Preoperative Anxiety in the Surgical Transfer and Waiting Area: A Cross-Sectional Mixed Method Study
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SUBMITTER: Dziadzko M
PROVIDER: S-EPMC9100941 | biostudies-literature | 2022 May
REPOSITORIES: biostudies-literature
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| S-EPMC10625733 | biostudies-literature
Project description:Aims and objectivesTo investigate preoperative anxiety in parents of paediatric surgical patients, testing whether the provision of information (using video and story books) regarding the surgical process can impact on reducing anxiety. Analyse if any personal factors influence the reduction of anxiety.BackgroundAttending a surgical theatre generates anxiety, especially in the case of children. The effect of different preoperative intervention procedures in children that attempt to reduce their anxiety level have been studied a great deal. However, although their parents also suffer high levels of anxiety, potential intervention to reduce their levels has not received the same attention.Study designRandomised Clinical trial.MethodsOne hundred and twenty-five parents of children (8-12 y.o.) undergoing surgery in a public hospital were randomly assigned to the control group CG (34 individuals) or one of the 3 experimental groups EG (91). In this Randomised Controlled Study, children and parents of the experimental groups were provided with a story book, a video with additional information of nursing, or both. Prior to the surgical intervention, the State Anxiety, S-A, and Trait Anxiety, T-A, of the parents and children were measured using the STAI and STAIC questionnaires respectively. Data collection was carried out for 12 months starting in October 2016.ResultsParents' S-A in the control group was higher than in the experimental groups. A linear model explains the parents' S-A using as regressors: children S-A, age and T-A of the parents, and children age.ConclusionsProviding information about the surgical process (through stories or videos) to which a child is going to be subjected can reduce the anxiety of the parents.Relevance to clinical practiceGiven their close connection to the patient and the potential effects on the children of their psychological situation, healthcare professionals should consider paying greater attention to communicating with the parents.
| S-EPMC10195889 | biostudies-literature
Project description:BackgroundPreoperative anxiety comprising anesthesia and surgery related anxiety is common and perceived by many patients as the worst aspect of the surgical episode. The aim of this study was to identify independent predictors of these three anxieties dimensions and to quantify the relevance of specific fears particularly associated with anesthesia.MethodsThis study was part of a cross-sectional survey in patients scheduled to undergo elective surgery. Anxiety levels were measured with the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Modified numeric rating scales (mNRS, range 0-10) were used to assess the severity of eight selected specific fears which were predominantly analyzed descriptively. Multivariate stepwise linear regression was applied to determine independent predictors of all three anxiety dimensions (APAIS anxiety subscales).Results3087 of the 3200 enrolled patients were analyzed. Mean (SD) total preoperative anxiety (APAIS-A-T, range 4-20) was 9.9 (3.6). High anxiety (APAIS-A-T > 10) was reported by 40.5% of subjects. Mean (SD) levels of concern regarding the eight studied specific fears ranged from 3.9 (3.08) concerning "Anesthesiologist error" to 2.4 (2.29) concerning "Fatigue and drowsiness" with an average of 3.2 (2.84) concerning all specific fears. Ranking of all specific fears according to mean mNRS scores was almost identical in patients with high versus those with low anxiety. Among nine independent predictors of anxiety, only 3 variables (female gender, negative and positive anesthetic experience) independently predicted all three APAIS anxiety subscales. Other variables had a selective impact on one or two APAIS anxiety subscales only. Female gender had the strongest impact on all three APAIS anxiety subscales. Adjusted r2 values of the three models were all below 13%.ConclusionsThe high variability of importance assigned to all specific fears suggests an individualized approach is advisable when support of anxious patients is intended. Considering independent predictors of anxiety to estimate each patient's anxiety level is of limited use given the very low predictive capacity of all three models. The clinical benefit of dividing patients into those with high and low anxiety is questionable.Trial registrationGerman Registry of Clinical Trials (DRKS00016725), retrospectively registered.
| S-EPMC7106568 | biostudies-literature
Project description:ObjectiveTo determine levels of burnout among surgical area nurses in Andalusia (Spain), to identify the phase of burnout in each participant and to consider its relationship with sociodemographic, occupational variables and personality factors considered.Data sourceData were collected by means of questionary. All nurses working in the surgical area on the date of data collection participated in the study. Sociodemographic and related to work variables were addressed in the questionnaire. Symptoms of anxiety and depression were measured using the Educational-Clinical Questionnaire: Anxiety and Depression (CECAD). Psychological personality variables were assessed using the NEO Five-Factor Inventory (NEO-FFI), adapted for a Spanish population. Burnout was measured using the Maslach Burnout Inventory (MBI).Study designMulticentre, cross-sectional, quantitative study carried out from August to October 2021.Data analysisDescriptive analysis, Student's t-test for independent samples, Pearson's correlation and multiple linear regression were performed with SPSS 25.0.Data extraction methodsThe study sample consisted of 214 surgical area nurses at 23 hospitals in Andalusia (Spain). Sociodemographic, occupational and personality variables were studied using the Maslach Burnout Inventory, the NEO Five-Factor Inventory (NEO-FFI) and the Educational-Clinical Questionnaire: Anxiety and Depression. The STROBE statement guidelines were applied.Principal findings29.4% of the nurses in the sample presented high levels of emotional exhaustion, 25.7% suffered from depersonalization and 28% had low levels of personal accomplishment. These three dimensions were significantly correlated with the NEO-FFI subscales (neuroticism, agreeableness, openness, conscientiousness and extraversion), and with all the anxiety and depression items considered. Agreeableness was a statistically significant predictor (p < 0.001) for all three dimensions of burnout.ConclusionNurses in the surgical area present high levels of Burnout. There is evidence that relates Burnout to personality factors and socio-demographic variables.
| S-EPMC11298497 | biostudies-literature
Project description:Gene-environment interaction is identified as the determinant in anxiety. ABO blood types represent a part of the genetic phenotype. Therefore, we assume ABO blood types correlate with preoperative anxiety. This cross-sectional study enrolled 352 patients with different ABO blood types, scheduled for elective surgery between 2018 and 2019 in the First Affiliated Hospital of Shihezi University. HADS (hospital anxiety and depression scale) scores and VA (visual analogue scales for anxiety) scores were all used to assess the preoperative anxiety in the A, B, AB, and O groups. Bivariate correlation and logistic regression were performed to identify relationships between preoperative anxiety and related variables. A significant difference in VA and HADS-A (anxiety) scores was found between the AB and other groups. The ratio of preoperative anxiety was 3.73 (95% CI [confidence interval]: 2.32-6.00, P < 0.001) times in female than in male; 0.36 (95% CI: 0.21-0.63, P < 0.001) times in ASA (American Society of Anesthesiologists) grade II than in grade I; 0.41 (95% CI: 0.20-0.86, P < 0.05) times in ASA grade III than in grade I; 1.25 (95% CI: 1.1-1.41, P < 0.001) times in higher VAS (visual analogue scales for pain) scores than in lower VAS scores; and 0.28 (95% CI: 0.16-0.49, P < 0.01) times in non-AB blood type than in AB blood type. Differences in ABO blood types were found in preoperative anxiety, and the AB group displayed a high preoperative anxiety level. ABO blood types, sex, ASA grade, and VAS were associated with preoperative anxiety. This trial is registered with ChiCTR1800019390.
| S-EPMC6913271 | biostudies-literature
Project description:BackgroundAnxiety is a behavioral expression of tension and unpleasant emotion that arises from multifactorial dimensions that might increase the mortality of patients during anesthesia and surgery. This study aimed to verify the prevalence and associated factors of preoperative anxiety among women undergoing elective cesarean delivery.MethodA cross-sectional study design was conducted on a total of 392 patients who underwent elective cesarean delivery in Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia from October 15, 2020, to September 15, 2021. Data was collected using a validated Amsterdam questionnaire, after translating to the local language (Amharic). Descriptive statistics were expressed in percentages and presented in tables. Bivariable and multivariable logistic analyses were done to identify factors associated with preoperative anxiety. The statistical significance level was set at P < 0.05 with 95% CI.ResultsThe overall prevalence of preoperative anxiety in women undergoing elective cesarean delivery was 67.9 [95% CI = (63.0-72.7)]. Participants who came from rural areas [AOR = 2.65; 95%CI: 1.27-5.53], farmers [AOR = 2.35; 95%CI: 1.02-5.40], participants with no previous surgical and anesthesia history [AOR = 2.91; 95%CI: 1.69-5.01], and primiparous women [AOR = 1.69; 95%CI: 1.01-2.83] were more significantly associated with preoperative anxiety.ConclusionThe prevalence of preoperative anxiety among elective cesarean deliveries was found to be high. So, preoperative maternal counseling and anxiety reduction services should therefore be given top priority, particularly for those women who came from rural areas, are farmers, have no prior surgical or anesthetic experience, and are primiparous.
| S-EPMC9382617 | biostudies-literature
Project description:Background and Objectives: Preoperative anxiety is a common emotional response before elective surgery that influences postoperative outcomes and can increase analgesic requirements. However, clinicians frequently overlook these concerns. This study aimed to quantify preoperative anxiety and evaluate its association with patient-related factors. Materials and Methods: Anxiety levels were evaluated in adult patients awaiting elective surgery using the Korean-translated version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Inventory-Korean YZ form (STAI-KYZ). The patients were also surveyed regarding the subjective causes of preoperative anxiety. Results: The study found that a total of 55 adult patients had a well-balanced subject distribution. Both questionnaires showed high internal consistency (Cronbach's alpha values of 0.85 and 0.93). Significant correlations were observed in situational anxiety scores from the questionnaires, indicating differences between groups with high trait anxiety and those with normal anxiety levels (p < 0.05). Notably, female sex was the only patient-related factor that significantly affected the anxiety scores (p < 0.05). Furthermore, when considering additional patient factors stratified by sex, it became evident that younger females and females with prior general anesthesia experience displayed higher anxiety levels than their male counterparts. The most commonly reported subjective concern related to anesthesia was the fear of not regaining consciousness, followed by concerns about postoperative pain, intraoperative emergence, and other issues. Conclusions: This study confirms that being female is a significant risk factor for preoperative anxiety. Therefore, it is necessary to provide enhanced preoperative anxiolytic therapies, including preoperative patient education and other interventions, to individuals undergoing surgical procedures.
| S-EPMC10972132 | biostudies-literature
Project description:BackgroundAnxiety is the most common problem in the preoperative period. This anxiety increases postoperative pain, delay healing, and prolong the hospital stay. Among the surgical population, a higher level of preoperative anxiety has been seen in obstetric patients.ObjectiveThe aim of this study was to assess the prevalence and associated factors of preoperative anxiety among obstetric patients undergoing cesarean section.MethodsAn institutional-based cross-sectional study was conducted from January 01, 2021, to May 30, 2021. A total of 376 obstetric patients who underwent cesarean sections were included. Descriptive statistics, cross-tabs, and binary logistic regression analysis were performed to identify the association shivering and independent variables. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval and a p-value<0.05 was considered as statistically significant state versions of state-trait anxiety inventory scale (S-STAI) were used for this study.ResultsThe overall prevalence rate of preoperative anxiety was 63% (95% CI: 58.2, 68.1). The patient's preoperative mean anxiety score of STAI was (43.81 ± 8.81). There was a high level of preoperative anxiety in patients undergoing emergency cesarean section as compared to elective patients. Patients' age less than 30 years, level of education, and previous anesthesia and surgery exposure were also highly associated with the dependent variable.ConclusionIn this study, fear of complications and fear of death result of operation were the most common factors responsible for preoperative anxiety while few patients were anxious about financial loss and osmotic issues.
| S-EPMC8844776 | biostudies-literature
Project description:BackgroundPreoperative anxiety in children is harmful. Despite this, there is a scarcity of studies examining the incidence of preoperative anxiety and its related effects in China. This study investigated preoperative anxiety in children aged 2 to 7 in the pediatric surgery department of a tertiary hospital in China. The factors influencing preoperative anxiety in these children were identified.MethodsThe researchers used the Chinese version of the modified Yale Preoperative Anxiety Scale (CmYPAS) and the Short Form of CmYPAS (CmYPAS-SF) to assess the preoperative anxiety state of children aged 2 to 7 who underwent elective surgery in the pediatric department of a tertiary hospital in China from July 1, 2020 to September 30, 2020 were enrolled in this study. The generalized estimating equation model was used to analyze the factors influencing preoperative anxiety in children.ResultsThe preoperative anxiety rate of 220 children in the tertiary hospital was 67.6%. Multivariate analysis revealed that children who attended elementary school had a lower risk of preoperative anxiety compared to children who did not attend school [odd ratio (OR) =0.39, 95% confidence interval (CI), 0.19 to 0.79, P=0.010]. Children whose caregivers felt very worried experienced an increased risk of preoperative anxiety compared to children whose caregivers were not worried about the surgery at all (OR =3.40, 95% CI, 1.35 to 8.56, P=0.009). Children who were very resistant, cried violently, twisted their bodies during puncturing the needle were 5.8 times more likely to experience preoperative anxiety compared to children who were very cooperative. The risk of preoperative anxiety in children who cooperated with a staff member was about 1.5 times higher than that of children who were very cooperative.ConclusionsThe incidence of preoperative anxiety in children aged 2 to 7 in the tertiary hospital in China was similar to the children in other countries. The caregivers' degree of concern priored to the operation and the degree of cooperation from the children during puncturing the indwelling needle were the main factors influencing the occurrence of preoperative anxiety.
| S-EPMC8429856 | biostudies-literature
Project description:IntroductionBeyond the provision of services, quality of care and patient safety measures such as optimal clinical handover at shift changes determine maternity outcomes. We aimed to establish the proportion of women handed over and the content of clinical handovers and communication between shifts within 3 diverse obstetrics units in Kerala, India, and to describe the handover environment.MethodsA cross sectional study was conducted for six weeks during February and March 2015at three hospitals in Kerala, India, during nurses obstetric handover in one tertiary private, one tertiary government and one secondary government hospital. Nursing handovers in obstetric post-operative, in-patient and labour wards were sampled. An SBAR-based (situation, background, assessment and recommendation) data schedule was completed whilst observing handover at nursing shift changes. Since obstetricians had no scheduled handover, qualitative interviews were conducted with obstetricians in two hospitals to establish how they acquire information when beginning a shift.ResultsData was obtained on 258 patients handed over, within 67 shift changes. The median percentage of women handed over was 100% in two of the hospitals and 27.6% in the other. The median number of information items included out of a possible 25 was 11, 5 and 4,and did not change significantly for women with high-risk status. Important items regarding assessment and recommendation for care were often missed, including high-risk status. The median number of environment items achieved was good at 7 out of 10 in all hospitals. Obstetricians sought information in various ways when required. All supported the development of structured tools, face-to-face and team handovers.ConclusionsMaternity unit handovers for doctors and nurses were inadequate. Ensuring handover of all women and including critical information, between shifts as well as between doctors, needs to be improved to increase patient safety.
| S-EPMC9098034 | biostudies-literature