1
|
Rtbey G, Mihertabe M, Andualem F, Melkam M, Takelle GM, Tinsae T, Fentahun S. Anxiety and associated factors among medical and surgical patients in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0306413. [PMID: 39046996 PMCID: PMC11268606 DOI: 10.1371/journal.pone.0306413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/12/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Individuals diagnosed with chronic medical conditions and patients appointed to undergo surgery face various degrees of anxiety as a result of doubts related to the outcome of surgery, and the psycho-socioeconomic costs of the medical illness. This can affect the treatment process and even the outcome of patients with medical and surgical cases. Though different studies were conducted on anxiety and associated factors among medical and surgical patients in Ethiopia, the findings were found to be inconsistent and had a wide discrepancy. So, this systematic review and meta-analysis estimated the pooled effect size of anxiety among this population and guides to plan appropriate intervention at a national level. METHODS Studies conducted on anxiety and associated factors among medical and surgical patients in Ethiopia were included. Data was extracted using Microsoft Excel and analyzed using STATA version 11. The random-effects model was used to estimate the pooled effect size of anxiety and its determinants with 95% confidence intervals. Funnel plots and Egger's regression tests were employed to check publication bias. Sub-group and sensitivity analyses were also conducted. RESULTS The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be 48.82% with a 95% CI (42.66, 54.99). Being female[OR = 2.84(2.02, 4.01)], fear of death [OR = 2.93(1.57, 5.50)], and history of surgery[OR = 0.42(0.27, 0.065)], among surgical patients and being female[OR = 2.35(1.94, 2.850], having poor social support[OR = 2.22(1.62, 3.05)], perceived stigma[OR = 4.25(1.97, 9.18)] and family history of mental illness[OR = 1.86(1.21, 2.86)] among medical patients were significantly associated with anxiety in this systematic review and meta-analysis. CONCLUSION AND RECOMMENDATION The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be high. Therefore, it would be good for professionals to screen patients for anxiety besides managing their medical or surgical cases to detect them early and address them.
Collapse
Affiliation(s)
- Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Milen Mihertabe
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
2
|
Yan F, Yuan LH, He X, Yu KF. Correlation between pre-anesthesia anxiety and emergence agitation in non-small cell lung cancer surgery patients. World J Psychiatry 2024; 14:930-937. [PMID: 38984337 PMCID: PMC11230093 DOI: 10.5498/wjp.v14.i6.930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/08/2024] [Accepted: 05/16/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery. Emergence agitation (EA) is a common complication of general anesthesia that may increase patient discomfort and hospital stay and may be associated with the development of postoperative complications. Pre-anesthetic anxiety may be associated with the development of EA, but studies in this area are lacking. AIM To determine the relationship between pre-anesthetic anxiety and EA after radical surgery in patients with non-small cell lung cancer (NSCLC). METHODS Eighty patients with NSCLC undergoing surgical treatment between June 2020 and June 2023 were conveniently sampled. We used the Hospital Anxiety and Depression Scale's (HADS) anxiety subscale (HADS-A) to determine patients' anxiety at four time points (T1-T4): Patients' preoperative visit, waiting period in the surgical waiting room, after entering the operating room, and before anesthesia induction, respectively. The Riker Sedation-Agitation Scale (RSAS) examined EA after surgery. Scatter plots of HADS-A and RSAS scores assessed the correlation between patients' pre-anesthesia anxiety status and EA. We performed a partial correlation analysis of HADS-A scores with RSAS scores. RESULTS NSCLC patients' HADS-A scores gradually increased at the four time points: 7.33 ± 2.03 at T1, 7.99 ± 2.22 at T2, 8.05 ± 2.81 at T3, and 8.36 ± 4.17 at T4. The patients' postoperative RSAS score was 4.49 ± 1.18, and 27 patients scored ≥ 5, indicating that 33.75% patients had EA. HADS-A scores at T3 and T4 were significantly higher in patients with EA (9.67 ± 3.02 vs 7.23 ± 2.31, 12.56 ± 4.10 vs 6.23 ± 2.05, P < 0.001). Scatter plots showed the highest correlation between HADS-A and RSAS scores at T3 and T4. Partial correlation analysis showed a strong positive correlation between HADS-A and RSAS scores at T3 and T4 (r = 0.296, 0.314, P < 0.01). CONCLUSION Agitation during anesthesia recovery in patients undergoing radical resection for NSCLC correlated with anxiety at the time of entering the operating room and before anesthesia induction.
Collapse
Affiliation(s)
- Fen Yan
- Department of Anesthesiology, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430000, Hubei Province, China
| | - Li-Hua Yuan
- Department of Anesthesiology, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430000, Hubei Province, China
| | - Xiao He
- Department of Anesthesiology, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430000, Hubei Province, China
| | - Kai-Feng Yu
- Department of Anesthesiology, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430000, Hubei Province, China
| |
Collapse
|
3
|
Mohsenpour M, Ebadi A, Mousavi B, Repišti S, Sharif Nia H, Ghanei Gheshlagh R. Psychometric Evaluation of the Farsi Version of the Surgical Anxiety Questionnaire. J Perianesth Nurs 2023; 38:907-911. [PMID: 37665300 DOI: 10.1016/j.jopan.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 03/04/2023] [Accepted: 03/11/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE The aim of this study was to evaluate the psychometric properties of the Farsi version of the Surgical Anxiety Questionnaire. DESIGN Cross-sectional study. METHODS This study was performed on 402 patients who were candidates for elective surgery in Mashhad [East Iran) hospitals in winter 2021. After forward-backward translation, face and content validity checks were performed qualitatively. The construct validity was assessed by exploratory and confirmatory factor analysis. Data analysis was performed with SPSS 16 and AMOS 26. FINDINGS In exploratory factor analysis, two factors were extracted: concerns about surgery and anesthesia; and postdischarge concerns, which explained 52% of the total variance. The Cronbach's alpha for the entire questionnaire was 0.91 and for the subscales ranged from 0.80 to 0.87. The final model had a good fit as determined by confirmatory factor analysis. CONCLUSIONS The Farsi version of the surgical anxiety questionnaire has acceptable validity and reliability. The existence of this scale measuring domain-specific anxiety allows for further research in this area.
Collapse
Affiliation(s)
- Mohaddeseh Mohsenpour
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Bahare Mousavi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Selman Repišti
- Applied Psychology, Faculty of Applied Sciences, University of Donja Gorica (UDG), Podgorica, Montenegro
| | - Hamid Sharif Nia
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Ghanei Gheshlagh
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
| |
Collapse
|
4
|
Ünver S, Yildirim M, Eyı S, Hüseyın S. Pain-related fear among adult patients undergoing open-heart surgery: an interpretative phenomenological analysis. Contemp Nurse 2023; 59:462-477. [PMID: 37608646 DOI: 10.1080/10376178.2023.2249127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 08/11/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND One of the sources of anxiety and fear among patients undergoing open-heart surgery is the possibility of experiencing pain, such as sternotomy-related chest pain. Giving them the chance to express their feelings about the potential pain may be effective in reducing their anxiety and may support their coping strategies. OBJECTIVES To examine pain-related fear among patients undergoing open-heart surgery and to understand the underlying reasons of their fears. METHODS A qualitative interview based on Heidegger's interpretative phenomenological approach was conducted adhering to the COREQ guidelines. Sixteen patients who were undergoing open-heart surgery in the following day were interviewed at the cardiovascular surgery ward of a university hospital. The organization and mapping of the qualitative data was done by using ATLAS.ti 8.0. RESULTS The patients who were afraid of experiencing pain after surgery seemed to be more concerned about open-heart surgery itself (such as pain from sternotomy and chest tubes) and the possibility of prolongation of postoperative pain. To cope with these fears, the patients employed a variety of social and self-coping strategies. Trusting the healthcare team, having a high pain tolerance, and having personal thoughts that take precedence over pain-related fear were the key factors explaining not being afraid of experiencing pain. CONCLUSIONS This study provides a deeper understanding of the underlying reasons and the needs of patients in controlling their pain-related fears before open-heart surgery. Trusting the healthcare professionals is one of the main factors for patients to control their pain-related fears. To develop a supportive sense of trust and to help patients in controlling their pain-related fears, surgical nurses must dedicate enough time for understanding patients' concerns while planning their nursing care plans. Future studies may focus on exploring the role of nursing interventions and multidisciplinary team approaches on the management of preoperative pain-related fear.
Collapse
Affiliation(s)
- Seher Ünver
- Faculty of Health Sciences, Department of Surgical Nursing, Trakya University, Edirne, Turkey
| | - Meltem Yildirim
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Semra Eyı
- Faculty of Health Sciences, Department of Surgical Nursing, Osmangazi University, Eskişehir, Turkey
| | - Serhat Hüseyın
- Medicine Faculty, Department of Cardiovascular Surgery, Trakya University, Edirne, Turkey
| |
Collapse
|
5
|
Shah SB, Sinha R, Hussain SY, Kumar A, Gupta A. Allaying Pediatric Preoperative Anxiety, Where are we Now? - A Nationwide Survey. J Indian Assoc Pediatr Surg 2023; 28:479-485. [PMID: 38173638 PMCID: PMC10760609 DOI: 10.4103/jiaps.jiaps_114_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/08/2023] [Accepted: 07/23/2023] [Indexed: 01/05/2024] Open
Abstract
Background Preoperative anxiety (PA) in children is a common phenomenon associated with various negative patient outcomes. Allaying PA is accepted as a standard of care, but its use is not universal and often overlooked. This survey is designed to evaluate the nationwide current practice patterns and attitudes of anesthesiologists toward the practice of allaying PA in children. Materials and Methods A questionnaire of 25 questions, including information on methods of relieving PA in children, reasons for noncompliance, and associated complications, was framed. It was circulated among members of the Indian Society of Anaesthesiologists through an online survey of Google Forms and manually. Results Four hundred and fifty anesthesiologists were surveyed. Responses were predominantly from anesthesiologists practicing in medical colleges across the country. Although 97% of the surveyed respondents practiced anxiety-relieving strategies, only 37% used it consistently. Seventy-three percent of anesthesiologists practiced both pharmacological and nonpharmacological techniques. The most common reason for avoiding premedication was an anticipated difficult airway (88%). Inadequate sedation was a commonly reported problem. Ninety-five percent of participants felt that PA-relieving strategies should be integral to pediatric anesthesia practice. The most common reason for not following these practices was an inadequate hospital infrastructure (67%). Ninety-seven percent of the participants believed that more awareness is required on this crucial perioperative issue. Conclusion Only 37% of the surveyed anesthesiologists consistently used some form of PA-relieving strategy and the practice varied widely. Further improvement and team approach involving anesthesiologists, surgeons, and nurses is required to ensure the quality of pediatric PA-relieving services and establish it as a standard of care.
Collapse
Affiliation(s)
- Shreya Bharat Shah
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Sinha
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Sana Yasmin Hussain
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Kumar
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Anju Gupta
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
6
|
Topal Hançer A. Prevalence and factors associated with surgery anxiety in hospitalized patients: a point-prevalence study. Ir J Med Sci 2023; 192:2095-2103. [PMID: 37548838 DOI: 10.1007/s11845-023-03475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Preoperative anxiety is a challenging problem in the preoperative care of patients. Identifying risk factors helps nurses provide psychological support during the pre-operative visit so that stress can be reduced. AIMS This study aimed to determine the prevalence of surgical anxiety and related factors in hospitalized surgical patients. METHODS This research was designed as a point-prevalence study. The study was completed with 223 patients hospitalized in the surgical clinics of a tertiary hospital in Turkey. Surgical anxiety questionnaire (SAQ) and State-trait anxiety inventory (STAI) were used for the assessment of anxiety. RESULTS Preoperative anxiety prevalence was 69.5% according to the SAQ and 49.3% according to STAI. Women, participants with no primary school education, those who were unemployed and had low income, those with no previous surgery, those living in fear of surgery, the participants who underwent major surgery and general anesthesia, and those who did not have knowledge about the surgical procedure and anesthesia had higher anxiety according to the two scales. A highly significant and positive correlation was found between total STAI and total SAQ. CONCLUSION The importance of surgical anxiety for the health system, which affects two out of every three hospitalized patients, should not be underestimated. Therefore, national and global plans should be made to prevent and manage surgical anxiety.
Collapse
Affiliation(s)
- Ayşe Topal Hançer
- Nursing Department, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey.
| |
Collapse
|
7
|
Xie W, Ye F, Yan X, Cao M, Ho MH, Kwok JYY, Lee JJ. Acupressure can reduce preoperative anxiety in adults with elective surgery: A systematic review and meta-analysis of randomised controlled trials. Int J Nurs Stud 2023; 145:104531. [PMID: 37321140 DOI: 10.1016/j.ijnurstu.2023.104531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/28/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Preoperative anxiety is prevalent amongst adults with elective surgery and is associated with multiple detrimental perioperative physiological effects. Increasing studies support the effectiveness of acupressure in managing preoperative anxiety. However, the magnitude of acupressure's positive association with preoperative anxiety is still unclear due to a lack of rigorous evidence synthesis. OBJECTIVE To estimate the efficacy of acupressure on preoperative anxiety and physiological parameters amongst adults scheduled for elective surgery. DESIGN Systematic review and meta-analysis. DATA SOURCES Search terms were combined for acupressure and preoperative anxiety in PubMed, Cochrane Library, EMBASE, CINAHL, China National Knowledge Infrastructure, and WanFang Data Knowledge Service Platform to search for eligible randomised controlled trials from the inception of each database through September 2022. METHODS Pairs of researchers independently screened and extracted data from included studies. The risk of bias was assessed using the Cochrane risk of bias tool Version 2.0. Meanwhile, random-effects meta-analysis of overall effects and prespecified subgroup (i.e., surgery types, intervention providers, and acupressure stimulation tools) was conducted using Review Manager Software 5.4.1. Meta-regression was performed to explore study-level variables that may contribute to heterogeneity using STATA 16. RESULTS Of 24 eligible randomised controlled trials, there were a total of 2537 participants from 5 countries contributed to this synthesis. When comparing acupressure with usual care or placebo, acupressure showed a large effect size for preoperative anxiety (SMD = -1.30; 95%CI = -1.54 to -1.06; p < 0.001; I2 = 86%). The significant mean reduction of heart rate, and systolic and diastolic blood pressure was -4.58 BPM (95%CI = -6.70 to -2.46; I2 = 89%), -6.05 mmHg (95%CI = -8.73 to -3.37; p < 0.001; I2 = 88%), and -3.18 mmHg (95%CI = -5.09 to -1.27; p = 0.001; I2 = 78%), respectively. Exploratory subgroup analyses showed significant differences in surgery types and acupressure stimulation tools, whilst the intervention providers (i.e., healthcare professionals and self-administered) showed no statistically significant difference for acupressure therapy. None of the predefined participants and study-level characteristics moderated preoperative anxiety through meta-regression. CONCLUSION Acupressure appears efficacious as a therapy for improving preoperative anxiety and physiological parameters amongst adults with elective surgery. Self-administered acupressure, which is effective with a large effect, may be considered as an evidence-based approach to managing preoperative anxiety. Hence, this review aids in the development of acupressure in different types of elective surgeries and the improvement of the rigour of acupressure therapy.
Collapse
Affiliation(s)
- Wenxuan Xie
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Fen Ye
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Xinyi Yan
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Mengyao Cao
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Jojo Yan Yan Kwok
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Jung Jae Lee
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China.
| |
Collapse
|
8
|
Shawahna R, Jaber M, Maqboul I, Hijaz H, Tebi M, Ahmed NAS, Shabello Z. Prevalence of preoperative anxiety among hospitalized patients in a developing country: a study of associated factors. Perioper Med (Lond) 2023; 12:47. [PMID: 37620871 PMCID: PMC10463373 DOI: 10.1186/s13741-023-00336-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Preoperative anxiety is a health concern among patients scheduled for surgical interventions. Little is known about the prevalence of preoperative anxiety among patients in different healthcare systems of developing countries. This study was conducted to determine the prevalence of preoperative anxiety among patients undergoing surgery in Palestine. Another objective was to identify the factors associated with preoperative anxiety. METHODS This study was conducted in a cross-sectional descriptive design. Patients scheduled for surgical interventions were interviewed using an interviewer-administered questionnaire. The questionnaire collected the demographic, clinical, and surgical variables of the patients. The questionnaire also contained the Amsterdam preoperative anxiety and information scale (APAIS), and a short version of the Spielberger state-trait anxiety inventory (STAIS-5/STAIT-5). RESULT A total of 280 patients were included. The mean APAIS total score was 13.6 ± 5.9, the mean APAIS anxiety domain score was 8.3 ± 4.3, and the mean APAIS need for information domain was 1.6 ± 0.50. Of the patients, 76 (27.1%) had high anxiety and 160 (57.1%) expressed a high need for information. The higher APAIS anxiety scores were predicted by being female, having chronic diseases, being scheduled to be operated on within 24 h, and having experienced surgical complications. The mean STAIS-5 score was 10.0 ± 4.2 and the mean STAIT-5 was 10.3 ± 3.8. Of the patients, 140 (50.0%) had high state anxiety and 56 (20.0%) had high trait anxiety. Higher STAIS-5 scores were predicted by being female, younger than 42 years, and scheduled to be operated on within 24 h. Higher STAIT-5 scores were predicted by being female. A positive correlation was identified between APAIS total, APAIS anxiety, APAIS need for information, STAIS-5, and STAIT-5 scores. CONCLUSION Preoperative anxiety was prevalent among patients scheduled for surgical operations in Palestinian hospitals. Anesthesiologists and other providers of perioperative care should screen preoperative patients who are female, have chronic diseases, are scheduled to be operated on within 24 h, and having had experienced surgical complications for preoperative anxiety. More studies are still needed to investigate the effects of the implemented measures on the prevalence of preoperative anxiety.
Collapse
Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, Palestine.
| | - Mohammad Jaber
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
- An-Najah National University Hospital, Nablus, Palestine.
| | - Iyad Maqboul
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
- An-Najah National University Hospital, Nablus, Palestine.
| | - Hatim Hijaz
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- An-Najah National University Hospital, Nablus, Palestine
| | - Marah Tebi
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Nada Al-Sayed Ahmed
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ziyad Shabello
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
9
|
Nimmaanrat S, Charuenporn B, Jensen MP, Geater AF, Tanasansuttiporn J, Chanchayanon T. The anxiolytic effects of preoperative administration of pregabalin in comparison to diazepam and placebo. Sci Rep 2023; 13:9680. [PMID: 37322140 PMCID: PMC10272144 DOI: 10.1038/s41598-023-36616-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
We aimed to evaluate the potential anxiolytic effects of premedication with pregabalin, compared with diazepam and placebo. We conducted this non-inferiority, double-blind, randomized controlled trial in ASA classification I-II patients aged 18-70 years, scheduled for elective surgery under general anesthesia. They were allocated to receive pregabalin (75 mg the night before surgery and 150 mg 2 h before surgery), diazepam (5 and 10 mg in the same manner) or placebo. Preoperative anxiety was evaluated using verbal numerical rating scale (VNRS) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) before and after premedication. Sleep quality, sedation level, and adverse effects were assessed as secondary outcomes. A total of 231 patients were screened and 224 completed the trial. The mean change (95%CI) in anxiety scores from before to after medication in pregabalin, diazepam, and placebo groups for VNRS were - 0.87 (- 1.43, - 0.30), - 1.17 (- 1.74, - 0.60), and - 0.99 (- 1.56, - 0.41), and for APAIS were - 0.38 (- 1.04, 0.28), - 0.83 (- 1.49, - 0.16), and - 0.27 (- 0.95, 0.40). The difference in change for pregabalin versus diazepam was 0.30 (- 0.50, 1.11) for VNRS and 0.45 (- 0.49, 1.38) for APAIS, exceeding the limit of inferiority for APAIS of 1.3. Sleep quality was statistically different between pregabalin and placebo groups (p = 0.048). Sedation in pregabalin and diazepam groups were significantly higher than placebo group (p = 0.008). No significant differences of other side effects, except dry mouth was higher in placebo group compared with diazepam (p = 0.006). The study filed to provide evidence at non-inferiority of pregabalin compared to diazepam. Furthermore, premedication with either pregabalin or diazepam did not significantly reduce the preoperative anxiety in comparison to placebo, despite the fact that both resulted in higher levels of sedation. Clinicians should weigh the benefits and risks of premedication with these 2 drugs.Thai Clinical Trials Registry: TCTR20190424001 (24/04/2019) Registry URL: https://www.thaiclinicaltrials.org/ .
Collapse
Affiliation(s)
- Sasikaan Nimmaanrat
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
| | - Benjalak Charuenporn
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Alan F Geater
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Jutarat Tanasansuttiporn
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Thavat Chanchayanon
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| |
Collapse
|
10
|
Akutay S, Ceyhan Ö. The relationship between fear of surgery and affecting factors in surgical patients. Perioper Med (Lond) 2023; 12:22. [PMID: 37296486 DOI: 10.1186/s13741-023-00316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 06/04/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND This study aimed to explain the fear of surgery in surgical patients, the affecting factors, and their relationship. METHODS This study was conducted as a descriptive and cross-sectional study. The study population consists of 300 patients undergoing surgical intervention. Data were collected using the "patient information form" and "Surgical Fear Questionnaire." Parametric and nonparametric tests were used to evaluate the data. The relationship between the fear questionnaire and age, number of previous surgeries, and pre-operative pain was evaluated using Spearman correlation analysis. The relationship with emotional stress was evaluated with multiple linear regression analysis. RESULTS In this study, it was determined that the predictors of the surgical fear level of the patients were age, gender, anesthesia type, and pre-operative pain experience. There was a negative correlation between the age of the patients and the fear of surgery score and a positive correlation between the pre-operative pain severity and the fear of surgery score. It was determined that the factors most associated with pre-operative fear levels were the patients' pre-operative sense of inadequacy (p < 0.001), feeling anxious and unhappy, and confusion about the surgery decision (p < 0.05). CONCLUSION According to the results of this study, it has been determined that the emotional states and fears of the patients before the surgery have significant effects on the fear of surgery. For this, it is recommended to determine the emotional states and fears of the patients before the surgery and to make appropriate interventions, as it will facilitate compliance with the surgical process.
Collapse
Affiliation(s)
- Seda Akutay
- Department of Surgical Diseases Nursing, Erciyes University Faculty of Health Sciences, Kayseri, 38030, Turkey.
| | - Özlem Ceyhan
- Department of Internal Medicine Nursing, Erciyes University Faculty of Health Sciences, Kayseri, 38030, Turkey
| |
Collapse
|
11
|
Abbasnia F, Aghebati N, Miri HH, Etezadpour M. Effects of Patient Education and Distraction Approaches Using Virtual Reality on Pre-operative Anxiety and Post-operative Pain in Patients Undergoing Laparoscopic Cholecystectomy. Pain Manag Nurs 2023; 24:280-288. [PMID: 36658058 DOI: 10.1016/j.pmn.2022.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 12/06/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fear of post-operative pain often contributes to pre-operative anxiety; accordingly, pain and anxiety are among the most common complications in patients undergoing laparoscopic cholecystectomy (LC). AIM The present study aimed to determine the effects of patient education and distraction using virtual reality (VR) on pre-operative anxiety and post-operative pain in patients undergoing LC. METHOD This randomized clinical trial included 150 patients in the surgery wards of educational hospitals in Mashhad, Iran, in 2020. The participants were randomly assigned to three groups of education, distraction, and control. The education and distraction groups watched two five-minute animations and three 360-degree images of nature using VR glasses 2 hours before and 4 hours after the surgery, respectively. On the other hand, the control group received routine care. Anxiety was measured using Spielberger's State Anxiety Inventory before and half an hour after the intervention. Moreover, the pain was measured using the visual analog scale and McGill Pain Questionnaire. RESULTS The results demonstrated a significant reduction in the two VR groups regarding the pre-operative anxiety mean scores, compared with the control group (p < .001). Furthermore, a significant reduction was observed in post-operative pain scores of patients in the two intervention groups compared with the control group (p = .001). CONCLUSIONS As evidenced by the results, both VR approaches of patient education and distraction equally decreased pre-operative anxiety and post-operative pain in patients undergoing LC.
Collapse
Affiliation(s)
- Fatemeh Abbasnia
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Aghebati
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hamid Heidarian Miri
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | | |
Collapse
|
12
|
Lakhe G, Shrestha BB, Subedi A. Preoperative Anxiety among Patients Undergoing Elective Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:681-684. [PMID: 36705210 PMCID: PMC9446492 DOI: 10.31729/jnma.7636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/21/2022] [Indexed: 01/31/2023] Open
Abstract
Introduction Preoperative anxiety is universal in patients before surgery. It is mostly unaddressed by health professionals due to a lack of time. The objective of this study was to find out the prevalence of preoperative anxiety among patients undergoing elective surgery in a tertiary care centre. Methods A descriptive cross-sectional study was conducted on 385 surgical patients in the Department of Anaesthesia, from 27 November 2021 to 20 April 2022 in a tertiary care hospital posted for elective surgery. Ethical approval was obtained from the Institutional Review Committee (Reference number: MEMG/481/IRC). A convenience sampling was used. The level of anxiety and need for information was assessed using the Amsterdam Preoperative Anxiety and Information Scale questionnaire in a preoperative holding area. Point estimate and 95% Confidence Interval were calculated. Results Out of 385 patients posted for elective surgery, preoperative anxiety was present in 88 (22.85%) (18.66-27.04, 95% Confidence Interval) patients. The mean Amsterdam Preoperative Anxiety and Information Scale score for total anxiety and need for information was 13.59±2.47 and 5.91±3.06 respectively. Anxiety was present in 60 (68.18%) females, 45 (51.13%) young patients aged <30 years and 50 (56.81%) patients without prior experience with surgery and anaesthesia. Conclusions The prevalence of preoperative anxiety among surgical patients was lower than in previous studies done in similar settings. Preoperative anxiety was common in females, young patients and patients without previous experience with anaesthesia and surgery. Keywords anxiety; patient; preoperative; surgical.
Collapse
Affiliation(s)
- Gajal Lakhe
- Department of Anaesthesia, Manipal College of Medical Sciences, Pokhara, Nepal,Correspondence: Dr Gajal Lakhe, Department of Anesthesia, Manipal College of Medical Sciences, Pokhara, Nepal. , Phone: +977-9843742529
| | - Binod Bade Shrestha
- Department of General Surgery, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Anil Subedi
- Department of Psychiatry, Manipal College of Medical Sciences, Pokhara, Nepal
| |
Collapse
|
13
|
Surgery as an Emotional Strain: An Observational Study in Patients Undergoing Elective Colorectal Surgery. J Clin Med 2022; 11:jcm11102712. [PMID: 35628839 PMCID: PMC9146204 DOI: 10.3390/jcm11102712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/21/2022] [Accepted: 05/09/2022] [Indexed: 02/01/2023] Open
Abstract
Recent research suggests an impact of psychological distress on postoperative outcomes in orthopedic and neurosurgery. It is widely unknown whether patients' mood might affect the postoperative outcome and complication rate in colorectal surgery. Over a period of 22 months, a monocentric, observational study among patients undergoing elective colorectal surgery without the creation of an ostomy was conducted. Patients were asked to fill in a standardized multi-dimensional mood questionnaire (MDMQ) preoperatively as well as on the third, sixth, and ninth postoperative days to assess mood, wakefulness, and arousal. The results of 80 patients (51% male, mean age 59 years) were analyzed. Almost half of the patients (58%) developed postoperative complications according to the Clavien-Dindo classification (Grade I 14%, Grade II 30%, Grade III 9%, Grade IV 3%). Patients' mood increased continually from the preoperative day to the ninth postoperative day. Patients' wakefulness decreased initially (pre- to third postoperative day) and increased again in the further course. Patients' arousal decreased pre- to postoperatively. Neither preoperative mood, nor arousal or wakefulness of patients showed a clear association with the development of postoperative complications. In conclusion, preoperative psychological distress measured by MDMQ did not affect the postoperative complication rate of patients undergoing elective colorectal surgery.
Collapse
|
14
|
Kashif M, Hamid M, Raza A. Influence of Preoperative Anxiety Level on Postoperative Pain After Cardiac Surgery. Cureus 2022; 14:e22170. [PMID: 35308773 PMCID: PMC8923043 DOI: 10.7759/cureus.22170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 11/05/2022] Open
|
15
|
Jovanovic K, Kalezic N, Sipetic Grujicic S, Zivaljevic V, Jovanovic M, Savic M, Bukumiric Z, Dragas M, Sladojevic M, Trailovic R, Koncar I, Davidovic L. Translation and validation of the Amsterdam preoperative anxiety and information scale (APAIS) in Serbia. Brain Behav 2022; 12:e2462. [PMID: 34908243 PMCID: PMC8785621 DOI: 10.1002/brb3.2462] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/22/2021] [Accepted: 11/14/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Preoperative anxiety is common and might affect surgical treatment outcomes. The aim was to translate and validate the Serbian version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). METHODS Following translation and initial evaluation, the Serbian version (S-APAIS) was administered to 385 patients. Internal consistency, construct validity, prognostic criteria validity, and concurrent validity between S-APAIS and Visual Analogue Scale for Anxiety (VAS-A) were evaluated. RESULTS Factor analysis revealed two factors: APAIS-anesthesia (items 1, 2, 3) and APAIS-procedure (items 4, 5, 6). The whole scale, APAIS-anesthesia, and APAIS-procedure subscales showed an adequate level of internal consistency (Cronbach's αs: 0.787, 0.806, and 0.805, respectively). High concurrent validity was observed between APAIS-anesthesia and VAS-A (ρ = 0.628, p < .001). A moderate correlation was found between APAIS-procedure and VAS-A scale (ρ = 0.537, p < .001). At the cut-off point of 9, the area under the curve (AUC) of APAIS-anesthesia was 0.815 (95% CI: 0.77-0.85, p < .001). For the APAIS-procedure, AUC was 0.772 (95% CI: 0.73-0.81, p < .001) at the cut-off point of 8. CONCLUSION The structure of S-APAIS substantially differs from the original and allows separate measurement of anesthesia- and procedure-related anxieties. S-APAIS is a comprehensive, valid, and reliable instrument for the measurement of preoperative anxiety.
Collapse
Affiliation(s)
- Ksenija Jovanovic
- Center for Anesthesiology and ResuscitationUniversity Clinical Center of SerbiaBelgradeSerbia
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
| | - Nevena Kalezic
- Center for Anesthesiology and ResuscitationUniversity Clinical Center of SerbiaBelgradeSerbia
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
| | | | - Vladan Zivaljevic
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Center for Endocrine SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Milan Jovanovic
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Center for Endocrine SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Milica Savic
- Center for Anesthesiology and ResuscitationUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Zoran Bukumiric
- Institute of Medical Statistics and InformaticsFaculty of Medicine, University of BelgradeBelgradeSerbia
| | - Marko Dragas
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic for Vascular and Endovascular SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Milos Sladojevic
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic for Vascular and Endovascular SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Ranko Trailovic
- Center for Anesthesiology and ResuscitationUniversity Clinical Center of SerbiaBelgradeSerbia
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
| | - Igor Koncar
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic for Vascular and Endovascular SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| | - Lazar Davidovic
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic for Vascular and Endovascular SurgeryUniversity Clinical Center of SerbiaBelgradeSerbia
| |
Collapse
|
16
|
Tadesse M, Ahmed S, Regassa T, Girma T, Hailu S, Mohammed A, Mohammed S. Effect of preoperative anxiety on postoperative pain on patients undergoing elective surgery: Prospective cohort study. Ann Med Surg (Lond) 2022; 73:103190. [PMID: 35070278 PMCID: PMC8767241 DOI: 10.1016/j.amsu.2021.103190] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/12/2021] [Accepted: 12/19/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction Anxiety is a feeling of tension, apprehension, nervousness, fear, discomfort, and high autonomic activity with varying degrees of intensity resulting from anticipation of danger. Post-operative pain is associated with the emotional status, behavioural response, and high anxiety index of patients. This study aimed to assess the effect of preoperative anxiety on Postoperative Pain in Patients Undergoing Elective Surgery. Methods An institutional-based prospective cohort study was conducted on patients scheduled for elective surgeries from November 1, 2019, to October 30, 2020, in Dilla University Referral Hospital. Data was collected by pretested questionnaires and analysed by SPSS version 20. Categorical data were analysed by chi-square while Continuous data were analysed by student t-test and Mann Whitney U for parametric and nonparametric data respectively with a P-value of <0.05 was considered as statistically significant. Result As our finding revealed patients with high preoperative anxiety experienced significantly increased postoperative pain at 2 h, 4 h, 6 h, and 12 h with the P-value of 0.012, 0.01, 0.001, and 0.002 respectively and total tramadol consumption in a patient with high preoperative anxiety level is 156.5 ± 23.4 while in low anxiety 147.1 ± 39. with a p-value of 0.036. Conclusion High preoperative anxiety increased the immediate postoperative pain score and 24 h tramadol consumption. It would be better to decrease preoperative anxiety levels to reduce postoperative pain and 24 h analgesic consumption. Preoperative anxiety increased risk of postoperative pain. High level of preoperative anxiety increased postoperative pain score. Total post-operative analgesia consumption was higher in patient with high level of preoperative anxiety.
Collapse
Affiliation(s)
| | - Siraj Ahmed
- Department of Anesthesiology, Dilla University, Dilla, Ethiopia
| | - Teshome Regassa
- Department of Anesthesiology, Dilla University, Dilla, Ethiopia
| | - Timsel Girma
- Department of Anesthesiology, Dilla University, Dilla, Ethiopia
| | - Seyoum Hailu
- Department of Anesthesiology, Dilla University, Dilla, Ethiopia
| | - Ayub Mohammed
- Department of Anesthesiology, Wello University, Dessie, Ethiopia
| | - Salih Mohammed
- Department of Anesthesiology, Wello University, Dessie, Ethiopia
| |
Collapse
|
17
|
Touil N, Pavlopoulou A, Momeni M, Van Pee B, Barbier O, Sermeus L, Roelants F. Evaluation of virtual reality combining music and a hypnosis session to reduce anxiety before hand surgery under axillary plexus block: A prospective study. Int J Clin Pract 2021; 75:e15008. [PMID: 34811860 DOI: 10.1111/ijcp.15008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/04/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS Preoperative anxiety, which can affect postoperative recovery, is often present in patients undergoing surgery under loco-regional anaesthesia (LRA). Minimising preoperative anxiety with premedication can be effective but results in drug-related side effects. Therefore, the use of non-pharmacological techniques should be encouraged. METHODS We evaluated whether a virtual reality (VR) incorporating music and a hypnosis session, provided during the performance of LRA, can reduce preoperative anxiety. Fifty patients scheduled for elective hand surgery under an axillary plexus block were enrolled (March-June 2019). The primary outcome measure was the change in the Amsterdam Anxiety and Preoperative Information Scale (APAIS) questionnaire 5 min after the VR session as compared to before the VR session. The secondary outcome measures were the visual analog scale (VAS) for anxiety before and 2 h after the surgery and the Evaluation du Vécu de l'ANesthésie-LocoRégionale (EVAN-LR) satisfaction score. RESULTS Data from 48 patients were analysed. The APAIS score as well as VAS for anxiety were significantly reduced after a VR session (p < .001 for both scores). Patients were very satisfied (EVAN-LR: 92 (88, 94)). CONCLUSIONS The use of VR incorporating music and a hypnosis session could be an effective tool in the management of a patient's preoperative anxiety during the performance of an axillary plexus block.
Collapse
Affiliation(s)
- Nassim Touil
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Athanasia Pavlopoulou
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Mona Momeni
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Benoît Van Pee
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Olivier Barbier
- Department of Surgery, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Luc Sermeus
- Department of Surgery, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Fabienne Roelants
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| |
Collapse
|
18
|
Preoperative Anxiety Levels in Surgical Patients: A Comparison of Three Different Scale Scores. J Perianesth Nurs 2021; 37:69-74. [PMID: 34810072 DOI: 10.1016/j.jopan.2021.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 05/22/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE The aim of this study was to compare Anxiety Specific to Surgery Questionnaire (ASSQ) with Spielberger State-Trait Anxiety Inventory (STAI) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) in the assessment of preoperative anxiety level and to evaluate the fears associated with surgery and anesthesia in surgical patients. DESIGN This is descriptive, correlational, and cross-sectional study. METHOD The study sample included 507 surgical patients in four surgery wards who underwent elective surgery. All the data were collected using The Descriptive Characteristics and Clinical Information Form, STAI, APAIS and ASSQ. FINDINGS A majority (70.8%) of the participants had fears associated with surgery and anesthesia and nearly half of them had a moderate level of preoperative anxiety. Anxiety prevalence was 46.4% according to the APAIS, 44.4% according to STAI and 49.3% according to ASSQ. Women, participants with no primary school education, participants undergoing major surgery and general anesthesia who did not have knowledge about the surgical procedure, and surgical complications had higher anxiety according to three scale scores. CONCLUSION Nearly half of the participants had moderate/high preoperative anxiety, there were consistent results among the scales and the tools were interchangeable to evaluate the preoperative anxiety level in the surgical patients.
Collapse
|
19
|
Ruiz Hernández C, Gómez-Urquiza JL, Pradas-Hernández L, Vargas Roman K, Suleiman-Martos N, Albendín-García L, Cañadas-De la Fuente GA. Effectiveness of nursing interventions for preoperative anxiety in adults: A systematic review with meta-analysis. J Adv Nurs 2021; 77:3274-3285. [PMID: 33755246 DOI: 10.1111/jan.14827] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/27/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
AIMS The aim of this review and meta-analysis is to analyse the effectiveness of nursing interventions for the management of preoperative anxiety in adults. BACKGROUND The perioperative process is a stressful situation for many people who are going to be operated and it can generate feelings of anxiety. Also, preoperative anxiety can appear in the perioperative period. Nursing management of preoperative anxiety through individualized interventions can be effective for reducing anxiety. DESIGN A systematic review with meta-analysis was performed. DATA SOURCES CINAHL, CUIDEN, Pubmed, ProQuest and Scopus databases were consulted without restriction per year of publication. The search was conducted in February 2020. REVIEW METHODS Experimental studies on nursing management in preoperative anxiety with adults sample (>18 years) published in English and/or Spanish were included. All types of surgery were included in the review. A random effects meta-analysis was performed to estimate the effect size for preoperative anxiety measured with STAI. RESULTS After the selection process n = 9 quantitative studies with nursing interventions for preoperative anxiety were included. A preoperative educational and informative interview was used in six studies, one study used empathic interview, one used motivational interview and one used hand massage. The meta-analysis, including four studies using nursing interviews, had a sample of n = 419 in the intervention group and n = 445 in the control group. The mean difference in preoperative state anxiety measured with the STAI was in favour of the nursing intervention. CONCLUSION Nursing interventions for patients who are going to be operated seems to have a positive impact in their preoperative anxiety. However, due to the low number of studies and the heterogeneity of the sample, more research is needed about the topic.
Collapse
Affiliation(s)
| | - José L Gómez-Urquiza
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Keyla Vargas Roman
- Department of Behavioral Sciences Methodology, Faculty of Psychology, University of Granada, Granada, Spain
| | - Nora Suleiman-Martos
- Department of Nursing, Faculty of Health Sciences, University of Granada, Ceuta, Spain
| | - Luis Albendín-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | |
Collapse
|
20
|
Personalized Prechemotherapy Education Reduces Peri-Chemotherapy Anxiety in Colorectal Cancer Patients. DISEASE MARKERS 2021; 2021:6662938. [PMID: 34007345 PMCID: PMC8110412 DOI: 10.1155/2021/6662938] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/26/2021] [Accepted: 03/06/2021] [Indexed: 12/28/2022]
Abstract
Objective To evaluate the effect of personalized prechemotherapy education in the reduction of peri-chemotherapy anxiety in patients with colorectal cancer. Methods Patients admitted to the Department of Oncology with a diagnosis of stage III or IV colorectal cancer and scheduled for initial chemotherapy from January 1, 2017, to June 30, 2019, were retrieved. Patients in the educated group completed the GAD-7 form to evaluate their anxiety level at admission and 14 days after personalized prechemotherapy education, the educator team of which included both physician and nurse staff. Patients in the control group only completed GAD-7 forms at admission and 14 days thereafter without personalized education. Results Three hundred and sixty-four patients were enrolled for analysis, including 127 patients who received personalized prechemotherapy education and 237 patients who did not receive education. There were no significant differences in age, gender, education level, or pretreatment GAD-7 scores between the two groups, but significantly lower posttreatment GAD-7 score, and fewer medium to severe posttreatment anxiety patients in the educated group. Conclusion Personalized prechemotherapy education involving physician for medical treatment and nursing staff for peri-treatment care, in contrast to traditional brief discussion with physicians during clinic visits and unified informed consent before treatments, may reduce peri-chemotherapy anxiety more efficiently.
Collapse
|
21
|
Li L, Li S, Sun Y, Zhang S, Zhang X, Qu H. Personalized Preoperative Education Reduces Perioperative Anxiety in Old Men with Benign Prostatic Hyperplasia: A Retrospective Cohort Study. Gerontology 2021; 67:177-183. [PMID: 33454707 DOI: 10.1159/000511913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/22/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Psychological health is important to old patients with benign prostatic hyperplasia (BPH) after prostatic surgery. In this retrospective cohort study, we evaluated the effect of personalized preoperative education in the reduction of perioperative anxiety in old BPH patients after prostatic surgery. METHODS Senior patients (≥65 years) admitted with a diagnosis of BPH and scheduled for initial transurethral resection of the prostate from January 1, 2017 to November 30, 2019 were retrieved. Patients in the preoperatively educated group completed the Chinese version of generalized anxiety disorder 7-item scale (GAD-7) form to evaluate their anxiety level at admission and 14 days clinical visits after individual preoperative education. Patients in the control group completed GAD-7 forms but did not receive personalized preoperative education. Patients in both groups discussed their disease with physicians during clinic visits and after admission, and were given an informed consent about their treatment plans. RESULTS Seven hundred and twenty-four patients were retrieved, including 312 patients who received preoperative education and 412 patients who did not. There were significantly lower postoperative GAD-7 score and fewer moderate to severe postoperative anxiety patients in the preoperatively educated group (p < 0.01). Patients with education above secondary education level had less perioperative anxiety. CONCLUSION Personalized education incorporated with shared valuable physiological and psychological experience and expectations dealing with BPH, in comparison to traditional uniformed patient education and informed consent before surgery, may reduce perioperative anxiety more efficiently in BPH patients. A higher educational level helps patients reduce perioperative anxiety before and after their personalized preoperative education.
Collapse
Affiliation(s)
- Lihong Li
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China,
| | - Shasha Li
- Department of Oncology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yating Sun
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shaoxia Zhang
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xue Zhang
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Haiming Qu
- Department of Urology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
22
|
Khalil H, Shajrawi A, Dweik G, Zaghmouri A, Henker R. The impact of preoperative pain-related psychological factors on pain intensity post-surgery in Jordan. J Health Psychol 2020; 26:2876-2885. [PMID: 32597221 DOI: 10.1177/1359105320937067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
This study aimed to investigate the impact of preoperative psychological factors on postoperative pain. We included 300 postoperative patients who underwent open reduction and internal fixation surgery. Pain Scale, Pain Catastrophizing Scale, and Depression, Anxiety, and Stress Scale were completed by patients preoperatively and at 24 hours after surgery. Clinical characteristics were obtained from medical records. Data were analyzed using multiple linear regression. Postoperative pain was predicted by pain catastrophizing and anxiety symptoms. High preoperative catastrophizing and anxiety levels were associated with increased pain postoperatively. However, the relationships between preoperative depressive and stress symptoms and postoperative pain were not significant.
Collapse
|
23
|
Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|