Samuel Attias1, Lital Keinan Boker2, Zahi Arnon3, Eran Ben-Arye4, Ayala Bar'am5, Gideon Sroka6, Ibrahim Matter6, Mostafa Somri7, Elad Schiff8. 1. Complementary & Integrative Surgery Service, and the Surgery Department, Bnai-Zion Medical Center, Israel; School of Public Health, University of Haifa, Israel. Electronic address: samuel.attias@b-zion.gov.il. 2. School of Public Health, University of Haifa, Israel; Israel Center for Disease Control, Ministry of Health, Israel. 3. Complementary & Integrative Surgery Service, and the Surgery Department, Bnai-Zion Medical Center, Israel; Yezreel Valley Academic College, Emek Yezreel, Israel. 4. Integrative Oncology Program, the Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel. 5. Department of Anesthesia, Bnai-Zion Medical Center, Haifa, Israel. 6. Department of General Surgery, Bnai-Zion Medical Center, Haifa, Israel. 7. Department of Anesthesiology, Bnai-Zion Medical Center, Haifa, Israel. 8. Complementary & Integrative Surgery Service, and the Surgery Department, Bnai-Zion Medical Center, Israel; Internal Medicine Department, Bnai Zion Medical Center, Haifa, Israel.
Abstract
STUDY OBJECTIVE:Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. DESIGN: Randomized controlled trial. SETTING: Holding room area PATIENTS: Three hundred sixty patients. INTERVENTIONS: Patients were randomly divided into 6 equal-sized groups. Group 1 received the standard treatment (ST) for anxiety alleviation with anxiolytics. The five other groups received the following, together with ST (anxiolytics): Compact Disk Recording of Guided Imagery (CDRGI); acupuncture; individual guided imagery; reflexology; and individual guided imagery combined with reflexology, based on medical staff availability. MEASUREMENTS: Assessment of anxiety was taken upon entering the holding room area (surgery preparation room) ('pre-treatment assessment'), and following the treatment, shortly before transfer to the operating room ('post-treatment assessment'), based on the Visual Analogue Scale (VAS) questionnaire. Data processing included comparison of VAS averages in the 'pre' and 'post' stages among the various groups. MAIN RESULTS: Preoperatively, CAM treatments were associated with significant reduction of anxiety level (5.54-2.32, p<0.0001). In contrast, no significant change was noted in the standard treatment group (4.92-5.44, p=0.15). Individualized CAM treatments did not differ significantly in outcomes. However, CDRGI was less effective than individualized CAM (P<0.001), but better than ST (p=0.005). CONCLUSIONS: Individual CAM treatments integrated within ST reduce preoperative anxiety significantly, compared to standard treatment alone, and are more effective than generic CDRGI. In light of the scope of preoperative anxiety and its implications for public health, integration of CAM therapies with ST should be considered for reducing preoperative anxiety.
RCT Entities:
STUDY OBJECTIVE: Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. DESIGN: Randomized controlled trial. SETTING: Holding room area PATIENTS: Three hundred sixty patients. INTERVENTIONS:Patients were randomly divided into 6 equal-sized groups. Group 1 received the standard treatment (ST) for anxiety alleviation with anxiolytics. The five other groups received the following, together with ST (anxiolytics): Compact Disk Recording of Guided Imagery (CDRGI); acupuncture; individual guided imagery; reflexology; and individual guided imagery combined with reflexology, based on medical staff availability. MEASUREMENTS: Assessment of anxiety was taken upon entering the holding room area (surgery preparation room) ('pre-treatment assessment'), and following the treatment, shortly before transfer to the operating room ('post-treatment assessment'), based on the Visual Analogue Scale (VAS) questionnaire. Data processing included comparison of VAS averages in the 'pre' and 'post' stages among the various groups. MAIN RESULTS: Preoperatively, CAM treatments were associated with significant reduction of anxiety level (5.54-2.32, p<0.0001). In contrast, no significant change was noted in the standard treatment group (4.92-5.44, p=0.15). Individualized CAM treatments did not differ significantly in outcomes. However, CDRGI was less effective than individualized CAM (P<0.001), but better than ST (p=0.005). CONCLUSIONS: Individual CAM treatments integrated within ST reduce preoperative anxiety significantly, compared to standard treatment alone, and are more effective than generic CDRGI. In light of the scope of preoperative anxiety and its implications for public health, integration of CAM therapies with ST should be considered for reducing preoperative anxiety.
Authors: Jennifer Ross Majumdar; Emily A Vertosick; Bevin Cohen; Melissa Assel; Marcia Levine; Margaret Barton-Burke Journal: Asia Pac J Oncol Nurs Date: 2019 Oct-Dec
Authors: J Fleckenstein; P Baeumler; C Gurschler; T Weissenbacher; T Annecke; T Geisenberger; D Irnich Journal: Sci Rep Date: 2018-10-24 Impact factor: 4.379