Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2017; 84(4):292-298 | DOI: 10.55095/achot2017/045

Vliv obav poskytovatele na obavy pacienta před "fast-track" aloplastikou kolenaPůvodní práce

P. ZIETEK^1,*, B. ZARZYCKA², J. ZIETEK³, M. STEPIEN-SLODKOWSKA⁴, E. SIENKO-AWIERIANOW⁴, D. KOTRYCH¹, K. DOBIECKI¹

¹ Department of Orthopaedics, Traumatology and Oncology of Pomeranian Medical University, Szczecin, Poland

² The John Paul II Catholic University of Lublin, Institute of Psychology, Lublin, Poland

³ Department of Psychiatry "ZDROJE", Szczecin, Poland

⁴ Department of Physical Culture and Heath Promotion University, Szczecin, Poland

PURPOSE OF THE STUDY:
Anxiety may have negative repercussions on the surgery including poorer outcomes. On the other hand, the majority of patients reporting preoperative anxiety fear not receiving enough attention from a caregiver.
In patients undergoing fast-track knee arthroplasty, we determined the relationship between patients' preoperative anxiety and the anxiety the patient's caregiver. We also analyzed the influence of selected psychosocial and demographic variables on the relationship between caregivers' and patients' anxiety.

MATERIAL AND METHODS:
We conducted a prospective, descriptive study in which baseline assessments of patients scheduled to undergo fast-track total knee arthroplasty between 1st November 2014 and 30th April 2015 were compared with those of their caregivers. Patients were recruited from a large teaching hospital through the orthopedics joint replacement clinic. Information on sex, age, body mass index (BMI), educational status, employment status, marital status, and living status was recorded for all patients. Patients and their caregivers completed the Spielberger State-Trait Anxiety Inventory. Baseline trait anxiety was assessed with STAI scores in the initial interview, 2 weeks before hospitalization, and state anxiety was assessed the day before the surgery.
The patients' caregivers were contacted during a scheduled postoperative clinic visit and asked to complete the STAI and to provide information on their age, degree of consanguinity with patient, and living status.

RESULTS:
The mean age was 66.4 years for the 118 patients and 55.7 years for the 93 caregivers. In male caregivers, caregiver anxiety and patient anxiety were positively related but not statistically so, and in women was not significant. In male patients, a relationship between caregiver's anxiety and patient's anxiety was positive, although not statistically significant, and in women was neither present nor significant.

DISCUSSION:
Given the widespread impacts of anxiety before knee arthroplasty, it is critical for surgeons to gain a better understanding of how to identify and reduce preoperative anxiety in operated patients. We found that male sex among caregivers was associated with more preoperative anxiety among patients than was female sex and that male patients more quickly accepted anxiety from their caregivers than did female patients.

CONCLUSIONS:
Anxious male caregivers appear to impart their anxiety to male patients but not to female patients. The anxiety of unrelated caregivers is associated with low preoperative anxiety among patients. Preoperative interventions should focus on caregivers, especially male caregivers, and to related caregivers to help patients cope with anxiety before knee arthroplasty.

Klíčová slova: knee arthroplasty, knee replacement, fast track, anxiety, caregiver, preoperative stress

Zveřejněno: 1. srpen 2017  Zobrazit citaci