Vijay Subramanian|P Akkamahadevi
The efficacy of different methods of pre-operative counselling on perioperative anxiety in patients undergoing regional anaesthesia
JSS Medical College and Hospital|JSS Medical College and Hospital
introduction unfamiliar operating theatre makes surgery potentially unpleasant experience causing high levels anxiety patients1 prevalence anxiety preoperatively patients ranges 11 802 increased anxiety surgery associated pathophysiological responses hypertension dysrhythmias increased requirements postoperative analgesia may cause patients refuse planned surgery providing information anaesthesia patients feel reassured3 objective determine whether preoperative visit anaesthesiologist alleviates anxiety compared efficacy different methods preoperative counselling perioperative anxiety patients undergoing regional anaesthesia ra methods study conducted september 2011 march 2013 patients posted surgery ra ninety patients either sex included study clearance institutional ethical committee inclusion criteria patients posted elective surgical procedures ra minimum education level higher secondary aged 18 65 years good comprehension skills accepted american society anaesthesiologists asa physical status grade iii excluded patients previous experience anaesthesia surgery mentally retarded deaf mute blind patients patients posted emergency surgery patients explained regarding study assigned one three groupsgroup personal interview pi group b pi brochure regarding procedure group c pi video regarding procedure microsoft excel 2010 used generate random numbers patients allocated three groups according random numbers generated preanaesthetic evaluation pae performed 1 day surgery postgraduate student department anaesthesia patients asked fill proforma patients interviewed asked read brochure regarding anaesthetic procedure shown video anaesthetic procedure asked fill proforma pae following day h surgical procedure assessed procedure figure 1figure 1 overview study structure time points data collectionthe patients anxiety levels measured using visual analogue scale vas anxiety state trait anxiety inventorystate stais scale total score stais ranges 20 80 vasa ranges 0no anxiety 100highest possible anxiety level sample size calculated based reported incidence preoperative anxiety 324 10 absolute allowable error 5 8704 rounded 90 equally divided three groups 30 statistical analysis performed using descriptive statistics ttest pairedindependent samples repeated measure anova using statistical package social sciences spss version 16 spss inc released 2007 spss windows version 160 chicago spss inc statistical significance accepted p 005 results significant differences among three study groups regarding age gender type ra asa classification significant intergroup differences demographic data prevalence anxiety patients preoperatively study shown table 1 three groups showed significant decrease anxiety pae surgery surgery p 00001 decrease anxiety stai pae surgery surgery different three groups video group showed greater decrease anxiety levels overall p 00001 groupwise p 0045table 1 prevalence anxietythe decrease anxiety vasa pae surgery surgery comparable three groups overall p 00001 group wise p 0090 significant overall decrease anxiety levels surgery using stai vas p 00001 compared anxiety levels pae groups showed similar decrease anxiety comparable stai p 0080 vas p 0693 significant overall decrease anxiety levels surgery using stai vas p 00001 compared anxiety levels pae group c significant decrease anxiety compared two groups using stai p 0037 whereas using vas groups caused similar decrease anxiety comparable p 0057 discussion randomised controlled study found overall decrease anxiety levels three groups anxiety allayed maximum patients group c surgery using stai scale followed group b group table 2table 2 summary resultsnumerous investigators agree interview alone insufficient technique preanaesthetic visit567 alternative complementary methods brochure use video material might serve patients interests1 video could reduce problems informing patients low levels literacy ample research shown videoassisted patient education compared interview alone interview plus brochure results better patient satisfaction improved patient knowledge regarding anaesthesia procedures video group group c study according stai scale significant decrease anxiety levels postsurgery comparison two groups similar jlala et al8 stai gold standard scale superior detecting subtle changes anxiety2 vas may retain usefulness assessing patients reading comprehension difficulties situations extreme anxiety overall decrease anxiety levels groups comparable whole comparative trends indicated decrease anxiety order group c b though statistically significant stai vas anxiety may used measure preoperative anxiety limitations short three groups overall decrease anxiety levels using stai vasa scale video group significant decrease anxiety levels using stai scale postoperative period compared two groups playing crucial role allaying anxiety perioperatively conclusion personal interview brochure video good alleviating anxiety throughout perioperative period transfer knowledge information video appears effective decreasing anxiety apprehension helpful patients illiterate actively participate interview hence personal interview along video good option allaying anxiety financial support sponsorship nil conflicts interest conflicts interest