Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany.
Interdisziplinäre Sektion Neuroonkologie, Zentrum für Neurologie & Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Hertie-Institut für Klinische Hirnforschung, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
Eur Spine J. 2021 Aug;30(8):2360-2367. doi: 10.1007/s00586-021-06824-1. Epub 2021 Jun 5.
Meeting the information needs of patients adequately is of high importance in informed consent consultations in surgery. However, information needs often remain unmet in the informed consent consultation. The aim of this study was to assess anxiety and pain in relation to the patients' information needs fulfillment perioperatively.
We applied a question prompt list (QPL) for patients undergoing spine surgery (SN-QPL) before (t1) and a question answering list (SN-QAL) after (t2) the informed consent consultation. The patients additionally completed the "State-Trait Anxiety Operation Inventory" (STOA, cognitive and affective scale) at t1, as well as a pain numerical rating scale (NRS) at t2 and postoperative (t3). We analyzed (1) the association between anxiety, information needs and pain and (2) anxiety and pain scores regarding information needs fulfillment after the consent consultation.
A total of n = 118 patients was included. Affective and cognitive state anxiety was only reduced postoperatively (affective p < .001, cognitive p < .05). The higher trait anxiety was, the more patients longed for information at t1-t3 (t1: r = .58/r = .74, each p < .001), (t2: r = .38/r = .49, each p < .001) and (t3: r = .29, p < .01/r = 34, p < .001). Higher grades of trait anxiety resulted in lower information needs fulfilment. Higher state anxiety levels were associated with higher pain levels. Information needs more often remained unfulfilled in high trait and state anxiety patients.
Patients' anxiety was associated with (un)fulfilled information needs. Meeting information needs should be optimized in the process of surgeon-patient communication. Adapting the information to the patients' anxiety levels seem to be an effective way to reduce anxiety.
充分满足患者的信息需求在手术知情同意咨询中非常重要。然而，知情同意咨询中患者的信息需求往往仍未得到满足。本研究旨在评估围手术期患者的焦虑和疼痛与信息需求满足程度的关系。
我们在脊柱手术患者中应用了问题提示清单（SN-QPL），并在知情同意咨询前后（t1 和 t2）使用问题回答清单（SN-QAL）。患者还在 t1 时完成了“状态特质焦虑操作量表”（STOA，认知和情感量表），在 t2 时和术后（t3）完成了疼痛数字评分量表（NRS）。我们分析了（1）焦虑、信息需求和疼痛之间的关系，以及（2）知情同意咨询后信息需求满足情况与焦虑和疼痛评分之间的关系。
共纳入 n=118 例患者。情感和认知状态焦虑仅在术后降低（情感 p<0.001，认知 p<0.05）。特质焦虑越高，患者在 t1-t3 时越渴望获得信息（t1：r=0.58/r=0.74，均 p<0.001）、（t2：r=0.38/r=0.49，均 p<0.001）和（t3：r=0.29，p<0.01/r=0.34，p<0.001）。较高的特质焦虑导致信息需求满足度较低。较高的状态焦虑水平与较高的疼痛水平相关。高特质和状态焦虑的患者信息需求往往得不到满足。
患者的焦虑与（未）满足的信息需求有关。在医患沟通过程中，应优化信息提供。根据患者的焦虑程度调整信息似乎是降低焦虑的有效方法。
