Introduction Anxiety is the subjective unpleasant feeling of dread over something unlikely to happen. The incidence of preoperative anxiety ranges from 32% to 76.7%. We aimed to measure the preoperative anxiety level using Amsterdam Preoperative Anxiety and Information Scale questionnaire and clinical rating scale given by attending anesthesiologist / anesthesia residents. MethodsIt was cross-sectional observational study conducted in wards. We enrolled 110 adult patients planned for elective gynecological and gastrointestinal surgeries. After taking informed written consent, principal investigator interviewed the patient, one day prior to surgery in wards using a structured questionnaire of Amsterdam Preoperative Anxiety and Information Scale. Demographics characters were recorded. The attending anesthesia residents (blinded to patient response) performed preanesthetic assessment, provided their subjective rating about patient anxiety and need for information using Clinical Rating Scale. ResultsOut of 110 patient, 57(51.81%) were found to have higher anxiety level. Comparing the APAIS score with various factors, we found younger age, female gender, unemployed status, higher level of education, adverse events in previous surgery and higher grade of surgery was associated with higher anxiety score. Comparing APAIS with Clinical Rating Score, there was poor correlation. ConclusionThe incidence of preoperative anxiety is high (51.81%) in adult patients undergoing elective surgery. During the preoperative anesthetic checkup, APAIS can be used as a screening tool. It provides relevant information on the presence of preoperative anxiety and need for information, which helps to achieve patient satisfaction and better outcome.
KEY WORDS IntroductionSevere sepsis and septic shock is a major cause of morbidity and mortality. The burden is higher and the outcome is dismal in the low and middle income countries. ObjectiveThis study aims to evaluate the knowledge about severe sepsis and septic shock among the medical officers of emergency department and intensive care unit in Nepal. It is a cross-sectional survey study. MethodologyThe medical officers working in emergency department and intensive care unit were asked to fill up the survey questionnaire, which contained the questions related to the demographics of the participant, about the knowledge of sepsis and the hindrances behind the effective management of septic patients. The percentage of correct answers for each question and average correct response for all the questions were analyzed. ResultsSeventy medical officers from twenty-four hospitals across the country were enrolled in the study. Among them, 39 were working in the emergency department and 31 were working in the intensive care unit. For the individual questions, the percentage of correct answers varied from 8.57% to 82.86% (average 48.16%). As per the response of the participants, lack of knowledge about sepsis and management guidelines, lack of experience for management of sepsis and lack of investigation facilities were considered to be the major barriers for effective management of septic patients. ConclusionsKnowledge and understanding about severe sepsis and septic shock among the medical officers of emergency department and intensive care unit in Nepal is sub-optimal. To improve the outcome of septic patients, efforts should be made to increase the understanding among these first-line health care workers by implementing regular and mandatory training programs. Knowledge, medical officer, septic shock, severe sepsis Affiliation:1.
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