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Immobilisation masks (IMs) are used for people with head and neck cancer (HNC) undergoing radiation therapy (RT) treatment to ensure accuracy and reproducibility between treatments. Claustrophobia-related mask anxiety in HNC patients is common and can compromise treatment due to patient distress. This scoping review aimed to describe the content of publicly available Patient Education Materials (PEMs) for people with HNC undergoing RT. Three search engines (Bing, Yahoo, and Google) were systematically searched using standard terms. PEMs in audio-visual or written formats were eligible for inclusion if the target readership was adults with HNC and included content on IMs for RT. Content was appraised using the Patient Education Materials Assessment Tool for Printable and Audio-Visual Materials to assess understandability and actionability. In total, 304 PEMs were identified of which 20 met the inclusion criteria. Sixteen PEMs were webpages, three were PDF format, and one was a standalone video. The understandability and actionability of PEMs ranged between 47 to 100% and 0 to 80%, respectively. PEMs authored by Foundations/Organisations scored higher in understandability (80–100%) and were more likely to discuss mask anxiety coping strategies. In comparison, News sites and IM manufacturers published PEMs with the lowest understandability scores (20–80%). The significant variations in the quality of IM PEMs identified suggest that some sources may be more effective at informing patients about IMs. Although multiple aspects of the PEMs were consistent across the reviewed materials, many PEMs lacked information, and a stronger focus on understandability and actionability is required. [ABSTRACT FROM AUTHOR]

The importance of patient education has become increasingly apparent in recent years. A prominent patient education tool in neurosurgery is the Neurosurgical Conditions and Treatments page provided by the American Association of Neurological Surgeons (AANS). This study aimed to investigate the readability of this resource page as many new articles have been incorporated in the past decade. Flesch-Kincaid Grade Level and Flesch-Kincaid Reading Ease scores were calculated for each article. One-way analysis of variance and Scheffé, Tukey-Kramer, Bonferroni, Fisher least significant difference, and Dunnett test post hoc analyses were conducted to determine differences between each category with respect to their mean grade level and reading ease scores. Overall mean (SD) Flesch-Kincaid Reading Ease score was 40.2 (12.24), and overall mean (SD) Flesch-Kincaid Grade Level score was 7.48 (1.26). Significant differences were found between mean reading ease scores between each categorization by the AANS (P = 0.014). No significant differences were found between mean grade level score for each categorization (analysis of variance, P = 0.154). As compared to a single previous investigation conducted 10 years ago, the readability of articles has changed modestly, and the reading grade level remains well above the recommendations by the American Medical Association and National Institutes of Health. The 6 new articles introduced in the past decade have demonstrated similar readability, presenting a persistent challenge in the realm of patient education in neurosurgery. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether modifications made to the current National Health Service (NHS) invitation letter for follow‐up colonoscopy examination affect participant state anxiety and behavioural intentions to attend. Methods: Five hundred and thirty‐eight adults of bowel cancer‐eligible screening age (56–74) were randomized to receive the current NHS invitation letter or the modified version of the letter as a hypothetical scenario. Modifications to the letter included fewer uses of the term cancer and awareness of alternative screening options. The history of the colonoscopy invitation, anticipated state anxiety, behavioural intention to attend the nurse appointment, and colonoscopy concerns upon reading the letter were measured. Results: Behavioural intentions were high in both conditions; however, participants reading the current letter reported significantly higher behavioural intentions compared to the modified letter. There was no main effect of previous invite status or interaction between previous invite status and letter condition on behavioural intentions. However, the effect of the letter on levels of anxiety depended on the participant's invitation history. Those never invited for a colonoscopy were more anxious when reading the modified letter compared to the current letter. Conversely, previous colonoscopy invitees were less anxious following reading the modified letter than those reading the current letter. Those never invited for a colonoscopy were more concerned about embarrassment and test invasiveness. All findings remained the same when controlling for age and education. Conclusion: Modifications to the invitation letter were not beneficial to levels of screening intention or anxiety. [ABSTRACT FROM AUTHOR]

Background: Patient anxiety is known to influence various aspects of dental procedures, including endodontic treatments. However, the extent of its impact on the efficacy of such procedures remains uncertain. Understanding this influence is crucial for improving patient outcomes and optimizing treatment protocols. Materials and Methods: A prospective cohort study was conducted involving 100 patients undergoing endodontic procedures. Patient anxiety levels were assessed using standardized anxiety scales before and after treatment. The efficacy of endodontic procedures was evaluated based on posttreatment pain scores, success rates of root canal treatments, and patient-reported satisfaction levels. Results: The mean pre-treatment anxiety score was 45.7 (SD = 9.2), while the mean posttreatment anxiety score reduced significantly to 32.4 (SD = 7.6), indicating a significant reduction in anxiety levels following endodontic procedures (P < 0.001). Posttreatment pain scores were lower in patients with reduced anxiety levels, with an average pain score of 2.1 (SD = 1.3) compared to 3.8 (SD = 1.6) in patients with persistently high-anxiety levels (P = 0.002). Additionally, the success rate of root canal treatments was higher in patients with lower anxiety levels (85%) than those with higher anxiety levels (65%) (P = 0.015). Overall patient satisfaction was also significantly higher in the low-anxiety group (P < 0.001). Conclusion: Patient anxiety significantly influences the efficacy of endodontic procedures, affecting posttreatment pain, success rates of root canal treatments, and patient satisfaction levels. Efforts to reduce patient anxiety before and during endodontic procedures may lead to improved treatment outcomes and higher patient satisfaction.

AbstractObjectiveMethodsResultsConclusionTo investigate the effect of two brief self-affirmation interventions, immediately prior to reading standard information about bowel cancer screening, on state anxiety, message acceptance and behavioural intention to screen for bowel cancer.242 adults aged 49 were randomised to one of two self-affirmation interventions (health or values) or one of two control conditions, before reading an NHS England bowel cancer screening leaflet. Participant friend and family history of bowel cancer, state anxiety, message acceptance, behavioural intention to screen, trait self-esteem and spontaneous self-affirmation were measured. Data were analysed using between-participants analysis of variance, planned contrasts and moderated regression.No main effects of experimental condition on levels of state anxiety, message acceptance and behavioural intention were found. However, planned contrasts showed participants who self-affirmed about their health or values (conditions-collapsed) were significantly less anxious and reported significantly higher behavioural intentions compared to participants in the controls (conditions-collapsed). Irrespective of condition, higher levels of spontaneous self-affirmation and trait self-esteem were correlated with lower anxiety, higher intentions, and message acceptance.There was some evidence of the effect of health-based self-affirmation on lowering anxiety; however, further research is needed to explore the effectiveness of different self-affirmation interventions in larger samples. [ABSTRACT FROM AUTHOR]

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has been regarded as a long-term problem after silicone breast implantations. We report a case in which BIA-ALCL and breast cancer were not detected preoperatively, with subsequent removal of a ruptured breast implant. A 52-year-old woman had silicone breast implants on both sides for breast augmentation 15 years ago. Right axillary lymphadenopathy and intracapsular ruptures were noted by magnetic resonance imaging. Right axillary lymph node biopsy was performed at our department of breast surgery. Flow cytometry for BIA-ALCL was also performed using the exudate around the implant. The results were negative for breast cancer and BIA-ALCL. However, taking into consideration exacerbation of breast implant rupture and the patient’s anxiety about BIA-ALCL, ruptured bilateral implants were removed by total capsulectomy. The postoperative course was uneventful 1 year after the operation, and her anxiety was dispelled despite her breast deformity. Appropriate explantation and periodic examination may be required to prevent excessive anxiety. [ABSTRACT FROM AUTHOR]

Patient education is an important part of cancer care as it increases patient activation and informed decision-making, reduces anxiety, and improves outcomes. However, challenges to providing appropriate education to patients exist on both the health provider and patient side of the equation, e.g., time constraints and health literacy issues. Digital health education is a fast-growing field of interest that has been shown to improve health outcomes, increase effectiveness of medical treatments and education, lower medical costs, and enhance both clinical diagnosis and research opportunities by streamlining data collection, sharing, and analysis. In 2019, Fox Chase Cancer Center was selected by ARCHES, an established patient education software company, to pilot its award-winning digital patient engagement system MyCareCompass. During the pilot, patients scheduled for port insertions were sent electronic messages inviting them to review various online educational materials related to their procedure and subsequent concerns. The invitations and resources were seamlessly integrated into the scheduling system and timed to arrive when patients would most need them. There was high usage of the port-related materials and patients reported a high level of satisfaction with the delivery system and the information. This automated process of delivering high-quality and relevant patient education was able to be implemented smoothly with IT involvement, had a positive impact on patients without adding any extra burden to the care team, and highlighted opportunities to integrate these types of interventions into routine care. [ABSTRACT FROM AUTHOR]

Patient education plays a crucial role in improving healthcare outcomes and ensuring high-quality care. The objective of this study was to assess patient satisfaction and knowledge about transcatheter arterial chemoembolization after watching some video-based education. A quasi experimental design was employed, involving 30 patients with hepatocellular carcinoma and their family caregivers. All participants received specialized video-based education on transcatheter arterial chemoembolization before undergoing the procedure. Pretest and post-test knowledge scores were compared using Wilcoxon matched-pairs signed ranks test, and satisfaction scores were analyzed and evaluated. The findings demonstrated a significant increase in post-test scores compared to pretest scores for all participants (p -value <.001). Moreover, participants who had prior experience with the procedure exhibited higher pretest scores than those who did not. Nevertheless, both groups experienced a significant improvement in post-test scores (p -value <.001). Additionally, all participants expressed high levels of satisfaction with the video-based education. In conclusion, video-based education effectively enhanced participants' knowledge of the transcatheter arterial chemoembolization procedure and yielded high patient satisfaction. This approach enables patients to actively engage in their treatment, thereby improving the overall quality of healthcare in interventional radiology. [ABSTRACT FROM AUTHOR]

Hirofumi Sasajima,1 Masahiro Zako,2 Yoshiki Ueta,1 Kenta Murotani3 1Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, 939-0243, Japan; 2Department of Ophthalmology, Asai Hospital, Seto, 489-0866, Japan; 3Biostatistics Center, Kurume University, Kurume, 830-0011, JapanCorrespondence: Hirofumi Sasajima, Department of Ophthalmology, Shinseikai Toyama Hospital, 89-10 Shimowaka, Imizu, Toyama, 939-0243, Japan, Tel +81-766-52-2156, Email hiro.sasa1228@icloud.comPurpose: We investigated the effects of 30% low-concentration nitrous oxide (N2O) anesthesia on anxiety, pain, and vital signs and the patient population that would benefit from low-concentration N2O anesthesia during cataract surgery.Patients and Methods: Sixty-three patients who underwent cataract surgery due to visual impairment from cataracts were included in this single-center retrospective cohort study conducted at the Ophthalmology Department of Shinseikai Toyama Hospital, Japan. Fifty eyes of 39 patients received a combination of local and N2O anesthesia (N2O group), and 30 eyes of 24 patients received local anesthesia without N2O anesthesia (Air group). The primary outcome measures were visual analogue scale (VAS) scores for patient anxiety, pain, and vital signs. The secondary outcome measures were the patient population.Results: The change in the VAS scores for anxiety and pain decreased significantly (p = 0.002 and p = 0.014, respectively) in the N2O group (− 15.6 ± 22.9 and 12.4 ± 14.9, respectively) compared with that in the Air group (1.2 ± 20.6 and 24.2 ± 22.4, respectively). The systolic and diastolic blood pressure changes did not significantly differ between both groups (p = 0.093 and p = 0.23, respectively). The change in heart rate decreased significantly (p = 0.001) in the N2O group (− 4.8 ± 4.8 bpm) compared with that in the Air group (− 0.6 ± 5.8 bpm). Multivariate analyses demonstrated that the change in anxiety level in the N2O group correlated significantly with patient age (p = 0.045) and preoperative VAS score for anxiety (p = 0.0001), whereas the change in anxiety level in the Air group did not correlate with any factor.Conclusion: Low-concentration N2O anesthesia showed beneficial effects on intraoperative anxiety and pain during cataract surgery; this may aid the stabilization of intraoperative vital signs. Moreover, low-concentration N2O anesthesia during cataract surgery could benefit young patients and patients with high levels of preoperative anxiety.Keywords: cataract surgery, low-concentration nitrous oxide anesthesia, patient anxiety

Budi Joko Santosa, Suparji Suparji, Heru Santoso Wahito Nugroho Department Health, Poltekkes Kemenkes Surabaya, Surabaya, Jawa Timur, IndonesiaCorrespondence: Suparji Suparji, Department Health, Poltekkes Kemenkes Surabaya, Jl. Pucang Jajar Tengah-56, Surabaya, Indonesia, Email suparjiyozabri@gmail.com

Background: Adequate preoperative information can lessen patient anxiety. Delivering sufficient information during a personal interview, however, is time consuming, and therefore a relevant economical aspect. We investigated whether video information given to the patient before the pre-anesthetic interview has an influence on the patient's anxiety and the duration of the interview. Method: We randomized 302 patients undergoing different types of anesthesia. In all, 151 patients watched a short video with general information about the anticipated anesthesia procedure. Afterward, all patients had a standard pre-anesthetic interview. Patients' anxiety and satisfaction with pre-anesthesia care were assessed after the interview using a visual analogue scale. The duration of the interview was documented. Student t-test and P < 0.05 for differences between the groups. Results: There was no difference in gender, age, ASA physical status, previous anesthesia experience, and the planned anesthesia procedure between the two groups. No difference in anxiety and satisfaction with pre-anesthesia care was observed. The duration of the pre-anesthetic interview was also not different between the groups. Discussion: Preoperative multimedia information did not reduce anxiety or increase the patient satisfaction undergoing anesthesia. The video containing general information did not save time in the pre-anesthetic interview.

BackgroundRespiratory depression is a life-threatening adverse effect of deep sedation. This study aimed to investigate the factors related to hypoxia caused by propofol during intravenous anesthesia.MethodsThree hundred and eight patients who underwent painless artificial abortion in the outpatient department of Shanghai Tenth People’s Hospital between November 1, 2019 and June 30, 2020 were divided into two groups according to whether the patients experienced hypoxia (SpO2 < 95%). Preoperative anxiety assessments, anesthesia process, and operation-related information of the two groups were analyzed. The univariate analysis results were further incorporated into logistic regression analysis for multivariate analysis to determine the independent risk factors affecting hypoxia.ResultsUnivariate analysis revealed that body mass index (BMI) (21.80 ± 2.94 vs. 21.01 ± 2.39; P = 0.038, 95% confidence interval (CI) = [−1.54, −0.04]), propofol dose (15.83 ± 3.21 vs. 14.39 ± 3.01; P = 0.002, CI = [−2.34, −0.53]), menopausal days (49.64 ± 6.03 vs. 52.14 ± 5.73; P = 0.004, CI = [0.79, 4.21]), State Anxiety Inventory score (51.19 ± 7.55 vs. 44.49 ± 8.96; P < 0.001, CI = [−9.26, −4.15]), and Self-rating Anxiety Scale score (45.86 ± 9.48 vs. 42.45 ± 9.88; P = 0.021, CI = [−6.30, −0.53]) were statistically significant risk factors for hypoxia during the operation. Logistic regression analysis showed that propofol dosage, menopausal days, and State Anxiety Inventory score were independent risk factors for hypoxia.ConclusionPatient anxiety affects the incidence of hypoxia when undergoing deep intravenous anesthesia with propofol. We can further speculate that alleviating patient anxiety can reduce the incidence of hypoxia.Clinical Trial Registration[http://www.chictr.org.cn], identifier [ChiCTR2000032167].

Background: Patient anxiety is known to influence various aspects of dental procedures, including endodontic treatments. However, the extent of its impact on the efficacy of such procedures remains uncertain. Understanding this influence is crucial for improving patient outcomes and optimizing treatment protocols., Materials and Methods: A prospective cohort study was conducted involving 100 patients undergoing endodontic procedures. Patient anxiety levels were assessed using standardized anxiety scales before and after treatment. The efficacy of endodontic procedures was evaluated based on posttreatment pain scores, success rates of root canal treatments, and patient-reported satisfaction levels., Results: The mean pre-treatment anxiety score was 45.7 (SD = 9.2), while the mean posttreatment anxiety score reduced significantly to 32.4 (SD = 7.6), indicating a significant reduction in anxiety levels following endodontic procedures ( P < 0.001). Posttreatment pain scores were lower in patients with reduced anxiety levels, with an average pain score of 2.1 (SD = 1.3) compared to 3.8 (SD = 1.6) in patients with persistently high-anxiety levels ( P = 0.002). Additionally, the success rate of root canal treatments was higher in patients with lower anxiety levels (85%) than those with higher anxiety levels (65%) ( P = 0.015). Overall patient satisfaction was also significantly higher in the low-anxiety group ( P < 0.001)., Conclusion: Patient anxiety significantly influences the efficacy of endodontic procedures, affecting posttreatment pain, success rates of root canal treatments, and patient satisfaction levels. Efforts to reduce patient anxiety before and during endodontic procedures may lead to improved treatment outcomes and higher patient satisfaction., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Objectives: State (situational) anxiety can create suboptimal outcomes for patients across a variety of health care specializations. While anxiolytic medications reduce anxiety, problematic side effects can compromise outcomes. These challenges have spurred searches for nonpharmaceutical approaches to alleviate patient anxiety. This systematic literature review, largely following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to determine patterns and effectiveness of interventions across medical health care specialty areas, including dentistry. Methods: A systematic review was conducted, using PubMed, CINAHL, and PsycINFO databases, with search terms related to anxiety, specific interventions, and medical or dental procedures. Hand searching for additional citations was performed on the bibliographies of dissertations, meta-analyses, and systematic reviews that met article inclusion criteria. The search process yielded 48,324 articles and 257 dissertations published in English between 1974 and 2018. Each abstract was evaluated for inclusion by two reviewers, yielding 718 articles that were read and evaluated for outcomes, risk of bias, pretest and post-test, controls and quality, using a Critical Appraisal Skills Programme instrument. Of these, 408 articles, describing 501 experimental trials, were accepted for inclusion in this analysis. Results: A total of 50,343 patients were included in these experiments, with an overall success rate of 71% for reducing patient anxiety. Results are summarized by health care specialty area: surgery, oncology, cardiology, obstetrics/gynecology, dentistry, and pain/trauma, and the following diagnostic testing and intervention areas: imaging, colonoscopy, mechanical ventilation, and other. The largest number of experiments (114) was in the surgery category. The types of interventions included music, education, relaxation, cognitive behavioral therapy (CBT), massage, distraction, hypnosis, acupuncture/acupressure, social support, aromatherapy, nature sounds, natural visual stimuli, special garment, and other. The largest numbers of experiments were done with music (143) and education (130). Discussion: The following interventions were most successful, reducing anxiety in over 70% of experiments: music, CBT, relaxation, massage, acupuncture/acupressure, hypnosis, and natural sounds. Confidence in results is limited by publication bias, small sample sizes, and the lack of placebo controls. Directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Objectives: A previous systematic literature review (SLR) evaluated 501 experiments on reducing patient anxiety across medical and dental environments. This integrative review examines those interventions and explores possible mechanisms leading to relative success or failure within those environments, in the interest of interprofessional education and communication. Methods: Reviewers evaluated 501 experiments testing interventions for reducing patient anxiety in a variety of medical and dental health care settings. Methodology for the SLR, largely following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, is briefly reviewed. Results: A total of 501 experiments (from 408 articles) met review criteria. One hundred and forty-three Music experiments were included, and Music interventions were largely effective, except in the case of colonoscopy. Education is the only intervention that occasionally (5 times of 130 experiments) raised patient anxiety in the face of a procedure; the discussion focuses on the wisdom of assessing patient need for information. Thirty-seven Cognitive Behavioral Therapy (CBT) experiments of various types are included, with a success rate of 89%, with a particularly high rate of success (12 of 12 experiments) in dentistry. Massage has a success rate that is similar to that of CBT, but Massage has been tested in far fewer specialty areas. Relaxation has been tested in every specialty area, except mechanical ventilation, with promising results. Acupuncture and Acupressure have not been widely tested, but their effectiveness rate is 100% when it comes to reducing patient anxiety in various procedural settings. Similarly, experiments show Hypnosis to be successful in 90% of trials. In contrast, Distraction was successful in only 40% of the experiments summarized, although it was more effective in dentistry. A variety of Nature-based Interventions (Aromatherapy, Nature Sounds, and Visual Stimuli) were highly successful across a variety of settings. Discussion: Possible mechanisms are discussed, along with commentary on feasibility. Limitations include publication bias, small sample sizes, and the lack of placebo controls. Future areas of research are pointed out. [ABSTRACT FROM AUTHOR]

Abstract Background This study compared a needle-free anesthesia method with traditional local anesthesia for insertion and removal of Nexplanon® long-acting removable contraceptive device. In our clinic, patients often avoid this highly effective form of contraception due to fear of needles. We sought to determine if patients perceived a difference in pain with the injection, anxiety level or pain with the procedure when local anesthesia was given with a needle v/s a needle-free jet injector device. Methods Patients were randomly assigned to one of two groups: jet injector or needle lidocaine delivery. Outcomes were ease of use, patient anxiety level, painfulness, and efficacy of anesthesia method. Results Patient pain perception with administration of jet injector lidocaine was statistically lower than traditional needle with no difference in anxiety or ease of use, or efficacy of the anesthesia. Conclusion The jet injector device is a reasonable alternative to needle injection delivery of anesthesia prior to insertion/removal of Nexplanon® device. Further studies may determine whether this needle-free alternative for administration of local anesthetic would result in more women choosing Nexplanon® as a contraceptive method.

Background: Adequate preoperative information can lessen patient anxiety. Delivering sufficient information during a personal interview, however, is time consuming, and therefore a relevant economical aspect. We investigated whether video information given to the patient before the pre‑anesthetic interview has an influence on the patient’s anxiety and the duration of the interview. Method: We randomized 302 patients undergoing different types of anesthesia. In all, 151 patients watched a short video with general information about the anticipated anesthesia procedure. Afterward, all patients had a standard pre‑anesthetic interview. Patients’ anxiety and satisfaction with pre‑anesthesia care were assessed after the interview using a visual analogue scale. The duration of the interview was documented. Student t-test and P < 0.05 for differences between the groups. Results: There was no difference in gender, age, ASA physical status, previous anesthesia experience, and the planned anesthesia procedure between the two groups. No difference in anxiety and satisfaction with pre‑anesthesia care was observed. The duration of the pre‑anesthetic interview was also not different between the groups. Discussion: Preoperative multimedia information did not reduce anxiety or increase the patient satisfaction undergoing anesthesia. The video containing general information did not save time in the pre‑anesthetic interview. [ABSTRACT FROM AUTHOR]

Background: Informed consent constitutes an important aspect of eye care. However, patients often experience difficulties understanding and retaining information presented to them during consultations. This study investigates the efficacy of pictorial aids in supplementing preoperative counselling of patients undergoing cataract surgery., Methods: Patients attending routine pre-cataract surgery counselling were randomized to receive either a standard verbal consultation (control) or a verbal consultation with a digitalized pictorial aid illustrating key surgical steps (intervention). Patients were assessed after the consultation on their knowledge, satisfaction, anxiety and preparedness using an anonymous questionnaire., Results: Seventy-six patients were recruited and randomized into the control and intervention groups. The intervention group attained better Knowledge Scores (control: 5 [2-6] vs. intervention: 6 [6]), and more patients "strongly agreed" that they were more prepared (control: 78.9% vs. intervention: 97.4%, P=0.028). A higher proportion of patients in the control group either "disagreed" or "neither disagree nor agreed (neutral)" that they were less worried (control: 15.8% vs. intervention: 0.0%, Fisher's Exact Test P=0.025). Although the consultation duration was shorter in the intervention group (21±4mins vs. 27±6mins, P<0.001), the use of digital pictorial aids during consultation resulted in more effective counselling with increased patient knowledge, easier decision-making process and reduced patient anxiety., Conclusion: Pictorial aids add to the repository of tools available to eye-care practitioners and are low-cost, easy to implement, and can effectively augment existing preoperative counselling processes to ensure accurate and effective preoperative counselling of patients., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Competing Interests: None disclosed.

Objective: Patients are often anxious and lack knowledge of radiotherapy prior to commencing treatment. Evidence‐based interventions are required to reduce patient anxiety and increase patient preparation before treatment. This study is part of a larger project examining the effectiveness of an innovative preparatory intervention "RT Prepare," to reduce patient psychological distress prior to treatment for breast cancer. This study aimed to explore patients' and RTs' perceptions about the "RT Prepare" intervention and was conducted to assist with refinement of the intervention for future implementation. Methods: Semi‐structured interviews were conducted with patients and radiation therapists (RTs) to elicit their perspectives on the "RT Prepare" intervention. Thematic analysis was used to analyse the data. Results: Telephone interviews were conducted with 21 patients who had received the intervention and 15 RTs who had delivered the intervention. Patients and RTs described the intervention positively and highlighted that it was beneficial for preparing patients for treatment planning and treatment. The overarching themes were communication skills; preparation; information provision and dedicated space and time. Conclusion: RT Prepare was well received by patients and RTs. Practice implications Based on the results of this study and our quantitative findings, implementation of the intervention would be beneficial for both patients and RTs. [ABSTRACT FROM AUTHOR]

A successful program of instruction for self-cannulation helps patients overcome the fear of needles. This article describes three techniques for self-cannulation. In tap cannulation, using the gate theory of pain, repeated needle tapping on the access site before cannulation can reduce the perception of pain during needle insertion. Touch cannulation is a technique in which holding the cannulation needle gives the cannulator more sensitivity for accurate placement of the needle in the vascular access. Tandem cannulation is a guided-hand approach, with the trainee's fingers placed directly on top of the trainer's fingers during cannulation. It gives the trainee a better view and feel for the skill. Followed by a reversal of tandem hand technique, the trainee receives very close physical and verbal support during the actual cannulation. The familiarity gained by handling the cannulation needle frequently in a harmless environment can ease patient anxiety. [ABSTRACT FROM AUTHOR]

Surgical patients may have doubts about bringing relatives into the perioperative setting because they are unfamiliar with the environment and rules. This study aims to investigate patients' experiences with relatives' participation in this context. We conducted 15 semistructured interviews with surgical patients and analyzed data according to Kvale and Brinkmann's meaning condensation. We found that patients believe they do not have tailored information to prepare themselves and their relatives for surgery. They believe that their individual information is not transferred between health care workers, making them feel unsafe and confused; that control reduces anxiety; and that cooperation among everyone involved in their care creates coherence. We concluded that a collaborative trialogue involving the patient, relatives, and health care workers may benefit all involved. In cooperation, patients can make individual choices about their care, relatives can understand their role and opportunities, and health care workers can tailor the care they provide. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the difference in anxiety levels between patients undergoing gastroscopy only and those subjected to both gastroscopy and colonoscopy. Despite known preoperative anxiety impacts, no prior research has compared these specific patient groups., Materials and Methods: A total of 150 patients were divided equally into two groups: Group I, undergoing gastroscopy only, and Group II, undergoing gastroscopy and colonoscopy. Inclusion criteria were patients in the age range 18-70 years and having an ASA (American Society of Anesthesiologists) physical status classification of I-III. Exclusion criteria were patients outside the age range, and patients with hearing disorders, psychiatric disorders, dementia, or recent anxiolytic drug use. Anxiety was analysed using the Beck Anxiety Inventory Scale before procedures, without any premedication., Results: Patients in Group II had significantly higher anxiety levels, with particular increases noted in symptoms such as leg weakness and tremors, inability to relax, and fears of adverse events and death. These results highlighted a considerable elevation in anxiety among patients anticipating or undergoing combined endoscopic procedures., Discussion: The findings revealed that undergoing combined gastroscopy and colonoscopy procedures significantly elevated patient anxiety levels compared to gastroscopy alone. This suggests a critical need for healthcare providers to implement more strong preoperative counselling and anxiety reduction strategies for patients facing multiple procedures. Addressing this increased anxiety could lead to better patient experiences, reduced procedural complications, and improved satisfaction and outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Albayrak et al.)

Perioperative patient anxiety in Mohs micrographic surgery (MMS) is associated with increased postoperative pain and decreased satisfaction. To determine whether a 3-dimensionally printed MMS model with standardized education (SE) improves perioperative patient understanding and anxiety. An unblinded, randomized controlled trial was conducted, with patients randomly assigned to receive the MMS model plus SE or SE alone. Baseline and poststage understanding and anxiety were evaluated with the Visual Analog Scale (VAS) and State-Trait Anxiety Inventory (STAI). Additionally, patients completed a 6-item knowledge assessment. Eighty-two patients were enrolled, 42 in the MMS model and 40 in the SE group, with similar group mean age (67.8 years), sex (59.8% male), and previous MMS experience (47.6%). Both groups experienced significant reductions in VAS anxiety and State-Trait Anxiety Inventory scores and significant increases in VAS understanding. Compared with SE alone, the MMS model group had larger VAS anxiety reduction (change, −1.31; approaching significance) than the SE group (change, −0.52; P =.052) and 5.59 (93.25%) correct responses versus 5.15 (85.83%) correct responses in the SE group (P <.028). Overestimations of baseline patient anxiety in our population and 91.1% recruitment of the intended study population limited study power. A 3-dimensionally printed MMS model with SE may improve patient understanding of MMS and decrease perioperative anxiety. [ABSTRACT FROM AUTHOR]

Aim: This study aims to assess the knowledge, attitude, and awareness about Gow-Gates technique among dental students. Introduction: The most commonly used technique for mandibular anesthesia is inferior alveolar nerve block (IANB). However, the failure reported for IANB remains high. Gow-Gates technique is used as a primary local anesthetic technique or as an adjuvant after failure of IANB. It provides sensory anesthesia to virtually the entire distribution of V3. Materials and Methods: Gow-Gates technique also called as true mandibular nerve block technique as it provides sensory anesthesia to virtually the entire distribution of V3. A questionnaire consisting of questions about Gow-Gates technique, its prevalence and success rate were given to dental students who practice in clinics. Their answer was obtained, evaluated, and compared. Results: Thus, this study was conducted to assess the knowledge, attitude, and awareness about Gow-Gates technique among dental students. Only about 60% of the respondents had adequate knowledge about the technique. Furthermore, they were not aware of the advantages, the technique offers over other techniques and the complications and their management. Conclusion: Their knowledge about Gow-Gates technique is less than adequate. Proper training, extra classes, conferences, and workshops should be conducted to provide them adequate knowledge which would eventually change their negative attitude toward the technique. [ABSTRACT FROM AUTHOR]

A creative art expression intervention using hand lettering was implemented on an outpatient oncology unit and evaluated for feasibility and its relationship with stress and anxiety in patients with cancer. Results suggest that a hand lettering intervention is feasible in this type of setting and may benefit patients experiencing stress and anxiety during outpatient treatment. [ABSTRACT FROM AUTHOR]

Abstract The patient environment in radiology laboratories and clinics has not been discussed in relationship to the noise within it and its impact on care. However, results of the Hospital Consumer Assessment of Healthcare Providers and Systems surveys have affirmed that noise remains a challenge for patients and health care organizations. The anxieties experienced by patients, whether waiting for a diagnostic test or radiation therapy, are influenced by the environment of the radiology waiting or laboratory areas. This article discusses the role of the environment and steps that can be taken to optimize the patient experience through environmental improvement. [ABSTRACT FROM AUTHOR]

Purpose This study was done to determine day surgery patients' presurgery anxiety levels related to information received. Design A descriptive and cross-sectional model was used. Methods The study was conducted with 151 patients who underwent day surgery at surgical clinics of a university hospital in Turkey. The data were gathered with the Patient Information Form and the State-Trait Anxiety Inventory. Findings The findings were that most of the patients received information about their day surgery, but the rate of receiving information about some issues was very low. Most of the patients reported that although they did not have any anxiety about surgery and anesthesia, observations revealed that their average state and trait anxiety scores were high. Conclusions Study results can be used as a basis to provide patients with clarifications about surgeries during the presurgery period and as a means of decreasing their anxiety about surgery and anesthesia. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Up to one third of radiation therapy patients are reported to have unmet psychosocial needs. Radiation therapists (RTs) have daily contact with patients and can provide daily psychosocial support to reduce patient anxiety, fear and loneliness. However, RTs vary in their values, skills, training, knowledge and involvement in providing psychosocial support. The aims of this study were to: (1) develop an online survey instrument to explore RT values, skills, training and knowledge regarding patient anxiety and psychosocial support, and (2) pilot the instrument with RT professionals to assess content validity, functionality and length. Method: An online cross‐sectional survey, titled ‘Radiation therapists and psychosocial support’ was developed. Items included patient vignettes, embedded items from RT research, and the Professional Quality of Life Scale (ProQOL5). Four radiation oncology departments volunteered to pilot the survey; each nominated four RT staff to participate. Survey data were analysed descriptively and qualitative feedback grouped and coded to determine whether the survey needed to be refined. Results: Thirteen of sixteen RTs completed the pilot survey and feedback form. Median time to completion was 35 mins, with 54% of respondents stating this was too long. Respondents reported content, questions and response options were relevant and appropriate. Feedback was used to: refine the survey instrument, minimise responder burden and drop out and improve functionality and quality of data collection. Conclusion: This pilot of the ‘Radiation therapists and psychosocial support’ survey instrument demonstrated content validity and usability. The main survey will be circulated to a representative sample of RTs for completion. [ABSTRACT FROM AUTHOR]

Background: In performing an MRI examination the patient may feel anxious due to the nature of the MRI scan as the patient would be inserted into the narrow bore of the MRI scanner and would be asked to be immobile during the examination period for approximately 20 to 90 minutes depending on the scan type. Patient feeling anxious may also be evoked by several causes and consequently may develop into anxiety reactions by the patient either before, during, or after the scan. Aim: This paper aim to study the issues surrounding the anxiety in patients undergoing MRI examinations by identifying the prominent causes, outlining the possible effects of anxiety, discussing the main potential methods for alleviating patient's anxiety. Materials and methods: This review is conducted by using a comprehensive search of PubMed, Google Scholar, and Elsevier, August 1993, through March 2018. The following search terms were used: causes of anxiety in MRI, claustrophobia and MRI, effects of anxiety in MRI, alleviation of anxiety in MRI patient. Conclusion: Patient's anxiety can pose problems that may impede the process of the MRI examination. Patient's anxiety may have adverse effects on both patient and the healthcare institution as it can cause financial losses for the healthcare institutions. However, sedation techniques, acoustic noise reduction, and adequate patient preparation for the MRI scan are possible methods that can alleviate patient's anxiety. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to characterize the relationships between the quality of the information given by the physician, the involvement of the patient in shared decision making (SDM), and outcomes in terms of satisfaction and anxiety pertaining to the treatment of inflammatory bowel disease (IBD).Methods: A Web survey was conducted among 200 Canadian patients affected with IBD. The theoretical model of SDM was adjusted using path analysis. SAS software was used for all statistical analyses.Results: The quality of the knowledge transfer between the physician and the patient is significantly associated with the components of SDM: information comprehension, patient involvement and decision certainty about the chosen treatment. In return, patient involvement in SDM is significantly associated with higher satisfaction and, as a result, lower anxiety as regards treatment selection.Conclusions: This study demonstrates the importance of involving patients in shared treatment decision making in the context of IBD.Practice Implications: Understanding shared decision making may motivate patients to be more active in understanding the relevant information for treatment selection, as it is related to their level of satisfaction, anxiety and adherence to treatment. This relationship should encourage physicians to promote shared decision making. [ABSTRACT FROM AUTHOR]

Purpose: Reducing surgery-related patient anxiety without under-emphasizing surgical risk is challenging for even the most experienced surgeon. The purpose of this study is to identify specific anxieties faced by patients in hopes of better informing the preoperative surgeon-patient dialogue. Setting: Comprehensive and specialty ophthalmology clinics at the University of California, San Francisco. Design: A prospective, survey-based study in which a pre- and postoperative questionnaire was administered to patients undergoing routine phacoemulsification. The surgeon was masked to patient enrollment and questionnaire responses. Materials and methods: A 36-item questionnaire on patient anxiety was developed from existing literature, building on the validated Surgical Fear Questionnaire. Patients were eligible if they were aged >18 years and willing to participate. Patients were excluded if having more than phacoemulsification alone or if unable to respond in English, and were retroactively excluded if there were complications during surgery. The primary outcome was self-reported anxiety on an 11-point Likert scale. Results: Sixty-one patients were included for analysis. Preoperatively, patients reported greatest anxiety around the operation itself and becoming blind. Reflecting postoperatively, patients reported the greatest anxiety for the operation itself. Statistically significant decreases were greatest for anxiety about the operation failing (p<0.001) and becoming blind (p<0.001). No decrease was observed for the operation itself (p=0.1). Conclusion: More effort must be made to specifically discuss the steps of the operation itself and the expected visual outcomes to alleviate patient anxiety. The authors hope these data can provide insight for surgeons into patient anxiety surrounding cataract surgery and help strengthen the patient-physician relationship. [ABSTRACT FROM AUTHOR]

Up to 49% of patients attending radiation therapy appointments may experience anxiety and distress. Anxiety is heightened during the first few visits to radiation oncology. Radiation therapists (RT) are the only health professionals in direct daily contact with patients during treatment, placing them in a unique position to explore patients' psychosocial needs. This review aims to synthesise literature regarding the effect of RT-led psychosocial support on patient anxiety. In May 2015, we searched the following electronic databases: Medline, PsycINFO, Embase, CINAHL, PubMed and Cochrane library. Radiation therapy-specific journals were hand-searched, and reference lists of identified studies searched. This review complies with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search identified 263 articles, of which 251 were excluded based on non-English language, duplicate article or relevance. A total of 12 articles involving 1363 patients were included and categorised into three broad themes: 'Patient Perspectives' 3 articles, 'Patient Information and Education' 5 articles and 'Screening and Needs Assessment' 4 articles. Two publications referred to the same sample and data. Quality ratings were mixed, with one study rated 'high' quality, seven 'moderate' and four 'low'. Methodological weaknesses were identified in relation to workflow, sample size and responder bias. RTs have a role in psychosocial support through increased communication and information sharing, which can benefit both patients and staff. RT-led practices such as relationship building, patient education sessions and screening and needs assessments are feasible and can reduce anxiety. [ABSTRACT FROM AUTHOR]

This literature review aimed to discover the factors that contribute to patients feeling unsafe in the healthcare setting. Electronic searches were undertaken using three databases to examine publications from 2002 to 2016. The design used a modified Cooper’s (1982) five-stage integrative review method. Fourteen articles were identified, producing seven themes: information and communication, loss of control, staff presence, impersonal care, patients’ vulnerable emotional and physical state, not being taken seriously, and the patient perception of of a lack of staff experience, knowledge, proactivity and interest. The findings suggest that, in maintaining a quality service for patients, nurses can contribute to the reduction of patients’ feelings of being unsafe and vulnerable. Patients do not just feel unsafe when errors occur, but also when service quality is noticeably poor. Where lack of quality is perceived as an indication of potential threat, this lack may contribute to patients feeling unsafe within the healthcare setting. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Informed consent means the process whereby patients are informed of all the necessary information about health care and subsequent treatment plans. In socioeconomically developing semi-urban setting, where most of the patients are illiterate, we wanted to assess knowledge, attitude and anxiety of patients towards informed consent. Methods: Patients were recruited from the waiting list for ophthalmic surgery at the department of Ophthalmology, Dhulikhel Hospital. A detail optometric and ophthalmologic evaluation was carried out. Data were collected through a 12-item questionnaire and an 8-item Likert scale. Statistics included regression analysis, chi-square test as well as frequency and percentages. Results: Of 42 questionnaire responders, female participation was high (64.3%). Sixty two percent of patients wanted the physician to decide for or against the surgery. Most of (69%) patients thought that by signing the consent they were agreeing for surgery and few (16.7%) thought that the consent was a legal document. Twenty two patients (52.4%) gave importance to the surgical intervention even though there were chances of serious complications. The preoperative anxiety was affected by surgical outcome (81%), complication (40.5%) and anaesthesia (9.5%). The patients prioritized the preoperative information on nature of illness, need for operation and the chances of vision improvement after surgery. Conclusion: Most of patients wanted the doctor to decide their treatment. Many patients wanted to know about the disease, treatment and the success rate of surgery. The success of the operation, the anaesthesia and the long list of complications tended to provoke anxiety.

Patient experience is a widely used indicator for assessing the quality-of-care process during a patient's journey in hospital. However, the literature rarely discusses three components: patient stress, anxiety, and frustration. Furthermore, little is known about what drives each component during hospital visits. In order to explore this, we utilized data from a patient experience survey, including patient- and provider-related determinants, that was administered at a local hospital in Abu Dhabi, UAE. A machine-learning-based random forest (RF) algorithm, along with its embedded importance analysis function feature, was used to explore and rank the drivers of patient stress, anxiety, and frustration throughout two stages of the patient journey: registration and consultation. The attribute 'age' was identified as the primary patient-related determinant driving patient stress, anxiety, and frustration throughout the registration and consultation stages. In the registration stage, 'total time taken for registration' was the key driver of patient stress, whereas 'courtesy demonstrated by the registration staff in meeting your needs' was the key driver of anxiety and frustration. In the consultation step, 'waiting time to see the doctor/physician' was the key driver of both patient stress and frustration, whereas 'the doctor/physician was able to explain your symptoms using language that was easy to understand' was the main driver of anxiety. The RF algorithm provided valuable insights, showing the relative importance of factors affecting patient stress, anxiety, and frustration throughout the registration and consultation stages. Healthcare managers can utilize and allocate resources to improve the overall patient experience during hospital visits based on the importance of patient- and provider-related determinants.

Introduction Patients sometimes present for radiation therapy with high levels of anxiety. Communication skills training may assist radiation therapists to conduct more effective consultations with patients prior to treatment planning and treatment commencement. The overall aim of our research is to examine the effectiveness of a preparatory programme ' RT Prepare' delivered by radiation therapists to reduce patient psychological distress. The purpose of this manuscript was to describe the communication skills workshops developed for radiation therapists and evaluate participants' feedback. Methods Radiation therapists were invited to participate in two communication skills workshops run on the same day: (1) Consultation skills in radiation therapy and (2) Eliciting and responding to patients' emotional cues. Evaluation forms were completed. Radiation therapists' consultations with patients were then audio-recorded and evaluated prior to providing a follow-up workshop with participants. Results Nine full day workshops were held. Sixty radiation therapists participated. Positive feedback was received for both workshops with 88% or more participants agreeing or strongly agreeing with all the statements about the different components of the two workshops. Radiation therapists highlighted participating in role play with an actor, discussing issues; receiving feedback; acquiring new skills and knowledge; watching others role play and practicing with checklist were their favourite aspects of the initial workshop. The follow-up workshops provided radiation therapists with feedback on how they identified and addressed patients' psychological concerns; time spent with patients during consultations and the importance of finding private space for consultations. Conclusion Communication skills training consisting of preparing patients for radiation therapy and eliciting and responding to emotional cues with follow-up workshops has the potential to improve radiation therapists' interactions with patients undergoing radiation therapy. Further research is warranted, similar to the RT Prepare study, to determine whether patient anxiety can be reduced as a result of improving communication and information provision. [ABSTRACT FROM AUTHOR]

Collaboration between perioperative nurses and music therapists can be beneficial in providing a safe, cost-effective means of managing patients’ anxiety and pain and reducing the need for pharmacologic intervention in the perioperative setting. The use of a board-certified music therapist may help to improve patient outcomes, ease nurse workload, and serve as an adjunct therapeutic modality that is enjoyable for both patients and staff members. We conducted a two-year, randomized controlled trial to determine how to best implement a music therapy program, navigate its challenges, and collaborate with nurse colleagues to bring its benefits to surgical patients. This article offers suggestions for alliances between perioperative nursing and music therapy staff members and describes the potential of music therapists to help provide optimal patient care. [ABSTRACT FROM AUTHOR]