Artikel
The neurosurgeons’ responsibility – anxiety of patients before and after informed consent for spine surgery. A prospective study
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Autoren
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Rebecca Nesbigall
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland; Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Psychosomatische Klinik und Poliklinik, Abteilung für Medizinische Psychologie und Soziologie, Mainz, Deutschland
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Mirjam Renovanz
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Julian Haaf
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland; Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Psychosomatische Klinik und Poliklinik, Abteilung für Medizinische Psychologie und Soziologie, Mainz, Deutschland
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Wilfried Laubach
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Psychosomatische Klinik und Poliklinik, Abteilung für Medizinische Psychologie und Soziologie, Mainz, Deutschland
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Florian Ringel
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Sabine Fischbeck
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Psychosomatische Klinik und Poliklinik, Abteilung für Medizinische Psychologie und Soziologie, Mainz, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: Preoperative situation and informed consent discussion can generate anxiety. The aim of this study was to study mod and well-being development in context of the informed consent communication. We assessed anxiety, psychological health and pain before and after consent discussion and postoperatively in clinical routine.
Methods: Patients scheduled for elective spine surgery were prospectively recruited. They filled in standardized questionnaires regarding patients' anxiety before and after informed consent (t1,t2) and postoperatively (t3). We used the "The State-Trait Anxiety Operation Inventory" (STOA) consisting of 30 items rating by a 4-point scale ("almost never" - "almost always", higher scores indicate greater anxiety). STOA is applied in clinical settings to diagnose acute anxiety (state anxiety) and anxiety disposition (trait anxiety). We analyzed the association between trait- und state-anxiety and the perioperative situation. Furthermore assessed the pain during the postoperative clinical course of patients with regard to linkages between patients' anxiety and pain.
Results: 118 patients (53 male, mean age 63 years) gave informed consent. All questionnaires were well accepted: 70% were filled in completely (t1, t2, t3). We found that anxiety was not reduced between t1 and t2. However, between t1 and t3, and t2 and t3 the burden was significantly less (Wilcoxon, p<.001). State anxiety (10 items) was positively correlated with trait anxiety (20 items) at t1, t2 and t3 (p<.001), indicating that patients with a higher level of trait-anxiety develop higher levels of state-anxiety preoperatively. Those patients who showed a reduced postoperative anxiety level stated less pain than patients with higher state-anxiety, so that patients' anxiety decreaseseems to be linked tothe pain coping during their clinical period postoperatively.
Conclusion: Preoperative anxiety of neurosurgical patients is high, the informed consent discussion (between t1 and t2) before spine surgery is performed under extremely demanding emotional conditions. To reduce patients' preoperative anxiety level and toimprove the postoperative outcomeregarding pain, the preoperative consent discussion should be adjusted to the individual anxiety level.
