Effectiveness of nursing interventions for preoperative anxiety in adults: A systematic review with meta‐analysis

Abstract

Aims The aim of this review and meta‐analysis is to analyse the effectiveness of nursing interventions for the management of preoperative anxiety in adults. Background The perioperative process is a stressful situation for many people who are going to be operated and it can generate feelings of anxiety. Also, preoperative anxiety can appear in the perioperative period. Nursing management of preoperative anxiety through individualized interventions can be effective for reducing anxiety. Design A systematic review with meta‐analysis was performed. Data sources CINAHL, CUIDEN, Pubmed, ProQuest and Scopus databases were consulted without restriction per year of publication. The search was conducted in February 2020. Review methods Experimental studies on nursing management in preoperative anxiety with adults sample (>18 years) published in English and/or Spanish were included. All types of surgery were included in the review. A random effects meta‐analysis was performed to estimate the effect size for preoperative anxiety measured with STAI. Results After the selection process n = 9 quantitative studies with nursing interventions for preoperative anxiety were included. A preoperative educational and informative interview was used in six studies, one study used empathic interview, one used motivational interview and one used hand massage. The meta‐analysis, including four studies using nursing interviews, had a sample of n = 419 in the intervention group and n = 445 in the control group. The mean difference in preoperative state anxiety measured with the STAI was in favour of the nursing intervention. Conclusion Nursing interventions for patients who are going to be operated seems to have a positive impact in their preoperative anxiety. However, due to the low number of studies and the heterogeneity of the sample, more research is needed about the topic.

Impact of an Operating Room Nurse Preoperative Dialogue on Anxiety, Satisfaction and Early Postoperative Outcomes in Patients Undergoing Major Visceral Surgery—A Single Center, Open-Label, Randomized Controlled Trial

“…Nursing interventions with the aim of reducing anxiety prior to surgical interventions have been assessed in a recent systematic review and meta-analysis [ 14 ]. Eight out of nine included studies were randomized trials, and all but one used nursing interviews as anxiety-reducing intervention.…”

Nursing Care during the Perioperative within the Surgical Context

“…(32) Lack of information, not only of the surgical procedure, but of the anesthesia and its complications, fear of the side effects, and the potential risk of death are aspects that can trigger anxiety. (33) Anxiety is manifested with increased state of alertness, heart rate, blood pressure, muscle tension, and respiratory disorders. (34) Superficial bodily signs may include pale skin, sweating, shivering, and dilated pupils.…”

“…Hence, preparing the patients and providing them with information, will allow them to understand what they expect to find during the perioperative period. (33) Tranquility can also be manifested and this is because their body and their environment are not governed by themselves, rather, there is a spiritual or material period that governs them, which can be called destiny, God, supernatural, or whatever. (32,37) That period "is manifested in the hands of the surgeon and the accompanying staff.…”

The Effect of Preoperative Educational Intervention on Anxiety and Pain of Patients Undergoing Spinal Decompression Surgery: A Pilot Randomized Controlled Study

“…Nurses often use educational interventions to reduce patients' anxiety [4,5], focusing on supporting selfmanagement, encouraging self-care, enhancing active participation in decision-making, providing emotional support and skills training to improve health and well-being, and generally promoting patients' active role in their treatment [6][7][8]. Preoperative educational interventions in patients undergoing spine surgery have been found effective in reducing postoperative anxiety [5,7,9], pain [5], and the use of analgesia [10].…”