Changes in Patients' Psychological Stress Before Surgery: An Observational Study Focusing on the Presence of Familiar...

Many surgical patients feel stressed and are exposed to the unusual environment of the operating room. Stressful conditions cause autonomic nervous system fluctuations and affect the body during and after surgery. Because familiar faces are believed to attract more attention and provide a sense of predictability and reassurance, thereby helping to reduce anxiety, the involvement of familiar nurses in the operating room may contribute to easing psychological stress. In this study, we aimed to observe changes in patients' psychological stress before surgery, focusing on the presence or absence of familiar nurses in the operating room. The subjects were patients undergoing surgery under general anesthesia. Of these 60 participants analyzed, 25 received a preoperative visit from the operating room nurse assigned to their surgery that day (acquaintance group), while 35 received a visit from a different operating room nurse (no-acquaintance group). To investigate the sequential changes in patients' psychological stress during the preoperative period, autonomic nerve activity indexes (sympathetic nerve activity index LF/HF, parasympathetic nerve activity index HF) were measured using a wearable device when leaving the ward, entering the operating room, and when anesthesia was administered. As a result, the LF/HF in the no-acquaintance group was highest upon entry into the operating room, with a median value of 3.47. During anesthesia induction, the LF/HF was significantly higher than at the time of departure from the ward (p < 0.01), but significantly lower than upon entry into the operating room (p = 0.02). The acquaintance group showed the highest LF/HF at the time of ward departure, with a median value of 4.87. In this group, the LF/HF significantly decreased during anesthesia induction compared to entry into the operating room (p = 0.02). Regarding HF, the no-acquaintance group exhibited the lowest HF upon entry into the operating room (median: 8.22), which significantly increased during anesthesia induction (p = 0.02). Conversely, in the acquaintance group, the lowest HF was observed at ward departure (median: 10.42), and the highest HF was recorded upon entry into the operating room (median: 11.78). HF was significantly higher at both entry into the operating room (p = 0.01) and anesthesia induction (p = 0.04) as compared to ward departure. In this study, patients' psychological stress was objectively assessed using a wearable device at three time points: ward departure, entry into the operating room, and anesthesia induction. The results suggest that regardless of the presence of familiar nurses, patients exhibited decreased sympathetic activity and increased parasympathetic activity during anesthesia induction, indicating a reduction in psychological stress.