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Lee S, Quinn L, Fritschi C, Fink AM, Park C, Reutrakul S, Collins EG. Physical Activity After Heart Surgery: Associations With Psychosocial and Sleep Factors. West J Nurs Res 2024; 46:333-343. [PMID: 38533821 DOI: 10.1177/01939459241240432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Heart surgery is an effective intervention for managing heart disease, the leading cause of death globally. After surgery, physical activity is key to improving patients' quality of life and decreasing mortality, but patients are frequently physically inactive after heart surgery. OBJECTIVE This cross-sectional pilot study aimed to examine how psychosocial and sleep factors influenced physical activity in patients after heart surgery. The mediating role of sleep factors between psychosocial factors and physical activity was also examined. METHODS Thirty-three patients who had undergone heart surgery were recruited. Psychosocial and sleep factors and physical activity were measured using an online survey and a wrist-worn ActiGraph for 7 days and nights. RESULTS The participants had heart surgery an average of about 7 years previously. They exceeded the recommended 150 minutes per week of moderate-intensity physical activity for Americans; however, 64% of them showed poor sleep quality (Pittsburgh Sleep Quality Index >5). Higher anxiety and depressive symptoms, lower self-efficacy, and greater sleep disturbances were associated with lower physical activity. Moreover, self-efficacy, sleep duration, sleep disturbance, sleep efficiency, and wake after sleep onset were predictors for physical activity. No mediating role of sleep factors was observed between psychosocial factors and physical activity. CONCLUSIONS Psychosocial and sleep factors should be considered when developing and implementing physical activity strategies for patients after heart surgery. Researchers should examine the relationships among the study variables with larger samples of postsurgical cardiac patients during different periods after heart surgery.
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Affiliation(s)
- Sueyeon Lee
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA
| | - Lauretta Quinn
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Cynthia Fritschi
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Anne M Fink
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Chang Park
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Sirimon Reutrakul
- Department of Medicine, University of Illinois Chicago, Chicago, IL, USA
| | - Eileen G Collins
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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Russo M, Watson K, Richards K, Olive RR, Krausova B, Kumar R, Burridge J, Goulding L, Chua KC, Hardy D, Vassilios A, Kamran B, Bhudia S, Alia N, Habib K, Sevdalis N, Petrou M. Study protocol for a cross-sectional online survey investigating patient preferences and experiences of waiting for elective cardiac surgery. BMJ Open 2024; 14:e079692. [PMID: 38443077 PMCID: PMC11146383 DOI: 10.1136/bmjopen-2023-079692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/31/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Being on a waiting list for elective (planned) cardiac surgery can be physically and psychologically challenging for patients. Research suggests that stress associated with waiting for surgery is dependent on different individual and contextual factors. However, most data on patients' experiences of waiting for surgery and preferences for waiting list management derives from non-cardiac clinical populations. The aim of the current study is to explore patients' experiences of being on a waiting list for elective cardiac surgery, and their views on how the waiting experience could be improved in the future. This work will inform the patient management strategy during the waiting period for surgery across the four major hospitals in London directly involved in this study, and potentially beyond by transferring learning to other services. METHODS AND ANALYSIS This is a mixed-methods study that will collect quantitative and qualitative data using a cross-sectional online survey. Patients who are on waiting lists for elective surgery across four major cardiac surgery departments in London hospitals, and are at least 18 years old, will be invited by their healthcare team via text message or letter to complete the survey. The target sample size of non-randomly selected participants will be 268. Bivariable and multivariable regression models will be used to assess associations between survey items measuring the impact of the cardiac condition on specific life domains (eg, daily activities, social and family relationships, hobbies, sexual life), anxiety and depression symptoms as measured by the Patient Health Questionnaire-4 and survey items evaluating experiences of health services. Data on experience and preferences for improvements to the waiting experience will be analysed with qualitative content analysis using an inductive approach. ETHICS AND DISSEMINATION This study was reviewed and granted ethical approval by the East of England-East Cambridge Research Ethics Committee. Findings from this study will be disseminated through peer-reviewed journals, a research website and social media and with an online event engaging patients, members of the public, healthcare professionals and other relevant stakeholders. TRIAL REGISTRATION NUMB NCT05996640.
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Affiliation(s)
- Manuela Russo
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kathryn Watson
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katie Richards
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rachel Rowan Olive
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Barbora Krausova
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | | | - Lucy Goulding
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kia-Chong Chua
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| | - David Hardy
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Baig Kamran
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sunil Bhudia
- Royal Brompton & Harefield hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Noorani Alia
- King's College Hospital NHS Foundation Trust, London, UK
| | - Khan Habib
- King's College Hospital NHS Foundation Trust, London, UK
| | - Nick Sevdalis
- Centre for Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mario Petrou
- Royal Brompton & Harefield hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Bikmoradi A, Omidvar S, Roshanaei G, Khatiban M, Harorani M. The impact of telenursing on level of depression, stress and anxiety in discharged patients after coronary artery bypass graft surgery: A randomized clinical trial. JOURNAL OF VASCULAR NURSING 2023; 41:89-94. [PMID: 37684095 DOI: 10.1016/j.jvn.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND After coronary artery bypass graft surgery patients are susceptible to mental disorders such as stress, anxiety, and depression following discharge from the hospital and often require post-discharge support and follow-up. Telenursing is an accessible method that may reduce stress, anxiety, and depression experienced by patients. This study aimed to investigate the impact of telenursing on depression, stress, and anxiety in discharged patients after CABG surgery. MATERIALS AND METHODS A randomized clinical trial was carried out. Eligible patients were divided randomly into intervention (n=40) and control (n=40) groups. Depression Anxiety Stress Scale-21 (DASS21) questionnaire was filled out by both groups one day before discharge from the hospital. The intervention group received SMS reminders of their treatment plan, referrals to the cardiac rehabilitation clinic, and routine care three times a week for six weeks, while the control group received routine care provided by the hospital only. In the week following the completion of the intervention period, both groups returned to fill out the questionnaire, and the data were analyzed using SPSS version 16.0, descriptive and inferential statistics, and independent and paired T-tests. RESULT The mean scores of depression, stress, and anxiety before intervention in the intervention group were 11.95, 18.75, and 18.17, and in the control group were 11.55, 18.37, and 17.4 respectively. The mean scores of depression, stress, and anxiety after intervention in the intervention group were 7.85, 10.5, and 10.45, and in the control group were 10.56, 17.9, and 16.5 respectively. No significant differences were seen between the two groups before the intervention (P>0.05), but the results showed significant differences between the two groups' mean scores of depression, stress, and anxiety after intervention (P<0.001). CONCLUSION Telenursing can reduce stress, anxiety, and depression in discharged patients after coronary artery bypass graft surgery by providing proper and cost-effective follow-up.
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Affiliation(s)
- Ali Bikmoradi
- Healthcare Management, Hamedan University of Medical Science, Hamedan, Iran.
| | - Safoora Omidvar
- School of Nursing and Midwifery, Hamedan University of Medical Science, Hamedan, Iran.
| | - Ghodratollah Roshanaei
- Modelling Non-Communicable Diseases Research Center and Department of Biostatistics and Epidemiology, School of Public Health, Hamedan University of Medical Science, Hamedan, Iran.
| | - Mahnaz Khatiban
- Healthcare Management, Hamedan University of Medical Science, Hamedan, Iran
| | - Mehdi Harorani
- Department of Nursing, Shazand School of Nursing, Arak University of Medical Sciences, Arak, Iran
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Ghanbari Jolfaei A, Parvaresh M, Ghalebandi M, Alavi K, Hajsadeghi S. Comparison the effects of gabapentin and oxazepam on sleep quality, anxiety, and pain in unstable angina patients admitted to coronary care unit of Hazrat Rasool Akram Hospital. Adv Biomed Res 2022; 11:57. [PMID: 36124023 PMCID: PMC9482373 DOI: 10.4103/abr.abr_154_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 03/15/2021] [Accepted: 09/22/2021] [Indexed: 11/04/2022] Open
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OUP accepted manuscript. Eur J Cardiothorac Surg 2022; 62:6523882. [DOI: 10.1093/ejcts/ezac041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 11/15/2022] Open
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Bouras AF, Aoudia A, Manchon J, Bahbouh G, Tadrist K, Cherchar K, Bouzid C, Cottencin O, Boudia FM. Prevalence and Impact of Depression in a Sample of Patients Treated in a Digestive Surgery Department. Indian J Surg 2021. [DOI: 10.1007/s12262-021-03013-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Koyuncu A, Yava A, Yamak B, Orhan N. Effect of family presence on stress response after bypass surgery. Heart Lung 2020; 50:193-201. [PMID: 33278754 DOI: 10.1016/j.hrtlng.2020.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Coronary artery bypass grafting (CABG) is a major surgery that may cause severe surgical stress response (SR). Although the presence of family members in intensive care unit (ICU) is known to benefit intensive care patients socially and emotionally, its effects on surgical SR are unknown. OBJECTIVES To investigate the effect of an informed family member (IFM)'s presence in the awakening process in ICU on patients' SR after CABG. METHODS A nonrandomized controlled clinical study was completed with a total of 73 patients: 37 patients in the control (CG) and 36 in the intervention group (IG) underwent CABG surgery. In the CG patients, no family members were taken into the ICU during the awakening process and routine care and treatment practices were continued. In the IG patients, besides routine care and treatment practices, an IFM was taken into the ICU during the awakening process in accordance with the research method. Groups were statistically compared in terms of serum cortisol level which is the one of the main indicators of surgical SR, state anxiety, sedative drug requirements, and duration of intubation, sedation, and ICU stay. A p value <0.05 was accepted as statistically significant. RESULTS Presence of an IFM in the ICU was found to be effective in decreasing serum cortisol level, state anxiety, sedative drug requirements, and the duration of intubation, sedation, and ICU stay (p<0.05). CONCLUSIONS In CABG, the presence of IFM in ICU is effective in reducing SR.
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Affiliation(s)
- Aynur Koyuncu
- Nursing Department, Hasan Kalyoncu University, Faculty of Health Sciences, Gaziantep, Turkey.
| | - Ayla Yava
- Nursing Department, Hasan Kalyoncu University, Faculty of Health Sciences, Gaziantep, Turkey.
| | - Birol Yamak
- Gaziantep Medikal Park Hospital, Gaziantep, Turkey.
| | - Nuri Orhan
- Gaziantep Medikal Park Hospital, Gaziantep, Turkey.
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Milisen K, Van Grootven B, Hermans W, Mouton K, Al Tmimi L, Rex S, Detroyer E. Is preoperative anxiety associated with postoperative delirium in older persons undergoing cardiac surgery? Secondary data analysis of a randomized controlled trial. BMC Geriatr 2020; 20:478. [PMID: 33208091 PMCID: PMC7672929 DOI: 10.1186/s12877-020-01872-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/05/2020] [Indexed: 11/18/2022] Open
Abstract
Background Although many studies have reported numerous risk factors for postoperative delirium, data are scarce about preoperative anxiety as a risk factor. The study aimed to investigate the association between preoperative anxiety and postoperative delirium in older patients undergoing cardiac surgery. Methods Secondary data analysis of a randomized, observer-blind, controlled trial. A total of 190 patients 65 years or older and admitted to the intensive care unit and cardiac surgery unit of a university hospital scheduled for elective on-pump cardiac surgery were included. State anxiety was measured preoperatively using the Amsterdam Preoperative Anxiety and Information Scale and the Visual Analogue Scale for anxiety. Incidence of delirium was measured during the first 5 postoperative days using the Confusion Assessment Method for Intensive Care Unit (when ventilated), or the 3 Minute Diagnostic Interview for Confusion Assessment Method (when extubated) and by daily chart review. Results Preoperative state anxiety was reported by 31% of the patients and 41% had postoperative delirium. A multiple step logistic regression analyses revealed no association between preoperative anxiety and postoperative delirium. Significant risk factors for postoperative delirium were age (OR = 1.10, 95% CI (1.03–1.18)), activities of daily living (0.69, 95% CI (0.50–0.96)), diabetes mellitus (OR = 3.15, 95% CI (1.42–7.00)) and time on cardiopulmonary bypass (OR = 1.01, 95% CI (1.00 to 1.02)). Conclusions No relationship could be found between preoperative anxiety and postoperative delirium.
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Affiliation(s)
- Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium. .,Department of Geriatric Medicine, KU Leuven - University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Bastiaan Van Grootven
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - Wim Hermans
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium
| | - Karen Mouton
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium
| | - Layth Al Tmimi
- Department of Anesthesiology, KU Leuven - University of Leuven, University Hospitals of Leuven, Herestraat 49, B-3000, Leuven, Belgium.,Department of Cardiovascular Sciences, KU Leuven - University of Leuven, B-3000, Leuven, Belgium
| | - Steffen Rex
- Department of Anesthesiology, KU Leuven - University of Leuven, University Hospitals of Leuven, Herestraat 49, B-3000, Leuven, Belgium.,Department of Cardiovascular Sciences, KU Leuven - University of Leuven, B-3000, Leuven, Belgium
| | - Elke Detroyer
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium.,Department of Geriatric Medicine, KU Leuven - University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium
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Callus E, Pagliuca S, Bertoldo EG, Fiolo V, Jackson AC, Boveri S, De Vincentiis C, Castelvecchio S, Volpe M, Menicanti L. The Monitoring of Psychosocial Factors During Hospitalization Before and After Cardiac Surgery Until Discharge From Cardiac Rehabilitation: A Research Protocol. Front Psychol 2020; 11:2202. [PMID: 33117210 PMCID: PMC7550819 DOI: 10.3389/fpsyg.2020.02202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 08/05/2020] [Indexed: 01/07/2023] Open
Abstract
Introduction: There is considerable evidence that psychosocial factors contribute to the etiology and prognosis of cardiac illness. Currently, in Italy, psychologists are only obligatory in the cardiac rehabilitation setting, although there are indications that patients could be experiencing distress also during other moments of hospitalization, such as on admission for cardiac surgery. Objective and Methods: The objective of this protocol is to gain more information about cardiac patients, specifically during the various moments of hospitalization for cardiac surgery, by collecting data at admission before cardiac surgery (t0), at admission to cardiac rehabilitation (t1), and at discharge (t2) at the Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato hospital. A psychosocial questionnaire was constructed after consulting the relevant national and international guidelines. Patients admitted for cardiac surgery and attending a rehabilitation program will be evaluated by acquiring data about their civil status, religiosity, education and work capacity, social condition (including the presence and quality of intimate relationships and support received), previous psychological and psychiatric histories, psychological status, lifestyle (including questions on nutrition, smoking, alcohol, and substance abuse), adherence to therapy, quality of life (QoL), health perception, anxiety, and depression at t0. Health perception, anxiety, and depression are also measured at t1 and t2. Discussion and Conclusion: This study is an attempt to identify the recommended psychosocial variables which need to be monitored during cardiac patients' hospitalization for cardiac surgery, through to the completion of cardiac rehabilitation. After implementing this study at the IRCCS Policlinico San Donato, attempts will be made to create studies on a national and international level to generate more evidence regarding these variables, in order to create tailor-made interventions for these patients during these specific and delicate moments.
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Affiliation(s)
- Edward Callus
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Silvana Pagliuca
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Valentina Fiolo
- Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Sara Boveri
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Carlo De Vincentiis
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Marianna Volpe
- Department of Cardiac Rehabilitation, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Lorenzo Menicanti
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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The Effect of Aromatherapy by Rose Essence on Anxiety and Physiological Indices of Conscious Patients Admitted at Intensive Care Units. ACTA ACUST UNITED AC 2020. [DOI: 10.5812/hmj.101124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Anxiety in patients admitted at the Intensive Care Unit (ICU) is common and usually moderate or severe. Anxiety affects endocrine and physiological responses. Objectives: This study aimed to determine the effect of aromatherapy by rose essence on anxiety and physiological indices of conscious patients admitted at ICU. Methods: In this clinical trial, 60 conscious patients admitted at ICU wards in Ali Ibn Abi Talib Hospital of Rafsanjan were selected and randomly allocated into two groups of intervention and control. In the intervention group, three drops of 10% rose essence were poured on the gauze and placed 20 cm from the patients’ nose on their shirt, and the patients inhaled it for 20 minutes three times a day. In the control group, three drops of distilled water were used likewise. Data collection tools included Spielberger State-Trait Anxiety Inventory (STAI) and the demographic questionnaire. Data were analyzed using SPSS V.18. Results: According to the results, in the intervention group, the systolic and diastolic blood pressure significantly increased (paired t-test, P < 0.05) in the second time after the intervention and significantly decreased (paired t-test, P < 0.05) in the third time. The mean oxygen saturation of arterial blood also significantly increased in the second time in this group after the intervention (paired t-test, P = 0.001). However, there was no significant difference in anxiety score before and after the intervention in each group. Conclusions: Although aromatherapy using rose essence was statistically significant on some of the physiological indices of conscious patients in ICU, these differences were not clinically significant.
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Muthukrishnan A, Muralidharan TR, Subash J, Lathamangeswari C. Association of poor sleep quality with risk factors after coronary artery bypass graft surgery—A prospective cohort study. JOURNAL OF VASCULAR NURSING 2020; 38:83-92. [DOI: 10.1016/j.jvn.2020.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/22/2020] [Accepted: 02/05/2020] [Indexed: 10/24/2022]
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Akhlaghi E, Babaei S, Abolhassani S. Modifying Stressors Using Betty Neuman System Modeling in Coronary Artery Bypass Graft: a Randomized Clinical Trial. J Caring Sci 2020; 9:13-19. [PMID: 32296654 PMCID: PMC7146725 DOI: 10.34172/jcs.2020.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 03/04/2019] [Indexed: 11/09/2022] Open
Abstract
Introduction: Coronary artery disease (CAD) is one of the major causes of mortality all over the world. In this relation, coronary artery bypass grafting (CABG) is one of the most important treatments for CAD patients. However, it leads to a lot of stress in the patient. The aim of this study was to use the Neuman model to moderate the stressors in patients undergoing coronary artery bypass graft. Methods: This study was a randomized clinical trial of two groups performed on patients admitted to the coronary artery bypass graft; and the study completed with 64 patients. The intervention was performed by the researcher according to the format of the Neuman Model, which included the investigation of the stressors, and the determination of the goals and strategies for the actions. Intrapersonal, interpersonal, and extra personal factors were evaluated using a Revised Cardiac Surgery Stressor Scale (RCSSS). The intervention program was designed by the researcher based on prevention levels using scientific resources. The collected data were analyzed in SPSS ver. 13 using descriptive and inferential statistics. Results: Before the intervention, the mean score of the stressors was not significantly different between the two groups. But immediately after the intervention and before discharging the intervention group, it was significantly less than the control group. Conclusion: Using a Neuman-based program as an effective and low-cost intervention can moderate the stressors and reduce the stress of patients awaiting coronary artery bypass graft. This theory can be a good guide to offering the roles needed to provide health services in the community.
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Affiliation(s)
- Elham Akhlaghi
- Department of Adult Health Nursing, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sima Babaei
- Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Iran
| | - Shahla Abolhassani
- Department of Adult Health Nursing, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
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Ramesh C, Nayak BS, Pai VB, George A, George LS, Devi ES. Pre-operative anxiety in patients undergoing coronary artery bypass graft surgery – A cross-sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2017. [DOI: 10.1016/j.ijans.2017.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Rajai N, Sajadi SA, Teymouri F, Zareiyan A, Siavoshi S, Malmir M. The Effect of Aromatherapy with Lavender Essential Oil on Anxiety and Stress in Patients Undergoing Coronary Artery Bypass Graft Surgery. ACTA ACUST UNITED AC 2016. [DOI: 10.17795/jjcdc-34035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Svensson M, Nilsson U, Svantesson M. Patients' experience of mood while waiting for day surgery. J Clin Nurs 2016; 25:2600-8. [DOI: 10.1111/jocn.13304] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Margita Svensson
- Faculty of Medicine and Health; School of Health Sciences; Örebro University; Örebro Sweden
| | - Ulrica Nilsson
- Faculty of Medicine and Health; School of Health Sciences; Örebro University; Örebro Sweden
| | - Mia Svantesson
- Faculty of Medicine and Health; Örebro University; Örebro Sweden
- University Health Care Research Center; Region Örebro County; Örebro Sweden
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Tsang GFZ, McKnight CL, Kim LM, Lee JM. Exploring the psychological morbidity of waiting for sinus surgery using a mixed methods approach. J Otolaryngol Head Neck Surg 2016; 45:36. [PMID: 27266530 PMCID: PMC4897809 DOI: 10.1186/s40463-016-0149-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 05/31/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with chronic rhinosinusitis (CRS) often have to endure significant wait times for endoscopic sinus surgery (ESS). The pyschiatric impact of placement on a waitlist for ESS has not been explored. METHODS Questionnaires measuring CRS symptom severity and health-related anxiety and stress (SNOT-22, HADS, WPAI-GH) were sent to patients diagnosed with CRS and currently on a waitlist for ESS. Fifteen representative waitlisted patients participated in one-on-one semi-structured interviews discussing their experience with their wait for ESS. A deductive thematic analysis was used to interpret the interview data using a quantitative driven mixed methods analysis. RESULTS Participants waiting for ESS reported worsening clinical symptomatology during their waiting period. Participants reported waitlist and CRS impact on both work and social aspects of their lives. The HADS scale showed no overall significant level of depression or anxiety in the HADS screening questionnaire. The qualitative data describe the effects of the symptom burden of CRS. CONCLUSIONS Patients waitlisted for ESS did not demonstrate any significant level of psychiatric distress, however variability exists. The qualitative arm of this study elucidates how patients cope with their wait.
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Affiliation(s)
- Gordon Fung-Zak Tsang
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Carmen L McKnight
- Department of Otolaryngology-Head & Neck Surgery, St. Michael's Hospital, Toronto, ON, Canada
| | | | - John M Lee
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada. .,Department of Otolaryngology-Head & Neck Surgery, St. Michael's Hospital, Toronto, ON, Canada.
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Bagheri Nesami M, Shorofi SA, Jafari A, Khalilian AR, Ziabakhsh Tabari S. The Relationship Between Stressors and Anxiety Levels After CABG in Sari, Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e25407. [PMID: 27437127 PMCID: PMC4939229 DOI: 10.5812/ircmj.25407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 12/23/2014] [Accepted: 01/04/2015] [Indexed: 11/16/2022]
Abstract
Background Hospitalization and surgery are crucial adverse life events that lead to considerable anxiety in patients. Objectives The present study aimed to investigate stressors after coronary artery bypass graft surgery and identify stressors that predict anxiety. Patients and Methods This is a descriptive-analytical study that uses a non-random convenience sampling method on patients undergoing coronary artery bypass graft surgery at the cardiac surgery intensive care unit of Fatemeh Zahra Cardiac center in Sari, Iran. A total of 186 patients completed the post-surgical stressors questionnaire and the Spielberger State-Trait Anxiety Inventory on postoperative days 2 or 3 in the cardiac surgery intensive care unit. Data were analyzed using descriptive statistics including frequencies, means, and standard deviations. The Mann–Whitney U test was used to determine the relationship between the observed variables, and the logistic regression model was used to identify the relationship between stressors and anxiety after-surgery. Results Post-surgical anxiety predictors included insufficient sleep during hospitalization (Odds ratio [OR]: 5.42; 95% confidence interval [CI]: 1.46 - 20.00; P = 0.010), treatment not explained to the patient by the nurse (OR: 4.83; 95% CI: 1.82 - 12.84; P = 0.002), being away from family members (OR: 3.88; 95% CI: 1.46 - 10.26; P = 0.006), presence of a chest tube (OR: 3.27; 95% CI: 1.83 - 5.84; P = 0.000), and pain in any part of the body (OR: 1.95; 95% CI: 1.06 - 3.58; P = 0.031). Conclusions Physical or physiological and psychological stressors impose greater stress and are predictors of anxiety. When preparing their nursing care plan, nurses should consider these stressors that affect anxiety levels in patients undergoing CABG surgery and those hospitalized in intensive care units.
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Affiliation(s)
- Masoumeh Bagheri Nesami
- Mazandaran Pediateric Infectious Disease Research Center (MPIDRC), Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Seyed Afshin Shorofi
- Traditional and Complementary Medicine Research Centre, Mazandaran University of Medical Sciences, Sari, IR Iran
- Adjunct Research Fellow, Flinders University, Adelaide, Australia
| | - Azam Jafari
- Student Research Committee, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran
- Corresponding Author: Azam Jafari, Student Research Committee, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran. Tel: +98-9101001520, Fax: +98-1133368915, E-mail:
| | - Ali Reza Khalilian
- Department of Biostatistics and Epidemiology, Mazandaran University of Medical Sciences, Sari, IR Iran
- Psychiatry and Behavioral Sciences Research Centre, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Shervin Ziabakhsh Tabari
- Department of Cardiac Surgery, Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
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Bikmoradi A, Seifi Z, Poorolajal J, Araghchian M, Safiaryan R, Oshvandi K. Effect of inhalation aromatherapy with lavender essential oil on stress and vital signs in patients undergoing coronary artery bypass surgery: A single-blinded randomized clinical trial. Complement Ther Med 2014; 23:331-8. [PMID: 26051567 DOI: 10.1016/j.ctim.2014.12.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/05/2014] [Accepted: 12/02/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES At present, aromatherapy is used widely in medical research. This study aimed to investigate the effects of inhalation aromatherapy using lavender essential oil to reduce mental stress and improve the vital signs of patients after coronary artery bypass surgery (CABG). DESIGN A single-blinded randomized controlled trial was conducted with 60 patients who had undergone CABG in a 2-day intervention that targeted stress reduction. PARTICIPANTS Sixty subjects following coronary artery bypass surgery in two aromatherapy and control groups. SETTING The study was conducted in Ekbatan Therapeutic and Educational Center, Hamadan, Iran, in 2013. INTERVENTIONS On the second and third days after surgery, the aromatherapy group patients received two drops of 2% lavender essential oil for 20min and the control group received two drops of distilled water as a placebo. MAIN OUTCOME MEASURES The primary outcome was mental stress, which was measured before and after the intervention using the DASS-21 questionnaire. The secondary outcomes were vital signs, including the heart rate, respiratory rate, and systolic and diastolic blood pressure, which were measured before and after the intervention. RESULTS The individual characteristics of the aromatherapy and control groups were the same. There were no significant difference in the mean mental stress scores and vital signs of the aromatherapy and control groups on the second or third days after surgery. CONCLUSION Inhalation aromatherapy with lavender essential oil had no significant effects on mental stress and vital signs in patients following CABG, except the systolic blood pressure.
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Affiliation(s)
- Ali Bikmoradi
- Chronic Diseases (Home Care) Research Center of Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Zahra Seifi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Jalal Poorolajal
- Modeling of Noncommunicable Diseases Research Center, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Malihe Araghchian
- Department of Pharmacology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Reza Safiaryan
- Department of Heart Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Khodayar Oshvandi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
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Guo P. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials. J Clin Nurs 2014; 24:34-46. [PMID: 24894181 DOI: 10.1111/jocn.12618] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To update evidence of the effectiveness of preoperative education among cardiac surgery patients. BACKGROUND Patients awaiting cardiac surgery may experience high levels of anxiety and depression, which can adversely affect their existing disease and surgery and result in prolonged recovery. There is evidence that preoperative education interventions can lead to improved patient experiences and positive postoperative outcomes among a mix of general surgical patients. However, a previous review suggested limited evidence to support the positive impact of preoperative education on patients' recovery from cardiac surgery. DESIGN Comprehensive review of the literature. METHODS The Cochrane Central Register of Controlled Trials from the Cochrane Library, MEDLINE, CINAHL, PsycINFO, EMBASE and Web of Science were searched for English-language articles published between 2000-2011. Original articles were included reporting randomised controlled trials of cardiac preoperative education interventions. RESULTS Six trials were identified and have produced conflicting findings. Some trials have demonstrated the effects of preoperative education on improving physical and psychosocial recovery of cardiac patients, while others found no evidence that patients' anxiety is reduced or of any effect on pain or hospital stay. CONCLUSION Evidence of the effectiveness of preoperative education interventions among cardiac surgery patients remains inconclusive. Further research is needed to evaluate cardiac preoperative education interventions for sustained effect and in non-Western countries. RELEVANCE TO CLINICAL PRACTICE A nurse-coordinated multidisciplinary preoperative education approach may offer a way forward to provide a more effective and efficient service. Staff training in developing and delivering such interventions is a priority.
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Affiliation(s)
- Ping Guo
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK; The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan, China
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Guo P, East L, Arthur A. Thinking outside the black box: the importance of context in understanding the impact of a preoperative education nursing intervention among Chinese cardiac patients. PATIENT EDUCATION AND COUNSELING 2014; 95:365-370. [PMID: 24666774 DOI: 10.1016/j.pec.2014.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 02/19/2014] [Accepted: 03/02/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE In a randomized controlled trial of a preoperative education intervention conducted for Chinese cardiac patients, we observed a greater effect on symptoms of anxiety and depression than that reported with regard to similar interventions in western care settings. The objective of this qualitative study was to help explain the findings of the trial by exploring Chinese patients' experience of seeking and receiving information before cardiac surgery. METHODS Semi-structured interviews were conducted with a purposive sample of 20 trial participants before discharge (ten from the preoperative education group; ten from the usual care control group). Data were analyzed using a thematic analysis approach. RESULTS A total of five themes were generated: the role of reputation and hierarchy; gaining strength from knowledge; information as a low priority; being kept in the dark; and learning through peer support. CONCLUSION In health care systems where service users are given relatively little information, interventions designed to inform patients about their treatment are likely to have a much greater impact on their psychological health. PRACTICE IMPLICATIONS Providers of services for patients undergoing cardiac surgery in China should be encouraged to incorporate information giving into routine practice, tailored according to individual need.
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Affiliation(s)
- Ping Guo
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, UK; The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.
| | - Linda East
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, UK
| | - Antony Arthur
- School of Nursing Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, UK
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Roohafza H, Sadeghi M, Khani A, Andalib E, Alikhasi H, Rafiei M. Psychological state in patients undergoing coronary artery bypass grafting surgery or percutaneous coronary intervention and their spouses. Int J Nurs Pract 2014; 21:214-20. [PMID: 24750214 DOI: 10.1111/ijn.12234] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Percutaneous coronary intervention (PCI) and the coronary artery bypass grafting surgery (CABG) are well accepted treatments for coronary artery disease. Many patients and their spouses experience increased level of stress, anxiety and depression before and after going under the procedure. One hundred and ninety-six cardiac patients who were candidate for CABG or PCI procedures and their spouses were asked to complete Hospital Anxiety and Depression Scale and General Health Questionnaire-12 before and 1 month after procedures. Anxiety, depression and stress level in patients and their spouses going under the procedures significantly reduced over time. Scores of anxiety, depression and stress in patients and their spouses were correlated. There was no difference in the level of anxiety, depression and stress between CABG and PCI groups before to after procedures. We suggest providing information about the procedures to both patients and their spouses to deal better with their own psychological state.
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Affiliation(s)
- Hamidreza Roohafza
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Lee MH, Kim DH, Yu HS. The effect of guided imagery on stress and fatigue in patients with thyroid cancer undergoing radioactive iodine therapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:130324. [PMID: 24369476 PMCID: PMC3857993 DOI: 10.1155/2013/130324] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 10/22/2013] [Accepted: 10/22/2013] [Indexed: 12/20/2022]
Abstract
This study was conducted to evaluate the effects of guided imagery on stress and fatigue in patients undergoing radioactive iodine therapy after thyroidectomy in Korea. Participants were 84 individuals (44 for experimental group and 40 for control group) with thyroid cancer. The experimental group listened to a guided imagery CD once a day for 4 weeks. Global Assessment of Recent Stress and Revised Piper Fatigue Scale were self-administered, and heart rate variability was measured at three time points; prior to intervention (T1), just before intervention (T2) and 1 week later after intervention (T3). Heart rate variability was consisted of Standard Deviation of all NN interval (SDNN), Total Power (TP), Low Frequency (LF), and High Frequency (HF). There were significant decreases in stress (F = 28.45, P < 0.001) and fatigue (F = 26.17, P < 0.001) over time in the experimental group compared to the control group. Heart rate variability changed over time in the experimental group relative to the control group; SDNN (F = 6.68, P = 0.002), TP (F = 5.29, P = 0.006), LF (F = 4.58, P = 0.012), and HF (F = 3.71, P = 0.026). From the results of this study guided imagery can be recommended as an effective intervention to thyroid cancer patients with stress and fatigue.
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Affiliation(s)
- Mi Hye Lee
- Department of Nursing, College of Nursing, Pusan National University, Yangsan-si, Gyeongsangnam-do 626-870, Republic of Korea
| | - Dong-Hee Kim
- Department of Nursing, College of Nursing, Pusan National University, Yangsan-si, Gyeongsangnam-do 626-870, Republic of Korea
| | - Hak Sun Yu
- Department of Parasitology, School of Medicine, Pusan National University, Yangsan-si, Gyeongsangnam-do 626-870, Republic of Korea
- Immunoregulatory Therapeutics Group in Brain Busan 21 Project, Busan Metropolitan City, Yeonje-gu 611-735, Republic of Korea
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Tou S, Tou W, Mah D, Karatassas A, Hewett P. Effect of preoperative two-dimensional animation information on perioperative anxiety and knowledge retention in patients undergoing bowel surgery: a randomized pilot study. Colorectal Dis 2013; 15:e256-65. [PMID: 23350660 DOI: 10.1111/codi.12152] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 11/21/2012] [Indexed: 02/08/2023]
Abstract
AIM The use of multimedia information provided preoperatively can potentially reduce anxiety in patients and improve the hospital experience. However, the use of two-dimensional (2D) animation (cartoon) to provide information to patients undergoing colorectal surgery has not been investigated. This study investigated the effect of preoperative 2D information on anxiety and knowledge retention in patients undergoing bowel surgery. METHOD Patients were randomized to one of two groups; the video group watched a 13-min cartoon animation whereas the nonvideo group did not. Anxiety levels were measured at the preadmission clinic, postvideo, on the day of admission for surgery, within 24-h after surgery and before discharge using the Spielberger state-trait anxiety inventory and visual analogue scale. Both groups completed a knowledge retention questionnaire and the video group completed a feedback questionnaire about the animation. RESULTS Thirty-one patients (16 video, 15 nonvideo) participated in the study. There was no significant difference in baseline anxiety score between two groups. An immediate reduction (P = 0.03) in anxiety score was observed in the video group after watching the video compared with baseline. There was a significant reduction in anxiety score in the video group at discharge compared with the nonvideo group (P = 0.03). There was no significant difference in knowledge retention between two groups. Eighty-eight per cent of patients who watched the video found it beneficial. CONCLUSION 2D animation is an effective medium for delivering information to patients undergoing bowel surgery and can potentially reduce anxiety related to surgery and improve the hospital experience.
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Affiliation(s)
- S Tou
- Department of Colorectal Surgery, The Royal Derby Hospital, Derby, UK.
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Eskander A, Devins GM, Freeman J, Wei AC, Rotstein L, Chauhan N, Sawka AM, Brown D, Irish J, Gilbert R, Gullane P, Higgins K, Enepekides D, Goldstein D. Waiting for thyroid surgery: A study of psychological morbidity and determinants of health associated with long wait times for thyroid surgery. Laryngoscope 2012; 123:541-7. [DOI: 10.1002/lary.23503] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2012] [Indexed: 11/11/2022]
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Patients' experiences with symptoms and needs in the early rehabilitation phase after coronary artery bypass grafting. Eur J Cardiovasc Nurs 2012; 11:14-24. [PMID: 21030311 DOI: 10.1016/j.ejcnurse.2010.09.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The first month after discharge for Coronary artery bypass graft (CABG) is particularly challenging for the patients. A larger interview study is warranted to elicit CABG patients' detailed experiences, and give direction for future clinical practice. AIM To explore the CABG patients' symptoms and needs in the early rehabilitation phase. METHODS A qualitative, mixed method design integrating qualitative and quantitative approaches was used. Ninety-three CABG patients aged 39-77, participated in interviews at home after 2 and 4 weeks. The semi-structured interview guide covered: experiences of relief of angina pectoris after surgery, experiences with prescribed discharge medications, psychological experiences: anxiety, depression, sexuality, health professional contact persons, and patient defined experiences. RESULTS Two weeks after CABG the patients symptoms and needs were characterised by a substantial amount of uncertainty and worries related to what to expect and what was normal for postoperative pain, assessment and sensation of surgical site, different experiences with physical activity/exercise, uncertainty about medications, difficulties with sleep pattern, irritability, postoperative complications,uncertainty about return to work, and insufficient information at discharge. Four weeks after surgery the patients' symptom level was decreased, and they experienced life beginning to return back to normal. Patency with grafts after CABG, decision to drive a car, impotence (erectile dysfunction), and a missing link to the hospital remained challenges. CONCLUSION CABG patients' experiences indicate a need to extend the hospital's discharge care to the first month after surgery for specific themes to promote rehabilitation outcomes.
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Guo P, East L, Arthur A. A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: A randomized controlled trial. Int J Nurs Stud 2012; 49:129-37. [DOI: 10.1016/j.ijnurstu.2011.08.008] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 08/11/2011] [Accepted: 08/22/2011] [Indexed: 11/24/2022]
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McKinley S, Fien M, Riegel B, Meischke H, Aburuz ME, Lennie TA, Moser DK. Complications after acute coronary syndrome are reduced by perceived control of cardiac illness. J Adv Nurs 2012; 68:2320-30. [PMID: 22235775 DOI: 10.1111/j.1365-2648.2011.05933.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To investigate the relationship between anxiety, perceived control and rate of in-hospital complications after acute coronary syndrome. BACKGROUND Anxiety may be associated with higher risk of complications following acute myocardial infarction; perceived control may moderate this relationship. DESIGN Prospective observational study. METHODS Patients enrolled in a trial investigating delay in seeking treatment for acute coronary syndrome had anxiety measured at enrolment and 3 months using the Brief Symptom Inventory anxiety subscale. The acute coronary syndrome hospital presentations investigated occurred between 2001-2006. Patients with anxiety scores greater than the population norm at both time points were categorized as persistently anxious. Perceived control was measured at enrolment using the control attitudes scale-revised. Data were collected from the medical record on in-hospital complications in patients presenting with acute coronary syndrome within 2 years of enrolment. Chi-square and t-tests were used for univariate analyses and multiple logistic regression to identify independent predictors of complications. RESULTS Patients (n = 171) were 64% men with mean age 69 years. Ischaemic or arrhythmic complications occurred in 26 patients (15%) with no difference in complication rates between those persistently anxious and others. Important univariate predictors of in-hospital complications were lower perceived control, diagnosis of acute myocardial infarction, heart failure and higher pulse rate on admission. Low perceived control and diagnosis of acute myocardial infarction were independent predictors of in-hospital complications in the multiple logistic regression. CONCLUSION Perceived control, but not persistent anxiety, prior to acute coronary syndrome was an important predictor of in-hospital complications after acute coronary syndrome. Interventions to increase cardiac patients' perceived control of their cardiac illness may reduce in-hospital complications after acute coronary syndrome.
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Affiliation(s)
- Sharon McKinley
- Critical Care Nursing Professorial Unit, University of Technology, Sydney, Australia.
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Sveinsdóttir H, Ingadóttir B. Predictors of psychological distress in patients at home following cardiac surgery: an explorative panel study. Eur J Cardiovasc Nurs 2011; 11:339-48. [DOI: 10.1016/j.ejcnurse.2011.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Herdís Sveinsdóttir
- Faculty of Nursing, University of Iceland, Eirberg Eiríksgötu 34, 101 Reykjavík, Iceland
| | - Brynja Ingadóttir
- Faculty of Nursing, University of Iceland, Eirberg Eiríksgötu 34, 101 Reykjavík, Iceland
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Sauls JL, Warise LF. Interventions for anxiety in the critically ill: a guide for nurses and families. Nurs Clin North Am 2010; 45:555-67, vi. [PMID: 20971336 DOI: 10.1016/j.cnur.2010.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Anxiety is a common feeling for patients and families during the critical care experience. As anxiety for critically ill patients presents increased risks for morbidity and mortality, it is imperative that nurses strive to identify unrelieved anxiety early to prevent adverse events. Alleviating anxiety experienced by families as a result of the critical care experience involves providing assurance, allowing them to remain near the patient, providing accurate and current information, providing for their comfort, and projecting a supportive attitude. As constant care providers, nurses can have the greatest impact on creating an environment that is safe, healing, and humane for critically ill patients and their families.
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Affiliation(s)
- Jenny L Sauls
- School of Nursing, Middle Tennessee State University, Murfreesboro, TN 37132, USA.
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Robley L, Ballard N, Holtzman D, Cooper W. The experience of stress for open heart surgery patients and their caregivers. West J Nurs Res 2010; 32:794-813. [PMID: 20696847 DOI: 10.1177/0193945910361469] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this research was to understand the modern experience of stress among adult coronary artery bypass grafting (CABG) patients who are hospitalized less than 10 days and among their significant caregivers. The naming of stressors and the nature and triggers for the stress response that either contributed to or ameliorated stress were examined. A qualitative research method using hermeneutic phenomenology was used to interpret and understand the experience of stress. The stressors identified by both patient and family participants in this study were shock and disbelief leading to a feeling of being overwhelmed. Among patients, mortality was foremost. Among family caregivers, anger was expressed. The importance of providing information, honesty, and trust were pivotal to alleviating stress. A more thorough knowledge of history and complementary therapies are needed to reduce stress.
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Affiliation(s)
- Lois Robley
- Kennesaw State University, Kennesaw, GA 30144, USA.
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McKenzie LH, Simpson J, Stewart M. A systematic review of pre-operative predictors of post-operative depression and anxiety in individuals who have undergone coronary artery bypass graft surgery. PSYCHOL HEALTH MED 2010; 15:74-93. [PMID: 20391226 DOI: 10.1080/13548500903483486] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In addition to the physical benefits, another important objective of coronary artery bypass graft (CABG) surgery is improvement of health-related quality of life. The aim of this systematic review is to provide an overview of the literature relating to the pre-operative prediction of post-operative depression and anxiety in individuals who have undergone CABG surgery. Forty-six studies were identified through a literature search of electronic databases conducted using explicit inclusion and exclusion criteria. The study characteristics, methodological features, and psychometric and clinical outcomes were summarised in a systematic manner. Collective appraisal of the studies indicated that symptoms of depression and anxiety exhibited after CABG surgery are best predicted by pre-operative measures of functioning in that area. Papers were inconclusive with respect to the predictive qualities of gender and age. Further research is required to clarify the predictive values of these and other factors, including pre-morbid ill health and socio-economic status. The findings of this review indicate a range of pre-operative predictors of post-operative depression and anxiety in patients with CABG. Chief among these are pre-operative depression and anxiety. These findings have clinical implications concerning the importance of pre and post-operative psychological assessment and intervention for individuals at risk of poor psychological recovery.
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Affiliation(s)
- Louise H McKenzie
- Division of Health Research, School of Health and Medicine, Lancaster University, Lancaster, UK.
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Abbott AA, Barnason S, Zimmerman L. Symptom burden clusters and their impact on psychosocial functioning following coronary artery bypass surgery. J Cardiovasc Nurs 2010; 25:301-10. [PMID: 20539164 PMCID: PMC2885049 DOI: 10.1097/jcn.0b013e3181cfbb46] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although there is extensive literature on symptoms experienced by patients after coronary artery bypass surgery (CABS), there is a paucity of data on symptom clusters and their impact on functional outcomes. The purpose of these descriptive, secondary analyses was to identify and describe cluster subgroups of 226 elderly CABS patients at discharge and to examine the cluster's impact on psychosocial functioning over time (baseline, 6 weeks, and 3 months) using the 36-item Medical Outcome Study Short Form subscales. Cluster analysis revealed a 3-cluster solution with low, low-moderate, and moderate symptom burden clusters. Significant differences were detected for Duke Activity Status Index (F(2,223) = 5.12, P = .007), Barnason Efficacy Expectation Scale (F(2,223) = 9.60, P < .0001), Hospital Anxiety and Depression Scale (F(2,219) = 15.14, P < .0001), and New York Heart Association classification (chi = 17.44, P = .008). Significant differences were noted on all variables between the low and moderate symptom burden clusters with differences between the low-moderate and moderate clusters for only the Barnason Efficacy Expectation Scale and the Hospital Anxiety and Depression Scale. Those in the moderate symptom burden cluster had more symptoms, anxiety, and depression along with lower self-efficacy and physiological functioning than those in the other 2 clusters. There was no interaction or simple main effects for the role-emotional or social subscales as measured by the 36-item Medical Outcome Study Short Form. There was no significant interaction for mental functioning by time and cluster (F(4,641) = .30, P = .88); however, there was a simple main effect for cluster (F(2,641) = 4.11, P = .02). Follow-up analysis indicated significant differences between the low and low-moderate clusters, indicating that those with low symptom burden had significantly better mental health functioning than those with moderate symptom burden. Findings provide a foundation of knowledge on symptom clusters in CABS populations and may be useful to clinicians to identify patients at risk for slowed or delayed recovery and for early intervention.
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Affiliation(s)
- Amy A Abbott
- Creighton University School of Nursing, Omaha, Nebraska 68178, USA.
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Gallagher R, McKinley S. Anxiety, depression and perceived control in patients having coronary artery bypass grafts. J Adv Nurs 2009; 65:2386-96. [DOI: 10.1111/j.1365-2648.2009.05101.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nilsson U. The effect of music intervention in stress response to cardiac surgery in a randomized clinical trial. Heart Lung 2009; 38:201-7. [DOI: 10.1016/j.hrtlng.2008.07.008] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 06/09/2008] [Accepted: 07/30/2008] [Indexed: 11/26/2022]
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Detroyer E, Dobbels F, Verfaillie E, Meyfroidt G, Sergeant P, Milisen K. Is preoperative anxiety and depression associated with onset of delirium after cardiac surgery in older patients? A prospective cohort study. J Am Geriatr Soc 2009; 56:2278-84. [PMID: 19112653 DOI: 10.1111/j.1532-5415.2008.02013.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the prevalence of preoperative anxiety and depressive symptoms and their relationship with the occurrence of postcardiac delirium and to describe the evolution of these symptoms from preoperative admission until discharge. DESIGN Descriptive, prospective, longitudinal study. SETTING The intensive care unit and two cardiac surgery units in a university hospital setting. PARTICIPANTS One hundred four patients (median age 71; 78.8% men) admitted for elective cardiac surgery. MEASUREMENTS Anxiety measured preoperatively using the State-Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS); depression using the HADS; cognitive functioning using the Mini-Mental State Examination (MMSE); delirium using the Confusion Assessment Method (CAM), the CAM for the Intensive Care Unit (CAMICU), and the Delirium Index (DI); and activities of daily living using the Katz index of activities of daily living (Katz ADL scale). MMSE, CAM/CAM-ICU, and DI were obtained on postoperative Days 1, 3, and 7. On Day 7 and at discharge, the STAI, HADS, and Katz ADL scale were repeated. RESULTS Postoperative delirium occurred in 26%; 55.8% reported preoperative state anxiety, 25.2% generalized anxiety, and 15.5% depressive symptoms, but no association was found with delirium occurrence. Based on multivariable analysis, prolonged intubation time (odds ratio (OR)51.10, CI: 1.05-1.15, P5.001) and a low intraoperative lowest body temperature (OR50.86, CI: 0.74-0.99, P5.03) were independent predictors of delirium onset. At discharge, 35.7% and 12.2% of patients reported state anxiety and generalized, and 15.3% reported depressive symptoms. CONCLUSION Despite the high prevalence of preoperative anxiety and depressive symptoms in older patients with cardiac surgery, no association was found with postoperative delirium.
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Affiliation(s)
- Elke Detroyer
- Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium
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Trame CD, Greene E, Moddeman G, Booth BA, Konstantakos EK, Parada S, Siebuhr K, Laughlin RT. Correlation of pain scores, analgesic use, and beck anxiety inventory scores during hospitalization in lower extremity amputees. Open Orthop J 2008; 2:145-50. [PMID: 19478937 PMCID: PMC2687119 DOI: 10.2174/1874325000802010145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 06/09/2008] [Accepted: 07/03/2008] [Indexed: 11/22/2022] Open
Abstract
Post amputation pain can be debilitating for patients and families. Chronic pain is a common phenomenon after lower extremity amputation, occurring in up to 80% of this population. The purpose of this pilot study was to correlate post amputation pain scores to opioid analgesic consumption and Beck Anxiety Inventory (BAI) scores. Twenty-three patients with lower extremity amputation at an 827-bed acute care inner-city hospital were surveyed pre-operatively and post-operatively to determine if there was a significant correlation between anxiety and pain. A numeric scale was utilized by patients to rate their pain level, while the BAI was utilized to measure their anxiety levels. A significant correlation was found between the pre-operative BAI levels and the BAI levels identified at time of discharge. Patients were found to have a higher than normal level of anxiety pre-operatively. No significant correlations were found between anxiety and pain.
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Affiliation(s)
- Cathy D Trame
- Miami Valley Hospital, Pain Center, 30 East Apple Street, Suite 5250, Dayton, Ohio 45409, USA
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Course of anxiety symptoms over an 18-month period in exhausted patients post percutaneous coronary intervention. Psychosom Med 2008; 70:349-55. [PMID: 18378871 DOI: 10.1097/psy.0b013e3181656540] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Anxiety is a neglected risk factor in coronary artery disease. We examined the different courses of anxiety over an 18-month period in patients post percutaneous coronary prevention (PCI) and the predictors of group membership of these courses. METHODS Consecutive exhausted PCI patients (n = 638), participating in the EXhaustion Intervention Trial (EXIT), were assessed for depression at baseline using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition and for symptoms of anxiety at baseline, 6, and 18 months using the State Trait Anxiety Inventory (state only). SAS procedure TRAJ was used to examine courses of anxiety symptoms over an 18-month period. RESULTS Five trajectories were identified: nonanxious (13.2%), mildly anxious (39.7%), decreasingly anxious (11.6%), moderately anxious (29.3%), and severely anxious (6.3%), with four of them being stable over 18 months. Multinomial logistic regression analyses showed that angina pectoris, major depression, the use of anxiolytics, and low educational level distinguished moderate-to-severe anxious patients from nonanxious. The absence of angina and major depression and not using diuretics explained the decreasing trend in anxiety in one of the trajectories. CONCLUSIONS Anxiety trajectories varied across patients, with four of five being stable over 18 months. In clinical practice, knowledge of these trajectories and their determinants may help identify distinct groups of patients with potentially differential risks of adverse health outcomes.
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Abstract
In the past two decades, the rate of surgery in older people has increased more rapidly than the rate of aging of the population, so both a larger proportion and a greater number of older people are now undergoing surgery. This may partly reflect a cultural change in surgery and anaesthesia with respect to a greater willingness to undertake elective procedures in older people, although there remain areas where they have less access to surgery than do younger patients. For instance, older people are less likely to undergo operative procedures after a cancer diagnosis. Furthermore, in those who do have surgery, resection rate (i.e. curative therapy) is lower than in younger people with equivalent tumour stages, and even more so in older patients with COPD, cardiovascular disease or diabetes. This article explores the complex relationship between age and surgical outcome, provides an evidence-based overview of risk assessment and common postoperative problems in older people, and summarizes good practice points (at times necessarily pragmatic) for clinical management of the older surgical patient. There has been a substantial expansion in the literature examining risks, outcomes and interventions in older surgical patients since the previous review article of this subject published in this journal. Although we do not cover anaesthesia in older people, the review of that topic remains relevant. The American Society of Anaesthesiologists' Classification of Risk which illustrates that risk is disease- rather than age- based, is shown in Table 1. Most publications examine elective rather than emergency surgery in older people (with the exception of hip fracture), and this is reflected in the content of the paper.
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