Department of Anesthesiology, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
Department of Anesthesiology, Washington University in St Louis School of Medicine, St Louis, Missouri, USA.
BMJ Open. 2022 Aug 23;12(8):e062398. doi: 10.1136/bmjopen-2022-062398.
The perioperative period is high risk for older adults. Depression and anxiety are common perioperative problems, frequently coexisting with cognitive impairment. Older patients with these conditions are more likely than younger patients to experience postoperative delirium, long hospital stays, poor quality of life and rehospitalisation. These experiences can, in turn, exacerbate anxiety and depressive symptoms. Despite these risks, little is known about how to treat perioperative anxiety and depression among older adults.
We designed a feasibility study of a perioperative mental health intervention bundle to improve perioperative mental health, specifically depression and anxiety. The overarching goals of this study are twofold: first, to adapt and refine an intervention bundle comprised of behavioural activation and medication optimisation to meet the needs of older adults within three surgical patient populations (ie, orthopaedic, oncological and cardiac); and second, to test the feasibility of study procedures and intervention bundle implementation. Quantitative data on clinical outcomes such as depression, anxiety, quality of life, delirium, falls, length of stay, hospitalisation and pain will be collected and tabulated for descriptive purposes. A hybrid inductive-deductive thematic approach will be employed to analyse qualitative feedback from key stakeholders.
The study received approval from the Washington University Institutional Review Board. Results of this study will be presented in peer-reviewed journals, at professional conferences, and to our perioperative mental health advisory board.
NCT05110690.
围手术期是老年人的高风险期。抑郁和焦虑是常见的围手术期问题,常伴有认知障碍。有这些疾病的老年患者比年轻患者更容易出现术后谵妄、住院时间延长、生活质量差和再住院。这些经历反过来又会加剧焦虑和抑郁症状。尽管存在这些风险,但对于如何治疗老年围手术期焦虑和抑郁知之甚少。
我们设计了一项围手术期心理健康干预包的可行性研究,以改善围手术期心理健康,特别是抑郁和焦虑。这项研究的总体目标有两个:首先,调整和完善包括行为激活和药物优化在内的干预包,以满足三种手术患者群体(即骨科、肿瘤和心脏)中老年人的需求;其次,测试研究程序和干预包实施的可行性。将收集和列表显示关于临床结果(如抑郁、焦虑、生活质量、谵妄、跌倒、住院时间、住院和疼痛)的定量数据,用于描述性目的。将采用混合归纳演绎主题方法分析主要利益相关者的定性反馈。
该研究已获得华盛顿大学机构审查委员会的批准。这项研究的结果将在同行评议的期刊、专业会议和我们的围手术期心理健康顾问委员会上发表。
NCT05110690。