Video Education to Improve Preoperative Anxiety in the Bariatric Surgical Patient: A Quality Improvement Project

The Effect of Preoperative Education Regarding Intraoperative Care on a Patient's Level of Fear of Surgery: A Randomized Controlled Study

This randomized controlled study aimed to investigate the effect that preoperative education provided by the perioperative nurse about the OR environment and intraoperative care has on surgical fear in patients who come to the OR for surgical intervention. The study involved 92 patients undergoing elective abdominal surgery who were randomly assigned to the intervention or routine care group. Preoperatively, patients in the intervention group received education via a form that described the OR environment, the surgical process, and intraoperative care. The patients' surgical fear levels were assessed in the patients' rooms, in the clinic before education, and on arrival to the OR after education. The results showed that preoperative education about the OR environment and intraoperative processes significantly reduced patients' surgical fears.

The Effect on Anxiety and Satisfaction of Video-Assisted Education Given Before an ERCP Procedure

Providing education in medical procedures may ensure patients' compliance, reduce anxiety, and increase satisfaction. This randomized controlled research study was conducted to determine the effect of video-assisted education on anxiety and satisfaction given before an endoscopic retrograde cholangiopancreatography procedure. A total of 70 patients participated between September 2017 and December 2018. Data were collected with the State-Trait Anxiety Inventory and the Visual Analogue Scale. Routine education was given to the control group, while routine education and video-assisted education were given to the intervention group. There was no difference between the state anxiety scores of the groups before the procedure ( p > .05). The state anxiety level of the intervention group was lower than that of the control group after the procedure ( p < .05). There was no significant difference between the trait anxiety scores of groups before and after the procedure ( p > .05). The postprocedure trait anxiety mean score of the intervention group decreased statistically significantly compared with the preprocedure mean score ( p < .05). The mean satisfaction score after the procedure was higher in the intervention group than in the control group ( p < .05). It was determined that video-assisted education decreased state and trait anxiety and increased satisfaction after the procedure.

Reducing Health Anxiety in Patients With Inflammatory Bowel Disease Using Video Testimonials: Pilot Assessment of a Video Intervention

BACKGROUND

Health anxiety has many damaging effects on patients with chronic illness. Physicians are often unable to alleviate concerns related to living with a disease that has an impact on daily life, and unregulated websites can overrepresent extreme anxiety-inducing outcomes. Educational clinician video interventions have shown some success as an acute anxiolytic in health settings. However, little research has evaluated if peer-based video interventions would be a feasible alternative or improvement.

OBJECTIVE

This pilot study assesses the efficacy of anxiety reduction for patients with Crohn disease (CD) and those with ulcerative colitis (UC) by showing patient testimonial videos during hospital visits. It investigates the degree to which patient testimonials can affect state anxiety, and whether patients are comfortable enough with the technology to share their stories.

METHODS

Patients with CD (n=51) and those with UC (n=49) were shown testimonial videos of patients with CD during their physician consultations at Kitasato University Kitasato Institute Hospital in Japan. The video testimonials were collected from Dipex Japan, the Japan branch of an international organization specializing in understanding patient experiences. Patients completed a Visual Analogue Scale for Anxiety before and after viewing the videos, a Hospital Anxiety and Depression Scale (HADS) survey before the videos, and satisfaction surveys. Patients receiving infusion therapy participated in the study while receiving treatment to minimize hospital workflow disruption.

RESULTS

Anxiety reduction, on the Visual Analog Scale for Anxiety, was significant in the entire cohort both when viewed as an ordinal variable (P=.003, t₉₈=1086.5) and as a continuous variable (P=.01, t₉₄=-2.54, 90% CI -3.47 to -0.72). Eighty percent (n=15) of patients with high HADS Anxiety (HADS-A) scores and 71% (n=24) of patients with high starting state anxiety experienced reduced anxiety after watching testimonials. Patients with high state anxiety but low HADS-A scores experienced anxiety reduction (69%, n=16). Forty-two percent (n=100) of patients responded that they would share their stories for future users. When patients with UC received testimonials from patients with CD, 71% (n=49) of patients reported that they were relevant despite differences in condition.

CONCLUSIONS

Our pilot results suggest that patient testimonial videos can reduce illness-related state anxiety for patients with CD and those with UC, especially in those with higher baseline state anxiety. The success of this study in reducing anxiety and achieving patient involvement suggests that video interventions for reducing anxiety might be a low-cost intervention that could scale to any number of hospitals, suggesting that technology can help scale up efforts to record and share patient testimonials. Future work can establish whether patient testimonials can be helpful in other contexts, such as before major surgeries or when a family member receives a difficult diagnosis.

A Randomized Controlled Trial to Assess the Efficacy of a Pre-operative Virtual Operation Theatre Tour on Anxiety and Patient Satisfaction in Adults Undergoing Elective Surgery

BACKGROUND

The study objective involves the evaluation of preoperative audiovisual information on the operation theater environment as a tool to relieve anxiety in patients posted for infra umbilical elective surgery under spinal anesthesia. Perioperative anxiety is detrimental to both intraoperative hemodynamic instability and postoperative recovery.

MATERIAL AND METHODS

 The design was a single-center, prospective, randomized control trial. There were 120 patients in this study within the 18-60-year-old age range who were American Society of Anaesthesiologists (ASA) class I-II admitted for infra-umbilical surgery excluding lower segment cesarean section (LSCS) under spinal anesthesia. Patients were randomized into two groups: those who were not exposed to an audiovisual tour (NA) (n = 60) and those who were exposed to an audiovisual tour (A) (n = 60). The measurements are based on the demographic details of the patient; the visual analogue score (VAS); and the Amsterdam Preoperative Anxiety and Information Scale (APAIS) for anxiety, hemodynamic parameters i.e., blood pressure (BP), heart rate (HR), respiratory rate (RR), and patient satisfaction score (PSS) on a five-point Likert scale were noted perioperatively for both the groups.

RESULTS

 The main results showed a significant (p-value <0.05) decrease in VAS and APAIS for anxiety, HR, and PSS. This was observed during the intraoperative and postoperative periods in the A group in comparison to the NA group.

CONCLUSION

The preoperative audiovisual virtual tour of the operation theater effectively reduces perioperative anxiety and stabilizes HR; it also improves the satisfaction of patients undergoing elective surgery under spinal anesthesia.

Effectiveness of the video medium to supplement preoperative patient education: A systematic review of the literature

BACKGROUND

The preoperative period is a critically important time point in that patients' information needs are high and must be met. Traditional methods of patient education, such as those in the form of pamphlets, may not be the most effective and have been shown to result in low patient comprehension. The aim of this systematic review is to explore the use of preoperative supplementary educational videos.

METHODS

A literature search using six databases was conducted. A total of 240 original research articles relating to preoperative educational videos were retrieved and screened for eligibility.

RESULTS

18 primary studies were identified and included in the review. Several outcomes were evaluated including knowledge, preparedness, and satisfaction, as well as psychological and physical wellbeing. Findings were varied, with many studies citing significant positive differences in these outcomes when patients viewed an educational video, while others report no differences.

CONCLUSION

Although findings are slightly mixed, the use of videos to supplement patient education has considerable potential in a preoperative setting. More research is needed to reach definitive conclusions.

PRACTICE IMPLICATIONS

We advocate for clinicians to challenge traditional methods of patient education and to consider exploring the possibility of integrating videos into routine preoperative education.

Non-pharmacologic Approaches in Preoperative Anxiety, a Comprehensive Review

During the pre-operation period, surgical candidates experience situations that stimulate psychological anxiety leading to stress during and after surgery which is known as preoperative anxiety. This condition can cause psychological and physiological adverse effects on both children and adults. Due to the high prevalence and adverse effects of preoperative anxiety, different treatments have been evaluated including pharmacological and non-pharmacological approaches. As pharmacological treatments may cause adverse effects such as breathing problems, drowsiness, interfering with anesthetic drugs, and prolonged recovery, non-pharmacological interventions are becoming more popular. These methods include cognitive-behavioral therapy, music therapy, pre-op preparation video, aromatherapy, hypnosis, guided imagery relaxation therapy, and massage. In this study, the most popular non-pharmacological approaches to preoperative anxiety are reviewed focusing on more recent evidence provided by clinical studies. The reviewed clinical evidence on the mentioned methods shows the efficacy of non-pharmacological interventions for the treatment of preoperative anxiety, so they can be used in patients of different ages and types of disease and surgery.

Satisfaction with preoperative education and surgical services among adults elective surgical patients at selected public hospitals in Addis Ababa, Ethiopia

Objectives:

The purpose of this study was to determine the level of satisfaction with preoperative education and surgical services among adult elective surgical patients at governmental hospitals in Addis Ababa, Ethiopia.

Methods:

Four hundred and twenty-two elective surgical patients at Addis Ababa’s governmental hospitals took part in a facility-based cross-sectional study from 8 October to 8 November 2021. Based on past experiments, an instrument for structured data collection was modified and employed. The data were cleaned and sent to Epidata version 4.2 before being exported and analysed in SPSS version 25. Descriptive statistics were used to describe the participant characteristics, and logistic regression, which also included bivariate and multivariate analysis, was used to evaluate the association between the independent and outcome variables. The level of statistical significance was indicated by a p value of 0.05.

Results:

84.6% of the participants reported feeling very satisfied with their preoperative education. Preoperative education about surgery (adjusted odds ratios (AOR) = 0.005; 95% confidence interval (CI): (0.000, 0.061)), previous surgery (AOR = 2.7; 95% CI: (2.51, 6.85)), and preoperative anxiety (AOR = 0.013; 95% CI: (0.003, 0.06)) were all significantly associated.

Conclusions:

About 84% of survey participants reported being satisfied with preoperative education and services. Preoperative patient satisfaction was negatively predicted by preoperative anxiety, prior surgery, and preoperative information about surgery. The decrease of anxiety and enhancement of surgical patient satisfaction may be significantly impacted by proper preoperative education.