Aims. Within a gynaecological surgical setting to identify the patterns and frequency of anxiety pre‐ and postoperatively; to identify any correlation between raised anxiety levels and postoperative pain; to identify events, from the patients’ perspective, that may increase or decrease anxiety in the pre‐ and postoperative periods.
Background. It is well documented that surgery is associated with increased anxiety, which has an adverse impact on patient outcomes. Few studies have been conducted to obtain the patient's perspective on the experience of anxiety and the events and situations that aggravate and ameliorate it.
Method. The study used a mixed method approach. The sample consisted of women undergoing planned gynaecological surgery. Anxiety was assessed using the State Trait Anxiety Inventory. Trait anxiety was measured at the time of recruitment. State anxiety was then assessed at six time points during the pre‐ and postoperative periods. Postoperative pain was also measured using a 10 cm visual analogue scale. Taped semi‐structured telephone interviews were conducted approximately a week after discharge.
Results. State anxiety rose steadily from the night before surgery to the point of leaving the ward to go to theatre. Anxiety then increased sharply prior to the anaesthetic decreasing sharply afterwards. Patients with higher levels of trait anxiety were more likely to experience higher levels of anxiety throughout their admission. Elevated levels of pre‐ and postoperative anxiety were associated with increased levels of postoperative pain. Telephone interviews revealed a range of events/situations that patients recalled distressing them and many were related to inadequate information.
Conclusion. This study found higher rates of anxiety than previously reported and anxiety levels appeared raised before admission to hospital. This has important clinical and research implications.
Relevance to clinical practice. Patients with high levels of anxiety may be identified preoperatively and interventions designed to reduce anxiety could be targeted to this vulnerable group. Patient experiences can inform the delivery of services to meet their health needs better.
Gender differences were examined in 182 freshman college students who had completed a packet of questionnaires and inventories to address the impact of separation from their parents and to test the relevance of self‐in‐relation theory. Instruments administered included the Social Support Questionnaire‐Short Form (SSQ‐6); the Family Adaptability and Cohesion Evaluation Scales‐Revised (FACES‐R); and the Separation‐Individuation Inventory. A multivariate analysis of variance performed on each instrument administered revealed significant differences between men and women on the SSQ‐6 and the FACES‐R. Differences indicated that, as expected, women reported establishing more of all kinds of support, were better satisfied with its quality, and viewed their families as more cohesive than did men. Unexpectedly, men and women viewed their families as equally socially desirable, and both men and women reported few disturbances in the separation‐individuation process.
Low enrollment in behavioral weight loss treatments limits their impact. We aimed to identify factors associated with treatment initiation. The participants were outpatients (n = 198) at Veterans Affairs (VA) healthcare facilities who were referred to a free VA-based behavioral weight loss treatment. Participants were assessed on psychosocial factors potentially relevant to treatment initiation. Subsequent treatment initiation was determined via medical record review. Study participants were 77 % male, 60 % African American, and 54 % initiated treatment. In multivariable analyses, treatment initiation was associated with being single, higher anxiety, and patients' perceptions that referring provider supported their weight autonomy. Endorsement of treatment barriers was not associated with treatment initiation. Treatments offering in-person sessions and mood management components were rated as more preferred. Initiation of behavioral weight loss treatments may increase if patients believe that providers respect their weight control autonomy and if healthcare organizations offer treatments that match patients' preferences.
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