Reduce Patient Anxiety Research Articles

The Effect Of Therapeutic Communication On The Anxiety Level Of The Elderly

Introduction: Anxiety disorders have a high incidence rate in the elderly, with the most significant factor being thinking about the disease they are suffering from. This requires therapeutic communication to build a nurse-patient relationship with the elderly to adapt to psychological disorders, including anxiety, to relieve and make elderly patients feel comfortable, ultimately speeding up their recovery. Goals: Aimed at evaluating the effectiveness of therapeutic communication in reducing anxiety levels in the elderly. Method: A review article was conducted based on research issues and methodology, with article searches using the PICO framework strategy using the Google Scholar, Springer, ResearchGate, and Semantic Scholar databases. Results: The results of the study show that anxiety is a common problem often experienced by the elderly during the aging process. Some factors that trigger anxiety in the elderly include health issues and a lack of social interaction due to death or relocation. The research indicates that therapeutic communication can help reduce anxiety levels in the elderly. Good therapeutic communication by healthcare professionals has a positive impact on reducing patient anxiety. Discussion: In this regard, the researcher highlights the importance of therapeutic communication in reducing anxiety in the elderly. Both verbal and nonverbal therapeutic communication is considered a key element in nursing care. Additionally, the researcher emphasizes the importance of adopting different approaches when applying therapeutic communication techniques to the elderly. Unstable emotional reactions and communication barriers pose specific challenges in interacting with the elderly.

A qualitative study of preoperative anxiety in orthognathic patients: The patient perspective

Increased preoperative anxiety may have an adverse impact on the patient experience. This qualitative study therefore aimed to explore those factors affecting anxiety in the approach to orthognathic surgery. A total of 28 orthognathic patients who had completed their presurgical orthodontic treatment and were within 8 weeks before their surgery underwent one-to-one in-depth interviews. The interviews explored their experience in the preoperative period, with the focus on aspects relating to anxiety. Interviews were audio-recorded and transcribed verbatim, and data were then analyzed using a thematic framework approach. Eight themes and associated subthemes were identified. The first theme related to time and described the approach to the surgery and the transience of the side effects. The second theme discussed control and how the need for control may affect anxiety; the third focused on fear related to the surgery and the element of "the unknown." The fourth theme highlighted the importance of trust between patients and clinicians, whilst the fifth focused on information and its delivery, which was crucial for managing uncertainty. The sixth theme centered on expectations about the surgery and the patient's ability to cope, and the seventh discussed coping strategies that were effective in alleviating anxiety. The final theme focused on the benefits of a strong, effective support system in reducing anxiety. No distinct typologies emerged from the data. Recommendations for consideration by clinicians are presented. The findings provide a novel insight into the multifactorial nature of preoperative anxiety in orthognathic patients and also highlight the important role of the clinical team in creating a supportive environment to help reduce patient anxiety.

Enhancing ICU care with nurse-written diaries.

Patient diaries are a supportive intervention aiding intensive care unit (ICU) survivors and their families post-critical illness. Despite their growing acceptance, ICU diary usage varies across settings. This study explored themes in nurse-written ICU diaries and their impact on nursing work and communication. This qualitative study employed an interpretative narrative methodology to explore the experiences of ICU nurses. The narrative approach enabled the synthesis of diverse events and impressions into coherent stories, facilitating a deeper understanding of participants' perspectives. Data collection involved thematic analysis of diaries following Braun and Clarke's methodology. The analysis included familiarization, coding, theme identification and validation by the research team. The findings were reviewed by participants and translated into English using the WHO's cultural adaptation guidelines, ensuring reliability and credibility in the study's outcomes. The sample consisted of 28 ICU nurses, each with professional experience ranging from 1 to 23 years. The hospitalized subjects for whom our sample wrote the diary consist of 13 participants aged 23-79 years. Two main themes emerged from the analysis: (1) simplifying the intensive care situation with specific minimization strategies and (2) attention to nonverbal communication. This study highlights the role of nurse-written ICU diaries in making the ICU environment more understandable and less intimidating for patients. Nurse-written ICU diaries contribute to improved communication and emotional support within the ICU environment. Further research is needed to explore these effects more fully and to assess the broader implications of ICU diaries on patient outcomes. Nurse-written intensive care unit (ICU) diaries have a significant impact on both patient care and nursing practice in ICUs. ICU diaries serve as a crucial tool for enhancing communication, emotional support and empathetic care within these high-stress environments. By simplifying complex medical information and focusing on nonverbal communication, nurses can make the ICU experience more comprehensible and less intimidating for patients. This approach reduces patient anxiety and psychological stress while fostering a stronger nurse-patient relationship, ultimately improving care quality.

Evaluating the Impact of Modern Laser Technologies on Dentistry in European Union Countries

Introduction: In dentistry, understanding laser wavelength interactions with oral tissues enhances patient management. Over two decades, lasers have been used in dental practices for diagnostics, caries detection, calculus identification, hard tissue cutting, and root canal disinfection. They reduce patient anxiety and the need for anesthesia in hard tissue applications Aim. The objective of this research is to provide a review on how European dentistry has been affected by the use of modern laser technology between 2020 and 2024. This was done by classifying the types of lasers, examining their uses in different dental treatments, investigating the problems that may arise as a result, and appraising the benefits for oral health and patient outcomes. Methods: A systematic literature review was conducted from 2020 to 2024, focusing on modern laser technologies in dentistry within European countries. Using the PRISMA flow diagram, studies were identified, screened, and included based on keywords related to dentistry and laser technologies. Initial searches identified 17,130 records, narrowed down to 27 relevant studies through various criteria. Inclusion required studies to focus on dental laser applications in specified European countries, published between 2020 and 2024, and be peer-reviewed. Results: The review covered studies from 2020 to 2024, highlighting various dental specialties and laser technologies like Erbium, CO2, Diode, Nd, Excimer, and Fiber lasers. Findings indicated lasers improved precision, reduced discomfort, and enhanced patient outcomes with minimal postoperative pain and faster recovery times. Noted risks included thermal damage and specific complications like bleeding and pain. Conclusions: The review highlights lasers' transformative potential in EU dental care, offering precision and improved outcomes. Future research should standardize protocols, assess long-term benefits and risks, focus on safety, and integrate patient-centered outcomes to enhance the evidence base supporting laser technologies in routine dental care.

Colostomy irrigation: implementing structured protocol-led follow-up.

Colostomy irrigation is a procedure that allows patients to achieve a certain degree of bowel control, and a period free of stoma effluent. It has the potential to improve quality of life, body image and confidence, and reduce patient anxiety. It may also help reduce odour and flatus, prevent/address peristomal skin irritation and alleviate constipation. Because it can reduce or eliminate the need for a colostomy bag, it may also cut expenditure on stoma appliances. However, colostomy irrigation is not offered to patients as standard. A protocol was drawn up to ensure colostomy irrigation was routinely offered to suitable patients and to provide them with a structured follow-up to ensure they were well supported throughout the first year of carrying out the procedure. Quality of life and the efficacy of colostomy irrigation can be monitored using questionnaires on these two issues. Two case studies demonstrate how patients' quality of life can improve when using colostomy irrigation as part of their stoma care routine.

Correlation Study on Personal Factors of General and Specialist Dentists Regarding Emergency Management of Traumatic Dental Injuries

Traumatic dental injuries are increasingly recognized as a significant dental health issue, particularly among children and adolescents. These injuries commonly result from falls, motorbike accidents, sports injuries, or violence. Both general dentists and specialists are responsible for providing emergency care for these injuries, making it essential for them to have sufficient knowledge and experience in managing such cases. This study aims to assess the personal factors influencing the emergency management of traumatic dental injuries among general dentists and specialists in Medan City. A quantitative, cross-sectional design was used, involving a total sample of 300 general and specialist dentists. Data analysis included univariate, bivariate, and multivariate methods. The results showed a significant correlation between knowledge, perception, experience, and work length in managing traumatic dental injuries (p<0.00). However, no correlation was found between age and gender with the ability to manage these injuries (p>0.00). Among the variables, knowledge was identified as the most influential factor. The study concludes that while knowledge, perception, experience, and work duration play a critical role in emergency management, age and gender do not. It is recommended that dentists in Medan continuously enhance their knowledge in this area to ensure effective treatment, reduce patient anxiety, and improve patient satisfaction.

A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach

This case report presents a multi-disciplinary treatment (MDT) approach to optimize anesthetic management for an elderly patient with a giant inguinal hernia and severe left ventricular dysfunction. The patient, a 68-year-old male, had a 30-year history of a large inguinal hernia and was diagnosed with left ventricular hypertrophy and cardiac insufficiency, with an ejection fraction of 24%. Given the patient's complex comorbidities and the risks associated with anesthesia, a MDT was formed to develop a personalized treatment plan. The team included gastrointestinal surgeons, anesthesiologists, cardiovascular specialists, and intensive care physicians who collaborated to mitigate perioperative risks. The MDT strategy involved continuing preoperative cardiovascular medications, selecting anesthesia techniques to minimize impact, and maintaining strict fluid management during surgery. The patient underwent a successful tension-free repair of the inguinal hernia with the aid of an ultrasound-guided nerve block and local infiltration anesthesia. Throughout the procedure, vital signs remained stable, and the patient experienced no discomfort or complications related to anesthesia. The patient recovered well and was discharged after five days. The effectiveness of MDT in overseeing the care of elderly patients with high-risk conditions throughout the perioperative anesthesia phase is underscored. It underscores the importance of a collaborative approach to ensure patient safety and optimal outcomes in complex surgical cases. The MDT framework helps to prevent treatment deviations and delays, reducing patient anxiety and improving the overall quality of care.

Enhancing Patient Outcomes Through Integrated Education and Navigation Programs at the Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University.

Breast cancer remains a significant global health challenge, particularly in low- and middle-income countries where disparities in healthcare exacerbate the disease burden. The Breast Cancer Comprehensive Center at the National Cancer Institute, Cairo University, has implemented integrated patient navigation and education programs aimed at enhancing patient outcomes and healthcare quality.This study evaluated the effectiveness of these programs involving 2202 participants over 12 months. The methodology included systematic data collection, material preparation, and the application of tailored educational strategies to facilitate the patient's journey from diagnosis to treatment. The study utilized three-phased patient navigation assistance to provide comprehensive support.The programs significantly improved patient satisfaction, with over 90% of participants reporting high levels of contentment with the services received. Key improvements included enhanced understanding of breast cancer (including risk factors, symptoms, importance of seeking early care, and treatment options), reduction in patient anxiety, improved treatment adherence, and streamlined diagnostic and treatment processes. Notably, the use of audio-visual educational tools effectively bridged the literacy gap among patients.The integration of patient navigation and education systems at BCCC-NCI has proven to be a highly effective model for improving breast cancer care. This model not only enhances patient understanding and treatment compliance but also facilitates a more efficient healthcare process. The study underscores the potential for replicating this approach in similar healthcare settings globally, suggesting that such integrations can significantly improve cancer care outcomes.

3D models for mohs micrographic surgery: a review on its use in patient education.

The use of a 3D model for patient education has shown encouraging results in surgical specialties like plastic surgery and neurosurgery, amongst many others; however, there is limited research on the clinical application of 3D models for Mohs Micrographic Surgery. This study delves into the utilization of 3D models for patient education in Mohs Surgery by juxtaposing different 3D modalities, highlighting their differences, and exploring potential avenues for future integration of 3D models into clinical practice. A literature search in the scientific database MEDLINE through PubMed and OVID and on the ProQuest Health & Medical Collection database was performed on the use of a 3D model for patient education. We limited the search to articles available in English and considered those mentioning the educational use of 3D models, especially for patient education, after excluding duplicate titles. We did not exclude articles based on publication year due to limited availability of literature. Utilizing 3D models for patient education within the framework of Mohs Micrographic surgery, including a 3D multicolored clay model and a 3D model accompanied by an educational video intervention, presents substantial advantages. 3D models offer a visual and tactile means to improve patients' comprehension of the Mohs procedure, the affected area, and possible outcomes. They hold the potential to reduce patient anxiety and improve decision-making. Currently, literature on the use of 3D models for patient education in Mohs Micrographic Surgery is limited, warranting further research in this area.

Assessing the Influence of Patient Anxiety on the Efficacy of Endodontic Procedures.

Patient anxiety is known to influence various aspects of dental procedures, including endodontic treatments. However, the extent of its impact on the efficacy of such procedures remains uncertain. Understanding this influence is crucial for improving patient outcomes and optimizing treatment protocols. A prospective cohort study was conducted involving 100 patients undergoing endodontic procedures. Patient anxiety levels were assessed using standardized anxiety scales before and after treatment. The efficacy of endodontic procedures was evaluated based on posttreatment pain scores, success rates of root canal treatments, and patient-reported satisfaction levels. The mean pre-treatment anxiety score was 45.7 (SD = 9.2), while the mean posttreatment anxiety score reduced significantly to 32.4 (SD = 7.6), indicating a significant reduction in anxiety levels following endodontic procedures (P < 0.001). Posttreatment pain scores were lower in patients with reduced anxiety levels, with an average pain score of 2.1 (SD = 1.3) compared to 3.8 (SD = 1.6) in patients with persistently high-anxiety levels (P = 0.002). Additionally, the success rate of root canal treatments was higher in patients with lower anxiety levels (85%) than those with higher anxiety levels (65%) (P = 0.015). Overall patient satisfaction was also significantly higher in the low-anxiety group (P < 0.001). Patient anxiety significantly influences the efficacy of endodontic procedures, affecting posttreatment pain, success rates of root canal treatments, and patient satisfaction levels. Efforts to reduce patient anxiety before and during endodontic procedures may lead to improved treatment outcomes and higher patient satisfaction.

Effectiveness of Preoperative Anxiolytics in Reducing Patient Anxiety Levels: Insights from a Tertiary Care Hospital in Bhawanipatna, Odisha

Effectiveness of Preoperative Anxiolytics in Reducing Patient Anxiety Levels: Insights from a Tertiary Care Hospital in Bhawanipatna, Odisha

(108) ENHANCING PELVIC EXAM COMFORT AND DIAGNOSTIC ACCURACY: REVIEWING THE UTILITY OF NITROUS OXIDE FOR HYPERTONIC PELVIC FLOOR ASSESSMENT

Abstract Introduction Nitrous oxide is an anesthetic, anxiolytic, and analgesic commonly used for general and dental anesthesia, sedation, and severe pain. Studies show that nitrous oxide is also used in several in-office gynecological and urological procedures as a sedative and anxiolytic agent with a safer drug profile than other anesthetic agents. It is also being trialed as a treatment for mood disorders. Nitrous oxide does not render individuals unconscious, making it a more favorable option for stressful and painful medical procedures than general anesthesia because it allows the patient to feel more in control of their body and aware of the proceedings. Objective To analyze the use of in-office nitrous oxide during medical procedures and evaluate its effectiveness in reducing pain and anxiety levels to predict the utility of it during pelvic exams in patients with vestibulodynia. Methods A literature review was performed through the PubMed database between 2007-2022. The authors independently and thoroughly screened abstracts and full-text articles and assessed the relevant medical literature that acknowledged the use of nitrous oxide in in-office medical procedures. Key terms used to refine the search include [“nitrous oxide in medical procedures”], [“nitrous oxide in gynecology”], [“nitrous oxide in urology”]. Results One study explored the use of nitrous oxide during childbirth in women diagnosed with PTSD, and the results were significant for nitrous oxide reducing PTSD symptom severity. Multiple studies suggest the use of nitrous oxide during dental procedures reduces patient anxiety; one specifically measured sixty anxious patients pre- and post-endodontic procedures and noted a significant reduction in anxiety during the procedure with the use of nitrous oxide. Various studies of gynecological and urological procedures report the successful use of nitrous oxide in reducing peri-procedural pain compared to other analgesic alternatives. A common example is its use during intrauterine device insertion, which is correlated with higher patient satisfaction as it decreases pain. Additionally, a study among patients undergoing extracorporeal shockwave lithotripsy found no significant difference between the use of meperidine, an opioid, and nitrous oxide in post-procedural Visual Analog Scale pain scores with no adverse events reported in the nitrous oxide group. Another study revealed that using local anesthesia in transrectal prostate biopsies resulted in some patients experiencing notable anxiety and pain. At the same time, no such relationship was observed among patients who received nitrous oxide before this procedure. Conclusions Vestibulodynia is a subset of genitopelvic pain isolated to the vulvar vestibule. Vestibulodynia has three proposed etiologies: tissue neural proliferation, musculoskeletal, and hormonally mediated. Discriminating these three etiologies can be difficult, especially when a proper pelvic exam cannot be achieved due to patients’ discomfort. The three etiologies are biologically intertwined, often resulting in vestibulodynia patients experiencing pelvic floor hypertonicity without regard to specific etiology. A painful pelvic exam is stressful and often an anxiety-producing experience for patients with pelvic hypertonicity and vulvodynia. Hence, with the data provided, we suspect that nitrous oxide will be a useful treatment option to mitigate these consequences for the patient, with the added benefit of easing the exam for the provider, leading to a more accurate diagnosis. Disclosure No.

Eficacia de la técnica autoasistida de Boss-Holzach- Matter para la reducción de luxaciones glenohumerales anteriores: revisión sistemática

Background: Anterior shoulder dislocation represents a common reason for emergency room visits. Despite the wide range of motion provided by this joint in three-dimensional space, it is prone to dislocation, with a significant incidence rate. The choice of reduction technique lacks consensus, with over 25 possible maneuvers, largely dependent on the physician's preference and experience. Additionally, potential neurovascular injuries resulting from the maneuver or its poor execution add complexity to this issue, challenging emergency physicians and orthopedic surgeons. The self-assisted technique Boss-Holzach-Matter (BHM) shows promising benefits in reducing patient anxiety and medical costs. Materials and Methods: A manual bibliographic search was conducted in PubMed, Scielo, and Central databases for studies from the last 10 years analyzing reduction techniques using the keywords "techniques for shoulder dislocation". Titles, abstracts, and full articles were reviewed, extracting pertinent data. Out of the 17 articles found, including systematic reviews, clinical trials, and other publications, 10 were selected without language restrictions. Results: Reduction methods varied significantly among studies. Comparison between self-assisted techniques like BHM and Spaso revealed differences in success rate and pain tolerance. The Davos technique demonstrated high effectiveness, although it was associated with potential complications. Comparative studies supported the efficacy of BHM and Milch in unassisted reduction. Conclusions: The need for further research to validate these findings, identify limitations, and evaluate clinical applicability is acknowledged. Additional studies are required to confirm the effectiveness of self-assisted techniques such as BHM, Milch, and Davos, as well as to address the potential limitations and considerations associated with each technique

Construction and Application of Patient-Participated Health Care Guidance Plan for Patients with Decompensated Hepatitis B Cirrhosis.

The goal of this study was to develop and assess the effectiveness of a patient-engaged healthcare guidance plan for individuals with decompensated hepatitis B cirrhosis. This study employed literature review, situational analysis, and expert consultations to create a healthcare guidance plan that includes patient participation for those suffering from decompensated hepatitis B cirrhosis. Between January 2022 and January 2023, 86 patients with this condition admitted to our hospital were selected through convenience sampling and randomly assigned into two groups using a random number table. The control group (n=43) received standard care, while the intervention group (n=43) received the novel patient-engaged healthcare guidance in addition to standard care. We compared both groups in terms of anxiety and depression levels, self-care capability, uncertainty about their illness, and overall quality of life. Upon discharge, scores for the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Mishel's Uncertainty in Illness Scale (MUIS) decreased in both groups compared to their scores at admission (P<0.05), with the intervention group showing more significant improvements than the control group (P<0.05). Additionally, scores for the Self-Care Ability Scale (ESCA) and the component threshold scores of the Health Survey Short Form (SF-36) increased for both groups from admission to discharge (P<0.05), with the intervention group showing greater improvements than the control group (P<0.05). The patient-engaged healthcare guidance plan developed for individuals with decompensated hepatitis B cirrhosis proved to be highly effective. It significantly reduced patient anxiety and depression, enhanced self-care capabilities, diminished illness uncertainty, and improved overall quality of life.

The Effects of Music Therapy on Patients Undergoing Colonoscopy in a Tertiary Care Hospital at Karachi, Pakistan: A Comparative Study

A colonoscopy is a procedure commonly used for the diagnosis of colorectal diseases but may be associated with high levels of anxiety and discomfort, which can lead to complications during sedation and decreased patient comfort and cooperation. This study was conducted at a tertiary care hospital in Karachi to assess the effectiveness of music therapy on pre-procedural anxiety, sedation requirements, pain, and procedure duration among patients undergoing colonoscopies. This comparative study included 110 outpatients. The intervention arm received non-lyrical soft music through earphones before and during the colonoscopy procedure, while the control group did not receive any music. In the intervention arm, significant reductions were seen in pre-procedural anxiety scores (p < 0.001), physiological measures (p < 0.001), sedation doses (p < 0.001), and procedure durations (p < 0.05). Control arm showed an increase in heart rate and systolic blood pressure (p < 0.001). Pain scores were similar for both groups. Music therapy is an effective tool to reduce patient anxiety pre- procedure. It is a simple, safe, and noninvasive relaxing intervention that could be used as an adjunct to sedative medications before and during the colonoscopy procedure.

Abstract PO3-01-09: Results of a prospective observational study evaluating the impact of the Prosigna assay on neoadjuvant treatment decision-making in patients with early-stage HR+/HER2- breast cancer

Abstract Background. Prosigna (PAM50) is an FDA-approved prognostic test that measures the expression of 50 classifier genes in breast cancer tissue samples. It provides intrinsic subtyping, which classifies the biology of an individual patient's tumor, as well as a risk of recurrence (ROR) score that predicts the probability of distant recurrence over 10 years. Currently, the Prosigna assay is only approved for use in postoperative specimens. Given studies demonstrating that Prosigna can identify tumors that are more likely to benefit from chemotherapy, this decision-impact study sought to evaluate whether the assay could influence physicians' choices and patients' confidence in the neoadjuvant treatment plan. Methods. This prospective observational study was conducted at a single institution and included patients with HR+/HER2- breast cancer measuring ≥ 0.5 cm, any nodal status, who were deemed candidates for neoadjuvant systemic treatment based on physician’s choice. Formalin-fixed paraffin-embedded core biopsy specimens were centrally analyzed using Prosigna. Patients' tumors were classified according to intrinsic tumor subtype (Luminal A, Luminal B, HER2-enriched, Basal-like) and ROR score (low, intermediate, or high). Physicians and patients were surveyed before and after performing Prosigna, regarding neoadjuvant therapy recommendations. The primary endpoint was assessment of the effect of Prosigna on oncologists' treatment recommendations and the actual treatment received (neoadjuvant hormonal therapy [NAHT], neoadjuvant chemotherapy [NACT], or upfront surgery). Secondary endpoints included determining whether treatment changes were based on ROR score, intrinsic subtype, or both, as well as assessing physicians' and patients' confidence in the treatment plan. Results. A total of 54 patients were enrolled in the study between March 2019 and April 2023. The distribution of intrinsic tumor subtypes was as follows: 15 patients (28%) had a Luminal A subtype, 34 (63%) had a Luminal B subtype, 3 (6%) had a HER2-enriched subtype, and 2 (4%) had a Basal-like subtype. Thirty-three patients (61%) were classified as ROR-low, 11 (20%) as ROR-intermediate, and 10 (19%) as ROR-high. Out of the 43 patients who had both pre- and post-assay survey results available, a change in the treatment decision was observed in 28% of cases. Specifically, 14% of patients transitioned from NAHT to NACT, 7% from NACT to NAHT, and 5% from NACT to upfront surgery, as shown in the Table. Treatment changes were based on the ROR score, intrinsic subtype, and both in 33%, 3%, and 64% of cases, respectively. Overall, 45% of physicians experienced an increase in confidence for the treatment plan after Prosigna testing, while 16% reported a decrease and 39% maintained the same level of confidence. Sixty-two percent of patients experienced a reduction in anxiety about treatment. Associations of ROR score and intrinsic subtypes will be presented at the meeting. Conclusion. Prosigna performed on presurgical core biopsies influenced oncologists' treatment recommendations regarding neoadjuvant treatment and reduced patient anxiety about treatment among patients with early-stage HR+/HER2- breast cancer. Table. Neoadjuvant treatment recommendations before and after Prosigna assay, overall and according to nodal status. Data are presented as frequencies (%). Abbreviations: NACT, neoadjuvant chemotherapy; NAHT, neoadjuvant hormonal therapy. Citation Format: Chiara Corti, Xiangying Chu, Pedro Exman, Danielle Kline, Nolan Priedigkeit, Nabihah Tayob, Erica Mayer, Adrienne Waks, Melissa Hughes, Antonio Giordano, Giuseppe Curigliano, Nancy Lin, Tari King, Rinath Jeselsohn, Deborah Dillon, Elizabeth Mittendorf, Sara Tolaney. Results of a prospective observational study evaluating the impact of the Prosigna assay on neoadjuvant treatment decision-making in patients with early-stage HR+/HER2- breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-01-09.

Assessment of Knowledge of General and Local Anesthesia among Patients Undergoing Elective Surgery

Objective Adequate knowledge of anesthesia and anesthesiologists can reduce patient anxiety. However, patients in developing countries are known to have relatively lesser knowledge and awareness regarding anesthesia. This study aims to evaluate the knowledge of patients referred for elective surgery regarding regional and general anesthesia and related factors. Methods In this descriptive-analytic cross-sectional study, 370 subjects were evaluated by a simple non-random sampling method. The researcher constructed a questionnaire study tool to assess demographic variables, backgrounds, and patients' level of awareness. After the collection, data were entered into the SPSS 21 software and were analyzed using chi-square, variance analysis and independent t-test. Results The mean age of our patients was 43.09±17.79 years and the mean score of knowledge regarding general and local anesthesia was 3.62±1.35 and 2.65±1.53, respectively. In this study, patients' awareness about general and local anesthesia had a significant association with female gender, age group 30-40 years, postgraduate education, government job previous local anesthesia, trust in the physician, having a history of surgery and willingness to visit the anesthesiologist before the surgery. In addition, patients who had eyes, nose and throat surgeries, and their source of information was limited, had greater scores, p&lt;0.005. Individuals were more aware of common side effects of local anesthesia than those of general anesthesia. However, over half of the patients preferred general anesthesia due to fear of live experience and sound during surgery. Conclusion Based on the results of the study, the awareness of patients about general anesthesia was greater than regional anesthesia. Overall, increasing awareness by strengthening the level of confidence and trust in anesthesiologists can lead to better postoperative outcomes and reduce patients’ anxiety levels.

Audio Distraction for Traction Pin Insertion: A Prospective Randomized Controlled Study.

Insertion of a skeletal traction pin in the distal femur or proximal tibia can be a painful and unpleasant experience for patients with a lower-extremity fracture. The purpose of this study was to determine whether providing patients with audio distraction (AD) during traction pin insertion can help to improve the patient-reported and the physician-reported experience and decrease pain and/or anxiety during the procedure. A prospective randomized controlled trial was conducted at 2 level-I trauma centers. Patients ≥18 years of age who were conscious and oriented and had a medical need for skeletal traction were included. Patients were randomized to receive AD or not receive AD during the procedure. All other procedure protocols were standardized and were the same for both groups. Surveys were completed by the patient and the physician immediately following the procedure. Patients rated their overall experience, pain, and anxiety during the procedure, and physicians rated the difficulty of the procedure, both on a 1-to-10 Likert scale. A total of 54 patients met the inclusion criteria. Twenty-eight received AD and 26 did not. Femoral fractures were the most common injury (33 of 55, 60.0%). Baseline demographic characteristics did not differ between the 2 groups. The overall patient-reported procedure experience was similar between the AD and no-AD groups (3.9 ± 2.9 [95% confidence interval (CI), 3.1 to 4.7] versus 3.5 ± 2.2 [95% CI, 2.9 to 4.1], respectively; p = 0.55), as was pain (5.3 ± 3.2 [95% CI, 4.4 to 6.2] versus 6.1 ± 2.4 [95% CI, 5.4 to 6.8]; p = 0.28). However, anxiety levels were lower in the AD group (4.8 ± 3.3 [95% CI, 3.9 to 5.7] versus 7.1 ± 2.8 [95% CI, 6.3 to 7.9]; p = 0.007). Physician-reported procedure difficulty was similar between the groups (2.6 ± 2.0 [95% CI, 2.1 to 3.1] versus 2.8 ± 1.7 [95% CI, 2.3 to 3.3]; p = 0.69). AD is a practical, low-cost intervention that may reduce patient anxiety during lower-extremity skeletal traction pin insertion. Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

Current role of viral biomarkers in cervical carcinogenesis

Viral biomarkers for cervical cancer screening are valuable in improving timely diagnosis and detection at early stage. The various biomarkers currently there is evidence include high-risk human papillomavirus (hrHPV) deoxyribonucleic acid (DNA) testing, there is place for further research for biomarkers such as hrHPV genotyping hrHPV transcriptional status, and host DNA methylation. Though the evidence is conclusive for hrHPV DNA testing, there is place for further research for biomarkers such as hrHPV genotyping hrHPV transcriptional status, and host DNA methylation. This application of these biomarkers in context of low resource settings has its limitations despite high prevalence of the disease. Improved women participation can be achieved by use of self-samples thereby improving diagnoses rate of the disease and higher cost effectiveness of the screening programme. In due course, biomarkers will be made available in the screening programmes together with self-sampling that will detect hrHPV infections and low-grade squamous intraepithelial lesions (LSIL) before they progress to high-grade squamous intraepithelial lesions (HSIL), and from there to malignancy. This would facilitate prudent timely clinical decisions, reduced patient anxiety, reduction in over referral and unnecessary treatments in women, especially in developing countries.

Preprocedural Video Education on Liver Ablation Treatment

BackgroundAnxiety is a common problem in patients scheduled for a procedure, and their level of anxiety increases as the procedure date approaches; pre-procedural anxiety is observed in hepatocellular carcinoma (HCC) patients scheduled for liver ablation treatment. There is currently a lack of standardized education provided to patients about liver ablation treatment, which may contribute to patients’ anxiety. PurposeTo test the effectiveness of a pre-procedural video educational tool to reduce patient anxiety and increase knowledge in HCC patients in an interventional radiology clinic setting. MethodsThis was a quasi-experimental, single-arm study, with a pre-test/post-test. Participant recruitment was based on a convenience sample. Inclusion criteria included: patients ages 18 and older; have biopsy-proven HCC or have a liver mass suspicious for HCC based on LI-RADS criteria imaging; no prior liver ablation treatment within three months of study onset. Participants watched a 7:04 minutes video and completed a 40-item State-Trait Anxiety Inventory and 10-item Knowledge Questionnaire before and after the video intervention to assess changes in anxiety and knowledge. Demographic variables evaluated included age, gender, education, and primary language. ResultsThere were 16 participants who met inclusion criteria. The state anxiety scores were significantly lower after the intervention (Md = 33.50, n = 16) compared to before (Md = 47.50, n = 16), z = −2.67, p = .009, with a medium effect size, r = 0.47. The trait anxiety scores did not show sufficient evidence for a difference after the intervention (Md = 40.00, n = 16) compared to before (Md = 39.50, n = 16), z = 0.71, p = .50, with a small effect size, r = 0.13. The knowledge scores were significantly higher after the intervention (Md = 9.00, n = 16) compared to before (Md = 2.00, n = 16), z = −3.53, p = .0005, with a large effect size, r = 0.62. A nonparametric bootstrap and nonparametric permutation test also showed evidence for a difference in mean between the distributions of the state anxiety and knowledge pre- and post-intervention scores. DiscussionThe results of this study showed evidence for the effectiveness of video education in decreasing anxiety and increasing knowledge in HCC patients. A standardized pre-procedural video educational tool can be a useful practice across all interventional radiology departments as it is associated with improved quality of care and positive health outcomes.