Search

Purpose: This study aimed to investigate the opinions and experiences of parents whose children are hospitalized in a pediatric surgery clinic in Turkey regarding care practices., Design and Methods: Sixteen in-depth interviews with parents whose children were hospitalized in a pediatric surgery clinic were conducted and analyzed between October and December 2023, by grounded theory methodology. The COREQ guidelines guided the reporting of this study., Results: A core category was identified, 'Preoperative information helps my child and I experience less anxiety and fear' demonstrating that parents are aware of their situation. Analyzing resulted in an interpretive theory of two interrelated categories: 'Quality Nursing Care' and 'Patient and Parent Satisfaction'., Conclusion: Children and parents who received accurate, sufficient, and timely information experienced less anxiety and fear in the preoperative. Quality nursing care significantly affects the well-being of parents and pediatric patients. As a result of all these, high patient and parent satisfaction is an important care outcome., Practice Implications: Reducing the anxiety and fears of pediatric patients and parents in the preoperative is an important goal. Quality nursing care is one of the most important perceived factors in achieving this goal. Providing in-service training on this subject can increase awareness, especially for nurses new to the pediatric surgery clinic., Competing Interests: Declaration of competing interest The author declares that there are no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: This study aimed to evaluate the effects of an artificial intelligence (AI) chatbot (ChatGPT-3.5, OpenAI) on preoperative anxiety reduction and patient satisfaction in adult patients undergoing surgery under general anesthesia., Design: The study used a single-blind, randomized controlled trial design., Methods: In this study, 100 adult patients were enrolled and divided into two groups: 50 in the control group, in which patients received standard preoperative information from anesthesia nurses, and 50 in the intervention group, in which patients interacted with ChatGPT. The primary outcome, preoperative anxiety reduction, was measured using the Japanese State-Trait Anxiety Inventory (STAI) self-report questionnaire. The secondary endpoints included participant satisfaction (Q1), comprehension of the treatment process (Q2), and the perception of the AI chatbot's responses as more relevant than those of the nurses (Q3)., Findings: Of the 85 participants who completed the study, the STAI scores in the control group remained stable, whereas those in the intervention group decreased. The mixed-effects model showed significant effects of time and group-time interaction on the STAI scores; however, no main group effect was observed. The secondary endpoints revealed mixed results; some patients found that the chatbot's responses were more relevant, whereas others were dissatisfied or experienced difficulties., Conclusions: The ChatGPT intervention significantly reduced preoperative anxiety compared with the control group; however, no overall difference in the STAI scores was observed. The mixed secondary endpoint results highlight the need for refining chatbot algorithms and knowledge bases to improve performance and satisfaction. AI chatbots should complement, rather than replace, human health care providers. Seamless integration and effective communication among AI chatbots, patients, and health care providers are essential for optimizing patient outcomes., Competing Interests: Declaration of Competing Interest None to report., (Copyright © 2024. Published by Elsevier Inc.)

Background: The authors aim to investigate the effect of music on hemodynamic fluctuations during induction of general anesthesia and reducing preoperative anxiety for women who underwent elective non-cardiac surgery., Methods: It is a multicenter, double-blind, randomized, parallel-group clinical trial. Patients were randomized 1:1 to either a Music Intervention group (MI) or a Control group (Control). The MI participants listened to their preferred music for more than 30 minutes in the waiting area. The State-Trait Anxiety Inventory (STAI) was used to measure anxiety levels in the groups, and hemodynamic parameters (Heart Rate [HR], Mean Arterial Pressure [MAP]) were continuously recorded before induction (T0), at loss of consciousness (T1), immediately before intubation (T2), and after intubation (T3). Intubation-related adverse events were also recorded. The primary outcome was the incidence of MAP changes more than 20 % above baseline during T0-T2., Results: A total of 164 patients were included in the final analyses. The incidence of MAP instability during T0-T2 was lower in the MI, and the 95 % Confidence Interval for the rate difference demonstrated the superiority of MI. HR instability was less frequent in MI participants both in T0-T2 and T2-T3. The overall incidence of preoperative anxiety was 53.7 % (88/164). After the music intervention, the mean score of STAI was significantly lower in the MI than in the Control, with a between-group difference of 8.01., Conclusions: Preoperative music intervention effectively prevented hemodynamic instability during anesthesia induction and significantly reduced preoperative anxiety in women undergoing elective non-cardiac surgery., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Background: Preoperative anxiety is a major mental health problem during the preoperative period. Admission of women to surgery is stressful, and a high level of anxiety was associated with increased perioperative morbidity and mortality, poor treatment satisfaction, and bad obstetric outcomes, including long-term cognitive impairment in children. Despite its negative consequences, little is known on this area, particularly in the study area., Objective: To assess preoperative anxiety and associated factors among women admitted for elective obstetrics and gynecologic surgeries in public hospitals in Southern Ethiopia, 2022., Methods and Materials: An institution-based cross-sectional study design was conducted among 389 women using structured interviewer-administered samples who were selected by systematic random sampling from May 20 th  to June 20 th , 2022. The Amsterdam preoperative anxiety and information scale (APAIS) was used to assess the level of anxiety. Data were collected electronically using the Open Data Kit version 2022.2.3 and analyzed with the Statistical Package for Social Sciences version 26.0. Bivariate and multivariable logistic regression analyses were done. The strength of the association was declared by using an adjusted odds ratio (AOR) with a 95% confidence interval, and a statistical significance of P < 0.05., Results: The magnitude of preoperative anxiety was 57.1% (95% CI = 51.4-61.5), and 48.1% of women required an average amount of information. Being a gynecologic patient (AOR = 2.0, 95% CI = 1.21, 3.32), having previous anesthesia and surgery (AOR = 2.09, 95% CI = 1.10, 3.96), having fear of postoperative pain (AOR = 1.96, 95% CI = 1.08, 3.53), having concern for family (AOR = 2.56, 95% CI = 1.49, 4.37), having poor social support (AOR = 3.75, 95% CI = 1.99, 7.09), and moderate social supports (AOR = 3.27, 95% CI = 1.74, 6.17), and having a high information requirement about anesthesia and surgery (AOR = 4.68, 95%CI = 2.16, 10.13) were statistically associated with preoperative anxiety., Conclusion: Preoperative anxiety was often high in the region. Associated factors were the type of surgery, previous anesthesia and surgery, fear of postoperative pain, fear for family, social support, and a high information need. So the national and regional health bureau should develop guidelines and implement strategies to reduce women preoperative anxiety as part of midwifery care. The women should be assessed regularly during the preoperative visits; and appropriate anxiety reduction and information regarding surgery, and anesthesia should be provided., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Purpose: The study was conducted to determine the effect of hand massage applied to preoperative children on anxiety level and hemodynamic variables., Design: This research study is a randomized controlled trial with control and study groups, pre- and post-tests., Methods: This study was conducted between April and September 2017 with 84 children who were planned to receive an operation by applying general/local anesthesia in a province in the south of Turkey. The population of the research was composed of children between the ages 9 and 12 (study group = 42 and control group = 42). The data were collected through "Child and Parent Information Form," "State-Trait Anxiety Inventory for Children," "Physical Symptoms Follow-up Form for Anxiety," and "Satisfaction Evaluation Scale.", Findings: The state-trait anxiety mean after hand massage was found to be 25.78 ± 5.90 in the study group, and 31.80 ± 6.51 in the control group (P < .05). There was a statistically significant difference (P < .05) between the systolic blood pressures and heart rate averages of the children in the study group after hand massage. There was a negative correlation between the satisfaction hand massage and state-trait anxiety means of the study group children (P < .05)., Conclusions: Hand massage was found to have a positive effect on reducing anxiety, systolic blood pressure and heart rate. No effect was found on diastolic blood pressure, respiratory rate and SpO 2 . We recommend that more extensive studies on hand massage are performed., (Copyright © 2023 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Aim: To evaluate the impact of a virtual reality (VR) intervention on adult patients' preoperative anxiety, heart rate, respiration rate and blood pressure., Design: A systematic review and meta-analysis of randomized controlled trials (RCTs)., Data Sources: A librarian-designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI and Wanfang databases was conducted to identify research studies in English or Chinese on RCTs from their inception to 31 May 2022. Detailed search strategies and the checklist are provieded in Supplementary files S1 and S2., Review Methods: Two researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. A fixed- or random-effects meta-analysis model was used to determine the pooled mean difference based on the results of the heterogeneity test., Results: This study included 11 articles with a total of 892 participants. VR distraction comprised five studies, and VR exposure consisted of six studies. The results indicated that VR could reduce preoperative anxiety in adult patients and VR exposure seems to be more effective. The results also indicated that VR intervention can effectively reduce patients' heart rate and blood pressure compared to traditional intervention methods, but had no significant effect on respiration rate., Conclusion: VR technology could relieve preoperative anxiety in adult patients through distraction or exposure. More well-designed RCTs containing a wider range of surgical types are needed to verify our findings before we can make strong recommendations., Impact: Our systematic review and meta-analysis show a positive effect of VR distraction and exposure interventions in reducing preoperative anxiety in adult patients. We suggest incorporating VR into preoperative procedures as an auxiliary way to reduce negative emotions in eligible patients., No Patient or Public Contribution: Our paper is a systematic review and meta-analysis and such details do not apply to our work., (© 2023 John Wiley & Sons Ltd.)

Background: Preoperative anxiety is a challenging problem in the preoperative care of patients. Identifying risk factors helps nurses provide psychological support during the pre-operative visit so that stress can be reduced., Aims: This study aimed to determine the prevalence of surgical anxiety and related factors in hospitalized surgical patients., Methods: This research was designed as a point-prevalence study. The study was completed with 223 patients hospitalized in the surgical clinics of a tertiary hospital in Turkey. Surgical anxiety questionnaire (SAQ) and State-trait anxiety inventory (STAI) were used for the assessment of anxiety., Results: Preoperative anxiety prevalence was 69.5% according to the SAQ and 49.3% according to STAI. Women, participants with no primary school education, those who were unemployed and had low income, those with no previous surgery, those living in fear of surgery, the participants who underwent major surgery and general anesthesia, and those who did not have knowledge about the surgical procedure and anesthesia had higher anxiety according to the two scales. A highly significant and positive correlation was found between total STAI and total SAQ., Conclusion: The importance of surgical anxiety for the health system, which affects two out of every three hospitalized patients, should not be underestimated. Therefore, national and global plans should be made to prevent and manage surgical anxiety., (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Background: The aim of this study was to evaluate the effect of reading a preoperative preparation-themed storybook on children's preoperative fear and anxiety levels., Methods: The research design was a randomized controlled experiment. The research sample included 80 children (40 in the story group and 40 in the control group) who met the inclusion criteria. Data collection tools were collected through face-to-face interviews with the 'Survey Form', 'Child Fear Scale (CFS)' and 'Modified Yale Preoperative Anxiety Scale (mYPAS)'. In the research, the book named Elif Has Surgery was used as an intervention tool. In the story group, the preoperative preparation-themed storybook was read to the child in their room at the clinic by their mother within 10 min. The control group received only clinical routine. The study was approved by the ethics committee., Results: There was a statistically significant difference between the groups in the mean scores of the CFS and mYPAS scales in the control and story groups (p < 0.05)., Conclusions: This study found that reading a preoperative preparation-themed storybook reduced children's fear and anxiety before surgery. It may be recommended to expand the use of preoperative preparation-themed storybooks in order to prevent fear and anxiety experienced before surgery in paediatric surgery clinics. Story reading is an effective, cheap, non-pharmacological intervention. The clinical trial registration number is NCT05478369., (© 2023 John Wiley & Sons Ltd.)

Objective: Stoma surgery is a profoundly life changing event that can result in a range of negative psychological and mental health outcomes, often requiring significant postoperative adaption. While postoperative avenues of support to address these outcomes exist, there remains a lack of preoperative psychological preparation for surgical candidates in standard models of care. The present systematic review and meta-analysis aims to examine the current and emerging models of psychological preparation available to stoma surgery candidates during the preoperative period., Methods: A systematic search of PubMed, Embase, Emcare, PsycINFO, CINAHL, and SCOPUS was conducted. All studies examining the effects of preoperative psychological interventions targeting postoperative psychological adjustment and/or mental health outcomes for individuals planning to undergo or who had undergone stoma surgery were included., Results: Overall, 15 publications meeting inclusion criteria were identified, encompassing 1565 total participants. Intervention types ranged from psychoeducational, counselling, and practical based skills, examining the postoperative outcomes of anxiety, depression, quality of life, adjustment, self-efficacy, and systematic improvements to standard models of care. Five studies examining postoperative anxiety were included for meta-analysis, demonstrating an overall significant effect (SMD = -1.13, 95% CI -1.96 to -0.30, p = .008). Due to the high level of heterogeneity between remaining studies, articles examining postoperative outcomes other than anxiety were synthesised in narrative form., Conclusion: Despite some promising advancements in the field, there remains insufficient evidence to judge the overall effectiveness of current and emerging models of preoperative psychological preparation on postoperative psychological outcomes for individuals facing stoma surgery., Competing Interests: Declaration of Competing Interest The authors have no competing interests to report., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Anxiety 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., Method: A 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., Results: The 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., Conclusion: The 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., (© 2022. The Author(s).)

Objective: To explore potential clinical applications, based on evidence and a nurse-driven test of change, of using lavender aromatherapy for preoperative anxiety as an intervention complementary to standard preoperative care., Design: A pre- versus postaromatherapy comparison using a visual analog scale (VAS)., Setting: The preoperative department at a level 2 trauma hospital with 544 beds., Participants: Forty-four surgical patients, including 29 female participants and 15 male participants., Intervention/measurements: Participants reported their anxiety on a VAS before receiving a lavender aromatherapy inhaler. Anxiety scores were measured again after receiving the lavender aromatherapy and shortly before participants left the preoperative area for surgery. A pre-post comparison of the two VAS anxiety measurements before and after receiving the lavender aromatherapy was completed, analyzed, and is discussed., Results: Mean anxiety scores were calculated for the pre- and postaromatherapy groups. Forty-eight percent of female participants (n = 29) reported a decrease in their anxiety after receiving preoperative lavender aromatherapy. Female participants reported higher preoperative anxiety scores and a larger decrease in their mean anxiety scores after receiving lavender aromatherapy when compared to male participants., Conclusion: The use of a nurse-driven complementary intervention in the preoperative area was associated with a decrease in mean anxiety scores among female patients about to undergo elective surgery. However, cause and effect cannot be determined because of a lack of a control group and randomization. Opportunities exist with support from seasoned staff for nurses to incorporate safe, evidence-based complementary interventions into the current standard of care for preoperative anxiety., Competing Interests: Conflict of Interest The author reports no conflicts of interest or relevant financial relationships., (Copyright © 2021 AWHONN. Published by Elsevier Inc. All rights reserved.)

Objectives: This qualitative review aims to provide a clearer understanding of concerns general surgery (GS) patients face in the preoperative period., Methods: Medline, CINAHL, PsycINFO and Web of Science were searched for articles describing the preoperative concerns of GS patients. Qualitative and mixed method studies were included. Key quotes were extracted, coded, and thematically analyzed according to Thomas and Harden's methodology., Results: 27 articles were included. Three main themes were generated: (1) lead-up to surgery, (2) postoperative recovery process and (3) standard of care. While waiting for surgery, patients were often shrouded with uncertainty and concerned themselves with the potential impacts of their disease and surgery on their wellbeing and recovery. Furthermore, patients' trust and confidence in Healthcare Professionals (HCPs) was compromised when standard of care was perceived to be deficient, resulting in doubts about HCPs' credibility and capabilities., Conclusion: Patients' preoperative concerns often stem from the uncertainty and unfamiliarity surrounding surgery. To address this, a combination of effective preoperative education, individualised communication and involvement of social support should be considered., Practice Implications: Preoperative concerns can negatively impact patients and effective interventions will result in a better perioperative experience with fewer negative consequences arising from patients' fear and anxiety., Competing Interests: Declaration of Competing Interest The authors report no declarations of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Purpose: The aim of this study was to investigate the effect of preoperative and postoperative anxiety on the state of recovery in patients undergoing abdominal surgery., Design: This research is a descriptive and cross-sectional study., Methods: The study included a total of 82 patients undergoing elective abdominal surgery. Demographic data were collected. State-Trait Anxiety Inventory was the measure for anxiety. The quality of recovery (QoR) was assessed using Quality of Recovery Scale (QoR-40). Both have known validity and reliability and valid translations into Turkish. After obtaining consent from patients, 82 patients completed their demographic profile and State-Trait Anxiety Inventory before surgery, and after 24 hours of surgery completed the state anxiety and QoR., Findings: Patients who received general anesthesia had higher anxiety before and after surgery (P = .004 and P = .022). Patients who were not informed about the surgery had higher preoperative trait anxiety (P = .01). The QoR scores of the patients were negatively related to preoperative and postoperative state anxiety (P = .01 and P = .000). Preoperative state anxiety was positively related to preoperative trait and postoperative state anxiety (P = .000 and P = .000)., Conclusions: The results provided more evidence that patients need education before surgery as to what to expect both in the surgical suite and immediately after surgery to alleviate anxiety. This should also improve QoR., (Copyright © 2020 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Objective: The objective of this systematic review was to determine the effectiveness of preoperative oral pregabalin for anxiety control, the most effective dosage regimen, its impact on postoperative pain, and its adverse effects., Materials and Methods: A search was conducted of PubMed/Medline and clinicaltrials.gov (National Library of Medicine, Washington, DC), Scopus, Web of Science, and Cochrane databases for studies published between January 2009 and November 2018, with no language restriction. Based on PRISMA guidelines, the specific question was: is preoperative oral pregabalin effective and safe for anxiety control in patients undergoing surgery? The critical reading of retrieved studies followed questions prepared by the CASPe Network, and their methodological quality was evaluated using the Jadad Scale., Results: Twelve randomized controlled trials were selected for review. All twelve studies were trials of high quality. A dose of 75 mg preoperative oral pregabalin has been found to reduce anxiety and stabilize intraoperative hemodynamics, although a more significant improvement appears to be achieved with a single dose of 150 mg pregabalin at least 1 h before the surgery. It is not associated with any severe adverse effects., Conclusion: Preoperative administration of oral pregabalin in a single dose of 150 mg appears to be effective to significantly reduce the anxiety of patients, intraoperative hemodynamic changes, and postoperative pain., Clinical Relevance: These findings suggest that pregabalin is useful and safe for preoperative and intraoperative anxiety control in patients undergoing surgery.

Background: Induction of anesthesia can be stressful: Up to 60% of children suffer significant anxiety immediately before surgery. Anxiety is associated with higher postoperative analgesia requirements, higher incidence of emergence delirium, and detrimental effects on sleep and behavior. Child Life preparation includes role-play, expectation-setting, and teaching coping strategies. AIM : The aim of this trial was to determine whether preoperative Child Life preparation reduces anxiety prior to intravenous induction of anesthesia., Methods: Children aged 3-10 years, with no known preexisting anxiety and no preoperative anxiolytics, undergoing elective day surgery lasting ≤ 2 hours, were enrolled in a randomized controlled trial. Each child's baseline anxiety was assessed in the anesthetic care unit, using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF, observational scores from 22.9, minimal anxiety, to 100, maximal anxiety) as the primary outcome. The child was randomly assigned to intervention (minimum 15 minutes Child Life preparation) or control (standard practice without Child Life preparation). Participants entered the operating room with one parent. A researcher (blinded to group allocation) scored the child's operating room anxiety using mYPAS-SF, up to the first attempt at intravenous cannulation., Results: Fifty-nine children completed the study, aged median [interquartile range] 5 [3-7] years. Baseline mYPAS-SF anxiety was 29.2 [22.9-37.5] for all children, and operating room anxiety was 29.2 [22.9-49.0]. Operating room anxiety was higher than baseline in 16/31 (52%) children in the control group and 6/28 (21%) in the Child Life preparation group. ANCOVA revealed a significant effect of baseline mYPAS-SF anxiety and group on operating room anxiety (F = 10.31, P < .001, adjusted R 2  = .24); individual parameter estimates indicated that Child Life preparation reduced operating room anxiety by 13.8 (95% CI 4.4-23.1) points compared to control, P = .005., Conclusion: A brief, targeted Child Life preparation session had a statistically significant effect on reducing preoperative anxiety prior to intravenous induction of anesthesia in young children, with no known preexisting anxiety. This effect may be clinically important and suggests that Child Life can be a valuable component of pediatric surgical care. Further research is required in specific populations., (© 2019 John Wiley & Sons Ltd.)

Preparation for surgery with the induction of general anesthesia is one of the most stressful events that a child can experience. It produces several threats to the child, including physical harm, parent separation, and fear of the unknown. Anesthesia providers utilize non-pharmacological and pharmacological interventions to decrease this preoperatively. However, little is known about the non-pharmacological interventions utilized by anesthesia providers in practice. The purpose of this study was to explore non-pharmacological interventions utilized by anesthesia providers before and during the induction of general anesthesia to reduce preoperative distress in children ages one to six years old. A qualitative descriptive approach was used in this study. Twenty anesthesia providers, fourteen registered nurse anesthetists and six anesthesiologists, participated in face to face, in-depth interviews in South Florida. Content analysis was used to identify and define the major themes that emerged from the interviews. A total of seven main themes were identified. Only the three themes directly related to parent-provider-child relationship are discussed in this paper: (I) Communication, (II) Observational Skills, and (III) Parental Presence. The anesthesia providers who participated in this study offered an opportunity to better understand the non-pharmacological interventions used to impact the management of preoperative distress among children. Study findings provide evidence about non-pharmacological anesthesia providers' clinical work not found elsewhere in the literature. Non-pharmacological interventions are effective in reducing preoperative distress in children., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Purpose: Comparing the effect of verbal education and education booklet on preoperative anxiety., Design: This study was a randomized clinical trial., Methods: Sixty patients were randomly allocated into three groups: control, booklet, and verbal education. The data were collected using Spielberger's State-Trait Anxiety Inventory before and after intervention. SPSS (version 20; IBM, Armonk, NY) with analysis of variance and the dependent t test were used for analysis., Findings: After intervention, there was a significant difference between the mean scores of state anxiety scale among the intervention groups (booklet and verbal) with the control group (P < .05). The mean difference between the two intervention groups (booklet and verbal) was not significant (P > .05)., Conclusions: According to the results, and given that nurses work under time pressure in Iran and other societies, it is concluded that well-designed education booklets can be used to reduce the preoperative anxiety., (Copyright © 2018 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Purpose: The aim of this study was to evaluate the use of a lavender aromatherapy skin patch on anxiety and vital sign variability during the preoperative period in female patients scheduled for breast surgery., Design: This observational pilot study used a one-group, pretest and post-test design., Methods: Participants received an aromatherapy patch in addition to standard preoperative care. Anxiety levels were assessed with a 10-cm visual analog scale at baseline and then every 15 minutes after patch placement. Vital sign measurements were recorded at the same interval., Findings: There was a statistically significant decrease (P = .03) in the anxiety visual analog scale measurements from baseline to final scores., Conclusions: Findings from this study suggest the use of aromatherapy is beneficial in reducing anxiety experienced by females undergoing breast surgery. Further research is needed to address the experience of preoperative anxiety, aromatherapy use, and the challenges of managing preoperative anxiety., (Copyright © 2018 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Background: Accurate measurement of preoperative anxiety is important for pediatric surgical patients' care as well as for monitoring anxiety-reducing interventions. The modified Yale Preoperative Anxiety Scale-short form is well validated for this purpose in children aged 2 years and above, but not in younger children., Aims: We aimed to validate the Dutch version of the modified Yale Preoperative Anxiety Scale-short form for measuring preoperative anxiety in children less than 2 years old., Methods: Two investigators independently assessed infants' anxiety at the holding area and during induction of anesthesia with the modified Yale Preoperative Anxiety Scale-short form and the COMFORT-Behavior scale-live and from video observations. Construct validity and responsiveness of both scales were tested with Pearson correlation coefficient. Internal consistency of the modified Yale Preoperative Anxiety Scale-short form was assessed using Cronbach's α, and inter-rater reliability and intra-rater reliability were tested using the intraclass correlation coefficient and Cohen's linearly weighted kappa. Hypotheses for sufficient inter-rater reliability (r > 0.60) and validity (r > 0.65) had been formulated a priori in line with the COSMIN guidelines., Results: Behavior of 129 infants (89.1% male) with a median age of 6.5 months (range 0.9-16.5 months) was observed. The correlations between the modified Yale Preoperative Anxiety Scale-short form and COMFORT-Behavioral scale were strong at the holding area and at induction of anesthesia, as were the correlation of change scores between the holding area and induction. Internal consistency of the modified Yale Preoperative Anxiety Scale-short form was excellent at both the holding area and at induction of anesthesia. Inter-rater reliability was good to excellent on scale level and moderate to good on item level., Conclusion: These findings support the validity and reliability of the Dutch version of the modified Yale Preoperative Anxiety Scale-short form in children less than 2-years-old., (© 2018 The Authors. Pediatric Anesthesia Published by John Wiley & Sons Ltd.)

Purpose: To examine anxiety and what older patients worry about related to anesthesia and colorectal surgery, and their perceptions regarding nurses' ability to ease preoperative worry., Design: Qualitative individual face-to-face interviews., Methods: The study included 18 patients aged between 62 and 91 years with lower abdominal tumors. The study was conducted in two day-surgery wards in Sweden. Interview data were analyzed with Malterud's systematic text condensation., Findings: Four themes were identified: (1) losing control of one's body, leaving one's life in someone else's hands, and the feeling that there is no going back, (2) claustrophobia and anticipated pain in an unknown environment, (3) unknown and frightening vocabulary concerning the surgery, and (4) what can happen if something goes wrong., Conclusions: Patients worry about a number of things. If preoperative worry could be identified, actions taken to reduce worry could be personalized and patients' own strategies to reduce worries may be helpful for them., (Copyright © 2018 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Purpose: The study was conducted to examine the effects of a preoperative preparation program on children and their parents in a pediatric surgery outpatient clinic., Design: A quasiexperimental design was used., Methods: Seventy-three children and their primary caregivers were included in the study (intervention = 36, control = 37). Data collection tools included the Characteristics of Children and Caregivers Data Form, the PedsQL Health Care Parental Satisfaction Scale, the State Anxiety Inventory, and the children's Koppitz Human Figure Drawing Test. Data were collected on the day before surgery and the day of surgery. The program comprised verbal and written information about the process that was given to families and children, and a medical play doll was used for therapeutic communication with children in the intervention group., Findings: The satisfaction level of parents in the intervention group was found to be significantly higher than in the control group (intervention = 100, control = 50; P < .05). During the preoperative and discharge periods, the anxiety scores of parents in the intervention group were significantly lower than the control group (P < .05). According to the Koppitz Drawing Test, the children in the control group's emotional state was higher than the intervention group regarding impulsiveness, anxiety, and anger on discharge (P < .05)., Conclusions: The preoperative preparation program was found to have a positive effect on the children and their parents. Nurses should use drawings of children as a therapeutic communication technique to evaluate the emotions of children., (Copyright © 2017 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

This article discusses the development of a clinical research question, the execution of a systematic literature search strategy, and the critical appraisal of a selected article. It demonstrates an evidence-based review process used by nurses to critique and evaluate the evidence used to support their work. This review was conducted by a novice researcher under the supervision of his lecturer. Learning to conduct an evidence-based practice review enables health professionals to understand how to systematically review primary research relating to clinical practice. This learning experience identified the many facets of a research study that need to be considered to ascertain the validity of the results, and their relevance and application to clinical practice.

Background: The relationship between pain catastrophizing and emotional disorders including anxiety and depression in osteoarthritic patients undergoing total joint arthroplasty (TJA) is an emerging area of study. The purpose of this study was to examine the association of these factors with preoperative patient characteristics., Methods: A prospective cohort study of preoperative TJA patients using the Pain Catastrophizing Scale (PCS) and Hospital Anxiety and Depression Scale (HADS-A/HADS-D) was conducted. Preoperative measures included visual analog pain scale (VAS), Harris Hip and Knee Society scores, Oxford Score, and Kellgren-Lawrence grade. Logistic and quantile regression were used to assess the relationship between preoperative characteristics and PCS or HADS, adjusting for covariate effects., Results: We recruited 463 TJA patients. VAS pain (odds ratio [OR] 1.23; 95% confidence interval [CI] 1.04-1.45) and Oxford (OR 1.13; 95% CI 1.07-1.20) were significant predictors for PCS and its subdomains excluding rumination. Oxford was the only significant predictor for abnormal HADS-A (OR 1.10; 95% CI 1.04-1.17). VAS pain (OR 1.27; 95% CI 1.02-1.52) and Oxford (OR 1.09; 95% CI 1.01-1.17) were significant predictors for abnormal HADS-D. The quantile regression showed similar patterns of association, with female gender, younger age, and higher ASA also associated with HADS-A., Conclusion: The most important predictor of catastrophizing, anxiety and/or depression in TJA patients is preoperative pain and poor subjective function. At-risk patients include those with increased pain and generally good clinical function, as well as younger women with significant comorbidities. Such patients should be identified and targeted psychological therapy implemented preoperatively to optimize coping strategies and adaptive behavior to mitigate potential for inferior TJA outcomes including pain and patient dissatisfaction., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Study Objective: The objective of this study was to determine whether lavender fleur oil (LFO) aromatherapy would reduce anxiety when administered to women before undergoing breast surgery., Design: This was a single-site, randomized study comparing the effect of LFO to unscented oil (UO)., Setting: The study was conducted in the preoperative holding area of the ambulatory surgery department of NYU Langone Medical Center., Patients: Ninety three women, 18 years and older, scheduled for breast surgery. Women meeting inclusion/exclusion criteria were randomized to either LFO or UO aromatherapy and were blind to their assigned treatment., Outcome Measures: Subjects completed a Speilberger State Anxiety Inventory for Adults (STAI) before and after aromatherapy. Vital signs were recorded before and after aromatherapy., Results: STAI-State questions were divided into positive and negative emotions for analysis. Before aromatherapy, there was no significant difference between groups by individual questions or overall average answer of either positive or negative questions. The use of both LFO and UO increased the positive STAI score totals, with the LFO group having a slightly, but statistically significant, greater increase. Both resulted in a statistically significant decrease in the negative score totals after treatment. There were no differences in vital signs between groups for either treatment. Following the conclusion of the trial LFO was analyzed and found to contain a very low content of the 2 major Lavandula angustifolia constituents., Conclusions: Both LFO and UO aromatherapy treatments lowered anxiety before surgery despite no significant changes in vital signs. LFO treatment generated a slight but statistically significant increase in positive feelings compared with UO treatment. It is probable that the beneficial effect observed was due to both aromatherapy with LFO and a placebo effect related to the added attention given to the patients., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Anxiety is a common thing that occurs in patients who will undergo surgery. The anxiety that occurs in preoperative patients can be felt from the time they are scheduled for surgery until the time of surgery arrives. Anxiety management can be done using pharmacological and non-pharmacological therapy. Purpose: The aim of this research is to analyze the effectiveness of finger grip relaxation techniques and progressive muscle relaxation on anxiety in pre-caesarean section surgery patients in the Kediri Regency Regional General Hospital. Method: This study used a Quasy-experiment With Pretest Posttest to determine the effect of finger grip and progressive muscle relaxation techniques. The sample selection in this study used a purposive sampling technique and a total of 56 patients were obtained who were divided into 2 groups, namely the finger grip intervention group and the progressive muscle intervention group. The pretest and posttest data for each group were then analyzed using the Wilcoxon Test to determine the effect and the Mann-Whitney Test to compare the posttest results of the 2 groups. Results: The results of the study showed that the Wilcoxon test in both intervention groups obtained a p-value < α (0.05), which means that before and after the intervention, both progressive muscle relaxation and finger grip relaxation had an influence on the anxiety level of pre-caesarean section patients. For the results of the Mann-Whitney test, the p-value was 0.063 or p-value > α (0.05), which means there was no significant difference between changes in anxiety whether those given progressive muscle relaxation intervention or finger grip relaxation. Conclusion: Finger grip relaxation techniques and progressive muscle relaxation techniques are both effective in reducing anxiety levels in pre-caesarean section surgery patients. So this non- pharmacological therapy can be an option for patients in dealing with anxiety problems before caesarean section surgery.

Background: Anxiety before surgery is one of the most challenging aspects of preoperative care. Preoperative anxiety has a number of postoperative complications. There are only a few studies that report on preoperative anxiety in surgical patients in Ethiopia, and their prevalence differs from one study to the next. Objective: The aim of this study was to assess the level of preoperative anxiety and associated factors among surgical patients admitted at public hospitals in southern Ethiopia. Methods: From July to August 2022, a facility-based cross-sectional study was conducted among patients admitted to surgical wards at public hospitals. Data collection was conducted using a pretested, structured questionnaire administered by an interviewer. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory scale. The data were coded and entered in Epi Data Version 4.6, then exported to Statistical Package for Social Sciences version 25 for analysis. To describe the study variables, descriptive statistics were used. The associated factors were then identified using bivariate and multivariate logistic regression analyses. Results were declared at a p-value of less than 0.05 based on an adjusted odds ratio with a 95% confidence interval. Result: A total of 220 patients were enrolled, with a 99.5% response rate. The observed preoperative anxiety level was 57.5% (95%CI: 54.63–62.35). High preoperative anxiety was associated with no formal educational status (AOR: 3.75; 95%CI = 1.36, 10.39), fear of death (AOR =2.01; 95%CI = 1.09, 3.73), fear of waking up in middle of surgery (AOR =3.42; 95%CI =1.19, 9.77), fear of postoperative pain (AOR = 2.56; 95%CI = 1.15, 5.74). Conclusion: This study found that five out of ten patients scheduled for surgery in public hospitals had high levels of preoperative anxiety. Anxiety levels were associated with factors such as the educational status of respondents, fear of death, fear of waking up in the middle of surgery, and fear of postoperative pain. Preoperative anxiety assessments should be conducted regularly in each hospital, and appropriate anxiety-reducing methods must be implemented. [ABSTRACT FROM AUTHOR]

Aim: To evaluate preoperative and postoperative levels of anxiety according to visual acuity and sociodemographic characteristics in patients undergoing cataract surgery. Materials and Methods: The study included 100 patients who were planned to undergo cataract surgery because of reduced vision. One day preoperatively and at one month postoperatively, all the patients were administered the sociodemographic data form and the Spielberger State-Trait Anxiety Inventory (STAI TX-1 and TX-2). All the patients underwent a detailed preoperative and postoperative ophthalmological examination. Visual acuity was evaluated with a logMAR Chart. Results: The visual acuity on the LogMAR chart of the patients was mean 1.1±0.3 preoperatively and 0.1±0.1 postoperatively. Visual acuity was determined to have significantly increased postoperatively and the STAI FORM TX-2 points significantly decreased (p=0.04). The postoperative decrease in the LogMAR chart was statistically significant (p<0.001). A significant positive correlation was determined between the preoperative STAI FORM TX-1 points and the preoperative STAI FORM TX-2 points. The mean STAI FORM TX-1 points of the patients with an education level of middle school or below were found to be significantly higher than those of patients educated to university level or higher (p=0.012). The visual acuity (LogMAR) of patients who had previously received psychiatric treatment were found to be significantly lower than those of patients who had not received any psychiatric drug treatment (p=0.027). Conclusion: Patients with cataracts are anxious in a general sense, independently of surgery. The increase in vision after cataract surgery is important in respect of decreasing levels of trait anxiety. [ABSTRACT FROM AUTHOR]

Background: The preoperative period is known as one of the disturbing events. It habitually prompts cognitive, physiological, and emotional reactions. Depression, anxiety, and stress are considered emotional states usually found in preoperative surgical patients. Objective: To find out the frequency and association of depression, anxiety, and stress with socio-demographic variables among preoperative patients. Methods: This cross-sectional analytical study of 258 preoperative patients was conducted at Dow University Hospital and Dr. Ruth Pfau Civil Hospital, Karachi from August 01, 2019, to July 31, 2020. Ethical approval was obtained before conducting the study. Depression, Anxiety, and Stress Scale-42 tool was used for the data collection. The data was analyzed by using SPSS version 21. Mean and frequency analyses were performed for demographic characteristics. Moreover, a chi-square test was performed to check the association of socio-demographic characteristics of study participants with depression, anxiety, and stress. Results: The majority of the participants (72.5%) in this study were male and 59.7% were between the ages of 20-35 years. The finding of this study revealed that most of the patients had moderate depression (43.02%), extreme anxiety (54.26%), and moderate stress 36.04%. Significant associations were found for depression with gender and monthly income, with a p-value of 0.035 and 0.003 respectively. Gender (p=0.021) and level of education (p=0.013) were significantly associated with stress levels. Conclusion: This study concluded that patients before surgeries had different levels of depression, anxiety, and stress. Age is the only variable that showed a significant association with stress and depression. Furthermore, anxiety is the only domain that is not significantly associated with any demographic characteristics.

Surgical interventions are known to induce anxiety in patients due to the associated risks and potential complications. Various methods are employed to alleviate preoperative anxiety. This study aimed to investigate the impact of lavender oil application on the anxiety levels of patients scheduled for surgical procedures. Systematic review and meta-analysis. Studies were accessed using the keywords "preoperative and lavender oil and stress" in Turkish and English between July 1 and 30, 2022, through PubMed (including MEDLINE), Cochrane, EBSCOhost, Web of Science, YÖK National Thesis Center, and Google Scholar. The standardized mean difference was calculated using random-effects models, and the Cochrane Collaboration tool was used to assess the risk of bias in each study. The study was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist. Twenty studies were included in the analysis. The anxiety level of the experimental group to which lavender oil was applied before the surgical intervention was significantly lower than that of the control group (standardized mean difference:−5.40; 95% CI: −8.76 to −2.04). Preoperative lavender oil application was found to be an effective method for relieving patients' anxiety. Lavender oil is thought to be a potential standalone treatment for preoperative anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Most patients are anxious in the preoperative period, being a natural reaction to predictable and potentially threatening situations. A growing number of studies have indicated that preoperative anxiety can be associated with increased and worse perioperative outcomes, including impaired wound healing, nausea, vomiting, postoperative pain, etc. Material and Method: The study group includes a number of 65 patients treated at the level of the Surgery II SCJU BH department, where a surgical intervention was performed. We divided the patients into 2 groups, 37 non-oncological patients, 28 oncological patients. We evaluated preoperative anxiety in patients. We used 3 scales APAIS, ASSQ, Questionnaire for evaluating the quality of life of patients in the preoperative and postoperative period VMM, through which the patient's anxiety level can be evaluated, which can be related to both the procedure and the anesthesia. In the group of patients with preoperative anxiety, we used the "step" interventions entitled: cognitive restructuring. At the end of this "step" I also taught a relaxation/ distraction exercise (to imagine themselves in their favorite place and to focus on the aspects of that place). Results: In the preoperative period, the anxiety level of patients, related to anesthesia and surgical intervention, is high, and in the postoperative period, related to recovery and the fear of complications. Patients also communicate various concerns related to the hospital, procedures, complications, family, job. In the patients with high level of anxiety in the preoperative period, we performed cognitive restructuring and relaxation interventions, and the level of anxiety decreased in the postoperative period. Conclusion: Anxiety in the preoperative and postoperative period can be reduced by using some evaluation scales and by providing specific interventions, such as restructuring cognitive and relaxation techniques, which allow a good postoperative recovery.

Abstract Background Preoperative anxiety is a major mental health problem during the preoperative period. Admission of women to surgery is stressful, and a high level of anxiety was associated with increased perioperative morbidity and mortality, poor treatment satisfaction, and bad obstetric outcomes, including long-term cognitive impairment in children. Despite its negative consequences, little is known on this area, particularly in the study area. Objective To assess preoperative anxiety and associated factors among women admitted for elective obstetrics and gynecologic surgeries in public hospitals in Southern Ethiopia, 2022. Methods and Materials An institution-based cross-sectional study design was conducted among 389 women using structured interviewer-administered samples who were selected by systematic random sampling from May 20th to June 20th, 2022. The Amsterdam preoperative anxiety and information scale (APAIS) was used to assess the level of anxiety. Data were collected electronically using the Open Data Kit version 2022.2.3 and analyzed with the Statistical Package for Social Sciences version 26.0. Bivariate and multivariable logistic regression analyses were done. The strength of the association was declared by using an adjusted odds ratio (AOR) with a 95% confidence interval, and a statistical significance of P

Preoperative anxiety (POA) is a concern for children undergoing surgery, especially with general anesthesia. POA can result in many postoperative problems, such as physical, psychological, and financial problems. Nonpharmacological treatments have been investigated for reducing POA as they are more pleasant and have fewer adverse effects compared to pharmacological treatments. Audiovisual technology treatment is one of the nonpharmacological treatments developed lately. This study aims to evaluate the efficacy of an audiovisual technology intervention for reducing POA in children undergoing general anesthesia. This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guideline 2020. Google Scholar, PubMed, ProQuest, and Cochrane databases were used for searching English articles published between January 2015 and June 2023. Cochrane Review Manager 5.4 was used for the meta-analysis and the Risk of Bias Tool 2.0 was used to measure the risk of bias. The studies included were randomized controlled trials (RCTs) that compared the audiovisual technology intervention with a control population. The modified Yale Preoperative Anxiety Scale was the outcome of interest. We found 627 articles in four databases using the search term. After screening with the eligibility criteria, three studies from Iran, Denmark, and China were included in the meta-analysis. A random effect model was applied. The meta-analysis resulted in a significant result as a lower modified Yale Preoperative Anxiety Scale score was found in the audiovisual technology intervention group compared with the control group (mean difference -10.75 [-16.48 to -5.03]; 95% confidence interval; P = .0002.) The presence of audiovisual technology interventions such as video games, cartoons or animation videos, and smartphone applications could significantly lower POA in children undergoing general anesthesia.

ObjectiveThe purpose of this study was to determine whether the use of a humanoid robot (Estrabot) could reduce preoperative anxiety levels in children.MethodsAn experimental study was conducted at Azienda Ospedaliero Universitaria delle Marche Hospital, involving the Pediatric Surgery ward and the Operating Room (OR). Patients aged between 2 and 14 years who underwent minor surgery were included. The Instruments used were the Children's Emotional Manifestation Scale to evaluate anxiety levels, and Estrabot, a humanoid robot that interacts with people. Medical records between April and May 2023 were analyzed and the data was anonymous. The level of anxiety is extrapolated in Pediatric Surgery during the administration of oral pre-medication, and in the Operating Room, during the induction of anesthesia. Patients were divided into an intervention group treated with Estrabot, and a control group without a robot.ResultsThe population consists of 60 patients (86.7% male) with a median (IQR) age of 6 (4–8) years. The median (IQR) anxiety score during premedication was 7 (5–11), while the median (IQR) anxiety score during anesthesia was 6 (5–10). A significantly lower level of anxiety was reported in the Estrabot group. Patients in the Estrabot group had significantly lower anxiety levels in different age groups.ConclusionA humanoid robot can reduce preoperative anxiety levels in children during premedication and the induction of anesthesia.

Abstract Background Anxiety 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. Method A 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

Objective: To study the effects of music on anxiety in patients undergoing hair transplantation. Materials and Methods: This randomized controlled trial enrolled patients undergoing hair transplantation. The patients were randomized into a music group, who listened to music for 15 minutes during the preoperative period, and a control group, who were not exposed to music. Two scales were used to measure anxiety. One was the State- Trait Anxiety Inventory (STAI), comprised of a state anxiety scale (STAI-S) and trait anxiety scale (STAI-T). The other was the Visual Analog Scale for Anxiety (VASA). Demographic and physical parameters (blood pressure, heart rate, and respiratory rate) were recorded. Results: The 26 patients had a mean age of 40.8 ± 10.4 years. Twenty-three (88.5%) were men. The 2 groups had no significant differences in their STAI-S or VASA scores, or physical parameters before and after intervention. The STAI-S score of the control group significantly increased with time (P = 0.027). Additionally, a significant decrease in the VASA score was observed after the intervention for the music group (P = 0.039). No adverse events were noted. Conclusion: Listening to music is an easy, effective, and safe method of reducing preoperative anxiety in patients undergoing hair transplantation. The method should be employed during the preoperative period for patients undergoing hair transplantation. It may also be considered for use in similar procedures. [ABSTRACT FROM AUTHOR]

Objective: To study the effects of music on anxiety in patients undergoing hair transplantation. Materials and Methods: This randomized controlled trial enrolled patients undergoing hair transplantation. The patients were randomized into a music group, who listened to music for 15 minutes during the preoperative period, and a control group, who were not exposed to music. Two scales were used to measure anxiety. One was the State-Trait Anxiety Inventory (STAI), comprised of a state anxiety scale (STAI-S) and trait anxiety scale (STAI-T). The other was the Visual Analog Scale for Anxiety (VASA). Demographic and physical parameters (blood pressure, heart rate, and respiratory rate) were recorded. Results: The 26 patients had a mean age of 40.8 ± 10.4 years. Twenty-three (88.5%) were men. The 2 groups had no significant differences in their STAI-S or VASA scores, or physical parameters before and after intervention. The STAI-S score of the control group significantly increased with time (P = 0.027). Additionally, a significant decrease in the VASA score was observed after the intervention for the music group (P = 0.039). No adverse events were noted. Conclusion: Listening to music is an easy, effective, and safe method of reducing preoperative anxiety in patients undergoing hair transplantation. The method should be employed during the preoperative period for patients undergoing hair transplantation. It may also be considered for use in similar procedures.

Background: Preoperative anxiety is a common issue in surgery. Preoperative anxiety may lead to increased mortality, pain and dissatisfaction with surgery. Melatonin is a drug with only mild adverse effects and has previously been shown to reduce anxiety and pain in the perioperative setting. The aim of study was to investigate the anxiolytic effect of melatonin in the preoperative setting.Methods: This study was a randomised, double-blinded, placebo-controlled clinical trial. Included patients were allocated in the ratio 1:1 to either the placebo group or the melatonin group. Patients received 10 mg melatonin or placebo the evening before surgery, 2 h before surgery, immediately after surgery and the evening after surgery. Preoperative anxiety was examined 1 h before surgery, using the State Trait Anxiety Inventory (STAI) questionnaire, along with a Visual Analogue Scale (VAS) of anxiety. Furthermore, participants filled out a sleep log each morning, where we examined sleep quality, comfort and drowsiness.Results: Sixteen patients received placebo treatment and 17 patients received melatonin. Median state anxiety on the STAI scale at baseline was 27 (interquartile range [IQR] 22-34) for the melatonin group and 27 (IQR 23-31) for the placebo group. In the primary outcome of preoperative anxiety 1 h before surgery, the median state anxiety on the STAI scale was 27 (IQR 24-34) for the melatonin group and 28 (24-33) for the placebo group, p = .814. VAS anxiety was median 7 (0-28) for the melatonin group and median 7 (1-13) for the placebo group, p = .813. Furthermore, there were no statistically significant differences between the two groups in the secondary outcomes of sleep quality and consumption of analgesics.Conclusion: Melatonin did not reduce preoperative anxiety in patients undergoing hernia repair. Preoperative anxiety levels were low, which limits the generalisability of our findings. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients experience higher levels of pathological anxiety than other patients. Though several studies have reported perioperative use of melatonin in alleviating preoperative anxiety with minimal side effects, research on the perioperative use of melatonin in oncology patients is scarce. Aim: To analyse the preoperative anxiolysis, sedation, sleepiness and hemodynamic response to intubation after premedication with oral melatonin at two different doses of 0.3 mg/kg and 0.5 mg/kg body weight and comparing them with placebo. Materials and Methods: This was randomised controlled trial on a total of 90 cancer patients aged 18-60 years undergoing elective surgeries under general anaesthesia were randomised into three groups of 30 patients each. Oral melatonin 0.3 mg/kg, oral melatonin 0.5 mg/kg, and placebo were given to patients in Groups A, B, and C, respectively. The Visual Analogue Score (VAS), Ramsay Sedation Scale (RSS), and Stanford Sleepiness Scale (SSS) were used to assess anxiety, sedation, and sleepiness before and 90 minutes after premedication. Heart rate (HR), systolic (SBP), diastolic (DBP), and mean arterial (MAP) blood pressures were also measured. For intragroup comparison, a paired t-test and for intergroup comparison, ANOVA (Analysis of Variance) and difference-in-differences regression analysis were performed. Results: The three groups (group A: oral melatonin 0.3 mg/kg, group B: oral melatonin 0.5 mg/kg, group C: placebo) each having 30 patients were comparable with regard to demographic profiles with insignificant p-value. Melatonin had no significant anxiolytic impact when compared to placebo (p>0.05). However, melatonin offered considerable sedation and haemodynamic stability in a dose-dependent manner. Melatonin 0.5 mg/kg (group B) gave better sedation (RSS score: 3.30±0.11) and haemodynamic stability (fall in Mean Heart Rate: by 7.4 after premedication) than melatonin 0.3 mg/kg) (RSS score: 2.77±0.12; fall in mean Heart rate after premedication: by 7.76) than the placebo (RSS score: 2.17±0.07; fall in mean Heart Rate: by 0.2). Conclusion: Oral melatonin provides better sedation and haemodynamic stability during endotracheal intubation in a dose-dependent manner when compared to placebo. But when required for sole anxiolysis melatonin was similar to placebo. Further studies are warranted to explore the safe dose for the anxiolytic effect of oral melatonin in cancer patients

Aim: The aim of the study is to evaluate the Distress Thermometer (DT) as a valid and reliable measurement tool that can be used to measure the patients stress because of surgery. Method: This was a methodological study conducted with 200 patients. Data were collected using the the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer (DT) and surgery related distress causes list (DCL) for preoperative patients. The validation of the Distres Thermometer was performed in conjunction with the Hospital Anxiety and Depression Scale (HADS). Results: Study results determined that the distress score average of the patients was 4.4 (SD 2.4), and the distress level of 47.5% of the patients was above this average. The sensitivity of HADS, which had a cut-off point of five or more, was 72.5% and specificity was 59.3%. The most expressed causes of distress were the development of infection after surgery. There was a moderate relation between the thermometer score and the total DCL score and HADS total score. Conclusion: The distress thermometer can be used as a valid tool in determining surgery-related anxiety. And also distress causes list can be used to determine distress factors. In this study, the HADS was used as a criterion for DT-DCL, and according to this scale, the sensitivity of the thermometer was high, and the specificity was moderate. The tool can be retested by using different distress scales.

Introduction: Preoperative anxiety is universal in patients before surgery. It is mostly unaddressed by health professionals due to a lack of time. The objective of this study was to find out the prevalence of preoperative anxiety among patients undergoing elective surgery in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted on 385 surgical patients in the Department of Anaesthesia, from 27 November 2021 to 20 April 2022 in a tertiary care hospital posted for elective surgery. Ethical approval was obtained from the Institutional Review Committee (Reference number: MEMG/481/IRC). A convenience sampling was used. The level of anxiety and need for information was assessed using the Amsterdam Preoperative Anxiety and Information Scale questionnaire in a preoperative holding area. Point estimate and 95% Confidence Interval were calculated. Results: Out of 385 patients posted for elective surgery, preoperative anxiety was present in 88 (22.85%) (18.66-27.04, 95% Confidence Interval) patients. The mean Amsterdam Preoperative Anxiety and Information Scale score for total anxiety and need for information was 13.59±2.47 and 5.91±3.06 respectively. Anxiety was present in 60 (68.18%) females, 45 (51.13%) young patients aged

Keywords: anxiety; auricular stimulation; meta-analysis; minimal clinically important difference; preoperative EN anxiety auricular stimulation meta-analysis minimal clinically important difference preoperative 1 4 4 05/26/22 20220415 NES 220415 Introduction The majority of patients commonly suffer from varying levels of exposure to physical and psychological stress during the perioperative period (before and after surgery). 10.1213/01.ane.0000242531.12722.fd 16 Luo, L, Dai, Q, Mo, Y, Yan, Y, Qian, M, Zhuang, X,The effect of auricular acupressure on preoperative anxiety in patients undergoing gynecological surgery. Discussion It should be pointed out that the STAI scale was employed in most included trials in the review by Usichenko et al. ([7]), however, we are curious about why effect-sizes were summarized as standard mean difference (SMD) rather than weighted mean difference (WMD). MCID is defined as the smallest change that is meaningful to patients and is considered the threshold needed to achieve treatment efficacy ([12]). [Extracted from the article]

Amare Belete Getahun, Nigussie Simeneh Endalew, Abraham Tarekegn Mersha, Biruk Adie Admass Department of Anaesthesia, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaCorrespondence: Nigussie Simeneh Endalew Email simenehn@gmail.comBackground: Anesthesia and surgery are common sources of anxiety and stressful experiences in children. This unpleasant sensation depends on several factors. This study aimed to determine the magnitude of preoperative anxiety and associated factors in pediatrics patients at the University of Gondar Comprehensive Specialized Hospital North West Ethiopia 2020.Methods: An institutional-based cross-sectional observational study was conducted from March to September 2020 at the University of Gondar Comprehensive Specialized Hospital. After obtaining ethical approval from the institutional review board. All consecutive ASA physical status I & II boys and girls with the age of 2– 12 years scheduled for a variety of elective (general, urologic, ENT, ophthalmic and other surgical) operations were included. The level of anxiety was measured using the Modified Yale Preoperative Anxiety Scale short form (m-YPAS-SF) observational tool. Parental anxiety was assessed using Spielberger’s short version of state-trait anxiety. Binary logistic regression analysis was performed to identify the association between preoperative children’s anxiety and independent variables. The strength of the association was present by adjusted odds ratios.Results: The magnitude of preoperative anxiety in children in the operation room was 75.44% (95% confidence interval (CI): 68.36, 81.34). Age (AOR: 3.83; 95% CI: 1.58, 9.30), previous surgery and anesthesia (AOR: 6.73, 95% CI: 1.25, 36.19), outpatient surgery (AOR: 5.16, 95% CI: 1.32, 20.23) and parental anxiety (AOR: 3.26, 95% CI: 1.30, 20.23) were significantly associated with preoperative children anxiety.Conclusion: The magnitude of preoperative anxiety in pediatric patients was considerably high in our setup. Younger age, previous surgery and anesthesia, outpatient surgical setting, and parental anxiety were the independent risk factors for preoperative anxiety. Therefore, the operating staff should assess the child’s anxiety and should consider appropriate anxiety reduction methods during the preoperative visit of pediatric patients and their families.Keywords: preoperative, anxiety, children, anesthesia, surgery

Introduction: Surgery is an experience that can cause anxiety, which, if not treated well, will cause some side effects. One of the forms of non-pharmacological therapy is hypnotherapy and yoga combination therapy. This study aimed to determine the effect of hypnotherapy and yoga combination therapy on anxiety scores in elective preoperative patients. Methods:This study used a quasi-experimental pretest and posttest with control group design. This study involved 17 respondents in the intervention group and 17 respondents in the control group. The sampling technique used consecutive sampling. Data collection used the instruments of The Amsterdam Preoperative Anxiety and Information Scale (APAIS). The statistical test used was the Mann-Whitney test. Results: The average age of respondents was 36.65 years old. In a majority, they were junior high school graduates who worked as employee. The major type of operation was tumor excision. The average anxiety scores before treatment in the intervention group were 14.71 (moderate anxiety) and decreased after being given hypnotherapy and yoga combination therapy to 9.47 (mild anxiety). The average anxiety scores before treatment in the control group were 15.71 (moderate anxiety) and decreased after deep breathing therapy to 13.76 (moderate anxiety). The difference test in anxiety scores of the intervention and control groups obtained p-value 0.015. Conclusion:Hypnotherapy and yoga combination therapy can reduce anxiety scores in elective preoperative patients.

Introduction: Geriatric patients with hip fractures often experience unexpected falls and they may have unfamiliar and unpleasant experiences within a brief period. This study aimed to investigate the prevalence and levels of preoperative anxiety in patients undergoing surgical treatment for hip fractures, and to determine the anxiety-related characteristics experienced by patients during the period before and after surgery. Materials and methods: We recruited a total of 75 geriatric patients who underwent surgical treatment for hip fractures and returned complete questionnaires. We used the State-Trait Anxiety Inventory (STAI)-X type to measure state-anxiety and defined a total score of 52 or higher as clinically meaningful state-anxiety. And, we investigated main cause of anxiety, moment of the highest level of anxiety, and the most helpful factor in overcoming anxiety before surgery and in reducing anxiety after surgery. Results: The mean STAI score was 47.2 points and one-third of the patients experienced various levels of clinically meaningful state-anxiety. The most common cause of preoperative anxiety was the surgery itself and patients experienced the greatest level of anxiety from the night preceding the surgery to the day of the surgery. Further, patients' trust in the medical staff prior to surgery and the surgeon's explanation after the surgery were the most key factors in overcoming anxiety. Conclusion: This study investigates the state-anxiety of geriatric patients undergoing surgery for hip fractures and presents important findings which can help in developing evidence-based interventions to improve the experience of patients undergoing hip surgeries. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients experience higher levels of pathological anxiety than other patients. Though several studies have reported perioperative use of melatonin in alleviating preoperative anxiety with minimal side effects, research on the perioperative use of melatonin in oncology patients is scarce. Aim: To analyse the preoperative anxiolysis, sedation, sleepiness and hemodynamic response to intubation after premedication with oral melatonin at two different doses of 0.3mg/kg and 0.5mg/kg body weight and comparing them with placebo. Materials and Methods: This was randomised controlled trial on a total of 90 cancer patients aged 18-60 years undergoing elective surgeries under general anaesthesia were randomised into three groups of 30 patients each. Oral melatonin 0.3 mg/kg, oral melatonin 0.5 mg/kg, and placebo were given to patients in Groups A, B, and C, respectively. The Visual Analogue Score (VAS), Ramsay Sedation Scale (RSS), and Stanford Sleepiness Scale (SSS) were used to assess anxiety, sedation, and sleepiness before and 90 minutes after premedication. Heart rate (HR), systolic (SBP), diastolic (DBP), and mean arterial (MAP) blood pressures were also measured. For intra-group comparison, a paired t-test and for inter-group comparison, ANOVA (Analysis of Variance) and difference-in-differences regression analysis were performed. Results: The three groups (group A: oral melatonin 0.3 mg/kg, group B: oral melatonin 0.5 mg/kg, group C: placebo) each having 30 patients were comparable with regard to demographic profiles with insignificant p-value. Melatonin had no significant anxiolytic impact when compared to placebo (p>0.05). However, melatonin offered considerable sedation and hemodynamic stability in a dose-dependent manner. Melatonin 0.5 mg/kg (group B) gave better sedation (RSS score: 3.30±0.11) and hemodynamic stability (fall in mean Heart Rate: by 7.4 after premedication) than melatonin 0.3 mg/kg) (RSS score: 2.77±0.12; fall in Mean Hear rate after premedication: by 7.76) than the placebo (RSS score: 2.17±0.07; fall in mean Heart rate: by 0.2). Conclusion: Oral melatonin provides better sedation and hemodynamic stability during endotracheal intubation in a dose-dependent manner when compared to placebo. But when required for sole anxiolysis melatonin was similar to placebo. Further studies are warranted to explore the safe dose for the anxiolytic effect of oral melatonin in cancer patients. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Anatolia Nursing & Health Sciences / Anadolu Hemsirelik Ve Saglik Bilimleri Dergisi is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)