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Anxiety in patients undergoing cataract surgery: a pre- and postoperative comparison

Authors Ramirez DA, Brodie FL, Rose-Nussbaumer J, Ramanathan S

Received 12 July 2017

Accepted for publication 8 September 2017

Published 10 November 2017 Volume 2017:11 Pages 1979—1986


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

David A Ramirez,1,2 Frank L Brodie,2 Jennifer Rose-Nussbaumer,2,3 Saraswathy Ramanathan2

1School of Medicine, University of California, San Francisco, 2Department of Ophthalmology, University of California, San Francisco, 3Francis I. Proctor Foundation, San Francisco, CA, USA

Purpose: Reducing surgery-related patient anxiety without under-emphasizing surgical risk is challenging for even the most experienced surgeon. The purpose of this study is to identify specific anxieties faced by patients in hopes of better informing the preoperative surgeon-patient dialogue.
Setting: Comprehensive and specialty ophthalmology clinics at the University of California, San Francisco.
Design: A prospective, survey-based study in which a pre- and postoperative questionnaire was administered to patients undergoing routine phacoemulsification. The surgeon was masked to patient enrollment and questionnaire responses.
Materials and methods: A 36-item questionnaire on patient anxiety was developed from existing literature, building on the validated Surgical Fear Questionnaire. Patients were eligible if they were aged >18 years and willing to participate. Patients were excluded if having more than phacoemulsification alone or if unable to respond in English, and were retroactively excluded if there were complications during surgery. The primary outcome was self-reported anxiety on an 11-point Likert scale.
Results: Sixty-one patients were included for analysis. Preoperatively, patients reported greatest anxiety around the operation itself and becoming blind. Reflecting postoperatively, patients reported the greatest anxiety for the operation itself. Statistically significant decreases were greatest for anxiety about the operation failing (p<0.001) and becoming blind (p<0.001). No decrease was observed for the operation itself (p=0.1).
Conclusion: More effort must be made to specifically discuss the steps of the operation itself and the expected visual outcomes to alleviate patient anxiety. The authors hope these data can provide insight for surgeons into patient anxiety surrounding cataract surgery and help strengthen the patient–physician relationship.

Keywords: cataract surgery, patient anxiety, preoperative counseling, informed consent

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