Anxiety Management Techniques Research Articles

A Pilot Study to Evaluate an Educational Intervention on Motivation and Learning Strategies in Prelicensure Nursing Students.

Nursing student attrition affects the nationwide nursing shortage. Interventions that improve student retention are needed. The Jeffreys nursing universal retention and success model provided a framework for an educational intervention that introduced students to validated study techniques and test-related anxiety management techniques. The intervention was evaluated using the Motivated Strategies for Learning Questionnaire. Results from our pilot study suggest that this type of intervention may impact the use of learning strategies and motivation and may improve overall retention and program completion.

Climate-conscious sedation: how can we sustainably manage dental anxiety using inhalation sedation?

Climate change represents an urgent global threat. Without action, rising temperatures resulting from human activity will increasingly affect our health and wellbeing through changing patterns of disease, extreme weather events and availability of resources. Expedient decarbonisation of the UK economy is an ambitious goal to which we must all contribute.The NHS aims to be the world's first net-zero health service and reach carbon-neutral status by 2040. Dental services are particularly resource-intensive. Some dental anxiety management techniques have a disproportionately high impact on the environment relative to their usage. Inhalation sedation with nitrous oxide is one such example.Nitrous oxide is a greenhouse gas almost 300 times more potent than carbon dioxide, but its utility to facilitate dental treatment for anxious and vulnerable patients is well-documented. This paper balances the health utility with environmental and social harm of continuing to use nitrous oxide and suggests evidence-based methods we can apply to limit the environmental impact of sedation services.

Effectiveness of Preoperative Alpha Wave Entrainment in Pediatric Dental Patients: A Randomized Controlled Trial.

Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown promise in adult studies for reducing procedural anxiety and pain perception, but its effectiveness in pediatric dental settings remains underexplored. Objective This study aims to evaluate the effectiveness of preoperative alpha wave entrainment in alleviating anxiety in gender-specific participants to the interventions. Methods We conducted a randomized controlled trial involving 252 pediatric patients (aged 7-12) with cooperative dispositions. Participants were randomly assigned to either an experimental group receiving alpha wave entrainment or a control group receiving conventional behavior management techniques. The experimental interventioninvolved 10-minute sessions of binaural beats with visualstimulation designed to induce alpha-wave synchronization. Anxiety levels were assessed using physiological measures (heart rate and blood pressure), both pre- and post-interventions. Results The intervention group demonstrated a significant reduction in heart rate and systolic blood pressure post-intervention compared to the control group. These changes indicate a decrease in anxiety levels, with no significant gender differences in the response to the intervention. Conclusion Alpha wave entrainment effectively reduces dental anxiety in pediatric patients, with similar efficacy observed across genders. This study supports the incorporation of alpha wave entrainment into pediatric dental practices as a viable alternative to traditional anxiety management techniques.

The use of dental anxiety management techniques during one-session treatment: a study on five video-recorded patient cases

Objective The aim was to examine what kinds of dental anxiety management techniques dentists use in the context of one-session treatment. Material and methods The data consisted of videotaped treatment sessions for five dentally anxious adults. The treatment was conducted by two experienced dentists without formal training in the treatment of dentally anxious patients or behavioral management techniques. Theory-driven qualitative content analysis, based on the anxiety management classification of Milgrom et al. was used to identify and classify the techniques used during the treatments. Results Altogether, diverse categories of dental anxiety management techniques were identified under the main themes of enhancing trust and control and psychological management. Techniques that fell into enhancing trust and control included the categories of ‘building a trustful relationship’, ‘informational control’, and ‘behavioral control’. These techniques were used consistently throughout the sessions. Additionally, psychological management techniques were identified and classified as ‘behavioral strategies: relaxing the body’ and ‘cognitive strategies: relaxing the mind’, which were regularly used in specific situations. Conclusion The results indicate that a variety of dental anxiety management techniques were used during one-session treatments. The findings provide valuable insights for dentists in managing their patients with dental anxiety and improving their overall treatment experience.

Assessment of anxiety markers in schoolchildren in a distance learning environment

<span lang="EN-US">This study outlines the theoretical foundations of diagnosing and dealing with children’s anxiety in a school setting. Based on these observations, the study proposes and tests practical anxiety management techniques. The study introduces a new term - school isolation anxiety - which is given an original definition. A total of 1,892 secondary school students (grades 4 to 9) in various regions of the Republic of Kazakhstan participated in the study. The sample encompasses 60 classes divided equally into 30 experimental groups and 30 control groups. Preliminary observation and interviews with participants allowed to identify 10 markers of school isolation anxiety, enabling its diagnosis. The next phase of the study suggested the development of anxiety management techniques. The use of the identified anxiety markers and the parallel application of techniques resulted in a significant reduction of anxiety levels in the experimental groups.</span>

Boredom Susceptibility and Quit Smoking: The Role of Anxiety Symptoms

Boredom is one of the main reported motives for smoking. However, scarce research has examined the relationship between boredom susceptibility and abstinence achievement in treatment-seeking smokers. The aim of this study is to examine the mediating effect of anxiety symptoms in the relationship between boredom susceptibility and abstinence at the end of a smoking cessation treatment. The sample was composed of 481 Spanish smokers who received a cognitive-behavioral treatment to quit (M age= 45.51, SD = 11.16; 60.6% female). The Boredom Susceptibility subscale of the Sensation Seeking Scale Form-V and the Beck Anxiety Inventory were used. Pearson correlations and mediation analyses were conducted to examine the relationships between the study variables. Boredom susceptibility was significantly and positively correlated to anxiety symptoms, but not to abstinence. Anxiety symptoms were significantly and negatively correlated to abstinence. A significant indirect effect of boredom susceptibility on abstinence at the end of treatment through anxiety symptoms was found. There was no direct relation between boredom susceptibility and abstinence. These findings extend previous literature by showing that higher boredom susceptibility is associated with less likelihood to be abstinent at the end of the treatment through higher anxiety symptoms. These results highlight the relevance of considering the inclusion of boredom and anxiety management techniques in smoking cessation interventions.

The Use of Sensors to Detect Anxiety for In-the-Moment Intervention: Scoping Review.

With anxiety a growing issue and barriers to accessing support services, there is a need for innovative solutions to provide early intervention. In-the-moment interventions support individuals to recognize early signs of distress and use coping mechanisms to prevent or manage this distress. There is potential for wearable sensors linked to an individual's mobile phone to provide in-the-moment support tailored to individual needs and physiological responses. The aim of this scoping review is to examine the role of sensors in detecting the physiological signs of anxiety to initiate and direct interventions for its management. Relevant studies were identified through searches conducted in Embase, MEDLINE, APA PsycINFO, ProQuest, and Scopus. Studies were identified if they were conducted with people with stress or anxiety or at risk of anxiety and included a wearable sensor providing real-time data for in-the-moment management of anxiety. Of the 1087 studies identified, 11 studies were included in the review, including 5 randomized controlled trials and 6 pilot or pretesting studies. The results showed that most studies successfully demonstrated improvements in their target variables. This included overall anxiety and stress levels, and the implementation of in-the-moment stress and anxiety management techniques such as diaphragmatic breathing. There was wide variation in the types of sensors used, physiological measures, and sensor-linked interventions. This review indicates that sensors are potentially a useful tool in detecting anxiety and facilitating the implementation of a known control mechanism to reduce anxiety and improve mood, but further work is needed to understand the acceptability and effectiveness of this type of intervention.

The (in) dependence of students' anxiety levels on socio-demographic factors during distance learning

The main purpose of this study is to describe and identify the general anxiety level and the influence of socio-demographic characteristics on anxiety among students during online learning because of the COVID-19 Pandemic. This is a quantitative non-experimental study. The instrument used in the study is the questionnaire Beck Anxiety Inventory. The results showed that during remote learning students experienced moderate anxiety levels. In addition, the results indicated that the variables of gender and educational profile had a significant impact on the anxiety levels experienced by students. In the light of study findings, we recommend the following: the need to conduct further systematic research on factors that influence the preparedness and performance of students during online learning; develop pilot studies on online learning that are not related to the pandemic context, structures of specialised training with regard to anxiety management techniques and the factors that encourage it. Keywords: Anxiety, distance learning, pandemic, socio-demographic variables, student.

A scoping review investigating the use of exposure for the treatment and targeted prevention of anxiety and related disorders in young people.

Cognitive Behavioural Therapy (CBT) is the gold standard intervention for anxiety and related mental health disorders among young people; however, the efficacy of individual elements of CBT (e.g., exposure to feared stimuli) have received little scrutiny. This scoping review, informed by three stakeholder groups and a scientific advisory group, aimed to identify the nature and extent of the available research literature on the efficacy of exposure to feared stimuli, moderators of effectiveness in young people aged 14-24years. Three international stakeholder groups composed of clinicians (N=8), parents/carers (N=5) and youth with lived experience of anxiety (N=7) provided input into study design and results. Using the PRISMA extension for scoping reviews, a search of MEDLINE/Ovid, PsycINFO, PubMed, CINAHL, SCOPUS, EMBASE, ERIC, and Health Collection (informit) was conducted using terms related to anxiety, ages 14-24, and exposure. From 3508 unique abstracts, 64 papers were included for the review. While there was evidence for the efficacy of exposure as a treatment for youth anxiety disorders, fundamental gaps in knowledge of exposure in this age group were identified. Most studies examined post-traumatic stress disorder, obsessive-compulsive disorder, and specific phobias with no randomised clinical trials uniquely evaluating exposure for the treatment of DSM-5 anxiety disorders. Exposure was typically delivered accompanied by other anxiety management techniques. A multitude of optimisation strategies have been tested, yet only one of these effects (timing relative to sleep) showed preliminary evidence of replication. A systematic and theoretically driven program of research investigating the efficacy of exposure in young people and factors that moderate its efficacy, along with methods to overcome barriers for delivery, is urgently needed.

The variables associated with dental anxiety and their management in primary care dental clinics in Bahrain: a cross-sectional study

Background20–80% of adults presenting to a dental clinic experience anxiety. Negative past dental experiences and environmental factors such as the waiting area of a dental clinic or sound of a drill are commonly considered triggering factors for anxiety. Anxiety management strategies are considered a part of routine dental procedure, due to increased prevalence and compromised patient care. Hence the aim of the present study is to identify the prevalence and variables associated with dental anxiety and their management in patients visiting the primary care dental clinics in Bahrain.MethodFour hundred and eighty participants were included. A 3-part questionnaire deciphered the demographic characteristics of the participants, the dental procedure undertaken, the level of anxiety, and the management strategy used by the dentist. The pre and post-treatment MDAS scores were recorded. Paired t test, ANOVA and Wilcoxon signed rank test was used to test the level of significance between the variables and the mean MDAS scores. The p ≤ 0.05 was considered statistically significant.ResultsThe prevalence of dental anxiety was 23.7% with moderate anxiety, and 11.4% with high anxiety. Females presented with a higher mean MDAS both pre and post-treatment compared with males. A statistically significant difference between the pre and post-treatment MDAS scores were observed in educated patients less than 50 years of age. Those with unpleasant previous dental experience showed statistically significant difference. Analyses of anxiety management techniques showed that single techniques worked better than combination techniques. Rest and breaks combined with any other technique of choice showed significant reduction in the MDAS scores post treatment.ConclusionTo conclude, all patients attending the dental clinic present with some level of anxiety that necessitates the dentist to use anxiety management strategies. Non-pharmacological methods that are non-invasive must be the first choice. Rests and breaks, with any technique of choice provides the best possible anxiety management. It is possible to achieve the desired anxiety reduction in single visit to complete the planned dental intervention, other than in patients who are dental phobic.

Remote Online Test Anxiety during the Coronavirus Disease 2019 Crisis: A Cross-Sectional Study among Medical Students

Background: The coronavirus disease 2019 (COVID-19) forced higher education to adopt e-learning and remote online tests as a kind of assessment that leads to new paradigms. Objectives: This study aimed to investigate the medical students' test anxiety toward remote online tests during the COVID-19 pandemic. Methods: The current cross-sectional study has been conducted in the 2020-2021 academic year. A self-reported online questionnaire was used to investigate the medical students' test anxiety at Mashhad University of Medical Sciences, Mashhad, Iran. The survey consisted of demographic characteristics, including gender, age, and curriculum phase, as well as the validated version of the Sarasons's test anxiety scale in Persian. Results: The findings indicated that the prevalence rates of mild, moderate, and severe test anxiety were 27.9%, 36.9%, and 35.2%, respectively, toward remote online tests. Although the comparison of test anxiety levels showed a statistically significant difference due to gender and age (P<0.05), the difference in test anxiety among the students of basic sciences and preclinical was not significant (P>0.05). Furthermore, the female students' test anxiety was more than that of male students, and participants over 20 years old had higher test anxiety scores (P<0.05). Conclusion: Moderate to severe test anxiety was more common in medical students, which can have devastating effects on the students' academic performance. There is a critical need to recommend anxiety management techniques and bring reforms in e-assessment systems to reduce test anxiety in medical students.

Utilizing a manualized therapy to provide parallel treatment to older adults with cancer and their caregivers: A case study.

The experience of anxiety is a common and understandable reaction to a diagnosis of and treatment for cancer. Patients of any age may experience negative psychological and physical symptoms during cancer treatment; older adults with cancer simultaneously face the impact of cancer and the effects of aging. Caregivers of older adults with cancer are also vulnerable to experiencing anxiety as their loved one navigates the physical and emotional sequelae of their illness and treatment. This paper describes the use of Managing Anxiety from Cancer (MAC), a 7-session telephone-delivered manualized cognitive-behavioral intervention that includes strategies from Acceptance and Commitment Therapy and Problem-Solving Therapy, with an older woman with cancer and her adult daughter. MAC includes a variety of techniques for patients and caregivers, who are encouraged to use these strategies individually or in different combinations to manage their anxiety. This brief treatment provided a parallel experience for the participants, as the older adult patient and her caregiver were taught the same anxiety-management techniques by their individual therapists. We will discuss the benefits and drawbacks of using a manualized psychotherapy intervention in this case, as well as MAC's impact on each member of this pair and on the dyad as a unit. Both the patient and her caregiver reported experiencing benefit from their participation in MAC and identified MAC-acquired skills they planned to use in the future to manage their anxiety and improve communication. While assessment data did not reflect a decrease in anxiety, it is possible that the stress of the COVID-19 pandemic confounded these data.

Awareness on Smoking and Alcohol Use and Its Association With Increased Levels of Dental Fear and Anxiety - A Survey Among Dental College Students

Lifestyle modifications, work pressure, stress may lead to adverse habits like smoking, drinking and tobacco chewing. These habits may lead to poor oral health. Not only poor oral health may also lead to dental fear and dental anxiety. Self-administered questionnaires were designed based on knowledge, attitude and practice. The questionnaire was distributed through an online platform. The study population included people belonging to the age group of 18-24 age groups. The participants were explained about the purpose of the study in detail. The questions were carefully studied and the participants marked the corresponding answers. The data were collected and statistically analysed using SPSS software. Results were collected as an ordinal data and reported that smoking and alcohol causes increased dental fear which leads to poor oral health and some anxiety management techniques should be employed by dental practitioners to make the procedures in a simple way. For a satisfactory dental treatment and good oral health status, the state of mind of the patient is very important and it is influenced by many factors, including smoking and alcohol use. The aim of the study is to evaluate whether students are aware that the increased level of dental fear and anxiety is associated with smoking and alcohol use.

Using Virtual Reality Environments to Augment Cognitive Behavioral Therapy for Fears and Phobias in Autistic Adults.

Fears and phobias are common in people on the autism spectrum and can impact on their ability to undertake usual daily activities. Graded exposure to the anxiety-provoking stimulus is a recognized method of treatment for fears/phobias in the nonautistic population but may pose specific difficulties for autistic people. For example, real-life exposure can be too anxiety-provoking to allow treatment to take place, and imaginal exposure can be problematic. To address this, we developed an intervention that combines cognitive behavioral therapy (CBT) with immersive virtual reality (VR) exposure to reduce anxiety. Following successful trials of this intervention with young people on the autism spectrum, we report a pilot study using the same intervention with autistic adults. Eight adults (aged 18–57 years) received one psychoeducation session and then four 20-minute sessions of graded exposure with a therapist in an immersive VR room (known as the Blue Room). Each participant completed all sessions showing that the intervention is feasible and acceptable. Outcomes were monitored at 6 weeks and 6 months postintervention. Five of the eight participants were classified as intervention responders and at 6 months after the end of intervention were experiencing real-life functional improvements. These preliminary findings show that VR-graded exposure alongside CBT may be an effective treatment for autistic people with phobias.Lay SummaryWhy was this study done?Anxiety is common in autistic adults. For some people, fears and phobias regarding everyday objects and situations occur frequently affecting everyday life. The main method to treat fears and phobias for people without autism is gradual exposure to the situation that causes anxiety. However, this method may be challenging for people on the autism spectrum. We wanted to test a new method of treatment that uses cognitive behavioral therapy (CBT) delivered with gradual exposure in a fully immersive virtual reality (VR) environment.What was the purpose of this study?We have already delivered this treatment successfully with autistic children. We wanted to test if this treatment would work for autistic adults. Changing traditional psychological treatments, such as CBT, to make it more suitable for autistic people is recommended by the National Institute for Health and Care Excellence.What did the researchers do?We recruited eight autistic adults (aged 18–57 years) with a fear/phobia and their supporter (parent/friend/support worker). Each adult had one session with a therapist to learn anxiety management techniques. They then had four 20-minute sessions of graded exposure with a therapist in an immersive VR room (known as the Blue Room). Each participant had a computer-generated scene designed for their specific anxiety-provoking situation. After four sessions, the participant tried real-life exposure with their supporter. We measured progress at 6 weeks and 6 months after the last VR session.What were the results of this study?Each participant completed all four sessions. This shows that the intervention was possible to deliver and acceptable to autistic people and therapists. Participants completed assessments at 6 weeks and 6 months after the VR sessions. Five of the eight participants were “responders” to the intervention. This means that 6 months after the last VR session, they still had real-life day-to-day improvements in relation to their phobia.What do these findings add to what was already known?We had not delivered this intervention to autistic adults previously. The findings show that this VR intervention has the potential to be an effective treatment for anxiety in autistic adults.What are the potential weaknesses in the study?This is a small study and future work will be a larger trial of this treatment—comparing results from people who get the intervention with people who do not. We would also want to have an outcome assessor who did not know whether people had received the intervention or not.How will these findings help autistic adults now or in the future?This new intervention has the potential to help autistic adults manage their anxiety in stressful situations and therefore may improve their quality of life.

Management of the Dentally Anxious Patient: The Dentist's Perspective.

To evaluate dental anxiety from the dentist's perspective. A cross-sectional study was performed on a convenience sample. Data were gathered using questionnaires that included general information and specific questions concerning dentally anxious patients. Three hundred ten practicing dentists completed the survey. Participants estimated that 27% of their adolescent/adult patients and 35% of their child patients suffer from dental anxiety. Dentists reported devoting about a quarter of their weekly work hours to treating such patients. The most common anxiety management techniques used for adults and children alike were nitrous oxide and/or behavioural techniques (such as distraction, reinforcement, gradual exposure, and relaxation). Dentists generally agreed that it is their responsibility to help dentally anxious patients. Eighty-one percent expressed interest in taking part in dental anxiety management courses. The consensus was that treating dentally anxious patients involves long treatment times, insufficient payment, and frequent appointment cancellations. According to practicing dentists, over one-quarter of their patients suffer from dental anxiety. Most dentists perceive themselves as responsible for treating these patients and are willing to receive appropriate training. Incorporating behavioural and pharmacological management techniques in the undergraduate dental curriculum and expanding postgraduate training programmes in this field are important issues that can improve the well-being of both dentally anxious patients and their dentists.

Needle-related pain and distress management during needle-related procedures in children with and without intellectual disability

Children with intellectual disability frequently undergo needle-related procedures for diagnosis or treatment. Nevertheless, only a few studies deal with pain and distress management during the procedure in this population of children. This study aimed to investigate the number of anxiety and pain management techniques performed during needle procedure in children with intellectual disability (cases) compared to a population of children without intellectual disability (controls). This multicenter cohort study was performed from July 2016 to January 2018 in the pediatric ward of four urban hospitals in Italy. Eligible subjects were children with and without intellectual disability, from 4 to 17years old, who needed venipuncture or intravenous cannulation for diagnosis or treatment. Use of topical anesthesia, distraction techniques, and physical or verbal comfort during procedures were recorded. Pain and anxiety scores were also recorded. Forty-seven cases and 94 controls were recruited. Three pain- and anxiety-relieving techniques were performed during the procedure in 12 (25%) cases and in 10 controls (11%); two techniques were performed in 23 (50%) cases and in 26 (28%) controls; 12 (25%) cases and 52 (55%) controls received only one.Conclusion: In this series, children with intellectual disability received significantly more relieving techniques, but experienced more pain and anxiety when compared to children without intellectual disability. What is Known: • Children with intellectual disability experience more episodes of pain than cognitively healthy ones, and almost 10% of these episodes are due to medical procedures. What is New: • Children with intellectual disability despite receiving more relieving techniques during a needle-related procedure experienced more pain and anxiety when compared to healthy children.

Group cognitive behaviour therapy (CBT) for social interaction anxiety in adults with autism spectrum disorders (ASD)

BackgroundGroup social skills interventions (SSI) are partially effective for addressing the communication and social interaction impairments experienced by individuals with autism spectrum disorders (ASD). Social anxiety has been found to be a moderating mechanism for SSI in young people with ASD. Comparatively few studies have investigated the effectiveness of SSI in the adult ASD population, and none so far have investigated group approaches incorporating SSI and anxiety management techniques. MethodThe present study describes the design and evaluation of a non-randomised single-arm, 11 week group interaction anxiety and social skills intervention, piloted on three occasions during routine clinical practice at an adult ASD service. The intervention was informed by a cognitive behaviour therapy (CBT) framework. Eighteen cognitively-able adult males with ASD attended. Outcome measures were completed pre- and post-intervention. ResultsSelf-reported social anxiety improved (p=0.01, d=0.65). Low mood, general anxiety and functioning did not change significantly (p>0.05, d<0.20). Qualitative feedback indicated that participants found the intervention to be acceptable and useful for improving social knowledge and coping strategies, and reducing avoidance behaviours. Attrition was low (n=2). ConclusionsThese results suggest that integrating SSI and anxiety management techniques in a group format is acceptable to adults with ASD, and can reduce symptoms of social anxiety. Whether SSI enhance social skills in adults requires further investigation. In clinical practice, consideration should be given to augmenting SSI with CBT techniques designed to target concurrent symptoms of social anxiety.

Self-Esteem and Anxiety Level of Students at the Technological Educational Institute of Athens–Planning of Interventions

Objectives: The identification of self-esteem and anxiety levels experienced by the students of the Technological Educational Institute (ΤEΙ) of Athens, as well as the investigation of the potential correlations of these two parameters to each other and to other demographic variables. Method: Data collection was performed during the academic year 2015-2016, in a sample of 763 students from all Schools and Faculties of the Institute, using a questionnaire which contained: (a) Rosenberg’s Self- Esteem Scale (RSES) (Rosenberg, 1965), in order to identify the self-esteem level of the participants (b) State Trait Anxiety Inventory (STAI) to assess the students’ anxiety level and (c) a series of questions about the demographic characteristics and the academic performance of the participants. The data was analyzed using Statistical Package for Social Sciences, version 21.0 software (SPSS v. 21.0). Results: According to the research results, the female students of the sample displayed statistically significantly higher anxiety levels and lower self-esteem than male students, whereas both genders showed a statistically significant negative correlation between self-esteem and the number of failed courses (the more the failed courses, the lower the score on self-esteem scale). Moreover, a statistically significant negative correlation was found between anxiety level and self-esteem, with students who scored higher on anxiety tending to also have lower selfesteem. Furthermore, the results appeared to be considerably different in each faculty, with the students of the Faculty of Fine Arts and Design displaying significantly lower self-esteem levels and higher anxiety levels compared to the students of other Faculties. Conclusion: The research findings highlight the need for planning interventions that will help students develop healthy self-esteem, acquire control over their educational achievements and gain anxiety management techniques to enhance their psychosocial identity development.

Dental Anxiety- Understanding is the Key to Effective Management.

Dental anxiety (DA) is a common problem; the latest Adult Dental Health Survey (UK) reported nearly half of the adult population experienced anxiety when visiting the dentist. Given individual differences in the experience of dental anxiety, it is important for the dentist to understand its development, detection and management. This article aims to provide an overview of the main psychological theories to explain the development of dental anxiety (behavioural, psychoanalytical and cognitive), as well as an overview of anxiety detection and management techniques from a psychological perspective. Clinical relevance: Dental anxiety is a common barrier to oral healthcare, with nearly half of the UK population affected. By understanding its causes, effective management can reduce anxiety, and therefore barriers to achieving high standards of oral health can be overcome.

Understanding fear and anxiety in patients at the time of an exacerbation of chronic obstructive pulmonary disease: a qualitative study.

ObjectivesTo determine the importance of fear and anxiety at the time of an exacerbation of chronic obstructive pulmonary disease. To assess the influence of carers and health professionals on this fear and anxiety.DesignA qualitative study to elicit the views of patients and their carers during a hospital admission for exacerbations of chronic obstructive pulmonary disease.SettingInterviews were conducted in a District General Hospital.ParticipantsTwenty patients were interviewed shortly after admission to hospital with an exacerbation.Main outcome measuresKey themes were identified using cross-sectional thematic analysis of transcripts where commonalities and differences were identified.ResultsFour themes emerged: panic and fear; anxiety management techniques used during an exacerbation; intervention from family members and carers; response to medical services.ConclusionPanic and fear are important emotions prior to admission. Many patients recognised the link between panic-fear and a worsening of symptoms, and some were able to use self-management techniques to reduce their panic-fear. Some relatives were seen as helping and others exacerbating the symptoms of panic-fear. The emergency services were seen as positive: providing reassurance and a sense of safety. How best to help patients with chronic obstructive pulmonary disease manage panic and fear remains a challenge.