Preoperative anxiety in patients before radiosurgery treatment by Gamma Knife

Introduction. The work is aimed at familiarizing readers with the results of a study of preoperative anxiety in patients admitted for radiosurgical treatment (RST) using the Gamma Knife device. The aim is to study the severity and characteristics of anxiety. Materials and methods. The sample consisted of 335 patients aged 19 to 73 years (M = 50.26 years; SD = 13.45 ), of which 247 women (73.7%) and 88 men (26.3%). The group included patients with benign brain tumors (meningiomas, vestibular schwannomas, pituitary adenomas; N = 145), metastatic brain lesions (due to malignant neoplasms of the breast, lung, gastrointestinal tract, kidney, and melanoma; N= 125), vascular diseases (arteriovenous malformations, cavernomas; N = 57) and functional disorders (trigeminal neuralgia, Parkinson’s disease; N = 8). The study was conducted using a clinical psychological interview and the Hamilton Anxiety Rating Scale (HARS) questionnaire. Results. The results revealed that 66.3% of patients had severe anxiety, 31.3% had moderate anxiety, and only 2.4% of patients had no signs of pre-procedural anxiety. The average anxiety score for the entire group was 24.4 points (SD = 9.4) and corresponded to the borderline value between moderate and highly expressed anxiety. Anxious experiences manifested themselves in most patients at both the mental and somatic levels. The content of the anxious experience was associated not only with the upcoming procedure, but also reflected the situation of the oncological disease. Conclusions. The results obtained make it possible to talk about the need for psychological support for patients admitted for radiosurgical treatment.

1. Golanov A.V., Antipina N.A., Kostjuchenko V.V., Trunin Yu.Yu., Krasnyansky S.A., Kozlov A.V., Usachev D.Yu. Changes in treatment paradigm for neurosurgical patients in the era of stereotactic irradiation. By the 15th anniversary of the Neuroradiosurgery in Russia. Voprosy neirokhirurgii imeni N.N. Burdenko = Burdenko’s Journal of Neurosurgery, 2021. Vol. 85, no. 5, pp. 48—56. DOI: 10.17116/neiro20218505148. (In Russ., abstr. in Engl.).
2. Dubinina E.A., Alekhin A.N. Psychological Reactions of Children to a Situation of Surgical Treatment: A Review of Studies. Klinicheskaya i spetsial'naya psikhologiya = Clinical Psychology and Special Education, 2023. Vol. 12, no. 4, pp. 5—26. (In Russ., abstr. in Engl.).
3. Ivanov P.I., Zubatkina I.S., Butovskaya D.A., Kozhokar T.I. Radiosurgical treatment of medically refractory Parkinson’s tremor. Neyrokhirurgiya = Russian journal of neurosurgery, 2021. Vol. 23, no. 1, pp. 16—25. DOI: 10.17650/1683-3295-2021-23-1-16-25. (In Russ., abstr. In Engl.).
4. Ilyalov S.R, Golanov A.V., Banov S.M. Stereotactic radiosurgery for vestibular schwannomas: evolution of the philosophy of treatment. Neyrokhirurgiya = Russian journal of neurosurgery, 2024. Vol. 26, no. 1, pp. 110—122. DOI: 10.17650/1683-3295-2024-26-1-110-122. (In Russ., abstr. In Engl.).
5. Zakharova M.L., Ivanov P.I., Anikin S.A. O psikhologicheskom soprovozhdenii patsiyentov detskogo vozrasta, poluchayushchikh lecheniye na apparate Gamma-nozh [Elektronnyi resurs]. Rossiyskiy neyrokhirurgicheskiy zhurnal im. professora A.L. Polenova = Russian neurosurgical journal named after professor A.L. Polenov, 2022. Vol. 14, no. S, pp. 198—199. Avialable at: https://polenovjournal.elpub.ru/jour/issue/viewIssue/18/13 (Accessed 05.12.2024). (In Russ.).
6. Zakharova M.L., Kirillova L.YU. Spetsifika psikhoemotsional'nogo sostoyaniya patsiyentov so zlokachestvennymi novoobrazovaniyami zheludochno—kishechnogo trakta pered protseduroy protivoopukholevoy lekarstvennoy terapii [Elektronnyш resurs]. Voprosy onkologii = Problems in oncology, 2023. Vol. 69, no. 3S, pp. 173—174. Avialable at: https://voprosyonkologii.ru/index.php/journal/issue/view/62/31 (Accessed 02.01.2025). (In Russ.).
7. Trukhan L.V., Avramenko K.A. Predoperatsionnaya trevoga kak determinanta vyrazhennoy posleoperatsionnoy boli. Nauchnyy forum: meditsina, biologiya i khimiya: sbornik statey po materialam XV mezhdunarodnoy nauchno—prakticheskoy konferentsii = Scientific forum: medicine, biology and chemistry: collection of articles based on the materials of the XV international scientific and practical conference, 2018. Vol. 7(15), pp. 31—35. Avialable at: http//nauchforum.ru/files/2018_09_24_med/7%2815%29.pdf (Accessed 02.01.2025). (In Russ., abstr. In Engl.).
8. Chernov A.V., Gardanova ZH.R. Predoperatsionnaya trevoga i psikhicheskiye zashchitnyye mekhanizmy u bol'nykh rakom prostaty [Elektronnyy resurs]. Molodoy uchenyy = Young scientist, 2016. Vol. 10 (114), pp. 1381—1383. Avialable at: https://moluch.ru/archive/114/30244/ (Accessed 05.02.2025). (In Russ.).
9. Aust H., Eberhart L., Sturm T., Schuster M., Nestoriuc Y., Brehm F., Rüsch D. A cross-sectional study on preoperative anxiety in adults. Journal of Psychosomatic Research, 2018. Vol. 111, pp. 133—139. DOI: 10.1016/j.jpsychores.2018.05.012
10. Demirci H., van der Storm S.L., Huizing N.J., Fräser M., Stufkens S.A.S., Krips R., Kerkhoffs G.M.M.J., Barsom E.Z., Schijven M.P. Watching a movie or listening to music is effective in managing perioperative anxiety and pain: a randomised controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 2023. Vol. 31, no 12, pp. 6069—6079. DOI: 10.1007/s00167-023-07629-z
11. Eberhart L., Aust H., Schuster M., Sturm T., Gehling M., Euteneuer F., Rüsch D. Preoperative anxiety in adults — a cross-sectional study on specific fears and risk factors. BMC Psychiatry, 2020. Vol. 20, no. 1, pp. 140. DOI: 10.1186/s12888-020-02552-w
12. Guo P. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials. Journal of Clinical Nursing, 2015. Vol. 24, no. 1—2, pp. 34—46. DOI: 10.1111/jocn.12618
13. Jarmoszewicz K., Nowicka-Sauer K., Zemła A., Beta S. Factors Associated with High Preoperative Anxiety: Results from Cluster Analysis. World Journal of Surgery, 2020. Vol. 44, no. 7, pp. 2162—2169. DOI: 10.1007/s00268-020-05453-x
14. Jeske P., Wojtera B., Banasiewicz T. Prehabilitation — Current Role in Surgery. Polish Journal of Surgery, 2022. Vol. 94, no. 3, pp. 64—72. DOI:10.5604/01.3001.0015.7340
15. Hernández-Palazón J., Fuentes-García D., Falcón-Araña L., Roca-Calvo M.J., Burguillos-López S., Doménech-Asensi P., Jara-Rubio R. Assessment of Preoperative Anxiety in Cardiac Surgery Patients Lacking a History of Anxiety: Contributing Factors and Postoperative Morbidity. Journal of cardiothoracic and vascular anesthesia, 2018. Vol. 32, no. 1, pp. 236—244. DOI: 10.1053/j.jvca.2017.04.044
16. Higuchi Y., Matsuda S., Serizawa T. Gamma knife radiosurgery in movement disorders: Indications and limitations. Movement Disorders, 2017. Vol. 32, no. 1, pp. 28—35. DOI: 10.1002/mds.26625
17. Kashif M., Hamid M., Raza A. Influence of Preoperative Anxiety Level on Postoperative Pain After Cardiac Surgery. Cureus, 2022. Vol. 14, no. 2, e22170. DOI: 10.7759/cureus.22170
18. Kassahun W.T., Mehdorn M., Wagner T.C. et al. The effect of preoperative patient-reported anxiety on morbidity and mortality outcomes in patients undergoing major general surgery. Scientific Reports, 2022. Vol.12, article no. 6312. DOI:10.1038/s41598-022-10302-z
19. Kok X.L.F., Newton J.T., Jones E.M., Cunningham S.J. Social support and pre-operative anxiety in patients undergoing elective surgical procedures: A systematic review and meta-analysis. Journal of Health Psychology, 2023. Vol. 28, no. 4, pp. 309—327. DOI: 10.1177/13591053221116969
20. Mulugeta H., Ayana M., Sintayehu M., Dessie G., Zewdu T. Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia. BMC anesthesiology, 2018. Vol. 18, no. 1, p. 155. DOI: 10.1186/s12871-018-0619-0
21. Nowicka-Sauer K., Zemła A., Banaszkiewicz D., Trzeciak B., Jarmoszewicz K. Measures of preoperative anxiety: Part two. Anaesthesiology Intensive Therapy, 2024. Vol. 56, no. 1, pp. 9—16. DOI: 10.5114/ait.2024.136508
22. Peña-Pino I., Chen C.C. Stereotactic Radiosurgery as Treatment for Brain Metastases: An Update. Asian Journal of Neurosurgery, 2023. Vol.18, no. 2, pp. 246—257. DOI: 10.1055/s-0043-1769754