The operating theatre staff is exposed to various constraints such as excessive working hours, severe medical conditions and dreadful consequences in case of malpractice. These working conditions may lead to high and chronic levels of stress, which can interfere with medical staff well-being and patients quality of care. The aim of this study is toassess the impact of music therapy on stress levels and burnout risk on the operating room staff. This is a preexperimental study including the operating rooms staff of urology and maxillofacial surgery in the academic hospital of Sahloul Sousse (Tunisia) over a period of six weeks. The study consisted of three phases. The first was an initial assessment of stress level with a predefined survey. The second included three music therapy sessions per day over one month. The third was an immediate stress level reassessment following the intervention. Stress levels were evaluated using the Perceived Stress Scale version PSS-10 and the Maslach Burnout Inventory. The overall response rate was 73.9%.The average age of the study population was 37.8 ± 7.7 years with a female predominance (64.7%). After the music therapy program, Perceived Stress Scale average score decreased from 22 ± 8.9 to 16 ± 7.9 (p = 0.006). Concerning the burnout, only the average score of emotional exhaustion decreased significantly from 27 ± 10.8 to 19.2 ± 9.5 (p = 0.004). Music therapy is an innovative approach that seems to reduce operating theatre staff stress. It must be considered as a non pharmacological, simple, economic and non invasive preventive tool.
Background
Ureteral double- J stent is usually inserted by retrograde approach to treating obstructed upper urinary tract. The antegrade approach, can be suitable alternative in certain situations without general or spinal anesthesia. The present study demonstrates the indications, success rate, and complications of this approach in treatmenting malignant obstructive uropathy.
Methods
Data of consecutive patients with malignant obstructive uropathy who underwent antegrade ureteral stenting in the Department of Interventional Radiology at Sahloul hospital from January 2013 to February 2020 was retrieved and retrospectively analyzed.
Result
A total of 188 attempts of antegrade ureteral stent insertion was performed during the study period (left side = 78, right side = 82, bilateral = 14). The mean age was 54 years (range: 9–91 years). The indication of the antegrade stenting was the failure of retrograde approach in 63 patients.The single-stage approach was performed 103 times. A percutaneous nephrostomy was placed for the average duration of 22.4 days (range: 2–60 days) for subsequent attempts. Only four patients required general anesthesia. Ureteral obstruction was caused by bladder cancer (n = 92), uterine cancer (n = 31), prostate cancer (n = 28), colorectal cancer (n = 15) and retroperitoneal tumor (n = 8). A protective nephrostomy was left in situ in 44 cases for 48 h. Clinical success was achieved in 96% of the cases. Two and three patients required hospitalization for perirenal abscess and hematuria, respectively.
Conclusion
This retrospective study shows that antegrade ureteral stent insertion has a high success rate with minimal complications.
Trial registration
ClinicalTrials.gov Identifier: NCT04649970.
Registered
december 2, 2020
- Retrospectively registered,
https://clinicaltrials.gov/ct2/show/NCT04649970
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