Anxiety Levels and Quality of Recovery Score-15 Assesment of Women Undergoing Cesarean Section

Öz

ABSTRACT Objective: The aim of this study to investigate the preoperative and postoperative anxiety levels in women undergoing ceserean section and the factors affecting their postoperative quality of life. Material and Methods: One hundred twenty patients aged between 18-45, who applied to our hospital between October 2017 and March 2018 and who had undergone cesarean section were included in this study. "Quality of Recovery Score-15” (QoR-15) scale was used to evaluate the healing quality of our patients, and “ The State-Trait-Anxiety Inventory” (STAI) scale was used to evaluate the preoperative and postoperative anxiety levels of the patients. Results: There was no statistically significant difference between the STAI levels of the preoperative period by age groups (p>0,05), but the average of postoperative STAI levels of the 31-35 age group was found to be significantly higher than the group aged over 35 years old (p=0,037; p <0,05). The average Quality of Recovery Score-15 scores of 31-35 age group was found to be significantly higher than the group aged 30 or below (p:0,001, p<0,01). The pain scores of the General Anesthesia group were significantly higher than the Combined Spinal Epidural Anesthesia group (p<0,01). Conclusions: Preoperative and postoperative anxiety had no effect on postoperative recovery score in pregnant women who had undergone elective cesarean section. In the 31-35 age group, the high levels of postoperative anxiety were attributed to high second birth rates, hence increased responsibilities to their families. However, it was concluded that this anxiety did not affect the postoperative quality of life, probably because of previously obtained neonatal care experience.

Anahtar Kelimeler

• Cesarean Section
• Anxiety Tests
• Quality of Recovery

Sezaryenlerde Anksiyete Düzeyleri ve Postoperatif Qor-15 Değerlendirilmesi

Öz

ÖZ Amaç: Sezaryen ile doğum yapan kadınların ameliyat öncesi ve sonrası kaygı düzeylerini, bu kaygının nedenlerini araştırmak ve bu hastaların postoperatif yaşam kalitelerini etkileyen faktörlerin belirlenmesidir. Gereç ve Yöntemler: Bu çalışmaya Ekim 2017-Mart 2018 tarihleri arasında hastanemize başvuran ve sezaryen uygulanan 18-45 yaş arası 120 hasta dahil edildi. Hastalarımızın iyileşme kalitesini değerlendirmek için “Quality of Recovery Score-15” (QoR-15) ölçeği, hastaların ameliyat öncesi ve sonrası kaygı düzeylerini değerlendirmek için “Durumluk-Sürekli-Kaygı Envanteri” (STAI) ölçeği kullanıldı. Bulgular: Yaş gruplarına göre ameliyat öncesi dönem STAI düzeyleri arasında istatistiksel olarak anlamlı fark bulunmadı (p>0,05), ancak 31-35 yaş grubunun ameliyat sonrası STAI düzeyleri ortalaması 35 yaş üstü gruba göre anlamlı olarak yüksek bulundu (p=0,037; p<0,05). Otuz bir – Otuz beş yaş grubunun ortalama Quality of Recovery Score-15 puanları 30 yaş ve altı gruba göre anlamlı olarak yüksek bulundu (p:0,001, p<0,01). Genel Anestezi grubunun ağrı skorları, Kombine Spinal Epidural Anestezi grubuna göre anlamlı olarak yüksekti (p<0,01). Sonuç: Elektif sezaryen uygulanan gebelerde preoperatif ve postoperatif anksiyetenin postoperatif derlenme skoruna etkisi yoktu. Otuz bir – Otuz beş yaş grubunda ameliyat sonrası kaygı düzeylerinin yüksek olması, yüksek ikinci doğum oranlarına ve dolayısıyla ailelerine karşı sorumlulukların artmasına bağlanmıştır. Ancak bu kaygının postoperatif yaşam kalitesini etkilemediği, muhtemelen daha önce yenidoğan bakım deneyimine sahip olunduğu sonucuna varıldı.

Anahtar Kelimeler

• Sezaryen
• Anksiyete testleri
• İyileşme kalitesi

Kaynakça

1. 1-Iddrisu M, Khan ZH. Anesthesia for cesarean delivery: general or regional anesthesia-a systematic review. Ain-Shams J Anesthesiol 2021; 13-1.
2. 2-Barker R, Kober A, Hoerauf K, Latzke D, Adel S, Kain ZN, Wang SM. Out-of-hospital auricular acupressure in elder patients with hip fracture: a randomized double-blinded trial. Acad Emerg Med 2006; 13(1): 19-23.
3. 3- Babacan Gümüş A, Çevik N, Hataf Hyusni S, Biçen Ş, Keskin G, Tuna Malak A, Gebelikte benlik saygısı ve beden imajı ile ilişkili özellikler Anatol. J. Clin. Investig 2011; 5:7-14.
4. 4-Badner NH, Nielson WR, Munk S, Kwiatkowska C, Gelb AW, Preoperative anxiety: detection and contributing factors. Can. J. Anaesth 1990; 37:444-7.
5. 5-Boeke S, Jelicic M, Bonke B, Pre‐operative anxiety variables as possible predictors of post‐operative stay in hospital. Br J Clin Psychol 1992; 31(3):366-8.
6. 6-Stark PA, Myles PS, Burke JA, Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology 2013;118(6):1332-40.
7. 7-Klopfenstein CE, Forster A, Van Gessel E, Anesthetic assessment in an outpatient consultation clinic reduces preoperative anxiety. Can. J. Anaesth 2000; 47(6):511-5.
8. 8-Yelland J, McLachlan H, Forster D, Rayner J, Lumley J, How is maternal psychosocial health assessed and promoted in the early postnatal period? Findings from a review of hospital postnatal care in Victoria, Australia. Midwifery 2007; 23(3):287-97.

9. 9-Aslan B, Arıkan M, Gedikli A, Horasanlı E. Gebe hastalarda preoperatif anksiyete sebepleri ve değerlendirilmesi: staı skorlarının karşılaştırılması Ortadogu Tıp Dergisi 2014; 6(3):129-35.
10. 10-Spielberger CD, Gorsuch RL, Lushene RE, Vagg PR, Jacobs GA, Manual for the state-trait anxiety ınventory (staı), Palo Alto, Consulting Psychologists Press, 1983.
11. 11-Demir A, Akyurt D, Ergün B, Haytural C, Yiğit T, Taşoğlu İ, Erdemli Ö. Kalp cerrahisi geçirecek olgularda anksiyete sağaltımı. Turk Gogus Kalp Dama 2010; 8(3):177-82.
12. 12- Shafer A, Fish MP, Gregg KM, Seavello J, Kosek P. Preoperative anxiety and fear: a comparison of assessments by patients and anesthesia and surgery residents. Anesth Analg 1996; 83(6):1285-91.
13. 13- Sunal N, Demiryay A, Physical and emotional complaints perceived by pregnancy woman. Fırat Sağlık Hizmetleri Dergisi 2009; 4(12):99-110.
14. 14-Domar AD, Everett LL, Keller MG. Preoperative anxiety: is it a predictable entity?. Anesth Analg 1989; 69(6):763-77.
15. 15-Erdem D, Ugis C, Albayrak MD, Akan B, Aksoy E, Gogus N, The effect of preoperative anxiety and postperative pain levels on anaesthesia methods applied to patients undergoing perianal region surgery. Med J Bakirkoy 2011; 7(1):11-6.
16. 16-Bowyer AJ, Royse CF, Postoperative recovery and outcomes–what are we measuring and for whom? Anaesthesia 2016; 71(1):72-7.
17. 17-Myles PS, Myles DB, Galagher W, Chew C, MacDonald N, Dennis A, Minimal clinically important difference for three quality of recovery scales. Anesthesiology 2016; 125(1):39-45.
18. 18- Myles PS, Weitkamp B, Jones K, Melick J, Hensen S, Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth 2000; 84(1):11-5.
19. 19-Stark PA, Myles PS, Burke JA, Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology 2013; 118(6):1332-40.
20. 20- Ciechanowicz S, Setty T, Robson E, Sathasivam C, Chazapis M, Dick J, Carvalho B, Sultan P. Development and evaluation of an obstetric quality-of-recovery score (ObsQoR-11) after elective Caesarean delivery. Br J Anaesth 2019; 122(1):69-78.
21. 21- Açıkel A, Öztürk T, Göker A, Hayran G, Keleş G T, Comparison of patient satisfaction between general and spinal anaesthesia in emergency caesarean deliveries. Turk J Anaesthesiol Reanim 2017; 45(1):41-6.
22. 22- Abdal Rahman AA, Mahdy NE, Kamaly AM. Predictive Factors Affecting Postoperative Quality of Recovery for Patients Undergoing Surgery. IOSR Journal of Nursing and health Science 2017; 6: 50-60.
23. 23-McIntosh S, Adams J, Anxiety and quality of recovery in day surgery: a questionnaire study using hospital anxiety and depression scale and quality of recovery score Int J Nurs Pract 2011; 17(1): 85-92.