Correlation Between Preoperative Anxiety And Perioperative Outcomes In Patients Undergoing Endoscopic Mucosal Dissection

Objective:To investigate and analyze the current situation of preoperative anxiety and its influencing factors in patients undergoing endoscopic mucosal dissection.Then,the relationship between preoperative anxiety and perioperative outcome was discussed.It was expected to lay a theoretical foundation for clinical nurses to formulate corresponding intervention measures to reduce preoperative anxiety and improve perioperative outcomes.Methods:A total of 187 inpatients undergoing endoscopic mucosal dissection（ESD）in the Department of Gastroenterology of in a Three-A hospital of were selected as research objects by cluster sampling method.The methods were as follows:The General Situation Questionnaire,State Anxiety Scale（SAI）,Amsterdam Preoperative Anxiety and Information Scale（APAIS）were given to the patients one day before ESD surgery.At the same time,the patients were instructed to fill in to evaluate the status of preoperative anxiety.Then the influencing factors of preoperative anxiety were screened out by binary logistic regression analysis.The perioperative outcomes of the patients were recorded on the perioperative outcome registration form.Among them,postoperative fatigue（POF）was measured by ICFS-10.Postoperative acute pain（APSP）was performed using the Digital Pain Rating Scale（NRS）.t test or Mann-Whitney U test and correlation analysis were used to determine the relationship between preoperative anxiety and perioperative outcome in patients undergoing ESD.Results:（1）A total of 187 effective datas were collected.The mean preoperative SAI score of the patients was 42.40±7.10,the mean preoperative SAI score of the male patients was 41.18±7.16,and the mean preoperative SAI score of the female patients was 43.99±6.74.The mean preoperative SAI score of ESD patients of different genders were higher than the domestic norm（P<0.001）,suggesting that preoperative anxiety is commom in ESD patients.The mean APAIS score was 11.38±3.0.The mean score of the subscale of information needs was 3.91±1.29,and the proportion of medium and high information needs was 37.43%,and the anxiety of surgical patients was higher than that of anesthesia（P<0.001）,suggesting that there was a high demand for preoperative information in ESD patients,especially for surgical information.（2）According to the SAI scoring criteria,the selected research objects were divided into high anxiety group（group H,SAI score≥46 points）and low anxiety group（group L,SAI score<46 points）.Univariate analysis showed that gender,age and surgical history had significant effects on preoperative anxiety（P<0.05）.Binary logistic regression analysis showed that age was the only independent risk factor for preoperative anxiety.Spearman correlation analysis showed that age was positively correlated with preoperative anxiety（P<0.05）.（3）The influence of preoperative anxiety on perioperative outcome:during anesthesia intubation（T₂）,SBP in group H was higher than that in group L（P<0.05）;At the time of extubation（T₃）,SBP,DBP,MAP and HR in group H were higher than those in group L（P<0.05）.The postoperative fatigue（POF）score in group H was higher than that in group L（P<0.05）.The results of Pearson or Spearman correlation analysis showed that the anxiety degree of ESD patients was positively correlated with SBP at T₂,SBP,DBP,MAP,HR and POF at T₃.Conclusion:Patients with ESD have obvious anxiety and information needs before operation,especially the degree of anxiety about surgery is higher than that about anesthesia.Age is positively correlated with preoperative anxiety,and is an independent risk factor for preoperative anxiety in ESD patients.Preoperative anxiety of ESD patients also affects intraoperative hemodynamics and postoperative fatigue,and there is a positive correlation between each other.