Assessment of preoperative anxiety: comparison of measures in patients awaiting surgery for breast cancer

Millar, Keith; Jelícic, Marko; Bonke, B.; Asbury, A. J.

doi:10.1093/bja/74.2.180

Cited by 205 publications

(149 citation statements)

References 7 publications

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“…First, there is no unequivocal cutoff value for the STAI to define high-anxiety. We used the earlier reported cutoff value of 45 and higher (Millar et al, 1995;Roth et al, 1998) which matches almost perfectly with the validated cutoff value of the HADS (Millar et al, 1995). Second, nonresponse at 5-year follow-up was present.…”

Section: Discussionmentioning

confidence: 84%

“…Scale scores range from 20 to 80 with higher scores indicating higher levels of anxiety (van der Ploeg et al, 1980). A STAI-State score of more than 44 defines an individual as highly anxious (Spielberger and Vagg, 1984;Millar et al, 1995). Applying this cutoff level, we defined men with pretreatment STAI-State scores equal to or below 44 as 'lowanxiety' and those with scores above 44 as 'high-anxiety'.…”

Section: Psychological Measuresmentioning

confidence: 99%

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Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up

et al. 2006

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To document anxiety and depression from pretreatment till 5-year follow-up in 299 men with localized prostate cancer. To assess, if baseline scores were predictive for anxiety and depression at 1-year follow-up. Respondents completed four assessments (pretreatment, at 6 and 12 months, and at 5-year follow-up) on anxiety, depression and mental health. Respondents were subdivided according to therapy (prostatectomy or radiotherapy) and high vs low-anxiety. Pretreatment 28% of all patients were classified as 'high-anxiety'; their average anxiety scores decreased significantly post-treatment, that is towards less anxiety. At all assessments, highanxiety men treated by prostatectomy reported less depression than high-anxiety men treated by radiotherapy. Of men treated by radiotherapy, 27% reported clinical significant levels of depression while 20% is expected in a general population. The improvement in mental health at 6-months follow-up was statistically significant and clinically meaningful in all respondent groups. Sensitivity of anxiety at baseline as a screening tool was 71% for anxiety and 60% for symptoms of depression. We recommend clinicians to attempt early detection of patients at risk of high levels of anxiety and depression after prostate cancer diagnosis since prevalence is high. STAIState can be a useful screening tool but needs further development.

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Section: Discussionmentioning

confidence: 84%

Section: Psychological Measuresmentioning

confidence: 99%

Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up

et al. 2006

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“…Previously, studies comparing the effectiveness and validity of these three scales found equivalent results in detecting preoperative anxiety. [42][43][44][45] In our study, VAS-A assessment scale was used as it would be a simple, rapidly applicable and a reliable method for urgent category-1 C/S performed parturients.…”

Section: Discussionmentioning

confidence: 99%

Effects of Sedation on Spinal Anesthesia-induced Maternal Hypotension in Preoperatively Anxious Parturients Underwent Urgent Category-1 Cesarean Section: A Historical Cohort Study

Şahan¹,

Şalvız²,

Alay³

et al. 2017

Turkiye Klinikleri J Anest Reanim

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : This study was designed to investigate the effect of sedation on maternal hypotension in preoperatively anxious parturients underwent urgent category-1 Cesarean section (C/S) under spinal anesthesia (SA). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : After ethics committee approval, data of 1824 parturients underwent C/S were reviewed from the surgical database and patient charts. Parturients with high preoperative anxiety scores (VAS-A)≥70) underwent C/S under SA with thiopental 2 mg/kg (if necessary additional 50 mg) sedation until reaching Ramsay sedation score≥3 (Group S, n=49), and without any other type of sedation (Group NS, n=53) were included in the study. All parturients received SA with hyperbaric bupivacaine 0.5% 2.5 mL. Hemodynamic parameters and maximum systolic arterial pressure (SAP) reductions (%) from the baseline were recorded. Maternal hypotension (SAP≥30% decrease or <100 mmHg) and bradycardia (heart rate <55 beats/min) incidences, required ephedrine (5mg IV bolus) and atropine (0.5 mg IV bolus) doses, and newborn Apgar scores were also analyzed. R Re es su ul lt ts s: : Fifty-nine parturients' data (Group S: 29 and Group NS: 30) were analyzed. The maximum SAP reductions were 23±12.8% and 30.8±16.1% in Groups S and NS, respectively (p=0,044). Hypotension was observed in 5 (17,2%) parturients of Group S and 15 (50%) of Group NS (p=0.012, 95% CI 0,14-0,82; relative risk=0,344). Ephedrine requirement was 17±4,4 mg and 25±7,4 mg in Groups S and NS, respectively (p=0,04). Incidence of bradycardia, required atropine dose and newborn Apgar scores were similar in both groups (p>0,05). C Co on nc cl lu us si io on ns s: : The maximum SAP reduction, hypotension incidence and required ephedrine doses were lower in thiopental sedation used preoperatively anxious parturients who underwent category-1 C/S under SA. K Ke ey yw wo or rd ds s: : Cesarean section; anxiety; anesthesia, spinal; conscious sedation; thiopental Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışma, preoperatif dönemde anksiyöz olup spinal anestezi (SA) altında acil kategori-1 sezaryen (C/S) operasyonu geçiren gebelerde, sedasyonun hipotansiyona etkisini araştırmak için planlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Etik kurul onayı alındıktan sonra, C/S operasyonu geçiren 1824 gebenin verileri cerrahi arşiv ve hasta dosyaları aracılığıyla incelendi. Preoperatif anksiyete skoru (VAS-A)≥70) yüksek olup SA altında C/S geçiren gebelerden Ramsay sedasyon skoru ≥3 olacak şekilde tiyopental 2 mg/kg (gereğinde 50 mg ek doz) uygulanan hastalar (Grup S, n=49) ve herhangi bir sedasyon uygulanmayan hastalar (Grup NS, n=53) çalışmaya dahil edildi. Tüm gebelere, 2,5mL %0,5'lik hiperbarik bupivakain ile SA uygulandı. Hemodinamik parametreler ve bazale göre sistolik arteryal basınçtaki (SAB) maksimum düşüşler (%) kaydedildi. Maternal hipotansiyon (SAB'ın ≥%30 düşmesi veya <100 mmHg olması) ve bradikardi (kalp hızı <55 atım/dk) insidansları, efedrin gereksinimi (5 mg IV b...

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“…However, the VAS system has been employed in other studies because it is easier to be used in routine clinical practice than the STAI. Furthermore, there are studies which have validated VAS compared with STAI (23)(24)(25). We therefore consider this to be a minor limitation.…”

Section: Main Endoscopic Diagnosis Principal (N %)mentioning

confidence: 99%

Prospective study of anxiety in patients undergoing an outpatient colonoscopy

Bensusán¹,

Martín²,

Álvarez³

2016

Rev Esp Enferm Dig

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Background: Undergoing a colonoscopy can cause anxiety in patients and this is something which has not been closely studied.Objective: To determine the frequency and intensity of anxiety prior to a colonoscopy and the factors which are related to the procedure.Methods: This is a prospective study of patients undergoing outpatient colonoscopy in our hospital. Anxiety was assessed using a visual analogue scale of 0 to 100. The severity of anxiety was rated as mild (1-29), moderate (30-79) or severe (80-100).Results: Three hundred and twenty-seven patients completed the study, of whom 154 (47.1%) were men with a median age of 54 years (p25-75: 45-65). Three hundred and nine (94.5%) patients were found to suffer a certain degree of anxiety. The median value on the visual analogue scale was 31 (p25-75: 10-53). Anxiety levels were mild in 136 patients (44%), moderate in 141 (45.6%) and severe in 32 (10.4%). Greater anxiety was associated with female patients (mean 40.38 vs 31.99, p = 0.01) and a poorly tolerated previous colonoscopy (mean 50.67 vs 28.44, p = 0.01) and correlated inversely with age (r = -0.170, p = 0.02).Conclusions: Colonoscopy causes some degree of anxiety in most patients. Being female, younger and having experienced poor tolerance to a previous scan are associated with greater degrees of anxiety. These findings should be taken into account in the implementation of measures to improve the quality and tolerance of colonoscopy.

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Assessment of preoperative anxiety: comparison of measures in patients awaiting surgery for breast cancer

Cited by 205 publications

References 7 publications

Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up

Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up

Effects of Sedation on Spinal Anesthesia-induced Maternal Hypotension in Preoperatively Anxious Parturients Underwent Urgent Category-1 Cesarean Section: A Historical Cohort Study

Prospective study of anxiety in patients undergoing an outpatient colonoscopy

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