A doctor stands with stethoscope in this undated handout photo..
(photo credit: REUTERS)
A combination of complementary medicine and standard medical care shows real potential to reduce preoperative anxiety levels and improve the outcome of the operation, according to University of Haifa Prof. Lital Keinan Boker. She noted that “consideration should be given to offering this combination to patients who are interested in it.”
Preoperative anxiety, which can manifest itself in elevated blood pressure, rapid pulse, sugar metabolism changes and other symptoms, is one of the most significant factors predicting mortality among postoperative cardiovascular patients. In addition, preoperative anxiety can also influence and extend the postoperative recovery period.
The current research was undertaken by Samuel Attias as part of his master’s studies in the university’s School of Public Health under Keinan Boker’s guidance together with Dr. Elad Schiff of the city’s Bnai Zion Medical Center. The researchers sought to examine whether complementary medicine practices, applied alongside conventional care, could help reduce anxiety levels.
The study examined 360 patients over the age of 16 about to undergo elective or acute surgery in the general surgery ward. The patients were divided into three groups. The first group received standard care for preoperative anxiety, including anti-anxiety drugs according to the anesthesiologist’s instructions 120 to 160 minutes before entering the surgical waiting room.
The second group received standard care as well as complementary medical care, including one of the following therapeutic means: acupuncture, reflexology, individual guided imagery or a combination of reflexology and guided imagery. The third group received standard care combined with generic guided imagery, provided in the form of a recording for the patient, rather than in person. The anxiety levels were measured on a scale of one to 10, before and after the intervention (both pre-operationally); scores of four and above constitute an intermediate or higher anxiety level.
The results of the study show that, in general, patients who received the combination of complementary medicine and standard care showed a reduction of 60% in their anxiety level, from a mean score of 5.54 to 2.32, representing a reduction from intermediate-high anxiety level to low anxiety level. By contrast, standard care alone actually caused the average anxiety level to slightly rise from 4.92 to 5.44, and 70% of patients in this group continued to report intermediate-to-high anxiety even after receiving medication.
The study findings also show that the greatest reduction in anxiety – by an average of 4.22 points – was achieved when patients received a combination of standard care together with reflexology and guided imagery. A reduction of 3.63 points was secured when patients received a combination of standard care and guided imagery; 3.52 points, when they received a combination of standard care and acupuncture; and 3.28 points, when they received a combination of standard care and reflexology.
The group of patients that received a combination of standard care and generic guided imagery, without intervention by a caregiver, showed a reduction in preoperative anxiety level from an average of 4.9 to 3.5. The researchers state that this reduction is statistically significant, but not clinically significant.
They acknowledged that this method enables a broad population to receive treatment, since there is no limit to the number of patients who may be treated, but it is logistically complex. Moreover, since this method does not include the presence of a caregiver close to the patient, it is subject to external interruptions, for example when the anesthesiologist or nurses come to perform routine preoperative tasks on the patient.
“Despite the growing popularity of complementary medicine, studies providing evidence of its therapeutic effectiveness are still lacking,” the researchers conclude.
“In this study, we showed that complementary treatments are apparently helpful in the context of preoperative anxiety.”
ALYN POOL FOR RESUSCITATED CHILDREN The Alyn Rehabilitation Hospital in Jerusalem has developed a hydrotherapy technique that makes it possible to be used for swimming by children attached to a respirator.
“Our aim was to make it possible for every child to enjoy life as much as possible. Even if the water does not provide functional therapy for children, it’s important for them to enjoy a normative experience, said Dr. Eliezer Be’eri, head of the respiratory rehabilitation department.
“There are very few places in the world today that treat ventilated children in swimming pools.” He noted that rehabilitation specialists from the US came specially to Alyn to see how the system works.
Hospital director Dr. Maurit Be’eri added that thanks to improved medical technology, “we can ensure that children with complicated conditions can be happy and enjoy new experiences. There is psychological and social importance to this.”
Alyn treats Jewish, Arab, Beduin and other children from around the country and tries to understand the cultural needs of all of them, she added. The 120-bed hospital, founded in 1934, treats 300 physically disabled children and young people up to the age of 22 every day.