What helps patients to prepare for and cope during awake craniotomy? A prospective qualitative study

IF 2 4区 心理学 Q2 PSYCHOLOGY
Aleksandra Bala, Agnieszka Olejnik, Tomasz Dziedzic, Jolanta Piwowarska, Anna Podgórska, Andrzej Marchel
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Abstract

There is growing interest in awake craniotomies, but some clinicians are concerned that such procedures are poorly tolerated by patients. Therefore, we conducted a study to assess this phenomenon. In this prospective qualitative study, 68 patients who qualified for awake craniotomy were asked to complete the Hospital Anxiety and Depression Scale (HADS)—two days before the surgery and visual analogue scales (VAS) for pain and stress, two days before the surgery and again about two days after. In addition, after their surgery, they took part in a structured interview about what helped them prepare for and cope with the surgery. Most patients tolerated the awake surgery well, scoring low on stress and pain scales. They reported a lower level of stress during the surgery (when questioned afterwards) than before it. Intensity of stress before the surgery correlated negatively with age, positively with HADS anxiety score and positively with stress subsequently experienced during surgery. The level of stress during surgery was associated with stress experienced before the surgery, pain and HADS anxiety and depression scores. Severity of pain during the surgery was positively correlated with stress during surgery and HADS depression and anxiety scores before the surgery. There was no correlation between stress, pain, anxiety and depression and the location of the lesion. Patients have a high tolerance for awake craniotomy. Various factors have an impact on how well patients cope with the operation. Extensive preoperative preparation should be considered a key part of the procedure.

在清醒开颅手术中,什么能帮助患者做好准备并应对手术?一项前瞻性定性研究。
人们对清醒开颅手术的兴趣与日俱增,但一些临床医生担心患者对此类手术的耐受性较差。因此,我们开展了一项研究来评估这一现象。在这项前瞻性定性研究中,我们要求 68 名符合清醒开颅手术条件的患者在手术前两天填写医院焦虑抑郁量表(HADS),并在手术前两天和手术后两天填写疼痛和压力视觉模拟量表(VAS)。此外,在手术后,他们还参加了一次结构化访谈,了解是什么帮助他们准备和应对手术。大多数患者对清醒手术的耐受性良好,在压力和疼痛量表中得分较低。与手术前相比,他们在手术过程中(术后接受询问时)的压力水平较低。手术前的压力强度与年龄呈负相关,与HADS焦虑评分呈正相关,与手术中的压力呈正相关。手术中的压力水平与手术前的压力、疼痛以及 HADS 焦虑和抑郁评分相关。手术中疼痛的严重程度与手术中的压力以及手术前的 HADS 抑郁和焦虑评分呈正相关。压力、疼痛、焦虑和抑郁与病变位置之间没有相关性。患者对清醒开颅手术的耐受性很高。患者对手术的耐受程度受多种因素影响。广泛的术前准备应被视为手术的关键部分。
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来源期刊
Journal of Neuropsychology
Journal of Neuropsychology 医学-心理学
CiteScore
4.50
自引率
4.50%
发文量
34
审稿时长
>12 weeks
期刊介绍: The Journal of Neuropsychology publishes original contributions to scientific knowledge in neuropsychology including: • clinical and research studies with neurological, psychiatric and psychological patient populations in all age groups • behavioural or pharmacological treatment regimes • cognitive experimentation and neuroimaging • multidisciplinary approach embracing areas such as developmental psychology, neurology, psychiatry, physiology, endocrinology, pharmacology and imaging science The following types of paper are invited: • papers reporting original empirical investigations • theoretical papers; provided that these are sufficiently related to empirical data • review articles, which need not be exhaustive, but which should give an interpretation of the state of research in a given field and, where appropriate, identify its clinical implications • brief reports and comments • case reports • fast-track papers (included in the issue following acceptation) reaction and rebuttals (short reactions to publications in JNP followed by an invited rebuttal of the original authors) • special issues.
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