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Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 10/2018

01-10-2018 | Reports of Original Investigations

Évaluation de la communication thérapeutique pour améliorer l’accueil du patient au bloc opératoire: étude d’impact

Authors: Emmanuel Boselli, MD, PhD, Nathalie Demaille, CRNA, Géraldine Fuchs, CRNA, Aïcha Manseur, CRNA

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 10/2018

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Résumé

Objectif

Nous avons voulu évaluer l’impact de la sensibilisation du personnel soignant à la communication thérapeutique sur l’amélioration de l’accueil du patient au bloc opératoire en chirurgie ambulatoire.

Méthode

Il s’agit d’une étude d’impact prospective, monocentrique, réalisée en chirurgie ambulatoire. Lors de la première phase, un questionnaire était effectué par l’infirmier(ère)-anesthésiste à l’arrivée du patient, permettant d’évaluer sur une échelle numérique simple le confort (ENSc) et la satisfaction et de calculer un score de communication négative (“CN”). Pendant la deuxième phase, le personnel soignant a été sensibilisé à la communication thérapeutique, consistant en partie en l’écoute, l’empathie et l’utilisation de formulations positives, après visionnage des vidéos pédagogiques. Pendant la troisième phase, après sensibilisation du personnel, le questionnaire a de nouveau été effectué. Les variables quantitatives (critère de jugement principal représenté par le nombre de patients ayant un score CN ≥ 5, ENSc, satisfaction) et qualitatives ont été comparées avant et après la phase de sensibilisation à la communication thérapeutique.

Résultats

Au total, 234 patients ont été inclus (109 avant et 125 après). Après sensibilisation du personnel à la communication thérapeutique, le score CN ≥ 5 a significativement diminué de 20 % à 6 %, ainsi que l’ENSc médiane [P25-P75] avant (8 [8-9] vs 8 [7-8]) et après (8 [8-9] vs 8 [7-8]) l’anesthésie. Le pourcentage de patients moins anxieux avant de commencer l’anesthésie était significativement supérieur après communication thérapeutique (32 % vs 17 %). La satisfaction a significativement augmenté après la phase de sensibilisation (8 [7-10] vs (9 [8-10]).

Conclusion

Cette étude préliminaire montre une amélioration modeste du confort et de la satisfaction des patients grâce à la communication thérapeutique. Un essai randomisé contrôlé est cependant nécessaire pour confirmer ces résultats.
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Literature
1.
go back to reference Badner NH, Nielson WR, Munk S, Kwiatkowska C, Gelb AW. Preoperative anxiety: detection and contributing factors. Can J Anaesth 1990; 37: 444-7.CrossRefPubMed Badner NH, Nielson WR, Munk S, Kwiatkowska C, Gelb AW. Preoperative anxiety: detection and contributing factors. Can J Anaesth 1990; 37: 444-7.CrossRefPubMed
2.
go back to reference Beydon L, Dima CE. Anxiété périopératoire: Évaluation et prévention. Le Praticien en Anesthésie-Réanimation 2007; 11: 161-70.CrossRef Beydon L, Dima CE. Anxiété périopératoire: Évaluation et prévention. Le Praticien en Anesthésie-Réanimation 2007; 11: 161-70.CrossRef
3.
go back to reference Fekrat F, Sahin A, Yazici KM, Aypar U. Anaesthetists’ and surgeons’ estimation of preoperative anxiety by patients submitted for elective surgery in a university hospital. Eur J Anaesthesiol 2006; 23: 227-33.CrossRefPubMed Fekrat F, Sahin A, Yazici KM, Aypar U. Anaesthetists’ and surgeons’ estimation of preoperative anxiety by patients submitted for elective surgery in a university hospital. Eur J Anaesthesiol 2006; 23: 227-33.CrossRefPubMed
4.
go back to reference Wilson CJ, Mitchelson AJ, Tzeng TH, et al. Caring for the surgically anxious patient: a review of the interventions and a guide to optimizing surgical outcomes. Am J Surg 2016; 212: 151-9.CrossRefPubMed Wilson CJ, Mitchelson AJ, Tzeng TH, et al. Caring for the surgically anxious patient: a review of the interventions and a guide to optimizing surgical outcomes. Am J Surg 2016; 212: 151-9.CrossRefPubMed
5.
go back to reference Beydon L, Rouxel A, Camut N, et al. Sedative premedication before surgery-a multicentre randomized study versus placebo. Anaesth Crit Care Pain Med 2015; 34: 165-71.CrossRefPubMed Beydon L, Rouxel A, Camut N, et al. Sedative premedication before surgery-a multicentre randomized study versus placebo. Anaesth Crit Care Pain Med 2015; 34: 165-71.CrossRefPubMed
6.
go back to reference Bucx MJ, Krijtenburg P, Kox M. Preoperative use of anxiolytic-sedative agents; are we on the right track? J Clin Anesth 2016; 33: 135-40.CrossRefPubMed Bucx MJ, Krijtenburg P, Kox M. Preoperative use of anxiolytic-sedative agents; are we on the right track? J Clin Anesth 2016; 33: 135-40.CrossRefPubMed
7.
go back to reference Maurice-Szamburski A, Auquier P, Viarre-Oreal V, et al. Effect of sedative premedication on patient experience after general anesthesia: a randomized clinical trial. JAMA 2015; 313: 916-25.CrossRefPubMed Maurice-Szamburski A, Auquier P, Viarre-Oreal V, et al. Effect of sedative premedication on patient experience after general anesthesia: a randomized clinical trial. JAMA 2015; 313: 916-25.CrossRefPubMed
8.
go back to reference Jaruzel CB, Kelechi TJ. Relief from anxiety using complementary therapies in the perioperative period: a principle-based concept analysis. Complement Ther Clin Pract 2016; 24: 1-5.CrossRefPubMed Jaruzel CB, Kelechi TJ. Relief from anxiety using complementary therapies in the perioperative period: a principle-based concept analysis. Complement Ther Clin Pract 2016; 24: 1-5.CrossRefPubMed
9.
10.
go back to reference Saadat H, Drummond-Lewis J, Maranets I, et al. Hypnosis reduces preoperative anxiety in adult patients. Anesth Analg 2006; 102: 1394-6.CrossRefPubMed Saadat H, Drummond-Lewis J, Maranets I, et al. Hypnosis reduces preoperative anxiety in adult patients. Anesth Analg 2006; 102: 1394-6.CrossRefPubMed
11.
go back to reference Faymonville ME, Nyssen AS. Communication soignant-soigné. Douleur et Analgésie 2014; 27: 210-4.CrossRef Faymonville ME, Nyssen AS. Communication soignant-soigné. Douleur et Analgésie 2014; 27: 210-4.CrossRef
12.
go back to reference Caddick J, Jawad S, Southern S, Majumder S. The power of words: sources of anxiety in patients undergoing local anaesthetic plastic surgery. Ann R Coll Surg Engl 2012; 94: 94-8.CrossRefPubMedPubMedCentral Caddick J, Jawad S, Southern S, Majumder S. The power of words: sources of anxiety in patients undergoing local anaesthetic plastic surgery. Ann R Coll Surg Engl 2012; 94: 94-8.CrossRefPubMedPubMedCentral
13.
go back to reference Lang EV, Hatsiopoulou O, Koch T, et al. Can words hurt? Patient-provider interactions during invasive procedures. Pain 2005; 114: 303-9.PubMed Lang EV, Hatsiopoulou O, Koch T, et al. Can words hurt? Patient-provider interactions during invasive procedures. Pain 2005; 114: 303-9.PubMed
14.
go back to reference Enck P, Benedetti F, Schedlowski M. New insights into the placebo and nocebo responses. Neuron 2008; 59: 195-206.CrossRefPubMed Enck P, Benedetti F, Schedlowski M. New insights into the placebo and nocebo responses. Neuron 2008; 59: 195-206.CrossRefPubMed
15.
go back to reference Bernard F, Musellec H. La communication dans le soin. Rueil-Malmaison: Arnette; 2013 . Bernard F, Musellec H. La communication dans le soin. Rueil-Malmaison: Arnette; 2013 .
16.
go back to reference Osborne-Smith L, Kyle Hodgen R. Communication in the operating room setting. Annu Rev Nurs Res 2017; 35: 55-69.CrossRefPubMed Osborne-Smith L, Kyle Hodgen R. Communication in the operating room setting. Annu Rev Nurs Res 2017; 35: 55-69.CrossRefPubMed
17.
go back to reference Des Jarlais DC, Lyles C, Crepaz N; Trend Group. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health 2004; 94: 361-6CrossRefPubMedPubMedCentral Des Jarlais DC, Lyles C, Crepaz N; Trend Group. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health 2004; 94: 361-6CrossRefPubMedPubMedCentral
20.
go back to reference Ali A, Altun D, Oguz BH, Ilhan M, Demircan F, Koltka K. The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy. J Anesth 2014; 28: 222-7.CrossRefPubMed Ali A, Altun D, Oguz BH, Ilhan M, Demircan F, Koltka K. The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy. J Anesth 2014; 28: 222-7.CrossRefPubMed
21.
go back to reference Fuzier R, Lavidale M, Bataille B, Richez AS, Magues JP. Anxiété: Facteur prédictif d’échec du bloc axillaire sous neurostimulation? Ann Fr Anesth Réanim 2010; 29: 776-81.CrossRefPubMed Fuzier R, Lavidale M, Bataille B, Richez AS, Magues JP. Anxiété: Facteur prédictif d’échec du bloc axillaire sous neurostimulation? Ann Fr Anesth Réanim 2010; 29: 776-81.CrossRefPubMed
22.
go back to reference Kil HK, Kim WO, Chung WY, Kim GH, Seo H, Hong JY. Preoperative anxiety and pain sensitivity are independent predictors of propofol and sevoflurane requirements in general anaesthesia. Br J Anaesth 2012; 108: 119-25.CrossRefPubMed Kil HK, Kim WO, Chung WY, Kim GH, Seo H, Hong JY. Preoperative anxiety and pain sensitivity are independent predictors of propofol and sevoflurane requirements in general anaesthesia. Br J Anaesth 2012; 108: 119-25.CrossRefPubMed
23.
go back to reference Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety. Cochrane Database Syst Rev 2013; 6: CD006908. Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety. Cochrane Database Syst Rev 2013; 6: CD006908.
24.
go back to reference Boselli E, Musellec H, Bernard F, et al. Effects of conversational hypnosis on relative parasympathetic tone and patient comfort during axillary brachial plexus blocks for ambulatory upper limb surgery: a quasiexperimental pilot study. Int J Clin Exp Hypn 2018; 66: 136-46.CrossRef Boselli E, Musellec H, Bernard F, et al. Effects of conversational hypnosis on relative parasympathetic tone and patient comfort during axillary brachial plexus blocks for ambulatory upper limb surgery: a quasiexperimental pilot study. Int J Clin Exp Hypn 2018; 66: 136-46.CrossRef
25.
go back to reference Dunn D. Responsibilities of the preoperative holding area nurse. AORN J 1997; 66: 820-34; 837-8; 839-40; 843-4. Dunn D. Responsibilities of the preoperative holding area nurse. AORN J 1997; 66: 820-34; 837-8; 839-40; 843-4.
27.
28.
go back to reference Harms C, Young JR, Amsler F, Zettler C, Scheidegger D, Kindler CH. Improving anaesthetists’ communication skills. Anaesthesia 2004; 59: 166-72.CrossRefPubMed Harms C, Young JR, Amsler F, Zettler C, Scheidegger D, Kindler CH. Improving anaesthetists’ communication skills. Anaesthesia 2004; 59: 166-72.CrossRefPubMed
29.
go back to reference Chooi CS, White AM, Tan SG, Dowling K, Cyna AM. Pain vs comfort scores after caesarean section: a randomized trial. Br J Anaesth 2013; 110: 780-7.CrossRefPubMed Chooi CS, White AM, Tan SG, Dowling K, Cyna AM. Pain vs comfort scores after caesarean section: a randomized trial. Br J Anaesth 2013; 110: 780-7.CrossRefPubMed
30.
go back to reference Swannell ER, Brown CA, Jones AK, Brown RJ. Some words hurt more than others: Semantic activation of pain concepts in memory and subsequent experiences of pain. J Pain 2016; 17: 336-49.CrossRefPubMed Swannell ER, Brown CA, Jones AK, Brown RJ. Some words hurt more than others: Semantic activation of pain concepts in memory and subsequent experiences of pain. J Pain 2016; 17: 336-49.CrossRefPubMed
32.
go back to reference Maurice-Szamburski A, Loundou A, Capdevila X, Bruder N, Auquier P. Validation of the French version of the Amsterdam preoperative anxiety and information scale (APAIS). Health Qual Life Outcomes 2013; 11: 166.CrossRefPubMedPubMedCentral Maurice-Szamburski A, Loundou A, Capdevila X, Bruder N, Auquier P. Validation of the French version of the Amsterdam preoperative anxiety and information scale (APAIS). Health Qual Life Outcomes 2013; 11: 166.CrossRefPubMedPubMedCentral
33.
go back to reference Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns. Anesth Analg 2000; 90: 706-12.CrossRefPubMed Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns. Anesth Analg 2000; 90: 706-12.CrossRefPubMed
34.
go back to reference Boker A, Brownell L, Donen N. The Amsterdam preoperative anxiety and information scale provides a simple and reliable measure of preoperative anxiety. Can J Anesth 2002; 49: 792-8.CrossRefPubMed Boker A, Brownell L, Donen N. The Amsterdam preoperative anxiety and information scale provides a simple and reliable measure of preoperative anxiety. Can J Anesth 2002; 49: 792-8.CrossRefPubMed
35.
go back to reference Burkle CM, Mann CE, Steege JR, Stokke JS, Jacob AK, Pasternak JJ. Patient fear of anesthesia complications according to surgical type: potential impact on informed consent for anesthesia. Acta Anaesthesiol Scand 2014; 58: 1249-57.CrossRefPubMed Burkle CM, Mann CE, Steege JR, Stokke JS, Jacob AK, Pasternak JJ. Patient fear of anesthesia complications according to surgical type: potential impact on informed consent for anesthesia. Acta Anaesthesiol Scand 2014; 58: 1249-57.CrossRefPubMed
36.
go back to reference Boon JH, Hopkins D. Hydroxyzine premedication-does it provide better anxiolysis than a placebo? S Afr Med J 1996; 86: 661-4.PubMed Boon JH, Hopkins D. Hydroxyzine premedication-does it provide better anxiolysis than a placebo? S Afr Med J 1996; 86: 661-4.PubMed
Metadata
Title
Évaluation de la communication thérapeutique pour améliorer l’accueil du patient au bloc opératoire: étude d’impact
Authors
Emmanuel Boselli, MD, PhD
Nathalie Demaille, CRNA
Géraldine Fuchs, CRNA
Aïcha Manseur, CRNA
Publication date
01-10-2018
Publisher
Springer US
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 10/2018
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-018-1167-2

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