[Management and methodological approaches for the assessment of emotional states in anesthesiology]

In anaesthesiology emotional states are of great importance. Reduction of anxiety and sedation in the preoperative preparation as well as stress reduction and the process of recovery are a challenge for anaesthetists as perioperative physicians. As emotions have different dimensions of manifestation like experience, expression, behaviour and somatic indicators, all these are needed to describe emotions sufficiently. In a multidimensional approach for the measure of emotional states, the different dimensions, their relationships and interactions are taken into account. The methodological approaches to registration of emotions in the anaesthesiological context are heterogeneous. In this summary the possibilities are differentiated by the source of information. Self-rating by the patient, rating by the observer, expression and behaviour and somatic indicators are taken into consideration. Analysis of the methods for the assessment of emotional states in anaesthesiological setting leads to the following recommendations: The most sensitive source of information is the patient. The rating scale used should be multidimensional and it should take specific as well as unspecific emotional aspects into account. As there are enough rating scales thoroughly developed and up to the demands of the classical test-theory, no ad hoc developed scales should be used. The rating of the emotional state should be supplemented by a rating of the physical state. The rating by the observer can be a valuable addition. The agreement between observers and the reliability of the method must be guaranteed. At presence there is no alternative in clinical practice to simple autonomic parameters such as blood pressure and heart rate as somatic indicators of emotion. Still it is important to consider the normal values for the individual patient. It is necessary to develop and to evaluate simple methods to register characteristics of expression in clinical context.