Visual Analogue Scale For Anxiety Research Articles

OP23 Early Detection Tools For Emotional Distress In Adult Cancer Patients In Spain: A Health Technology Assessment Report

IntroductionPatient-reported outcome measures are being increasingly considered both in clinical practice and in the field of health technology assessment. Although emotional distress is currently recognized as the sixth vital sign in cancer care, its early detection and screening is not yet included in routine clinical practice in Spain. The main objective of this study was to assess the psychometric properties and diagnostic accuracy of validated tools for the early detection of distress among adults with cancer in the Spanish context, at the request of the Spanish National Health System (NHS) Cancer Strategy.MethodsA systematic review was carried out to analyze development and validation studies. The Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) was used for the risk of bias assessment, and a multicriteria global assessment was used for the tests. Ethical and organizational aspects were also addressed.ResultsFifteen validation studies were included, corresponding to seven tests. The tools considered were the Distress Thermometer (DT), the Brief Symptom Inventory-18 (BSI-18), the Edmonton Symptom Assessment System-revised (ESAS-r), the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale for Anxiety and Depression (VAS-AD), the Detection of Emotional Distress (DED) scale, and the Psychosocial and Spiritual Needs Evaluation (ENP-E) scale. Evidence of validity, reliability (internal consistency), and diagnostic accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) were summarized. Three scales were rated as poor (VAS-AD, BSI-18, and ESAS-r), the ENP-E scale was rated as acceptable, and three scales were rated as moderate (DT, DED, and HADS).ConclusionsThe DT (single-item measure) stands out as an appropriate tool for early detection of emotional distress in the Spanish NHS. The use of this scale could be considered a first stage, to be combined later with a longer scale to improve screening specificity. The HADS scale could be utilized for this purpose. The use of these tools should be framed within a structured screening program that ensures further evaluation and subsequent psychological care when needed.

The Effects of Progressive Muscle Relaxation on Preoperative Anxiety and Blood Pressure in Patient with Aneurysm

This study, conducted on diagnosed aneurysm patients, in order to test the effects of progressive muscle relaxation on blood pressure and anxiety levels in the preoperative period, was carried out in a quasi-experimental study with a pre-test and post-test application. The data of this study were collected between January 2022-September 2022 at the neurosurgery clinic on 38 patients (twenty women and eighteen men) who’ve been diagnosed with cerebral aneurysm, awaiting a surgical operation, and have other criteria to be taken into the study. Pre- and post-exercise vital signs and anxiety levels of patients receiving progressive muscle relaxation exercises for twenty minutes in the preoperative period were measured with the Visual Analogue Scale (VAS) and Beck Anxiety Inventory (BAI). Frequency analysis for descriptive statistics, and t-test analysis for blood pressure, pulse, respiration, BAI, and VAS scores in a single group were utilized. Progressive muscle relaxation exercises in the preoperative period for neurosurgery patients diagnosed with aneurysm have statistically significant effects in reducing the patients’ anxiety and blood pressure (p<0.001). It is recommended that progressive muscle relaxation exercises be used in the clinic during the preoperative period. A clinically important finding is the positive effect of progressive muscle relaxation exercises on patients' vital signs and anxiety.

Inhalation of Origanum majorana L. essential oil while working reduces perceived stress and anxiety levels of nurses in a COVID-19 intensive care unit: a randomized controlled trial.

Nurses caring for patients with coronavirus disease 2019 (COVID-19) experience higher psychosocial distress than other healthcare workers, and this can adversely affect the quality of patient care. There is evidence that inhalation of essential oil from marjoram (Origanum majorana L.) has calming effects, suggesting this intervention may help to reduce the stress and anxiety of nurses working in a COVID-19 intensive care unit (ICU). This study aimed to investigate the effect of inhalation of marjoram essential oil at work on the stress and anxiety levels of nurses in a COVID-19 ICU. Nurses (n = 57) working in a single COVID-19 ICU were randomly assigned to inhale 3% marjoram essential oil (marjoram group, n = 29) or almond oil (control group, n = 28) for 2 h while at work. Mean arterial pressure (MAP), heart rate, state anxiety score, and score on a visual analog scale for anxiety (VAS-anxiety) and stress (VAS-stress) were measured before and after the intervention. The two groups had similar baseline variables. MAP did not have within-group or between-group differences. Heart rate increased significantly in the marjoram group after the intervention (p = 0.031), but it remained within the normal range and the increase was not clinically meaningful. There was no significant between-group difference in the state-anxiety or VAS-anxiety score after the intervention, but the marjoram group had a significantly lower state-anxiety (p = 0.001) and VAS-anxiety (p = 0.037) score at posttest vs. pretest. The VAS-stress score was significantly lower in the marjoram group at the posttest vs. the pretest (p = 0.026). Nurses caring for patients in a COVID-19 ICU experience significant stress, and strategies are needed to address this important issue. Inhalation of 3% marjoram essential oil while caring for patients in a COVID-19 ICU may be a simple and effective intervention that reduces perceived stress and anxiety in nurses.Clinical Trial Registration: https://cris.nih.go.kr/, KCT0007543.

Spiritual Emotional Freedom Technique Intervention on Anxiety Level of Hypertensive Heart Disease Patients

Hypertension is one of the leading causes of various heart diseases. In patients with Hypertensive Heart Disease (HHD), anxiety symptoms can continue to increase, which can affect the treatment and healing process and can cause various complications. This study aims to determine the effect of Spiritual Emotional Freedom Technique (SEFT) therapy on anxiety levels in HHD patients in the ICCU room of Kendari City Hospital. This type of research is a pre-experiment with a one-group pretest-posttest design. The population in this study were all HHD patients treated in the ICCU room of Kendari City Hospital. The sampling technique used was purposive sampling, with a total sample size of 22 respondents. This research instrument uses the Anxiety Visual Analog Scale (VAS-A) questionnaire sheet to measure anxiety levels. The analysis method uses a paired-sample t-test. The results showed that the level of anxiety before and after SEFT therapy decreased. This can be seen from the statistical test p-value = 0.000 < α = 0.05, which shows a significant difference. It can be concluded that SEFT therapy influences reducing anxiety levels in HHD patients. It is expected for service institutions and other institutions to provide training for health workers to perform SEFT therapy to help reduce patient anxiety levels.

The combination of listening to background music and deep breathing as a stress reduction strategy during dental preclinical study.

According to our earlier study, background music can help foster dental preclinical manual dexterity training and learning and has the potential to increase student satisfaction and productivity. Deep diaphragmatic breathing helps produce a relaxed mental state and is considered a behavioral coping strategy to reduce anxiety. Experimental data on whether background music combined with deep belly breathing reduces the stress and anxiety of preclinical dental students during practice is lacking. Thus, we focused on evaluating the effects of the combined use of these two techniques on dental students during preclinical manual skills training. Thirty-one voluntary 3rd-year dental students' anxiety levels and their behavioral changes were monitored via anonymous, voluntary surveys including the Patient Health Questionnaire-4, General Health Questionnaire-12 (GHQ-12), and Visual Analogue Scale for Anxiety (VAS-A). Overall, stress measured by GHQ-12 decreased significantly in female students (p=0.025), but not in males. Both background music and deep belly breathing significantly reduced all students' fear and stress based on their VAS-A scores in practice. However, a clear difference from the nonuse of coping strategies could not be conclusively shown. The students regarded the course positively based on survey replies. The combined use of the two coping strategies delivered beneficial effects to the preclinical dental students: they reduced the amount of stress in the supervised preclinical students and considerably cut down the students' anxiety. Further investigation of this new dental training scenario may help professionals provide better student education and care management during the dental preclinical phase.

The use of virtual reality during extra-amniotic balloon insertion for pain and anxiety relief—a randomized controlled trial

Background: Induction of labor with extra-amniotic balloon (EAB) catheter is a procedure commonly associated with maternal discomfort, pain, and anxiety. Objective(s): We aimed to investigate the distractive effect of virtual reality (VR) technology on pain and anxiety- in pregnant patients who undergo Induction of labor with EAB.Study design: In this randomized controlled trial, pregnant patients intended for Induction of labor with EAB at term, for various obstetric indications, were recruited and randomized in a 1:1 ratio into two groups. Patients in the VR group were exposed to a VR technology clip (using SootheVR All-In-One VR care system for pain and anxiety) during the entire EAB insertion while patients in the control group received the institutional standard care for EAB insertion. Pain scores expressed by Visual Analog Scale (VAS) and maternal hemodynamic parameters, were obtained before, during, and after EAB insertion. Anxiety was evaluated by the validated State-Trait Anxiety Inventory Scale (STAI-S) before and after the procedure. Maternal satisfaction from the VR technology was also recorded. The primary outcome was the change in VAS score before and during EAB insertion. Among the secondary outcomes was the change in Anxiety levels before and after EAB insertion. The study was powered to detect a 25% decrease in the primary outcome.Results: A total of 132 pregnant patients were recruited (66 in each group). There were no differences between groups in terms of age, BMI, gestational age at enrollment, indication for Induction of labor, and pre-procedural VAS score and anxiety levels. The change in VAS score (maximal VAS score during the procedure subtract the initial VAS score before the procedure, i.e the primary outcome) was significantly lower in the VR group compared to the control group (2.78±3.0 vs 4.09±2.99, p=0.01). In addition, the VR group benefited a higher rate of anxiety relief expressed by the difference between pre-procedure and post-procedure STAI score, (-6.46 ± 9.6 vs -2.01 ± 9.11, P=0.007). Patients in the VR group reported an overall very high (94%) satisfaction score.Conclusions: In this randomized controlled trial, we demonstrated that the use of VR technology in patients undergoing Induction of labor with EAB was associated with lower VAS scores during the procedure and significant anxiety reduction compared to patients who received standard care. There was also a very high satisfaction rate from the use of VR technology.

The efficacy of audiovisual distraction as an anxiety-minimizing technique during echocardiography in preschool children

Background Echocardiography procedures can cause fear and anxiety in children, especially at preschool age. Audiovisual distraction is a simple, harmless, and low-cost technique that does not interfere with the procedure.
 Objective To assess the effect of audiovisual distraction on the anxiety levels of children aged 2-5 years during echocardiography.
 Methods This quasi-experimental study included children aged 2-5 years who were admitted for echocardiography. Patients with hearing or visual impairment, Down syndrome, autism, or attention-deficit/hyperactivity disorder were excluded. We administered anxiety-reducing intervention in the form of cartoon audiovisual media shown on a ceiling-mounted television during the echocardiography procedure. Anxiety levels were assessed using the Visual Analogue Scale - Anxiety (VAS-A) before and after the intervention was given. We compared the subjects’ pre- and post-procedure VAS-A scores and heart rates.
 Results Of the 43 subjects who underwent echocardiography during the study period, the mean age was 3.2 (SD 0.9) years, with an equal sex distribution. Most subjects had a history of repeated echocardiography procedures and hospitalizations. Thirty-nine (90.6%) of subjects demonstrated anxiety during the echocardiography procedure. There was a significant mean difference of 11.9 (SD 13.2) bpm (95%CI 7.8 to 15.9 bpm, p<0.001) in heart rate pre- vs. post-intervention. Median pre- and post-intervention VAS-A scores were 5 (range 0-10) and 1 (range 0-4), respectively (P=0.001). Post-intervention, almost all (97.7%) subjects had no or mild anxiety.
 Conclusion Audiovisual content presented on television serves as an effective distraction method to reduce children's anxiety during echocardiography.

Effect of pre-operative patient anxiety on post-spinal shivering during elective cesarean delivery: a prospective observational study

BackgroundShivering after spinal anesthesia is common during cesarean delivery (CD), and is thought to be primarily a thermoregulatory response. By inducing autonomic changes, pre-operative anxiety could alter the functioning of the thermoregulatory center, hence modifying the incidence and severity of obstetric post-spinal shivering. This prospective observational study was conducted to explore the relationship between pre-operative anxiety and obstetric post-spinal shivering. MethodsPatients ≥18 years of age and scheduled for elective CD under spinal anesthesia were enrolled. Pre-operative anxiety was measured on the day of surgery using a visual analogue scale (VAS) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and was correlated with the incidence of post-spinal shivering. Other possible risk factors for post-spinal shivering were explored using univariate and multivariate logistic regression models. ResultsAmong the 150 participants, 46 (31%) experienced post-spinal shivering. The relative risk of intra-operative shivering in those with high APAIS pre-operative anxiety was 2.76 (95% CI 1.55 to 4.90; P = 0.0005). Younger patient age (aOR 0.91, 95% CI 0.83 to 0.98; P = 0.02), higher APAIS anxiety score (aOR 1.21, 95% CI 1.06 to 1.37; P = 0.005), higher VAS anxiety score (aOR 1.48, 95% CI 1.24 to 1.78; P < 0.001) were independent risk factors for post-spinal shivering. ConclusionsHigh pre-operative anxiety and younger patient age were independent risk factors for post-spinal shivering during elective CD. Targeted interventions to reduce pre-operative patient anxiety might have a positive impact in decreasing the incidence of intra-operative post-spinal shivering in this patient population.

An examination of worry and self-distancing as coping strategies for anxiety-provoking experiences in individuals high in worry

ABSTRACT Objectives This preliminary online study investigated the short-term effects of self-distancing, worry, and distraction on anxiety and worry-related appraisals among individuals high in worry. Design and Methods N = 104 community members high in trait worry were randomly assigned to think about a personally identified worry-provoking situation using self-distancing (SC), worry (WC), or distraction (DC). Participants rated their anxiety (Visual Analogue Scale for Anxiety) and appraisals of the situation (Perceived Probability, Coping, and Cost Questions) at post-task and one-day follow-up. Results Mixed factorial ANOVAs revealed an increase in anxiety within the WC (d = .475) and no difference in anxiety within the SC (d = .010) from pre- to post-task. There was no difference in anxiety within the DC (p = .177). Participants within the SC reported a decrease in the perceived cost associated with their identified situation from pre- to post-task (d = .424), which was maintained at one-day follow-up (d = .034). Participants reported an increase in perceived ability to cope from post-task to one-day follow-up (d = .236), and from pre-task to one-day follow-up (d = .338), regardless of condition. Conclusions Self-distancing may prevent increases in anxiety and catastrophizing while reflecting on a feared situation.

Trigeminal Ganglion Electrical Stimulation for Trigeminal Nerve Postherpetic Neuralgia: A Retrospective Study.

To investigate the clinical outcome of trigeminal ganglion electrical stimulation for the treatment of trigeminal postherpetic neuralgia (TPHN). A retrospective analysis of clinical data was performed on six patients who suffered from severe postherpetic neuralgia involving the trigeminal nerve maxillary and mandibular branch. They were admitted under the Pain Management Department of the First Hospital of Shanxi Medical University from July 2022 to February 2023 and underwent trigeminal ganglion electrical stimulation therapy. Visual analogue scale (VAS) scores, pregabalin dosage, pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) were recorded before treatment, as well as after treatment at 1, 4, 8, 12, and 24-week. Adverse reactions related to the treatment were also documented. After trigeminal ganglion electrical stimulation therapy, the VAS scores, PSQI scores, anxiety scores, depression scores, and pregabalin dosage of six patients showed significant reductions at 1, 4, 8, 12, and 24 weeks. (P < 0.05). No serious adverse reactions occurred in any of the patients. Trigeminal ganglion electrical stimulation effectively relieved postherpetic neuralgia in the distribution areas of the trigeminal nerve 2 and 3 branches, reduced the dosage of analgesics, improved the quality of sleep, and alleviated anxiety and depression symptoms in patients. Our data suggested that It was a safe and effective clinical.

Mikrodiskektomi ile Opere Edilen Lomber Disk Hernili Hastalarda Anksiyete ve Depresyon Düzeylerinin Değerlendirilmesi

Aim: Studies examining the effect of microdiscectomy and surgical treatment on the psychiatric complaints of patients with lumbar disc herniation are new and few. Although the international literature reports that depression and anxiety decrease in the long term after microdiscectomy, we observed that these complaints were resolved much earlier in our clinical practice. We aimed to determine depression, anxiety, and pain levels in the preoperative period and in the first month postoperatively with validated scales for the documentation of these observations. Method: After eliminating patients with comorbid pathologies that may affect pain and psychiatric factors, pain levels in 31 patients with lumbar disc herniation were evaluated with the Visual Analog Scale (VAS) and depression and anxiety levels were evaluated with the Hospital Anxiety and Depression (HAD) scale. Statistical comparisons were made with the Student-T test in NCSS (2020, Utah, USA). Results: It was observed that the low back and leg pain scores improved significantly after microdiscectomy, and the preoperative anxiety and depression scores were widely distributed, but both were significantly reduced in the postoperative period. Conclusion: The decrease in depression and anxiety levels after microdiscectomy earlier than international observations can be explained by the higher surgical anxiety in the Turkish population and the higher correlation between mood and pain levels. Since pain and psychiatric complaints have the feature of increasing each other, more successful management of these factors by clinicians will contribute to more effective treatments.

Role of detailed information about anaesthesia during PAC to reduce patient’s anxiety during the perioperative period

ABSTRACT Background: Perioperative anxiety may adversely influence anaesthetic induction and patient’s recovery. Pharmacological interventions include the use of narcotics, sedatives and anxiolytics. However, such drug interventions are typically accompanied by adverse reactions. Perioperative anxiety experienced by patients can be significantly diminished through the provision of comprehensive information regarding the anaesthesia procedure, surgical procedure and perioperative events during the pre-anaesthetic assessment conducted in an outpatient consultation clinic. Aims: This prospective study was conducted to assess the impact of providing comprehensive information on alleviating patient anxiety throughout the perioperative period. Materials and Methods: This prospective observational study was conducted on 60 patients to assess patient’s perioperative anxiety for anaesthesia and surgery. All study participants were asked to mark their pre-operative anxiety on the Visual Analogue Scale-Anxiety (VAS-A) and asked to fill the questionnaire of Amsterdam Pre-operative Anxiety and Information Scale (APAIS). Results: During the pre-information evaluation, patient’s mean VAS-A score was 4.73 ± 2.75 which decreased to 3.65 ± 2.53 in post-information evaluation (P = 0.027). The overall APAIS score during pre-information and post-information evaluation was 17.4 ± 8.06 and 13.18 ± 7.06 (P = 0.002). The mean APAIS score for anaesthesia and surgery during the pre-information evaluation was 2.67 ± 1.46 and 3.13 ± 1.54, respectively, which decreased to 2.04 ± 1.18 and 2.35 ± 1.30, respectively, in post-information evaluation. This difference in APAIS score evaluation during pre-information and post-information evaluation for anaesthesia (P = 0.0105) and surgery (P = 0.003) was statistically significant. Conclusion: Perioperative anxiety experienced by patients can be effectively mitigated by providing comprehensive information pertaining to anaesthesia procedures, surgical procedures and perioperative events during the pre-anaesthetic assessment conducted within an outpatient consultation clinic.

Effets de l'hypnose par réalité virtuelle sur la tolérance de la bronchoscopie flexible

Patients often perceive flexible bronchoscopy as an unpleasant procedure. The aim of this study was to investigate the effect of virtual reality (VR) hypnosis on tolerance to flexible bronchoscopy. We conducted a prospective, randomized, controlled, monocentric study comparing flexible bronchoscopy with VR-induced hypnosis to the usual procedure. Patient tolerance was evaluated using a visual analogue scale (VAS), the state-trait anxiety inventory (STAI) before and after the procedure and, finally, willingness to repeat the examination under the same conditions (WTR). Among the 70 patients included, 34 were randomized to the VR hypnosis group and 36 to the control group. There was no difference between the 2 groups in terms of modification of the pre-/post-bronchoscopy VAS for anxiety, pain, cough, choking, nausea and overall discomfort, or modification of the STAI score and WTR. Subgroup analysis among patients who were more anxious before the procedure revealed a trend toward reduced anxiety in the VR hypnosis group. This study did not observe any effect of VR hypnosis on the tolerance of patients during routine flexible bronchoscopy. However, VR hypnosis may be beneficial in patients with higher anxiety score before bronchoscopy, a hypothesis that needs to be confirmed by further studies with a larger number of subjects.

Effect of a music intervention on anxiety in adult critically ill patients: a multicenter randomized clinical trial

BackgroundPrevious studies show positive effect of music on reducing anxiety, pain, and medication requirement. Anxiety has become a more pertinent issue in the intensive care unit (ICU) since wakefulness is preferred according to recent guidelines. Nevertheless, evidence on the effect of music in ICU patients is scarce. Therefore, we studied the effect of music intervention on anxiety in ICU patients.MethodsA multicenter randomized clinical trial was conducted between August 2020 and December 2021 in ICU’s at an academic medical centre and two regional hospitals. Adult critically ill patients were eligible when hemodynamically stable and able to communicate (Richmond agitation-sedation scale (RASS) of at least − 2). Patients in the intervention arm were offered music twice daily during three days for at least 30 min per session. Patients in the control group received standard care. The primary outcome was anxiety level assessed with the visual analogue scale for anxiety [VAS-A; range 0–10] twice daily (morning and evening). Secondary outcomes included; 6-item state-trait anxiety inventory (STAI-6), sleep quality, delirium, heart rate, mean arterial pressure, pain, RASS, medication, ICU length of stay, patients’ memory and experience of ICU stay.Results94 patients were included in the primary analysis. Music did not significantly reduce anxiety (VAS-A in the intervention group; 2.5 (IQR 1.0–4.5), 1.8 (0.0–3.6), and 2.5 (0.0–3.6) on day 1, 2, and 3 vs. 3.0 (0.6–4.0), 1.5 (0.0–4.0), and 2.0 (0.0–4.0) in the control group; p > 0.92). Overall median daily VAS-A scores ranged from 1.5 to 3.0. Fewer patients required opioids (21 vs. 29, p = 0.03) and sleep quality was lower in the music group on study day one [5.0 (4.0–6.0) vs. 4.5 (3.0–5.0), p = 0.03]. Other outcomes were similar between groups.ConclusionsAnxiety levels in this ICU population were low, and music during 3 days did not decrease anxiety. This study indicates that efficacy of music is context and intervention-dependent, given previous evidence showing decreased anxiety.Trial registration Netherlands Trial Register: NL8595, Registered, 1 April 2020. ClinicalTrials.gov ID: NCT04796389, Registered retrospectively, 12 March 2021

Effectiveness of Wudhu to Reducing Anxiety During Competency Test on Students

Anxiety is an emotional response to individuals perspective thas was subjective and an unknown cause. National competency exams anxiety is one of psychological problems that nursing students often experience that is a fear of failure, getting bad grades, or cannot get through the exams. Therefore, there is a need to minimize anxiety. The treatment of anxiety can be with nonpharmacological therapy. One of the nonpharmacological therapy using hydotheraphy with wudu’ technique. This research aims to identify the effect of wudu’ on changes toward anxiety for nursing students in the national competency exam. The research design used in this research is preexperiment with single group design, pre- and post-test design. The research samples in this research were 24 respondents with simple random sampling technique. Instrument used in this research is Visual Analog Scale for Anxiety (VAS-A). Statistical test was doneusing wilcoxon signed-rank test, the obtained p-value = 0.000 (&lt; 0.05), showed the influence of wudu’ on changes of anxiety for Universitas Faletehan nursing students anxiety in the national competency examination. Wudu’ contains elements of relaxation to reduce anxiety and provides benefits for physical, psyclogical, and emotional control. The results of this research can be used as a reference of nonpharmacological therapy to treat anxiety in national competency examination.&#x0D; Keywords: anxiety, national competency test, wudhu’

Anesthetic Efficacy of Endo-Ice and Intrapulpal Ice Sticks After Inferior Alveolar Nerve Block in Symptomatic Irreversible Pulpitis: A Randomized Controlled Study.

There is a dearth of studies to assess the effectiveness of cryotherapy as a possible adjuvant in anesthesia. Therefore, this study aimed to compare the impact of pretreatment intraoral ice packs, application of Endo-ice, and a combination of Endo-ice and intrapulpal ice sticks use on the effectiveness of pulpal anesthesia as an adjunct in the management of pain and dental anxiety in mandibular second molars with symptomatic irreversible pulpitis (SIP) against traditional inferior alveolar nerve block (IANB) technique. The randomized controlled double-blind clinical study comprised of 200 subjects within the age group of 20-45 years with SIP involving mandibular second molars and divided into four groups of 50 each. Conventional IANB was administered in group 1. Intraoral compact ice packs, Endo-ice, and combined use of Endo-ice and intrapulpal ice sticks were employed following conventional IANB in groups 2, 3, and 4, respectively. The intensity of pain and anxiety before and after the intervention was documented using Heft-Parker visual analog scale (HP-VAS) and Corah's Dental Anxiety Scale-Revised (DAS-R). The average age of the overall study sample was 30.8±2.08 years, and the differences in age and gender distribution were found to be statistically insignificant. The mean HP-VAS scores on access opening and pulpectomy, using ANOVA paired with Tukey's post hoc multiple comparison tests were evaluated to be statistically highly significant (p<0.001). The greatest reduction in HP-VAS score was observed in group 4 receiving combined use of both Endo-ice and intrapulpal ice sticks. While the pretreatment DAS-R score was determined to be statistically insignificant between groups, group 1 subjects had the highest DAS-R score postoperatively (p<0.001). The effectiveness of pulpal anesthesia was found to be 84%, 96%, 92%, and 98% for groups 1 through 4, respectively, and demonstrated a statistically significant difference. The combined use of Endo-ice and intrapulpal ice sticks used as an adjuvant to local anesthesia (LA) was found to be significantly effective in lowering pain compared to the control groups in molars with SIP. Cold administration before and during the procedure was more effective than conventional LA in lowering intraoperative anxiety. Furthermore, the use of Endo-ice and intrapulpal cold after IANB significantly improves the effectiveness of pulpal anesthesia in mandibular second molars with SIP.

The Effect of Virtual Glasses Application on Pain and Anxiety During Episiotomy Repair: Randomized Controlled Trial

BackgroundIn the literature, the efficacy of virtual glasses on acute pain and anxiety has been investigated, and no study has been found on its effect on pain and anxiety during episiotomy repair. AimsTo determine the efficacy of virtual glasses application in pain and anxiety during episiotomy repair. DesignRandomized controlled trial design was used. ParticipantsThe study included 120 women who were primiparous and pregnant: 40 in the control group and 80 in the experimental groups (virtual glasses and skin to skin contact). MethodsData were collected using Descriptive Information Form, the Visual Analog Scale (VAS), and the State Anxiety Inventory. In experimental groups, virtual glasses and skin to skin contact were applied during episio tomy repair by the researcher, and they were not applied to the control group. The VAS and State Anxiety Inventory were used to assess pain and anxiety in all groups before and after application. In the statistical analysis of the data, the SPSS 23.0 packa ge program was used. In all tests, p < .005 wa s considered statistically significant. ResultsImmediately post intervention, the women in the experimental groups had significantly decreased anxiety and pain during episiotomy repair. Comparing three methods, the virtual glasses significantly reduced anxiety and pain after application (p < .05). ConclusionsVirtual glasses are more effective than skin to skin contact and control methods in decreasing pain and reducing anxiety during episiotomy repair. Additionally, virtual glasses may reduce the need for pharmacological medication due to this reduction in pain and anxiety during episiotomy repair.

Development and validation of nomograms to predict preoperative anxiety and postoperative pain in patients undergoing gynecological surgery: An observational analysis

BackgroundPerioperative anxiety and pain are associated with patient dissatisfaction, postoperative complications, and prolonged hospital stay. Early identification of high-risk patients with preoperative anxiety and postoperative pain will be useful for the implementation of preventive management. MethodsPatients, who underwent gynecological surgery in our hospital between March 2022 and September 2022, were consecutively enrolled. Perioperative anxiety and pain were evaluated with the Visual Analogue Scale of Anxiety (VAA) and Visual Analogue Scale of Pain (VAS), respectively. Step Akaike Information Criterion analysis was performed to identify risk factors and logistic regression was used to establish nomograms, followed by discrimination, calibration, and clinical utility evaluation. ResultsA total of 197 patients were included for analysis, including 116 and 81 patients who were randomized to training and test groups, respectively. The prediction model of preoperative moderate to severe anxiety identified four preoperative relevant factors: age, sleep duration, preoperative pain, and regular exercise before gynecological surgery. The model had an area under the receiver operating characteristics curve of 0.808 (0.729, 0.887) and 0.754 (0.634, 0.875) in the training and test groups, respectively. The prediction model of postoperative moderate to severe pain identified four relevant factors: preoperative pain, surgery type, VAA before anesthesia, and patient-controlled analgesia. The model had an area under the receiver operating characteristics curve of 0.867 (0.798, 0.935) and 0.852 (0.761, 0.943) in the training and test groups, respectively. ConclusionsThe established nomograms accurately identified high-risk patients with preoperative anxiety and postoperative pain before gynecological surgery.Clinical registration at: www.chictr.org.cn (ChiCTR2200057757).

Correlates of higher anxiety scores reported by women admitted for elective caesarean section

BackgroundAn elective caesarean section (CS) has been associated with high anxiety scores, and there are associations between higher anxiety scores and younger age, primigravidae, higher educational level, and previous experience with anaesthesia. In this study, the aim is to measure anxiety scores associated with an elective CS using two measuring scales and identify women's characteristics and obstetrics variables that are associated with higher scores. MethodsA cross-sectional study was conducted between Nov 15, 2019 and Nov 15, 2020. Women were included if they were 18 years of age or more, had viable pregnancies, and were admitted for an elective CS. Anxiety scores were measured on admission using the visual analogue scale for anxiety (VASA) and then the State-Trait Anxiety Inventory (STAI-Y). Associated factors were studied using logistic regression analyses. ResultsThree hundred women were recruited. Means (SD) for the participant's age and gestation age were 30.5 (5.7) years and 37.6 (1.4) weeks, respectively. Additionally, 29.3% of the participants having a CS were primigravidae and 62.3% were for maternal indications. Furthermore, 55%, 59%, and 61% of the women had scores above the means of VASA and STAI-S components 1 and 2, respectively.Variables that showed statistically significant associations with higher anxiety scores were that the woman's age was 25–34, the CS was for foetal indications, the choice of anaesthesia was general, and the source of information for the choice of anaesthesia was a layperson. ConclusionHigher anxiety scores are prevalent among women admitted for an elective CS. STAI-Y and VASA correlated well, and the short VASA may replace the lengthy STAI-Y in clinical practice. Identification of women with risk factors may help in implementing strategies to reduce anxiety.

Mechanistic investigation of acupuncture treatment in patients with migraine: Evidence from brain imaging study (I): 针刺治疗偏头痛的效应机制研究:来自脑影像研究的证据 (I)

ObjectiveMagnetic resonance imaging (MRI) studies have demonstrated anatomical and functional alterations of brain regions in patients with migraine, and the efficacy of acupuncture for migraine could regulate these abnormal alterations. However, its pathogenesis remains ambiguous, and inconsistent results have been reported. The purpose of this study was to explore abnormal structural and functional alterations in patients with migraine using voxel-based morphometry (VBM) analysis and a seed-based functional connectivity (FC) approach and to provide a basis for future research. MethodsThe study recruited 34 patients with migraine and 38 healthy controls who underwent structural and resting-state functional magnetic resonance imaging (fMRI). VBM was evaluated across the whole brain, and group differences in the gray matter (GM) were compared. The significantly altered GM volumes considered as the seeding area were further calculated for the FC of the whole brain. The correlation between structural or functional changes of the brain and clinical features was also evaluated. ResultsPatients with migraine manifested higher GM volumes in the left occipital lobe than healthy controls. Seed-based analyses demonstrated reduced FC between the left occipital lobe and right inferior frontal gyrus, extending to the anterior cingulate cortex (ACC) and right insula. Decreased FC in the left ACC was positively correlated with visual analog scale (VAS) and self-rating anxiety scale (SAS). ConclusionsThis study indicated that patients with migraine exhibited abnormal changes in brain regions, which could facilitate a better understanding of how brain structure and function impact the symptoms of migraine and provide the basis for elucidating the potential mechanisms of acupuncture for migraine. Trial registrationChinese Clinical Trial Registry, Chi CTR2000033995. Registered on 20 June 2020.