Conscious surgery: influence of the environment on patient anxiety

Mitchell, MJ

Abstract

Aims: i) To investigate anxiety arising from the experience of the clinical environment during surgery under local/ regional anaesthesia and, ii) to uncover the specific aspects patients find anxiety provoking and possibly dissuade them from opting for such anaesthesia.
Background: Operating theatres have historical been designed for safe, efficient surgery on the unconscious patient and not primarily designed for the care of the ‘awake’ patient. However, with the rise in day surgery, the quantity of surgery performed under local/ regional anaesthesia is increasing.
Method: As part of a larger study investigating anxiety within modern elective day surgery, adult patients undergoing surgery and local/ regional anaesthesia (n=214) were provided with a questionnaire on the day of surgery for return by mail 24 - 48 hours following surgery.
Findings: The experience of being awake, possibly feeling surgeon, seeing body cut open or surgery being more painful were anxiety provoking aspects. Utilising factor analysis ‘intra-operative apprehension’, ‘anaesthetic information provision and ‘health control’ were identified as central features. Moreover, when employing multiple regression, apprehension associated with the intra-operative experience and anaesthetic information provision were significantly associated with an increase in the overall level of anxiety.
Conclusions: Although the surrounding clinical environment has previously been a cause of apprehension, the sensations associated with the physical act of surgery on the conscious self appear also to have a considerable influence. Focusing care upon managing patient intra-operative experience and providing anaesthetic information in advance may help limit anxiety and expel the apparent misapprehensions associated with conscious surgery.

Citation

Mitchell, M. (2008). Conscious surgery: influence of the environment on patient anxiety. Journal of Advanced Nursing, 64(3), 261-271. https://doi.org/10.1111/j.1365-2648.2008.04769.x

• Journal Article Type: Article
• Publication Date: Nov 1, 2008
• Deposit Date: Jan 16, 2009
• Publicly Available Date: Jan 16, 2009
• Journal: Journal of Advanced Nursing
• Print ISSN: 0309-2402
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Issue: 3
• Pages: 261-271
• DOI: https://doi.org/10.1111/j.1365-2648.2008.04769.x
• Keywords: Conscious, day/ambulatory surgery, local and regional anaesthesia, nursing, patient anxiety, questionnaires, surgery
• Publisher URL: http://dx.doi.org/10.1111/j.1365-2648.2008.04769.x
• Additional Information: Additional Information : The definitive version is available at www.blackwell-synergy.com