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KMID : 0980120220200020088
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Annals of Phlebology
2022 Volume.20 No. 2 p.88 ~ p.94
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EFficacy of the Family Guardian Observation System during vaRicose Vein Surgery under Local anesThesia: A Pilot Study of the EFFORT Prospective Observational Study
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Yie Kil-Soo
Hwang Eun-Jung
Shin A-Rom
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Abstract
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Objective: To establish trust between patients and medical staff, and to reduce patient and guardian anxiety before surgery, we have developed and implemented the “Next of Kin Observation of Surgery Intervention” (NoKOSI). It includes a comprehensive process with sufficient explanation prior to surgery, especially attendance of family guardian during the operation.
Methods: We conducted a pilot study to evaluate the possibility of using the NoKOSI system before conducting the main study which will identify whether this system reduces anxiety and determine any clinical significance. The study included 133 patients (mean age, 52.3±13.8 and majority female gender, 88 [66.2%]) who underwent varicose vein surgery under local anesthesia between May 2022 and August 2022. The primary outcome was the actual observation rate of the participants with the NoKOSI system. The secondary outcomes were to analyze differences in modified Amsterdam Preoperative Anxiety and Information Score (mAPAIS) between the observing group (Group O) and non-observing group (Group NO).
Results: Of the 133 surgeries, 44 (33%) voluntarily participated in NoKOSI (Group O). There was no difference between the two groups in relation to age, sex, comorbidity, Chronic Venous Insufficiency, Quality of Life Scale-14 score, Venous Clinical Severity Score (VCSS), patient-reported symptom severity score (0~5), and surgical method. There was no statistical correlation between the preoperative mAPAIS score and the operative Visual Analogue Scale in all patients (r=0.013, p=ns). However, the preoperative anxiety score was significantly correlated with the Family Guardian Observation Request Scale (r=0.474, p=0.000). Of the 11 patients who reported their impression, ten gave a positive opinion and one a negative opinion. Of the 49 reported guardian responses, 38 (77.6%) were positive and 11 (22.4%) were negative.
Conclusion: In varicose vein surgeries performed under local anesthesia, 33% of family or guardians participated in NoKOSI. The necessity and efficacy of NoKOSI should be further investigated in larger prospective studies.
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KEYWORD
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Varicose vein, Local anesthesia, Pilot-study, Anxiety, Word count
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