Evolving with modern technology: Impact of incorporating audiovisual aids in preanesthetic checkup clinics on patient education and anxiety

Haramritpal Kaur, Gurpreet Singh, Amandeep Singh, Gagandeep Sharda, Shobha Aggarwal, Haramritpal Kaur, Gurpreet Singh, Amandeep Singh, Gagandeep Sharda, Shobha Aggarwal

Abstract

Background and aims: Perioperative stress is an often ignored commonly occurring phenomenon. Little or no prior knowledge of anesthesia techniques can increase this significantly. Patients awaiting surgery may experience high level of anxiety. Preoperative visit is an ideal time to educate patients about anesthesia and address these fears. The present study evaluates two different approaches, i.e., standard interview versus informative audiovisual presentation with standard interview on information gain (IG) and its impact on patient anxiety during preoperative visit.

Settings and design: This prospective, double-blind, randomized study was conducted in a Tertiary Care Teaching Hospital in rural India over 2 months.

Materials and methods: This prospective, double-blind, randomized study was carried out among 200 American Society of Anesthesiologist Grade I and II patients in the age group 18-65 years scheduled to undergo elective surgery under general anesthesia. Patients were allocated to either one of the two equal-sized groups, Group A and Group B. Baseline anxiety and information desire component was assessed using Amsterdam Preoperative Anxiety and Information Scale for both the groups. Group A patients received preanesthetic interview with the anesthesiologist and were reassessed. Group B patients were shown a short audiovisual presentation about operation theater and anesthesia procedure followed by preanesthetic interview and were also reassessed. In addition, patient satisfaction score (PSS) and IG was assessed at the end of preanesthetic visit using standard questionnaire.

Statistical analysis used: Data were expressed as mean and standard deviation. Nonparametric tests such as Kruskal-Wallis, Mann-Whitney, and Wilcoxon signed rank tests, and Student's t-test and Chi-square test were used for statistical analysis.

Results: Patient's IG was significantly more in Group B (5.43 ± 0.55) as compared to Group A (4.41 ± 0.922) (P < 0.001). There was significant reduction in total anxiety from the baseline values in both the groups. This reduction was significantly more in Group B (8.47 ± 1.861) as compared to Group A (9.29 ± 1.616) (P < 0.001). PSS was also more in Group B (29.27 ± 2.378) as compared to Group A (25.62 ± 1.745) (P < 0.001).

Conclusion: Audiovisual presentation provides unhurried, detailed, and reliable information about the perioperative environment and anesthesia procedure. This helps in significant IG and reduction of patient anxiety.

Keywords: Anxiety; audiovisual; information gain; patient satisfaction; preoperative visit.

References

    1. Matthias AT, Samarasekera DN. Preoperative anxiety in surgical patients – Experience of a single unit. Acta Anaesthesiol Taiwan. 2012;50:3–6.
    1. Sagün A, Birbiçer H, Yapici G. Patients’, who applied to the anesthesia clinic, perceptions and knowledge about anesthesia in Türkiye. Saudi J Anaesth. 2013;7:170–4.
    1. Jawaid M, Mushtaq A, Mukhtar S, Khan Z. Preoperative anxiety before elective surgery. Neurosciences (Riyadh) 2007;12:145–8.
    1. Nigussie S, Belachew T, Wolancho W. Predictors of preoperative anxiety among surgical patients in Jimma University Specialized Teaching Hospital, South Western Ethiopia. BMC Surg. 2014;14:67.
    1. Zvara DA, Mathes DD, Brooker RF, McKinley AC. Video as a patient teaching tool: Does it add to the preoperative anesthetic visit? Anesth Analg. 1996;82:1065–8.
    1. Andersen BL, Farrar WB, Golden-Kreutz D, Kutz LA, MacCallum R, Courtney ME, et al. Stress and immune responses after surgical treatment for regional breast cancer. J Natl Cancer Inst. 1998;90:30–6.
    1. Pritchard MJ. Identifying and assessing anxiety in pre-operative patients. Nurs Stand. 2009;23:35–40.
    1. Jafar MF, Khan FA. Frequency of preoperative anxiety in Pakistani surgical patients. J Pak Med Assoc. 2009;59:359–63.
    1. Maranets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg. 1999;89:1346–51.
    1. Klafta JM, Roizen MF. Current understanding of patients’ attitudes toward and preparation for anesthesia: A review. Anesth Analg. 1996;83:1314–21.
    1. Matthey P, Finucane BT, Finegan BA. The attitude of the general public towards preoperative assessment and risks associated with general anesthesia. Can J Anaesth. 2001;48:333–9.
    1. Lee A, Chui PT, Gin T. Educating patients about anesthesia: A systematic review of randomized controlled trials of media-based interventions. Anesth Analg. 2003;96:1424–31.
    1. Snyder-Ramos SA, Seintsch H, Böttiger BW, Motsch J, Martin E, Bauer M. Patient satisfaction and information gain after the preanesthetic visit: A comparison of face-to-face interview, brochure, and video. Anesth Analg. 2005;100:1753–8.
    1. Prabhakar AR, Marwah N, Raju OS. A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients. J Indian Soc Pedod Prev Dent. 2007;25:177–82.
    1. Berth H, Petrowski K, Balck F. The Amsterdam preoperative anxiety and information scale (APAIS) – The first trial of a German version. Psychosoc Med. 2007;4:Doc01.
    1. Snyder-Ramos SA, Seintsch H, Böttiger BW, Motsch J, Martin E, Bauer M. Development of a questionnaire to assess the quality of the preanesthetic visit. Anaesthesist. 2003;52:818–29.
    1. Wilkinson SM, Love SB, Westcombe AM, Gambles MA, Burgess CC, Cargill A, et al. Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: A multicenter randomized controlled trial. J Clin Oncol. 2007;25:532–9.
    1. Subramanya P, Telles S. Effect of two yoga-based relaxation techniques on memory scores and state anxiety. Biopsychosoc Med. 2009;3:8.
    1. Sherman KJ, Ludman EJ, Cook AJ, Hawkes RJ, Roy-Byrne PP, Bentley S, et al. Effectiveness of therapeutic massage for generalized anxiety disorder: A randomized controlled trial. Depress Anxiety. 2010;27:441–50.
    1. Bailey L. Strategies for decreasing patient anxiety in the perioperative setting. AORN J. 2010;92:445–57.
    1. Standing L, Conezi J, Haber RN. Perception and memory for pictures: Single-trial learning of 2500 visual stimuli. Psychon Sci. 1970;19:73.
    1. Cohen MA, Horowitz TS, Wolfe JM. Auditory recognition memory is inferior to visual recognition memory. Proc Natl Acad Sci U S A. 2009;106:6008–10.
    1. Salzwedel C, Marz S, Bauer M, Schuster M. Video-assisted patient education in anaesthesiology: Possibilities and limits of a new procedure for improvement of patient information. Anaesthesist. 2008;57:546–54.
    1. Jlala HA, French JL, Foxall GL, Hardman JG, Bedforth NM. Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia. Br J Anaesth. 2010;104:369–74.
    1. Done ML, Lee A. The use of a video to convey preanesthetic information to patients undergoing ambulatory surgery. Anesth Analg. 1998;87:531–6.

Source: PubMed

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