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Nowadays, thalassaemia major (TM) patients are surviving into mature young adulthood; however, no published instrument exists to measure the expectations’ dimensionality among older TM patients in their thirties. This study seeks to validate a novel multidimensional expectation questionnaire suitable for TM patients (MEQ-TMP) reaching their fourth decade of life. In order to establish the psychometric properties of the instrument, data analysis was carried out. The principal component analysis revealed four components (‘Supportive social network’; ‘Raising one’s own family’; ‘Career advancement’; ‘Ability of daily activities’). Their cumulative contribution rate was 66.32%. Cronbach’s alpha for the total scale was 0.87. Each subscale had an alpha value above 0.70; three subscales were in the 0.80 range. MEQ-TMP reliability was proved to be good. The known-group method served as a strategy in examining the operationalisation of the questionnaire’s constructs. The present MEQ-TMP, developed for the aged group of TM patients, would be a useful tool for clinical personnel providing care to TM patients in understanding their outlook on life as they are growing up, to have better psychosocial adjustment to illness chronicity, live life as normally as possible, and fulfill their ambitions; thus enhancing their life satisfaction and quality of life.

Background:circumcision in children is a painful procedure. We aim compare the intraoperative and postoperative efficacy of three different surgical procedures of the ring block using levobupivacaine 0.25% combined with rectal paracetamol as opposed to rectal paracetamol alone.Methods:the study included 106 boys scheduled to undergo circumcision. The patients were randomly assigned within two groups to receive either ring block with levobupivacaine 0.25% and rectal paracetamol 30 mg/kg, or rectal paracetamol 30 mg/kg alone. The following surgical procedures were performed: sutureless proctoplasty, preputial plasty, and conventional circumcision. The efficacy of intraoperative analgesia was estimated on the basis of increases in heart rate and mean arterial pressure. Postoperatively, children were assessed for pain, pain-free (PF) period, and the total doses of analgesics administered during hospitalization, on the day after discharge, and on the first and second postoperative days.Results:all children remained stable during anesthesia. Postoperatively, the mean pain score did not show statistical differences between the groups. Children who received combined analgesia had a longer PF period (P < 0.001). However, the total doses of paracetamol administered during the observational period showed no differences. Children undergoing sutureless prepuceplasty received lower doses of paracetamol postoperatively (P < 0.001).Conclusion:subcutaneous ring block either with levobupivacaine 0.25% plus rectal paracetamol or rectal paracetamol alone provides adequate intraoperative and postoperative analgesia in circumcised children. However, combined analgesia allows a longer PF period. The need for less analgesic administration in children undergoing sutureless prepuceplasty could mean that the circumcision techniques might be a mitigating factor in terms of pain.

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Introduction: Preoperative anxiety is a common attitude in patients scheduled to undergo r surgery and represents with psychological and physical disturbances affecting postoperative recovery and quality of life (QoL). Objective: The aim of this study was to identify the effect of preoperative education on preoperative and postoperative anxiety and postoperative QoLin patients scheduled to undergo laparoscopic cholecystectomy (LC) and inguinal hernia (IH) repair, without prior surgical experience. Methods: Patients scheduled to underwent LC and IH repair were randomly assigned to control group (CG) and to interventional group (IG). The 'State-Trait Anxiety Inventory for Adults' questionnaire was used to validate anxiety before surgery and after 3 months postoperatively. The 36- item Medical Outcomes Short Form Health Survey (SF-36) was used to investigate mental, physical and emotional domains of QoL. The CG was received only routine information by doctors. The IG received additionally oral information plus a booklet from an experienced surgical nurse. Data analyzed using paired and unpaired t-test and Αnova tests. The level of statistical signicance was set at ≤ 5%. Results: Four hundred and fty patients were scheduled to undergo either LC or IH repair, with 200 assigned to the IG and 250 to the CG. Age, sex, marital status and educational level were similar in both groups. Postoperative State anxiety was signicantly lower in IG (p<0.001). Patients of the IG showed greater improvement in all of the SF-36 scale domains, specically in physical functionality (p<0.001), physical role (p<0.001), physical pain (p<0.001), general health (p<0.001), vitality (p<0.001), social functionality (p<0.001), emotional role (p<0.001) and mental health (p<0.001). There was not mortality or signicant morbidity in both groups. Conclusion: Preoperative education by an experienced nurse with oral and written information improves perioperative state anxiety and QoL. This method could be used for all surgical patients, irrespective for the surgical procedure.