Effective reduction of anxiety in hospitalised children through bibliotherapy.

AIM: The process of being admitted to a hospital is widely recognised as a distressing encounter for children, frequently resulting in notable levels of anxiety. The main aim was to assess the effectiveness of bibliotherapy in reducing anxiety and to associate anxiety levels with demographic and clinical variables. METHODS: This study was conducted at a paediatric ward in a tertiary care hospital located in Tamil Nadu, India, for 3 months from 1 August 2023-30 October 2023. In this study, a one-group pre-test and post-test design was employed. A sample of 60 children, aged between 5 and 12 years, was recruited using a convenience sampling method. Spence Children Anxiety Scale was used for assessing anxiety levels. RESULTS: The mean age of the participants was 8.46 ± 1.91 years, and the majority, comprising 57%, were male. Following bibliotherapy, 72% of children showed mild anxiety, 28% showed moderate anxiety and no individual had considerable anxiety. Anxiety scores dropped 27%. Significant associations were found between anxiety reduction and variables such as age, educational status, and type of family. CONCLUSION: Bibliotherapy was notably effective in substantially reducing anxiety levels among children aged 5-12 years who were admitted to hospitals.

Domestic pigs (Sus scrofa) engage in non-random post-conflict affiliation with third parties: cognitive and functional implications.

In social mammals, conflict resolution involves the reunion of former opponents (aggressor and victim) after an aggressive event (reconciliation) or post-conflict triadic contacts with a third party, started by either opponent (solicited-TSC) or spontaneously offered by the third party (unsolicited-TUC). These post-conflict strategies can serve different functions, including consolation (specifically when TUCs reduce the victim's anxiety). We investigated the possible presence and modulating factors of such strategies on semi-free ranging pigs (Sus scrofa; N = 104), housed at the ethical farm Parva Domus (Cavagnolo, Italy). Kinship was known. Reconciliation was present and mainly occurred between weakly related pigs to possibly improve tolerant cohabitation. Triadic contacts (all present except aggressor TSCs) mostly occurred between close kin. TSCs enacted by victims reduced neither their post-conflict anxiety behaviors nor further attacks by the previous aggressor, possibly because TSCs remained largely unreciprocated. TUCs towards aggressors did not reduce aggressor post-conflict anxiety but limited aggression redirection towards third parties. TUCs towards the victim reduced the victim but not the third-party's anxiety. However, TUCs may also provide inclusive fitness benefits to third parties by benefiting close kin. In sum, pigs engaged in non-random solicited/unsolicited triadic contacts, which suggests that pigs might possess socio-emotional regulation abilities to change their own or others' experience and elements of social appraisal, necessary to detect the emotional arousal of relevant others and (in case of TUCs) take the agency to restore homeostasis.

Organization of psychosocial factors associated with worry about acquiring SARS-CoV-2 among women undergoing cancer treatment: an empirical network comparison approach.

OBJECTIVES: Pandemic-induced anxiety can have adverse mental and somatic health consequences on cancer patients (CP). This study aimed to (1) explore the intricate relationships between worry related to potential SARS-CoV-2 infection, COVID-19 perception, sociodemographic factors, and the perceived effectiveness of lockdown measures and (2) investigate if these relationships differ between cancer patients and individuals without a history of cancer (IWHC). METHODS: We conducted a cross-sectional quantitative study in France between December 1 and 14, 2020. Network analysis was employed on a sample of 1889 women, including 282 cancer patients and 1607 noncancer individuals. RESULTS: Our findings indicate that CP were 20% more likely to express worry than IWHC. Anxiety is embedded within a complex network involving sociodemographic, cognitive, and emotional factors. The emotional components related to COVID-19 perception were found to play a crucial role. The networks for both groups were observed to be identical. CONCLUSIONS: Our study underscores the heightened vulnerability of cancer patients to pandemic-induced anxiety, emphasizing the crucial role of emotional components related to COVID-19 perception. The observed similarities in the anxiety network between cancer patients and those without a history of cancer suggest that universal approaches might be effective across groups. IMPLICATIONS: Utilizing the Causal Attitude Network Model, we propose potential methods for managing and reducing individual anxiety levels.

[Effects of preoperative neurobiological education on postoperative outcome : A systematic review]. / Effekte von präoperativer neurobiologischer Edukation auf das postoperative Outcome : Ein systematisches Review.

BACKGROUND: Pain may have a crucial impact on human quality of life. An increase in knowledge about neurobiological and neuroscientific processes alone can positively influence the subjective perception of pain as well as psychometric variables. There are different forms of preoperative patient education with the aim to explain postoperative pain. Based on current literature, preoperative biomedical education has a low level of evidence. It can increase the preoperative anxiety and stress level of patients, which has a negative impact on the postoperative outcome. In contrast, the neuroscientific understanding considers postoperative pain from the viewpoints of the plasticity of the nervous system and involves sensitizational processes in the central and peripheral nervous systems. PURPOSE: To systematically investigate short- and long-term effects of pain neuroscience education (PNE) in patients before spine surgery. MATERIALS AND METHODS: The literature search involved a search of medical databases according to the PI(C)O scheme, and 83 articles were shortlisted. Nine articles that met the inclusion and exclusion criteria were finally included. RESULTS: Preoperative pain neuroscience education can positively influence postoperative catastrophizing tendencies as well as postoperative kinesiophobia but has no influence on postoperative pain and function. CONCLUSION: Preoperative reduction of anxiety and pain-maintaining factors mainly on the psychological and social level may have a positive effect on postoperative subjective pain evaluation, which is reflected in a reduction of anxiety, catastrophizing tendencies, and a lower utilization of postoperative health care services.

[Is supplemental ear acupuncture for surgical tooth removal with local anesthesia effective? : A pilot study]. / Ist die Supplementierung der Ohrakupunktur bei operativer Zahnentfernung in Lokalanästhesie effektiv? : Eine Pilotstudie.

BACKGROUND: The application of ear acupuncture can contribute to a reduction of acute pain. Data on the application of ear acupuncture following oral surgery in odontology is insufficient. OBJECTIVE: This study investigated the effectiveness of ear acupuncture as an auxiliary analgesic treatment in addition to local anesthesia for operative tooth removal. METHODS: In this prospective open non-randomized pilot study (in accordance with the CONSORT publication) 2 cohorts of 50 patients each with the indications for an operative tooth removal either with or without the application of ear acupuncture in addition to local anesthesia with articain were observed. Patients were allocated to the groups according to their preference. Pain intensity while resting and while chewing was recorded as the primary parameter for a period of 10 days. The secondary parameters were the subjective experience of anxiety and symptoms, such as headaches, dizziness and nausea. RESULTS: The two groups did not differ significantly with respect to demographic variables or the use of local anesthetics. At the various measurement intervals, pain intensity while resting or chewing differed significantly between the two groups (ANOVA, p = 0.004, p = 0.007, respectively). Furthermore, the experience of anxiety (ANOVA, p = 0.0001), the number of patients taking analgesics (χ2-test, p = 0.017) and the total postoperative consumption of analgesics (t-test, 0.001) revealed significant differences. In both groups the numerical rating scales (NRS) for postoperative headaches, dizziness and nausea were low. DISCUSSION AND CONCLUSION: Despite a potential bias and methodological limitations of the study design, the results of this investigation suggest that ear acupuncture influences the experience of pain and anxiety in the postoperative period after tooth removal. As a treatment method with low adverse effects ear acupuncture can contribute to postoperative pain control, especially in patients with preoperative anxiety.

Survival modeling of discontinuation from psychotherapy: a consumer decision-making perspective.

OBJECTIVE: This study examines discontinuation of psychotherapy from a consumer decision-making perspective. Two plausible predictors, the level of illness and rate of progress from where the patient started, were examined as predictors of treatment discontinuation. METHOD: Using data from 139 patients (45.5% women; mean age = 32.18 years) participating in a 12-week transdiagnostic cognitive-behavioral therapy program for anxiety, weekly assessments of anxiety severity were examined to investigate the extent to which level of anxiety and rate of improvement predicted treatment discontinuation. RESULTS: Support was found for a significant interaction effect wherein at higher anxiety levels, rate of progress was less associated with discontinuation than at lower anxiety levels. CONCLUSION: Faster rates of anxiety reduction are associated with greater likelihood of discontinuation when the client is at a lower level of anxiety, whereas rate of improvement is less associated with discontinuation if there remains continued impairment and room for improvement. As such, clinicians should monitor rates of improvement throughout treatment to help identify and evaluate patients at increased risk of premature discontinuation.

Witness for resolution: post-conflict quadratic affiliation in semi-free ranging pigs.

In social mammals, post-conflict resolution can involve the reunion of former opponents (reconciliation), spontaneous/solicited post-conflict affiliation of a third party with either opponent (triadic contacts), and affiliation between other individuals (hereafter bystanders; quadratic contacts). Quadratic contacts-possibly informing complex cognitive abilities-have been neglected in post-conflict studies. We investigated quadratic affiliation in semi-free ranging pigs Sus scrofa, at the ethical farm Parva-Domus (Cavagnolo, Italy). Kinship was known. We collected behavioral data on adult pigs (n = 104) via video recordings (43 h) followed by video analyses. Affiliative and anxiety behaviors between bystanders were collected under post-conflict (PC; following a conflict between non-bystanders) and matched-control (MC; no conflict) conditions. Quadratic affiliation was present in pigs, as bystanders affiliated more in PC than MC, and such affiliation was followed by a decrease in the anxiety behaviors of both the interacting bystanders. Thus, quadratic contacts may be partly aimed at reducing one's own anxiety (intrinsic regulation). Quadratic affiliation was highest between closely related bystanders, which suggests that such affiliation may be most effective when close kin is involved. Quadratic affiliation was lowest after reconciliation and spontaneous triadic contacts. This suggests that direct peacemaking between opponents and spontaneous triadic contacts with close kin may most likely replace quadratic affiliation. Hence, pigs can be influenced by the negative events that affect other pigs-but not themselves-and their response may be modulated by social factors. Such non-random quadratic affiliation may point toward the presence of elements of social appraisal abilities in pigs.

Effect of Binaural Beats on Anxiety and Tolerance in Patients Undergoing Upper Gastrointestinal Endoscopy Without Sedation: A Randomized Controlled Trial.

Objective: Binaural beats, or the perceptual auditory illusions created when simultaneously presenting two similar frequencies to each ear separately, have been used to reduce anxiety in various procedures. Unfortunately, no prior study involved preprocedure binaural music exposure among patients undergoing upper gastrointestinal endoscopy, and this study sought to investigate its effect on anxiety and tolerance among participants undergoing sedation-free upper gastrointestinal endoscopy. Methods: The prospective, controlled, randomized trial included the participation of 96 Turkish patients aged between 18 and 70 years who were scheduled for an upper gastrointestinal endoscopy, regardless of sex or illness, and were divided randomly into two different groups to undergo endoscopy, namely, the binaural beats group (n = 48) and a control group (n = 48). Patients in the binaural beat music group wore headphones, and music was given 15 mins before endoscopy; however, no particular treatment was given for either group. Anxiety levels were assessed by using the State Trait Anxiety Inventory questionnaire, in addition to changes before and after endoscopy to measure patient satisfaction based on the physician's recorded numbers of retches noted by doctors as tolerance was documented and compared among both groups. Results: The results showed that following this procedure, in the music group, state scores remained significantly lower than before them (p = 0.016), compared with the control group (p > 0.05). There was no significant difference regarding changes in diastolic or systolic heart rate or blood pressure (p > 0.05). However, the procedure tolerance and satisfaction scores were significantly higher in the music group than those without music (p < 0.05). Conclusion: For patients undergoing upper gastrointestinal endoscopy, music with binaural beats was found to significantly reduce anxiety levels and increase patient tolerance, providing an alternative option to sedative medications as a potential sedative treatment option.Clinical trials registration number: NCT06114524.

Virtual Reality in Cancer Care: Enhancing Knowledge and Reducing Anxiety about Chemotherapy among Patients and Caregivers.

Virtual reality (VR) technology has evolved from entertainment to significant applications in healthcare and education. Despite its potential, there is limited research on the role of VR in cancer care. This study investigates VR's ability to simulate the chemotherapy process, aiming to enhance patients' knowledge and mitigate anxiety associated with chemotherapy. Utilizing a two-arm, mixed-methods pre/post-survey design, the study measured changes in patients' anxiety and knowledge before and after exposure to a VR simulation. Participants (n = 267) engaged with VR simulations or interactive 360-degree videos depicting the chemotherapy process. Data analyses revealed a significant median increase in chemotherapy knowledge post-exposure to the VR content (z = 12.511, p < 0.001). Demographic factSors significantly influenced perceptions of VR realism and usefulness (p < 0.05). Additionally, VR exposure was correlated with reduced anxiety levels and improved treatment expectations (p < 0.05). Participants with higher post-understanding chemotherapy scores considered VR a useful tool for managing anxiety about chemotherapy and recommended VR for other medical procedures (p < 0.001). These findings underscore VR technology's potential as a valuable tool in cancer treatment, suggesting it can enhance patient education and reduce anxiety, thereby improving patient outcomes during cancer therapy.

A pilot study exploring the effectiveness of binaural beats at reducing anxiety associated with cadaveric dissection.

This study explored the effects of a novel intervention, binaural beats (BB), on anxiety levels of anatomy students during cadaveric dissections and its impact on the learning environment. The study was quasi-experimental, employing a purposive sampling strategy. State (SA) and trait (TA) anxiety levels were measured using the State-Trait Anxiety Inventory during two routine dissection sessions. SA was measured at three time points: at the start, after a 3-min control (silence)/intervention (10 Hz BB) session, and at the end of the dissection. A post-study survey was distributed to the participants to obtain qualitative feedback on their perceptions of BB use during cadaveric dissections. Thirteen female students participated in this study (mean age 19.62 ± 0.65 years). Both control and intervention measures significantly reduced SA levels, with BB demonstrating a greater effect size (Hedges' g = 0.98 for intervention vs. 0.76 for control). SA decreased significantly after the BB intervention (t(12) = 3.78, p = 0.003) and remained low throughout the session, in contrast to the control session, where the reduction post-measure was not sustained (t(12) = -0.64, p = 0.54). Feedback from the post-study survey indicated that most students found the BB intervention effective in reducing their anxiety levels before the dissection. The BB intervention was effective in reducing and maintaining students' SA levels during dissection. Students reported positive experiences with BB. Further investigations are warranted to determine whether the findings of this study can be generalized to larger and more heterogeneous populations.

Development and Effectiveness Evaluation of 360-Degree Virtual Reality-Based Educational Intervention for Adult Patients Undergoing Colonoscopy.

Providing patients with accurate and organized information about colonoscopy, while reducing anxiety, is critical to the procedure's success. This study evaluated the impact of an immersive 360° virtual reality (VR)-based educational intervention for first-time adult colonoscopy patients regarding anxiety, attitudes, knowledge, compliance with bowel preparation, and bowel cleanliness. A quasi-experimental design with a non-equivalent control group and non-synchronized pretest-post-test clinical trial was conducted with 40 patients in the experimental group and 40 in the control group. The 360° VR intervention included two sessions: precautions before colonoscopy and the colonoscopy process. The control group received education through individual verbal explanations with written materials. The findings indicated that the VR intervention significantly improved patients' colonoscopy-related anxiety, attitudes, adherence to bowel preparation instructions, and bowel cleanliness. Utilizing 360° VR as an educational tool has the potential to enhance the effectiveness of educational programs by providing realistic information and engaging patients. These findings suggest that 360° VR has the capacity to enhance screening rates and clinical outcomes by reducing negative perceptions associated with colonoscopy. Furthermore, the application of this method can extend to diverse diagnostic testing-related nursing situations in clinical settings.

Improving Mental Skills in Precision Sports by Using Neurofeedback Training: A Narrative Review.

Primary objectives of neurofeedback training (NFT) are to improve concentration, stress and anxiety management, and performance optimisation. This narrative review examines the role of NFT as a tool to improve mental and cognitive skills of target shooting and archery athletes. Current research discusses how neurofeedback training can act on brain waves by influencing specific EEG frequency bands in order to improve cognitive flexibility. This contribution reports studies that have applied neurofeedback protocols in precision disciplines such as archery and shooting. The results of the studies considered showed that neurofeedback can lead to faster reaction times, more sustained attention, and better emotion management, contributing significantly to athletes' performance. Furthermore, it is emphasised that neurofeedback could be combined with other techniques such as motor imagination to maximise effectiveness in precision sports training. This review emphasises the importance of future studies that focus on the integration of neurofeedback with biofeedback in neuromodulation protocols. Current perspectives and limitations of research in this area are also indicated. Neuromodulation by means of neurofeedback represents a promising strategy to improve the overall mental and cognitive abilities of target shooting and archery athletes with an interesting potential for high-level performance. Future research should focus on integrated approaches and customised protocols to optimise the use of neurofeedback in a precision sports context.

Enhancing Working Memory and Reducing Anxiety in University Students: A Neurofeedback Approach.

(1) Background: Neurofeedback training (NFT) has emerged as a promising approach for enhancing cognitive functions and reducing anxiety, yet its specific impact on university student populations requires further investigation. This study aims to examine the effects of NFT on working memory improvement and anxiety reduction within this demographic. (2) Methods: A total of forty healthy university student volunteers were randomized into two groups: an experimental group that received NFT and a control group. The NFT protocol was administered using a 14-channel Emotiv Epoc X headset (EMOTIV, Inc., San Francisco, CA 94102, USA) and BrainViz software version Brain Visualizer 1.1 (EMOTIV, Inc., San Francisco, CA 94102, USA), focusing on the alpha frequency band to target improvements in working memory and reductions in anxiety. Assessment tools, including the Corsi Block and Memory Span tests for working memory and the State-Trait Anxiety Inventory-2 (STAI-2) for anxiety, were applied pre- and post-intervention. (3) Results: The findings indicated an increase in alpha wave amplitude in the experimental group from the second day of NFT, with statistically significant differences observed on days 2 (p < 0.05) and 8 (p < 0.01). Contrary to expectations based on the previous literature, the study did not observe a concurrent positive impact on working memory. Nonetheless, a significant reduction in state anxiety levels was recorded in the experimental group (p < 0.001), corroborating NFT's potential for anxiety management. (4) Conclusions: While these results suggest some potential of the technique in enhancing neural efficiency, the variability across different days highlights the need for further investigation to fully ascertain its effectiveness. The study confirms the beneficial impact of NFT on reducing state anxiety among university students, underscoring its value in psychological and cognitive performance enhancement. Despite the lack of observed improvements in working memory, these results highlight the need for continued exploration of NFT applications across different populations and settings, emphasizing its potential utility in educational and therapeutic contexts.

The Ameliorating Role of A Playful Situational Game Intervention in School-Aged Children Undergoing Ophthalmic Surgeries: A Randomized Controlled Trial.

PURPOSE: The objective of the study was to investigate if a playful situational game (PSG) intervention, as a perioperative procedure, could effectively alleviate stress and anxiety and improve postoperative outcomes for children to receive ophthalmic surgeries. METHODS: This trial enrolled 153 children, among which 116 met inclusion criteria and were randomized to control (n = 58, who did not participate in PSG) or PSG group (n = 58, who participated PSG). In the PSG group, children were arranged in renovated wards and allocated to play situational games specifically designed to improve surgery readiness. Satisfaction of the care from parents, posthospitalization behavioral change incidences, Yale Preoperative Anxiety Scale (YPAS) scores, induction compliance checklist (ICC) scores, and pediatric anesthesia emergence delirium (PAED) scores were documented as postoperative assessments. RESULTS: The PSG group demonstrated significantly higher satisfaction of the care from the parents (p = 0.004), and posthospitalization behavioral change incidences were markedly rarer in the PSG group (p = 0.015). The YPAS scores of the PSG group showed a slower increase compared to the control group before and after surgery (p < 0.001). ICC and PAED scores were also lower in the PSG group (p < 0.01). CONCLUSION: Our data could support that PSG is an effective intervention in alleviating the anxiety of children undergoing ophthalmic surgery and PSG can increase the satisfaction rate among patients and decrease behavioral change incidences. The adoption of PSG in children could potentially been promoted in the clinical setting.

Virtual reality can reduce anxiety during office-based great saphenous vein radiofrequency ablation.

OBJECTIVE: Office-based treatment of venous pathology is common and frequently involves the use of anxiolytic medication to reduce anxiety. Virtual reality (VR) has been shown to effectively reduce pain and anxiety in a variety of settings. The objective of the present study was to determine whether VR could be smoothly integrated into office-based vascular procedures and to ascertain whether VR could reduce procedural pain or anxiety. METHODS: A total of 40 patients undergoing an office-based endovenous radiofrequency ablation were included in the present study. Of the 40 patients, 20 were randomized to the VR group and 20 to the control group. The patients in the VR group were equipped with a Samsung GearVR headset and headphones (Samsung, Suwon, South Korea) running AppliedVR software (AppliedVR Inc, Los Angeles, Calif), which ran throughout the duration of the procedure. All 40 patients underwent unilateral great saphenous vein radiofrequency ablation. After the procedure, the patients were surveyed regarding their preprocedure anxiety and their pain and anxiety during the procedure using the Wong-Baker scale. RESULTS: All procedures were successfully completed, and all patients were generally satisfied with their treatment. The average procedure time was not significantly different. No statistically significant differences were present in preprocedure anxiety or procedural pain between the two groups. The anxiety level during the procedure, however, was 4.09 of 10 in the control group vs 2.95 of 10 in the VR group, statistically significant difference using a paired t test. Furthermore, the anxiety level for the control group had increased during the procedure but that of the VR group had decreased. Finally, 85% of the patients in the VR group would recommend using VR to someone undergoing a similar procedure. CONCLUSIONS: VR can be safely and efficiently integrated into office-based vascular procedures. VR was generally well liked and recommended by those who used it. Most importantly, our findings suggest that VR can decrease procedural anxiety. Further research should examine whether this might obviate the need for anxiolytic medication.

Indian classical music with incremental variation in tempo and octave promotes better anxiety reduction and controlled mind wandering-A randomised controlled EEG study.

Studies have reported the benefits of music-listening in stress-reduction using musical pieces of specific scale or 'Raaga'. But the influence of lower-level musical properties (like tempo, octave, timbre, etc.) lack research backing. Carnatic music concerts use incremental modulations in tempo and octave (e.g.: 'Ragam-Tanam-Pallavi') to elevate the mood of audiences. Therefore, the current study aimed to examine the anxiolytic effect of this musical property. A randomised controlled cross-over study with 21 male undergraduate medical students was followed. 11 participants listened to 'Varying music' (VM: instrumental music with incremental variations in tempo and octave) and 10 listened to 'Stable music' (SM: instrumental music without such variations), thrice daily for 6 days, both clips recorded in Raaga-Kaapi and silence being the control intervention. Electroencephalography (EEG) and Electrocardiography (for heart rate variability or HRV) were done on all 6 days. Beck's Anxiety inventory and State-trait anxiety scale were administered on Day-1 and Day-6. A significant anxiety score reduction was seen only in VM. VM showed marked decrease in lower frequency EEG power in bilateral temporo-parieto-occipital regions compared to silence, whereas SM showed increase in higher frequencies. Relatively, VM showed more midline power reduction (i.e., lower default mode network or DMN activity) and SM showed greater left-dominant alpha/beta asymmetry (i.e., greater right brain activation). During both music interventions HRV remained stable, unlike silence intervention. We speculate that, gradual transition between lower-slower and higher-faster music portions of VM induces a 'controlled-mind wandering' state involving balanced switching between heightened mind wandering ('attention to self') and reduced mind wandering ('attention to music') states, respectively. Therefore, music-selection has remarkable influence on stress-management and warrants further research.

Anxiety Reduction and Improved Concentration in Schoolchildren through Wingwave® Coaching.

(1) Background: For nearly 20 years, the wingwave® method, which combines elements of eye movement desensitization and reprocessing (EMDR) and a muscular strength test, has been used to reduce anxiety and improve relaxation in subjects. Past studies have scientifically evaluated this method in various contexts and have found it to be effective. In this study, we investigated the effects of short-term wingwave® coaching on specific anxiety parameters regarding school, concentration ability, and subjective feelings towards two self-chosen themes in schoolchildren. (2) Methods: A group of 53 schoolchildren aged 11 to 12 years were randomly divided between an experimental and a control group. The experimental group received an intervention of three wingwave® coaching sessions (one hour each). In these sessions, past and present negative feelings towards school as well as psychological resources to face future tasks in school were focused on and utilized. (3) Results: The results showed that the overall text anxiety, manifested anxiety, and dislike of school decreased significantly in the experimental group after the three coaching sessions compared to the control group. Furthermore, both concentration ability and the subjective feeling towards self-chosen subjects improved significantly in the experimental group compared to the control group. (4) Conclusions: Our results indicate that the wingwave® method is an appropriate and effective instrument to reduce school anxiety and to improve concentration performance in schoolchildren-at least in the short and medium term.

Classroom Interventions and Foreign Language Anxiety: A Systematic Review With Narrative Approach.

Experimental studies have developed, conducted, and evaluated classroom interventions for foreign language anxiety (FLA) reduction. However, various characteristics of those classroom interventions make it difficult to synthesize the findings and apply them to practice. We conducted what is, to the best of our knowledge, the first systematic review on educational interventions for FLA. Six criteria were established for inclusion of studies. Using English keywords, we identified 854 potentially eligible studies through ProQuest and Scopus, 40 of which were finally included. All included studies were published from 2007 to 2020. The studies differed in type of intervention, duration of intervention, and scale to measure FLA. Our systematic review resulted in seven features of classroom interventions, categorized as student-student interactions, student-teacher interactions, self-management, and mood boosters; we also categorized interventions as either individual or interactional.

Assessment and Management of Preoperative Anxiety.

BACKGROUND: Preoperative anxiety has the potential to alter the dynamics of an elective procedure and has been shown to detrimentally affect patients both cognitively and physiologically. If mismanaged, it can lead to essential procedures being postponed or canceled, delay postoperative recovery, and increase patients' requirements for medical intervention postoperatively. These outcomes have harmful implications both clinically and economically. Our primary objective was to evaluate the levels of anxiety patients experience immediately before elective otorhinolaryngologic procedures. Our secondary outcome was to assess the subjects' views on potential management strategies to tackle their anxiety. METHODS: This is an observational cross-sectional project evaluating 53 patients who were selected consecutively from a list of elective otorhinolaryngologic procedures. All procedures were to be completed under general anesthetic, and all patients had received the same preoperative assessment preparation. 29 male and 24 female patients were included, aged between 19 and 76 years (mean 45). The Spielberger State-Trait Anxiety Inventory was used to assess preoperative anxiety directly before the otorhinolaryngologic procedure. The Service Improvement questionnaire was used to assess whether patients would favor the introduction of anxiety-reduction measures. RESULTS: There was neither a significant increase in patient anxiety levels preoperatively (P = 0.37) nor a significant increase in anxiety levels preoperatively when results were stratified according to patient gender and age (P = 0.45 and P = 0.27). 54% of the patients felt that their anxiety would have been reduced if they had read a procedural information leaflet, and 22% felt it would have been reduced if they had received preoperative behavioral training. 17% of the patients wanted more information from the surgical team. However, 12% of the patients would have liked less information from the surgical team preoperatively. CONCLUSIONS: Patients did not have a significant increase in their anxiety levels preoperatively. On the basis of our findings, we will work to improve the information we provide to patients preoperatively and to identify patient subgroups that require additional preoperative support.

Beyond Pills: Acupressure Impact on Self-Rated Pain and Anxiety Scores.

Objectives: To determine impact of an acupressure protocol on self-rated pain and anxiety scores. Design: Retrospective database analysis of self-rated pain and anxiety scores before and immediately after administration of stress release acupressure protocol. Participants: Participants include hospitalized patients, nurses, and public. Intervention: Involves a 16-point stress release acupressure protocol. Outcome measures: Outcome measures involve pre- and post-treatment self-rated pain scores (0-10) with the Wong-Baker Faces Scale and pre- and post-treatment self-rated anxiety scores (0-10) on a visual analog scale. Results: Five hundred and nineteen acupressure treatments were retrospectively analyzed with pre- and post-treatment self-rated pain and anxiety scores, where 0 represented no pain or anxiety and 10 represented the worst pain and anxiety. Overall, participants demonstrated a two-point decrease in pain scores and a four-point decrease in anxiety scores post-treatment. Hospitalized patients demonstrated a four-point decrease in pain scores and a five-point decrease in anxiety scores post-treatment. Nurses demonstrated a three-point decrease in pain scores and four-point decrease in anxiety scores post-treatment. Public population demonstrated a one-point decrease in pain scores and two-point decrease in anxiety scores post-treatment. Seventy-five percent of participants were highly satisfied with acupressure treatments, and 96% of treatments were administered in less than 30 minutes. Conclusions: Acupressure is a highly satisfactory complementary therapy that can demonstrate a clinically significant decrease in self-rated pain and anxiety scores.