Journal of Perianesthesia Nursing最新文献

Purpose: Nonpharmacological intervensions, particularly Virtual Reality (VR), have emerged as a promising approach to mitigate preoperative anxiety in children. This systematic review and meta-analysis aimed to evaluate the effectiveness of VR in reducing preoperative anxiety in pediatric patients and to analyze the impact of VR immersion level and timing of exposure on outcomes.

Design: Systematic review and meta-analysis.

Methods: We conducted a systematic search of five electronic databases (PubMed, PMC, ScienceDirect, SCOPUS, and Embase) for experimental studies published up to October 31, 2023. Our search included randomized controlled trials, cohort, and case-control studies focusing on pediatric patients (1 to 18 years) undergoing elective surgery. Study quality was assessed using the Cochrane risk-of-bias tool (RoB 2). Data extraction was performed independently by two reviewers, and meta-analysis was conducted using RevMan 5.4.1 (Manufactered by Cochrane). We calculated the effect size using a standardized mean difference with a 95% confidence interval (CI) and a random-effects model. The review protocol was registered with PROSPERO (CRD42023469123).

Findings: Eight studies with a total of 786 participants were included. The meta-analysis found that VR intervention was significantly more effective than conventional therapy in reducing preoperative anxiety (mean difference [MD] = -10.93, 95% CI [-14.50, -7.36], P < .00001). Subgroup analysis revealed that fully immersive VR systems (MD = -11.38, 95% CI [-21.38, -1.38], P = .03) and interventions administered closer to the time of surgery (MD = -13.77, 95% CI [-18.40, -9.15], P < .00001) yielded more favorable outcomes. The overall risk of bias was found to be low to moderate.

Conclusions: VR technology is an effective non-pharmacological intervention for managing preoperative anxiety in pediatric patients. Our findings suggest that fully immersive and late-stage VR interventions are particularly effective, providing a strong basis for clinical application.

Purpose: Despite being overall safe, the anticipation of anesthesia and surgery causes fear and anxiety in millions of patients each year. Knowing what matters to patients on the day of surgery and the extent of their worry may help health care professionals support them better. This study aimed to examine the correlation between the degree of worry and surgical fear among patients undergoing surgery, and to explore the characteristics and intensity of preoperative concerns.

Design: The study was a multicenter, flash-mob study, where many sites collect data within a short time frame, using a convergent mixed-methods design, with data collected using a cross-sectional electronic survey.

Methods: On International Patient Safety Day, we surveyed adult patients scheduled for surgery under local, regional, or general anesthesia. The survey contained questions about what mattered to the patient on the day of surgery, their degree of worry, and the eight-item Surgical Fear Questionnaire. We analyzed correlations and agreement between the degree of worry and the Surgical Fear Questionnaire, and explored factors associated with a higher degree of worry and surgical fear. Finally, we quantified and compared qualitative statements from those with the lowest and highest degree of worry and surgical fear with themes identified in a qualitative analysis.

Findings: Of 966 patients, 51% had moderate or high levels of surgical fear. Female gender and younger age were associated with higher levels of worry and surgical fear. Correlation between the degree of worry and Surgical Fear Questionnaire was strong (Spearman's ρ 0.7, P < .0001). Patients with high levels of worry and a high degree of surgical fear were characterized by a need for health care professionals to comfort them, help them through the procedure, be sensitive to their individual needs, and offer them an individualized approach.

Conclusions: There was a strong correlation between the patients' degree of worry and fear of surgery. Patients with a high degree of worry and a high level of surgical fear needed individualized care. Asking patients how worried they are and what matters to them may help health care professionals identify patients with a high degree of surgical fear, and knowing what matters to the patient may help health care professionals mitigate the patients' fears, resulting in better patient care.

Purpose: The aim of this study is to identify current themes and research trends by reviewing the research published in the literature on mobile applications in postoperative patient care.

Design: Descriptive and bibliometric analyses were used.

Methods: This study used the Web of Science (WoS) database to conduct a comprehensive literature review on October 24, 2024. A total of 108 articles meeting the inclusion criteria were analyzed. Data analysis was performed using MS Excel for forecasting, the RStudio Bibliometrix package for bibliometric analysis, and VOSviewer for data visualization.

Findings: A bibliometric analysis of 108 articles published between 2011 and 2024 revealed that 65.74% of the studies were published in the last 5 years. Journals in health, surgery, nursing, and informatics have led the dissemination of research on this topic. Key author keywords included "mHealth," "telemedicine," and "eHealth." The United States emerged as the most prolific and cited contributor to the field, followed by Canada in productivity and the Netherlands in citations.

Conclusions: The study highlights an annual growth rate of 22.51% in publications and forecasts an increase in research in this field. The integration of mobile applications in postoperative care has empowered patients, improved health outcomes, enhanced the efficiency of health care services, and contributed to cost reductions. However, as technology continues to permeate health care, further research is needed to optimize the efficacy and usability of mHealth applications in postoperative patient care.

Purpose: This study aimed to evaluate the association between frailty and the quality of postoperative recovery in older adults undergoing neurosurgery.

Design: A prospective observational study of descriptive and correlational design.

Methods: The study included 105 older adults hospitalized in the neurosurgery department of a university hospital. Data were collected using the Individual Data Form, the Quality of Recovery-40 (QoR-40) Questionnaire, and the Edmonton Frail Scale (EFS). The EFS was administered both preoperatively and 24 hours postoperatively.

Findings: The mean age of the participants was 71.53 ± 6.08 years. The mean EFS score was 7.73 ± 2.52 preoperatively and 7.57 ± 1.88 postoperatively. The postoperative QoR-40 mean score was 134.49 ± 11.09 indicating moderate recovery. A statistically significant weak negative association was found between the QoR-40 total score and both preoperative (r = -0.277, P < .05) and postoperative EFS scores (r = -0.336, P < .05).

Conclusions: Participants exhibited a high prevalence of mild-to-moderate frailty in both the preoperative and postoperative periods. Their postoperative recovery quality was moderate. The findings indicate a weak negative association between frailty and postoperative recovery quality, suggesting that preoperative frailty assessment may be a critical step for guiding care and potentially mitigating poorer recovery outcomes in older neurosurgical patients.