Patterns and frequency of anxiety in women undergoing gynaecological surgery

Abstract

Aims. Within a gynaecological surgical setting to identify the patterns and frequency of anxiety pre‐ and postoperatively; to identify any correlation between raised anxiety levels and postoperative pain; to identify events, from the patients’ perspective, that may increase or decrease anxiety in the pre‐ and postoperative periods. Background. It is well documented that surgery is associated with increased anxiety, which has an adverse impact on patient outcomes. Few studies have been conducted to obtain the patient's perspective on the experience of anxiety and the events and situations that aggravate and ameliorate it. Method. The study used a mixed method approach. The sample consisted of women undergoing planned gynaecological surgery. Anxiety was assessed using the State Trait Anxiety Inventory. Trait anxiety was measured at the time of recruitment. State anxiety was then assessed at six time points during the pre‐ and postoperative periods. Postoperative pain was also measured using a 10 cm visual analogue scale. Taped semi‐structured telephone interviews were conducted approximately a week after discharge. Results. State anxiety rose steadily from the night before surgery to the point of leaving the ward to go to theatre. Anxiety then increased sharply prior to the anaesthetic decreasing sharply afterwards. Patients with higher levels of trait anxiety were more likely to experience higher levels of anxiety throughout their admission. Elevated levels of pre‐ and postoperative anxiety were associated with increased levels of postoperative pain. Telephone interviews revealed a range of events/situations that patients recalled distressing them and many were related to inadequate information. Conclusion. This study found higher rates of anxiety than previously reported and anxiety levels appeared raised before admission to hospital. This has important clinical and research implications. Relevance to clinical practice. Patients with high levels of anxiety may be identified preoperatively and interventions designed to reduce anxiety could be targeted to this vulnerable group. Patient experiences can inform the delivery of services to meet their health needs better.

Chronic pain, healthcare utilization, and quality of life following gastrointestinal surgery

“…The State Trait Anxiety Inventory was used to measure state and trait anxiety. 17 Scores were categorized into low (\ 45) and high (C 45) anxiety. Pain catastrophizing was assessed using the twoitem version of the pain catastrophizing scale.…”

Obawy pacjentów operowanych w systemie chirurgii jednego dnia — przegląd literatury

“…Carr i wsp. przytacza opinię pacjentki: "czułam się prawdziwą osobą, wszyscy wiedzieli kim jestem" [32]. Bellani podkreśliła, że w czasach coraz bardziej dynamicznego rozwoju chirurgii jednego dnia kluczowym zadaniem dla personelu medycznego staje się spostrzeganie i świadomość obaw pacjentów oraz nawiązywanie w sposób fachowy relacji interpersonalnych [33].…”

Change in Preoperative Nervousness: A Randomized Controlled Trial in Gynecological Cancer Patients

“…Recent systematic reviews of patient education find information techniques to be promising but not convincing [17] [23] and, again, the authors emphasize the importance of meeting individual support needs. Others found the supportive element and the patient-nurse relationship to be important [1] [24], as this might allow healthcare professionals to choose appropriate techniques. Close relatives might also be a valuable support for patients before anesthesia, as they already know each other and often have affectional bonds, and relatives might intuitively support the patient in the way best suited to the patient [20] [25].…”

“…for a nurse to be present, attentive, empowering and otherwise helpful towards the patient and to talk about what is on the patient's mind. Such support could be of a therapeutic nature, and gives the patient the opportunity to initiate a close bond with the healthcare professional [1] [15] [20] [21]. However, the time spent on the operating ward might be too short for patients to create a close psychological bond and obtain the optimum benefit from it [5].…”

“…Preoperative nervousness and anxiety are common [1]- [8]. Anxiety is "a feeling of worry, nervousness, or unease about something with an uncertain outcome" [9] and nervousness is found to express essential elements of anxiety [3] [10].…”