Effect of Preoperative Multimedia Information on Perioperative Anxiety in Patients Undergoing Proced
Effect of Preoperative Multimedia Information on Perioperative Anxiety in Patients Undergoing Procedures Under Regional Anaesthesia
Background. Provision of preoperative information can alleviate patients' anxiety. However, the ideal method of delivering this information is unknown. Video information has been shown to reduce patients' anxiety, although little is known regarding the effect of preoperative multimedia information on anxiety in patients undergoing regional anaesthesia.
Methods. We randomized 110 patients undergoing upper or lower limb surgery under regional anaesthesia into the study and control groups. The study group watched a short film (created by the authors) depicting the patient's in-hospital journey including either a spinal anaesthetic or a brachial plexus block. Patients' anxiety was assessed before and after the film and 1 h before and within 8 h after their operation, using the Spielberger state trait anxiety inventory and a visual analogue scale.
Results. There was no difference in state and trait anxiety between the two groups at enrolment. Women had higher baseline state and trait anxiety than men (P=0.02). Patients in the control group experienced an increase in state anxiety immediately before surgery (P<0.001), and patients in the film group were less anxious before operation than those in the control group (P=0.04). After operation, there was a decrease in state anxiety from baseline in both groups, but patients in the film group were less anxious than the control group (P=0.005).
Conclusions. Preoperative multimedia information reduces the anxiety of patients undergoing surgery under regional anaesthesia. This type of information is easily delivered and can benefit many patients.
Many patients experience substantial anxiety before operation, and this is reported to affect 60–80% of surgical patients. Increased anxiety before surgery is associated with pathophysiological responses such as hypertension and dysrrhythmias and may cause patients to refuse planned surgery. Anxiety also increases the requirement of anaesthetic drugs to produce unconsciousness and therefore may indirectly increase the risk of awareness. Anxiety may also worsen patients' perception of pain and increase requirements for postoperative analgesia. Anxiety may decrease patients' overall satisfaction with perioperative care. Reducing preoperative anxiety may improve surgical outcome, shorten hospital stay, and minimize lifestyle disruption.
Provision of preoperative information can alleviate patients' anxiety. The ideal method of delivering this information is unknown. Written information has been used as an effective way for delivering information to patients, but not all patients are literate enough to read and understand an information sheet; in addition, patients will retain information to a variable extent. Multimedia information (in the form of a video) has been the subject of randomized controlled studies, and the value of this form of information in decreasing patients' anxiety before surgery has been demonstrated, although these effects were small and not supported by other studies. Conflicting results may have arisen because of differences in methodology, multimedia format, measurement tools, and variability in study populations. No study has addressed the patient population undergoing surgery under regional anaesthesia. Therefore, we developed a short film depicting the patient journey through hospital (including regional anaesthesia) and examined the effect of this film on patients' perioperative anxiety.
Abstract and Introduction
Abstract
Background. Provision of preoperative information can alleviate patients' anxiety. However, the ideal method of delivering this information is unknown. Video information has been shown to reduce patients' anxiety, although little is known regarding the effect of preoperative multimedia information on anxiety in patients undergoing regional anaesthesia.
Methods. We randomized 110 patients undergoing upper or lower limb surgery under regional anaesthesia into the study and control groups. The study group watched a short film (created by the authors) depicting the patient's in-hospital journey including either a spinal anaesthetic or a brachial plexus block. Patients' anxiety was assessed before and after the film and 1 h before and within 8 h after their operation, using the Spielberger state trait anxiety inventory and a visual analogue scale.
Results. There was no difference in state and trait anxiety between the two groups at enrolment. Women had higher baseline state and trait anxiety than men (P=0.02). Patients in the control group experienced an increase in state anxiety immediately before surgery (P<0.001), and patients in the film group were less anxious before operation than those in the control group (P=0.04). After operation, there was a decrease in state anxiety from baseline in both groups, but patients in the film group were less anxious than the control group (P=0.005).
Conclusions. Preoperative multimedia information reduces the anxiety of patients undergoing surgery under regional anaesthesia. This type of information is easily delivered and can benefit many patients.
Introduction
Many patients experience substantial anxiety before operation, and this is reported to affect 60–80% of surgical patients. Increased anxiety before surgery is associated with pathophysiological responses such as hypertension and dysrrhythmias and may cause patients to refuse planned surgery. Anxiety also increases the requirement of anaesthetic drugs to produce unconsciousness and therefore may indirectly increase the risk of awareness. Anxiety may also worsen patients' perception of pain and increase requirements for postoperative analgesia. Anxiety may decrease patients' overall satisfaction with perioperative care. Reducing preoperative anxiety may improve surgical outcome, shorten hospital stay, and minimize lifestyle disruption.
Provision of preoperative information can alleviate patients' anxiety. The ideal method of delivering this information is unknown. Written information has been used as an effective way for delivering information to patients, but not all patients are literate enough to read and understand an information sheet; in addition, patients will retain information to a variable extent. Multimedia information (in the form of a video) has been the subject of randomized controlled studies, and the value of this form of information in decreasing patients' anxiety before surgery has been demonstrated, although these effects were small and not supported by other studies. Conflicting results may have arisen because of differences in methodology, multimedia format, measurement tools, and variability in study populations. No study has addressed the patient population undergoing surgery under regional anaesthesia. Therefore, we developed a short film depicting the patient journey through hospital (including regional anaesthesia) and examined the effect of this film on patients' perioperative anxiety.
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