Preventive Care in Nursing and Midwifery Journal
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Volume 13, Issue 4 (10-2023)
PCNM 2023, 13(4): 71-86 |
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Modanloo M, Halakou S, Khoddam H, Nikpeyma N, MojaverAghili S. Non-pharmacological interventions for anxiety management in patients undergoing anesthesia (a way to preoperative caring): A narrative review. PCNM 2023; 13 (4) :71-86
URL: http://nmcjournal.zums.ac.ir/article-1-882-en.html
URL: http://nmcjournal.zums.ac.ir/article-1-882-en.html
Department of Paramedical faculty, Golestan University of Medical Sciences, Gorgan, Iran , solmazhalakou@gmail.com
Abstract: (1189 Views)
Background: Anxiety disorders are the most common mental health problem and amongst the leading causes of disability worldwide. Patients undergoing surgery often experience varying degrees of anxiety. Management of pre-anesthesia anxiety and related factors is an essential and integral part of preoperative nursing care.
Objectives: The purpose of this study was to determine the anxiety management strategies for patients undergoing anesthesia focused on non-pharmacological interventions.
Methods: This review conducted based on searching in PubMed, Web of Science, ProQuest, Scopus, Science Direct databases and Google Scholar motor engineer using main key words Anxiety and Anesthesia and Surgery from 2000 to 2022. Comprehensive selection and screening process was used to extract information. Conventional content analysis was used for analyzing and interpreting sources that inform this literature review.
Results: 35 relevant articles identified inductively, were categorized into "patient-based", "healthcare providers-based" and "environment-based" interventions these strategies.
Conclusion: The findings of studies reviewed in the present study indicate the effectiveness of non-pharmacological modalities for management of patient anxiety, particularly preoperative anxiety. Therefore, it is recommended to consider these interventions as safe, effective and simple alternatives to pharmacological approaches for reducing patient anxiety. Patient-based interventions are the most important approach to reduce patient anxiety and nurses should be receptive for the patients’ thoughts and beliefs preoperatively. The majority of studies reviewed in the present study were in this category. The care procedures performed by nurses and other healthcare staff should be based on the needs, values and preferences of patients.
Objectives: The purpose of this study was to determine the anxiety management strategies for patients undergoing anesthesia focused on non-pharmacological interventions.
Methods: This review conducted based on searching in PubMed, Web of Science, ProQuest, Scopus, Science Direct databases and Google Scholar motor engineer using main key words Anxiety and Anesthesia and Surgery from 2000 to 2022. Comprehensive selection and screening process was used to extract information. Conventional content analysis was used for analyzing and interpreting sources that inform this literature review.
Results: 35 relevant articles identified inductively, were categorized into "patient-based", "healthcare providers-based" and "environment-based" interventions these strategies.
Conclusion: The findings of studies reviewed in the present study indicate the effectiveness of non-pharmacological modalities for management of patient anxiety, particularly preoperative anxiety. Therefore, it is recommended to consider these interventions as safe, effective and simple alternatives to pharmacological approaches for reducing patient anxiety. Patient-based interventions are the most important approach to reduce patient anxiety and nurses should be receptive for the patients’ thoughts and beliefs preoperatively. The majority of studies reviewed in the present study were in this category. The care procedures performed by nurses and other healthcare staff should be based on the needs, values and preferences of patients.
Type of Study: Review Articels |
Subject:
Nursing
Received: 2023/07/17 | Accepted: 2023/10/2 | Published: 2023/10/2
Received: 2023/07/17 | Accepted: 2023/10/2 | Published: 2023/10/2
References
1. 1. Rajput SK, Tiwari T, Chaudhary AK. Effect of preoperative multimedia based video information on perioperative anxiety and hemodynamic stability in patients undergoing surgery under spinal anesthesia. Journal of Family Medicine and Primary Care. 2021;10(1):237-42.
https://doi.org/10.4103/jfmpc.jfmpc_1544_20 [Crossref]
2. Dagli R, Avcu M, Metin M, Kiyma S, Ciftci H. The effects of aromatherapy using rose oil (Rosa damascena Mill.) on preoperative anxiety: A prospective randomized clinical trial. European Journal of Integrative Medicine. 2019;26:37-42. [Crossref]
3. Laufenberg-Feldmann R, Kappis B. Assessing preoperative anxiety using a questionnaire and clinical rating: a prospective observational study. European Journal of Anaesthesiology (EJA). 2013;30(12):758-63. DOI: 10.1097/EJA.0b013e3283631751. [Crossref]
4. Mehboudi A, Modanloo M, Shariati A, Behnampour N, Bardestani G, Basiri H, et al. Relationship between anxiety and sleep quality in patients on hemodialysis in Borazjan City, 2014. Journal of Research Development in Nursing & Midwifery. 2016;12(3):56-63URL: http://nmj.goums.ac.ir/article-1-816-en.html.[in Persian]
5. Hoque AF. Assessment of Anxiety at Three Different Point of Adult Elective Surgical Patient. Sch J App Med Sci. 2021;3:487-92. DOI:10.36347/sjams.2021.v09i03.036. [Crossref]
6. Yuzkat N, Soyalp C, Turk O, Keskin S, Gulhas N. Effects of showing the operating room on preoperative anxiety and hemodynamics among patients with hypertension: A randomized controlled trial. Clinical and Experimental Hypertension. 2020;42(6):553-8. DOI: 10.1080/10641963.2020.1723619. [Crossref]
7. WenPing L, PaoYuan W, MengYing L, LunHui H, WheiMei S. Music listening alleviates anxiety and physiological responses in patients receiving spinal anesthesia. Complementary therapies in medicine. 2017;31:8-13. DOI: 10.1016/j.ctim.2016.12.006. [Crossref]
8. Raghavan G, Shyam V, Murdoch JA. A survey of anesthetic preference and preoperative anxiety in hip and knee arthroplasty patients: the utility of the outpatient preoperative anesthesia appointment. Journal of anesthesia. 2019;33(2):250-6. DOI: 10.1007/s00540-018-02608-y. [Crossref]
9. Hu P, Harmon D, Frizelle H. Patient comfort during regional anesthesia. Journal of clinical anesthesia. 2007;19(1):67-74. DOI:10.1016/j.jclinane.2006.02.016. [Crossref]
10. Arakelian E, Laurssen E, Oster C. Older Patients' Worries in Connection With General Anesthesia and Surgery-A Qualitative Study. J Perianesth Nurs. 2018;33(6):822-33. DOI: 10.1016/j.jopan.2018.01.005. [Crossref]
11. Ortiz J, Wang S, Elayda MA, Tolpin DA. Preoperative patient education: can we improve satisfaction and reduce anxiety?. Rev Bras Anestesiol. 2015;65(1):7-13. DOI: 10.1016/j.bjan.2013.07.009. [Crossref]
12. Fayazi S, Babashahi M, Rezaei M. The effect of inhalation aromatherapy on anxiety level of the patients in preoperative period. Iranian journal of nursing and midwifery research. 2011;16(4):278-83. PMID: 23449862
13. Lee C, Liu J, Lin S, TY Hsu, Lin C, Lin L. Effects of Educational Intervention on State Anxiety and Pain in People Undergoing Spinal Surgery: A Randomized Controlled Trial. Pain Manag Nurs. 2018;19(2):163-71. DOI: 10.1016/j.pmn.2017.08.004. [Crossref]
14. Halakou S, Khoddam H, Nikpeyma N, Modanloo M. Development and implementation of anxiety management program for women under gynecological surgery with spinal anesthesia: Protocol of action research study. Journal of Education and Health Promotion. 2022;11:e 374. DOI: 10.4103/jehp.jehp_762_21. [Crossref]
15. D Lopes, Baena M, Rosângela H. The role of the clinical nurse specialist in caring for patients with prostate cancer: a narrative review. Nursing: Research and Reviews. 2014;4:77-89. DOI:10.2147/NRR.S36752. [Crossref]
16. Onwuegbuzie AJ, Leech NL, Collins KM. Qualitative analysis techniques for the review of the literature. Qualitative Report. 2012;17:56:1-28DOI: 10.46743/2160-3715/2012.1754. [Crossref]
17. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004;24(2):105-12. DOI: 10.1016/j.nedt.2003.10.001. [Crossref]
18. Cioffi I, Farella M. Quality of randomised controlled trials in dentistry. International dental journal. 2011;61(1):37-42. DOI: 10.1016/j.nedt.2003.10.001. [Crossref]
19. Polit DF, Beck CT. Essentials of nursing research: Appraising evidence for nursing practice: Lippincott Williams & Wilkins; 2017.
20. Akhlaghi F, Azizi S, Malek B, Mahboubi F, Shams S, Karimizadeh M. Effect of Preoperative Anesthesia Consultation on Decreasing Anxiety in Patients Undergoing Oral and Maxillofacial Surgery. Journal of Dentistry. 2020;21(2):102-105. DOI: 10.30476/DENTJODS.2019.77883.0
21. Lemos MF, Lemos-Neto SV, Barrucand L, Vercosa N, Tibirica E. Preoperative education reduces preoperative anxiety in cancer patients undergoing surgery: Usefulness of the self-reported Beck anxiety inventory. Revista Brasileira De Anestesiologia. 2019;69(1):1-6. DOI: [Crossref]
22. Jlala H, French J, Foxall G, Hardman J, Bedforth N. Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia. British journal of anaesthesia. 2010;104(3):369-74. DOI: 10.1093/bja/aeq002. [Crossref]
23. Dias R, Baliarsing L, Barnwal N, Mogal S, Gujjar P. Role of pre-operative multimedia video information in allaying anxiety related to spinal anaesthesia: A randomised controlled trial. Indian Journal of Anesthesia. 2016;60(11):843-47. DOI: 10.4103/0019-5049.193681. [Crossref]
24. Cakmak M, Kose I, Zinzircioglu C, Karaman Y, Tekgul ZT, Pektas S, et al. Effect of video-based education on anxiety and satisfaction of patients undergoing spinal anesthesia. Revista brasileira de anestesiologia. 2018;68(3):274-9. DOI: 10.1016/j.bjan.2018.01.001. [Crossref]
25. Medina-Garzón M. Effectiveness of a nursing intervention to diminish preoperative anxiety in patients programmed for knee replacement surgery: preventive controlled and randomized clinical trial. Investigacion y educacion en enfermeria. 2019;37(2): e07. DOI: 10.17533/udea.iee.v37n2e07. [Crossref]
26. Kukreja P, Talbott K, MacBeth L, Ghanem E, Sturdivant AB, Woods A, et al. Effects of Music Therapy During Total Knee Arthroplasty Under Spinal Anesthesia: A Prospective Randomized Controlled Study. Cureus. 2020;12(3): e7396. DOI: 10.7759/cureus.7396. [Crossref]
27. Abadi F, Fereidouni Z, Amirkhani M, Karimi S, Kalyani M. Effect of acupressure on preoperative cesarean section anxiety. Journal of acupuncture and meridian studies. 2018;11(6):361-6. DOI: 10.1016/j.jams.2018.07.001. [Crossref]
28. Hepp P, Hagenbeck C, Gilles J, Wolf OT, Goertz W, Janni W, et al. Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study. BMC pregnancy and childbirth. 2018;18(1):1-8. DOI: 10.1186/s12884-018-2069-6. [Crossref]
29. Sahin G, Basak T. The Effects of Intraoperative Progressive Muscle Relaxation and Virtual Reality Application on Anxiety, Vital Signs, and Satisfaction: A Randomized Controlled Trial. Journal of PeriAnesthesia Nursing. 2020;35(3):269-76. DOI: 10.1016/j.jopan.2019.11.002. [Crossref]
30. Hamester L, Souza ENd, Cielo C, Moraes MA, Pellanda LC. Effectiveness of a nursing intervention in decreasing the anxiety levels of family members of patients undergoing cardiac surgery: a randomized clinical trial. Revista Latino-Americana de Enfermagem. 2016;24(0) : e2729. DOI:10.1590/1518-8345.0208.2729. [Crossref]
31. Choubsaz M, Rezavand N, Bayat A, Farhadi K, Amirifard N. Comparison between the Effect of Ear Plug and Music in Reducing Anxiety in Patients Undergoing Elective Cesarean Section under Spinal Anesthesia. Kuwait Medical Journal. 2018;50(1):37-42. URL: https://www.scopus.com/inward/record.uri?eid=2-s2.
32. Acar K, Aygin D. Efficacy of Guided Imagery for Postoperative Symptoms, Sleep Quality, Anxiety, and Satisfaction Regarding Nursing Care: A Randomized Controlled Study. Journal of PeriAnesthesia Nursing. 2019;34(6):1241-9. DOI: 10.1016/j.jopan.2019.05.006. [Crossref]
33. Eminovic S, Vincze G, Fink A, Fischerauer SF, Sadoghi P, Leithner A, et al. Positive effect of colors and art in patient rooms on patient recovery after total hip or knee arthroplasty. Wiener klinische Wochenschrift. 2021:1-6. DOI: 10.1007/S00508-021-01936-6. [Crossref]
34. Park S-H, Mattson RH. Ornamental indoor plants in hospital rooms enhanced health outcomes of patients recovering from surgery. The journal of alternative and complementary medicine. 2009;15(9):975-80. DOI: 10.1089/acm.2009.0075. [Crossref]
35. Niknejad R, Mirmohammad-Sadeghi M, Akbari M, Ghadami A. Effects of an orientation tour on preoperative anxiety in candidates for coronary artery bypass grafting: A randomized clinical trial. ARYA atherosclerosis. 2019;15(4):154-160. DOI: 10.22122/arya.v15i4.1806
36. Çalışır F, Urfalıoğlu A, Bilal B, Tok A, Bolcal HA, Öksüz H. The effect of lavender aromatherapy on the level of intraoperative anxiety in caesarean case under spinal anesthesia: A randomized controlled trial. EXPLORE. 2022. Dec 2;S1550-8307(22)00212-9. [Crossref]
37. Gómez‐Urquiza JL, Hueso‐Montoro C, Urquiza‐Olmo J, Ibarrondo‐Crespo R, González‐Jiménez E, Schmidt‐Riovalle J. A randomized controlled trial of the effect of a photographic display with and without music on pre‐operative anxiety. Journal of advanced nursing. 2016;72(7):1666-76. doi: 10.1111/jan.12937. [Crossref]
38. Ozhanli Y, Akyuz N. The effect of progressive relaxation exercise on physiological parameters, pain and anxiety levels of patients undergoing colorectal cancer surgery: a randomized controlled study. Journal of PeriAnesthesia Nursing. 2022;37(2):238-46. [Crossref]
39. Yamashita Y, Shimohira D, Aijima R, Mori K, Danjo A. Clinical application of virtual reality to alleviate anxiety during oral surgery under local anesthesia. Journal of Oral and Maxillofacial Surgery Medicine and Pathology. 2020;32(6):441-4. DOI: 10.1016/j.joms.2019.11.016. [Crossref]
40. Uysal Aİ, Altıparmak B, Güner Ö. The effect of an informative leaflet on preoperative anxiety and patient's knowledge of anesthesia and anxiety. Journal of Clinical and Analytical Medicine. 2017;8(5):370-4. DOI:10.4328/JCAM.4875. [Crossref]
41. Moon JS, Cho KS. The effects of handholding on anxiety in cataract surgery patients under local anaesthesia. J Adv Nurs. 2001;35(3):407-15. DOI: 10.1046/j.1365-2648.2001.01855.x. [Crossref]
42. Anuja B, Devi ES, Sequira L, Rao L, Pai VH. Effectiveness of intra operative hand holding on anxiety and physiological parameters among patients undergoing cataract surgery. Nitte University Journal of Health Science. 2014;4(2):27-33. DOI:10.1055/S-0040-1703760. [Crossref]
43. Sadati L, Pazouki A, Mehdizadeh A, Shoar S, Tamannaie Z, Chaichian S. Effect of preoperative nursing visit on preoperative anxiety and postoperative complications in candidates for laparoscopic cholecystectomy: a randomized clinical trial. Scandinavian journal of caring sciences. 2013;27(4):994-8. DOI: 10.1111/scs.12022. [Crossref]
44. Kim BH, Kang HY, Choi EY. Effects of handholding and providing information on anxiety in patients undergoing percutaneous vertebroplasty. J Clin Nurs. 2015;24(23-24):3459-68. DOI: 10.1111/jocn.12928. [Crossref]
45. Hur Y, JJ Woo, Ahn H. Anxiety Relief Effects of Non-Pharmacological Intervention on Patients under Local Anesthesia. nternational Journal of Bio-Science and Bio-Technology. 2016;8(5):323-36. DOI:10.14257/IJBSBT.2016.8.5.29. [Crossref]
46. Kacem I, Kahloul M, El Arem S, Ayachi S, Hafsia M, Maoua M, et al. Effects of music therapy on occupational stress and burn-out risk of operating room staff. Libyan Journal of Medicine. 2020;15(1):1768024. DOI: 10.1080/19932820.2020.1768024. [Crossref]
47. Zulkifli NA, Zain U, Hadi AA, Ismail MN, Aziz KH. Effects of listening to Quran recitation and nature sounds on preoperative anxiety among patients undergoing surgery. Pakistan Journal of Psychological Research. 2022;37(2):295-310. [Crossref]
48. Jenkins BN, Fortier MA, Stevenson R, Makhlouf M, Lim P, Converse R, et al. Changing healthcare provider and parent behaviors in the pediatric post‐anesthesia‐care‐unit to reduce child pain: Nurse and parent training in postoperative stress. Pediatric Anesthesia. 2019;29(7):730-7. DOI:10.1111/pan.13649. [Crossref]
49. Martin SR, Chorney JM, Tan ET, Fortier MA, Blount RL, Wald SH, et al. Changing healthcare providers' behavior during pediatric inductions with an empirically based intervention. The Journal of the American Society of Anesthesiologists. 2011;115(1):18-27. DOI: 10.1097/ALN.0b013e3182207bf5. [Crossref]
50. Ilkkaya N, Ustun F, Sener E, Kaya C, Ustun Y, E Koksal, et al. The effects of music, white noise, and ambient noise on sedation and anxiety in patients under spinal anesthesia during surgery. J Perianesth Nurs. 2014;29(5):418-26. DOI: 10.1016/j.jopan.2014.05.008. [Crossref]
51. Ayesha K. Patient friendly operating room complexes: what can be done? Anaesthesia, Pain & Intensive Care. 2021;25(5): 682-86. DOI: [Crossref]
52. Zulkifli NA, Zain UI, Hadi AA, Ismail MN, Aziz KH. Effects of listening to Quran recitation and nature sounds on preoperative anxiety among patients undergoing surgery. Pakistan Journal of Psychological Research. 2022;37(2):295-310. DOI:10.33824/PJPR.2022.37.2.18. [Crossref]
53. Pokharel K, Bhattarai B, Tripathi M, Khatiwada S, Subedi A. Nepalese patients' anxiety and concerns before surgery. Journal of clinical anesthesia. 2011;23(5):372-8. DOI: 10.1016/j.jclinane.2010.12.011. [Crossref]
54. Pestana-Santos M, Pereira MJ, Santos E, Lomba L, Santos MR. Effectiveness of non-pharmacological interventions to manage anxiety in adolescents in the perioperative period: a systematic review protocol. JBI Evidence Synthesis. 2021; 19(10):2863-2869.10.11124/JBIES-20-00359.DOI: 10.11124/JBIES-20-00359.10.11124/JBIES-20-00359 []
55. Attri JP, Sandhu GK, Mohan B, Bala N, Sandhu KS, Bansal L. Conflicts in operating room: Focus on causes and resolution. Saudi journal of anaesthesia. 2015;9(4): 457-463. DOI: 10.4103/1658-354X.159476. [Crossref]
56. Von Vogelsang AC, Swenne CL, Gustafsson BÅ, Falk Brynhildsen K. Operating theatre nurse specialist competence to ensure patient safety in the operating theatre: A discursive paper. Nursing open. 2020;7(2):495-502. DOI: 10.1002/nop2.424. [Crossref]
57. Barari F, Mollahadi M, Moshtagh Z, Salaree M. Investigating the Effect of Rhythmic Breathing Training by Teach Back Method on Anxiety in Patients Undergoing Tympanoplasty. Education Strategies in Medical Sciences (ESMS). 2020;9(3):172.8. URL :http://edcbmj.ir/article-1-2627-en.html
58. Jamshidi S, Parker JS, Hashemi S. The effects of environmental factors on the patient outcomes in hospital environments: A review of literature. Frontiers of Architectural Research. 2020;9(2):249-63. DOI : [Crossref]
59. Waterman H, Tillen D, Dickson R, De Koning K. Action research: a systematic review and guidance for assessment. Health technology assessment (Winchester, England). 2001;5(23):iii. DOI: [Crossref]
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