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Anxiety in Older Persons Waiting for Cataract Surgery: Investigating the Contributing Factors

Published online by Cambridge University Press:  29 November 2010

Heather D. Hadjistavropoulos
Affiliation:
University of Regina
Bonnie S. Snider
Affiliation:
University of Regina
Thomas Hadjistavropoulos
Affiliation:
University of Regina

Abstract

Cataract surgery is one of the most frequent surgical procedures experienced by seniors. In Canada, substantial waiting lists for cataract surgery are common. This study systematically studied anxiety among older persons who were waiting for cataract surgery, and factors that may underlie anxiety in this population. Factors examined in relation to anxiety were age, sex, education, medical and ocular problems, previous cataract surgery, concern about wait, previous decisions to delay surgery, length of wait, visual functioning, visual acuity, worry about health, and coping strategies. A random sample (n = 50) of patients on a waiting list for cataract surgery took part in telephone interviews. Patients' ophthalmologists provided preoperative visual acuity. Over one-third of patients reported anxiety within the range reported for panic disorder patients and Beck Anxiety Inventory scores were well above reported norms for seniors. Increased anxiety was found among those with a general tendency to worry about their health, poorer visual functioning, and greater use of palliative coping strategies. The clinical implications of the findings are discussed. The results highlight the importance of assessing anxiety while elderly patients wait for surgery, designing interventions, and providing assistance to those patients found to have elevated levels of anxiety.

Résumé

La chirurgie de la cataracte est une des chirurgies auxquelles les aîné(e)s doivent le plus souvent avoir recours. Au Canada, les listes d'attente sont souvent très chargées. La présente étude examine systématiquement le phénomène de l'anxiété chez les aîné(e)s en attente d'une chirurgie de la cataracte et les facteurs qui l'entourent, à savoir l'âge, le sexe, l'instruction, les problèmes médicaux et oculaires, une chirurgie de la cataracte précédente, l'inquiétude de l'attente, une décision antérieure concernant la remise à plus tard de la chirurgie, la durée de l'attente, le fonctionnement visuel, l'acuité visuelle, les inquiétudes au sujet de la santé et les stratégies d'adaptation. Un échantillonnage de patients tiré au hasard (n = 50) en attente d'une chirurgie de la cataracte ont pris part à une enquête téléphonique. Les opthtalmologistes avaient fourni l'acuité visuelle préopératoire des patients. Plus d'un tiers des patients ont signalé une anxiété se situant dans les limites des troubles paniques et les résultats au test d'anxiété de Beck s'élevaient bien audelà des normes habituelles chez les aîé(e)s. L'anxiété était plus importante chez ceux qui avaient une tendance à se préoccuper de leur santé, qui avaient un fonctionnement visuel plus faible et qui faisaient un plus grand usage de stratégies d'adaptation palliatives. Le texte présente les répercussions cliniques des résultats. L'analyse signale l'importance d'évaluer l'anxiété des patients en attente d'une chirurgie, de concevoir des méthodes d'intervention et de fournir de l'aide à ceux qui éprouvent un haut degré d'anxiété.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2001

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References

Allen, M., Knight, C., Falk, C., & Strang, V. (1992). Effectiveness of a preoperative teaching programme for cataract patients. Journal of Advanced Nursing, 17, 303309.CrossRefGoogle ScholarPubMed
Applegate, W.B., Miller, S.T., Elam, J.T., Freeman, J.M., Wood, T.O., & Gettlefinger, T.C. (1987). Impact of cataract surgery with lens implantation on vision and physical function in elderly patients. Journal of American Medical Association, 257(8), 10641066.CrossRefGoogle ScholarPubMed
Beck, A.T., Epstein, N., Brown, G., & Steer, R.A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893897.CrossRefGoogle ScholarPubMed
Boezaart, A.P., Berry, R.A., Laubscher, J.J., & Nell, M.L. (1998). Evaluation of anxiolysis and pain associated with combined peri – and retrobulbar eye block for cataract surgery. Journal of Clinical Anesthesia, 10, 204210.CrossRefGoogle ScholarPubMed
Cox, B.J., Cohen, E., Direnfeld, D.M., & Swinson, R.P. (1996). Does the Beck Anxiety Inventory Measure Anything Beyond Panic Attack Symptoms? Behaviour Research and Therapy, 34(11/12), 949954.CrossRefGoogle ScholarPubMed
Cruise, C.J., Chung, F., Yogendran, S., & Little, D. (1997). Music increases satisfaction in elderly outpatients undergoing cataract surgery. Canadian Journal of Anaesthesia, 44(1), 4348.CrossRefGoogle ScholarPubMed
Drummond, M.F., & Yates, J.M. (1991). Clearing the Cataract Backlog in a (not so) developing country. Eye, 5, 481486.CrossRefGoogle Scholar
Endler, N.S., Parker, J.D., & Summerfeldt, L.J. (1998). Coping with health problems: Developing a reliable and valid multidimensional measure. Psychological Assessment, 10, 195205.CrossRefGoogle Scholar
Fagerström, R. (1992). Correlations of memory and learning with vision in aged patients before and after a cataract operation. Psychological Reports, 71, 675686.Google ScholarPubMed
Fagerström, R. (1993). Fear of a cataract operation in aged persons. Psychological Reports, 72, 13391346.CrossRefGoogle ScholarPubMed
Hadjistavropoulos, T., Owens, K., & Asmundson, G.J.G. (1999). Addressing the need for appropriate norms when measuring anxiety in seniors. Submitted for presentation at the International Psychogeriatric Congress, Vancouver, BC.Google Scholar
Hadjistavropoulos, H.D., Snider, B., & Bartlett, G. (1998). Measuring the quality of performance in the management of waiting lists: Using cataract surgery as an example. Joint Commission Journal on Quality Improvement, 24, 407–122.Google ScholarPubMed
Hirth, A.M., & Stewart, M.J. (1994). Hope and social support as coping resources for adults waiting for cardiac transplantation. Canadian Journal of Nursing Research, 26(3), 3148.Google ScholarPubMed
Javitt, J.C., Brenner, H., Curbow, B., Legro, M.W., & Street, D.A. (1993). Outcomes of cataract surgery: Improvement in visual acuity and subjective visual function after surgery in the first, second and both eyes. Archives of Ophthalmology, 111, 686691.CrossRefGoogle ScholarPubMed
Kahn, H.A., Liebowitz, H.M., Ganley, J.P., Kini, M.M., Colton, T., Nickerson, R.S., & Dawber, T.R. (1977). The Framingham Eye Study - Outline and major prevalence findings. American Journal of Epidemiology, 106(1), 1732.CrossRefGoogle ScholarPubMed
Kellner, R. (1986). Somatization and hypochondriasis. New York: Praeger Publishers.Google Scholar
Kellner, R., Abbott, P., Winslow, W., & Pathak, D. (1987). Fears, beliefs, and attitudes in DSM-III hypochondriasis. Journal of Nervous and Mental Disease, 175, 2025.CrossRefGoogle ScholarPubMed
Lundström, M., Fregell, G., & Sjoblom, A. (1994). Vision related daily life problems in patients waiting for a cataract extraction. British Journal of Ophthalmology, 78, 608611.CrossRefGoogle ScholarPubMed
Lundström, M., Stenevi, U., & Thorburn, W. (1996). Assessment of waiting time and priority setting by means of a national register. International Journal of Technology Assessment in Health Care, 12,(1), 136140.CrossRefGoogle ScholarPubMed
Muirhead, J., Meyerowitz, B.E., Leedham, B., Eastburn, T.E., Merrill, W.H., & Frist, W.H. (1992). Quality of life and coping in patients awaiting heart transplantation. The Journal of Heart and Lung Transplantation, 11(2), 265272.Google ScholarPubMed
Mulgan, R., & Logan, R.L. (1990). The coronary bypass waiting list: a social evaluation. New Zealand Medical Journal, 103, 371372.Google ScholarPubMed
Nathenson, A.L. (1992). Cataract development and removal: How to answer the questions a patient asks. Postgraduate Medicine, 91, 129138.CrossRefGoogle ScholarPubMed
O'Malley, T.P., Newmark, T.S., Rothman, M.I., & Strassman, H.D. (1989). Emotional aspects of cataract surgery. International Journal of Psychiatry in Medicine, 19(1), 8589.CrossRefGoogle ScholarPubMed
Parker, P. (1990). The EyeCare Group: A volunteer support group for cataract patients. Journal of Ophthalmic Nursing & Technology, 9(6), 240242.Google Scholar
Petrie, K., Chamberlain, K., & Azariah, R. (1994). The psychological impact of hip arthroplasty. Australian and New Zealand Journal of Surgery, 64, 115117.CrossRefGoogle ScholarPubMed
Porter, R.R., Krout, L., Parks, V., Gibbs, S., Luers, E.S., Nolan, M.T., Cupples, S.A., Lepley, D., Givan, D.A., Ohler, L., & Nunes, N. (1994). Perceived stress and coping strategies among candidates for heart transplantation during the organ waiting period. The Journal of Heart and Lung Transplantation, 13(1), 102107.Google ScholarPubMed
Ramsay, C., & Walker, M. (1995). Waiting your turn: Waiting lists in Canada (5th ed.). Vancouver: Fraser Institute.Google Scholar
Ruehl, C.A., & Schremp, P.S. (1992). Nursing care of the cataract patient: Today's outpatient approach. Ophthalmic Nursing, 27(3), 727743.Google ScholarPubMed
Salkovskis, P.M., & Warwick, H.M. (1986). Morbid preoccupations, health anxiety and reassurance: A cognitive-behavioural approach to hypochondriasis. Behaviour Research and Therapy, 24, 597602.CrossRefGoogle ScholarPubMed
Steinberg, E.P., Tielsch, J.M., Schein, O.D., Javitt, J.C., Sharkey, P., Cassard, S.D., Legro, M.W., Diener-West, M., Bass, E.B., Damiano, A.M., Steinwachs, D.M., & Sommer, A. (1994a). National study of cataract surgery outcomes: Variation in 4-month postoperative outcomes as reflected in multiple outcome measures. Archives of Ophthalmology, 100, 11311140.CrossRefGoogle Scholar
Steinberg, E.P., Tielsch, J.M., Schein, O.D., Javitt, J.C., Sharkey, P., Cassard, S.D., Legro, M.W., Diener-West, M., Bass, E.B., Damiano, A.M., Steinwachs, D.M., & Sommer, A. (1994b). The VF-14: An index of functional impairment in cataract patients. Archives of Ophthalmology, 112, 630638.CrossRefGoogle Scholar
Straatsma, B.R., Foos, R.Y., Horwitz, J., Gardner, K.M., & Pettit, T.H. (1985). Aging-related cataract: Laboratory investigation and clinical management. Annals of Internal Medicine, 102, 8292.CrossRefGoogle ScholarPubMed
Tabachnick, B.G., & Fidell, L.S. (1996). Using multivariate statistics: Third edition. New York: Harper Collins.Google Scholar
Underwood, M.J., Firmin, R.K., & Jehu, D. (1993). Aspects of psychological and social morbidity in patients awaiting coronary artery bypass grafting. British Heart Journal, 69(b), 382384.CrossRefGoogle ScholarPubMed
Warwick, H.M., & Salkovskis, P.M. (1990). Hypochondriasis. Behaviour Research and Therapy, 28(2), 105117.CrossRefGoogle ScholarPubMed
Wright, D., & Arthur, H. (1996). An analysis of the impact of a management system on patients waiting for cardiac surgery. Canadian Journal of Cardiovascular Nursing, 7(1), 59.Google ScholarPubMed