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dc.rights.licenseReconocimiento 4.0 Internacional
dc.contributor.advisorGrillo Ardila, Carlos Fernando
dc.contributor.authorMoreno Hernández, Leydy Angélica
dc.description.abstractINTRODUCTION: 75% of patients facing a surgical procedure experience anxiety. Under a procedure in a state of consciousness, such as ophthalmological surgeries, considerable levels of anxiety can be produced and, consequently, states of insomnia, pain and physiological stress. Sounds designed to enhance the patient experience can help not only distract, but also isolate distracting sounds or conversations in the operating theater. In the context of plastic surgery, the presence of music has been shown to improve the quality of surgical closure and patient anxiety. There is interest in evaluating interventions that stimulate psychological and physiological relaxation in patients. The purpose of this project was to assess sound-based interventions in the context of ophthalmic surgery, being useful to indicate or reject their potential use. OBJECTIVES: To assess the safety and effectiveness of sound-based interventions for patients undergoing ophthalmic surgery. METHODOLOGY: An explicit systematic search was performed using the highly sensitive search strategy in Medline (Ovid), CENTRAL LILACS, Cochrane Central Register of Controlled Trials,, EMBASE, International Clinical Trials Registry Platform (ICTRP), and Web of science until July 1, 2021; conference proceedings and reference lists of retrieved studies were handsearched. Randomized controlled trials (RCTs) comparing sound-based interventions in different regimens or with other therapeutic alternatives for people undergoing ophthalmic surgery were selected. Two authors independently assessed trials for inclusion, data extraction and risk of bias assessment, disagreements resolved by consensus. A random effects meta-analysis was implemented. RESULTS: We examined 13,277 records; after reading the eligible trials, 14 published trials met the inclusion criteria. Sample sizes ranged from 40 to 330 participants, 4 trials describe the method used for randomization, and 2 trials used intention-to-treat analysis. The most common type of ophthalmic surgery was cataract surgery, followed by intravitreal injection. The overall risk of bias was 'low risk' in two trials and high risk in six trials. The effect in favor of the sound intervention was identified on the anxiety outcome (-0.73 95% CI -1.17 to -0.29) and on some secondary outcomes (heart rate, diastolic blood pressure, systolic blood pressure). Using the GRADE system, we rate the certainty of the evidence from low to very low for the results. CONCLUSION: The results of this study could suggest the potential use of sound-based interventions to reduce anxiety in patients undergoing ophthalmic surgery.
dc.description.abstractINTRODUCCIÓN: El 75% de los pacientes que se enfrentan a un procedimiento quirúrgico experimentan ansiedad. Bajo un procedimiento en estado de conciencia, como son las cirugías oftalmológicas, se pueden producir niveles considerables de ansiedad y consecuentemente estados de insomnio, dolor y estrés fisiológico. Los sonidos diseñados para mejorar la experiencia del paciente pueden ayudar no solo a distraer, sino también a aislar los sonidos molestos o las conversaciones en el quirófano. En el contexto de la cirugía plástica, la presencia de la música ha demostrado mejorar la calidad del cierre quirúrgico y la ansiedad del paciente. Existe interés en evaluar intervenciones que estimulen la relajación psicológica y fisiológica en los pacientes. El propósito de este proyecto fue evaluar las intervenciones basadas en el sonido en el contexto de la cirugía oftalmológica, siendo útil para indicar o rechazar su potencial uso. OBJETIVOS: Evaluar la seguridad y la efectividad de las intervenciones basadas en sonido para los pacientes sometidos a cirugía oftalmológica. METODOLOGÍA: se efectuó una búsqueda sistemática explícita mediante la estrategia de búsqueda de alta sensibilidad en Medline (Ovid), CENTRAL LILACS, Cochrane Central Register of Controlled Trials (CENTRAL),, EMBASE, International Clinical Trials Registry Platform (ICTRP) y Web of science hasta el 1 julio de 2021; se realizó búsquedas manuales en actas de congresos y listas de referencias de estudios recuperados. Se seleccionaron Ensayos controlados aleatorios (ECA) que comparan intervenciones basadas en sonidos en diferentes regímenes o con otras alternativas terapéuticas para pacientes sometidos a cirugía oftalmológica. Dos autores evaluaron de forma independiente los ensayos para su inclusión, extracción de datos y evaluación del riesgo de sesgo, los desacuerdos se resolvieron mediante consenso. Se implementó un metaanálisis de efectos aleatorios. RESULTADOS: Examinamos 13 277 registros; después de leer los ensayos elegibles, 14 ensayos publicados cumplieron con los criterios de inclusión. Los tamaños de muestra variaron de 40 a 330 participantes, 4 ensayos describen el método utilizado para la aleatorización y 2 ensayos utilizaron análisis por intención de tratar. El tipo de cirugía oftálmica más frecuente fue la cirugía de catarata, seguida de la inyección intravítrea. El riesgo general de sesgo fue de "riesgo bajo" en dos ensayos y riesgo alto en seis ensayos. Se identificó el efecto a favor de la intervención sonora sobre el resultado de ansiedad (- 0,73 IC del 95%: -1,17 a -0,29) y sobre algunos resultados secundarios (frecuencia cardiaca, presión arterial diastólica, presión arterial sistólica). Con el sistema GRADE calificamos la certeza de la evidencia de baja a muy baja para los resultados. CONCLUSION: Los resultados de este estudio podrían sugerir el uso potencial de las intervenciones basadas en sonido para reducir la ansiedad en pacientes sometidos a cirugía oftálmica. (Texto tomado de la fuente)
dc.format.extentxix, 97 páginas
dc.publisherUniversidad Nacional de Colombia
dc.subject.ddc610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología
dc.titleSound-based interventions in the ophthalmological surgery setting: systematic review of randomized clinical trials
dc.typeTrabajo de grado - Maestría
dc.publisher.programBogotá - Medicina - Maestría en Epidemiología Clínica
dc.description.degreenameMagister en Epidemiología Clínica
dc.description.methodsSystematic Review of Randomized Clinical Trials
dc.description.technicalinfoSystematic Review of Randomized Clinical Trials
dc.identifier.instnameUniversidad Nacional de Colombia
dc.identifier.reponameRepositorio Institucional Universidad Nacional de Colombia
dc.publisher.facultyFacultad de Medicina
dc.publisher.placeBogotá, Colombia
dc.publisher.branchUniversidad Nacional de Colombia - Sede Bogotá
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dc.subject.lembSurgery (topology)
dc.subject.lembCirugía (topología)
dc.subject.proposalOphthalmologic Surgical Procedures
dc.subject.proposalRandomized Controlled Trials
dc.title.translatedIntervenciones basadas en sonido en el ámbito de la cirugía oftalmológica: revisión sistemática de ensayos clínicos aleatorizados
oaire.awardtitleSound-based Interventions in The Ophthalmological Surgery Setting: Systematic Review of Randomized Clinical Trials
dcterms.audience.professionaldevelopmentPúblico general

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