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Methods
cancer, illness
CANCER
This study applied a qualitative method using a narrative research design by collecting self‐stories of illness in order to conceptualize human experiences of illness among AYA cancer survivors. Eight in‐depth interviews were conducted using a narrative analysis according to the narrative plots of
PMC10075285
Results
cancer, Hopelessness, ill
CANCER
Hopelessness and a struggle to take part in the activities of daily life as survivors of cancer were revealed. Too ill to fully take part in the society, the AYA cancer survivors strive to be understood for what they are, namely young survivors.
PMC10075285
Conclusion
cancer, Cancer
CANCER, CANCER
The survivors'stories reveal a moral imperative that needs to be honored by medical professionals in order to improve cancer care. Cancer survivorship may be a lifelong process necessitating long‐term follow‐up care. With the lack of specific care programs for AYA cancer survivors, follow‐up care is provided by general...
PMC10075285
BACKGROUND
cancer, Cancer
CANCER, CANCER
Cancer survival rates have increased over the past 40 years due to modern cancer therapy.There is a lack of consensus as to what age defines adolescents and young adults (AYA).Internationally, AYA cancer patients are gradually being recognized as a distinctive population in oncology as a result of the unique challenges...
PMC10075285
Illness narratives
cancer
CANCER, DISEASE, FRANK, LENS, FOUNDERS
By telling one's story, one can give meaning to the seemingly meaningless. The AYA cancer survivors in this study were just about to establish a life of their own as adults when interrupted by disease. This seemingly senseless situation might be given a sense of meaning through the act of telling their stories to other...
PMC10075285
Ethical and philosophical perspectives
To capture the central values inherent in the participants' narratives, we focused on participants' subjective experiences and personal narratives, as well as their relationships with family, friends, and medical professionals. The ethics of care is the ethical perspective most relevant to this study.
PMC10075285
AIM AND RESEARCH QUESTIONS
cancer
CANCER, LATE EFFECTS
Surviving cancer successfully entails more than just immediate physical survival. It has been well established that AYA cancer survivors have a higher risk of long‐term and late effects of cancer, and they are in a unique phase of life in regard to psychosocial, cognitive and emotional transitions.This study attempted ...
PMC10075285
METHODS
PMC10075285
Design
cancer, illness
CANCER, FRANK
This study applied a qualitative method using a narrative research design that involved collecting self‐stories of illness to conceptualize human experiences of illness among AYA cancer survivors. In our analysis, the narrative plots of “restitution,” “chaos,” and “quest” as suggested by Arthur Frank (see below) were a...
PMC10075285
Participants
cancer, Cancer
CANCER, RECURRENCE, CHILDHOOD CANCER, CANCER
Participants were recruited via the Norwegian Cancer Society by attending patient association meetings, as well as via Facebook and posters in oncology clinics. Adolescent survivors of cancer who had diagnosed with cancer or had had a recurrence in the age‐range of 15–35 years and at least 1 year post‐treatment were in...
PMC10075285
The interviews
cancer, negatively?As cancer
CANCER, DISEASE
Eight loosely semi‐structured, in‐depth qualitative interviews were conducted using open‐ended questions. The first questions were designed to make the participant freely tell his or her story.Interview guideWould you please tell me about yourself and your experiences in light of having struggled with cancer at an earl...
PMC10075285
Data processing
The transcribed interviews were read closely by three of the authors (KH, PN, and MHH) individually to identify emerging themes, topics and plots. The authors met regularly to compare and discuss their individual findings. The fourth writer (HB) was involved after the initial analysis was done to secure validity by und...
PMC10075285
The analysis
illness
A narrative analysis was conducted looking at the themes that emerged during the interviews as well as how the tellers structured their stories of self. The themes and structures are discussed separately. Firstly, themes and topics of concern to the participants were identified and considered together to develop larger...
PMC10075285
Ethical concerns
Cancer
CANCER
As the quality of the data collected could potentially activate a reflexive process among the participants and lead to psychological distress, the participants were offered support by a nurse representing the Norwegian Cancer Society. The study was reviewed and accepted by the regional ethics review board (REK in Norwa...
PMC10075285
RESULTS
PMC10075285
Sample characteristics
cancer, cancers, tumors
OVARIAN CANCER, CANCERS, LATE EFFECTS, CANCER, DISEASE, TUMORS, ACUTE LEUKEMIA
Two men and six women aged 21–34 participated in this study. They had been diagnosed with different cancers at different stages of late childhood and early adolescence. One participant had ovarian cancer. Both men suffered from tumors of the central nervous system (CNS) and four women suffered from acute leukemia. Only...
PMC10075285
Three emerging themes
cancer, ill
CANCER
Several themes emerged from the interviews. All participants addressed three major themes, which are the basis for this study. The first theme deals with the situation of being neither ill, nor well because of the struggle with the side effects of cancer therapy. The second describes the complicated life phase in which...
PMC10075285
Neither ill, nor well: A remission society
hopelessness, shock, cancer, tiredness, ill, osteoporosis, Cancer
SHOCK, CANCER, BRAIN TUMORS, REMISSION, SAID, OSTEOPOROSIS, CANCER
The experience of being neither ill, nor effectively well was explicitly described by all of the participants: “My life is split in two. I live two different lives, and it takes a lot of hard work to separate the twoMargret, a 30‐year‐old anthropologist, got sick while at the university: “Once you have finished therapy...
PMC10075285
In a unique position: Transitions from sickness to wellness, and from childhood to adulthood
ovarian cancer, tumor, illness, cancer, leukemia
OVARIAN CANCER, TUMOR, LUNG FIBROSIS, CANCER, LEUKEMIA, BRAIN TUMOR, SHOCKING, SAID, IMPOTENT, CHRONIC FATIGUE SYNDROME (CFS)
The conflict between sickness and wellness coincides with the AYA cancer survivors' young age at the time of diagnosis, which puts them in a unique position. As Anita explained, “It is a special thing getting sick as a teenager. I had not had the chance yet to develop a life as an adult.”June (27), who had been diagnos...
PMC10075285
Hopelessness and no places to turn for help
cancer, depressions, fatigue, ill
CANCER, SAID
So far, our findings reveal the hopelessness of adolescents who are neither being sick nor well after battling cancer therapy. Their sense of hopelessness, it seems, is even greater when there are few places to turn for help. All the participants expressed frustration at having nowhere to turn for follow‐up care, or ha...
PMC10075285
The survivor as narrator – narrative structures
Because this study was interested in how the participants revealed their selves through the act of telling their stories, we shifted our attention from what was being told to the telling. This shift meant looking at how the stories were organized and put together to better see what a particular story did and really was...
PMC10075285
A story of restitution
cancer, pain
CANCER, CHRONIC PAIN
Sophie's story is one of restitution. Her restitution is not limited to the absence of pain, but also includes the establishment of new meaning in her life. She has gained a reflective grasp of what she has lived through. The choice of restitution rather than chaos as the dominant narrative element relates to her story...
PMC10075285
A story of chaos
cancer, chronically ill
CANCER, FRANK, CHRONICALLY ILL
Chaos dominates Ingrid's story: “I wanted to give up. But the reason why I am disabled today is not the cancer. It is that I have not received any help. That is why I am disabled. It is no fun in receiving unemployment benefits. I feel I am staying put. This happened when I was 20, now I am 34, I still haven't recovere...
PMC10075285
The quest
The teller of a quest story has gained an insight that must be passed on to others.All participants were involved in the patient associations to varying degrees believing they should pass on the experiences they had gained. As Mark put it, “It is about using the negative experiences, and turning them into something pos...
PMC10075285
Multiple stories, one narrator
cancer
CANCER, REMISSION, STILL
The participants' stories had different plots depending on what they were talking about and the situation they were describing. In illness narratives, all the suggested plots appear alternatively and repeatedly. Still, at any given moment, there is one plot that predominates. Accordingly, the participants revealed the ...
PMC10075285
DISCUSSION
PMC10075285
Interruptions
illness
Living with illness is living with perpetual interruption.
PMC10075285
A new approach
cancer, cancer survivors face significant challenges
CANCER, STILL
AYA cancer survivors face significant challenges when transitioning into adulthood. For one, they may become marginalized as patients are medically and legally considered children until the age of 16 years. Still, the challenges facing the AYA cancer survivors are far different from both pediatric and adult cancer surv...
PMC10075285
Young members of the remission society
cancer
CANCER, FRANK, REMISSION
The participants in this study illustrate both the difficulty of recovering from cancer and the extent to which the transition to early adulthood is affected by their illness. Though the participants have reached a “new” normal life, the restitution plot becomes problematic when the survivor is still battling the side ...
PMC10075285
A lack of care, a lack of connectedness
voice of illness, cancer
CANCER, LATE EFFECTS
Though many of the frustrations the participants expressed could be connected to how the health care systems and of follow‐up care are organized in Norway, the participants expressed their frustration at having their needs unmet and revealed a sense of hopelessness when not provided with sufficient information or not f...
PMC10075285
Implications and limitations
cancer, weakness, illness
CANCER, RECRUITMENT, STILL
This study provides further insights into how AYA cancer survivors understand themselves after going through cancer therapy while attempting to re‐enter into the lives they once lived. They are forever affected by their experiences. With its narrative approach, this study provides knew knowledge as to how the experienc...
PMC10075285
CONCLUSION
cancer, hopelessness, cancer survivors
CANCER
The results suggest a sense of hopelessness among the AYA cancer survivors. Despite being cured from cancer, they still cannot regard themselves as well. Furthermore, the findings speak to a lack of information specific to this group, as well as a lack of places available for help and follow‐up care. The existing liter...
PMC10075285
AUTHOR CONTRIBUTIONS
PMC10075285
CONFLICT OF INTEREST
All authors declare that they have no conflicts of interest.
PMC10075285
ETHICS STATEMENT
This study conforms to the recognized standards according to the Declaration of Helsinki. The Regional Ethics Committee of South East Norway approved this study (REK Sørøst). Clinical trial number is 2012/1141. Written consent was obtained from all the participants.
PMC10075285
ACKNOWLEDGMENTS
Cancer
CANCER
We want to thank the participants who agreed to share their stories with us. We also wish to thank the Norwegian Cancer Society (Kreftforeningen) and UNGKreft for their help in organizing the study. No external funding was received.
PMC10075285
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author (KH) upon reasonable request.
PMC10075285
REFERENCES
PMC10075285
Background
Whether body mass index (BMI) is a risk factor for poor bowel preparation is controversial, and the optimal bowel preparation regimen for people with a high BMI is unclear.
PMC10698874
Methods
We prospectively included 710 individuals with high BMIs (≥ 24 kg/m
PMC10698874
Results
colonoscopic bowel
After enrollment, 15 individuals didn’t undergo colonoscopy, finally 345 participants took 3 L split-dose PEG regimen, and 350 participants took 2 L PEG regimen for colonoscopic bowel preparation. 3 L split-dose PEG regimen was superior to 2 L PEG regimen in the rate of adequate bowel preparation (81.2% vs. 74.9%,
PMC10698874
Conclusions
overweight
3 L split-dose PEG regimen is superior to 2 L PEG regimen for colonoscopic Bowel Preparation in relatively high-BMI individuals, especially overweight individuals (BMI 25-29.9 kg/m
PMC10698874
Trial Registration
This trial was registered in the Chinese Clinical Trials Registry (ChiCTR2000039068). The date of first registration, 15/10/2020,
PMC10698874
Supplementary Information
The online version contains supplementary material available at 10.1186/s12876-023-03068-9.
PMC10698874
Keywords
PMC10698874
Introduction
CRC, malignancy, stroke, cirrhosis, inadequate bowel, constipation, overweight, Colorectal cancer
OBESE, HYPERTENSION, STROKE, DIABETES MELLITUS, CIRRHOSIS, COLORECTAL CANCER
Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer-related mortality worldwide [Several risk factors have been reported to be associated with inadequate bowel cleaning, such as age, male sex, constipation, diabetes mellitus, hypertension, cirrhosis, and stroke [Polyethyle...
PMC10698874
Methods
PMC10698874
Setting and ethics
This study was a multicenter, endoscopist single-blinded RCT. This study was approved by the research ethics boards from all participating hospitals. In addition, we registered at the Chinese Clinical Trial Registry (ChiCTR2000039068).
PMC10698874
Study populations
Patients scheduled to undergo colonoscopy were selected from 7 tertiary hospitals in Sichuan Province from January to November 2021. The inclusion criteria were as follows: (1) patients who underwent colonoscopy for the first time within one month; (2) age of 18-65 years; (3) BMI ≥ 24 kg/m
PMC10698874
Bowel preparation and colonoscopy
Eligible participants were randomly assigned to the experimental group or the control group. The experimental group was given a 3 L split-dose regimen (1 L PEG was taken at 8:00 pm one day before the colonoscopy date, and 2 L PEG was taken 4-6 h before the colonoscopy). The control group was given a single dose regimen...
PMC10698874
Definition
The bowel preparation quality was assessed using the Boston Bowel Preparation Scale (BBPS) score [
PMC10698874
Outcome measures
PDR, polyp, abdominal pain, dizziness, abdominal distension, nausea,
ADVERSE REACTIONS, SECONDARY, ADVERSE EVENTS
The primary outcome was the rate of adequate bowel preparation (RABP). The secondary outcomes included BBPS score; polyp detection rate (PDR); cecal intubation rate (CIR); and adverse reactions during bowel preparation, including dizziness, weakness, nausea, vomiting, abdominal pain, abdominal distension, and anal pend...
PMC10698874
Sample size and randomization method
WEST
Based on current research, the RABP in normal-weight people is approximately 80%, while that in people with high BMIs is less than 70%. Therefore, we assumed that the RABP for high-BMI individuals using 3 L PEG would be approximately 80%. The α value was set at 0.05, the β value was set at 0.2, and the lost to follow-u...
PMC10698874
Statistical analysis
IBM SPSS 26.0 was used for statistical analysis. Qualitative data were expressed as frequencies (percentages) and were compared using Person’s χ2 test or Fisher’s exact test, as appropriate. Quantitative data were reported as the mean with standard deviation (SD), or median with interquartile range (IQR). Normally dist...
PMC10698874
Results
ADVERSE REACTIONS
A total of 710 patients were enrolled from January to November 2021, including 353 individuals in 3 L split dose PEG group and 357 individuals in 2 L PEG group. After enrollment, 8 and 7 individuals in the 3 L and 2 L group, respectively did not undergo colonoscopy at last. Moreover, 28 individuals in 3 L split dose PE...
PMC10698874
Adverse reactions
ADVERSE REACTIONS, ADVERSE EVENT, ADVERSE EVENTS
28 individuals in the 3 L group and 22 in the 2 L group were lost to follow up, without data on adverse reactions. No serious adverse events requiring medical intervention occurred in either group. As shown in Table Adverse events of bowel preparation*
PMC10698874
Subgroup Analysis for adequate bowel prep
overweight
Subgroup analysis based on BMI classifications by WHO criteria showed that overweight individuals (BMI 25-29.9 kg/mExploratory subgroup analyses for adequate bowel preparation*
PMC10698874
Discussion
Adequate bowel prep, overweight, colonoscopic bowel preparation, constipation
ADVERSE REACTIONS, OBESE
This multicenter randomized controlled trial study confirmed that 3 L split-dose PEG regimen was superior to 2 L PEG regimen in colonoscopic bowel preparation in relatively high-BMI individuals (BMI ≥ 24 kg/mThe optimum dose of PEG for bowel preparation before colonoscopy remains a matter of debate. A meta-analysis [Ad...
PMC10698874
Acknowledgements
Not applicable.
PMC10698874
Authors’ contributions
Conception and design: Jilin Yang, and Kai Deng; acquisition of data: Hongyu, Dailan Yang, Zonghua Chen, Chao Liu, Zhong Huang, Rui Zhao, and Jing Shan; analysis and interpretation of data: Hailin Yan; drafting of the manuscript: Hailin Yan, Hongyu Huang; critical revision of the manuscript: Jilin Yang and Kai Deng; st...
PMC10698874
Funding
GASTROINTESTINAL CANCER
This study was supported by the Sichuan Science and Technology Program (22ZDYF1618, and 2022YFH0003), Operation Funding of Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer (No.161200021), and National Natural Science Foundation of China (No. 82173253).
PMC10698874
Availability of data and materials
The data supporting the findings of this study are available from the corresponding author, Kai Deng, upon reasonable request.
PMC10698874
Declarations
PMC10698874
Ethics approval and consent to participate
WEST
This study was conducted in accordance with the 1964 Helsinki declaration and was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University. This trial was registered in the Chinese Clinical Trials Registry (ChiCTR2000039068). All patients are required to provide written informed...
PMC10698874
Consent for publication
Not applicable.
PMC10698874
Competing interests
The authors declare no competing interests.
PMC10698874
References
PMC10698874
Significance:
deaths, tumor, death
TUMOR, TUMOR GROWTH
In translational oncology research, the patient-derived xenograft (PDX) model and its use in mouse clinical trials (MCT) are increasingly described. This involves transplanting a human tumor into a mouse and studying its evolution during follow-up or until death. A MCT contains several PDXs in which several mice are ra...
PMC10035449
Introduction
deaths, tumor, death
REGRESSION, TUMOR, TUMOR GROWTH
In the preclinical phase of oncology drug development, various Moving beyond the classical efficacy study with PDX models to estimate antitumor efficacy for a single tumor model, there is an innovative and recent preclinical experiment design, the mouse clinical trial (MCT) or PDX Clinical Trial (Description of PDX mod...
PMC10035449
Materials and Methods
REGRESSION, TUMOR GROWTH
Two statistical models of tumor growth based on linear mixed-effects regression model on the one hand and a joint shared random-effects model of tumor growth and survival on the other hand were used to analyze a MCT dataset.
PMC10035449
MCT Study
tumor, triple-negative breast cancer, death, breast cancer
TUMOR, TRIPLE-NEGATIVE BREAST CANCER, DNA DAMAGE, BREAST CANCER
The MCT study was performed at OncoDesign. All experimental procedures were approved by the Ethics Committee of OncoDesign (C2EA; registration number 91) and were performed in full compliance with the ARRIVE guidelines, EU Directive 2010/63/ EU for animal experiments, and the 2013 French Regulatory Decree. All efforts ...
PMC10035449
Statistical Modeling Strategy
tumor
TUMOR, TUMOR GROWTH
A log transformation of tumor volume was used to assume an exponential model which is often used to model tumor growth and allows to obtain a Gaussian distribution after transformation.
PMC10035449
Missing Data Mechanisms
deaths, death, tumor
TUMOR GROWTH, TUMOR
In MCT, the tumor growth process is stopped by death (regardless of the cause of death) which entails a dropout and missing tumor volumes. Before applying any statistical method, it is crucial to understand the nature of the missing data as statistical models are not all robust to the same type of missing data mechanis...
PMC10035449
Linear Mixed-effects Regression Model
REGRESSION
A linear mixed-effects regression model, such as recommended by authors (with Several change points were tested (3, 4, and 5 weeks post treatment initiation; These models were implemented with the package lme4 (
PMC10035449
Joint Shared Random-Effects Model
EVENT
Joint shared random-effects models (Survival model for the time of event TWith In our case with current true level with The estimation of the model parameters was done by maximum likelihood using package JM (For these two types of statistical model, the convergence and the accuracy (residuals analysis for linear mixed ...
PMC10035449
Simulations
deaths, Tumor
REGRESSION, TUMOR
A simulation study was carried out to evaluate the impact of the proportion of MAR and MNAR deaths on the estimation of the parameters of mixed and joint models. In these simulations, we assumed a single group with a 28-day follow-up with several sample size of mice (300, 200, and 100). In addition, a proportion of all...
PMC10035449
Data Availability Statement
Qualified researchers may request access to study data that underlie the results reported in this publication. Additional relevant study documents, including the clinical study report, study protocol with any amendments, annotated case report form, statistical analysis plan and dataset specifications may also be made a...
PMC10035449
Results
PMC10035449
Description of MCT
deaths, tumor, breast cancer
TUMOR, BREAST CANCER
The real MCT dataset was composed of 25 PDX breast cancer models with a total of 225 mice (between 1 to 18 measures per mice, 75% with at least 11 measures during follow-up) distributed by subtypes and doses as described in During the follow-up period, 103 deaths were observed and the reasons and description of deaths ...
PMC10035449
Statistical Modeling Strategy
deaths, death, tumor
TUMOR GROWTH, TUMOR
Concerning the modeling strategy of the mixed model, the final model was the model with a change of slope at week 4 and random effects on the intercept and the two slopes (The estimates of the treatment effect by subtypes and doses with three different models (piecewise linear mixed model with one-level random effects,...
PMC10035449
Results of the Simulation Study
deaths
The simulation study showed that, whatever the sample size and the proportion of MAR and MNAR deaths, the mixed model converged more often than the joint model (Estimation of treatment effect (slope) by mixed and joint models of the simulation study
PMC10035449
Discussion
deaths, death, tumor
REGRESSION, TUMOR GROWTH, TUMOR
In MCTs, antitumor efficacy is evaluated by modeling tumor growth using statistical models for longitudinal data. These models must handle the early dropout induced by the death of mice to avoid survivor bias in analyses over time. Using an example of a MCT with a high rate of dropout due to death during the follow-up,...
PMC10035449
Supplementary Material
tumor growths
REGRESSION, TUMOR GROWTH
Definition of summary measures of tumor growths used MCT endpoints in the literature.Click here for additional data file.Details on statistical modeling strategy.Click here for additional data file.Linear mixed-effects regression modelClick here for additional data file.Residuals analysis of joint shared random effect ...
PMC10035449
Acknowledgment
This study was sponsored by Ipsen.
PMC10035449
Authors’ Disclosures
H. Savel reports other from Ipsen during the conduct of the study; other from Ipsen outside the submitted work. F. Meyer-Losic reports other from Ipsen during the conduct of the study. L. Richert reports grants from Ipsen during the conduct of the study. No disclosures were reported by the other authors.
PMC10035449
Authors’ Contributions
PMC10035449
References
PMC10035449
Key Points
PMC10436133
Question
anxiety
Does a preoperative walkthrough of a patient’s day of surgery using augmented reality (AR) effect the patient’s anxiety levels?
PMC10436133
Findings
Anxiety
In this randomized clinical trial that included 95 patients, patients who received the preoperative AR experienced a significant decrease in preoperative State-Trait Anxiety Inventory (STAI) score compared with the control group that received standard education materials. There was no significant difference in STAI sco...
PMC10436133
Meaning
anxiety
These findings suggest that a preoperative AR walkthrough may be a useful tool for reducing preoperative anxiety, but its impact on postoperative anxiety is less clear.This randomized clinical trial assesses whether the use of an augmented reality walkthrough of the day of surgery reduces patient perioperative anxiety ...
PMC10436133
Importance
anxiety
Both augmented reality (AR) and virtual reality (VR) have had increasing applications in medicine, including medical training, psychology, physical medicine, rehabilitation, and surgical specialties, such as neurosurgery and orthopedic surgery. There are little data on AR’s effect on patients’ anxiety and experiences.
PMC10436133
Objective
anxiety
To determine whether the use of an AR walkthrough effects patient perioperative anxiety.
PMC10436133
Design, Setting, and Participants
This randomized clinical trial was conducted at an outpatient surgery center in 2021 to 2022. All patients undergoing elective orthopedic surgery with the senior author were randomized to the treatment or control group. Analyses were conducted per protocol. Data analysis was performed in November 2022.
PMC10436133
Intervention
AR experience explaining to patients what to expect on their day of surgery and walking them through the surgery space. The control group received the standard educational packet.
PMC10436133
Main Outcomes and Measures
Anxiety
The main outcome was change in State-Trait Anxiety Inventory (STAI) from the screening survey to the preoperative survey.
PMC10436133
Results
anxiety
A total of 140 patients were eligible, and 45 patients either declined or were excluded. Therefore, 95 patients (63 [66.3%] male; mean [SD] age, 38 [16] years) were recruited for the study and included in the final analysis; 46 patients received the AR intervention, and 49 patients received standard instructions. The A...
PMC10436133
Conclusions and Relevance
pain, anxiety, postoperative anxiety
In this randomized clinical trial, the use of AR decreased preoperative anxiety compared with traditional perioperative education and handouts, but there was no significant effect on postoperative anxiety, pain levels, or narcotic use. These findings suggest that AR may serve as an effective means of decreasing preoper...
PMC10436133
Trial Registration
ClinicalTrials.gov Identifier:
PMC10436133
Introduction
Anxiety, anxiety
Anxiety experienced by patients before a surgical intervention is a well-documented phenomenon, occurring in up to 60% to 80% of patients, and it can lead to alterations in cognitive and physiologic function.There is strong evidence that preoperative educational interventions can reduce patient perioperative anxiety.Ad...
PMC10436133