Anxiety Disorders Clinical Trial
Official title:
The Effect of Informational Videos on Preoperative Anxiety and Satisfaction Levels in Patients Undergoing Elective Ambulatory Surgery. A Case-control Clinical Trial
Preoperative anxiety is a common problem with an impact on surgical outcome, anaesthetic drug
dosage and patient's satisfaction. An important component of preoperative anxiety is due to
concerns related to anaesthesia. Appropriate patients information has been shown to reduce
preoperative anxiety level and this can be effectively achieved through a video. The aim of
this study is to assess the impact of an informative video about the anaesthesia technique on
patient's preoperative anxiety levels before minor ambulatory procedures.
The study design is a prospective, randomized, controlled clinical trial, where we use of
short patient educational video to reduce preoperative anxiety level, explaining all sequence
of major events between the arrival in the operating room and the performance of anaesthesia.
Anxiety is a common problem in patients undergoing invasive procedures, arriving in some
studies up to 60-80%. Perioperative anxiety is correlated with hemodynamic effects (such as
arterial hypertension and arrhythmias), it can have an impact on final surgical outcome, on
anaesthetics drug dosage, and also with an growth about the perception of post-operative
pain, leading to a substantial increase in analgesics dose and the number of post-operative
hospitalization days. Finally, perioperative anxiety can reduce the patient's overall
satisfaction with the quality of perioperative care.
Patients' satisfaction is largely based on their expectations and it forms part of the
surgeon's reward: satisfied patients are more likely to maintain a good relationship with the
surgeon, abstain from so called "doctor shopping", avoid malpractice litigations and
recommend their surgeon to others. Last but not least, satisfied patients are more likely to
comply with postoperative prescriptions and attend follow-up appointments. In non-life
threatening procedures however, the main source of preoperative anxiety is often the outlook
of anaesthesia rather than surgery itself, this being mainly related to a lack of enough
information about the anaesthetic procedure. These fears are largely underestimated in
routine minor procedures (such as ambulatory surgery) and thus risk to be not properly
addressed. Due to lack of time and resources, this could have a significant impact on global
patient satisfaction. Also if major complications (e.g. cardiac mortality) are
surgery-related, anxiety is also associated with poor surgical outcome. How to identify and
treat patients who will likely benefit from more information about anaesthesia is an
important question that remains relatively unaddressed. However, it's known that more
information about surgery reduces the level of anxiety and apprehension.
Some strategies have been developed to try to reduce pre-operative stress: deliver clinical
information has proven to be able to relieve patient anxiety. Written information has
recognised useful, but not all patients have shown the same degree of culture needed to read
and understand texts. The use of multimedia information (such as videos) has already been
studied and some trials have shown a certain anxiolytic effect, but data are conflicting. A
part of this disparity probably derives from differences in methodology and culture between
patients.
For these reasons the investigators developed a trial using a short educational video about
the global management of local anaesthesia on outpatient hand surgery. The aim of this study
is to assess the impact of this educational video about perioperative patient's anxiety
levels.
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