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Cho HJ, Chung HS, Hwang EC, Jung SI, Kwon D, Park K, Patel DP, Hsieh TC. Music from Noise-Canceling Headphones Is Beneficial against Anxiety in Male Bladder Cancer Patients Undergoing Follow-Up Cystoscopy: A Prospective Randomized Trial. Urol Int 2024; 108:414-420. [PMID: 38735280 PMCID: PMC11449191 DOI: 10.1159/000539312] [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: 01/25/2024] [Accepted: 04/13/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Bladder cancer, with a greater incidence in males than in females, requires frequent cystoscopies. We aimed to evaluate the effect of music played through noise-canceling headphones on male bladder cancer patients during follow-up cystoscopy. METHODS A total of 160 male bladder cancer patients undergoing follow-up flexible cystoscopy were randomly divided into the noise-canceling headphones without music group and the noise-canceling headphones with music group (groups 1 and 2, respectively; n = 80 per group). The patients' clinical characteristics were examined, and objective and subjective measurements were compared before and after cystoscopy. The primary outcomes that were evaluated included the visual analog scale (VAS, 0-10) and the state-trait anxiety inventory (STAI, 20-80). Other outcomes, including vital signs and scores for assessing satisfaction and the willingness to repeat the procedure, were also examined. RESULTS The characteristics of the patients in groups 1 and 2, and their pre-cystoscopy status, did not differ significantly. Although post-cystoscopy vital signs for the objective parameters and VAS pain scores were similar between the groups, subjective parameters were not. When compared with group 1, post-cystoscopy STAI-state scores were significantly lower in group 2, whereas patients' satisfaction scores and the willingness to repeat the procedure were significantly higher in group 2 (p = 0.002, 0.001, and 0.001, respectively). Additionally, in group 2, STAI-state scores changed significantly after the procedure when compared with before the procedure (p = 0.002). CONCLUSION Providing music to male bladder cancer patients through noise-canceling headphones was found to reduce anxiety during cystoscopy and to improve patient satisfaction and willingness to undergo repeat cystoscopy.
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Affiliation(s)
- Hyun-Jin Cho
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Urology, University of California San Diego, La Jolla, California, USA
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Dongdeuk Kwon
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Darshan P Patel
- Department of Urology, University of California San Diego, La Jolla, California, USA
| | - Tung-Chin Hsieh
- Department of Urology, University of California San Diego, La Jolla, California, USA
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Demirci H, van der Storm SL, Huizing NJ, Fräser M, Stufkens SAS, Krips R, Kerkhoffs GMMJ, Barsom EZ, Schijven MP. Watching a movie or listening to music is effective in managing perioperative anxiety and pain: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 2023; 31:6069-6079. [PMID: 37897624 PMCID: PMC10719121 DOI: 10.1007/s00167-023-07629-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/09/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Despite the use of perioperative anxiolytics and pain medication, surgery can be a stressful and painful experience. Providing patients with distractions using video and/or audio tools in addition to medication may be helpful. To date, no studies have compared different distraction modalities in a same-day surgical setting in adults. This study aims to determine whether audio-visual distraction with video glasses (AVD) is more effective in reducing anxiety and pain compared to audio distraction (AD) in conscious patients undergoing orthopaedic surgery. It was hypothesised that AVD, being the more immersive modality, would be more effective than AD on the outcome parameters. METHODS Fifty patients undergoing orthopaedic surgery with local and/or regional anaesthesia in a clinical day-care setting were randomly assigned to receive either fixed-scenery AVD or patient-choice AD with music. Primary outcome was anxiety, as measured by the Dutch version of the Spielberger State-Trait Anxiety Inventory-6 (STAI-6) prior to and 15 min after the intervention. Secondary outcomes were pain (Numeric Rating Scale Pain [NRS-P]), systolic and diastolic blood pressure, heart rate and patient satisfaction. RESULTS Within each group, there was a significant reduction in anxiety (p = 0.028 for AVD, p < 0.001 for AD). In contrast to our hypothesis, listening to music without watching a video (AD group) reduced anxiety significantly more than experiencing full AVD (p = 0.018). The mean pain score did not change significantly within either user group, nor did pain scores differ between user groups. CONCLUSION In conscious patients undergoing surgery, watching a movie (using video glasses and a headphone set) and listening to music (using only a headphone set) are able to significantly reduce anxiety. AVD, although believed to provide higher levels of distraction, did not prove to be superior to AD. The clinical relevance of this study highlights the potential benefits of AVD or AD modalities in improving the surgical experience for conscious patients. Further research is required to examine the influence of freedom of choice in content on the aforementioned outcomes. To estimate the true value of higher immersion levels, different distraction modalities (e.g. AVD versus virtual reality) featuring the exact same scenery or content need to be compared. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Hafize Demirci
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands.
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands.
| | - Sebastiaan L van der Storm
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| | - Nathalie J Huizing
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Morgianne Fräser
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Sjoerd A S Stufkens
- Amsterdam UMC, Department of Orthopedic Surgery, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Rover Krips
- Department of Orthopaedic Surgery, Flevoziekenhuis, Almere, The Netherlands
| | - Gino M M J Kerkhoffs
- Amsterdam UMC, Department of Orthopedic Surgery, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Esther Z Barsom
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands.
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands.
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Law YXT, Kesavan A, Loke W, Chua WJ, Tai BC, Shen L, Tiong HY, Chen WJK. Does addition of aromatherapy and music help to reduce pain and anxiety during shockwave lithotripsy compared to standard analgesia alone? A randomised controlled trial. Int Urol Nephrol 2023; 55:2405-2410. [PMID: 37395910 DOI: 10.1007/s11255-023-03684-0] [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: 04/03/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE To assess the effect of aromatherapy with lavender oil alone, and in combination with music, on pain and anxiety during extracorporeal shockwave lithotripsy for kidney stones. METHODS This was a single-centre prospective, randomised controlled trial. The subjects were block randomised into 3 study groups, Group 1: Control; Group 2: Aromatherapy only; Group 3: Aromatherapy and music. All subjects were given patient-controlled intravenous alfentanil as standard analgesia. The primary outcome measures were pain and anxiety scores using visual analogue scale (VAS) and State-Trait Anxiety Inventory. RESULTS Ninety patients were recruited and randomised prospectively into Group 1 (n = 30), Group 2 (n = 30), and Group 3 (n = 30). For pain outcome, both Group 2 and Group 3 showed a trend towards lower mean VAS pain scores of 2.73 in both groups compared to the control with a mean VAS score of 3.50, but it was not statistically significant (p = 0.272). There was no significant difference in anxiety scores between groups post-treatment. CONCLUSIONS Our study was unable to show a significant improvement in pain relief and anxiety when aromatherapy with lavender oil was added to standard analgesia alone during shockwave lithotripsy. There was also no difference when aromatherapy was combined with music.
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Affiliation(s)
- Yu Xi Terence Law
- Department of Urology, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore, 119228, Singapore.
| | - Arshvin Kesavan
- Department of Urology, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore, 119228, Singapore
| | - Wayren Loke
- Department of Urology, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore, 119228, Singapore
| | - Wei Jin Chua
- Department of Urology, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore, 119228, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ho Yee Tiong
- Department of Urology, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore, 119228, Singapore
| | - Wei Jing Kelven Chen
- Department of Urology, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 8, Singapore, 119228, Singapore
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Zeng G, Zhong W, Chaussy CG, Tiselius HG, Xu C, Turney B, Turk C, Tailly GG, Preminger GM, Akpinar H, Petrik A, Bernardo N, Wiseman O, Farahat Y, Budia A, Jones DK, Beltran Suarez E, De Marco F, Mazzon G, Lv J, Natchagande G, Guven S, Ibrahim TAA, Xu H, Xie L, Ye Z, Sarica K. International Alliance of Urolithiasis Guideline on Shockwave Lithotripsy. Eur Urol Focus 2023; 9:513-523. [PMID: 36435718 DOI: 10.1016/j.euf.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/04/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022]
Abstract
Different international associations have proposed their own guidelines on urolithiasis. However, the focus is primarily on an overview of the principles of urolithiasis management rather than step-by-step technical details for the procedure. The International Alliance of Urolithiasis (IAU) is releasing a series of guidelines on the management of urolithiasis. The current guideline on shockwave lithotripsy (SWL) is the third in the IAU guidelines series and provides a clinical framework for urologists and technicians performing SWL. A total of 49 recommendations are summarized and graded, covering the following aspects: indications and contraindications; preoperative patient evaluation; preoperative medication; prestenting; intraoperative analgesia or anesthesia; intraoperative position; stone localization and monitoring; machine and energy settings; intraoperative lithotripsy strategies; auxiliary therapy following SWL; evaluation of stone clearance; complications; and quality of life. The recommendations, tips, and tricks regarding SWL procedures summarized here provide important and necessary guidance for urologists along with technicians performing SWL. PATIENT SUMMARY: For kidney and urinary stones of less than 20 mm in size, shockwave lithotripsy (SWL) is an approach in which the stone is treated with shockwaves applied to the skin, without the need for surgery. Our recommendations on technical aspects of the procedure provide guidance for urologists and technicians performing SWL.
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Affiliation(s)
- Guohua Zeng
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China.
| | - Wen Zhong
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Christian G Chaussy
- University of Munich, Munich, Germany; University of Regensburg, Regensburg, Germany
| | - Hans Göran Tiselius
- Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Changbao Xu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ben Turney
- Department of Urology, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Christian Turk
- Department of Urology, Hospital of the Sisters of Charity, Vienna, Austria
| | | | - Glenn M Preminger
- Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Haluk Akpinar
- Department of Urology, Florence Nightingale Hospitals Group, Istanbul, Turkey
| | - Ales Petrik
- Department of Urology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Norberto Bernardo
- Department of Urology, Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
| | - Oliver Wiseman
- Department of Urology, Cambridge University Hospitals, Cambridge, UK
| | - Yasser Farahat
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Alberto Budia
- Department of Urology, La Fe Polytechnic University Hospital, Valencia, Spain
| | - David K Jones
- Department of Pharmacology, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Edgar Beltran Suarez
- Department of Urology, Specialty Hospital La Raza, National Medical Center of the Mexican Institute of Social Security, Mexico City, Mexico
| | - Ferdinando De Marco
- Urology Division, Istituto Neurotraumatologico Italiano-Grottaferrata, Rome, Italy
| | - Giorgio Mazzon
- Department of Urology, San Bassiano Hospital, Vicenza, Italy
| | - Jianlin Lv
- Department of Urology, Jiangning Hospital, Nanjing Medical University, Nanjing, China
| | | | - Selcuk Guven
- Urology Department, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | | | - Hanfeng Xu
- Department of Urology, First Affiliated Hospital of University of South China, Henyang, China
| | - Lei Xie
- Department of Urology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Zhangqun Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kemal Sarica
- Department of Urology, Biruni University Medical School, Istanbul, Turkey.
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Weynants L, Chys B, D'hulst P, Merckx L, Van Besien J, Tailly T. Virtual reality for pain control during shock wave lithotripsy: a randomized controlled study. World J Urol 2023; 41:589-594. [PMID: 36680576 DOI: 10.1007/s00345-023-04280-8] [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: 08/13/2022] [Accepted: 12/30/2022] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Although external shock wave lithotripsy (SWL) is an outpatient procedure generally not requiring anesthesia or sedation, patients may experience pain during the procedure. The aim of this study is to evaluate whether a virtual reality device is effective in reducing patient-reported pain during the procedure, consequently leading to exposure to higher energy levels and better clinical outcomes. METHODS Inclusion criteria for SWL were according to the latest EAU guidelines on urolithiasis. Patients were randomized 1:1 in two groups (SWL with VR and SWL without VR). The primary outcome of this randomized, controlled study (RCT) was an overall difference in pain levels determined by VAS-scores. Secondary outcomes were differences in comfort levels, determined by Likert-scale scores, clinical success and total delivered energy. RESULTS Between January 2019 and September 2021, we enrolled 166 patients; 84 were randomized to the control arm and 82 to the VR arm. Patients without VR experienced significantly more pain compared to the VR group (mean VAS-score = 4.94 vs 4.01; p = 0.011). The mean total delivered energy was significantly higher in the VR group compared to the control group (55.2 J vs. 48.8 J; p = 0'037). No significant differences in comfort levels and clinical success were found. CONCLUSION This study supports the use of VR as a method of pain relief during shock wave lithotripsy. Higher energy levels can be achieved during the treatment while comfort levels remained equal; this however did not lead to improved clinical success. REGISTRATION NUMBER AND NAME OF TRIAL REGISTRY Clinicaltrials.gov: NCT05183269. Virtual reality for pain control during extracorporeal shock wave lithotripsy: prospective, comparative, randomized study at a single institution. https://clinicaltrials.gov/ct2/show/NCT05183269?term=shock+wave+lithotripsy&cond=virtual+reality&cntry=BE&draw=2&rank=1 .
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Affiliation(s)
- Laurens Weynants
- Department of Urology, AZ Sint-Lucas Ghent, Groenebriel 1, 9000, Ghent, Belgium. .,Department of Urology, University Hospital Ghent, Ghent, Belgium.
| | - Brecht Chys
- Department of Urology, AZ Sint-Lucas Ghent, Groenebriel 1, 9000, Ghent, Belgium
| | - Pieter D'hulst
- Department of Urology, AZ Sint-Lucas Ghent, Groenebriel 1, 9000, Ghent, Belgium
| | - Luc Merckx
- Department of Urology, AZ Sint-Lucas Ghent, Groenebriel 1, 9000, Ghent, Belgium
| | - Jeroen Van Besien
- Department of Urology, AZ Sint-Lucas Ghent, Groenebriel 1, 9000, Ghent, Belgium
| | - Thomas Tailly
- Department of Urology, University Hospital Ghent, Ghent, Belgium
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Moradipoor Y, Rejeh N, Heravi Karimooi M, Tadrisi SD, Dahmardehei M, Bahrami T, Vaismoradi M. Comparing Auditory and Visual Distractions for Reducing Pain Severity and Pain Anxiety in Older Outpatients with Burn: A Randomized Controlled Trial. Geriatrics (Basel) 2022; 7:54. [PMID: 35645277 PMCID: PMC9149902 DOI: 10.3390/geriatrics7030054] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023] Open
Abstract
Pain and anxiety are major issues among older patients with burn injuries. Complementary medicine and non-pharmacological methods can relieve pain and anxiety in older people, but comparison of the effects of these methods needs further research. This study aimed to compare the effects of auditory and visual distractions on pain severity and pain anxiety in older outpatients referred to a burn clinic for dressing change. In this randomized controlled clinical trial, older men were randomly assigned to three groups as auditory distraction, visual distraction, and control (n = 45 in each group). The Visual Analogue Scale (VAS) and the Burn Specific Pain Anxiety Scale (BSPAS) were used to asses pain severity and pain anxiety before and immediately after the interventions, and after wound dressing. Reduction in pain severity and pain anxiety after visual distraction was reported. Auditory distraction only reduced pain anxiety. Therefore, visual distraction had a better effect on alleviating pain anxiety compared with auditory distraction. Visual distraction is suggested to be used during dressing changes for older outpatients with burn injuries in outpatient clinics in order to reduce their burn-related suffering and improve their collaboration with the therapeutic regimen.
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Affiliation(s)
- Yaghob Moradipoor
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Nahid Rejeh
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Majideh Heravi Karimooi
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Seyed Davood Tadrisi
- Trauma Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran;
| | - Mostafa Dahmardehei
- Burn Research Center, Iran University of Medical Sciences, Tehran 1449614535, Iran;
| | - Tahereh Bahrami
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway;
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