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Chen X, Chen L, Gao Y. The impact of music on anxiety, pain, and blood pressure in ophthalmic surgery: A systematic review and meta-analysis. Complement Ther Med 2024; 83:103062. [PMID: 38844046 DOI: 10.1016/j.ctim.2024.103062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVES To evaluate the effectiveness of music therapy in reducing anxiety, pain, and vital sign changes in ophthalmic surgery patients. METHODS An extensive search of databases, including PubMed, Embase, Cochrane, Web of Science, and Google Scholar, identified relevant studies up to Jan 2024. Selection of studies was conducted based on the PICOS criteria. The quality of methodology was assessed using the Cochrane risk-of-bias assessment tool and Review Manager 5.4. Meta-analysis comparing the control group and the music therapy group was performed using R and Stata/SE 15.1 random or fixed effects model. RESULTS This meta-analysis included fifteen studies comprising 2098 participants. The analysis revealed that music therapy significantly reduced the risk of high anxiety levels as measured by Visual Analogue Scale (VAS) (I2 = 0 %, RR(95 %CI): 0.75(0.63, 0.88), p = 0.0006), indicating a substantial effect without heterogeneity. The Anxiety scores determined by State-Trait Anxiety Inventory-State (STAI-S) also showed a significant decrease (SMD(95 %CI): -0.75(-0.88, -0.61), p < 0.0001), albeit with moderate heterogeneity (I² = 36 %). Additionally, music therapy was associated with a reduction in intraoperative pain levels, with no observed heterogeneity (I2 = 0 %, SMD(95 %CI): -0.74(-0.93, -0.56), p < 0.0001). In contrast, music intervention did not significantly influence self-reported nervousness, relaxation, or satisfaction levels as determined by VAS. Regarding to physiological parameters, a marginal decrease in systolic blood pressure (SBP) was observed (SMD(95 %CI): -0.42(-0.79, -0.04), p = 0.0286), with considerable heterogeneity (I² = 92 %). Diastolic blood pressure (DBP) experienced a slight reduction (I² = 90 %, SMD(95 %CI): -0.45(-0.79, -0.11), p = 0.0088). However, no significant effect was observed on patients' heart rate (p = 0.0864). CONCLUSION Music therapy effectively reduced anxiety and pain, and moderately improved vital signs in patients undergoing ophthalmic surgery, highlighting its role in enhancing patient well-being. Further in-depth RCTs are needed to confirm its efficacy.
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Affiliation(s)
- Xue Chen
- School of Life Sciences, Jilin University, Changchun, China
| | - Long Chen
- School of Music, Herzen University, Moika River Embankment, St. Petersburg, Russia
| | - Yin Gao
- School of Life Sciences, Jilin University, Changchun, China.
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Wang S, Du Z, Lai C, Seth I, Wang Y, Huang Y, Fang Y, Liao H, Hu Y, Yu H, Zhang X. The association between cataract surgery and mental health in older adults: a review. Int J Surg 2024; 110:2300-2312. [PMID: 38668662 PMCID: PMC11020056 DOI: 10.1097/js9.0000000000001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Although cataract surgery has been proposed as a potentially modifiable protective factor for enhancing emotional well-being in cataract patients, studies examining the relationship between anxiety or depression and cataract surgery have yielded inconsistent findings. This review summarizes existing evidence to establish whether cataract surgery is associated with depression and anxiety in older adults. METHODS A literature search was conducted across PubMed, Medline, Web of Science, and Embase databases. An initial screening by abstracts and titles was performed, followed by a review and assessment of the methodological quality of the relevant full papers, and final inclusion of 44 studies were deemed eligible for inclusion in this review. RESULTS Among 44 included studies, 36 studies (81.8%) were observational studies concerning the association of cataract surgery or cataracts with anxiety or depression, four studies (9.1%) were interventional studies, and four studies (9.1%) were reviews. Cataract surgery notably enhances the mental health of individuals with impaired vision. However, the multifaceted nature of psychological well-being, influenced by various factors, suggests that cataract surgery may not address all aspects comprehensively. Additionally, preoperative anxiety and depression significantly impact cataract surgery outcomes. CONCLUSION Vision impairment in older adults is closely associated with increased symptoms of depression and anxiety. While surgical intervention for cataracts improves these symptoms, it might be less effective for mental disorders with multifactorial causes. Notably, anxiety or depression poses challenges to successful preoperative and intraoperative cataract surgeries.
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Affiliation(s)
- Shan Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Zijing Du
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Chunran Lai
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Ishith Seth
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
| | - Yaxin Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yu Huang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
| | - Ying Fang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Huiyi Liao
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Image Analysis and Application, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences
| | - Xiayin Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
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Gupta AS, Sulewski ME, Armenti ST. Performance of ChatGPT in cataract surgery counseling. J Cataract Refract Surg 2024; 50:424-425. [PMID: 38523277 DOI: 10.1097/j.jcrs.0000000000001345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/11/2023] [Indexed: 03/26/2024]
Affiliation(s)
- Angela S Gupta
- From the Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania
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Lin MX, Li G, Cui D, Mathews PM, Akpek EK. Usability of Patient Education-Oriented Cataract Surgery Websites. Ophthalmology 2024; 131:499-506. [PMID: 37852419 DOI: 10.1016/j.ophtha.2023.10.019] [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: 07/08/2023] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
PURPOSE To assess the web accessibility and readability of patient-oriented educational websites for cataract surgery. DESIGN Cross-sectional electronic survey. PARTICIPANTS Websites with information dedicated to educating patients about cataract surgery. METHODS An incognito search for "cataract surgery" was performed using a popular search engine. The top 100 patient-oriented cataract surgery websites that came up were included and categorized as institutional, private practice, or medical organization according to authorship. Each site was assessed for readability using 4 standardized reading grade-level formulas. Accessibility was assessed through multilingual availability, accessibility menu availability, complementary educational video availability, and conformance and adherence to the Web Content Accessibility Guidelines (WCAG) 2.0. A standard t test and chi-square analysis were performed to assess the significance of differences with regard to readability and accessibility among the 3 authorship categories. MAIN OUTCOME MEASURES The main outcome measures were the website's average reading grade level, number of accessibility violations, multilingual availability, accessibility menu availability, complementary educational video availability, accessibility conformance level, and violation of the perceivable, operable, understandable, and robust (POUR) principles according to the WCAG 2.0. RESULTS A total of 32, 55, and 13 sites were affiliated with institutions, private practice, and other medical organizations, respectively. The overall mean reading grade was 11.8 ± 1.6, with higher reading levels observed in private practice websites compared with institutions and medical organizations combined (12.1 vs. 11.4; P = 0.03). Fewer private practice websites had multiple language options compared with institutional and medical organization websites combined (5.5% vs. 20.0%; P = 0.03). More private practice websites had accessibility menus than institutions and medical organizations combined (27.3% vs. 8.9%; P = 0.038). The overall mean number of WCAG 2.0 POUR principle violations was 17.1 ± 23.1 with no significant difference among groups. Eighty-five percent of websites violated the perceivable principle. CONCLUSIONS Available patient-oriented online information for cataract surgery may not be comprehensible to the general public. Readability and accessibility aspects should be considered when designing these resources. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Michael X Lin
- The Ocular Surface Disease Clinic, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gavin Li
- The Ocular Surface Disease Clinic, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Icahn School of Medicine at Mount Sinai, New York, New York
| | - David Cui
- The Ocular Surface Disease Clinic, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Krieger Eye Institute, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Priya M Mathews
- The Ocular Surface Disease Clinic, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Center for Sight, Sarasota, Florida
| | - Esen K Akpek
- The Ocular Surface Disease Clinic, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Nowicka-Sauer K, Zemła A, Banaszkiewicz D, Trzeciak BG, Jarmoszewicz K. Measures of preoperative anxiety: Part two. Anaesthesiol Intensive Ther 2024; 56:9-16. [PMID: 38741439 PMCID: PMC11022642 DOI: 10.5114/ait.2024.136508] [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: 12/05/2023] [Accepted: 02/14/2024] [Indexed: 05/16/2024] Open
Abstract
The current literature indicates that routine evaluation of preoperative anxiety, its determinants, and patient-specific concerns is universally advocated. This aligns with the increasingly acknowledged importance of prehabilitation - a comprehensive process preparing patients for surgery. A crucial component of prehabilitation is assessing patients' mental health. Recommendations for psychological evaluations in prehabilitation encompass, inter alia, determining the severity of anxiety. This work builds on a 2019 article, which presented scales for preoperative anxiety assessment: the State Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the Visual Analogue Scale (VAS). This article extends the possibilities of preoperative anxiety assessment by introducing four additional methods: the Surgical Fear Questionnaire (SFQ), the Anxiety Specific to Surgery Questionnaire (ASSQ), the Surgical Anxiety Questionnaire (SAQ), and Anesthesia- and Surgery-dependent Preoperative Anxiety (ASPA). The authors provide comprehensive details on these instruments, including scoring, interpretation, availability, and usefulness both in scientific research and clinical practice. The authors also provide the data on the availability of Polish versions of the presented methods and preliminary data on the reliability of SFQ in patients awaiting cardiac surgery. This review seems relevant for professionals in multiple disciplines, including anesthesiology, surgery, clinical psychology, nursing, primary care and notably prehabilitation. It emphasizes the necessity of individualizing anxiety assessment and acknowledging patient subjectivity, which the presented methods facilitate through a thorough evaluation of specific patient concerns. The literature review also identifies concerns and future research avenues in this area. The importance of qualitative studies and those evaluating prehabilitation intervention is emphasized.
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Affiliation(s)
- Katarzyna Nowicka-Sauer
- Department of Family Medicine, Faculty of Medicine, Medical University of Gdańsk, Poland
- Department of Cardiac Surgery, Kashubian Centre for Cardiac and Vascular Diseases, Florian Ceynowa Specialist Hospital, Wejherowo, Poland
| | - Adam Zemła
- Department of Cardiac Surgery, Kashubian Centre for Cardiac and Vascular Diseases, Florian Ceynowa Specialist Hospital, Wejherowo, Poland
| | - Dorota Banaszkiewicz
- Department of Statistics, Faculty of Management, Gdańsk University, Gdańsk, Poland
| | - Bartosz G. Trzeciak
- Department of Family Medicine, Faculty of Medicine, Medical University of Gdańsk, Poland
| | - Krzysztof Jarmoszewicz
- Department of Cardiac Surgery, Kashubian Centre for Cardiac and Vascular Diseases, Florian Ceynowa Specialist Hospital, Wejherowo, Poland
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Chen R, Chen Y, Yang M, Liu Y, Zhang X, Li J, Yang X, Liao Y, Du G, Cao X. Patients' caring experience during procedures under regional anesthesia in Mainland China: A phenomenology study. Heliyon 2023; 9:e20330. [PMID: 37810870 PMCID: PMC10556589 DOI: 10.1016/j.heliyon.2023.e20330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 09/09/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
Background Although regional anesthesia is common, the procedure results in feelings of uncertainty and anxiety in some patients. Increased care is needed for these patients under general anesthesia. Few studies have focused on the intraoperative caring experience of patients during regional anesthesia. This study focused on the caring experience of patients during procedures involving regional anesthesia. Methods The descriptive phenomenology method of Husserl was employed. Semi-structured interviews were conducted with a purposive sample in five Grade III-A hospitals in Zhengzhou City, Henan Province. The seven-step analysis method of Colaizzi was applied for the analysis, summation, and theme refinement of the interview data. Results A total of 14 patients from five hospitals participated in the interviews. Four domains and 16 themes emerged during analysis: be informed (about the operation site, progression of the operation, informed in advance, receive explanation for abnormal experience); take care of my body (painless, gentle movements, special care); be protected (work seriously, favorable atmosphere, skilled, authority); and treated as an individual (pay attention, accompany, ask for opinions, encourage patient expression, humorous). Conclusion Patients during procedure under regional anesthesia had specific caring experiences relative to other patients. Medical staff should recognize the importance of regional anesthesia patients' intraoperative caring experience. Hospital administrators should offer support to allow healthcare staff to provide targeted caring for patients during procedure under regional anesthesia.
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Affiliation(s)
- Rui Chen
- Department of Infection Control, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Zhengzhou, Henan, China
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fujian, Fuzhou, China
| | - Ying Chen
- Department of Nursing, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Zhengzhou, Henan, China
| | - Meng Yang
- Department of Infection Control, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Zhengzhou, Henan, China
| | - Yilan Liu
- Department of Nursing, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinhui Zhang
- Department of Nursing, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Zhengzhou, Henan, China
| | - Jianlei Li
- Department of Knee Injuries, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Zhengzhou, Henan, China
| | - Xue Yang
- Department of Nursing, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Zhengzhou, Henan, China
| | - Yufeng Liao
- School of Medical Technology and Nursing, Shenzhen Polytechnic, Shenzhen, Guangdong, China
| | - Guijuan Du
- Department of Nursing, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Zhengzhou, Henan, China
| | - Xiangyang Cao
- Department of Hospital President, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Zhengzhou, Henan, China
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Benzy M, Venkatesh R, Vellam Ramakrishnan V, Odayar VS. Effect of Video Counselling Versus Verbal Counselling on Patient's experience during phacoemulsification under topical anaesthesia. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100050. [PMID: 37846388 PMCID: PMC10577861 DOI: 10.1016/j.aopr.2022.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/23/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2023]
Abstract
Purpose To evaluate the impact of video and verbal counselling on patients' undergoing phacoemulsification under topical anaesthesia. Methods This is a prospective randomized controlled trial conducted at Aravind Eye Care System, Pondicherry, India. All patients had a 15 min one-on-one verbal counselling covering surgical technique, implant options, anaesthesia and payment options one day prior to surgery. On the day of surgery, patients were randomized into two groups; in the first group, patients were provided with video counselling and in the second group, patients were given verbal counselling prior to undergoing phacoemulsification under topical anaesthesia. Measurements of blood pressure, heart rate, respiration rate, and the Likert-scale anxiety rating were collected at preoperative, perioperative, and postoperative time points. Results A group of 186 patients (aged 45-70 years) were provided video counselling via portable iPad before first-time phacoemulsification, and a second group of 186 patients underwent surgery with verbal counselling. Systolic and diastolic blood pressure measurements were lower in both the video and verbally counselled groups during the intraoperative time point. Furthermore, during the intraoperative period, 123 (66.1%) video counselled patients felt relaxed compared to 119 (64%) patients who were provided verbal counselling (P = 0.6636). Patient cooperation during surgery was excellent in 76(40.9%) video counselled patients and 67(36%) verbally counselled patients (P = 0.3374). 25.8% and 21% (P = 0.2703) of patients experienced no pain during surgery in the video and verbal counselled groups respectively. Conclusions Although measures such as pulse rate, respiratory rate and feelings of relaxation did not show significant differences among the two groups of video and verbal counselling, patients marked cooperation during surgery and furthermore, the level of anxiety is most reassuring.
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Affiliation(s)
- Merlin Benzy
- Department of Cataract and IOL Services, Aravind Eye Hospital, Pondicherry, India
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Taylan S, Çelik GK. The Effect of Preoperative Fear and Related Factors on Patients’ Postcataract Surgery Comfort Level: A Regression Study. J Perianesth Nurs 2022; 37:398-403. [DOI: 10.1016/j.jopan.2021.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/05/2021] [Accepted: 08/28/2021] [Indexed: 10/18/2022]
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Pfeifer LS, Heyers K, Ocklenburg S, Wolf OT. Stress research during the COVID-19 pandemic and beyond. Neurosci Biobehav Rev 2021; 131:581-596. [PMID: 34599918 PMCID: PMC8480136 DOI: 10.1016/j.neubiorev.2021.09.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/27/2022]
Abstract
The COVID-19 pandemic confronts stress researchers in psychology and neuroscience with unique challenges. Widely used experimental paradigms such as the Trier Social Stress Test feature physical social encounters to induce stress by means of social-evaluative threat. As lockdowns and contact restrictions currently prevent in-person meetings, established stress induction paradigms are often difficult to use. Despite these challenges, stress research is of pivotal importance as the pandemic will likely increase the prevalence of stress-related mental disorders. Therefore, we review recent research trends like virtual reality, pre-recordings and online adaptations regarding their usefulness for established stress induction paradigms. Such approaches are not only crucial for stress research during COVID-19 but will likely stimulate the field far beyond the pandemic. They may facilitate research in new contexts and in homebound or movement-restricted participant groups. Moreover, they allow for new experimental variations that may advance procedures as well as the conceptualization of stress itself. While posing challenges for stress researchers undeniably, the COVID-19 pandemic may evolve into a driving force for progress eventually.
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Affiliation(s)
- Lena Sophie Pfeifer
- Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany,Corresponding author at: Lena Sophie Pfeifer (Cognitive Psychology, Ruhr University Bochum, Universitätsstraße 150, Room: IB 6/77, 44780, Bochum, Germany)
| | - Katrin Heyers
- Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany,General Psychology II and Biological Psychology, Institute of Psychology, School of Human Sciences, Osnabrück University, Osnabrück, Germany
| | - Sebastian Ocklenburg
- Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Oliver T. Wolf
- Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
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Preoperative and perioperative music to reduce anxiety during first-time phacoemulsification cataract surgery in the high-volume setting: randomized controlled trial. J Cataract Refract Surg 2021; 47:471-475. [PMID: 33196574 DOI: 10.1097/j.jcrs.0000000000000485] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/29/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine whether preoperative and perioperative music exposure reduced patient self-rated anxiety and physiologic indicators of stress during first-time phacoemulsification cataract surgery in the high-volume setting. SETTING Aravind Eye Care System, Pondicherry, India. DESIGN Prospective single-masked randomized controlled trial. METHODS Patients were provided music before and during first-time phacoemulsification in 1 group and patients underwent surgery without music in another group. Measurements of blood pressure (BP), heart rate, respiration rate, and a Likert scale anxiety rating were collected at preoperative, perioperative, and postoperative timepoints. RESULTS One hundred sixty-five patients (aged 53-65 years) were provided music using a portable MP3 player before and during first-time phacoemulsification, and 165 patients underwent surgery without music. Systolic and diastolic BPs were statistically significantly lower in the music intervention group at the postoperative timepoint, with similar physiologic measures between groups during the perioperative timepoints. In the preoperative period, before music exposure, 62 patients (38%) in the music group reported being very or extremely anxious. After 10 minutes of music exposure, only 7 patients (4%) reported this anxiety level. In the perioperative period, 80 patients (48%) in the intervention group reported feeling not at all or a little anxious, compared with 50 patients (30%) of the control group. In the postoperative period, 139 (84%) music group patients felt not at all or a little anxious postoperatively compared with 92 patients (56%) in the control group. CONCLUSIONS Marked reductions in self-reported anxiety preoperatively, intraoperatively, and postoperatively when exposed to music and a statistically significant decrease in postoperative BP showed that music can be an inexpensive and effective solution to improve the patient experience of cataract surgery in the high-volume setting.
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Obuchowska I, Konopinska J. Fear and Anxiety Associated with Cataract Surgery Under Local Anesthesia in Adults: A Systematic Review. Psychol Res Behav Manag 2021; 14:781-793. [PMID: 34177276 PMCID: PMC8219311 DOI: 10.2147/prbm.s314214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022] Open
Abstract
Cataract surgery is one of the most frequently performed surgical procedures worldwide. Patients usually experience strong negative emotions, such as fear and anxiety. A systematic review of the recent literature regarding the emotional states experienced during cataract surgery under local anaesthesia was performed based on the PubMed and Scopus databases. The objective of this review was to determine the causes and frequency of fear and anxiety, as well as methods for improving intraoperative experience and supporting the patient prior to surgery. Anxiety is mainly caused by fear of the surgery itself, fright of pain, and loss of vision. Abstaining and visual sensations experienced during cataract surgery also increased the preoperative anxiety. Women and hypochondriacs showed higher levels of anxiety. The greatest intensity of negative emotions occurred on the day of the cataract surgery. Patients operated on both eyes experienced greater fear and anxiety before the operation of the first eye surgery. In order to reduce patients’ negative experiences, pharmacological sedation, preoperative education and counselling, manual massage immediately before surgery, and listening to music during surgery are used. Taking this information into consideration allows the introduction of effective methods of eliminating the patient’s negative feelings in connection with cataract surgery, which leads to an improvement in the results of the operation and an increase in the patients’ sense of satisfaction and quality of life.
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Affiliation(s)
- Iwona Obuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Konopinska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland
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Stuhlreyer J, Klinger R. Development and Validation of the Pain and State of Health Inventory (PHI): Application for the Perioperative Setting. J Clin Med 2021; 10:1965. [PMID: 34063725 PMCID: PMC8124984 DOI: 10.3390/jcm10091965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022] Open
Abstract
Currently, general measurements and evaluations of the quality of recovery are difficult because no adequate measuring tools are available. Therefore, there is an urgent need for a universal tool that assesses patient-relevant criteria-postoperative pain, state of health, and somatic parameters. For this purpose, a pain and state of health inventory (PHI, Schmerz- und Befindlichkeitsinventar (SBI) in German) has been developed. In this study, we describe its development and validation. The development phase was led by an expert panel and was divided into three subphases: determining the conceptual structure, testing the first editions, and adjusting the inventory for a finalized edition. For the purpose of validation, the PHI was filled in by 132 patients who have undergone total knee replacement and was analyzed using principal component analysis. Construct validity was tested by correlating the items with validated questionnaires. The results showed that the inventory can test pain, state of health, and somatic parameters with great construct validity. Furthermore, the inventory is accepted by patients, map changes, and supports to initiate adequate treatment. In conclusion, the PHI is a universal tool that can be used to assess the quality of recovery in the perioperative setting and allow immediate intervention.
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Affiliation(s)
- Julia Stuhlreyer
- Center for Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany;
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Obuchowska I, Ługowska D, Mariak Z, Konopińska J. Subjective Opinions of Patients About Step-by-Step Cataract Surgery Preparation. Clin Ophthalmol 2021; 15:713-721. [PMID: 33658752 PMCID: PMC7917310 DOI: 10.2147/opth.s298876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/22/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose We analyzed the subjective feelings and opinions of patients regarding modified cataract phacoemulsification procedures. Patients and Methods A consecutive case series of patients undergoing phacoemulsification of cataracts, who completed questionnaires designed by the authors to evaluate their subjective opinions about hospital admission, medical examination, and intraoperative procedures carried out at the operating theater. Results Two hundred patients (82 men and 118 women) were included in the study. Subjects aged ≥65 years more often than younger respondents presented negative opinions about hospital admission procedures (15% vs. 2.5%, p=0.032) and were less satisfied with physicians’ explanations about the matter of phacoemulsification (71.3% vs. 92.5%, p=0.004), type of artificial lens to be implanted (43.8% vs. 85%, p<0.001), and potential complications (69.4% vs. 95%, p<0.001). The most unpleasant intraoperative experiences included venipuncture (35.5%), artificial lens implantation (30.5%), and peeling off of a sterile surgical drape (24%). Conclusion Persons aged ≥65 years presented with negative opinions about routine procedures related to phacoemulsification. Older age seems to be associated with less tolerance to time-consuming bureaucratic procedures and a lesser understanding of the specific stages of the surgery. Older patients should be notified in advance about all routine procedures to be carried out and provided with a rationale for these activities. Trial Registration The study was registered on clinicaltrials. gov (NCT04327856).
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Affiliation(s)
- Iwona Obuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Dorota Ługowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Zofia Mariak
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
| | - Joanna Konopińska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland
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Emmerich GM. Psychosomatic Aspects in Preparation and Follow-Up in Glaucoma Surgery and Their Special Impact on Patients. Klin Monbl Augenheilkd 2021; 238:146-152. [PMID: 33543764 DOI: 10.1055/a-1333-3429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Glaucoma patients often bear a long-lasting burden of disease. This can result in anxiety and stress. Causes and effects of anxiety are identified and case studies illustrate how to deal with them. Some knowledge of psychosomatic management is helpful for doctors in dealing with their patients to provide necessary treatment in a less fearful and stressful format.
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Ługowska D, Konopinska J, Mariak Z, Obuchowska I. Comparison of Subjective Preoperative Experiences of Patients Before First- or Second-Eye Cataract Surgeries. Clin Ophthalmol 2020; 14:2883-2889. [PMID: 33061274 PMCID: PMC7524183 DOI: 10.2147/opth.s270196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the subjective preoperative experiences of patients undergoing their first- or second-cataract surgeries. Patients and Methods Consecutive patients undergoing phacoemulsification were asked to complete postoperative questionnaires evaluating their subjective preoperative experiences, including their emotional state, decision-making process, and opinions on the admission and examination processes, medical interviews, and quality of service. The obtained data were compared between patients undergoing their first (group I)- or second (group II)-cataract surgeries. Results Two hundred patients (group I, 124; group II, 76) were included in the evaluation. Presurgical anxiety was more prevalent in group I than in group II (55.7% vs 34.2%, P = 0.005). Fear was the major trigger for reconsidering the decision to undergo surgery, with 29% and 13.2% of patients in groups I and II, respectively, considering abandoning the operation (P = 0.016). The preoperative medical examination was reported to be sufficiently accurate by 66.1% and 80.3% of patients in groups I and II, respectively (P = 0.047), while 28.2% and 21% of patients in groups I and II, respectively, did not understand the information presented about possible complications of surgery (P = 0.039). Administration of eyedrops before surgery was uncomfortable for 71.4% and 68.4% of patients in groups I and II, respectively (P = 0.553), while 22.6% and 9.2% of patients in groups I and II, respectively, found repeated administration of drops to be highly uncomfortable (P = 0.026). Conclusion Patients experienced greater anxiety before their first-cataract surgery than before their second-cataract surgery. Moreover, many patients from both groups did not understand the medical information provided by doctors regarding the surgery and its possible complications. The most unpleasant stage of preparation for cataract surgery was repeated administration of eyedrops. Trial Registration The study was registered on clinicaltrial.gov under the number NCT04327856.
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Affiliation(s)
- Dorota Ługowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok 15-276, Poland
| | - Joanna Konopinska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok 15-276, Poland
| | - Zofia Mariak
- Department of Ophthalmology, Medical University of Bialystok, Bialystok 15-276, Poland
| | - Iwona Obuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok 15-276, Poland
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Barabady A, Baghdassarians A, Memary E, Yazdani A, Barabady A, Sayadi S. Effect of Benson's Relaxation Technique on Propofol Consumption and Preoperative Anxiety of Patients Undergoing Cataract Surgery. Anesth Pain Med 2020; 10:e100703. [PMID: 32944558 PMCID: PMC7472786 DOI: 10.5812/aapm.100703] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/25/2020] [Accepted: 05/28/2020] [Indexed: 11/16/2022] Open
Abstract
Background Benson’s relaxation (BR) technique is a suitable non-pharmacological approach to reduce preoperative anxiety (PA). Objectives This study aimed to investigate the effect of BR therapy on PA and the induction and maintenance dose of propofol during cataract surgery (CS). Methods Seventy-two patients were randomly divided into two experiments or BR and control groups. The Amsterdam and Spielberger State-Trait Anxiety inventory (STAI) scores were used to assess PA directly two days and a half-hour before the CS. The control group did not receive any preoperation intervention or relaxation. Benson’s relaxation method was performed three times, each time for 20 minutes, including two days before surgery, a night before surgery, and an hour before the surgery in the presence of a researcher by an audio file. The induction and maintenance dose of anesthetic drug was recorded and compared between the two groups. Results The mean propofol consumption was significantly reduced during the induction of anesthesia in the intervention group compared to the control group (0.99 ± 0.29 versus 1.29 ± 0.49; P = 0.005) as well as the maintenance of anesthesia (84.66 ± 17.98 versus 108.33 ± 34.38, P = 0.001). The results of the post-intervention Amsterdam anxiety score showed a significant decrease in the intervention group compared to the control group (P = 0.032, F = 9.61, Eta2 = 0.12). The control group showed a higher Spielberger state score compared to the intervention group as well as the Spielberger trait (P < 0.001, F = 14.78, Eta2 = 0.18). Conclusions The BR method effectively reduces the level of PA in patients undergoing CS. Moreover, it reduces the need for anesthetic drug, propofol, during surgery.
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Affiliation(s)
- Afsaneh Barabady
- Department of Psychology, Tehran Markaz Branch, Islamic Azad University, Tehran, Iran
| | - Anita Baghdassarians
- Department of Psychology, Tehran Markaz Branch, Islamic Azad University, Tehran, Iran
| | - Elham Memary
- Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Akram Yazdani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Barabady
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Sayadi
- Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Impact of Video Education on Patient Knowledge, Anxiety, and Satisfaction in Selective Laser Trabeculoplasty: A Pilot Study. J Glaucoma 2020; 29:1158-1161. [PMID: 32925516 DOI: 10.1097/ijg.0000000000001657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PRéCIS:: In patients undergoing selective laser trabeculoplasty, preoperative video education did not improve patient knowledge regarding the procedure, decrease anxiety, or increase satisfaction, as these metrics were already favorable across all patients in this study. PURPOSE To assess the effect of an educational video on patient knowledge, anxiety, and satisfaction at a selective laser trabeculoplasty (SLT) procedure visit. MATERIALS AND METHODS This is a prospective, randomized trial. Patients at a single academic medical center completed a survey at their procedure visit for SLT; patients were randomized to view an educational video or no video before survey administration. Knowledge was assessed with a 10-item questionnaire. The 6-item State-Trait Anxiety Inventory scale (STAI-6) assessed anxiety (score >40 defined significant anxiety). Perceptions of visit quality were assessed using a Likert scale. RESULTS Twenty-two patients were randomized into video (n=11) and control (n=11) groups. No difference in knowledge was observed between groups (83.6% control vs. 82.7% video group, P=0.635). No patient had significant anxiety (STAI-6 range, 20 to 40, average 29) and scores were similar between groups (P=0.385). Overall, patients had positive perceptions of visit quality, and there was no significant difference between groups (P=0.999). CONCLUSION Patients undergoing SLT had high levels of knowledge, low levels of anxiety, and high levels of satisfaction. In this clinical setting, an educational video seemed to have no additional benefit on these metrics and thus, may be omitted. Further research may be directed toward optimizing patient education regarding SLT, particularly in settings with poor health literacy, limited resources, or limited access to glaucoma specialists.
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Stanley PF, Wan LF, Karim RA. A Randomized Prospective Placebo-Controlled Study of the Effects of Lavender Aromatherapy on Preoperative Anxiety in Cataract Surgery Patients. J Perianesth Nurs 2020; 35:403-406. [PMID: 32178950 DOI: 10.1016/j.jopan.2019.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/22/2019] [Accepted: 12/27/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine if lavender aromatherapy can reduce preoperative anxiety in cataract surgery patients. DESIGN Single-center prospective randomized placebo-controlled trial. METHODS Seventy-five patients awaiting cataract surgery were randomized to lavender essential oil or grape seed oil (control) and administered the State-Trait Anxiety Inventory. Vital signs were also recorded. FINDINGS Patients in the lavender group showed greater improvements in self-reported anxiety using the State-Trait Anxiety Inventory (P = .023, two-sample t test). Compared with the control group, the effects of lavender on the reduction of anxiety were statistically significant when adjusting for age, gender, and baseline scores (P = .012, analysis of covariance). CONCLUSIONS Lavender aromatherapy reduced anxiety in preoperative cataract surgery patients.
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Affiliation(s)
| | - Lai Foon Wan
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
| | - Rostihar Abdul Karim
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
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Kumar CM, Seet E, Eke T, Irwin MG, Joshi GP. Peri‐operative considerations for sedation‐analgesia during cataract surgery: a narrative review. Anaesthesia 2019; 74:1601-1610. [DOI: 10.1111/anae.14845] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2019] [Indexed: 12/30/2022]
Affiliation(s)
- C. M. Kumar
- Department of Anaesthesiology Khoo Teck Puat Hospital SingaporeSingapore
| | - E. Seet
- Department of Anaesthesiology Khoo Teck Puat Hospital SingaporeSingapore
| | - T. Eke
- Department of Ophthalmology Norfolk and Norwich University Hospitals NorwichUK
| | - M. G. Irwin
- Department of Anaesthesiology The University of Hong Kong Hong Kong Special Administrative Region Hong Kong China
| | - G. P. Joshi
- Department of Anesthesiology and Pain Management University of Texas Southwestern Medical Center Dallas TX USA
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Moinul P, Ligori T, Qian J, Tin E, Calotti M, Ceyhan T, Barbosa J, Chaudhary V. Evaluating patient preparedness for cataract surgery and satisfaction with preoperative care. Can J Ophthalmol 2019; 54:458-466. [PMID: 31358144 DOI: 10.1016/j.jcjo.2018.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/22/2018] [Accepted: 11/08/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate preoperative preparedness and patient satisfaction after implementation of the Cataract Screening Preprocedural Questionnaire (CSPQ) at Hamilton Regional Eye Institute. DESIGN Single-centred, prospective, cross-sectional study. PARTICIPANTS/METHODS One-hundred fifty-one adult patients undergoing elective cataract surgery completed the CSPQ questionnaire. Based on the responses, patients were triaged to the preoperative anaesthesia clinic or booked directly for surgery. Outcome measures included anxiety level, delays or cancellations in surgery, preoperative blood pressure, glucose levels, and satisfaction with the quality of preoperative instructions provided. Results were compared between patients who attended and those who bypassed the preoperative anaesthesia clinic. RESULTS Of the study population, 87 patients were female (57.6%) and the mean age was 72.0 ± 10.5 years. Only 11 patients (7.43%) were referred for preoperative consultation. Patients reported receiving preoperative instructions via handouts (94%) and verbally in combination with handouts (59.33%). Patients felt that adequate information was provided regarding preoperative medications (96.69%), eye drops (99.34%), fasting guidelines (98.68%), arrival time (99.34%), and instructions for accompaniment/drivers postoperatively (100%). All patients were compliant with the fasting guidelines. Patient satisfaction with the information received regarding cataract surgery and anaesthesia were 4.39 ± 0.88 and 3.80 ± 0.95, respectively. There was no difference in the anxiety level between patients who attended and those who bypassed the preoperative clinic (4.09 ± 2.92 and 5.18 ± 2.57, p = 0.14). There were no cancellations, delays, or immediate postoperative systemic complications. CONCLUSIONS The CSPQ model can be effectively used to streamline the preoperative preparation of patients for cataract surgery while maintaining a high degree of patient satisfaction with the perioperative experience.
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Affiliation(s)
- Prima Moinul
- Department of Ophthalmology, St Joseph's Healthcare Hamilton, Hamilton Regional Eye Institute, Hamilton, Ont..
| | - Tania Ligori
- Department of Anaesthesia, McMaster University, St Joseph's Healthcare Hamilton, Hamilton, Ont
| | - Jenny Qian
- Department of Ophthalmology, St Joseph's Healthcare Hamilton, Hamilton Regional Eye Institute, Hamilton, Ont
| | - Enoch Tin
- Department of Ophthalmology, St Joseph's Healthcare Hamilton, Hamilton Regional Eye Institute, Hamilton, Ont
| | - Martin Calotti
- Department of Ophthalmology, St Joseph's Healthcare Hamilton, Hamilton Regional Eye Institute, Hamilton, Ont
| | - Tiandra Ceyhan
- Department of Ophthalmology, St Joseph's Healthcare Hamilton, Hamilton Regional Eye Institute, Hamilton, Ont
| | - Joshua Barbosa
- Department of Ophthalmology, St Joseph's Healthcare Hamilton, Hamilton Regional Eye Institute, Hamilton, Ont
| | - Varun Chaudhary
- Department of Ophthalmology, St Joseph's Healthcare Hamilton, Hamilton Regional Eye Institute, Hamilton, Ont
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