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患者报告的围手术期麻醉相关焦虑与患者满意度降低有关:瑞士前瞻性观察研究的二次分析。

Patient-reported perioperative anaesthesia-related anxiety is associated with impaired patient satisfaction: a secondary analysis from a prospective observational study in Switzerland.

机构信息

Department of Anaesthesiology Spital Grabs, Spitalregion Rheintal Werdenberg Sarganserland, Grabs, Switzerland.

Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.

出版信息

Sci Rep. 2023 Sep 28;13(1):16301. doi: 10.1038/s41598-023-43447-6.

Abstract

Perioperative anxiety is common. The relationship between anxiety and patient satisfaction with anaesthesia is still under debate. We assessed the prevalence and different causes of anaesthesia-related fears leading to perioperative anxiety and its association with patient satisfaction. A multiple-time validated, psychometrically developed questionnaire assessing the presence of anxiety, causes of fear, and different dimensions of patient satisfaction was sent to patients after discharge. The clinical data were obtained from a previous study. The sample size was calculated to recruit a minimum of 300 completed questionnaires. Statistical analyses included multivariate logistic regression models. Complete data were available for 474 of the 600 patients recruited for the study (response rate: 79%). A total of 141 patients (30%) reported anxiety regarding anaesthesia before hospital admission. The prevalence of anxiety was significantly associated with patient age (< 54 years: n = 196, prevalence = 37%; > 54 years: n = 263, prevalence = 24%; p = 0.002), female sex (female: n = 242, prevalence 39%; male: n = 223, prevalence 20%; p < 0.001), and surgical speciality (gynaecology (n = 61, prevalence = 49%), otolaryngology (n = 56, prevalence = 46%); p < 0.001). Fear of not awakening from anaesthesia (n = 44, prevalence = 32%, SD 45.8) and developing postoperative nausea or vomiting (n = 42, prevalence = 30%, SD 46.0) were the most reported anaesthesia-related causes of fear. Anxiety was associated with impaired overall patient satisfaction (mean dissatisfaction score 15%, versus 23%, SD 16.3 in the anxious group, SD 16.3, p < 0.001), especially regarding the dimensions "information and involvement in decision-making" (14% of deficits stated in the non-anxious group compared to 23% in the anxious group, p < 0.001), "respect and trust" (2% vs 6.26%, p < 0.001) and "continuity of care" (50% vs 57%, p < 0.015). Patient-reported anaesthesia-related anxiety is common and may affect important outcome parameters such as patient satisfaction. Abstract presented in e-poster format at Euroanaesthesia 2023, June 3-5, Glasgow.

摘要

围手术期焦虑很常见。焦虑与患者对麻醉的满意度之间的关系仍存在争议。我们评估了导致围手术期焦虑的与麻醉相关的恐惧的发生率和不同原因,并评估了其与患者满意度的关系。在出院后,向患者发送了一份经过多次验证、心理测量学开发的问卷,评估焦虑的存在、恐惧的原因以及患者满意度的不同维度。临床数据来自之前的一项研究。为了招募至少 300 份完成的问卷,我们计算了样本量。统计分析包括多变量逻辑回归模型。在纳入研究的 600 名患者中,有 474 名患者(应答率:79%)提供了完整的数据。共有 141 名患者(30%)在入院前对麻醉感到焦虑。焦虑的发生率与患者年龄(<54 岁:n=196,发生率 37%;>54 岁:n=263,发生率 24%;p=0.002)、女性性别(女性:n=242,发生率 39%;男性:n=223,发生率 20%;p<0.001)和手术科室(妇科(n=61,发生率 49%)、耳鼻喉科(n=56,发生率 46%)显著相关;p<0.001)。对无法从麻醉中醒来(n=44,发生率 32%,SD 45.8)和术后恶心或呕吐(n=42,发生率 30%,SD 46.0)的恐惧是最常见的与麻醉相关的恐惧原因。焦虑与整体患者满意度受损相关(平均不满意评分 15%,焦虑组为 23%,SD 16.3,p<0.001),尤其是在“信息和参与决策”维度(非焦虑组中表示的缺陷为 14%,而焦虑组为 23%,p<0.001)、“尊重和信任”(2%与 6.26%,p<0.001)和“连续性护理”(50%与 57%,p<0.015)。患者报告的与麻醉相关的焦虑很常见,可能会影响重要的结局参数,如患者满意度。该摘要以电子海报的形式在 2023 年 6 月 3 日至 5 日在格拉斯哥举行的欧洲麻醉学会(Euroanaesthesia 2023)上展示。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/260f/10539284/b4805afe2788/41598_2023_43447_Fig1_HTML.jpg

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