Utilizing a Sleep Mask to Reduce Patient Anxiety During Nail Surgery

BACKGROUND Sharing progress notes as a common social capital is essential in research and education, but the content of progress notes is sensitive and needs to be kept confidential. Publishing actual progress notes are difficult due to privacy concerns. OBJECTIVE This study aims to generate a large repository of pseudo-progress notes of authentic quality. We focused on two requirements for authentic quality: the validity and consistency of the data, from the perspective of medical practice, and the empirical and semantic characteristics of progress notes, such as shorthand styles used for reporting changes in a patient's physical status, long narrative sentences detailing patient anxiety, and interprofessional communications. METHODS We proposed a practical framework that consists of a simulation of the notes and evaluation of the simulated notes. The framework utilized two human cognitive traits: (1) the ability to use imitation to simulate objects with diverse characteristics without background knowledge and (2) the use of comparison as a strategy for deep thinking. This enabled crowd workers to generate a large number of progress notes. Our framework involved three steps. In step 1, crowd workers imitated actual progress notes decomposed into subject data (S), object data (O), and assessment and plan (A/P). These imitated texts were then shuffled and recomposed in S, O, and A/P in order to create simulated progress notes. In step 2, crowd workers identified the characteristics of actual progress notes based on comparisons between actual and dummy progress notes. These characteristics were clustered based on their similarities. Each cluster exhibited the empirical and semantic characteristics of the actual progress notes. Finally, in step 3, the texts from step 1 that exhibited the identified characteristics from step 2 were evaluated as quality-guaranteed progress notes that met the two requirements. All data were preprocessed to protect patient privacy. RESULTS Step 1: By recomposing the 700 imitated texts, 9,856 simulated progress notes were generated. Step 2: 3,938 differences between actual progress notes and dummy progress notes were identified. After clustering, 166 characteristics were evaluated to be appropriate as empirical and semantic characteristics of the actual progress notes. Step 3: 500 crowd workers demonstrated that 83.0% of the simulated progress notes satisfied at least one of the characteristics obtained in step 2. The crowd workers' artificially-reproduced progress notes were evaluated to determine the most realistic, based on four metrics: disease, morpheme, readability, and reality. CONCLUSIONS Our results demonstrated that crowd workers could generate and evaluate highly professional documents. We have made our large repository of high-quality crowdsourced progress notes publicly available, and we encourage their use in the development of medical education and research.

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How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons

BMC Oral Health ◽

10.1186/s12903-021-01688-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael Korsch ◽

Winfried Walther ◽

Bernt-Peter Robra ◽

Aynur Sahin ◽

Matthias Hannig ◽

...

Keyword(s):

Decision Making ◽

Treatment Decision ◽

Bisphosphonate Therapy ◽

Bone Block ◽

Patient Anxiety ◽

Patient Age ◽

Endocarditis Prophylaxis ◽

Therapy Decision ◽

Patient Âgé ◽

Case Vignettes

Abstract Background There is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons. Methods A total of 250 maxillofacial (MFS) and oral (OS) surgeons in southern Germany were surveyed for atrophic single- or multiple-tooth gap with the help of case vignettes. The influence of different determinants on the therapy decision was investigated. Two case vignettes were designed for this purpose: vignette 1 with determinants “patient age” and “endocarditis prophylaxis” and vignette 2 with determinants “anxiety” and “bisphosphonate therapy”. Furthermore, the specialist designation was assessed for both. The options available to achieve a sufficient implant site were "bone split", "bone block", "augmentation with bone substitute material" and "bone resection". Therapy was either recommended or rejected based on principle. Results A total of 117 participants returned the questionnaire: 68 (58%) were OS and 49 (42%) MFS. “Patient age” and “patient anxiety” were not significantly associated with any therapy decision. However, required “endocarditis prophylaxis” led to significantly higher refusal rates for "bone split", "bone block" and "bone replacement material" and to higher rates of general refusal of a therapy. “Bisphosphonate therapy” was significantly associated with general refusal of therapy, but with no significant correlation with different therapy options. In vignette 1, OS refused therapy significantly more often than MFS, though there was no association with the specialist designation for other therapy modalities. In vignette 2, specialty was not significantly associated with the therapy decision. Conclusion “Patient age” as well as “patient anxiety” appear to have no or little influence on the treatment decision for severely atrophic single- or multiple-tooth gap by specialist surgeons. Surgeons more often refuse treatment for patients with endocarditis prophylaxis and bisphosphonate therapy.

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Magnetic Targeting Systems for Endo-Bronchoscope Diagnosis and Intramedullary-Nail Surgery: A Review

IEEE Sensors Journal ◽

10.1109/jsen.2021.3059044 ◽

2021 ◽

pp. 1-1

Author(s):

Chin-Chung Chen ◽

Po-Chen Yeh ◽

Chih-Cheng Cheng ◽

Ching-Kai Lin ◽

Tze-Hong Wong ◽

...

Keyword(s):

Intramedullary Nail ◽

Magnetic Targeting ◽

Nail Surgery

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Management of pineal and colloid cysts

Practical Neurology ◽

10.1136/practneurol-2020-002838 ◽

2021 ◽

pp. practneurol-2020-002838

Author(s):

Michael D Jenkinson ◽

Samantha Mills ◽

Conor L Mallucci ◽

Thomas Santarius

Keyword(s):

Optimal Management ◽

Patient Anxiety ◽

Pineal Cyst ◽

Neurosurgical Treatment ◽

Colloid Cysts ◽

Long Term Monitoring ◽

Term Monitoring

The widespread use of MRI has led to the increasingly frequent diagnosis of pineal and colloid cysts. While most are small and incidental, do not require long-term monitoring and will never need treatment, they are a cause of patient anxiety and clinician uncertainty regarding the optimal management—particularly for larger cysts or those with an atypical appearance. Occasionally pineal cysts, and more commonly colloid cysts, cause hydrocephalus that requires urgent neurosurgical treatment. More recently the non-hydrocephalic symptomatic pineal cyst has been described in the neurosurgical literature but there is controversy over this entity and its management. This review addresses the difficulties in managing pineal and colloid cysts and provides a pragmatic framework for the practising clinician.

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A Survey of Current Preferences of Plastic Surgeons Regarding the Assessment and Reduction of Preoperative Patient Anxiety

Aesthetic Plastic Surgery ◽

10.1007/s00266-021-02154-1 ◽

2021 ◽

Author(s):

Arif Musa ◽

Alex K. Wong ◽

Jahan Tajran ◽

Daniel Chen ◽

Jeffrey C. Wang ◽

...

Keyword(s):

Patient Anxiety ◽

Preoperative Patient

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Understanding Patient Anxiety and Pain During Initial Image-guided Breast Biopsy

Journal of Breast Imaging ◽

10.1093/jbi/wbaa072 ◽

2020 ◽

Vol 2 (6) ◽

pp. 583-589

Author(s):

Santo Maimone ◽

Andrey P Morozov ◽

Annamaria Wilhelm ◽

Inna Robrahn ◽

Tedra D Whitcomb ◽

...

Keyword(s):

Breast Biopsy ◽

Procedural Pain ◽

Patient Anxiety ◽

Initial Image ◽

Image Guided ◽

Pain Scores ◽

Multiple Biopsies ◽

Lower Pain ◽

Malignant Lesions ◽

Positive Correlations

Abstract Objective Image-guided breast biopsies are safe, efficient, and reliable. However, patients are often anxious about these procedures, particularly those who have never undergone a prior biopsy. Methods This prospective IRB-approved study surveyed 163 patients undergoing their first breast biopsy. Participants provided informed consent and completed a short written survey prior to and immediately after their procedure. Level of anxiety as well as anticipated and actual levels of pain prior to and following the procedure were assessed using a 0–10-point Likert scale. Correlation, bivariate, and regression analyses were performed. Results Regarding the biopsy experience, 133/163 (81.6%) of patients reported it as better than expected. Anxiety decreased significantly from a prebiopsy mean score of 5.52 to a postbiopsy mean score of 2.25 (P < 0.001). Average and greatest pain experienced during the procedure had mean scores of 2.03 and 2.77, respectively, both significantly lower compared to preprocedural expectation (mean 4.53) (P < 0.001). Lower pain scores were reported in US-guided procedures compared to stereotactic- and MRI-guided biopsies (P < 0.001). No significant differences in pain scores were seen in those undergoing single versus multiple biopsies, or when benign, elevated-risk, or malignant lesions were sampled. Positive correlations were seen with prebiopsy anxiety levels and procedural pain as well as with anticipated pain and actual procedural pain. Conclusion Image-guided biopsies are often better tolerated by patients than anticipated. We stress the benefit of conveying this information to patients prior to biopsy, as decreased anxiety correlates with lower levels of pain experienced during the procedure.

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