The value of handholding during intravitreal injections.
AMD
Anxiety
Handholding
Intravitreal injection
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
02
02
2022
accepted:
15
03
2022
pubmed:
26
3
2022
medline:
4
2
2023
entrez:
25
3
2022
Statut:
ppublish
Résumé
Repeated intravitreal injections (IVI) have become the therapeutic standard of care for multiple retinal conditions. Reducing discomfort and anxiety around IVIs is important to ensure ongoing patient compliance with therapy. The study aimed to investigate if handholding during an IVI reduces patient anxiety, and to ascertain if their anxiety lessens following repeated therapy. Patients attending for IVIs were asked preoperatively to plot their anxiety level using the visual analogue scale for anxiety (VASA) from 0-10. They were randomised into three groups: Hand-Held-Skin-to-Skin (HHS), Hand-Held-Skin-to-Glove (HHG) and Hand-not-Held (HNH) during IVI. Post-IVI, patients were asked to recall and plot their experienced level of anxiety at the time of their first injection (First Injection Anxiety, FIA) on the 0-10 visual analogue scale for anxiety. Both hand-held cohorts were also asked their preference for handholding for future injections. In total, 195 patients were surveyed: HHS, n = 67; HHG, n = 58 and HNH, n = 70. A total of 98% of respondents in both Hand-Held cohorts stated they found the intervention useful in reducing anxiety, with 97% saying they would like their hand held for subsequent IVIs. Patients' anxiety levels significantly reduced when their hand was held gloved or ungloved for IVIs (p = 0.007). IVI associated anxiety did not lessen with repeated therapy. Patient stress levels are considerably reduced when their hand is held during IVI. Handholding is a useful intervention throughout the patient journey and not solely at the time of initiation of treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Repeated intravitreal injections (IVI) have become the therapeutic standard of care for multiple retinal conditions. Reducing discomfort and anxiety around IVIs is important to ensure ongoing patient compliance with therapy.
AIMS
OBJECTIVE
The study aimed to investigate if handholding during an IVI reduces patient anxiety, and to ascertain if their anxiety lessens following repeated therapy.
METHODS
METHODS
Patients attending for IVIs were asked preoperatively to plot their anxiety level using the visual analogue scale for anxiety (VASA) from 0-10. They were randomised into three groups: Hand-Held-Skin-to-Skin (HHS), Hand-Held-Skin-to-Glove (HHG) and Hand-not-Held (HNH) during IVI. Post-IVI, patients were asked to recall and plot their experienced level of anxiety at the time of their first injection (First Injection Anxiety, FIA) on the 0-10 visual analogue scale for anxiety. Both hand-held cohorts were also asked their preference for handholding for future injections.
RESULTS
RESULTS
In total, 195 patients were surveyed: HHS, n = 67; HHG, n = 58 and HNH, n = 70. A total of 98% of respondents in both Hand-Held cohorts stated they found the intervention useful in reducing anxiety, with 97% saying they would like their hand held for subsequent IVIs. Patients' anxiety levels significantly reduced when their hand was held gloved or ungloved for IVIs (p = 0.007). IVI associated anxiety did not lessen with repeated therapy.
CONCLUSION
CONCLUSIONS
Patient stress levels are considerably reduced when their hand is held during IVI. Handholding is a useful intervention throughout the patient journey and not solely at the time of initiation of treatment.
Identifiants
pubmed: 35332505
doi: 10.1007/s11845-022-02986-z
pii: 10.1007/s11845-022-02986-z
doi:
Substances chimiques
Angiogenesis Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
441-445Informations de copyright
© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
Références
Rosenfeld PJ, Brown DM, Heier JS et al (2006) Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 355(14):1419–1431. https://doi.org/10.1056/NEJMoa054481
doi: 10.1056/NEJMoa054481
Campochiaro PA, Heier JS, Feiner L et al (2010) Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 117(6):1102-1112.e1. https://doi.org/10.1016/j.ophtha.2010.02.021
doi: 10.1016/j.ophtha.2010.02.021
Nguyen QD, Brown DM, Marcus DM et al (2012) Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology 119(4):789–801. https://doi.org/10.1016/j.ophtha.2011.12.039
doi: 10.1016/j.ophtha.2011.12.039
Wolf S, Balciuniene VJ, Laganovska G et al (2014) RADIANCE: a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia. Ophthalmology 121(3):682–92.e2. https://doi.org/10.1016/j.ophtha.2013.10.023
doi: 10.1016/j.ophtha.2013.10.023
Chopra R, Preston GC, Keenan TDL et al (2021) Intravitreal injections: past trends and future projections within a UK tertiary hospital. Eye (Lond). Published online June 2021:1–6. https://doi.org/10.1038/s41433-021-01646-3
Johnston RL, Lee AY, Buckle M et al (2016) UK age-related macular degeneration electronic medical record system (AMD EMR) users group report IV: incidence of blindness and sight impairment in ranibizumab-treated patients. Ophthalmology 123(11):2386–2392. https://doi.org/10.1016/j.ophtha.2016.07.037
doi: 10.1016/j.ophtha.2016.07.037
Gillies M, Arnold J, Bhandari S et al (2020) Ten-year treatment outcomes of neovascular age-related macular degeneration from two regions. Am J Ophthalmol 210:116–124. https://doi.org/10.1016/j.ajo.2019.10.007
doi: 10.1016/j.ajo.2019.10.007
Rofagha S, Bhisitkul RB, Boyer DS et al (2013) Seven-year outcomes in ranibizumab-treated patients in ANCHOR, MARINA, and HORIZON: a multicenter cohort study (SEVEN-UP). Ophthalmology 120(11):2292–2299. https://doi.org/10.1016/j.ophtha.2013.03.046
doi: 10.1016/j.ophtha.2013.03.046
Peden MC, Suñer IJ, Hammer ME et al (2015) Long-term outcomes in eyes receiving fixed-interval dosing of anti-vascular endothelial growth factor agents for wet age-related macular degeneration. Ophthalmology 122(4):803–808. https://doi.org/10.1016/j.ophtha.2014.11.018
doi: 10.1016/j.ophtha.2014.11.018
Vaze A, Fraser-Bell S, Gillies M (2014) Reasons for discontinuation of intravitreal vascular endothelial growth factor inhibitors in neovascular age-related macular degeneration. Retina 34(9):1774–1778. https://doi.org/10.1097/IAE.0000000000000173
doi: 10.1097/IAE.0000000000000173
Polat O, İnan S, Özcan S et al (2017) Factors affecting compliance to intravitreal anti-vascular endothelial growth factor therapy in patients with age-related macular degeneration. Turk Oftalmoloiji Derg 47(4):205–210. https://doi.org/10.4274/tjo.28003
doi: 10.4274/tjo.28003
Segal O, Segal-Trivitz Y, Nemet AY et al (2016) Anxiety levels and perceived pain intensity during intravitreal injections. Acta Ophthalmol 94(2):203–204. https://doi.org/10.1111/aos.12802
doi: 10.1111/aos.12802
Leese GP, Boyle P, Zhiqiang F et al (2008) Screening uptake in a well-established diabetic retinopathy screening program the role of geographical access and deprivation. Diabetes Care 31(11):2131–2135. https://doi.org/10.2337/dc08-1098
doi: 10.2337/dc08-1098
Moinul P, Barbosa J, Qian J et al (2020) Does patient education improve compliance to routine diabetic retinopathy screening? J Telemed Telecare 26(3):161–173. https://doi.org/10.1177/1357633X18804749
doi: 10.1177/1357633X18804749
Gualino V, Fourmaux E, Grenet T et al (2020) Patient experience of anti-vegf intravitreal injection. J Fr Ophtalmol 43(10):1047–1053. https://doi.org/10.1016/j.jfo.2020.02.006
doi: 10.1016/j.jfo.2020.02.006
Rifkin L, Schaal S (2012) Factors affecting patients’ pain intensity during in office intravitreal injection procedure. Retina 32(4):696–700. https://doi.org/10.1097/IAE.0b013e3182252ad3
doi: 10.1097/IAE.0b013e3182252ad3
Cintra LP, Lucena LR, Da Silva JA et al (2009) Comparative study of analgesic effectiveness using three different anesthetic techniques for intravitreal injection of bevacizumab. Ophthalmic surgery, lasers imaging Off J Int Soc Imaging Eye 40(1):13–18. https://doi.org/10.3928/15428877-20090101-05
doi: 10.3928/15428877-20090101-05
Davis MJ, Pollack JS, Shott S (2012) Comparison of topical anesthetics for intravitreal injections : a randomized clinical trial. Retina 32(4):701–705. https://doi.org/10.1097/IAE.0b013e31822f27ca
doi: 10.1097/IAE.0b013e31822f27ca
Chaudhary V, Gusenbauer K, Mak M et al (2016) Waiting room educational media effect on preinjection anxiety for initial intravitreal injections. Can J Ophthalmol 51(2):71–75. https://doi.org/10.1016/j.jcjo.2015.11.003
doi: 10.1016/j.jcjo.2015.11.003
Moisseiev E, Regenbogen M, Bartfeld Y et al (2012) Evaluation of pain in intravitreal bevacizumab injections. Curr Eye Res 37(9):813–817. https://doi.org/10.3109/02713683.2012.681335
doi: 10.3109/02713683.2012.681335
Chen X, Seth RK, Rao VS et al (2012) Effects of music therapy on intravitreal injections: a randomized clinical trial. J Ocul Pharmacol Ther Off J Assoc Ocul Pharmacol Ther 28(4):414–419. https://doi.org/10.1089/jop.2011.0257
doi: 10.1089/jop.2011.0257
Ouadfel A, El Sanharawi M, Tahiri Joutei Hassani R (2021) [Contribution of respiratory relaxation techniques during intravitreal injections: a pilot study]. J Fr Ophtalmol 44(6):842–848. https://doi.org/10.1016/j.jfo.2020.09.028
Carreras-García D, Delgado-Gómez D, Baca-García E et al (2020) A probabilistic patient scheduling model with time variable slots. Comput Math Methods Med 2020. https://doi.org/10.1155/2020/9727096
Sii S, Aspinall P, Borooah S et al (2018) Exploring factors predicting changes in patients’ expectations and psychosocial issues during the course of treatment with intravitreal injections for wet age-related macular degeneration. Eye (Lond) 32(4):673–678. https://doi.org/10.1038/eye.2017.271
doi: 10.1038/eye.2017.271
Turner JG, Clark AJ, Gauthier DK et al (1998) The effect of therapeutic touch on pain and anxiety in burn patients. J Adv Nurs 28(1):10–20. https://doi.org/10.1046/j.1365-2648.1998.00770.x
doi: 10.1046/j.1365-2648.1998.00770.x
Simington JA, Laing GP (1993) Effects of therapeutic touch on anxiety in the institutionalized elderly. Clin Nurs Res 2(4):438–450. https://doi.org/10.1177/105477389300200406
doi: 10.1177/105477389300200406
Weekes DP, Kagan SH, James K et al (1993) The phenomenon of hand holding as a coping strategy in adolescents experiencing treatment-related pain. J Pediatr Oncol Nurs Off J Assoc Pediatr Oncol Nurses 10(1):19–25. https://doi.org/10.1177/104345429301000105
doi: 10.1177/104345429301000105
Moon JS, Cho KS (2001) The effects of handholding on anxiety in cataract surgery patients under local anaesthesia. J Adv Nurs 35(3):407–415. https://doi.org/10.1046/j.1365-2648.2001.01855.x
doi: 10.1046/j.1365-2648.2001.01855.x
Modi N, Shaw S, Allman K et al (2008) Local anaesthetic cataract surgery: factors influencing perception of pain, anxiety and overall satisfaction. J Perioper Pract 18(1):28–33. https://doi.org/10.1177/175045890801800104
doi: 10.1177/175045890801800104
Miller B, Shapira Y, Flores V et al (2019) Reducing perceived pain intensity during intravitreal injections by patient handholding. Ophthalmol Retin 3(5):451–453. https://doi.org/10.1016/j.oret.2018.12.004
doi: 10.1016/j.oret.2018.12.004
Rudnicka AR, Jarrar Z, Wormald R et al (2012) Age and gender variations in age-related macular degeneration prevalence in populations of European ancestry: a meta-analysis. Ophthalmology 119(3):571–580. https://doi.org/10.1016/j.ophtha.2011.09.027
doi: 10.1016/j.ophtha.2011.09.027
Prowse M (2007) Postoperative pain in older people: a review of the literature. J Clin Nurs 16(1):84–97. https://doi.org/10.1111/j.1365-2702.2005.01482.x
doi: 10.1111/j.1365-2702.2005.01482.x
Hepp P, Hagenbeck C, Burghardt B et al (2016) MAGIC Group. Measuring the course of anxiety in women giving birth by caesarean section: a prospective study. BMC Pregnancy Childbirth. 18;16:113. https://doi.org/10.1186/s12884-016-0906-z . PMID: 27188222; PMCID: PMC4870728.