scholarly journals The efficacy of computer-assisted cognitive behavioral therapy (cCBT) on psychobiological responses and perioperative outcomes in patients undergoing functional endoscopic sinus surgery: a randomized controlled trial

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Yang Yang ◽  
Yuling Li ◽  
Haibin Zhang ◽  
Yong Xu ◽  
Binquan Wang
Keyword(s):  
Blood Pressure ◽  
Cognitive Behavioral Therapy ◽  
Endoscopic Sinus Surgery ◽  
Behavioral Therapy ◽  
Functional Endoscopic Sinus Surgery ◽  
Cognitive Behavioral ◽  
Sinus Surgery ◽  
Perioperative Outcomes ◽  
Computer Assisted ◽  
Duration Of Surgery

Abstract Background Functional endoscopic sinus surgery (FESS) is required to minimize bleeding to maintain a clear operative field during surgery, so it is important to preoperative anti-anxiety and stable hemodynamics. Initial evidence suggests cognitive behavioral therapy (CBT) is effective to minimize surgery-related stress and to speed up recovery. The study aimed to evaluate the efficacy of a newly developed computer-assisted CBT (cCBT) program on surgery-related psychobiological responses in patients undergoing FESS. Methods Participants were allocated to a CCBT group (cCBT; n = 50) or a UC group (usual care; n = 50) by random number table. The State Anxiety Inventory (SAI), Patients Health Questionnaire-9 (PHQ-9), Athens Insomnia Scale (AIS), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed before intervention (T1), at 1 h before operation (T2), at postoperative 48 h (T3), and 96 h (T4: after intervention completed) respectively. The stress hormone was assayed at T1 and T2. The duration of surgery, anesthesia, and post-anesthesia care unit (PACU) were recorded. A satisfaction survey about nursing services was completed by participants before discharge. Results Compared to the UC group, the SAI scores at T2 and the AIS scores at T3 were lower in the CCBT group (p < 0.01 and p = 0.002). The positive rate of participants who were moderate and severe anxiety (SAI score > 37) at T2 were lower (72% vs. 88%, p = 0.04); the cortisol levels, SBP, DBP, and HR at T2 in the CCBT group were lower (p = 0.019 and all p < 0.01); the duration of anesthesia and PACU was shorter (p = 0.001 and p < 0.01); the CCBT group showed higher satisfaction scores. Conclusion The newly developed cCBT program was an effective non-pharmacological adjunctive treatment for improving the surgery-related psychosomatic responses and perioperative outcomes. Trial registration The study was registered with the Chinese Clinical Trial Registry (ChiCTR1900025994) on 17 September 2019.

scholarly journals The Efficacy of Computer-Assisted Cognitive Behavioral Therapy on Psychobiological Responses in Patients Undergoing Functional Endoscopic Sinus Surgery: A Randomized-controlled Clinical Trial

2020 ◽  
Author(s):  
Yang Yang ◽  
Yuling Li ◽  
Haibin Zhang ◽  
Yong Xu ◽  
Binquan Wang
Keyword(s):  
Clinical Trial ◽  
Endoscopic Sinus Surgery ◽  
State Anxiety ◽  
Behavioral Therapy ◽  
Vital Signs ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Computer Assisted ◽  
Stress Hormone ◽  
Psychological Care

Abstract BackgroundPrevious reports have shown computer-assisted cognitive behavioral therapy (CCBT) could improve mood and sleep for chronic health conditions and some anesthetics can help reduce preoperative anxiety, stabilize hemodynamics and lessen hormone response. But it is unclear whether CCBT could help adults with short-lived acute stressor (e.g. surgery) to experience similar responses.ObjectiveThis study aimed to assess the effects of CCBT on surgery-related physiological and psychological indices (mood, insomnia, vital signs and stress hormone) in patients undergoing functional endoscopic sinus surgery (FESS) during the perioperative period. MethodsParticipants were randomly assigned to a usual care (UC: disease care and psychological care) group (n = 50) or a computer-assisted cognition behavior intervention (CCBT: cognitive therapy and behavioral relaxation) group (n = 50). The primary outcome was state anxiety measured at baseline (T1) using the State Anxiety Inventory (SAI), with repeat assessment conducted 1 hour before anesthesia administration (T2) and post-intervention (T4). Secondary outcomes, including symptoms of depression and insomnia, were recorded at T1, 48 hours after surgery (T3), and T4. The stress hormone were assayed at T1 and T2, and participant satisfaction with intervention was assessed at T4. Blood pressure, and heart rate were collected at above four time points. Repeated-measure ANOVA models were then used to compare results between-two groups and analyze changes in anxiety, depression, and insomnia levels among participants.ResultsAt T2/T3 and T4, compared to the UC group, the CCBT group showed reduced anxiety (F = 17.10, p < .01 and F = 38.54, p < .01), and relieved insomnia symptoms (F = 10.10, P = .002 and F = 9.46, P = .003). Furthermore, the secondary analysis revealed a significant reducer in the participants falling above the clinical cut-off scores in the CCBT group as compared with UC group in SAI scores at T2 (72% vs 88%, p = .04) and in AIS scores at T4 (4% vs 22%, p = .01). For stress hormone, not only the increase in cortisol levels in the UC group was significantly higher at T2 compared to T1 ( p = .001); but also cortisol levels for UC group compared to the CCBT group was found to have a significant effect ( p = .024) at T2. For vital signs, the change of BP and HR were different significantly between-two group at T2 (p < .01). Moreover, the CCBT group showed higher satisfaction scores with Psychological care, Psychosomatic management and total score than the UC group.ConclusionThe CCBT appeared to reduce anxiety level and insomnia symptom, stabilize preoperative hemodynamics and cortisol level in patients undergoing FESS under general anesthesia. Participants also evaluated the CCBT positively, suggesting that it may represent an effective adjunct in preparing patients for surgery.Trial stateThe study was registered with the Chinese Clinical Trial Registry (ChiCTR1900025994) on September 17, 2019. http://www.chictr.org.cn/listbycreater.aspx/ChiCTR1900025994 The study protocol was conducted with the consent of the Ethics Committee of First Hospital of Shanxi Medical University in China on July 31, 2019 (document number [2019]K-SK028)

scholarly journals A Qualitative Examination of a School-Based Implementation of Computer-Assisted Cognitive-Behavioral Therapy for Child Anxiety

2021 ◽  
Author(s):  
Margaret E. Crane ◽  
Katherine E. Phillips ◽  
Colleen A. Maxwell ◽  
Lesley A. Norris ◽  
Lara S. Rifkin ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Child Anxiety ◽  
Cognitive Behavioral ◽  
Computer Assisted ◽  
School Based

Low-Dosage Adrenaline Induces Transient Marked Decrease of Blood Pressure during Functional Endoscopic Sinus Surgery

2006 ◽  
Vol 20 (2) ◽  
pp. 182-185 ◽  
Author(s):  
Feng Zhao ◽  
Zhongyun Wang ◽  
Jianjun Yang ◽  
Jie Sun ◽  
Qiuping Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endoscopic Sinus Surgery ◽  
Marked Decrease ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Low Dosage

Consumers’ and Providers’ Perceptions of Utilizing a Computer-Assisted Cognitive Behavioral Therapy for Childhood Anxiety

2013 ◽  
Vol 43 (1) ◽  
pp. 31-41 ◽  
Author(s):  
Alison Salloum ◽  
Erika A. Crawford ◽  
Adam B. Lewin ◽  
Eric A. Storch
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Childhood Anxiety ◽  
Cognitive Behavioral ◽  
Computer Assisted ◽  
Successful Implementation ◽  
Staff Support ◽  
Implementation Challenges ◽  
Mental Health Centers ◽  
Implementation Themes

Background: Computer-assisted cognitive behavioral therapy (CCBT) programs for childhood anxiety are being developed, although research about factors that contribute to implementation of CCBT in community mental health centers (CMHC) is limited. Aim: The purpose of this mixed-methods study was to explore consumers’ and providers’ perceptions of utilizing a CCBT for childhood anxiety in CMHC in an effort to identify factors that may impact implementation of CCBT in CMHC. Method: Focus groups and interviews occurred with 7 parents, 6 children, 3 therapists, 3 project coordinators and 3 administrators who had participated in CCBT for childhood anxiety. Surveys of treatment satisfaction and treatment barriers were administered to consumers. Results: Results suggest that both consumers and providers were highly receptive to participation in and implementation of CCBT in CMHC. Implementation themes included positive receptiveness, factors related to therapists, treatment components, applicability of treatment, treatment content, initial implementation challenges, resources, dedicated staff, support, outreach, opportunities with the CMHC, payment, and treatment availability. Conclusion: As studies continue to demonstrate the effectiveness of CCBT for childhood anxiety, research needs to continue to examine factors that contribute to the successful implementation of such treatments in CMHC.

Tele-3-Dimensional Computer-Assisted Functional Endoscopic Sinus Surgery: New Dimension in the Surgery of the Nose and Paranasal Sinuses

2002 ◽  
Vol 127 (6) ◽  
pp. 549-557 ◽  
Author(s):  
Ivica Klapan ◽  
Ljubimko Šimičić ◽  
Ranko Rišavi ◽  
Nada Bešenski ◽  
Karlo Pasarić ◽  
...  
Keyword(s):  
Operating Room ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Optimal Path ◽  
3D Models ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Computer Assisted ◽  
3 Dimensional ◽  
Nose And Paranasal Sinuses

One of the main objectives of our 3-dimensional (3D) computer-assisted functional endoscopic sinus surgery was to design a computer-assisted 3D approach to the presurgical planning, intraoperative guidance, and postoperative analysis of the anatomic regions of the nose and paranasal sinuses. Such an extremely powerful approach should allow better insight into the operating field, thereby significantly increasing the safety of the procedure. The last step to implementing the technology in the operating room was to connect the computer workstations and video equipment to remote locations by using a high-speed, wide-bandwidth computer network. During patient preparation, the surgeon in the operating room consulted remote experienced and skillful surgeons by viewing CT images and 3D models on computer workstations. The surgeon and consultants used software for CT image previews and 3D model manipulations on top of collaboration tools to define the pathosis, produce an optimal path to the pathosis, and decide how to perform the real surgical procedure. With tele-flythrough or tele-virtual endoscopy rendered through the use of 3D models, both surgeons can preview all the characteristics of the region (ie, anatomy, pathosis) and so predict and determine the next steps of the operation. This ensures greater safety thanks to the operation guidance and reduces the possibility of intraoperative error. The duration of the teleconsultation is thus shortened, which may prove the greatest benefit of tele-3D computer-assisted surgery. If this method were used, clinical institutions would spend less money for telesurgical consultation.

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