Three Enemies of Circadian Rhythm: Anxiety, Sleeplessness and Pain in Patients Following Open-Heart Surgery

Abstract

Objective: This study aimed to determine the relationship between preoperative anxiety and postoperative pain and perioperative sleep quality in open-heart surgery patients. Methods: It was a cross-sectional study. The research sample included 126 patients who underwent open-heart surgery for the first time and remained in intensive care for a maximum period of 48 hours. All patients' procedures were performed with cardiopulmonary bypass and sternotomy. Data were collected using a Patient Identification Form, developed by the researcher and used to determine patients' characteristics; the Anxiety Specific to Surgery Questionnaire (ASSQ), used to determine patients' anxiety level; the Pittsburgh Sleep Quality Index (PSQI), used to measure perioperative sleep quality, and the Numeric Pain Scale (NPS), used to determine postoperative pain levels. Results: Open-heart surgery patients experienced moderate levels of anxiety (27.28±8.48), moderate postoperative pain (4.30±2.29) and poor sleep quality (10.27±4.23) perioperative period. In this paper, a significant, weak, and positive correlation between ASSQ score and postoperative NPS score (r=0.318, p<0.05) was found; no correlation between the ASSQ score and perioperative PSQI score was found. It was determined that 90.48% (n = 114) of patients who underwent open heart surgery had poor sleep quality and there was no relation between preoperative anxiety and postoperative sleep quality. Conclusion: The authors concluded that preoperative anxiety impacts postoperative pain but has no effect on sleep quality for open-heart surgery patients in Turkish people.

The Effect of Anxiety Levels of Patients Before Laparoscopic Cholecystectomy Surgery on Postoperative Pain and Sleep: Descriptive Research

“…Hastanede yatışta hastaların uykusunu olumsuz etkileyen en önemli durumun ağrı olduğu literatürde belirtilmektedir. 11,24 Uyku, davranışsal ve fizyolojik süreçleri içeren karmaşık ve aynı zamanda doğal bir süreçtir. 25 Hastanede yatan hastaların uyku alışkanlıklarında ciddi değişimler olduğu bilinmektedir.…”

“…25 Hastanede yatan hastaların uyku alışkanlıklarında ciddi değişimler olduğu bilinmektedir. 24 Çalışmada, RCSQ sınıflamasına göre hastaların uyku kalitesinin orta düzeyde olduğu görüldü. Bu durum, kolesistektomi ameliyatının laparoskopik olarak uygulanması, laparoskopik girişimlerin minimal invaziv cerrahi olması, ameliyat sonrası ağrı ve komplikasyon gelişiminin daha az olması ve hastanede yatışın kısa olması ile ilişkilendirilebilir.…”

Measures of preoperative anxiety: Part two

“…The test has satisfactory psychometric properties (Cronbach's a coefficient in the original study was 0.79) [18]. The scale has been used in several recently published studies involving patients undergoing various surgical procedures, mainly in Turkey [15,[19][20][21][22][23][24][25][26][27]. After obtaining permission from the authors of the original version of the questionnaire, we translated it into Polish according to the principles of adaptation of psychometric methods: translation from English to Polish independently by three clinicians (including a clinical psychologist and two physicians), agreement on a common Polish version, translation from Polish to English by a native English speaker who is also fluent in Polish and who was not familiar with the original version, further consultations with the team of clinicians, comparison of the back-translation version with the original version, and conducting a pilot study among 10 patients (see Supplement 1 file for the English (Table 1) and Polish (Table 2) versions of ASSQ).…”