Department of Cardiac Surgery, Florian Ceynowa Specialist Hospital, Dr. Jagalski Str. 10, 84-200, Wejherowo, Poland.
Department of Family Medicine, Medical University of Gdańsk, Gdańsk, Poland.
World J Surg. 2020 Jul;44(7):2162-2169. doi: 10.1007/s00268-020-05453-x.
Preoperative anxiety is a common patients' reaction related to serious adverse events post-operatively. The aim was to explore the characteristics of cardiac surgery patients experiencing high preoperative anxiety.
A total of 127 patients (mean age 64.48 years; 34.6% women) assessed their level of anxiety while waiting for surgery, need for information, depression and illness perception with the use of Amsterdam Preoperative Anxiety and Information Scale, Visual Analogue Scale, Hospital Anxiety and Depression Scale and Brief Illness Perception Questionnaire, respectively. Clinical and socio-demographic data were gathered using structured interview and medical files review. K-means and hierarchical cluster analyses were performed. α 0.05 was considered significant.
The analysis revealed two different clusters: Cluster 1 involved 46 patients (36.2%; mean age 58.91); Cluster 2 involved 81 patients (63.8%; mean age 67.65). Patients from Cluster 2 had significantly higher anxiety on the day prior to surgery (12.09 vs. 7.93), at a decision stage (6.16 vs. 3.85) and during prehospitalization week (8.01 vs. 4.41). These patients also had more negative illness perception (43.84 vs. 28.35), depressive symptoms (4.9 vs. 2.5) and higher information desire (6.68 vs. 5.54) than patients from Cluster 1. Female sex and planned combined surgery were additional contributors to higher anxiety.
Patients scheduled for cardiac surgery experienced high anxiety throughout the presurgery period. Early intervention addressing not only anxiety but also illness perception and depressive symptoms seems vital. The results can be helpful in planning tailored, needs-based psycho-educational intervention which might improve patients' preoperative psychological state.
术前焦虑是与术后严重不良事件相关的一种常见患者反应。本研究旨在探讨经历术前高度焦虑的心脏手术患者的特征。
共纳入 127 名患者（平均年龄 64.48 岁，34.6%为女性），分别使用阿姆斯特丹术前焦虑和信息量表、视觉模拟量表、医院焦虑抑郁量表和简要疾病感知问卷评估他们在等待手术时的焦虑程度、对信息的需求、抑郁和疾病感知。使用结构化访谈和病历回顾收集临床和社会人口学数据。采用 K 均值聚类分析和层次聚类分析。α 0.05 为差异有统计学意义。
分析显示存在两个不同的聚类：聚类 1 包括 46 名患者（36.2%，平均年龄 58.91 岁）；聚类 2 包括 81 名患者（63.8%，平均年龄 67.65 岁）。与聚类 1 相比，聚类 2 的患者术前一天（12.09 分比 7.93 分）、决策阶段（6.16 分比 3.85 分）和住院前一周（8.01 分比 4.41 分）的焦虑程度更高。这些患者的疾病感知也更为消极（43.84 分比 28.35 分）、抑郁症状（4.9 分比 2.5 分）和信息需求更高（6.68 分比 5.54 分）。与聚类 1 相比，女性和计划联合手术是导致更高焦虑的额外因素。
计划接受心脏手术的患者在整个术前期间都经历了高度的焦虑。早期干预不仅要解决焦虑问题，还要解决疾病感知和抑郁症状问题，这似乎至关重要。研究结果有助于制定基于需求的个体化心理教育干预计划，从而改善患者的术前心理状态。
