Anxiety In Family Members Research Articles

Quality of life in atrial fibrillation patients and its relationship to family member anxiety and depression

Abstract Background Atrial fibrillation (AF) has been found to decrease quality of life (QOL), and a few studies suggest that family members of AF patients can also experience negative emotions. This study aims to assess the anxiety and depression of the immediate family members of AF patients and to investigate the influence of the QOL of the AF patients on this anxiety and depression. Method This cross-sectional study recruited 121 pairs of AF patients and their immediate relatives along with 121 controls who and whose immediate relatives did not have AF. The patients filled out the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire, and the relatives and the controls were required to complete the State-Trait Anxiety Inventory (ST-AI) and Self-Rating Depression Scale (SDS). Results The score (mean (SD)) of the State Anxiety Inventory (S-AI, a subscale of ST-AI) in the relatives’ group was 44.9 (10.6), which was significantly higher than that of the control group (38.5 (9.5), p < 0.001). Among the different kinship subgroups, the children of the AF patients had the highest state anxiety score (mean value = 47.0, p=0.075). A negative linear relationship between the patients' overall AFEQT score and the relatives' S-AI score was found (standardized regression coefficient = -0.244, p < 0.001). For those patients who had particularly low AFEQT scores of less than 40, their relatives’ S-AI scores were significantly higher than other members of the relatives’ group (52.1 vs. 42.9, p = 0.001). AF patients in the peri-ablation period (81, 66.9%) had no difference in their AFEQT scores compared to other patients (60.8 vs. 64.4, p= 0.316) and there was also no difference in their family members’ ST-AI or SDS scores. Conclusion Study members showed considerable state anxiety if their family members had AF and increases in this anxiety were positively correlated with decreases in the HRQOL of the AF patients.

Factors Related to Transfer Anxiety in Family Members of Critically Ill Patients

Factors Related to Transfer Anxiety in Family Members of Critically Ill Patients

Prevalence and severity of anxiety symptoms among family members of nyaope users in Tshwane, South Africa.

Nyaope is a strongly addictive novel psychoactive substance that is commonly used in predominantly black townships in South Africa. The undesired behaviours of the users result in family members developing mental health challenges. Nyaope users often commit petty crimes, including stealing from families and neighbours. The aim of this study was to quantify anxiety symptoms among family members of nyaope users in Tshwane, South Africa. Data were collected from nine townships within Tshwane Metropolitan Municipality. The quantitative cross-sectional survey used the General Anxiety Disorder (GAD-7) tool to quantify anxiety symptoms, and a questionnaire was used to collect sociodemographic data from a sample of 390 participants. The ages of the participants ranged from 18 years to 87 years, with a mean of 47 years. The mothers to the nyaope users were the biggest group at 35% (n = 138). The prevalence of anxiety symptoms was 73% (n = 286) of the total sample and ranged from mild (41.8, n = 163), moderate (14.62, n = 57) and severe (16.92%, n = 66). The Pearson chi-square test identified significant associations between anxiety symptoms and the gender of the participant (p = 0.001), the age of the nyaope user and the period of nyaope use (p = 0.008). Multivariate regression model indicated gender and place of residence as a significant variable in the development of anxiety symptoms (p = 0.01). Nyaope use is a risk factor for the development of anxiety for family members of nyaope users with the highest proportion reporting mild symptoms. There is a need to develop interventions for mental health support for families of nyaope users.

Social Connectedness Between Family Caregivers and Older Adults Living in Long-Term Care Homes in the Context of COVID-19.

The coronavirus disease (COVID-19) pandemic and resulting restrictions on physical access to long-term care homes culminated in health declines for older adults living there and their families. Knowledge gaps exist regarding maintaining social connectedness when physically separated. The study aimed to explore family members' perceptions of the impact that restrictions on physical access to long-term care homes had on the experience of social connectedness between family members and older adults living in long-term care. The method used was a qualitative description, using in-depth semi-structured interviews. Themes arising from inductive qualitative content analysis of 21 interviews with family members included: (a) lack of connection threatening mental, emotional health, and physical health; (b) navigating trust in the unknown; (c) feelings of stress and anxiety for family members; and (d) technology - an asset, but not for everyone. Study findings suggest more emphasis should be placed on supporting social connections between older adults and their families in the context of long-term care beyond COVID-19.

Cost-benefit analysis of migration in the context of environmental change in Ben Tre Province of Viet Nam

Changes in the natural environment and the socio-economic environment have had both direct and indirect impacts on agricultural production and farmer’s life in three coastal districts of Ben Tre Province of Viet Nam, including Binh Dai, Ba Tri, and Thanh Phu. Natural environment changes are drought, saline intrusion, and landslides while the socio-economic environment changes consist of agricultural market fluctuation, rising labor and agricultural input price, decreasing output price, diseases, etc. One of the solutions that households take to cope with these changes is migration. In this article, the authors examine factors that affected households’ migrating decisions and behaviors using cost-benefit approach. Two research methods used in this study are social surveys and in-depth interviews. The survey was conducted with 79 households that have migrants in 3 coastal districts. The research suggests that migrants themselves made the migration decision in most cases (85%). Three main reasons for migration among farmers in the area have been identified as (1) solving the immediate difficulties of the household, (2) being part of the family’s long-term plan, and (3) being the family’s livelihood strategy in the short term (solving difficulties) and long-term (transforming livelihoods). The costs that migrants and their families can face are direct costs (packing, travel costs, rental housing, etc.) and indirect costs (change in living environment and social relations, anxiety of family members, and social evils at the destination, etc.). The benefits of migration can be immediate benefits (economic and non-economic) as well as long-term effects that have a great impact on household life and the migrants themselves. The research finds that migration provided more benefits related to the living conditions of households. It also points out that migration has become a feasible long-term adaptation strategy for farmers, those who stayed behind, in the context of environmental change.

Impact of individual factors and personality trait on psychological problems of family members living with staff of a COVID-19 frontline hospital: A cross-sectional self-administered anonymous questionnaire survey.

This study aims to evaluate the association between individual factors/personality traits and depression and anxiety in family members living with staff working on the frontline of COVID-19 care. The subjects were family members over the age of 15 years living with staff members of a COVID-19 frontline hospital. Between March 27 and April 11, 2021, 204 self-administered anonymous questionnaires were distributed, and 149 responses were received. Symptoms of depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). Personality trait was assessed using the Big Five personality traits, and fear of COVID-19 was assessed using the Fear of COVID-19 Scale. We examined associations between HADS depression or anxiety scores with individual background factors, scores of Big Five personality traits, and Fear of COVID-19 Scale. The participants with anxiety had significantly higher scores for neuroticism and for the Fear of COVID-19 Scale. The participants with depression had significantly lower scores for extraversion and higher scores for the Fear of COVID-19 Scale. No individual background factors were significantly associated with HADS depression or anxiety scores. Among family members of staff of a COVID-19 frontline hospital, lower extraversion, higher neuroticism, and fear of COVID-19 were associated with anxiety and depression. This questionnaire survey was conducted before wide-spread rollout of COVID-19 vaccination, so the findings of this study are expected to be applicable to other future novel infectious outbreaks.

Mediating Role of Rumination Between Anger and Anxious-Depressive Symptomatology in Family Members of People with Gambling Disorder

Gambling disorder is characterized by a behavioural pattern of dysfunctional gambling that persists despite its negative implications in different areas of people’s daily life. One of the most negatively affected areas is the one related to family members. This study aimed, firstly, to study the differences between family members of people with gambling disorder and a general population sample in anger (state, trait, expression-out, expression-in. control-out and control-in), rumination (brooding, reflection and total), and anxiety and depression. The second aim was to analyse the correlation between these variables in the family members of people with gambling disorder, and thirdly, to analyse the mediating role of rumination between anger, anxiety and depression. This study consisted of 170 people, of whom 87 were family members of people with a gambling disorder, and 83 were from the general population. Instruments measuring anger, anxiety, depression, and ruminative responses were administered. Results showed that family members had significantly higher scores in anger (state), depression, anxiety, rumination (total and brooding). Also, results showed that anger correlated positively and significantly with rumination, depression and anxiety, which also correlated positively and significantly with each other. Third, rumination mediated the relationship between the following variables: anger (state) and depression; anger (trait) and anxiety and depression; anger (external expression) and anxiety and depression. A complete mediating effect was found in the latter case and a partial mediating effect in the first two cases. In conclusion, it is found that having a family member with a gambling disorder may increase levels of anger, anxiety, depression and rumination. Furthermore, it is shown that working on rumination may reduce depression and anxiety in family members of gamblers.

Cross-lagged effects between parent depression and child internalizing problems.

The bidirectional associations between maternal depression and child psychological functioning are generally well-established. Paternal depression may also share some bidirectional associations with child psychological functioning, but there is limited research in this area. It is unclear how or when one family member's anxiety or depression might affect another family member's mental health. The present study tested the bidirectional associations between maternal depression, paternal depression, and children's internalizing problems of anxiety and depression from early childhood into mid-adolescence. The present study also included unmarried parents, who are often underrepresented in research. Secondary analyses were performed using a subset of data from the Fragile Families and Child Wellbeing (FFCW) study, beginning when children were 3-years-old and ending when children were 15-years-old. Families (N = 4,873) were from racially and economically diverse backgrounds-nearly half of the mothers were non-Hispanic Black and 65% of mothers had a high school degree or further education. We found evidence of bidirectional associations between maternal depression and child internalizing problems across early childhood and into adolescence. We found no bidirectional associations between paternal and maternal depression or between paternal depression and children's internalizing problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An Exploration of Death Anxiety of Family Members of Silent Mentor Body Donation Program.

Background: This study assesses the level of death anxiety among the family members of the Silent Mentor Programme (SMP) and determines whether their participation in various ceremonies during the training session impacted their death anxiety. Methods: The revised Collett-Lester Fear of Death Scale (CL-FODS) was administered to the study participants before the opening ceremony and after the sending-off ceremony of the programme. Results: All the four subscales that measure fear of one's own death, fear of the process of one's own dying, fear of the death of others and fear of the process of others dying in the CL-FODS showed significant reduction after the sending-off ceremony compared with before the opening ceremony. Younger family members reported significantly higher mean total death anxiety scores compared to the older members. Conclusion: The SMP not only nurtures doctors with humanity but also helps the family members to cope with grief and loss.

The effect of short music videos on needs satisfaction and separation anxiety of children's family members during COVID-19: The example of TikTok.

ObjectiveTo investigate the effect of short music videos on needs satisfaction and separation anxiety of the family members of children with congenital heart disease (CHD) in the cardiac intensive care unit (CICU) during the COVID-19 pandemic.MethodsEighty-seven children's family members were divided into the study group and the control group between February 2020 and March 2021. During the COVID-19 pandemic, the participants in the control group were visited by telephone, while the participants in the study group used the TikTok short music video application and WeChat as communication tools. After the intervention, the critical care family needs inventory (CCFNI) and separation anxiety scale (SAS) for all participants were recorded and analyzed.ResultsThere were no statistically significant differences in general characteristics or preintervention data between the two groups. However, the two dimensions of the support scale and information scale of the CCFNI in the study group were significantly different from those in the control group after the intervention (P = 0.008, and P = 0.021, respectively). There were significant differences in the three dimensions of the SAS between the two groups (P = 0.004, P = 0.007, and P = 0.041, respectively).ConclusionThe visiting system of the ICU changed during the COVID-19 pandemic, and the use of the TikTok short music video application and WeChat was conducive to optimizing the CICU ward visiting process, reducing the separation anxiety of the family members of children in the CICU, and improving their needs satisfaction.

Study on the Application of the Concept of Childlike Interest with Refined Nursing Intervention in the Treatment of Children with Severe Pneumonia.

Objectives To analyze the application of childlike concept with refined nursing intervention in the treatment of children with severe pneumonia. Methods 100 cases of children with severe pneumonia admitted to our hospital from June 2019 to June 2021 were selected and divided into the control group and the observation group, in which the control group was given refined nursing care and the observation group was given the childlike concept with refined nursing intervention to compare the treatment effects of patients in both groups. The clinical indexes such as recovery time of body temperature, disappearance time of pulmonary rales, recovery time of heart rate, disappearance time of cough, and hospitalization time, were compared between the two groups. Results Compared with the control group, the time to recovery of body temperature, time to disappearance of pulmonary rales, time to recovery of heart rate, time to disappearance of cough, and hospitalization time were significantly lower in the observation group, and the difference was statistically significant (P < 0.05). Compared with the control group, the compliance rate of patients in the observation group was significantly lower, and the difference was statistically significant (P < 0.05). Compared with the control group, the total effective rate of patients in the observation group was significantly higher, and the difference was statistically significant (P < 0.05). Compared with the control group, the overall satisfaction rate of patients in the observation group was significantly higher, and the difference was statistically significant (P < 0.05). The results of univariate analysis showed that the differences between the two groups were statistically significant (P < 0.05) in terms of economic conditions, payment method, child's condition, child's age, comorbid underlying diseases, and nursing care method, and the results of logistic multifactor regression analysis showed that the payment method of self-payment, child's critical condition, and comorbid underlying diseases were the most important factors affecting the anxiety of the family members of children with severe pneumonia. risk factors for the occurrence of anxiety in the families of children with severe pneumonia, and the method of care was a protective factor (P < 0.05). Conclusion The concept of childlike fun and refined nursing interventions can effectively improve the treatment effect of children with severe pneumonia, improve patients' condition, increase patients' compliance and satisfaction, and reduce the risk of anxiety and other negative emotions of the child's family members.

Prevalence Anxiety Family Members of Patients Admitted to Inpatient Hospital Room during Pandemic COVID-19

BACKGROUND: Anxiety is confusion or worry about something that is not certain with unclear causes, causing feelings of uncertainty and powerlessness over the assessment of an object. Based on data at Izza Hospital, the number of patients who were hospitalized in July was 427 patients. The increasing number of patients in inpatient rooms during the COVID-19 pandemic caused psychological shocks to family members which caused anxiety. AIM: The purpose of this study was to find out the description of family anxiety in the inpatient room during the COVID-19 pandemic. METHODS: The design of this research is descriptive analytic with a cross-sectional approach. The population of this study was the entire family of patients who were treated in inpatient rooms during the COVID-19 pandemic, with a total sample of 96 respondents using a consecutive sampling technique. This study used a visual analog scale for anxiety (VAS-A) questionnaire to measure the respondents’ level of anxiety. RESULTS: The results of this study showed that the patient’s family in the hospital inpatient room experienced mild anxiety 42 respondents (43.8%), with an average age of 40-44 years (n = 18; 0.19%), female gender (n = 51; 0.53), respondents’ education (n = 53; 0.55), work (n = 57; 0.6), nuclear family (n = 83; 0.09). CONCLUSION: The conclusion of this study that the prevalence of anxiety in family members mostly experienced mild anxiety with a total of 42 (43.8%) respondents.

The effects of self-encouragement training on distress tolerance among the mothers of hospitalized children

Background and aims: The crisis of children’s illnesses and their hospitalization is often a main source of stress and anxiety for family members and threatens distress tolerance (DT) among parents, particularly mothers. Self-encouragement training (SET) is one of the strategies with potential positive effects on DT. The present study aimed at evaluating the effects of SET on DT among the mothers of hospitalized children. Methods: This quasi-experimental study was conducted in 2019. Participants were sixty mothers whose children were hospitalized in Ghadir subspecialty pediatric hospital, Shiraz, Iran. They were conveniently selected and randomly allocated to an intervention and a control group. Participants in the intervention group received SET based on the Schoenaker method in ten one-hour sessions in five days, while their counterparts in the control group received no SET. Data were collected using a demographic questionnaire and the Distress Tolerance Scale and were analyzed using the SPSS software (v. 22.0) and the independent-sample and the paired samples t tests. Results: There was no significant difference between the intervention and the control groups respecting the pretest mean score of DT (39.17±8.39 vs. 41.55±10.28; P=0.33), while the posttest mean score of DT in the intervention group was significantly more than the control group (51.23±6.95 vs. 41.23±10.26; P&lt;0.001). Conclusion: SET is effective in significantly improving DT among the mothers of hospitalized children. Nursing managers can use SET to improve DT among these mothers.

Comparison of the Effects of Face-to-Face and Group Education on Awareness and Anxiety of Family Members of Candidates for Coronary Angiography

Comparison of the Effects of Face-to-Face and Group Education on Awareness and Anxiety of Family Members of Candidates for Coronary Angiography

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KECEMASAN ANGGOTA KELUARGA PADA PENULARAN TB PARU DI RUMAH SAKIT UMUM SEMBIRING DELI TUA

Lungs Tuberculosis is an infectious disease caused by microbial tuberculosis. In 2015 the results of WHO data, Indonesia was among the top 6 countries with the most cases of lungs TB. For the community, TB disease has become a threat, because if one family member has TB then it might affect other family members, one of which will cause anxiety about transmission. The purpose of this study was to determine the factors associated with anxiety of family members in pulmonary TB transmission in sembiring public hospital. The method of this study was observational analytic with cross sectional approach with the sample in this study were 25 family members of lungs tuberculosis patients. An instrument of anxiety research use questionnaire of State Anxiety Invntory (S-Ai) Form Y. Statistical test used Chi Square test. The results of this study indicate that there is a significant relationship between age factors with family member anxiety on transmission of lungs TB at the sembiring public hospital with p value 0.005 (p <0.05), this study shows that there is a significant relationship between sex factors with anxiety of family members on transmission of lungs TB at the sembiring public hospital with p value 0.002 (p <0.05), this study showed that there was a significant relationship between factors of knowledge and anxiety of family members on transmission of lungs TB at sembiring public hospital with p value 0.003 (p <0.05), this study shows that there is a significant relationship between attitudinal factors and family members' anxiety on transmission of lungs TB at the sembiring public hospital with p value 0.009 (p <0.05). Suggestions for health agencies are expected to provide additional insight, information and also the basis for optimizing the handling of anxiety by family members about transmission of lungs TB.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KECEMASAN ANGGOTA KELUARGA PADA PENULARAN TB PARU DI RUMAH SAKIT UMUM SEMBIRING DELI TUA

Lungs Tuberculosis is an infectious disease caused by microbial tuberculosis. In 2015 the results of WHO data, Indonesia was among the top 6 countries with the most cases of lungs TB. For the community, TB disease has become a threat, because if one family member has TB then it might affect other family members, one of which will cause anxiety about transmission. The purpose of this study was to determine the factors associated with anxiety of family members in pulmonary TB transmission in sembiring public hospital. The method of this study was observational analytic with cross sectional approach with the sample in this study were 25 family members of lungs tuberculosis patients. An instrument of anxiety research use questionnaire of State Anxiety Invntory (S-Ai) Form Y. Statistical test used Chi Square test. The results of this study indicate that there is a significant relationship between age factors with family member anxiety on transmission of lungs TB at the sembiring public hospital with p value 0.005 (p &lt;0.05), this study shows that there is a significant relationship between sex factors with anxiety of family members on transmission of lungs TB at the sembiring public hospital with p value 0.002 (p &lt;0.05), this study showed that there was a significant relationship between factors of knowledge and anxiety of family members on transmission of lungs TB at sembiring public hospital with p value 0.003 (p &lt;0.05), this study shows that there is a significant relationship between attitudinal factors and family members' anxiety on transmission of lungs TB at the sembiring public hospital with p value 0.009 (p &lt;0.05). Suggestions for health agencies are expected to provide additional insight, information and also the basis for optimizing the handling of anxiety by family members about transmission of lungs TB.

The Effect of a Multifaceted Family Participation Program in an Adult Cardiovascular Surgery ICU.

To develop and implement a patient- and family-centered care program for patients in a cardiovascular surgery ICU. Prospective, pre- and postintervention evaluations were conducted. The cardiovascular surgery ICU was located in a tertiary hospital. Participants included 56 family members of patients in cardiovascular surgery ICU between May and July 2019. Providing personalized treatment plans for patients by: 1) providing an ICU diary, 2) communicating with the medical staff, 3) providing personal care using ICU visitation kit, and 4) guiding bedside range of motion exercises. The experimental group received a guided ICU diary and education program from a nurse, including the application of a family participation visitation program. Family members were provided with customized information from the ICU diary and communicated with the medical staff for approximately 10 minutes. Family members were instructed on how to perform personal care using an "ICU visitation kit" during visitation hours when permitted to participate in bedside activities for approximately 10-minute intervals. Scores for satisfaction with the provided care and information increased significantly for the experimental group compared with the control group (t = 8.62; p < 0.001). Anxiety levels decreased significantly after intervention in both groups (t = -7.05; p < 0.001 and t = -12.94; p < 0.001) with a significant association observed between group and time point (F = 20.50; p < 0.001). However, no significant change was observed in satisfaction with decision-making following intervention in either group, and no significant association was noted between groups and time points for this variable (F = 0.24; p = 0.626). This set of implemented family participation processes significantly improved satisfaction and reduced anxiety in family members of critically ill patients.

Burnout and its Factors in Healthcare Workers Involved in Providing Health Care for Patients With COVID-19 at Different Stages of the Pandemic

Abstract. In the context of the pandemic, when healthcare professionals are forced to work under extreme stress and an increased threat of infection, research on professional burnout and emotional maladjustment of medical workers is gaining particular relevance around the world.Aim of study. To assess the severity of symptoms of depression and anxiety, professional burnout and emotional distress among the employees of the N.V. Sklifosovsky Research Institute for Emergency Medicine, providing care to patients with COVID-19 in the current period (July). To compare them with the indicators of a mixed sample of medical workers from different institutions and regions surveyed in the first months of the pandemic (March–April), and also to highlight the main factors of distress and protective factors.Material and methods. The research methods were combined into a Google form, and participation in the research was anonymous. Of the 175 people who were sent questionnaires, filled out the form completely 120 people (69% samples), of which 43 men and 77 women, 54.2% were doctors of different specialties; 40% were nurses, the rest of the categories accounted for 5.8% of the sample. The mean age of the respondents was 36.1 years (from 21 to 61 years).Results. The data obtained on the indicators of mental distress are generally consistent with international data: 8.3% of the surveyed demonstrate symptoms of depression of moderate and severe severity according to the Beck’s Depression Scale; 6.7 % noted the presence of suicidal thoughts; 29.3% had symptoms of anxiety of moderate and high severity according to the Beck’s Anxiety Scale. And 35% had high level of emotional exhaustion according to the Maslach Burnout Inventory. Nevertheless, the data obtained indicate a greater mental well-being of employees of the N.V. Sklifosovsky Research Institute in comparison with a mixed sample of specialists surveyed in March - April. The limitations of such a comparison are indicated, which are associated with differences in organizational affiliation and the composition of specialists. Anxiety for family members (noted by 54.7%) and fear of infection (noted by 38.3%) were most often named as an important factor of distress in the entire sample of 120 people. The most significant protective factors (reducing the level of distress), noted by more than half of the employees, were information about the current situation and tasks from the management, support from family and colleagues, material incentives and the opportunity to take breaks for rest. Based on the data of the regression analysis, it is concluded that it is important to take measures for psychological relief, provide personnel with protective equipment, reduce the level of physical discomfort associated with the use of personal protective equipment and lack of sleep, explain to the staff the meaning of all measures and decisions taken, and collegial discussion of the organization of work. The quality of support from relatives, colleagues and administration helps maintain a sense of the importance of their profession and self-respect for themselves as a professional among medical personnel.

The Effect of Intra-operative Text Messages in Reducing Anxiety Levels Among Family Members of Patients Undergoing Major Musculoskeletal Tumour Surgery.

The family of patients undergo profound anxiety when their family member is undergoing major oncological surgery. In this study, we evaluated the effectiveness of periodic intraoperative text messages regarding the status of ongoing surgery in reducing anxiety levels among the patients' family members. Family members of 60 patients (one for each patient) who were undergoing major oncological surgery lasting more than 1h were recruited and randomized into two groups (30 patients each). Group 1 (no SMS group) did not receive any text message while Group 2 (SMS group) received periodic intraoperative text messages. Respondents aged less than 16years, those with associated psychiatric illnesses, and those who did not consent to the study were excluded. Anxiety among family members was assessed using the Visual Analogue Scale for Anxiety (VAS-A) and Anxiety component of Hospital Anxiety and Depression Scale (HADS-A) at five different periods; (P1) 1day prior to surgery (P2) at separation from family at the operation theatre (P3) 1h after commencement of surgery (P4) immediately after completion of surgery, and (P5) 1day after surgery. The mean VAS-A and HADS-S scores between both the groups did not show a statistically significant difference for P1, P2 and P5 assessment periods (preoperative period, separation in operation theatre, post-operative period). However, mean VAS-A and HADS-A scores were significantly higher for Group 1 compared to Group 2 during P3 and P4 periods, 1h after commencement of surgery and completion of surgery, respectively. Periodic text messages updating the status of ongoing surgery helps to reduce anxiety for family members of patients undergoing oncological surgery during the intraoperative period.

The quality, understandability, readability, and popularity of online educational materials for heart murmur.

Murmurs are abnormal audible heart sounds produced by turbulent blood flow. Therefore, murmurs in a child may be a source of anxiety for family members. Families often use online materials to explore possible reasons for these murmurs, given the accessibility of information on the Internet. In this study, we evaluated the quality, understandability, readability, and popularity of online materials about heart murmur. An Internet search was performed for "heart murmur" using the Google search engine. The global quality score (on a scale of 1 to 5, corresponding to poor to excellent quality) and Health on the Net code were used to measure the quality of information presented. The understandability of the web pages identified was measured using the Patient Education Materials Assessment Tool (score range from 0 to 100%, scores below 70% reflect poor performance). The readability of each web pages was assessed using four validated indices: the Flesch Reading Ease Score, the Flesch-Kincaid Grade Level, the Gunning Frequency of Gobbledygook, and the Simple Measure of Gobbledygook. The ALEXA traffic tool was used to reference domains' popularity and visibility. We identified 230 English-language patient educational materials that discussed heart murmur. After exclusion, a total of 86 web pages were evaluated for this study. The average global quality score was 4.34 (SD = 0.71; range from 3 to 5) indicating that the quality of information of most websites was good. Only 14 (16.3%) websites had Health on the Net certification. The mean understandability score for all Internet-based patient educational materials was 74.6% (SD = 12.8%; range from 31.2 to 93.7%). A score suggesting these Internet-based patient educational materials were "easy to understand". The mean readability levels of all patient educational materials were higher than the recommended sixth-grade reading level, according to all indices applied. This means that the level of readability is difficult. The average grade level for all web pages was 10.4 ± 1.65 (range from 7.53 to 14.13). The Flesch-Kincaid Grade level was 10 ± 1.81, the Gunning Frequency of Gobbledygook level was 12.1 ± 1.85, and the Simple Measure of Gobbledygook level was 9.1 ± 1.38. The average Flesch Reading Ease Score was 55 ± 9.1 (range from 32.4 to 72.9). We demonstrated that web pages describing heart murmurs were understandable and high quality. However, the readability level of the websites was above the recommended sixth-grade reading level. Readability of written materials from online sources need to be improved. However, care must be taken to ensure that the information of web pages is of a high quality and understandable.