Zemła Adam Jarosław, Nowicka-Sauer Katarzyna, Jarmoszewicz Krzysztof, Wera Kamil, Batkiewicz Sebastian, Pietrzykowska Małgorzata
Department of Cardiac Surgery, Ceynowa Specialist Hospital in Wejherowo, Poland.
Specjalistyczny Szpital Miejski w Toruniu.
Anaesthesiol Intensive Ther. 2019;51(1):64-69. doi: 10.5603/AIT.2019.0013.
The evaluation of treatment from the patient's perspective (Patient Reported Outcomes, PROs) currently remains one of the most vibrant and dynamically developing fields of research. Among PROs, patient self-assessment of various symptoms, including one's psychological state, is of great importance. Anxiety is one of the most frequently observed psychological reactions among patients awaiting various surgeries, and may occur even in up to 80% of patients scheduled for high-risk surgical procedures. An increased level of preoperative anxiety has been proved to be related to negative consequences, both psychological and somatic, and affecting, in consequence, anaesthesia, postoperative care and treatment, along with the rehabilitation process. It is also considered as a risk factor for mortality in patients after surgeries. Planning of necessary educational, pharmacological and psychological interventions should be preceded by the evaluation of anxiety level which should be considered a routine element of preoperative care. The assessment of anxiety intensity may be performed using psychometric scales. Various factors should be taken into consideration while choosing the scale, including its reliability and accuracy, the aim of the assessment, the patient's age and clinical state, as well as the type of surgery being planned. In the current article, we present standardised and reliable methods which may be used in the evaluation of preoperative anxiety among patients scheduled for surgery, namely: the State-Trait Anxiety Inventory (STAI); the Hospital Anxiety and Depression Scale (HADS); the Amsterdam Preoperative Anxiety and Information Scale (APAIS); and the Visual Analogue Scale (VAS). A detailed description of the scales, including their main advantages and limitations, as well as their usefulness in both clinical evaluation of various patients' groups and scientific research are presented.
从患者角度评估治疗效果(患者报告结局,PROs)目前仍是最活跃且发展迅速的研究领域之一。在PROs中,患者对包括心理状态在内的各种症状进行自我评估非常重要。焦虑是等待各种手术的患者中最常观察到的心理反应之一,甚至在高达80%计划进行高风险手术的患者中也可能出现。术前焦虑水平升高已被证明与心理和躯体方面的负面后果相关,进而影响麻醉、术后护理与治疗以及康复过程。它还被视为术后患者死亡的一个风险因素。在规划必要的教育、药物和心理干预之前,应先评估焦虑水平,这应被视为术前护理的常规内容。可以使用心理测量量表来评估焦虑强度。选择量表时应考虑各种因素,包括其可靠性和准确性、评估目的、患者年龄和临床状态以及计划进行的手术类型。在本文中,我们介绍了可用于评估计划手术患者术前焦虑的标准化且可靠的方法,即:状态 - 特质焦虑量表(STAI);医院焦虑抑郁量表(HADS);阿姆斯特丹术前焦虑与信息量表(APAIS);以及视觉模拟量表(VAS)。文中对这些量表进行了详细描述,包括它们的主要优点和局限性,以及它们在不同患者群体的临床评估和科学研究中的用途。