scholarly journals Can an informative video about the anesthesia technique be an effective tool to treat preoperative anxiety in patients undergoing minor, elective, outpatient hand surgery procedures?

2019 ◽  
Author(s):  
Cesare Fusetti ◽  
Samuele Ceruti ◽  
Michele Musiari ◽  
Bruno Minotti ◽  
Stefano Cafarotti ◽  
...  
Keyword(s):  
Hand Surgery ◽  
Anxiety Level ◽  
Preoperative Anxiety ◽  
Ambulatory Setting ◽  
Patient’S Satisfaction ◽  
Patients Satisfaction ◽  
Intravenous Regional Anesthesia ◽  
Anesthesia Technique ◽  
The Impact ◽  
Clinical Trial Methods

Abstract Background Preoperative anxiety is a common problem with an impact on surgical outcome, anesthetic drug amount and patient’s satisfaction. An important component of preoperative anxiety is worries related to anesthesia. Suitable patients information has been shown to reduce preoperative anxiety level and this can be effectively achieved through a video. Objectives To assess the impact of an informative video about regional intra-venous anesthesia technique on patient’s preoperative anxiety levels before minor ambulatory hand surgery procedures. Study design retrospective, single-centre, case-control clinical trial. Methods To assess the impact of an educational video illustrating all the passages of intravenous regional anesthesia on preoperative anxiety level and overall patients’ satisfaction. Results Anxiety level measured after admission in the day hospital clinic did not differ between the two groups, however overall patients’ satisfaction levels were higher when patients were shown the video. Conclusions Informative videos does not seem to significantly reduce preoperative anxiety but have the potential to increase patients’ satisfaction in the ambulatory setting.

scholarly journals 71 Predictors of children anxiety and association with parental anxiety in the preoperative setting at a tertiary pediatric center

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e29-e30
Author(s):  
Amelie Bastarache ◽  
Genevieve Normand
Keyword(s):  
Risk Factors ◽  
Trait Anxiety ◽  
The State ◽  
Anxiety Level ◽  
Preoperative Anxiety ◽  
Parental Anxiety ◽  
State Trait Anxiety Inventory ◽  
Children’S Anxiety ◽  
The Impact ◽  
Pediatric Center

Abstract Background Preoperative anxiety is a prevalent phenomenon in the pediatric population. The impact of anxiety can be seen in the children and accompanying family and have significant consequences during anesthesia, the perioperative and postoperative period. Previous studies examining risk factors of anxiety were contradictory and a few studied children aged under 5. Objectives The aim of this study is to evaluate the association between parental anxiety and child anxiety in patients undergoing elective surgery in a tertiary pediatric center. The secondary objectives were to identify the cohort characteristics and the risk factors associated with higher anxiety. Design/Methods In this prospective cohort study, 166 children aged from 2 to 12 years old, who had a surgery between March and June 2019, were analyzed. Children’s anxiety at induction was assessed by the anesthesiologist with the Modified Yale Preoperative Scale Short form (mYPAS-SF). Anxiety level of children over 8 years old was self-assessed by the State-Trait Anxiety Inventory-Child form (STAIC) during the preoperative evaluation. Parents’ anxiety was measured with the State-Trait Anxiety Inventory form (STAI). Data recorded included personal, familial and sociodemographic details, past healthcare history and prior separations. Unadjusted and adjusted logistic regression were performed to identify possible risk factors of children’s anxiety and association between child and parent anxiety. Results The prevalence of significant anxiety at induction was 39.8%. No significant association was observed between the level of anxiety of parents compared to their children except in the group of children aged over 8. In this population, statistically significant correlation was observed between the STAIC and the STAI score, with a Pearson coefficient of 0.4. Children aged 2 to 5 years old and parents aged 15 to 35 years old, being an only child and no anterior history of separation were all associated with higher anxiety at induction. In the adjusted analysis, being five years or older was a protective factor (OR 0.23, 95% CI 0.12;0.45, p<0.001). Conclusion Parent anxiety does not seem to be a good indicator of children’s anxiety even if an association was observed in the group of 8 to 12 years old. Children under 5 are more at risk of preoperative anxiety and could benefit from new technologies and preparative strategies to lower their anxiety level. Anxiety at induction remains difficult to predict and more studies on the subject need to be carried out.

Effects of Video Information on Parental Preoperative Anxiety Level and Their Perception of Conscious Sedation vs. General Anesthesia for the Dental Treatment of Their Young Child

2007 ◽  
Vol 31 (2) ◽  
pp. 90-92 ◽  
Author(s):  
Ari Kupietzky
Keyword(s):  
General Anesthesia ◽  
Conscious Sedation ◽  
Dental Treatment ◽  
Treatment Options ◽  
Young Patients ◽  
Anxiety Level ◽  
Preoperative Anxiety ◽  
Video Information ◽  
Significant Difference ◽  
The Impact

Aim. To investigate the impact of video information on parental preoperative anxiety and perception and their preference of conscious sedation versus general anesthesia for the dental treatment of young patients. Method/materials. Parents were given a verbal explanation regarding the two treatment options and were then asked to fill out a prescreening questionnaire. Their preference for mode of treatment was obtained and their preoperative anxiety level was measured on a visual analog scale (VAS). A video film depicting two children under going dental treatment with conscious sedation (CS) and a third child undergoing general anesthesia (GA) for dental treatment was shown to the parent. Following the viewing of the video film a post-screening questionnaire was given. Parents' post screening anxiety was measured and they were asked if their perception and preference of the two modes of treatment remained the same or changed. Results. 40 parents were included and completed the trial. The prescreening anxiety level of parents was 2.79 (± 1.05, SD) and was not significantly different than the post screening anxiety level of 2.91 (± .99 SD, paired t- test p=0.432). The majority of parents preferred CS to GA for the treatment of their child prior to screening of the video. Among the few who chose GA (n=5) all but one changed their choice after viewing the video to CS. However, this difference was not found to be statistically significant due to the small number of subjects in this group (McNemar test, p = 0.125). Most parents voiced the opinion that the video film contributed to their knowledge and also considered GA as having more risks than CS. An interesting finding was that a statistically significant difference was found regarding parent's perception of the two procedures and what they actually saw in the video. The majority of parents stated that their initial perception of GA was not similar to their viewing experience, conversely, CS matched their expectations. Conclusion. Parents' anxiety regarding their child's dental treatment under GA or CS is not affected by the viewing of a video film depicting either method. Parent's perception of GA is different than the actual procedure and may affect their choice of treatment.

scholarly journals Impact of Regional Block Failure in Ambulatory Hand Surgery on Patient Management: A Cohort Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2453
Author(s):  
Lucile Picard ◽  
Pierre Belnou ◽  
Claire Debes ◽  
Nathanael Lapidus ◽  
Eileen Sung Tsai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Patient Management ◽  
Hand Surgery ◽  
University Hospital ◽  
Ambulatory Setting ◽  
Anesthetic Technique ◽  
Factors Associated ◽  
Regional Block ◽  
Upper Limb Surgery ◽  
The Impact

Regional anesthesia (RA) is an anesthetic technique essential for the performance of ambulatory surgery. Failure rates range from 6% to 20%, and the consequences of these failures have been poorly investigated. We determined the incidence and the impact of regional block failure on patient management in the ambulatory setting. This retrospective cohort study includes all adult patients who were admitted to a French University Hospital (Hôpital Saint-Antoine, AP-HP) between 1 January 2016 and 31 December 2017 for unplanned ambulatory distal upper limb surgery. Univariate and stepwise multivariate analyses were performed to determine factors associated with block failure. Among the 562 patients included, 48 (8.5%) had a block failure. RA failure was associated with a longer surgery duration (p = 0.02), more frequent intraoperative analgesics administration (p < 0.01), increased incidence of unplanned hospitalizations (p < 0.001), and a 39% prolongation of Post-Anesthesia Care Unit (PACU) length of stay (p < 0.0001). In the multivariate analysis, the risk factors associated with block failure were female sex (p = 0.04), an American Society of Anesthesiologists (ASA) score > 2 (p = 0.03), history of substance abuse (p = 0.01), and performance of the surgery outside of the specific ambulatory surgical unit (p = 0.01). Here, we have documented a significant incidence of block failure in ambulatory hand surgery, with impairment in the organization of care. Identifying patients at risk of failure could help improve their management, especially by focusing on providing care in a dedicated ambulatory circuit.

TERAPI MUSIK DAN TINGKAT KECEMASAN PASIEN PREOPERASI

2016 ◽  
Vol 5 (1) ◽  
pp. 1-6
Author(s):  
Wenny Savitri ◽  
Nani Fidayanti ◽  
Paulus Subiyanto
Keyword(s):  
Music Therapy ◽  
Intervention Group ◽  
Complementary Therapy ◽  
T Test ◽  
Anxiety Level ◽  
Preoperative Anxiety ◽  
Control Group ◽  
Music Intervention ◽  
Significant Difference ◽  
Anxiety Levels

Background: Surgery is one of medical interventions which can cause fear, anxiety, and stressed because of its effects toward the integrity of body and soul. Nurses have significant roles in any preoperative care which is helping patients to decrease preoperative anxiety by using complementary therapy. The use of music therapy as one of the complementary therapies is not common in Indonesia. Therefore, scientific studies to prove the role of this therapy to decrease the level of anxiety of pre-operative patients is needed. Objective: To investigate the effects of music therapy in reducing anxiety levels of preoperative patients. Methods: A quasy experimental study with pre-test and post-test design with control group was applied to 50 respondents from medical ward in Panembahan Senopati Hospital of Yogyakarta who met the inclusion criteria.Dara were then analyzed by using t-test statistical analysis. Results: The control group showed the increased value of anxiety level of0.8 without music intervention (t= - 1503, df = 24, p<.05), whereas the intervention group showed the decreased value of anxiety level of -5.52 (t=5.081, df=24, p<.05). Meanwhile the independent t-test results for both groups showed a significant difference between group (t= 3,373, df=48, p<.05). Conclusion: Music therapy has significant effect in reducing preoperative anxiety levels of patients. Keywords: anxiety, preoperative, music therapy

An Analysis of Procedural Medicare Reimbursement Rates in Hand Surgery: 2000 to 2019

Hand ◽  
2021 ◽  
pp. 155894472199080
Author(s):  
Danielle A Thornburg ◽  
Nikita Gupta ◽  
Nathan Chow ◽  
Jack Haglin ◽  
Shelley Noland
Keyword(s):  
Consumer Price Index ◽  
Hand Surgery ◽  
The United States ◽  
Medicare Reimbursement ◽  
Reimbursement Rate ◽  
Time Period ◽  
Long Term Trends ◽  
Fee Schedule ◽  
Procedure Codes ◽  
The Impact

Background: Medicare reimbursement trends across multiple surgical subspecialties have been analyzed; however, little has been reported regarding the long-term trends in reimbursement of hand surgery procedures. The aim of this study is to analyze trends in Medicare reimbursement for commonly performed hand surgeries. Methods: Using the Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File, we determined the 20 hand surgery procedure codes most commonly billed to Medicare in 2016. Reimbursement rates were collected and analyzed for each code from The Physician Fee Schedule Look-Up Tool for years 2000 to 2019. We compared the change in reimbursement rate for each procedure to the rate of inflation in US dollars, using the Consumer Price Index (CPI) over the same time period. Results: The reimbursement rate for each procedure increased on average by 13.9% during the study period while the United States CPI increased significantly more by 46.7% ( P < .0001). When all reimbursement data were adjusted for inflation to 2019 dollars, the average reimbursement for all included procedures in this study decreased by 22.6% from 2000 to 2019. The average adjusted reimbursement rate for all procedures decreased by 21.92% from 2000 to 2009 and decreased by 0.86% on average from 2009 to 2019 ( P < .0001). Conclusion: When adjusted for inflation, Medicare reimbursement for hand surgery has steadily decreased over the past 20 years. It will be important to consider the implications of these trends when evaluating healthcare policies and the impact this has on access to hand surgery.

scholarly journals Communication as a Key Issue in the Care of Diabetes Mellitus

2015 ◽  
Vol 22 (3) ◽  
pp. 305-310
Author(s):  
Elena-Daniela Grigorescu ◽  
Cristina Mihaela Lăcătuşu ◽  
Gina Eosefina Botnariu ◽  
Raluca Maria Popescu ◽  
Alina Delia Popa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Modern Medicine ◽  
Therapeutic Education ◽  
Communicative Interaction ◽  
Patient Centered ◽  
Patient’S Satisfaction ◽  
Communication Techniques ◽  
Physician Patient ◽  
The Impact

Abstract The physician-patient communication has an essential role in establishing and supporting the relationship between these two partners. Moreover, modern medicine highlights the patient-centered approach. Publications assessing the impact of an efficient physicianpatient communication on medical care results in diseases such as diabetes and hypertension have revealed a positive correlation between patient’s satisfaction about the communication with the physician and values of blood pressure, glycated hemoglobin and pain intensity. Interventions needed in both doctors and patients for developing communication abilities were paid special attention in order to achieve an appropriate improvement in their communicative interaction during periodical appointments. In the field of diabetes mellitus, the medical challenge is to improve patients’ knowledge about medical care; this aim is achieved only by therapeutic education, using high-quality communication techniques.

IMPACT OF EARLY LIFE STRESS ON ANTI-DEPRESSANT SENSITIVITY

2021 ◽  
pp. 123-132
Author(s):  
V.A. Vokina
Keyword(s):  
Open Field ◽  
Life Stress ◽  
Early Life ◽  
Early Life Stress ◽  
Anxiety Level ◽  
Male Rats ◽  
Porsolt Test ◽  
The Impact ◽  
Sexually Mature

Long-term consequences of impaired perinatal development are very significant. They appear during the neonatal period and in the first years of life, and persist during ontogenesis. There is little data on the impact of any prenatal factors on the sensitivity of a sexually mature organism to medications. The aim of the study is to assess the impact of early life stress on the development of individual antidepressant sensitivity. Materials and Methods. The authors conducted the experiments on sexually mature outbred male rats. To simulate the early life stress, a standard protocol was used. From the 2nd to 15th days of the postnatal period the pup rats were separated from their mother for 3 hours and kept in an incubator. The open-field test, Porsolt test and Sucrose consumption test were used to determine rat’s anxiety level as well as motor, orientation and exploratory activity at puberty. Then, for 14 days, the rats were intragastrically administered with a fluoxetine solution (10 mg/kg/daily), followed by their full examination. Statistical analysis of results was performed using the Mann-Whitney U-test to compare unrelated groups and Wilcoxon's test to compare related groups. Results. Fluoxetine did not have a pronounced antidepressant effect in animals that survived the early life stress. Such animals demonstrated passive floating during the Porsolt test, without any changes in immobility time. When testing in an open field, a sharp increase in the number of freezing behavior was observed, which was an indicator of an increased anxiety level in animals. Conclusion. The results obtained indicate that the long-term effects of neonatal stress may be associated with a change in antidepressant sensitivity or an increase in development of unwanted adverse reactions. Keywords: early life stress, depression, antidepressants, fluoxetine, rats. Отдаленные последствия нарушения перинатального развития весьма значительны и не только проявляются в период новорожденности и в первые годы жизни, но и сохраняются в период онтогенеза. Данные о влиянии каких-либо пренатальных факторов на чувствительность половозрелого организма к действию лекарственных веществ в доступной литературе представлены незначительно. Цель исследования – оценить роль стресса раннего периода жизни в формировании индивидуальной чувствительности к действию антидепрессантов. Материалы и методы. Эксперименты проведены на половозрелых беспородных крысах-самцах. Для моделирования стресса раннего периода жизни использовали стандартный протокол, подразумевающий отделение детенышей от матери со 2-го по 15-й дни постнатального периода на 3 ч в условиях инкубатора. В половозрелом возрасте проводили оценку уровня тревожности, двигательной и ориентировочно-исследовательской активности крыс в условиях теста открытого поля, теста Порсолта и теста «Потребление раствора сахарозы». Затем в течение 14 дней крысам внутрижелудочно вводили раствор флуоксетина (10 мг/кг/сут), после чего обследование повторяли в том же объеме. Статистический анализ результатов исследования проводили с использованием U-критерия Манна–Уитни для сравнения несвязанных групп и критерия Вилкоксона для сравнения связанных групп. Результаты. У животных, переживших стресс раннего периода жизни, флуоксетин не оказывал выраженного антидепрессантного действия. У данных животных в тесте Порсолта преобладало пассивное плавание, без изменения длительности иммобильности. При тестировании в открытом поле наблюдалось резкое повышение числа актов фризинга, что является показателем повышенного уровня тревожности у животных. Выводы. Полученные результаты свидетельствуют о том, что отдаленные последствия неонатального стресса могут быть связанны с изменением чувствительности к действию антидепрессантов или повышением риска развития нежелательных побочных реакций. Ключевые слова: стресс раннего периода жизни, депрессия, антидепрессанты, флуоксетин, крысы.

scholarly journals Comparison of Effectiveness and Patient Satisfaction of Vaginal Versus Oral Misoprostol in Treatment of Missed Miscarriage

2019 ◽  
Vol 7 (6) ◽  
pp. 955-958 ◽  
Author(s):  
Elham Mohammadi ◽  
Geetha Jayaprakash ◽  
Afshin Shiva ◽  
Nader Motallebzadeh
Keyword(s):  
Patient Satisfaction ◽  
Statistical Difference ◽  
Missed Abortion ◽  
Patient’S Satisfaction ◽  
Patients Satisfaction ◽  
Satisfaction Rate ◽  
Oral Misoprostol ◽  
Surgical Evacuation ◽  
The Difference ◽  
Vaginal Misoprostol

BACKGROUND: In recent years’ medical management with misoprostol is an effective alternative to surgical evacuation. But there is a dearth of evidence to reveal the effectiveness of the different routes of misoprostol and satisfaction rate among the patients treated with these routes. AIM: This study was conducted to compare the effectiveness and patient’s satisfaction rate of vaginal versus oral misoprostol. METHODS: It was a prospective non-interventional study. One hundred women of having missed abortion confirmed by ultrasonography examination were enrolled in the trial. Fifty-eight subjects were administered 200 mcg of oral and 42 subjects received 200 mcg of vaginal misoprostol every four hours up to four doses. If complete expulsion did not occur 12 hours after the last dose, the surgical evacuation was done. RESULTS: There was no significant statistical difference between the effectiveness of treatment with vaginal (78.57%) and oral misoprostol (79.31%) (p = 0.928). The difference between Patients’ satisfaction at the time of discharge for the vaginal group (64.29%) and oral group (65.52%) was not statistically significant (P = 0.991). There was an increase in patients’ satisfaction for both groups at the follow-up session, but still, the difference was not significant (P = 0.897). CONCLUSION: This study confirms that there is no statistical difference between the effectiveness and patient satisfaction of oral and vaginal misoprostol in the treatment of missed abortion.

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