• Title/Summary/Keyword: Preoperative Anxiety

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Limited Impact of Music Therapy on Patient Anxiety with the Large Loop Excision of Transformation Zone Procedure - a Randomized Controlled Trial

  • Kongsawatvorakul, Chompunoot;Charakorn, Chuenkamon;Paiwattananupant, Krissada;Lekskul, Navamol;Rattanasiri, Sasivimol;Lertkhachonsuk, Arb-Aroon
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2853-2856
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    • 2016
  • Background: Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. Materials and Methods: A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. Results: A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Conclusions: Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.

A Study of The Effect of Waiting time for Operation in the Operating Room on Preoperative Patients (수술환자에 있어 수술실내에서 수술대기 시간이 불안에 미치는 영향에 관한 연구)

  • Lee, Hea-Won;Lee, Kyu-Chung;Kim, Hae-Ock;Lee, Haik-Ock;Kim, Hea-Suk;Lee, Mi-Kyung;Song, Mal-Soon
    • The Korean Nurse
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    • v.29 no.3
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    • pp.36-48
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    • 1990
  • This study was attempted to provide us with basic information on how to improve understanding with patients for operation, and to offer then better nursing and treatment. This kind of study will help scientific application to nursing practice and operating room. The data was collected by interviewing 29 patients who underwent the elective surgery under the general anesthesia at Y hospital in Seoul. The interview ran from October 15 to December 15, 1989. The research instrument was a anxiety measurement device (SAAI) originally developed by Spielberger, et al and modified by Jung-Tack Kim. 1. Hypothesis Testing Hypothesis one was that there would be a difference in state anxiety level according to a time difference in watiting for operation. This hypothesis was rejected(state.anxiety level one hour before operation P>.05, r-.747, State anxiety level half an hour before operation P>.05, r-.1550, state anxiety level just before operation, P>.05, r=.1099). However, state anxiety, evel appeared to be associated with a longer watiting period, like one day before operation (P<.05, r-.4628). Hypothesis two was that there would be a difference according to state anxiety level of patients for operation. This was rejected. (Change of blood perssure in systolie P>.05 r=.1082, Change of blood pressure in diastolic P>.05, r=.088, Change of pulse rate, P>.05, r-1.909) 2. Examining trait anxiety and state anxiety levels, the average level of trait anxiety was 42.034, and the average level of state anxiety one day before operation was 43,000. The average level of state anxiety was averaged 42.356 in a waiting room for operation. 3. Examining the state anxiety level by time period, the one hour before was 42.379 the level half an hour before 42.276, and the level just before operation 42.414. The low level of state anxiety was due to the fact that premedication was not eliminated. 4. Age and time period like one day before operation was related to state anxiety level (F=5.271, P<.0.01) and blood pressure in waiting room for operation. That is, state anxiety level and blood pressure of patients one day before operation appeared high. Sex was relation to changes of blood pressure ; the blood pressure of male patients appeard higer than of female patients. A marital status was also related anxiety level one hour before operation the married patient for operation showed a higher state anxiety level than that of the unmarried patient for operation. Education was similarily related to trait anxiety level in which highly educated patients show lower levels of trait anxiety than poorly educated ones. Motive for hospitalization was related to state anxiety level for patient one hour before operation (F=6.464, P<.05) likewise, patients who are supposed to undergo operation hastily showed higher levels of anxiety than patients who expect elective surgeries.

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The Effects of Information Service Program by Media on Anxiety and Educational Satisfaction in Patients with Cataract Surgery (시청각매체를 이용한 정보제공 프로그램이 백내장 수술 환자의 불안과 교육만족도에 미치는 효과)

  • Oh, Yun Hee;Choi, Eun Joung
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.3
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    • pp.305-313
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    • 2016
  • Purpose: The purpose of this research was to identify the effects of providing an information service program by media on preoperative anxiety and postoperative educational satisfaction in patients with cataract surgery. Methods: For this study 52 patients who visited the ophthalmology clinic at P Hospital in B metropolitan city and who were scheduled to undergo one-day cataract surgery under local anesthesia were recruited. The 52 patients were assigned to the experimental group (25) or the control group (27). This study was conducted from August 27, 2015 to May 29, 2016. Results: Following the provision of cataract surgery related information service by media, the experimental group had a lower mean score for anxiety and higher mean score for educational satisfaction compared to the control group of patients. Conclusion: Results indicate that information service program by media "Goodbye Cataract" is useful educational materials for cataract patients in outpatient department and outpatient operating rooms.

Effects of Surgical Operation and Induced Thyroid Hormone Deficiency During Cancer Treatment on Emotional Distress in Thyroid Cancer Patients (갑상샘암 환자에서 수술 및 치료과정에서 유도된 갑상샘 호르몬 결핍이 정서적 스트레스에 미치는 영향)

  • Kim, Jong Sun;Choi, Won-Jung;Chang, Hang-Seok;Lee, Yong Sang;Oh, Young-Ja;Seok, Jeong-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.75-81
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    • 2012
  • Objectives : Thyroid cancer patients may experience emotional distress during cancer treatment including surgical operation and radioactive iodine treatment. The aims of this prospective study were to investigate changes of anxiety and depressive symptoms in patients with differentiated thyroid cancer(DTC) under preoperative, postoperative and short-term hypothyroidism state. Methods : Using the Hospital Anxiety and Depression scale(HAD) and the Distress Thermometer, we sequentially assessed the levels of anxiety, depression and distress in 41 DTC patients at 3 time points such as preoperative state, postoperative state and short-term hypothyroidism state. Results : The HAD-anxiety score was significantly higher in preoperative state($6.93{\pm}3.97$) than postoperative state($4.22{\pm}2.92$) and short-term hypothyroidism state($4.93{\pm}3.64$). Any other significant change in depression or distress thermometer score was not observed. Especially, difference of HADS score between the distress and none-distress groups was significant in preoperative state and post-operative state, but the difference become not significant in the short-term hypothyroidism state. Conclusions : Induced thyroid hormone deficiency during cancer treatment does not significantly affect emotional distress in patient with DTC. Anxiety and depression in these patients may be associated with distress of the patient before active cancer treatment.

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A Study on Emotional State of Preoperative Patients and Postoperative Pain (patients with abdominal surgery who received IV-PCA) (수술전 환자의 정서적 상태와 수술후 통증에 관한 연구 - IV-PCA를 부착한 수술환자 대상으로 -)

  • Kim Kyung-Hee;Chung Hae-Kyoung;Lee Hyun-Su
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.2
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    • pp.288-299
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    • 2002
  • The patients with abdominal surgery usually have acute pain. It is important for a patient's qualify of life and for good recovery after surgery to control the postoperative pain. The purpose of this study is to identify the relationship between emotional state of preoperative patients and postoperative pain. The participants in this study were the 100 patients receiving abdominal surgery who received Intravenous Patient Controlled Analgesia (IV-PCA) at the end of the operation. The data were collected using questionnaires and the period of the data collection was from March to August, 2001. The instruments used for this study were The State-Trait Anxiety Inventory (STAI) Developed by Spielberger (1972), The Center for Epidemeologic Studies-Depression (CESD) scale and Visual Analog scale (VAS). The data were analyzed using descriptive statistics. t-test, ANOVA and Pearson Correlation coefficient with the SPSS program. The results are as follows. 1. For general characteristics there were significant differences in the degree of trait anxiety according to gender (p= 0.0010), marital status (p=0.0122), religion (p=0.0040), education (p=0.0001), occupation (p=0.0002). monthly income (p=0.0001), diagnosis (p=0.0001), and operation title (p = 0.0001). 2. For general characteristics there were significant differences in the degree of state anxiety according to gender (p= 0.0023), education (P=0.0073), monthly income (p=0.0001), diagnosis (p=0.0005), and operation title (P =0.0063). 3. For general characteristics there were significant differences in the degree of depression according to gender (p= 0.0073), occupation (p=0.0469), monthly income (p=0.0001), diagnosis (p=0.012). and operation title (p =0.0033). 4. For general characteristics there were significant differences in the degree of postoperative pain according to gender (p=0.0213), marital status (p=0.0082), education (p=0.0016), occupation (p =0.0128). monthly income (p=0.0008), diagnosis (p =0.0007), and operation title (p =0.0008). 5. The relationship between trait anxiety and postoperative pain revealed a significant positive correlation (r =0.51, p =0.0001), and the relationship between state anxiety and postoperative pain revealed a significant positive correlation (r=0.50. p=0.0001) and the relationship between Depression and pain revealed a significant positive correlation (r =0.49. p =0.0001).

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The Effect of topical EMLA Cream for venipuncture on Patients' Pain and Anxiety (엠라크림이 정맥천자 시 통증과 불안에 미치는 영향)

  • Kim, Jung-Kyoung;Shim, Moon-Sook;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.9
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    • pp.4065-4072
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    • 2012
  • The purpose of this study was to examine the effect of topical EMLA Cream on venipuncture related pain and anxiety of surgery patient from oct. 27 to nov, 13, 2011, EMLA Cream was applied to the experimental group(n=40) 1hour before the procedure, but was not applied to the control group (n=37). The collected data were analyzed with the SPSS WIN 15.0 program. The percentage, mean and standard deviation were figured statistic, ${\chi}^2$-test, t-test, ANOVA, Correlation analysis were performed. Consequently, Pain in the EMLA applied experimental group was significantly lower than that of the control group. also state anxiety in the experimental group was lower than that of the control group. correlation of pain and anxiety after EMLA was related. EMLA cream was considered to be an effective local anesthetic for preoperative venipuncture on pain and anxiety.

Perioperative Hypertension Management during Facelift under Local Anesthesia with Intravenous Hypnotics

  • Chung, Ki Ho;Cho, Myeong Soo;Jin, Hoon
    • Archives of Plastic Surgery
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    • v.44 no.4
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    • pp.276-282
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    • 2017
  • Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure. In general, a systolic blood pressure goal of <150 mm Hg and a diastolic blood pressure goal of >65 mm Hg are recommended. This article discusses the causes of increased blood pressure and the treatment methods for perioperative hypertension during the preoperative, intraoperative, and postoperative periods, in order to find ways to maintain normal blood pressure in patients during surgery. Further, in this paper, we review the causes of perioperative hypertension, such as anxiety, epinephrine, pain, and postoperative nausea and vomiting. The treatment methods for perioperative hypertension are analyzed according to the following 3 operative periods, with a review of the characteristics and interactions of each drug: preoperative antihypertensive medicine (atenolol, clonidine, and nifedipine), intraoperative intravenous (IV) hypnotics (propofol, midazolam, ketamine, and dexmedetomidine), and postoperative antiemetic medicine (metoclopramide and ondansetron). This article focuses on the knowledge necessary to safely apply local anesthesia with IV hypnotics during facelift surgery without the assistance of an anesthesiologist.

Hemodynamic changes and pain perception-related anxiety after experiencing an impacted-tooth removal: clinical practice outcome

  • Raocharernporn, Somchart;Boonsiriseth, Kiatanant;Khanijou, Manop;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.2
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    • pp.105-111
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    • 2017
  • Background: Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status. Method: Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used. Results: The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05). Conclusion: There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.

The Effects of Supportive Nursing Intervention Using Video-Program of Operating Room Nurses before Operation on Laparoscopic Hysterectomy Patient's Anxiety (수술 전 수술실간호사의 동영상 프로그램을 활용한 지지간호중재가 자궁적출술 환자의 불안에 미치는 효과)

  • Eo, Yong-Sook;Lee, Nae-Young;Lee, Ji-Won;Cha, Hyeon-Jun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2639-2646
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    • 2015
  • This study was to identify the effects of supportive nursing intervention using video-program of operating room nurses before operation on laparoscopic hysterectomy patient's anxiety. This study was nonequivalent control group pre-post test design. The data were collected from May 1 to Jun 20, 2013 and analyzed by $x^2-test$, Fisher's exact test and t-test using SPSS 20.0 program. Experimental group(who received supportive nursing intervention) and control group(who received booklet education) was respectively consisted of 25 patients who were laparoscopy hysterectomy. The anxiety(p=.002) of experimental group was significantly lower than control group. The systolic(p=.012) and diastolic(p=.045) pressure of experimental group was significantly lower than control group, but pulse wasn't. The supportive nursing intervention for preoperative patient is considered effective and useful in reducing anxiety. Further research is warranted to investigate the supportive nursing intervention long-term effect.

Perioperative Comprehensive Supportive Care Interventions for Chinese Patients with Esophageal Carcinoma: a Prospective Study

  • Zhang, Xiao-Dan;Zhao, Qing-Yu;Fang, Yi;Chen, Guan-Xuan;Zhang, Hui-Fang;Zhang, Wen-Xiao;Yang, Xiao-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7359-7366
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    • 2013
  • Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.