Authors (including presenting author) :
Tse WLW (1)(2), Cheng HY (2), Cheung YS (1), Lau WY (1), Chan Y (1), Wong WY (1)
Affiliation :
(1) Department of Surgery, North District Hospital (2) The Nethersole School of Nursing, The Chinese University of Hong Kong
Introduction :
Emergency abdominal surgery (EAS) accounted for 80 percent of major and ultra-major emergency surgeries in Hospital Authority. Within the limited time for preparation, patients undergoing EAS could experience various degrees of anxiety, which potentially hinder their postoperative recovery, such as delay postoperative flatus return and prolong length of hospital stays. Consequently, a theory- and evidence-based programme called "Calming Anxiety and Relaxation for Emergency Abdominal Surgery" (CARES) was developed, which included three components: (I) a preoperative and (II) a postoperative 10-minute counselling session, and (III) five-consecutive-days self-implemented 15-minute postoperative body-mind exercises.
Objectives :
To evaluate the effects of CARES on pre- and postoperative anxiety, postoperative flatus return, and length of stay among adult patients undergoing EAS.
Methodology :
A clinical controlled trial was conducted to evaluate the effects of CARES from North District Hospital. Participants allocated to the intervention group (IG) received CARES, in addition to usual care. The participants of the control group (CG) received usual care only. Anxiety was assessed using visual analog scale after offering EAS (baseline), during pre-medication, on postoperative day one, and day three. Time of resuming postoperative flatus (days) and length of hospital stay (days) were compared between groups. Intention-to-treat principle was followed.
Result & Outcome :
Results: This study presented the findings of a total of 120 participants (IG=60; CG=60). There were no significant differences in baseline socio-demographic and clinical characteristics between groups. As compared to the CG, the IG demonstrated a significant reduction in preoperative anxiety during pre-medication (p<0.001, d=1.14), and a significant decrease in postoperative anxiety from baseline to postoperative day one and day three (p=0.008, η2=0.039) via repeated measures ANOVA. Furthermore, the IG showed significance in shortening the duration in resuming postoperative flatus (p=0.008, d=0.50) and length of stay (p=0.024, d=0.42) when compared to the CG. Conclusion: The findings indicated that CARES effectively manages pre- and postoperative anxiety, expedites the resumption of postoperative flatus, and reduces the length of stay among patients undergoing EAS. Other surgical settings can adopt CARES to provide a pleasant perioperative experience and improve patient’s outcomes among patients undergoing EAS with a minimal resource allocation.
