Alleviate Patient Anxiety Research Articles

Discussion of the Causes, Effect and Potential Methods of Alleviating Patient Anxiety When Undergoing Magnetic Resonance Imaging (MRI)

Background: In performing an MRI examination the patient may feel anxious due to the nature of the MRI scan as the patient would be inserted into the narrow bore of the MRI scanner and would be asked to be immobile during the examination period for approximately 20 to 90 minutes depending on the scan type. Patient feeling anxious may also be evoked by several causes and consequently may develop into anxiety reactions by the patient either before, during, or after the scan. Aim: This paper aim to study the issues surrounding the anxiety in patients undergoing MRI examinations by identifying the prominent causes, outlining the possible effects of anxiety, discussing the main potential methods for alleviating patient's anxiety. Materials and methods: This review is conducted by using a comprehensive search of PubMed, Google Scholar, and Elsevier, August 1993, through March 2018. The following search terms were used: causes of anxiety in MRI, claustrophobia and MRI, effects of anxiety in MRI, alleviation of anxiety in MRI patient. Conclusion: Patient's anxiety can pose problems that may impede the process of the MRI examination. Patient's anxiety may have adverse effects on both patient and the healthcare institution as it can cause financial losses for the healthcare institutions. However, sedation techniques, acoustic noise reduction, and adequate patient preparation for the MRI scan are possible methods that can alleviate patient's anxiety.

Prechemotherapy Education: Reducing Patient Anxiety Through Nurse-Led Teaching Sessions .

Patients with cancer experience stress surrounding diagnosis and treatment. Many cancer centers employ a nurse-led education session to alleviate patient anxiety and confusion. . The goal was to evaluate the effect of a nurse-led chemotherapy teaching session on patients' knowledge, anxiety, and preparedness for cancer-directed therapy. . After discussing treatment with their oncologist, participants completed a survey assessing their perceived understanding of various treatment topics. After, they underwent a teaching session with an oncology nurse. The survey was readministered when patients returned for their first and second treatment cycles. . Significant increases were observed in patients' understanding of their treatment schedule, potential adverse effects, and antiemetic medication regimen by the first cycle of therapy and a reduction in treatment-related anxiety by the second cycle of therapy.

Evaluation of the diagnostic efficacy and spectrum of autofluorescence of benign, dysplastic and malignant lesions of the oral cavity using VELscope

ObjectivesConventional oral examination and biopsy are the only reliable methods for the early detection of oral cancer at present. Autofluorescence examination of oral tissues using the VELscope has been suggested as an adjunctive tool for cancer detection and diagnosis. The aim of our study was to evaluate the efficacy of the VELscope in recognizing dysplastic and/or neoplastic changes in oral mucosal lesions that were identified on conventional oral examination. Materials and methodsTwo hundred patients with oral mucosal lesions were subjected to conventional oral examination followed by VELscope examination and their autofluorescence characteristics were compared with the histopathological diagnosis. The sensitivity, specificity, positive and negative predictive values of the VELscope examination was calculated. ResultsThe VELscope examination showed sensitivity and specificity values of 76% (95% CI: 54.87–90.64%) and 66.29% (95% CI: 58.76–73.24%) respectively while the positive and negative predictive values were 24.36% (95% CI: 19.22–30.36%) and 95.08% (95% CI: 90.52–97.51%) respectively. ConclusionThe VELscope examination alone cannot provide a definitive diagnosis as to the presence of dysplastic tissue change. In spite of having a reasonable sensitivity, the high number of false-positive results limits its efficiency as an adjunct. However, a high negative predictive value can serve to alleviate patient anxiety regarding suspicious mucosal lesions in a general practice setting.

Anxiety in patients undergoing cataract surgery: a pre- and postoperative comparison.

PurposeReducing surgery-related patient anxiety without under-emphasizing surgical risk is challenging for even the most experienced surgeon. The purpose of this study is to identify specific anxieties faced by patients in hopes of better informing the preoperative surgeon-patient dialogue.SettingComprehensive and specialty ophthalmology clinics at the University of California, San Francisco.DesignA prospective, survey-based study in which a pre- and postoperative questionnaire was administered to patients undergoing routine phacoemulsification. The surgeon was masked to patient enrollment and questionnaire responses.Materials and methodsA 36-item questionnaire on patient anxiety was developed from existing literature, building on the validated Surgical Fear Questionnaire. Patients were eligible if they were aged >18 years and willing to participate. Patients were excluded if having more than phacoemulsification alone or if unable to respond in English, and were retroactively excluded if there were complications during surgery. The primary outcome was self-reported anxiety on an 11-point Likert scale.ResultsSixty-one patients were included for analysis. Preoperatively, patients reported greatest anxiety around the operation itself and becoming blind. Reflecting postoperatively, patients reported the greatest anxiety for the operation itself. Statistically significant decreases were greatest for anxiety about the operation failing (p<0.001) and becoming blind (p<0.001). No decrease was observed for the operation itself (p=0.1).ConclusionMore effort must be made to specifically discuss the steps of the operation itself and the expected visual outcomes to alleviate patient anxiety. The authors hope these data can provide insight for surgeons into patient anxiety surrounding cataract surgery and help strengthen the patient–physician relationship.

Patient satisfaction with the role of a Clinical Specialist Radiation Therapist in palliative care

AbstractAimTo examine patient satisfaction with a Clinical Specialist Radiation Therapist (CSRT) in a palliative radiotherapy clinical environment.Materials and methodsA one-point dissemination design captured satisfaction scores from patients who did (n=19) and did not (n=14) receive palliative care from the CSRT. The ‘Patient Satisfaction Questionnaire’ included six common questions and four additional questions for patients seen by a CSRT. T-tests compared results from common questions and mean values, standard deviations were also calculated.ResultsFor questions ‘I was told everything that I want to know about my condition’ and ‘I felt that the problem that I came with was sorted out properly’, those who received care from the CSRT scored significantly (p&lt;0·05) higher than those that did not (p=0·033, 0·037). For CSRT-specific questions, 89% of participants felt the experience with the CSRT was excellent, 78% strongly agreed/agreed having a CSRT on the care team was important, and 89% of participants strongly agreed/agreed having a CSRT on the care team was important to patients’ understanding of treatment.FindingsPatients receiving care from the CSRT had better understanding of treatment and an excellent experience with the CSRT. This interaction provided more opportunities to address patient questions/concerns, thus alleviating patient anxiety, increasing satisfaction with care, and demonstrating how new roles can develop new models of care within the current healthcare system.

Role of flupirtine in reducing preoperative anxiety of patients undergoing craniotomy procedure.

Background:Kv7 neuronal channels are recognized as a potential drug target for anxiolytic effects. We hypothesize that flupirtine as a potassium channel opener would effectively reduce the preoperative anxiety of patients undergoing craniotomy procedure.Methods:In prospective-double-blinded fashion, 124 counseled patients were randomized to receive 5 sequential doses of capsule flupirtine 100 mg (F Group) or physically similar starch capsules (C Group), at 12 h intervals during preoperative hospitalization. Primary outcome included various aspects of patient anxiety measured by visual analog scale (VAS) just before preoperative counseling and 2 h after the completion of drug regimen under trial. Statistical tool included Mann–Whitney U-test and Wilcoxon signed rank test.Results:Baseline VAS scores were higher for fear of surgical harm, being at the mercy of medical staff, and not awakening after surgery. A significant decline in VAS scores was observed after the completion of drug regime, but to a higher extent in flupirtine-treated patients; it achieved statistical significance in comparison to Group C. No side effects were observed in any patient.Conclusion:Flupirtine is a useful premedication in conjunction with behavioral therapy to alleviate patient anxiety during the preoperative period.

Contrast-enhanced ultrasound: Extended role outside 'regulations'.

Contrast-enhanced ultrasound (CEUS) has come a long way from the early pioneering days of ‘Doppler rescue’, interpreting the increased signal from vascular structures within potentially malignant tumours in the liver and the breast, and the improvement in the enhancement of large vessels. Early agents have fallen by the wayside, with newer agents allowing for lengthier imaging, using techniques that preserve the integrity of the microbubbles, and with improvement in separation of the acoustics of normal tissue and the microbubbles. The safety of microbubble contrast agents in the liver is undoubted, with adverse reactions seen less commonly than contrast agents used in other imaging modalities, further allowing for the safe progression into imaging other body structures. The true intra-vascular nature of the microbubble contrast is unique, potentially giving much better information in perfusion studies. The early indications for the use of CEUS, bound by the licensing constraints, were in the breast, liver, heart and peripheral vasculature. The legality of using the agents outside the licensing constraints is established and accepted, which has allowed clinicians to move into many other areas of the body, utilising the undoubted improvements microbubble contrast brings to the ultrasound (US) examination. CEUS is continuously being added to clinical practice in many areas by imaging pioneers, allowing the establishment of CEUS in many new areas. The addition of CEUS to the kidneys, pancreas, testis, aorta, spleen and salivary glands US examination improves the interpretation of findings, potentially reducing downstream imaging costs and alleviating patient anxiety. The singe area where non-licensed use of CEUS has been the most beneficial is in the assessment of the kidney. From the confirmation of normality, assessment of the simple and complex cyst to the establishment of intra-lesion vascularity in malignancy, CEUS has been unsurpassed for useful additional information to alter management. The kidney is likely to become the organ where CEUS is most frequently used, perhaps second to the liver in radiological practice. The use of percutaneous techniques to treat aneurysmal dilatation of the aorta, stent grafts in endovascular aortic repair (EVAR) results in life-long surveillance of complications, traditionally provided by computed tomography (CT). The use of CEUS has the potential to reduce the number of surveillance CT performed, with the additional benefit of alleviating the need for nephrotoxic contrast agents. Microbubble contrast agents are unique in two aspects: they are truly intravascular agents and any microbubbles in the aneurysmal sac indicate an endoleak, and they are not nephrotoxic, with no necessity to monitor renal function. The application in venous disease would also open opportunities for more accurate imaging. The usefulness of microbubble contrast agents in small parts is less clear; the interaction of the microbubbles with the transducer frequency is complex with the higher frequencies used in small parts imaging necessitating higher concentrations of microbubbles at the optimal size. Often, the use of CEUS in small parts is a component of the entire gamut of US: B-mode, colour and spectral Doppler, tissue elastography and CEUS, termed multiparametric US. This special issue contains articles that illustrate all the aspects of CEUS described above, allowing the establishment of the usefulness of this technique in clinical practice, increasing the knowledge pool that will eventually allow this technique to be fully accepted as an ideal and robust imaging tool. Most importantly, CEUS adds another layer of safety to the already safe US examination. This is surely also the tool for imaging in paediatrics – this may be just over the horizon.

Changes in First Postoperative Night Bispectral Index After Daytime Sedation Induced by Dexmedetomidine or Midazolam Under Regional Anesthesia: A Randomized Controlled Trial

Background and ObjectivesSupplementation of spinal anesthesia with various sedatives is a standard protocol to alleviate patient anxiety associated with the surgical procedure. We hypothesized that, compared with dexmedetomidine, midazolam might...

Cognitive behavior therapy treated preoperative anxiety and depression for patients with aneurysm clipping

Objective To investigate the effects of cognitive behavior therapy on anxiety and depression for patients with aneurysm clipping. Methods A total of 80 patients with aneurysm clipping were chosen and averagely divided into intervention group with cognitive behavior therapy based on control group and control group taking routine nursing and health education by random number table. The mean arterial blood pressure (MAP) and heart rate(HR)were compared and documented the level of anxiety and depression by SAS and SDS. Results Compared with the control group, after the interventions the SAS [(52.12±3.46)] and SDS [(31.25±2.82)] score were dramatically decreased in the intervention group (t=2.98, 3.14; P<0.05); and the MAP [(88.5±2.8)mmHg] and HR [(87.5±3.7)beats/min] in the intervention group were better than these of the control group as well (t=3.74, 3.23; P<0.05). Conclusions Cognitive behavior therapy can reduce the intensity of stress reaction and alleviate anxiety and depression emotions in the patients with aneurysm clipping. Key words: Cognitive behavior therapy; Aneurysm; Anxiety; Depression

Effect of comprehensive care interventions on patients with liver cirrhosis upper gastrointestinal bleeding

Objective To explore effect of integrated care interventions on patients with upper gastrointestinal bleeding of liver cirrhosis. Methods From March 2013 to January 2014, 80 cases of upper gastrointestinal bleeding resulted from liver cirrhosis were selected as research objects. According to the random number table, patients were divided into two groups, 40 patients were treated with routine care in control group, and 40 patients were treated with comprehensive nursing intervention in observation group. Care outcomes were compared between the two groups. Results After care, hospital stay of patients in observation group, rebleeding and bleeding time were(17.51±2.36) d, 0,(32.01±5.74)h, which were significantly better than those of control group, there were significant differences between the two groups(P< 0.05).SDS scores and SAS scores in observation group were significantly improved than those of control group, there were statistically significant differences between the two groups(P<0.05) . Conclusions Integrated care interventions for cirrhosis upper gastrointestinal bleeding has a very significant effect, which not only could effectively alleviate depression and anxiety in patients, keeping patients feel relaxed, but also could effectively reduce hospitalization time and reduce the rate of rebreeding, greatly improve the quality of life of patients, is worthy of clinical application. Key words: Comprehensive nursing intervention; Cirrhosis; Upper gastrointestinal hemorrhage

Patient Satisfaction with the Role of a Clinical Specialist Radiation Therapist in Palliative Care

Aim To examine patient satisfaction with a Clinical Specialist Radiation Therapist (CSRT) in a palliative radiotherapy clinical environment. Materials and methods A one-point dissemination design captured satisfaction scores from patients who did (n=19) and did not (n=14) receive palliative care from the CSRT. The ‘Patient Satisfaction Questionnaire’ included six common questions and four additional questions for patients seen by a CSRT. T-tests compared results from common questions and mean values, standard deviations were also calculated. Results For questions ‘I was told everything that I want to know about my condition’ and ‘I felt that the problem that I came with was sorted out properly’, those who received care from the CSRT scored significantly (p<0·05) higher than those that did not (p=0·033, 0·037). For CSRT-specific questions, 89% of participants felt the experience with the CSRT was excellent, 78% strongly agreed/agreed having a CSRT on the care team was important, and 89% of participants strongly agreed/agreed having a CSRT on the care team was important to patients’ understanding of treatment. Findings Patients receiving care from the CSRT had better understanding of treatment and an excellent experience with the CSRT. This interaction provided more opportunities to address patient questions/concerns, thus alleviating patient anxiety, increasing satisfaction with care, and demonstrating how new roles can develop new models of care within the current healthcare system.

Effect of point massage to prevent stress response in patients after lower abdominal surgery

Objective To discuss the effect of point massage to prevent stress response in patients after lower abdominal surgery. Methods Totals of 90 patients after lower abdominal surgery were chosen and randomly divided into the intervention group and the control group, each with 45 cases. The control group only received conventional nursing while the intervention group received point massage in addition. SAS was used to evaluate their anxiety one day before surgery and after surgery, and physiological stress response in both groups was compared. Results The score of SAS after surgery was （39.08 ± 3.5）, SBP was （ 120. 1 ± 7.2） mm Hg, DBP was （85.8±2.8） mmHg, HR was （75.0 ±5.0） times/min in the intervention group, all lower than （46.24 ± 3.35）,（124.2±6.5） mm Hg, （86.9±4.1）mm Hg and （84.0 ± 3.0） times/min in the control group, and the differences were statistically significant （t =2. 084,2. 835,1. 486,10. 357,repectively;P 〈0. 05）. Conclusions Point massage can alleviate anxiety of patients after lower abdominal surgery and stabilize their blood pressure and heart rate, so as to reduce their operation stress reaction. Key words: Stress ; Anxiety; Blood pressure ; Heart rate ; Point massage ; Lower abdominal surgery

Effects of high quality nursing care in the perioperative period of neurointerventional surgery

Objective To investigate the effects of high quality nursing care in the perioperative period of neurointerventional treatment.Methods 86 patients who needed neurointerventional surgery were randomly assigned to receive high quality care ( quality care group ) or routine care ( conventional care group ).The anxiety scores and satisfaction rate for nursing service were compared between the two groups,so was the incidence rate of postoperative complications.Results The anxiety scores,satisfaction rate,and incidence rate of postoperative complications were ( 1.4 ± 1.1 ),95.3％,and 2.3％ in the quality care group,while were ( 3.1 ± 1.8 ),83.7 ％,and 7.0 ％ in the conventional care group.The anxiety score and the incidence of complications was significantly lower in the quality care group than in the conventional care group ( P ＜ 0.05 ),while the satisfaction rate was significantly higher ( P ＜ 0.05 ).Conclusions High quality nursing care in the perioperative period of neurointerventional surgery can alleviate patient anxiety,lower the incidence of postoperative complications,and improve patient satisfaction.It is worth popularizing clinically. Key words: High quality nursing care; Neurointerventional surgery; Perioperative period

Sedating the Apprehensive Debilitated Patients for Dental Procedures by Combining Parenteral Sedation and Hypnosis with Supplemental Acupuncture Therapy

Treating apprehensive debilitated patients (i.e. geriatric patients, patients with cardiac, pulmonary, kidney, or liver diseases, and those with other severe systemic conditions) for dental procedures can cause unexpected medical complications such as cardiac arrest, stroke, asthma or shock, etc. Due to diminishing functional capacities of their organs, sedating those patients with sedative drugs in normal regular dosage could increase the risk of adverse events for this group of patients and can also increase the risk of liability for the clinician. The authors treated 34 apprehensive dental patients with a combination technique using parenteral sedation and hypnosis together with acupuncture. We used Bi-Digital O-Ring Test (BDORT) to select the compatible sedative drugs and to individualize the dosage suitable to the patient's medical condition. Oftentimes, BDORT predetermined dosage amounts to a fraction of regular dosage that is normally recommended by manufacturer for regular healthy patients. Such a reduced dosage, though benign to patient, may be insufficient to render a patient to the sedation level for dental treatment. Nevertheless, hypnosis with acupuncture can be applied to potentiate the therapeutic effect of parenteral sedation, thereby reducing the amount of sedative agents required to alleviate patient anxiety. The results indicated that hypnosis with acupuncture and BDORT could effectively allow the reduction of the sedative dosage and may beneficially provide a safe and comfortable situation for the debilitated patients to receive the necessary treatment.

Early human papillomavirus testing predicts residual/recurrent disease after LEEP

ObjectiveThe purpose of this study was to determine the predictive factors for residual/recurrent disease and to analyze the timing for Pap smears and human papillomavirus (HPV) testing during follow-up after loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 2 or worse.MethodsWe retrospectively analyzed 183 patients (mean age, 39.3 years) with CIN 2/3 who were treated with LEEP. Post-LEEP follow-up was performed by Pap smear and HPV hybrid capture2 (HC2) testing. The definition of persistent/recurrent disease was biopsy-proven CIN 2 or worse.ResultsAmong 183 patients, punch biopsies were CIN 2 in 31 (16.9%) and CIN 3 in 152 (83.1%). HPV HC2 tests before LEEP were positive in 170 (95.5%) of 178 patients. During follow-up, 12 patients (6.6%) had residual/recurrent CIN 2+. LEEP margin status was a significant predictive factor for persistent/recurrent disease. Other factors such as age, HPV HC2 viral load (≥100 relative light units), and HPV typing (type 16/18 vs. other types) did not predict recurrence. Early HPV HC2 testing at 3 months after LEEP detected all cases of residual/recurrent disease. The sensitivity and negative predictive value of the HPV HC2 test for residual/recurrent disease were both 100% at 3 and 6 months.ConclusionMargin involvement in conization specimens was a significant factor predicting residual/recurrent disease after LEEP. HPV test results at 3 and 6 months after treatment were comparable. Early 3-month follow-up testing after LEEP can offer timely information about residual/recurrent disease and alleviate patient anxiety early about treatment failure.

Timeliness of Care

The treatment of patients with colon and rectal cancer frequently involves multiple disciplines of medicine, including surgery, radiation, and chemotherapy. Timely treatment is widely accepted as a cornerstone of quality of care, with the goal of arresting progression of disease and alleviating patient anxiety. Existing research, however, has had difficulties with characterizing the relationship between delays in treatment and short- or long-term outcomes. In this review we examine reasons for this and propose that, despite these difficulties, timely treatment is an appropriate target for efforts in quality assessment and quality improvement.

Evaluation of a training programme to teach a guided self-help psychological intervention to hospice staff

A recent trial demonstrated that a brief guided self-help intervention reduces anxiety in palliative patients. This study investigated whether training palliative nurses to deliver a guided self-help intervention would improve their routine management of psychological distress. A randomized controlled cluster trial compared a team of nurses who attended training (n=5) with a team allocated to a no-training control condition (n=5) on self-reported behaviour and confidence in addressing psychological distress. Ratings of patient psychological distress at routine clinical assessments were also examined pre- and post-training to assess the impact of training on patient distress. As predicted, patients cared for by the trained team demonstrated a significantly greater reduction in distress post-training than patients cared for by the untrained team. However, there was no significant difference in self-reported behaviour and confidence. These findings suggest that brief workshop-based training improves clinical outcomes on psychological distress and may be a means to increase the accessibility of effective psychological interventions in palliative care.

The follow-up of patients with head and neck cancer: an analysis of 1,039 patients

In all cancer specialities, there has been much debate about the best follow-up regime. The provision of a service that meets high standards whilst being cost-effective is increasingly pertinent. The objectives of the study were to examine: whether routine follow-up facilitates early diagnosis and recurrence; whether there is a cohort of patients who require a more intensive follow-up regime; whether follow-up should be customised to individual patients. A total of 1,039 consecutive outpatient consultations were prospectively analysed in a multicentre study. All adult patients who had undergone multidisciplinary, multimodality management for head and neck cancer were included. The case mix was representative of all head and neck tumour sites and stages. Suspicion of recurrence was noted in 10% (n = 96/951) of patients seen routinely. This rose to 68% (n = 60/88) for the subset of patients who had requested an appointment. Most recurrences were found within the first follow-up year (n = 64/156, 54%). Only 0.3% (n = 3/1,039) of asymptomatic patients attending routine appointments were suspected of having a recurrence, and two (0.2%) were found to have an actual recurrence following investigation. Of the total number of patients reporting a new suspicious symptom, recurrence was suspected in 56% (n = 152/270). Patients thus had a 98.1% sensitivity to raising suspicion for a recurrence based on the reporting of new symptoms with a 99.6% negative predictive value. Our data show that the efficiency of the current follow-up regime at detecting suspected recurrence of head and neck cancer is low, suggesting the need for a customised, more focused follow-up regime, tailored to individual cases. Patient education and close relationships with clinicians and allied health-care professionals are essential for early diagnosis and management of cancer recurrence. Follow-up regimes within the first year should be most intensive as recurrence is most likely within this time, and it serves to alleviate patient anxiety in the early post-treatment period. More research needs to be carried out to investigate the role of patient self-reporting and surveillance of cancer recurrence.

Scrotal Edema Associated with the Use of Dasatinib in Patients with Chronic Myeloid Leukemia

Dasatinib is a new tyrosine kinase inhibitor which is approved by the FDA for the treatment of patients with chronic myeloid leukemia (CML) resistant or intolerant to imatinib. Dasatinib can cause fluid retention in some patients, leading to peripheral edema and pleural effusion. Herein, we report 2 patients with chronic phase CML who developed significant scrotal and penile edema while on treatment with dasatinib. In both patients, transient dasatinib interruption and use of diuretics helped alleviate the symptoms. Both patients had the dose schedule of dasatinib switched to once daily from twice daily. Scrotal and penile edemas are unusual manifestations of fluid retention that, to our knowledge, have not been reported in patients treated with dasatinib. Recognition of these symptoms as a potential complication of dasatinib will help prevent unnecessary investigations, facilitate adequate management, and help alleviate patient anxiety.

A Multimedia Tool for the Informed Consent of Patients prior to Gastric Banding

Severe obesity is a clear indication for appropriate, effective weight loss therapy. One option is operative intervention, e.g., gastric banding. Risks of the operation and therapeutic alternatives need to be comprehensibly presented to the patient. The literature has shown that better informed consent is obtained using information presented in a multimedia/video-based format. The current study developed and evaluated a multimedia program aimed at obtaining informed consent from obese patients before gastric banding. An interactive multimedia program was developed with information about preoperative examinations, the operation itself, hospital stay, operative risks, alternative therapies, and the pathophysiology and health risks of obesity. Two groups (Group 1, n = 20, mean age 38 years, informed consent attained with conventional document information; Group 2, n = 20, mean age 37 years, informed consent attained with additional multimedia information) were interviewed regarding comprehensibility of the information presented, personal satisfaction, and anxiety levels during the informed consent process. Group 2 showed significantly better (p < 0.05) understanding of the presented information and higher levels of satisfaction with the informed consent process. Anxiety levels did not significantly differ between the two groups. Because patient satisfaction with the informed consent process and understanding of the presented information significantly improved, the multimedia program clearly benefits both surgeons and patients. Personal contact from the surgeon remains essential. High volumes of information presented in multimedia format do not alleviate patient anxiety, and personal contact may be beneficial.