Influence of preoperative comprehensive education on anxiety, depression, pain, and sleep in elderly patients operated under general anesthesia

Abstract

BACKGROUND

Owing to the particularities of their physical characteristics, older patients undergoing surgery under general anesthesia experience great surgical traumas. Thus, exploring more refined and individualized nursing approaches is an urgent need to mitigate the negative effects of surgery on such patients.

AIM

To analyze the influence of preoperative comprehensive education on anxiety, depression, pain, and sleep in older patients who underwent surgery under general anesthesia.

METHODS

In total, 163 older adults who underwent surgery under general anesthesia between June 2022 and November 2023 were selected, 77 of them received routine nursing care (control group), and 86 received preoperative comprehensive education (research group). Subsequently, comparative analyses were performed from the following perspectives: Surgical indicators (operation time, time to complete regain of consciousness, and temperature immediately after the procedure and upon recovery from anesthesia) before and after nursing care; negative emotions [self-rating anxiety scale (SAS)/self-rating depression scale (SDS)]; pain severity [visual analog scale (VAS)]; sleep quality [Pittsburgh sleep quality index (PSQI)]; incidence of sleep disturbances (difficulties in falling asleep for the first time, falling asleep again after waking up frequently at night, falling asleep again after waking up early, and falling asleep all night); and incidence of adverse events (airway obstruction, catheter detachment, aspiration, and asphyxia).

RESULTS

The research group had significantly lower operation time and time to complete regain of consciousness than the control group after nursing care and markedly better recovery of postoperative body temperature and body temperature at awakening. In addition, more notable decreases in SAS, SDS, VAS, and PSQI scores were observed in the research group than in the control group. Furthermore, the incidence rate of sleep disturbance (8.14% vs 29.87%) and adverse events (4.65% vs 19.48%) were lower in the research group than in the control group.

CONCLUSION

Preoperative comprehensive education in older patients who underwent surgery under general anesthesia can improve postoperative indicators, effectively reduce the occurrence of anxiety and depression, alleviate postoperative pain, and improve sleep quality.

Keywords: Preoperative comprehensive education; Surgery under general anesthesia; Elderly patients; Anxiety and depression; Pain; Sleep

Core Tip: This study primarily analyzed the influence of preoperative comprehensive education on anxiety, depression, pain, and sleep in older patients who underwent surgery under general anesthesia to address the relatively greater surgical traumas endured by older patients owing to their particular physical characteristics. We conducted a comprehensive analysis from multiple dimensions, including surgical indicators, negative emotions, pain levels, sleep quality, incidence of sleep disturbances, and the incidence of adverse events. Providing comprehensive preoperative education to older patients undergoing surgery under general anesthesia can improve postoperative indicators, significantly reduce anxiety and depression, alleviate postoperative pain, and enhance patients’ sleep quality. Our findings can provide more optimized management options for older patients undergoing general anesthesia surgery.