Anxiety Levels In Patients Research Articles

Risk Factors of Perioperative Anxiety Levels in Sectio Caesarea Patients: A Cross-Sectional Study in Single Center, Bali, Indonesia

Introduction: Anxiety is a prevalent emotional response in patients undergoing surgical procedures, including cesarean sections. Perioperative anxiety can negatively impact patient outcomes, affecting physiological parameters and postoperative recovery. This study aimed to identify the prevalence and risk factors associated with perioperative anxiety levels in patients undergoing cesarean section at Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali, Indonesia. Methods: This cross-sectional study involved 37 patients scheduled for elective cesarean section at Prof. Dr. I.G.N.G. Ngoerah Hospital. Anxiety levels were assessed using the Perioperative Anxiety Scale (PASS), a validated instrument for measuring anxiety related to surgery. Data on sociodemographic characteristics, obstetric history, and medical history were collected through a questionnaire. Descriptive statistics and logistic regression analysis were used to analyze the data. Results: The majority of participants (59.5%) experienced mild to moderate anxiety levels. Age, occupation, education level, history of emergency surgery, previous surgical history, and gravidity were identified as potential risk factors associated with higher anxiety levels. Patients aged 25-29 years, housewives, those with a high school education, a history of emergency surgery, previous surgical experience, and primiparity were more likely to report mild to moderate anxiety. Conclusion: Mild to moderate anxiety is prevalent among cesarean section patients. Identifying risk factors associated with perioperative anxiety can aid healthcare providers in implementing targeted interventions to reduce anxiety and improve patient well-being.

The Relationship of Age, Gender, and Socio-Economic Factors with Patients Anxiety Levels (A Review of Early Adult Patients at the Gusti Hasan Aman Oral and Dental Hospital, Banjarmasin)

ABSTRACT The definition of dental anxiety is fear of dental procedures. The prevalence of dental anxiety was found to range from 5.7% to 20.2% across all age groups and was closely related to sociodemographic factors such as age, gender, and socioeconomic status. For patients between the ages of 18 and 40, dental anxiety can be the result of traumatic formative experiences involving dental and oral care. To analyze the relationship of sociodemographic factors which include age, gender, and socioeconomic the level of patient anxiety about treatment at the dentist based on early adulthood at RSGM Gusti Hasan Aman Banjarmasin, South Kalimantan. The investigation employed a cross-sectional, analytic observational design. According to the research criteria, the sample size was calculated using the correlative analytic formula, which yielded 85 respondents. This study utilized the Kleinknecht DFS (Dental Fear Survey) to assess the anxiety level of early adult patients in the field of dental care. This questionnaire consists of 20 questions grouped into three dimensions: avoidance of dental appointments, patient's physiological reactions, and stimulation of specific dental anxiety. There is a correlation between sociodemographic factors and dental anxiety at the Gusti Hasan Aman General Hospital in Banjarmasin, as demonstrated by a significance level of 0.05 for the Spearman test. Sociodemographic factors which include age, gender, and socio-economic relationship with the level of dental care anxiety in early adult patients. Keywords: Dental Anxiety, Sociodemography, Early Adulthood, Gender, Socieconomic

Assistive Communication Device Used During Pediatric Noninvasive Ventilation.

Noninvasive ventilation therapy is a common approach in acute respiratory failure as an alternative to invasive mechanical ventilation. Assistive communication strategies are necessary to overcome communication impairments and anxiety caused by oronasal obstruction in pediatric intensive care unit patients undergoing noninvasive ventilation. A 7-year-old girl was admitted with a history of pulmonary arterial hypertension and recurrent respiratory failure requiring bilevel positive airway pressure intervention. The patient experienced initial lack of bilevel positive airway pressure mask compliance due to oronasal mask discomfort. The trial of a novel communication device (SPEAX, Ataia Medical) involving a microphone that attaches to the patient's bilevel positive airway pressure mask for enhanced communication. Use of the assistive communication device was associated with increased intelligibility to familiar listeners, mask compliance, enhanced mobility, and reduced patient anxiety levels throughout hospitalization and in later episodes of readmission. The implementation of assistive communication devices can alleviate communication barriers in pediatric bilevel positive airway pressure users, contributing to increased compliance and diminished anxiety for patients and caregivers. Providing a pathway for effective communication may reduce sedation use, minimizing risks of sedation-related delirium and improving overall quality of life in these patients.

Effectiveness of Virtual Reality Glasses on Surgical Fear and Anxiety in Patients Before Open-heart Surgery: A Double-blind Randomized Controlled Trial

PurposeFear and anxiety in open-heart surgery patients can adversely affect their physiological well-being and recovery. Although virtual reality glasses (VR-G) have been advanced for preoperative anxiety management, their effectiveness specifically for open-heart surgery patients remains under-researched. This study aims to evaluate the efficacy of watching a video through VR-G on surgical fear and anxiety levels of patients undergoing open-heart surgery. DesignA randomized controlled and double-blind study. MethodsIn total, 90 patients were randomly assigned to the VR-G intervention group or control group. On the surgery morning, intervention group patients watched a 360-degree video with nature sounds through VR-G before being transferred to the operating theater. The surgical fear and anxiety levels of the patients were evaluated at three stages using the Surgical Fear Questionnaire and Visual Analog Scale-Anxiety: initial evaluation in the morning, second evaluation before being transferred, and third evaluation in the waiting room of the operating theater. FindingsThe surgical fear level of the intervention group at the third evaluation was significantly lower than the control group (P < .000). There was no significant difference between the anxiety levels of the study groups (P > .05). ConclusionsWatching a 360-degree video with nature sounds through VR-G is an effective intervention in reducing surgical fear levels of patients before undergoing open-heart surgery. Use of VR-G interventions may be a practical and fast-resulting nursing strategy to manage patients’ surgical fear in the preoperative period. RegistrationNCT06165861

Assessment of the level of anxiety-depressive disorders, quality of life, and therapy adherence in patients with plaque psoriasis

Relevance. The treatment of moderate and severe psoriasis poses significant challenges in clinical practice. This article is devoted to the analysis of real-world clinical practice in the treatment of plaque psoriasis, factors causing relapses of plaque psoriasis, the prevalence of anxiety and depressive disorders, and the assessment of the quality of life of patients with psoriasis using various systemic medications among patients who were observed in dermatovenereological dispensaries of the Central Federal District during the period 2022–2023.Objectives. To determine the optimal drug therapy for patients with plaque psoriasis based on comprehensive pharmacoepidemiological, clinical, compliance, and medication adherence assessments.Materials and methods. Retrospective comparative analysis of the medical records of 336 patients with plaque psoriasis (L40.0), moderate and severe. Two comparison groups: Group I — 166 patients receiving methotrexate and Group II — 170 patients receiving genetically engineered drugs. Patients were surveyed by physicians to confirm their therapy compliance. The levels of anxiety and depression were assessed using the HADS scale, and quality of life was assessed using the dermatological quality of life index — DLQI.Results. The highest rate of adherence to therapy (&gt;80%) was recorded in the group of patients undergoing therapy with genetically engineered drugs and who had a high level of anxiety (r=0.202, p&lt;0.05). In the group of patients with average adherence to the applied genetic engineering therapy (30–80%), a higher level of anxiety was associated with reduced adherence to treatment (r=–0.202, p&lt;0.05). Average adherence to methotrexate (r =–0.249, p&lt;0.05).Conclusions. An increased level of anxiety in patients undergoing therapy with genetically engineered drugs increased their adherence to treatment (r=0.202, p&lt;0.05). The worse the quality of life of patients undergoing therapy with genetically engineered drugs, the less adherence.

Anxiety level in patients with vital signs monitor at Cardiovascular Center, Hanoi Medical University

Anxiety level in patients with vital signs monitor at Cardiovascular Center, Hanoi Medical University

Correlation among anxiety and depression, fear of disease progression, and social support in coronary heart disease

BACKGROUND The mental well-being of individuals with coronary heart disease (CHD) during the intensive care unit (ICU) transition period is a multifaceted and significant concern. In this phase, the individuals might encounter psychological challenges like anxiety and depression, which can impede their recuperation and potentially have lasting effects on their health. AIM To investigate the correlation among psychological factors in CHD patients in the ICU transition period. METHODS A questionnaire survey was conducted with 119 patients admitted to the ICU after coronary artery bypass grafting between March and December 2023. Variations in Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), Fear of Progression Questionnaire-Short Form (Fop-Q-SF), and Social Support Rating Scale (SSRS) were collected and analyzed among diverse populations. We used Pearson’s correlation analysis to examine the correlation. Multiple linear regression analysis was used to explore whether these indicators influenced depression and anxiety in the patients. RESULTS The total scores for anxiety, depression, fear of disease progression, and social support were (7.50 ± 1.41) points, (8.38 ± 1.62) points, (35.19 ± 8.14) points, and (36.34 ± 7.08) points, respectively (P &lt; 0.05). Multivariate regression analysis showed that both the level of disease progression and social support affected the level of postoperative depression and anxiety in patients. CONCLUSION The anxiety and depression levels were positively related to each dimension of phobia disease progression and negatively related to each dimension of social support among patients with CHD.

Effects of clowning on anxiety, stress, pain, and hormonal markers in paediatric patients

BackgroundClowning has been used in many hospitals, particularly for children. Studies suggest the effectiveness of this methodology, but more evidence is needed. The aim of this study was to evaluate the impact of a humour therapy intervention on biological markers, pain and anxiety levels in paediatric patients.MethodsThree different clinical contexts were chosen to assess the effect of clowning interventions: patients who were subjected to venepuncture (group 1), patients undergoing general anesthesia for any cause (group 2)and patients hospitalized in the pediatric ward without distinction of their disease (group 3). Groups 1 and 2 were divided into control (C) and intervention (I) subgroups. A saliva sample was taken from all the children to measure oxytocin and cortisol levels by ELISAs. Validated scales and crying time were used to determine pain, stress, and anxiety levels. Children in group 3 were assessed before and after the intervention, employing the same methods.ResultsA total of 272 patients were included. The children in group 1 (n = 125) were 7.7 ± 3.2 years old, and 53.6% were females. 48% were in the I group, which showed decreased cortisol levels and increased oxytocin levels. The I group exhibited a decrease in perceived pain and crying time. The children in group 2 (n = 69) were aged 7.1 ± 3.5 years, and 36% were females. 51% were in the I group, which showed increased oxytocin levels and decreased cortisol levels, acute stress levels, perceived pain, and crying time. The children in group 3 (n = 78) were 8.6 ± 3.3 years old, and 54% of the children were females. There was an increase in oxytocin levels and a decrease in cortisol levels, stress levels and perceived pain following the intervention.ConclusionsThis study suggested that an intervention based on clowning is an effective strategy for decreasing pain, stress, and anxiety levels in paediatric patients in different clinical contexts. These findings support the implementation of humour therapy programs in paediatric units.

Exploring the Variations in the Use of Modified Dental Anxiety Scale (MDAS) in Literature: A Survey of Studies Published from 2014 to 2023.

Modified Dental Anxiety Scale (MDAS) is a frequently used psychometric tool to evaluate the dental anxiety level of dental patients or the general population. However, it was largely unclear if MDAS was consistently administered in the original format in the academic literature. This work aimed to survey the literature published in the last 10 years to reveal the current usage of MDAS. Web of Science and Scopus were queried to identify papers that mentioned the use of MDAS. Among a total of 260 analyzed papers, 101 papers included comprehensive information regarding both the questions posed and the response format employed. Two papers only used an explicitly renamed MDAS with modified contents. Among the 258 papers that used MDAS that were supposed to be standardized, many discrepancies from the original version were discovered. There were only 39 papers that strictly followed the recommended scoring scheme: if a participant had a score of ≥ 19, he or she might be highly dentally anxious. Notable modifications included the use of a cut-off score different from the original recommendation, the use of multiple cut-off scores, modifications of the response format or descriptors, and modifications to the question items especially adding extra questions. These modifications would create confusion when researchers and clinicians tried to compare data across studies. Researchers are recommended to administer MDAS in its original format.

Clinical effectiveness of guided breathing exercises in reducing anxiety, stress, and depression in COVID-19 patients

The COVID-19 pandemic has led to an increase in the prevalence of anxiety, stress and depression among affected people. This study was conducted with the aim of investigating the clinical effectiveness of guided breathing exercises in reducing anxiety, stress and depression in patients with COVID-19. A quasi-experimental study design was used, involving a sample of COVID-19 patients who underwent guided breathing exercises as a complementary therapy. After simple sampling, eligible subjects were randomly divided into two groups: intervention (30 patients) and control (30 patients) using random block method. The Depression Anxiety Stress Scale-21 (DASS-21) questionnaire was administered before and after the intervention to evaluate changes in anxiety, stress, and depression levels. The results of this study demonstrated that clinically guided breathing exercises had a significant effect on reducing anxiety and stress in COVID-19 patients. The intervention significantly reduced anxiety and stress scores (p < 0.001). However, there was no significant reduction in depression scores among patients who participated in guided breathing exercises (p = 0.946). Guided breathing exercises are an effective complementary technique in reducing the level of anxiety and stress in COVID-19 patients. Moreover, the exercises may provide a worthy non-pharmacological approach to managing psychological distress in COVID-19 patients.

Effect of Music on Anxiety and Fatigue in Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial.

Anxiety and fatigue are symptoms typically experienced by cancer patients undergoing chemotherapy. In dealing with these symptoms, listening to music may help patients. The randomized controlled study was conducted between May 1, 2022 and November 10, 2022 with 60 patients treated in the outpatient chemotherapy unit. The data were gathered using a patient information form, Brief Fatigue Inventory, and the State Trait Anxiety Inventory. In addition to standard treatment and care, 30-minute music was played with a passive listening method in a total of three cycles of chemotherapy in the intervention group patients who completed the first cycle and visited for the second cycle of chemotherapy. According to the analysis of covariance (ANCOVA) findings, the group variable significantly affected the post-test state anxiety scores when an adjustment was made for pre-test state anxiety scores (F=240.398, P<0.001, η²=0.808). In addition, pre-test state anxiety scores affected post-test results (F=7.925, P=0.007, η²=0.122). According to the ANCOVA findings, the group variable significantly affected the post-test trait anxiety scores (F=235.243, P<0.001, η²=0.805). In addition, pre-test trait anxiety scores affected post-test results (F=34.977, P<0.001, η²=0.380). According to ANCOVA results, the group variable significantly affected post-test fatigue scores (F=79.201, P<0.001, η²=0.582). In addition, pre-test scores affected post-test scores (F=11.082, P=0.002, η²=0.163). We observed that music had positive effects on fatigue and anxiety levels in cancer patients undergoing chemotherapy. It may be recommended to include music intervention in nursing practices for cancer patients during chemotherapy. The study results demonstrated that music intervention can be used in nursing practices for cancer patients during chemotherapy. Its low-cost and non-invasive nature also provide ease of application. Therefore, we can recommend the application of music intervention in outpatient chemotherapy units.

KECEMASAN PADA PASIEN DENGAN LUKA KAKI DIABETIK

The prevalence of diabetes continues to increase from year to year in 2021. There were 90 million cases and 5.5% are predicted to have diabetic foot ulcers, and it is predicted that it will increase by 68% in 2045 with 152 million patients. This study was conducted to determine whether there was a relationship between duration of diabetes and age on the level of anxiety in patients with diabetic foot ulcers at the Kitamura clinic in Pontianak. This type of research is descriptive analytic with a cross sectional approach. The sample used in this study were 60 respondents with diabetic foot ulcers who received treatment at the Kitamura Pancasila Pontianak Clinic, the instruments used in this study were the Anxiety Inventory (S-AI) Form questionnaire to measure anxiety levels and observation sheets for respondent demographic data. The results of the Spearman Ranks test obtained with the results of significance (2-tailed) or p value = 0.005 there is a relationship between the length of time suffering from DM with anxiety levels in diabetic foot ulcers patients and there is no relationship between age and anxiety levels in diabetic foot ulcers patients with p-value 0.064. Conclusion, there was no relationship between age and anxiety level and there was a relationship between duration of DM and anxiety level in patients with DM.

Effectiveness of Finger Hand Relaxation and Progressive Muscle Relaxation Techniques on Anxiety in Pre-Operative Sectio Caesarea Patients

Background: Anxiety is a common thing that occurs in patients who will undergo surgery. The anxiety that occurs in preoperative patients can be felt from the time they are scheduled for surgery until the time of surgery arrives. Anxiety management can be done using pharmacological and non-pharmacological therapy. Purpose: The aim of this research is to analyze the effectiveness of finger grip relaxation techniques and progressive muscle relaxation on anxiety in pre-caesarean section surgery patients in the Kediri Regency Regional General Hospital. Method: This study used a Quasy-experiment With Pretest Posttest to determine the effect of finger grip and progressive muscle relaxation techniques. The sample selection in this study used a purposive sampling technique and a total of 56 patients were obtained who were divided into 2 groups, namely the finger grip intervention group and the progressive muscle intervention group. The pretest and posttest data for each group were then analyzed using the Wilcoxon Test to determine the effect and the Mann-Whitney Test to compare the posttest results of the 2 groups. Results: The results of the study showed that the Wilcoxon test in both intervention groups obtained a p-value &lt; α (0.05), which means that before and after the intervention, both progressive muscle relaxation and finger grip relaxation had an influence on the anxiety level of pre-caesarean section patients. For the results of the Mann-Whitney test, the p-value was 0.063 or p-value &gt; α (0.05), which means there was no significant difference between changes in anxiety whether those given progressive muscle relaxation intervention or finger grip relaxation. Conclusion: Finger grip relaxation techniques and progressive muscle relaxation techniques are both effective in reducing anxiety levels in pre-caesarean section surgery patients. So this non- pharmacological therapy can be an option for patients in dealing with anxiety problems before caesarean section surgery.

Assessing the impact of implantable loop recorder placement on anxiety level

Abstract Background Anxiety is a prolonged state of apprehension or worry that can be an independent predictor of cardiovascular events, associated with a 48% increased risk of cardiac death. About one-third of patients with arrhythmias present with high anxiety levels, and subsequently worse quality of life. In our experience of patient care, many patients feel anxious about the possibility of an arrhythmia that could lead to their demise, especially if their symptoms are undiagnosed. Purpose Our project aims to explore the change in patients’ anxiety levels following implantable loop recorder (ILR) placement. Methods This is a survey-based observational study that was performed in an outpatient clinic and hospital using validated General Anxiety Disorder-7 (GAD-7) questionnaires. Individuals who met indications to undergo ILR implantation including palpitations, syncope, subclinical atrial fibrillation, and cryptogenic stroke underwent baseline assessment of anxiety prior to implantation. Individuals had repeat assessments at 6 weeks and 12 weeks post-implantation to evaluate the effect of ILR placement. Results Our study included 50 individuals. Out of the initial subjects, 10/25 females and 11/25 males were lost to follow-up. The average initial GAD-7 score was 3.3 (Range 0, 15), average 6-week score was 1.6 (Range 0, 14), and average 12-week score was 0.9 (Range 0, 10). Total decrease in GAD-7 score after 6 weeks of having ILR was 50%. Total decrease in GAD-7 score after 12 weeks of ILR was statistically significant at 73% (P=0.03). Females showed greater improvement of GAD-7 scores in comparison to males at 6 weeks (67% vs 36%) and 12 weeks (81% vs 66%). Conclusion Studies have suggested an overall decreased level of anxiety in patients receiving implantable devices that have the potential to treat arrhythmias such as implantable cardiac defibrillators and pacemakers. Our results suggest that the benefit may extend to implantable devices that seek to provide further diagnostic information and aid in the prognostication of disease burden. As seen in our study population, GAD-7 scores showed dramatic improvement with greater percentage in female than male population. After the placement of loop recorders, many patients experience a sense of security with having a device that monitors them. Our study is the first to address the association between ILR and anxiety. Future studies evaluating this association would help increase the power of the study.Figure 1:Bar graph of GAD-7 Scores

Metaverse-based cardiac magnetic resonance simulation to overcome claustrophobia (META-MRI): a feasibility trial

Abstract Background Cardiac Magnetic Resonance Imaging (CMR) is crucial for diagnosing and stratifying cardiac disease, but up to 10% of patients face challenges due to claustrophobia. Conventional methods for overcoming claustrophobia have limited success. The metaverse, an immersive 3D environment using virtual and augmented reality, is under investigation for healthcare applications. A metaverse-based VR CMR simulation program was developed to assist patients with claustrophobia, but its clinical effectiveness is unexplored. Methods The META-MRI study involved 450 patients screened, with 32 enrolled. They were randomly assigned to intervention (Metaverse-based simulation + standard care) or control (standard care alone). The Metaverse program used a VR headset within the Aimedis metaverse platform. Training sessions occurred before scheduled CMR exams, with anxiolytic treatment when necessary. Primary endpoints included successful CMR completion, anxiety assessment using the State-Trait Anxiety Inventory (STAI), and usability through a questionnaire. Results Patients in the intervention group (n=16) completed Metaverse training successfully. During simulations, anxiety decreased (STAI scores: 73 ± 8 to 51 ± 11, p=0.02). Intervention group completion rate was significantly higher (81%) than the control group (37%) during real CMR exams (p=0.01). Usability scores indicated moderate satisfaction. Discussion The metaverse-based program significantly improved CMR completion rates and reduced anxiety levels in patients with severe claustrophobia compared to standard care alone. Traditional methods for claustrophobia have limitations, making the metaverse a promising tool. Despite promising results, further research is necessary, considering identified usability issues and economic implications. Conclusion This feasibility trial demonstrates the effectiveness of a metaverse-based simulation program in enhancing compliance with CMR exams for patients with severe claustrophobia. The strategy, combined with standard care, led to reduced anxiety and increased CMR completion. Further investigation with larger cohorts is required to validate these findings, addressing usability concerns and assessing the cost-effectiveness of incorporating the metaverse into routine clinical practice.Clinical and demographic characteristics

Relationship of anxiety-related symptoms with pain, disability and postoperative period after degenerative lumbar spinal stenosis surgery.

Purpose: This study investigates the anxiety levels of patients who have undergone surgery for degenerative lumbar spinal stenosis (DLSS) and the impact of this condition on their post-operative recovery process. Materials and methods: The study group consisted of 71 patients and the control group consisted of 65 healthy individuals. The study assessed the patients' pain, disability and anxiety levels. The results show that the patients' anxiety levels are higher than those of the general population, and that anxiety levels increase even more in patients with high pain and disability scores. Postoperative State Anxiety (SA) and Trait Anxiety (TA) scores were compared between DLSS patients and healthy individuals. The anxiety scores of the patient group were analyzed in relation to age, gender, pain, physical disability and postoperative period. Results: It was found that the SA scores were statistically significantly higher in the pain group. It was found that the SA scores of patients were statistically significantly different according to their physical disability status. It was also found that both the painful early postoperative group and the painful late postoperative group had higher SA scores than the painless early postoperative group and the painless late postoperative group. Conclusion: These findings highlight the importance of considering pain, physical activity, and anxiety together in supporting the postoperative recovery process. It is suggested that holistic approaches that focus on pain, physical disability and anxiety may have a positive impact on recovery. More extensive and prospective studies are needed to clarify the causal relationship between these concepts

Effectiveness of the re-engineered discharge (RED) care model in patients with rheumatoid arthritis.

This study aims to investigate whether the re-engineered discharge (RED) model can significantly improve the quality of life, enhance the health status, and reduce the levels of depression and anxiety in patients with rheumatoid arthritis during hospitalization. This study selected 108 rheumatoid arthritis patients treated at our facility between February 2023 and February 2024. Based on the different treatment methods, these patients were divided into a control group and an observation group, with 54 patients in each group. During hospitalization, both groups received standardized routine care provided by the hospital. After discharge, the control group continued with regular follow-up visits, while the observation group received a more comprehensive and multidimensional extended care based on the RED model. The intervention period for both groups was set to 3 months. The core observation indicators of this study focused on the emotional fluctuations, symptom improvement, and changes in self-care ability of the patients before and after the intervention. After the intervention, the scores of the Self-Rating Anxiety Scale and Self-Rating Depression Scale in both groups showed significant decreases, with the scores in the observation group being significantly lower than those in the control group, showing a highly significant statistical difference (P < .01). Additionally, the joint pain scores in both groups were alleviated, reflected by shorter morning stiffness times, reduced joint swelling, and increased grip strength. The observation group had lower joint pain scores, shorter morning stiffness times, fewer swollen joints, and stronger grip strength, all of which were statistically significant (P < .01). Furthermore, the distribution of self-care abilities in the observation group showed a significant difference compared to the control group (P < .05), with the observation group having a higher proportion of self-care abilities, which was also statistically significant (P < .05). For patients with rheumatoid arthritis, the implementation of the RED model nursing strategy can significantly alleviate negative emotions, reduce the distress caused by symptoms, and markedly improve their quality of life, providing a more comfortable and reassuring treatment experience.

Does virtual reality affect breast cancer patients' pain?: A literature review

Purpose: To comprehensively analyze scientific evidence regarding the effect of virtual reality on pain in breast cancer patients. Method: This is literature study using PubMed, ScienceDirect and Cochrane Library databases. The inclusion criteria in this literature review are articles published in the last 5 years (2020-2024), articles using Indonesian and English in journals of national or international reputation and research articles. The selected articles are articles that the author can download or open access. Result: Of the total 493 articles, there were 9 articles that were duplicates or the same article. After that, it was found that the titles of 457 articles did not match the topic. There were 14 articles that did not meet the inclusion criteria and 7 articles had inappropriate interventions and methodology. Finally, 5 articles were obtained that were suitable for analysis. Conclusion: The use of VR can effectively reduce levels of pain, anxiety, fatigue and depression in breast cancer patients, as well as improve their quality of life. These findings suggest that VR has the potential to be a valuable adjunct in the pain management of breast cancer patients.

Impact of Dental Treatment Simulation App on Anxiety of Pediatric Dental Patients: An Observational Study

ABSTRACT Aim: The study aimed to investigate the effect of a dental treatment simulation app on the anxiety levels of pediatric dental patients. Materials and Methods: Forty children, aged 4–8 years and with no prior dental experience, were randomly assigned to either the control group (group I) or the dental app group (group II). The children’s anxiety levels were measured before and after undergoing restorative dental treatment, using the Chota Bheem Chutki pictorial scale. Results: The initial anxiety levels were similar across both groups. Post treatment, the dental app group exhibited a significant reduction in anxiety compared to the control group. This suggests that the simulation app has a beneficial effect in lowering dental anxiety in children. Conclusion: The dental treatment simulation app can effectively reduce pre and postoperative anxiety in pediatric patients, potentially enhancing their overall dental experience.

Anxiety and depression in papillary thyroid cancer patients: a longitudinal study.

Researches indicate that patients with papillary thyroid cancer (PTC) are prone to experiencing anxiety and depression. However, lacking of large-scale, prospective studies thoroughly examine the trajectory of these emotional states. Therefore, this study aims to investigate changes in anxiety and depression levels in PTC patients before and after operation and assess the impact of gender and menopausal states on emotional well-being. A prospective longitudinal study enrolled 320 PTC patients who completed the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) at pre- and post-operation. Paired-sample T-tests and logistic regression analysis were used to evaluate emotional changes and identify influencing factors. Anxiety and depression levels significantly increased (p = 0.028, p = 0.005) postoperatively, with incidence of 13.8% for anxiety and 26.9% for depression. Multivariate regression analysis showed that gender was a factor affecting depression (p = 0.041), and menopausal state significantly influenced emotions including anxiety and depression (p = 0.004, p = 0.031). Subgroup analysis showed that female patients exhibited higher levels of adverse emotions postoperatively compared to preoperatively (p = 0.003, p < 0.001). Postoperatively, female patients were more susceptible to anxiety and depression (p = 0.011, p = 0.029), and postmenopausal women were particularly at risk for depression (p = 0.017). The study highlights the importance of postoperative psychological care, particularly for female and postmenopausal patients. Larger sample sizes and longer follow-up periods are needed for a comprehensive understanding of psychological changes in PTC survivors.