Virtual reality for preoperative patient education: Impact on satisfaction, usability, and burnout from the perspective of new nurses

BACKGROUND Traditional paper-based preoperative patient education is a struggle for new nurses and requires extensive training.In this situation,virtual reality technology can help the new nurses.Despite its potential benefits,there are studies on patient satisfaction but there is limited information on the usability of virtual reality(VR)technology for new nurses in giving preoperative education to patients.AIM To investigate the impact on satisfaction,usability,and burnout of a system using VR technology in preoperative patient education.METHODS The study involved 20 nurses from the plastic surgery ward and 80 patients admitted between April and May 2019.Each nurse taught four patients:Two using traditional verbal education and two using virtual reality.The System Usability Scale,After-Scenario Questionnaire,and Maslach Burnout Inventory(MBI)were employed to evaluate the impact of these education methods.RESULTS The VR education groups showed a statistically higher satisfaction than the traditional verbal education groups.Among the three subscales of the MBI,emotional exhaustion and personal accomplishment improved statistically significantly.VR was also better in terms of usability.CONCLUSION This study suggests VR enhances usability and reduces burnout in nurses,but further research is needed to assess its impact on depersonalization and objective measures like stress and heart rate.

Effect of interesting games on relief of preoperative anxiety in preschool children

Purpose:To evaluate the effect of interesting games on reducing preoperative anxiety and improving compliance with anaesthesia in children.Methods:Ninety preschool-aged children undergoing elective surgery were randomly assigned to two groups.The children in the control group were admitted to a general preoperative room with one parent for 15e20 min,and were then taken into the anaesthesia room.During anaesthetic induction,the nurse attracted the children’s attention using an interesting game with encouragement and attention diversion.The children’s anxiety was assessed using the Modified Yale Preoperative Anxiety Scale(mYPAS)when they entered the operating room,while they were waiting to undergo s0urgery,and during anaesthetic induction.Moreover,the children’s compliance with anaesthetic induction was assessed using the Induction Compliance Checklist(ICC).Results:No statistically significant differences in the mYPAS scores were observed between the two groups upon entering the operating room(p>0.05).The mYPAS scores were significantly lower in the experimental group than in the control group while waiting for surgery and during anaesthetic induction(p<0.05),while there were no significant differences in the mYPAS scores upon entering the operating room.The children’s compliance with anaesthetic induction was significantly higher in the experimental group than in the control group(p<0.05).Conclusion:Engagement in an interesting game can reduce preschool-aged children’s preoperative anxiety and improve their compliance with anaesthetic induction.

Preoperative and Postoperative Spirometry in Patients Undergoing Lobectomy for Sequelae of Pulmonary Tuberculosis

Objective: To assess preoperative and postoperative spirometry values in patients undergoing lobectomy for sequelae of pulmonary tuberculosis. Method: A total of 20 patients (10 males) with history of treatment for tuberculosis and presenting with symptomatic sequelae (repeat infection or hemoptysis) who sought assistance at the chest surgery outpatient clinic between 11.09.07 and 04.02.10, were selected for the study. Only patients that met theeligibility criteria (symptomatic, submitted to tuberculosis treatment) were included in the study. The age of patients ranged from 15 to 56 years (mean: 35.75 years). The average treatment time for tuberculosis was 6 months and onset of symptoms occurred between 01 and 32 years after treatment. To assess the impact of surgery on the variables VC, FVC, FEV1, FEV1/FVC, FEF and PEF preoperative values were compared with postoperative values at 1st, 3rd, 6th and 12th month using the paired t test. The level of significance (α) applied for all tests was 5% where a value of p 0.05 was considered significant. Results: 11 patients were treated because of recurrent infections and 9 because of haemoptysis. The most common lobectomy was right upper lobectomy (7 patients), followed by left upper lobectomy (6 patients), left lower lobectomy (6 patients), and right middle lobectomy (1 patient). There were no postoperative complications. There was no postoperative mortality. Conclusion: Based on the results of the present study, it can be concluded that, at the 12th postoperative month, spirometric parameters of patients with tuberculosis sequelae submitted to lobectomy had returned to preoperative levels.

Risk Factors for Preoperative Anxiety and Depression in Patients Scheduled for Abdominal Aortic Aneurysm Repair

Background： Perioperative emotional disorders of patients underwent abdominal aortic aneurysm （AAA） repair is an emerging area of study, and preoperative mental distress of those patients remains poorly understood. The aim of this study was to investigate the prevalence and identify the risk factors of preoperative anxiety and depression in patients scheduled for AAA repair. Methods： A total of 189 patients who underwent elective AAA repair between 2015 and 2016 were included in this study. These patients were preoperatively evaluated by Hospital Anxiety and Depression Scale （HADS）. Demographics and anxiety and depression scores of the patients were documented. Logistic regression was used to identify the independent risk factors of preoperative anxiety and depression. Results： A total of 150 AAA patients were included in final analysis. Of these 150 patients, 44 patients （29.3%） had borderline anxiety or clinical anxiety, and 42 patients （28.0%） were found to have borderline or clinical depression. Female （odds ratio [OR]： 2.81, 95% confidence interval [C1]： 1.08-7.26）, the American Society of Anesthesiologists （ASA） Grade 3/4 （OR： 4.34, 95% CI： 1. 13-16.68）, higher education （OR： 1.44, 95% CI： 1.02-2.04）, and abdominal or back pain （OR： 3.08, 95% CI： 1.20-7.87） were identified as significant independent risk factors of abnormal HA DS-anxiety in overall patients; and higher level of education （OR： 1.87, 95% CI： 1.16-3.01） was predictive of anxiety in patients planned for endovascular aortic repair. Besides, higher body mass index （BMI） （OR： 1.18, 95% CI： 1.04-1.33） and abdominal or back pain （OR： 3.93, 95% CI： 1.70-9.11） were predictive of abnormal preoperative HADS-depression in overall patients. Conclusion： As for patients scheduled for AAA repair, female, higher ASA, higher level of education, and symptom may be independent risk factors for preoperative anxiety, and symptom and higher BMI may predict preoperative depression.

Preoperative preparation and surgical separation of conjoined pygopagus twins

Conjoined twins are very rare with an estimated ,incidence of about 1 in 200 000 births with a male-female ratio of 1：3 The separation ot conjolned twins presents a challenge to surgeons and also a test for comprehensive efficiency of a hospital. Recently, a rare pair of pygopagus twins were admitted to our hospital and a successful surgical separation was carded out.

Treatment of uterine fibroid with triptorelin before hysterectomy

OBJECTIVE: To study the effects of pretreatment with triptorelin on uterine fibroid before abdominal hysterectomy. METHODS: Fifteen premenopausal Chinese women with symptomatic uterine fibroids requiring hysterectomy were recruited in the study. All patients received monthly intramuscular injections of 3.75 mg triptorelin for three months prior to abdominal hysterectomy. RESULTS: There was significant reduction in the serum levels of oestradiol (68.6%), progesterone (95.6%) and luteinizing hormone (73.9%) and in uterine (45.0%) and fibroid (68.0%) volumes. The serum level of follicle-stimulating hormone and haemoglobin concentration were not significantly different. CONCLUSIONS: Shrinkage of uterine fibroids can be achieved in women who are rendered hypoestrogenic with monthly injections of triptorelin for three months. This treatment modality may be of value prior to hysterectomy or myomectomy especially when the fibroid is large.