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Conscious surgery: influence of the environment on patient anxiety

Mitchell, MJ 2008, 'Conscious surgery: influence of the environment on patient anxiety' , Journal of Advanced Nursing, 64 (3) , pp. 261-271.

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    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.

    Item Type: Article
    Additional Information: The definitive version is available at
    Uncontrolled Keywords: Conscious, day/ambulatory surgery, local and regional anaesthesia, nursing, patient anxiety, questionnaires, surgery
    Themes: Subjects / Themes > R Medicine > RT Nursing
    Subjects / Themes > R Medicine > RD Surgery
    Health and Wellbeing
    Schools: Colleges and Schools > College of Health & Social Care
    Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences
    Journal or Publication Title: Journal of Advanced Nursing
    Publisher: Blackwell Publishing Ltd
    Refereed: Yes
    ISSN: 03092402
    Depositing User: MJ Mitchell
    Date Deposited: 16 Jan 2009 12:21
    Last Modified: 24 Jul 2014 12:05

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