achieve optimal prognosis in patients with DR and depression, more attention to combined psychiatric therapies for depression is recommended.
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Affiliation(s)
- Xiaohong Chen
- Department of Fundus Diseases Center, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, PR China
| | - Lin Lu
- Department of Fundus Diseases Center, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, PR China.
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Affiliation(s)
- Robert Adam Baddeley
- Department of Physiotherapy, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
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Prediction of anxiety and depression in general surgery inpatients: A prospective cohort study of 200 consecutive patients. Int J Surg 2015; 23:18-22. [PMID: 26384837 DOI: 10.1016/j.ijsu.2015.09.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 08/26/2015] [Accepted: 09/11/2015] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Surgery is a major stress factor for patients, and is associated with significant anxiety or depression. The Hospital Anxiety and Depression Scale is one of the most common instruments used for assessment of patients' psychological stress. Here, we aimed to identify predictors of anxiety and depression in surgical inpatients. METHODS The study group consisted of consecutive two-hundred patients who completed the Hospital Anxiety and Depression Scale questionnaire. A patient scoring more than cut-off values (10 for anxiety and seven for depression) was considered as being at risk of anxiety or depression. Demographical data, socioeconomic status, education level and diagnoses were recorded. The Chi-square, Fisher's exact, Mann-Whitney, Kruskal-Wallis tests and binary logistic regression analysis were used to identify the predictive parameters for anxiety and depression. RESULTS It was found that female patients, patients older than 35 years, patients with low socioeconomic status and low education level had a relatively higher risk of anxiety. In addition, patients with low education and a hospital stay greater than seven days were at risk of depression. Logistic regression analysis revealed that socioeconomic status and education level were strongly predictive for anxiety. However, presence of anxiety was shown to be strongly predictive for depression. CONCLUSION Healthcare providers should be aware of their patients' psychology and, therefore, it is recommended to consider predictive factors for anxiety and depression.
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