Using a Delphi consensus process to develop a structured reflexology treatment protocol to reduce preoperative anxiety

摘要

1. Background:1.1. Preoperative anxiety: Many individuals undergoing surgery have negative experiences associated with their operations due to major preoperative anxiety, as reported by ll%-80% of adult surgical patients [1,2]. A research study that examined treatment of preoperative anxiety in the waiting room area found that 70% of all surgical patients experienced an intermediate to high level of preoperative anxiety (Visual Analog Scale -VAS > 4 out of 10) [3]. A state of preoperative anxiety is liable to affect the course of the surgery and the postoperative recovery period. Moreover, it can also influence perioperative morbidities, such as pain [4], wound healing [5], nausea and vomiting [6], length of hospitali-zation and recuperation [7], immune system status [8] and anesthesia use [9]. Several studies have proven the effectiveness of anti-anxiety drugs as part of premedication treatment prior to surgery, among them Midazolam [10], Gabapentin [11], Diazepam [12] and Oxazepam [13]. The window of opportunity for providing treatment in the waiting room is narrow and challenging due to the relatively short amount of time the patient spends there before being brought to the operating room [3]. In addition, several studies have shown beneficial effects of various complementary treatment methods, among them reflexology, in reducing anxiety before surgery or medical procedures [3,14,15].