Nurse Anesthesist Assessment of Patient Preoperative Anxiety

Study Overview
=================
Brief Summary
-----------------
Preoperative anxiety is a major concern for patients who undergo surgery. To accurately identify anxious patient is therefore crucial to improve perioperative patient care. Preoperative anxiety remain highly difficult to quantify in current practice. Many patient fail to express their anxiety and the assessment of the level of anxiety is mainly based on heteroevaluation by caregivers. Nurse anesthetists provide closed support to patient prior to the induction of anesthesia. The aim of the study is to assess whether nurse anesthetist accurately assess patient preoperative anxiety from arrival to the operating room to the induction of anesthesia.

Detailed Description
-----------------
EVALANXI is a single-center prospective observational study. The main objective of the study is to assess whether the assessment of preoperative anxiety by nurse anesthetist (hetero-assessment) accurately estimate the level of anxiety reported by the patient from arrival to the operating room to the induction of anesthesia (self-assessment).

Official Title
-----------------
Assessment of Patient Preoperative Anxiety by Nurse Anesthetist

Conditions
-----------------
Anesthesia, General, Anxiety

Intervention / Treatment
-----------------
* Other: Pre operative assessment


Participation Criteria
=================
Eligibility Criteria
-----------------
Patient Inclusion Criteria: Age > 18 years old Patients with ASA 1, ASA 2 ou ASA 3 Patients undergoing planned surgery with general anesthesia Patient Exclusion Criteria: Age <18 Refusal, inability to oral consent Cardio-thoracic surgery or emergency surgery Patient with dementia, medically diagnosed psychiatric disorder, inability to answer questions Nurse anesthetist Inclusion Criteria: Nurse anesthesis in charge of the corresponding patient Nurse anesthetist Exclusion Criteria: Assessment of the preoperative anxiety of a previously included patient

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PATIENT group<br>Adult patients shedule for general anesthesia | Other: Pre operative assessment<br>* Anxiety assessment : Numeric rating scale (patient and caregiver), APAIS scale (patient), Covi Scale (Caregiver) Verbalization : anesthesia-related concerns (expressed by patient and considered by caregiver)<br>|
| NURSE group<br>Nurse anesthesist in charge of the corresponding patient | Other: Pre operative assessment<br>* Anxiety assessment : Numeric rating scale (patient and caregiver), APAIS scale (patient), Covi Scale (Caregiver) Verbalization : anesthesia-related concerns (expressed by patient and considered by caregiver)<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of preoperative anxiety level expressed by the patient (self-assessment) with that estimated by murse anesthetist (hetero-assessment) | Agreement between patient's Numeric Rating Scale (NRS from 0 to 10) and nurse anesthetist NRS (kappa coefficient) | Self- and hetero-assessment will be performed peroperatively during the period from arrival in the operating room to the induction of general anesthesia. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient anxiety self assessment : NRS (from 0 to 10) versus Amsterdam Preoperative Anxiety and Information (APAIS) scale (from 6 to 30) | correlation between NRS and APAIS scale | Self- and hetero-assessment will be performed preoperatively during the period from arrival in the operating room to induction of general anesthesia. | 
| Patient's Anxiety assessment by caregiver : NRS (from 0 to 10) versus Covi scale from 3 to 15) (Lipman & Covi 1976) | correlation between NRS and Covi scale | Self- and hetero-assessment will be performed preoperatively during the period from arrival in the operating room to induction of general anesthesia. | 
| Reliability of hetero-assessment performed by caregiver | sub group analysis based on nurse anesthetist professional experience | Hetero-assessment will be performed preoperatively during the period from arrival in the operating room to induction of general anesthesia. | 
| Anesthesia-related concerns | Comparison between the patient's expression and caregiver's estimate | Anesthesia-related concerns observed by the patient and the corresponding nurse anesthetist will be collected preoperatively from arrival in the operating room to induction of general anesthesia. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Concordance, Preoperative anxiety, Self-assessment assessment of anxiety, Nurse anesthesist hetero-assessment of anxiety