Kim Myung Jo, Oh Heung-Kwon, Lee Keun Chul, Yang Hyun Hui, Koo Bon-Wook, Lee Jebong, Kim Min-Hyun, Kang Sung Il, Kim Duck-Woo, Kang Sung-Bum
Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea.
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Ann Surg Treat Res. 2019 Jun;96(6):290-295. doi: 10.4174/astr.2019.96.6.290. Epub 2019 May 29.
Surgery is the primary curative treatment for colorectal cancer; however, it remains a frightening procedure that can cause stress and pain in affected patients. Therefore, patients typically experience significant anxiety during the preoperative period, which has been associated with poorer outcome after surgery. This study aimed to evaluate the effect of an Internet-based informational video on preoperative anxiety level in patients with colorectal cancer.
This prospective, single-arm, observational study included patients scheduled to undergo elective colorectal cancer surgery, who did not have a history of previous surgery or major cognitive impairment. The primary outcome measure was the change in Amsterdam Preoperative Anxiety and Information Scale - Anxiety (APAIS-A) before and after watching a 5-min informational video (https://youtu.be/VzhtOMPUe4Q) during the preoperative period. Secondary outcome measures were the change in Hospital Anxiety and Depression Scale (HADS), length of postoperative hospital day, and postoperative morbidity.
Thirty-two patients were enrolled. Anxiety was significantly decreased after watching the video (APAIS-A score: from 10.8 ± 3.7 to 8.2 ± 3.2, P < 0.001, mean reduction: 22.2%). HADS score was also significantly decreased (from 5.8 ± 4.4 to 4.0 ± 3.3, P = 0.001, mean reduction: 26.5%). All preoperative anxiety level did not significantly differ between patients who developed postoperative complication and those who did not.
The informational video was an effective tool to reduce preoperative anxiety. Viewing this video may confer a higher level of confidence and realistic expectations, as well as reducing patients' preoperative anxiety.
手术是结直肠癌的主要治愈性治疗方法；然而，它仍然是一个令人恐惧的过程，会给受影响的患者带来压力和疼痛。因此，患者在术前通常会经历严重的焦虑，这与术后较差的预后相关。本研究旨在评估基于互联网的信息视频对结直肠癌患者术前焦虑水平的影响。
这项前瞻性、单臂观察性研究纳入了计划接受择期结直肠癌手术、无既往手术史或重大认知障碍的患者。主要结局指标是术前观看一段5分钟信息视频（https://youtu.be/VzhtOMPUe4Q）前后阿姆斯特丹术前焦虑与信息量表-焦虑（APAIS-A）的变化。次要结局指标包括医院焦虑抑郁量表（HADS）的变化、术后住院天数和术后发病率。
共纳入32例患者。观看视频后焦虑显著降低（APAIS-A评分：从10.8±3.7降至8.2±3.2，P<0.001，平均降低：22.2%）。HADS评分也显著降低（从5.8±4.4降至4.0±3.3，P=0.001，平均降低：26.5%）。术后发生并发症的患者与未发生并发症的患者术前焦虑水平均无显著差异。
信息视频是降低术前焦虑的有效工具。观看此视频可能会带来更高的信心和现实期望，同时降低患者的术前焦虑。
