title: Patient communication during cataract surgery.
abstract: OBJECTIVE
  Most cataract surgery is now performed under local anaesthesia on a day-case basis. As patients are fully conscious during the procedure, it is important that they remain still. There are a variety of reasons why patients may need to move, and it is important that the surgeon is made aware that this may happen. Some centres offer a nurse's hand as a means of perioperative patient communication. We sought to study the safety and efficacy of using an electronic patient-controlled alert device.
  
  
  METHODS
  We compared hand-holding with the use of a patient alert device, and with both communication methods at the same time, on 150 subjects undergoing cataract surgery under local anaesthesia. Assessment of pre- and postoperative state anxiety was undertaken and patients' satisfaction with the communication strategies was assessed.
  
  
  RESULTS
  There was a significant difference between pre- and postoperative state anxiety for each group (P<0.001) but no significant differences in pre-, peri-, or postoperative state anxiety between groups. There were no significant differences in confidence, pain, understanding, satisfaction, memory, and reassurance between the three groups. A total of 46% of all patients reported experiencing one or more of the potential problems enquired about, during the operation. Significant correlations were also identified between some of the psychological variables investigated.
  
  
  CONCLUSIONS
  An electronic patient alert device is as effective a means of perioperative patient communication as holding a nurse's hand, during cataract surgery under local anaesthesia. It is safe, reassuring and it allows patients to communicate directly with the surgeon.
authors.affiliation: Manchester Royal Eye Hospital, Manchester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Mokashi
authors.forename: B
authors.initials: B
authors.lastname: Leatherbarrow
authors.forename: J
authors.initials: J
authors.lastname: Kincey
authors.forename: R
authors.initials: R
authors.lastname: Slater
authors.forename: V
authors.initials: V
authors.lastname: Hillier
authors.forename: S
authors.initials: S
authors.lastname: Mayer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000523:psychology; D001007:Anxiety / Q000517:prevention & control; D002387:Cataract Extraction; D003142:Communication; D006225:Hand; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods* / Q000451:nursing; D007431:Intraoperative Complications / Q000175:diagnosis*; D007432:Intraoperative Period; D008875:Middle Aged; D010817:Physician-Patient Relations; D017751:Safety Management / Q000379:methods; D012656:Self-Help Devices; D011795:Surveys and Questionnaires