Amsterdam Preoperative Anxiety And Information Scale Research Articles

Kecemasan Preoperasi pada Pasien di Unit One Day Surgery(ODS)

ODS (One Day Surgery) service is an innovation in surgical treatment in recent decades and is claimed to have many advantages. However, increased use of anesthetic drugs, pain management during postoperative, increased length of recovery or hospitalization, increased risk of infection and increased costs are complications that can result from poorly managed preoperative anxiety. This study aimed to identify anxiety preoperative ODS patients in Dr. Hasan Sadikin Bandung. This research used quantitative descriptive design with sample of 60 patients recruited by purposive sampling technique. Data collection used Spielberger State-Trait Anxiety Inventory (STAI: Y-6) instrument and APAIS (Amsterdam Preoperative Anxiety And Information Scale) are valid and reliable. Data analysis used descriptive statistics. The results showed that all respondents experienced preoperative anxiety with mean 53,94 (SD ± 9,38). Based on the source of preoperative anxiety, the preoperative anxiety picture associated with the mean operating procedure 5.65 (SD ± 1.94), anxiety concerning the mean anesthesia procedure of 5.37 (SD ± 1.83) and the anxiety associated with the need to obtain the mean information of 7.43 (SD ± 1.98). It can be concluded that all preoperative patients in ODS experience preoperative anxiety in relation to the need for information. It is recommended that hospitals improved the quality of providing information to patients and families by involving interdisciplinary teams, thereby improved the overall quality of ODS services and improved patient and family satisfaction. Keywords: Anxiety, One Day Surgery (ODS), Preoperative.

Incidence and features of preoperative anxiety in patients undergoing elective non-cardiac surgery.

Due to its implications on postoperative outcomes and patient satisfaction, anxiety evaluation should be incorporated in the preoperative assessment of the patients. A series of consecutive patients undergoing elective surgery were included in the study. Preoperative anxiety was evaluated using the Hospital Anxiety and Depression Scale (HADS), the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the Visual Analogue (Face) Scale (VAFS). Qualitative and quantitative analyses were used to describe features of anxiety. 149 patients were included in the study, of whom 40.9% were scheduled for low, 47.7% for intermediate, and 11.4% for high-risk procedures. Based on HADS, 19 patients (12.6%) were positive for anxiety. VAFS revealed that 10.3% of patients experience medium/high intensity of anxiety. Patients were mostly concerned about the success (29.3%) and complications (11.4%) of the surgery APAIS score analysis revealed significantly higher anxiety (p < 0.01) and a need of information (p < 0.01) about surgery compared to anaesthesia. In contrast to age, education, or previous surgery, anxiety was associated with female sex (p < 0.01), surgical risk (p = 0.02), and subjective health evaluation (p < 0.01).Patients tended to choose a conversation with the doctor (45.6%) or a relative (44.8%) as a measure to relieve anxiety, and 18.4% would choose medication. Praying, music therapy, massage, or even sexual intercourse were among the measures suggested by patients. A significant part of patients experience anxiety before surgery, predominantly about the success of the surgery. According to the patients, conversation is the best option to reduce anxiety.

Effects of IDEAS visits model on anxiety in ear, nose and throat department patients before day surgery

Objective To explore the effects of IDEAS visits model on anxiety in ear, nose and throat (ENT) patients before day surgery. Methods Totally 200 ENT patients before day surgery were selected using convenient sampling from July 2017 to June 2018. 5 cases fell off before the end of study. Totally 97 patients admitted between July and December 2017 were finally included into the control group, while 98 patients admitted between January and June 2018 were finally included into the intervention group. Patients in the control group received conventional visits before surgery, whereas patients in the intervention group received visits according to IDEAS model. Blood pressure, pulse rate and Visual Analogue Score (VAS) on pain were compared between the two groups before and after intervention. Amsterdam Preoperative Anxiety and Information Scale (APAIS) was used to evaluate the patients' anxiety. Results There was no statistically significant difference in blood pressure and pulse rate between the two groups before intervention (P>0.05) ; blood pressure and pulse rate were lower in the intervention group than in the control group, and the VAS of the intervention group was lower than that of the control group after intervention (P 0.05) ; while the APAIS score of the intervention group was lower than that of the control group (P<0.05) . Conclusions IDEAS visits model can reduce the preoperative anxiety in ENT patients before day surgery. Key words: Anxiety; IDEAS model; Preoperative visits; Day surgery; Ear, Nose and Throat (ENT) Department

Measures of preoperative anxiety.

The evaluation of treatment from the patient's perspective (Patient Reported Outcomes, PROs) currently remains one of the most vibrant and dynamically developing fields of research. Among PROs, patient self-assessment of various symptoms, including one's psychological state, is of great importance. Anxiety is one of the most frequently observed psychological reactions among patients awaiting various surgeries, and may occur even in up to 80% of patients scheduled for high-risk surgical procedures. An increased level of preoperative anxiety has been proved to be related to negative consequences, both psychological and somatic, and affecting, in consequence, anaesthesia, postoperative care and treatment, along with the rehabilitation process. It is also considered as a risk factor for mortality in patients after surgeries. Planning of necessary educational, pharmacological and psychological interventions should be preceded by the evaluation of anxiety level which should be considered a routine element of preoperative care. The assessment of anxiety intensity may be performed using psychometric scales. Various factors should be taken into consideration while choosing the scale, including its reliability and accuracy, the aim of the assessment, the patient's age and clinical state, as well as the type of surgery being planned. In the current article, we present standardised and reliable methods which may be used in the evaluation of preoperative anxiety among patients scheduled for surgery, namely: the State-Trait Anxiety Inventory (STAI); the Hospital Anxiety and Depression Scale (HADS); the Amsterdam Preoperative Anxiety and Information Scale (APAIS); and the Visual Analogue Scale (VAS). A detailed description of the scales, including their main advantages and limitations, as well as their usefulness in both clinical evaluation of various patients' groups and scientific research are presented.

Validity and reliability of the Amsterdam Preoperative Anxiety and Information Scale in the Turkish population

Background/aim This study aimed to adapt the Amsterdam Preoperative Anxiety and Information Scale (APAIS) to measure the preoperative anxiety of adult Turkish patients undergoing surgery.Materials and methods The sample of this methodological study included 210 patients. Data were collected by using personal information forms, the APAIS, and the State Anxiety Scale (STAI). Cronbach’s α-coefficient was calculated, and test–retest reliability was tested. Results Cronbach’s α-coefficients of the APAIS anxiety and information requirement subscales were 0.897 and 0.786, respectively. The mean test and retest scores of the APAIS were not different. The test and retest scores of the patients were significantly, positively, and strongly related. The APAIS and STAI-I were correlated. Factorial analysis revealed that two factors accounted for 81.435% of the total variance with an eigenvalue of >1. These results showed that the Turkish version of the APAIS is a valid and reliable scale.Conclusion The Turkish translation of the APAIS is valid and can be reliably used to determine the preoperative anxiety experienced by patients who are undergoing elective surgery.

A survey of anesthetic preference and preoperative anxiety in hip and knee arthroplasty patients: the utility of the outpatient preoperative anesthesia appointment.

The general public's perceptions of anesthesia and the risks associated with it may be skewed. The outpatient preoperative appointment with an anesthesiologist allows for patient education regarding different anesthetic options and counseling regarding anxiety related to anesthesia and surgery. This study investigates whether the preoperative appointment for hip and knee arthroplasty alters patient preference for general or spinal anesthesia and reduces patient anxiety. Sixty-two patients undergoing hip or knee arthroplasty were administered two verbal questionnaires at the preoperative clinic. The first questionnaire was completed prior to meeting the anesthesiologist and addressed patient anesthetic preferences, previous anesthetic experiences, and perioperative anxiety and need for information using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The second questionnaire was completed immediately following the appointment and addressed the patient's anesthetic preference, reasons for any preference changes, and anxiety levels and need for information using the APAIS. The clinic anesthesiologist was blinded to the nature of the study. Following the clinic appointment, a significant decrease in patients wanting general anesthesia (from 48 to 18%, P < 0.001) and a significant increase in patients wanting spinal anesthesia (from 39 to 76%, 95%, P < 0.01) was noted. A significant decrease in overall anxiety and anxiety related to the patients' upcoming surgeries and need for information was also noted. The preoperative anesthesia meeting serves an important role in educating patients regarding anesthesia, and can influence patients' choice of anesthetic while also reducing overall patient anxiety.

Effect of preoperative education about spinal anesthesia on anxiety and postoperative pain in parturients undergoing elective cesarean section: A randomized controlled trial

Background: Preoperative anxiety is a common problem in all patients. The reason could be incomplete information regarding the anesthesia and surgical procedure. Cesarean section (CS) is a common surgery and treatment of postoperative pain after CS continues to be an ongoing challenge. Aim: The present study was carried out to assess if preoperative education with a handout about spinal anesthesia can reduce anxiety and postoperative pain in parturients undergoing CS under spinal anesthesia. Methods and Materials: We randomized 64 parturients into two equal groups; study (Group A) and control group (Group B). The study group was given a handout and a structured education about spinal anesthesia. The control group was given routine preoperative information. The Amsterdam preoperative anxiety and information scale (APAIS) was used to measure anxiety preoperatively and visual analogue scale (VAS) for pain at 5 h and 24 h postoperatively. Statistical Analysis: The two groups were compared using Student's t test and non-parametric Wilcoxon-Mann-Whitney U test. Result: The median difference in preoperative anxiety scores (APAIS) in the two groups was found to be 8.00 (P

Effects of an Internet-based informational video on preoperative anxiety in patients with colorectal cancer.

PurposeSurgery is the primary curative treatment for colorectal cancer; however, it remains a frightening procedure that can cause stress and pain in affected patients. Therefore, patients typically experience significant anxiety during the preoperative period, which has been associated with poorer outcome after surgery. This study aimed to evaluate the effect of an Internet-based informational video on preoperative anxiety level in patients with colorectal cancer.MethodsThis prospective, single-arm, observational study included patients scheduled to undergo elective colorectal cancer surgery, who did not have a history of previous surgery or major cognitive impairment. The primary outcome measure was the change in Amsterdam Preoperative Anxiety and Information Scale - Anxiety (APAIS-A) before and after watching a 5-min informational video (https://youtu.be/VzhtOMPUe4Q) during the preoperative period. Secondary outcome measures were the change in Hospital Anxiety and Depression Scale (HADS), length of postoperative hospital day, and postoperative morbidity.ResultsThirty-two patients were enrolled. Anxiety was significantly decreased after watching the video (APAIS-A score: from 10.8 ± 3.7 to 8.2 ± 3.2, P < 0.001, mean reduction: 22.2%). HADS score was also significantly decreased (from 5.8 ± 4.4 to 4.0 ± 3.3, P = 0.001, mean reduction: 26.5%). All preoperative anxiety level did not significantly differ between patients who developed postoperative complication and those who did not.ConclusionThe informational video was an effective tool to reduce preoperative anxiety. Viewing this video may confer a higher level of confidence and realistic expectations, as well as reducing patients' preoperative anxiety.

Evaluation of preoperative anxiety and fear of anesthesia using APAIS score

BackgroundPreoperative anxiety is one of the most important problems for the patients, because it causes emotional and psychiatric problems as well as physical problems. It is crucial to detect the patient’s existing anxiety to assist patients. Our primary aim in this study is to investigate how the patient’s age, gender, the operation, surgical briefing, type of anesthesia recommended for the operation ahead, and patient’s prior anesthesia experience affect the patient’s anxieties. Our secondary aim is to reveal the causes of the patient’s anxieties regarding anesthesia.MethodsOur study was conducted as a prospective cohort study between May 2016–2017. Interviews with the patients were performed in the anesthesia clinic for preoperative examination. For the study, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) has been used. The answers were evaluated in two scales: the anxiety score and the desire for information score. Answers to the statements were evaluated with Likert Scale. In addition, our patients were asked whether they had received prior anesthesia, if so, the type of anesthesia, whether they received surgical briefing and anesthetic method we recommended. We also asked our patients about the cause of their anxiety regarding the anesthesia.ResultsA total of 637 patients were recruited to the study, after excluding the patients who do not meet the criteria for inclusion, and 499 patients were included. Between the age and desire for information sub-scores, a negative significant correlation was detected (r: − 0.241; p = 0.001). We found that the scores of graduates of university and higher were statistically significant than the primary school graduates (p = 0.003) and secondary school graduates (p = 0.034). Anxiety sub-scores of the patients who underwent general anesthesia were found to be significantly higher than the patients who underwent regional anesthesia (p = 0.029). Anxiety sub-scores of females were found to be significantly higher than the males (p = 0.001).ConclusionsWe think that being aware of the patients’ anxiety and finding appropriate approaches for their anxieties can be valuable. APAIS is an effective method to measure patient anxiety and it might be beneficial to use during preoperative visits. Patient satisfaction and superior outcomes can be achieved in this way.Trial registration ISRCTN43960422. Registered 19/02/2018—Retrospectively registered. http://www.isrctn.com/ISRCTN43960422

Assessment of preoperative anxiety in neurosurgical patients: Comparison of widely used measures and recommendations for clinic and research

ObjectivePreoperative anxiety is frequent in neurosurgical patients and of high clinical relevance (e. g., associated with anestesiological requirements and surgery outcome). Little however is known about the quality of instruments for assessment of preoperative anxiety in this specific patient group and setting. This paper therefore focused on the psychometric properties of widely used questionnaires. Aim of this study was thus to enable both the clinician and the researcher to select appropriate instruments for assessment of surgery-related anxiety. Patients and MethodsThe following instruments for assessment of preoperative anxiety were administered in a pseudo-randomized order one day prior to surgery in sample of 158 neurosurgical patients: The State Trait Operation Anxiety Inventory (STOA) – state scale, the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the one-item visual analogue scale (VAS). The questionnaires were psychometrically tested according to classical test theory (validity, reliability, diagnostic accuracy). ResultsConstruct validity was supported in all applied measures (convergent and divergent validity, known-group comparisons). For the STOA state, we found a one factor scale structure and thus no support for the proposed subscales covering cognitive and affective anxiety. The proposed scale structure of the APAIS, measuring anxiety and information requirement, was replicated. Internal consistency as indicator for reliability of the STOA and the APAIS was excellent (Cronbach’s alpha = 0.937/0.868). All instruments showed adequate diagnostic accuracy with the most favourable results of the STOA. ConclusionsAll instruments included in this study can be recommended for assessment of surgery-related anxiety in neurosurgical patients with regard to their psychometric properties. Each instrument offers distinct advantages. Thus, clinicians and researchers can base their individual choice on specific aims and available resources.

Effect of Psychoneurobics (Meditation Technique) on Status of Anxiety in Patients Undergoing Cataract Surgery: A Randomized Controlled Trial

Introduction: Anxiety is a normal adaptive reaction to stress. Preoperative anxiety around cataract surgery affects a large proportion of patients, despite advances in technique and anesthesia administration. Thus, cancellation of cataract surgery due to anxiety is a challenge in the preoperative care of patients. Psychoneurobics is a meditation technique through complete involvement of mind, body and soul in which cosmic energy is inhaled through the power of mind and then transferred to the body’s neuro system. So the objective of the present study was to assess the effect of psychoneurobics on anxiety level of patients undergoing cataract surgery. Materials and Methods: A prospective randomized control study was carried out in a private eye hospital. One hundred patients undergoing cataract surgery were enrolled and randomized into two groups, namely, experimental group (receiving psychoneurobics and counseling both, n=50) and control group (receiving counseling only, n=50). Anxiety was measured using Amsterdam Preoperative Anxiety and Information Scale (APAIS) preoperatively before and after the psychoneurobics and counseling. Result: In the study, during first assessment, done before psychoneurobics/counseling, anxiety level of experimental group was found higher than the control group. However, in second assessment (after intervention), experiment group receiving psychoneurobics showed a higher decrease in anxiety (APAIS score) than control group. This finding was statistically significant (7.74±2.15 vs. 12.2±2.64, p<0.001). Conclusion: Psychoneurobics, the mind-body intervention, was found to be effective in reducing the anxiety of patients undergoing cataract surgery. Clinical Trial Registration: CTRI/2018/04/012999

Transcutaneous electrical acupoint stimulation alleviates the anxiety levels of IVF: A prospective, randomized and controlled study

IntroductionIt is recognized that all over the world, infertile women undergoing in vitro fertilization (IVF) experience high levels of stress, but most remain undiagnosed and untreated. This study explored whether transcutaneous electrical acupoint stimulation (TEAS) could relieve anxiety levels in infertile women. MethodsA total of 360 infertile women with tubal blockage were randomized into four groups: control group, TEAS–2 Hz group, TEAS–100 Hz group and TEAS-2/100 Hz group. After excluding patients who did not complete embryo transfer, 84, 84, 80 and 86 cases respectively remained in the above groups. Anxiety levels were measured using the Spielberger's State Trait Anxiety Inventory (STAI) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). ResultsWe found that 2/100 Hz TEAS treatment significantly decreased the levels of state anxiety and preoperative anxiety (P < 0.05). In addition, there were indications that a100 Hz TEAS treatment could decrease the scores of APAIS. ConclusionsTEAS using a frequency of 2/100 Hz could help to alleviate state anxiety and preoperative anxiety levels.The trial was registered at Chinese Clinical Trial Register (ChiCTR) with the identifier ChiCTR-TRC-14004493.

Psychological factors as predictors of early postoperative pain after open nephrectomy.

PurposeThere is an increasing interest in the identification of predictors for individual responses to analgesics and surgical pain. In this study, we aimed to determine psychological factors that might contribute to this response. We hence investigated patients undergoing a standardized surgical intervention (open nephrectomy).Patients and methodsBetween May 2014 and April 2015, we conducted a prospective observational cohort study. The following psychological tests were administered preoperatively: Mini-Mental State Examination, Amsterdam Preoperative Anxiety and Information Scale (APAIS), Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Pain Catastrophizing Scale. The primary outcome, postoperative pain intensity (11-point numerical rating scale, [NRS]), was assessed in the “immediate early” (first 8 hours), “early” (12 and 24 hours), and “late early” periods (48 and 72 hours).ResultsA total of 196 patients were assessed, and 150 were finally included in the study. NRS scores improved from 4.9 (95% confidence interval [CI]: 4.7–5.1) in the “immediate early” to 3.1 (95% CI: 2.9–3.3) in the “early” and 2.3 (95% CI: 2.1–2.5) in the “late early” postoperative period. Most (87%) patients received intravenous opioids, while 13% received analgesics epidurally. Repeated measures analysis of variance indicated better pain management with epidural analgesia in the first two postoperative periods (F=15.01, p<0.00). Postoperative pain correlated strongly with analgesic strategy and preoperative psychological assessment. Multiple linear regression analysis showed “expected pain” was the only predictor in the “immediate early” phase, and “anxiety” was most important in the “early” postoperative period. In the “late early” phase, catastrophizing was the predominant predictor, alongside “preoperative analgesic usage” and “APAIS anxiety”.ConclusionAfter open nephrectomy, epidural analgesia conveys a clear advantage for pain management only within the first 24 hours. Moreover, as the psychological phenotype of patients changes distinctively in the first 72 postoperative hours, psychological variables increasingly determine pain intensity, even surpassing employed analgesic strategy as its main predictor.

Using virtual reality to control preoperative anxiety in ambulatory surgery patients: A pilot study in maxillofacial and plastic surgery

IntroductionPreoperative anxiety may lead to medical and surgical complications, behavioral problems and emotional distress. The most common means of prevention are based on using medication and, more recently, hypnosis. The aim of our study was to determine whether a virtual reality (VR) program presenting natural scenes could be part of a new therapy to reduce patients’ preoperative anxiety. Materials and methodsOur prospective pilot study consisted of a single-blind trial in skin cancer surgery at the Henri-Mondor teaching hospital in France. In the outpatient surgery department, 20 patients with a score of >11 on the Amsterdam preoperative anxiety and information scale (APAIS) were virtually immersed into a natural universe for 5minutes. Their stress levels were assessed before and after this experience by making use of a visual analog scale (VAS), by measuring salivary cortisol levels, and by determining physiological stress based on heart coherence scores. ResultsThe VAS score was significantly reduced after the simulation (P<0.009) as was the level of salivary cortisol (P<0.04). Heart coherence scores remained unchanged (P=0.056). DiscussionVR allows patients to be immersed in a relaxing, peaceful environment. It represents a non-invasive way to reduce preoperative stress levels with no side effects and no need for additional medical or paramedical staff. Our results indicate that VR may provide an effective complementary technique to manage stress in surgery patients. Randomized trials are necessary to determine precise methods and benefits.

Validation of the Spanish version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS)

BackgroundPreoperative anxiety is a frequent and challenging problem with deleterious effects on the development of surgical procedures and postoperative outcomes. To prevent and treat preoperative anxiety effectively, the level of anxiety of patients needs to be assessed through valid and reliable measuring instruments. One such measurement tool is the Amsterdam Preoperative Anxiety and Information Scale (APAIS), of which a Spanish version has not been validated yet.ObjectiveTo perform a Spanish cultural adaptation and empirical validation of the APAIS for assessing preoperative anxiety in the Spanish population.MethodsA two-step forward/back translation of the APAIS scale was performed to ensure a reliable Spanish cultural adaptation. The final Spanish version of the APAIS questionnaire was administered to 529 patients between the ages of 18 to 70 undergoing elective surgery at hospitals of the Agencia Sanitaria Costa del Sol (Spain). Cronbach’s alpha, homogeneity index, intra-class correlation coefficient, and confirmatory factor analysis were calculated to assess internal consistency and criteria and construct validity.ResultsConfirmatory factor analysis showed that a one-factor model was better fitted than a two-factor model, with good fitting patterns (root mean square error of approximation: 0.05, normed-fit index: 0.99, goodness-of-fit statistic: 0.99). The questionnaire showed high internal consistency (Cronbach’s alpha: 0.84) and a good correlation with the Goldberg Anxiety Scale (CCI: 0.62 (95% CI: 0.55 to 0.68).ConclusionsThe Spanish version of the APAIS is a valid and reliable preoperative anxiety measurement tool and shows psychometric properties similar to those obtained by similar previous studies.

A STUDY OF THE EFFECTS OF COGNITIVE ADAPTATION TRAINING (CAT) ON THE PREOPERATIVE ANXIETY OF CANDIDATES FOR CHOLECYSTECTOMY

The patients who need surgery are prone to anxiety, and they should be able to adapt themselves to the surgery from the physical, mental and social aspects because there should be a balance between the physical-mental and social-cultural needs. So, the present study aimed to investigate the effects of cognitive adaptation training (CAT) on the preoperative anxiety of candidates for cholecystectomy. In the present quasi-experimental study, the statistical population comprised all patients who were hospitalized in the men and women’s surgical wards of Imam Reza Hospital, Kermanshah, Iran, to undergo cholecystectomy in 2016. To select the samples, the convenience sampling was employed (n=40). In accordance with the inclusion criteria, 40 patients were randomly divided into two groups of 20 patients: control group (preoperative individual counseling) and an experimental group (routine preoperative care). The Amsterdam Preoperative Anxiety and Information Scale (APAIS) was used. Data were analyzed through the SPSS Statistics Software Version 23.0 using the descriptive (mean and standard deviation) and inferential statistics such as analysis of covariance. Following the intervention, the mean of the total score of anxiety of the experimental group was less than that of the control group. Further, there was a significant difference between the means and standard deviations obtained in the posttest (p<0.001). The cognitive adaptation training (CAT)-based individual counseling proved efficacious in reducing the preoperative anxiety of patients. In this regard, this approach can be employed to lessen the preoperative anxiety of patients.

Italian validation of the Amsterdam Preoperative Anxiety and Information Scale.

Preoperative anxiety is usually experienced by patients awaiting surgical procedures and it can negatively impact patient's outcome. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a questionnaire created to identify anxious patients and their need for information: it has been translated and validated in many languages because of its reliability and ease of completion. To date, no Italian version of the APAIS has been produced; our aim was to translate and validate the APAIS in Italian. We produced an Italian version of the APAIS and we administered it to 110 patients undergoing elective surgery; we explored its structure by factor analysis and its reliability by Cronbach's alpha. We analyzed its external validity by confronting it to the Spielberg's State-Trait Anxiety Inventory (STAI). Sensitivity, specificity, and positive and negative predictive values of the Italian version of the APAIS were determined. The Italian version of the APAIS confirmed the original structure of the questionnaire and its internal consistency; it well correlated with the STAI-Y1, the subscale of the STAI which explore the anxiety "state." An APAIS score of 14 was found as best cutoff to distinguish anxious and non-anxious patients. The Italian translation of the APAIS showed psychometric properties similar to the original version. Its reliability and its efficiency make it a powerful tool even in Italian population to detect anxiety and need for information.

Validity and Reliability of the Czech Version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS)

The purpose of this study was to validate the Czech version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in adult patients undergoing elective surgery. A cross-sectional study. Data were collected from July 2012 to January 2013. For reliability and validity testing, two instruments measuring preoperative anxiety were administered to the participants on the same occasion, (APAIS and the Spielberg State Anxiety Inventory (STAI-S)). The sample consisted of 344 patients undergoing elective surgery. Reliability of APAIS anxiety subscale measured by Cronbach's alpha was 0.91. Reliability of APAIS information subscale measured by Cronbach's alpha was 0.78. The APAIS anxiety subscale correlated significantly with the STAI-S (0.69). Women scored significantly higher on anxiety scales than men. APAIS may be a useful tool to measure preoperative anxiety in Czech patients undergoing elective surgery.

Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy.

Aim:To compare the effects of propofol/remifentanil and meperidine/midazolam on postprocedure cognitive function.Materials and methods:A total of 100 American Society of Anesthesiologists (ASA) score I to III patients undergoing elective colonoscopy were taken into the study and divided into two groups. Exclusion criteria were patient refusal, mini mental test (MMT) <26, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) >10, advanced cardiopulmonary or psychiatric disease, chronic alcohol abuse, morbid obesity, and known allergy to study drugs. In group MM, 2 mg midazolam and 20 mg meperidine was given intravenously and additional 1 to 2 mg midazolam and 20 mg meperidine (with a maximum total of 5 mg midazolam and 50 mg meperidine) was given when bispectral index (BIS) was >80. In group RP, 100 μg/kg/minute propofol infusion and 1 μg/kg remifentanil bolus was administered and additional 0.5 μg/kg remifentanil bolus was given when BIS was >80. Observer’s Assessment of Alertness/Sedation scale (OAA/S) and Facial Pain Score (FPS) values were recorded. Cognitive function was measured by Trieger Dot Test (TDT) and Digit Symbol Substitution Test (DSST).Results:The study was concluded with 100 patients. Heart rate was slower and BIS values were lower in group RP throughout the procedure. Blood pressure was lower in group RP without clinical significance. There was no difference concerning recovery time and visual analog scores (VASs). In group MM, TDT scores were higher and DSST scores were lower. Satisfaction was higher in group RP.Conclusion:Propofol/remifentanil combination is better than meperidine/midazolam combination concerning cognitive function in sedation for colonoscopy.Clinical significance:The addition of BIS monitorization to evaluate the depth of sedation and the negative effects of midazolam meperidine combination on postprocedural cognitive function.How to cite this article: Ekmekci P, Erkan G, Yilmaz H, Kazbek BK, Koksoy UC, Doganay G, Tüzüner F. Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy. Euroasian J Hepato-Gastroenterol 2017;7(2):158-162.

The evaluation of anxiety before cataract surgery

Objective To analyse the changes in anxiety level and the information requirement of cataract patients at three different time points before surgery. Methods This was a prospective study. One hundred and thirty-nine adult patients scheduled for elective cataract operation were enrolled. Level of anxiety and the information requirement about surgery and/or anesthesia were assessed with the Amsterdam Preoperative Anxiety and Information Scale (APAIS) at three time points, including Ward(T1), preoperative holding area(T2) and operating room before the start of surgery(T3). Results The frequency of patients with highest preoperative anxiety peaked at the preoperative holding area. The median score of the need for information decreased from T1 to T2 and T3. While at all three time points, the mean anxiety scores for anesthesia were significantly higher than those for the surgical procedure (P< 0.001, respectively). In the ward, the patients' demand for information about their surgical procedure was significantly greater than that about the anesthesia (P< 0.05). The patient who desired more for the surgical information showed more anxious behaviors (P<0.001). Female patients had absolutely higher opportunity to develop high anxiety before the surgery (odds ratio 4.75, 95% confidence interval 1.12~13.78). Conclusion The frequencies of patients' anxiety vary at three preoperative time points. The factors that influence pre-operation anxiety are unchangeable. Providing surgery information is the only way to release anxiety. Key words: Cataract; Surgery; Anxiety; Scale