BACKGROUND Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery.Emergence agitation(EA)is a common complication of general anesthesia that ...BACKGROUND Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery.Emergence agitation(EA)is a common complication of general anesthesia that may increase patient discomfort and hospital stay and may be associated with the development of postoperative complications.Pre-anesthetic anxiety may be associated with the development of EA,but studies in this area are lacking.AIM To determine the relationship between pre-anesthetic anxiety and EA after radical surgery in patients with non-small cell lung cancer(NSCLC).METHODS Eighty patients with NSCLC undergoing surgical treatment between June 2020 and June 2023 were conveniently sampled.We used the Hospital Anxiety and Depression Scale’s(HADS)anxiety subscale(HADS-A)to determine patients’anxiety at four time points(T1-T4):Patients’preoperative visit,waiting period in the surgical waiting room,after entering the operating room,and before anesthesia induction,respectively.The Riker Sedation-Agitation Scale(RSAS)examined EA after surgery.Scatter plots of HADS-A and RSAS scores assessed the correlation between patients’pre-anesthesia anxiety status and EA.We performed a partial correlation analysis of HADS-A scores with RSAS scores.RESULTS NSCLC patients’HADS-A scores gradually increased at the four time points:7.33±2.03 at T1,7.99±2.22 at T2,8.05±2.81 at T3,and 8.36±4.17 at T4.The patients’postoperative RSAS score was 4.49±1.18,and 27 patients scored≥5,indicating that 33.75%patients had EA.HADS-A scores at T3 and T4 were significantly higher in patients with EA(9.67±3.02 vs 7.23±2.31,12.56±4.10 vs 6.23±2.05,P<0.001).Scatter plots showed the highest correlation between HADS-A and RSAS scores at T3 and T4.Partial correlation analysis showed a strong positive correlation between HADS-A and RSAS scores at T3 and T4(r=0.296,0.314,P<0.01).CONCLUSION Agitation during anesthesia recovery in patients undergoing radical resection for NSCLC correlated with anxiety at the time of entering the operating room and before anesthesia induction.展开更多
Background: Nurses in emergency departments often face department overcrowding with patients, and deal with very ill patients, critical incidents and excessive workloads. Research has indicated that these situations m...Background: Nurses in emergency departments often face department overcrowding with patients, and deal with very ill patients, critical incidents and excessive workloads. Research has indicated that these situations may be associated with work-related stress and the onset of depressive disorders among nursing staff. Aim & Objective: To investigate length of service in relation to occupational stress levels among nurses working in an emergency department, and develop interventions to reduce stress. Methods: A cross-sectional study using a survey was conducted among nurses(N=79) working in the emergency department of one hospital. Occupational stress was measured using the Symptom Checklist 90(SCL-90). Results: Respondents were categorized according to their length of service. Length of service was categorized as follows: group A, <1 year(n=16); group B, between 1 and 5 years(n=31); group C, between 5 and 10 years(n=20); and group D, >10 years(n=12). Group A reported more somatic and anxiety symptoms and a higher total symptom score on the SCL-90 compared with the normal group(p<0.05). Nurses who had worked for longer than 1 year scored above mid-score on all the SCL-90 subscales except on the interpersonal sensitivity and phobic anxiety subscales(p<0.05). There was no difference between groups B, C and D groups for total SCL-90 score. Conclusion: Nurses who had worked for >1 year in the emergency department experienced more work-related stress than the general population. Further research on suitable interventions for the management of occupational stress in nurses working in emergency departments is required.展开更多
BACKGROUND Emergency department(ED)overcrowding is a severe health care concern,while anxiety and depression rates among ED patients have been reported to be substantially higher compared to the general population.We ...BACKGROUND Emergency department(ED)overcrowding is a severe health care concern,while anxiety and depression rates among ED patients have been reported to be substantially higher compared to the general population.We hypothesized that anxiety due to over crowdedness may lead to adverse events in EDs.AIM To investigate correlations between crowdedness in EDs and anxiety of patients and nurses,and to identify factors affecting their anxiety.METHODS In this prospective observational study,a total 43 nurses and 389 emergency patients from two tier III hospitals located in Beijing were included from January 2016 to August 2017.Patients were grouped into inpatients when they were hospitalized after diagnoses,or into outpatients when they were discharged after treatments.The State Trait Anxiety Inventory(STAI Form Y)questionnaire was used to investigate patient and nurse anxieties,while crowdedness of EDs was evaluated with the National Emergency Department Over Crowding Score.RESULTS The present results revealed that state anxiety scores(49.50±6.00 vs 50.80±2.80,P=0.005)and trait anxiety scores(45.40±5.70 vs 46.80±2.70,P=0.002)between inpatients(n=173)and outpatients(n=216)were significantly different,while the state anxiety of nurses(44.70±5.80)was different from those of both patient groups.Generalized linear regression analysis demonstrated that multiple factors,including crowdedness in the ED,were associated with state and trait anxieties for both inpatients and outpatients.In addition,there was an interaction between state anxiety and trait anxieties.However,multivariable regression analysis showed that while overcrowding in the ED did not directly correlate with patients’and nurses’anxiety levels,the factors that did correlate with state and trait anxieties of inpatients were related to crowdedness.These factors included waiting time in the ED,the number of patients treated,and the number of nurses in the ED,whereas for nurses,only state and trait anxieties correlated significantly with each other.CONCLUSION Waiting time,the number of patients treated,and the number of nurses present in the ED correlate with patient anxiety in EDs,but crowdedness has no effect on nurse or patient anxiety.展开更多
BACKGROUND： Demanding profession has been associated with poor psychological health due to multiple factors such as overworking hours and night shifts. This study is to determine prevalence and associated factors of ...BACKGROUND： Demanding profession has been associated with poor psychological health due to multiple factors such as overworking hours and night shifts. This study is to determine prevalence and associated factors of depression, anxiety and stress among medical officers working at emergency department in Malaysian hospitals.METHODS： A cross-sectional study was conducted on 140 emergency department medical officers working at general hospitals from seven Malaysia regions. They were randomly selected and their depression, anxiety and stress level were measured by the 21-item Depression, Anxiety, Stress Scale. RESULTS： The highest prevalence was anxiety （28.6%） followed by depression （10.7%） and stress （7.9%）. Depression, anxiety and stress between seven hospitals were not significantly different （P〉0.05）. Male medical officers significantly experienced more anxiety symptoms than female medical officers （P=0.0022）, however depression and stress symptoms between male and female medical officers were not signi？ cantly different （P〉0.05）. Depression, anxiety and stress were not associated with age, working experience, ethnicity, marital status, number of shifts and type of system adopted in different hospitals （P〉0.05）. CONCLUSION： The prevalence of anxiety was high, whereas for depression and stress were considerably low. Gender was the only factor significantly associated with anxiety. Other factors were not associated with depression, anxiety and stress. Future research should aim to gain better understanding on unique factors that affect female and male medical officers’ anxiety level in emergency setting, thus guide authorities to chart strategic plans to remedy this condition.展开更多
The present study aimed to investigate the impact of chronic psychosocial stress and resilience, including at a biological level (immune and neuroendocrine function) in Portuguese citizens with psychic anomaly/mental ...The present study aimed to investigate the impact of chronic psychosocial stress and resilience, including at a biological level (immune and neuroendocrine function) in Portuguese citizens with psychic anomaly/mental disorder. The sample aggregated 69 participants. It has been used the following psychometric instruments: 21-item depression, anxiety and stress scales (DASS-21), in the Portuguese validated version;measuring state resilience (MSR), in the Portuguese validated version;the Portuguese scale of 23 questions on vulnerability to stress. Serum levels of cortisol, dehydroepiandrosterone sulfate, antibodies anti-viral capsid antigen of Epstein-Barr virus, triglycerides, high density lipoprotein-cholesterol and body mass index have been measured. It has been concluded that factors of vulnerability to stress and chronic stress, of social nature (lack of social support, adverse living conditions), correlate positively with depression, anxiety and stress, and, through alostatic load, are involved in a greater propensity for immune and neuroendocrine dysfunction in this population.展开更多
BACKGROUND： An emergency department （ED） visit may be distressing and anxiety-provoking for older adults （age 〉 65 years）. No studies have specifically evaluated the effect of music listening on anxiety in older...BACKGROUND： An emergency department （ED） visit may be distressing and anxiety-provoking for older adults （age 〉 65 years）. No studies have specifically evaluated the effect of music listening on anxiety in older adults in the ED. OBJECTIVE： The objective of this pilot study was to evaluate the effect of music listening on anxiety levels in older ED patients. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This was a randomized pilot study in the geriatric ED of an urban academic tertiary medical center. This was a sample of English-speaking adults （age 〉 65 years） who were not deaf （n = 35）. Subjects consented to participate and were randomized to receive up to 60 min of music listening with routine care, while the control group received routine care with no music. Subjects in the music treatment group received headphones and an electronic tablet with pre-downloaded music, and were allowed to choose from 5 selections. MAIN OUTCOME MEASURES： The primary outcome was change in anxiety levels, measured by the state- trait anxiety inventory （STAI）, at enrollment and 1 h later. RESULTS： A total of 35 participants were enrolled： 74% were female, 40% were white, and 40% were black; of these, 32 subjects completed the study protocol. When comparing control （n = 18） against intervention subjects （n = 17）, there were no significant differences in enrollment STAI scores （43.00 ± 15.00 vs. 40.30± 12.80, P = 0.57）. STAI scores 1 hour after enrollment （after the music intervention） were significantly reduced in the intervention subjects compared to the control subjects （with reduction of 10.00± 12.29 vs. 1.88 ± 7.97, P = 0.03）. CONCLUSION： These pilot results suggest that music listening may be an effective tool for reducing anxiety among older adults in the ED.展开更多
文摘BACKGROUND Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery.Emergence agitation(EA)is a common complication of general anesthesia that may increase patient discomfort and hospital stay and may be associated with the development of postoperative complications.Pre-anesthetic anxiety may be associated with the development of EA,but studies in this area are lacking.AIM To determine the relationship between pre-anesthetic anxiety and EA after radical surgery in patients with non-small cell lung cancer(NSCLC).METHODS Eighty patients with NSCLC undergoing surgical treatment between June 2020 and June 2023 were conveniently sampled.We used the Hospital Anxiety and Depression Scale’s(HADS)anxiety subscale(HADS-A)to determine patients’anxiety at four time points(T1-T4):Patients’preoperative visit,waiting period in the surgical waiting room,after entering the operating room,and before anesthesia induction,respectively.The Riker Sedation-Agitation Scale(RSAS)examined EA after surgery.Scatter plots of HADS-A and RSAS scores assessed the correlation between patients’pre-anesthesia anxiety status and EA.We performed a partial correlation analysis of HADS-A scores with RSAS scores.RESULTS NSCLC patients’HADS-A scores gradually increased at the four time points:7.33±2.03 at T1,7.99±2.22 at T2,8.05±2.81 at T3,and 8.36±4.17 at T4.The patients’postoperative RSAS score was 4.49±1.18,and 27 patients scored≥5,indicating that 33.75%patients had EA.HADS-A scores at T3 and T4 were significantly higher in patients with EA(9.67±3.02 vs 7.23±2.31,12.56±4.10 vs 6.23±2.05,P<0.001).Scatter plots showed the highest correlation between HADS-A and RSAS scores at T3 and T4.Partial correlation analysis showed a strong positive correlation between HADS-A and RSAS scores at T3 and T4(r=0.296,0.314,P<0.01).CONCLUSION Agitation during anesthesia recovery in patients undergoing radical resection for NSCLC correlated with anxiety at the time of entering the operating room and before anesthesia induction.
文摘Background: Nurses in emergency departments often face department overcrowding with patients, and deal with very ill patients, critical incidents and excessive workloads. Research has indicated that these situations may be associated with work-related stress and the onset of depressive disorders among nursing staff. Aim & Objective: To investigate length of service in relation to occupational stress levels among nurses working in an emergency department, and develop interventions to reduce stress. Methods: A cross-sectional study using a survey was conducted among nurses(N=79) working in the emergency department of one hospital. Occupational stress was measured using the Symptom Checklist 90(SCL-90). Results: Respondents were categorized according to their length of service. Length of service was categorized as follows: group A, <1 year(n=16); group B, between 1 and 5 years(n=31); group C, between 5 and 10 years(n=20); and group D, >10 years(n=12). Group A reported more somatic and anxiety symptoms and a higher total symptom score on the SCL-90 compared with the normal group(p<0.05). Nurses who had worked for longer than 1 year scored above mid-score on all the SCL-90 subscales except on the interpersonal sensitivity and phobic anxiety subscales(p<0.05). There was no difference between groups B, C and D groups for total SCL-90 score. Conclusion: Nurses who had worked for >1 year in the emergency department experienced more work-related stress than the general population. Further research on suitable interventions for the management of occupational stress in nurses working in emergency departments is required.
基金Supported by the Capital Nursing Research Special Project,No.17HL21.
文摘BACKGROUND Emergency department(ED)overcrowding is a severe health care concern,while anxiety and depression rates among ED patients have been reported to be substantially higher compared to the general population.We hypothesized that anxiety due to over crowdedness may lead to adverse events in EDs.AIM To investigate correlations between crowdedness in EDs and anxiety of patients and nurses,and to identify factors affecting their anxiety.METHODS In this prospective observational study,a total 43 nurses and 389 emergency patients from two tier III hospitals located in Beijing were included from January 2016 to August 2017.Patients were grouped into inpatients when they were hospitalized after diagnoses,or into outpatients when they were discharged after treatments.The State Trait Anxiety Inventory(STAI Form Y)questionnaire was used to investigate patient and nurse anxieties,while crowdedness of EDs was evaluated with the National Emergency Department Over Crowding Score.RESULTS The present results revealed that state anxiety scores(49.50±6.00 vs 50.80±2.80,P=0.005)and trait anxiety scores(45.40±5.70 vs 46.80±2.70,P=0.002)between inpatients(n=173)and outpatients(n=216)were significantly different,while the state anxiety of nurses(44.70±5.80)was different from those of both patient groups.Generalized linear regression analysis demonstrated that multiple factors,including crowdedness in the ED,were associated with state and trait anxieties for both inpatients and outpatients.In addition,there was an interaction between state anxiety and trait anxieties.However,multivariable regression analysis showed that while overcrowding in the ED did not directly correlate with patients’and nurses’anxiety levels,the factors that did correlate with state and trait anxieties of inpatients were related to crowdedness.These factors included waiting time in the ED,the number of patients treated,and the number of nurses in the ED,whereas for nurses,only state and trait anxieties correlated significantly with each other.CONCLUSION Waiting time,the number of patients treated,and the number of nurses present in the ED correlate with patient anxiety in EDs,but crowdedness has no effect on nurse or patient anxiety.
文摘BACKGROUND： Demanding profession has been associated with poor psychological health due to multiple factors such as overworking hours and night shifts. This study is to determine prevalence and associated factors of depression, anxiety and stress among medical officers working at emergency department in Malaysian hospitals.METHODS： A cross-sectional study was conducted on 140 emergency department medical officers working at general hospitals from seven Malaysia regions. They were randomly selected and their depression, anxiety and stress level were measured by the 21-item Depression, Anxiety, Stress Scale. RESULTS： The highest prevalence was anxiety （28.6%） followed by depression （10.7%） and stress （7.9%）. Depression, anxiety and stress between seven hospitals were not significantly different （P〉0.05）. Male medical officers significantly experienced more anxiety symptoms than female medical officers （P=0.0022）, however depression and stress symptoms between male and female medical officers were not signi？ cantly different （P〉0.05）. Depression, anxiety and stress were not associated with age, working experience, ethnicity, marital status, number of shifts and type of system adopted in different hospitals （P〉0.05）. CONCLUSION： The prevalence of anxiety was high, whereas for depression and stress were considerably low. Gender was the only factor significantly associated with anxiety. Other factors were not associated with depression, anxiety and stress. Future research should aim to gain better understanding on unique factors that affect female and male medical officers’ anxiety level in emergency setting, thus guide authorities to chart strategic plans to remedy this condition.
文摘The present study aimed to investigate the impact of chronic psychosocial stress and resilience, including at a biological level (immune and neuroendocrine function) in Portuguese citizens with psychic anomaly/mental disorder. The sample aggregated 69 participants. It has been used the following psychometric instruments: 21-item depression, anxiety and stress scales (DASS-21), in the Portuguese validated version;measuring state resilience (MSR), in the Portuguese validated version;the Portuguese scale of 23 questions on vulnerability to stress. Serum levels of cortisol, dehydroepiandrosterone sulfate, antibodies anti-viral capsid antigen of Epstein-Barr virus, triglycerides, high density lipoprotein-cholesterol and body mass index have been measured. It has been concluded that factors of vulnerability to stress and chronic stress, of social nature (lack of social support, adverse living conditions), correlate positively with depression, anxiety and stress, and, through alostatic load, are involved in a greater propensity for immune and neuroendocrine dysfunction in this population.
文摘BACKGROUND： An emergency department （ED） visit may be distressing and anxiety-provoking for older adults （age 〉 65 years）. No studies have specifically evaluated the effect of music listening on anxiety in older adults in the ED. OBJECTIVE： The objective of this pilot study was to evaluate the effect of music listening on anxiety levels in older ED patients. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This was a randomized pilot study in the geriatric ED of an urban academic tertiary medical center. This was a sample of English-speaking adults （age 〉 65 years） who were not deaf （n = 35）. Subjects consented to participate and were randomized to receive up to 60 min of music listening with routine care, while the control group received routine care with no music. Subjects in the music treatment group received headphones and an electronic tablet with pre-downloaded music, and were allowed to choose from 5 selections. MAIN OUTCOME MEASURES： The primary outcome was change in anxiety levels, measured by the state- trait anxiety inventory （STAI）, at enrollment and 1 h later. RESULTS： A total of 35 participants were enrolled： 74% were female, 40% were white, and 40% were black; of these, 32 subjects completed the study protocol. When comparing control （n = 18） against intervention subjects （n = 17）, there were no significant differences in enrollment STAI scores （43.00 ± 15.00 vs. 40.30± 12.80, P = 0.57）. STAI scores 1 hour after enrollment （after the music intervention） were significantly reduced in the intervention subjects compared to the control subjects （with reduction of 10.00± 12.29 vs. 1.88 ± 7.97, P = 0.03）. CONCLUSION： These pilot results suggest that music listening may be an effective tool for reducing anxiety among older adults in the ED.
