Object
Title: Preoperative information as a factor impacting the level of anxiety in patients operated in short-term and stationary procedures in selected fields of interventional medicine
Abstract:
Introduction: Planned surgical treatment is frequently associated with the many months of waiting, often with longer hospital stay, disturbing the patient's daily routines: home life or career. Detachment of the patient from the daily functioning, for an undetermined time, is conductive to increasing and extending the period of anxiety, which is naturally associated with the new situation which is surgery. This negative emotional condition may influence, in various ways, the patient's behaviour and thus the course of the treatment or recovery. It is also pointed out that there is a clear relationship between the reduction of anxiety level in patients in the perioperative period, and the quality and way of providing them with information. One - Day surgery provides an alternative to hospitalization. Trends of moving the procedures, both small or medium ones, to one-day surgery centres are associated with the development of surgery and the drive to change the economic situation of health care. They will also help increase patient satisfaction with a well-executed procedure, and to ensure widely understood security. The majority of patients undergoing the procedures of varying extent and invasiveness has a particular need for knowledge in this field. Preoperative education, which is based mainly on the providing information verbally, is one of the characteristic features of prepar ; ing a patient for surgery. Doctor and nurse, in the process of preparing a patient for a surgery or invasive diagnostic procedure, become special, professionally aware source of information about the preparation for surgery, type of anaesthesia, as well as the possible negative effects and complications of the treatment. Optimum, planned provision of information, facilitating the influence on the emotional condition of the patient, seems to be an important factor in modern medical care. Systematic and continuous education of professionals related to the issue of concern, anxiety and broadly understood informing patients and their families before a surgery is still an important, noteworthy issue. The aim of my study was to determine the relationship between the information and the level of anxiety in patients undergoing the short-term and inpatient care (hospital) procedure in selected fields of interventional medicine based on the hypothesis that the essential factors affecting the level of anxiety experienced in connection with surgery is the scope of information obtained from nursing staff and duration of the perioperative period. Material and method: My research was carried out on the basis of consent issued by the local Bioethical Committee of 30 November 2010 in two multi-profile hospitals and 4 one-day surgery centers, considering a necessary factor of performing surger ; ies of the same scope of procedures. In the research, a division into groups A and B was applied. Group A consisted of adults waiting for surgery under general anesthesia in accordance with the short-term (One-Day Surgery - ODS) and inpatient care (hospital) procedure. In this group, we distinguished subgroup A1 - adults treated at the hospital, and a subgroup A2 - adults treated in one-day surgery facility. Group B consisted of parents of children waiting for surgery under general anesthesia in both treatment systems. The exclusion criteria for group A were: age below 18 and above 70, medical or psychological education, emergency surgeries, surgeries within the past month, constant receiving of sedatives or hypnotics, other conditions that prevent independent oral or written answering questions included in the questionnaires, no written consent to participate in the study. The exclusion criteria for group B included: parents who are minors and persons who are not legal guardians, parents of children under the age of 3 and above 6, medical or psychological education of parents, emergency surgery of the child, the operation of the child in the past month, no written consent to participate in the research. Anonymous tests were conducted in the period from January 2011 to November 2011 using the following questionnaires: State-Trait Anxiety Inventory (STAI) self-assessment questio ; nnaire - Sheet X-1, the Amsterdam Preoperative Anxiety and Information Scale (APAIS), Visual Analogue Scale (VAS), and my own questionnaire. Results: The two analyzed groups (A: 113 people, B: 93 people) did not show statistically significant differences in terms of age; dominant group consisted of persons aged up to 40. In the whole group of patients predominance of women over men was found. The scope of education showed no significant differences between groups. Research results have shown that 62% of patients in group A felt medium or high level of anxiety associated with surgery. In patients from A2 subgroup, the state anxiety level was statistically significantly lower than in the A1 subgroup. It has been demonstrated that anxiety measured by VAS, STAI and APAIS-anxiety was significantly higher in women as compared to men. Using APAIS, it has been demonstrated that the wish to expand the knowledge associated with anesthesia and surgery, and only with anesthesia or only surgery, developed at the respondents in both subgroups at a similar level. Type of the scheduled surgery was known to most patients. Respondents from the A1 subgroup statistically significantly more frequently in relation to the A2 subgroup claimed to have knowledge in this respect. In terms of having information related to anesthesia, adults waiting for the surgery in ODS (A2) statistically significantly ; more often declared to have such knowledge. The level of information of nursing and medical procedures before and after the surgery was higher in ODS than in the hospital. Comparing the two subgroups, patients confirmed their knowledge concerning the duration of the stay in the ward with similar frequency. Adults waiting for treatment in ODS statistically significantly more often declared knowledge on the subject. Analyzing the perception of the waiting time for surgery in subgroups A1 and A2 it was found that respondents from the subgroup A2 in 83.4% opted for waiting time "As expected," "Long" in 16.7%, and "Too long" was not chosen by any of the respondents, in contrast to the A2 subgroup, where the respondents chose the above options in 30.5%, 47.5% and 22% respectively. Research results enabled to note how important the information provided to patients during medical staff-patient interpersonal relations was. It has been shown that both in the A1 and A2 subgroup direct conversation with a doctor or a nurse was important for the patients. Also, a statistically significant advantage of direct conversation over all other forms of knowledge transfer to the patient has been confirmed. Multiple regression analysis confirmed the impact of a number of independent variables in 9% on the level of Anxiety-state in the A1 subgroup. In the A2 subgroup, independent variables had an impa ; ct on the level of Anxiety-state in 12% of the respondents. The presented results, consistent with data from the literature, confirm the existence of a number of factors that reduce anxiety, among which the information given to the patient by medical personnel are not among the most important. The analysis of the data confirmed the hypothesis assuming higher levels of preoperative anxiety of parents of children as compared to adults. The presented results highlighted the importance of obtaining information by the patient during direct conversation with the medical staff.
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Last modified:
Mar 16, 2023
In our library since:
Jun 15, 2015
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http://dl.cm-uj.krakow.pl:8080/publication/3994
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| Edition name | Date |
|---|---|
| ZB-122746 | Mar 16, 2023 |
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