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

Abstract

Background: Anxiety is common before surgery and known to negatively impact recovery from surgery. The aim of this study was to evaluate the impact of a preoperative nurse dialogue on a patient’s anxiety, satisfaction and early postoperative outcomes. Method: This 1:1 randomized controlled trial compared patients undergoing major visceral surgery after a semistructured preoperative nurse dialogue (interventional group: IG) to a control group (CG) without nursing intervention prior to surgery. Anxiety was measured with the autoevaluation scale State-Trait Anxiety Inventory (STAI, Y-form) pre and postoperatively. The European Organization for Research and Treatment of Cancer (EORTC) In-Patsat32 questionnaire was used to assess patient satisfaction at discharge. Further outcomes included postoperative pain (visual analogue scale: VAS 0–10), postoperative nausea and vomiting (PONV), opiate consumption and length of stay (LOS). Results: Over a period of 6 months, 35 participants were randomized to either group with no drop-out or loss to follow-up (total n = 70). The median score of preoperative anxiety was 40 (IQR 33–55) in the IG vs. 61 (IQR 52–68) in the CG (p < 0.001). Postoperative anxiety levels were comparable 34 (IQR 25–46) vs. 32 (IQR 25–44) for IG and CG, respectively (p = 0.579). The IG did not present higher overall satisfaction (90 ± 15 vs. 82.9 ± 16, p = 0.057), and pain at Day 2 was similar (1.3 ± 1.7 vs. 2 ± 1.9, p = 0.077), while opiate consumption, PONV levels and LOS were comparable. Conclusion: A preoperative dialogue with a patient-centered approach helped to reduce preoperative anxiety in patients undergoing major visceral surgery.

Efficacy of nonpharmacologic interventions in preoperative anxiety: A systematic review of systematic reviews

“…Most studies apply the intervention in a single session, with an average duration of less than 30 min, anxiety is usually assessed with the State-Trait Anxiety Inventory (STAI), one of the most researched and widely used measures of general anxiety, which is also available in many different languages (Julian, 2011) and 5/emotional support throughout the process (Dias et al, 2022a(Dias et al, , 2022bNg et al, 2022;Ruiz-Hernández et al, 2021) In addition, nurses can work with other health care professionals to develop an individualised treatment plan that addresses specific patient needs (Turunen et al, 2017).…”

“…In addition, they have specific training in patient care and are trained to provide emotional care and support. Thus, nurses can use a variety of strategies and practices aimed at reducing preoperative anxiety and stress, helping patients feel more prepared and confident and improving their emotional well‐being including: 1/effective communication with patients, 2/education: about the procedure, potential complications, pain management and postoperative care, 3/implementing relaxation techniques, 4/creating a calm and relaxing environment both in the waiting room and in the patient's room and 5/emotional support throughout the process (Dias et al, 2022a, 2022b; Ng et al, 2022; Ruiz‐Hernández et al, 2021) In addition, nurses can work with other health care professionals to develop an individualised treatment plan that addresses specific patient needs (Turunen et al, 2017).…”

“…Several studies (Dias et al, 2022a(Dias et al, , 2022bMedina-Garzón, 2019;Ruiz-Hernández et al, 2021;Xu et al, 2020) have found that the preoperative nursing visit can decrease anxiety and postoperative complications. In these visits, nursing professionals, in addition to collecting data and educating patients on how to cooperate during their surgical process, can offer psychological support.…”

“…Nursing professionals play an important role in the perioperative care pathway. Their direct contact with patients and care that provides a close relationship, promotes listening and trust, and addresses both the physical and emotional dimensions, thus helping to reduce their discomfort, fears and preoperative anxiety (Çengel & Andsoy, 2022;Dias et al, 2022aDias et al, , 2022bMedina-Garzón, 2019;Xu et al, 2020).…”

Nurses’ Assessments Versus Patients’ Self-Assessments of Postoperative Pain: Knowledge and Skills of Nurses for Effective Pain Management

“…Giusti et al note in their study that patient self-reported pain assessment is considered the gold standard of assessment and is the most accurate measurement tool [15]. Self-assessment of pain can result in inaccuracy if the patient is influenced by changes in mood, sleep disturbances, or medications [17]. Nurses, on the other hand, may be sceptical of the patient's self-assessment of pain, as they create their own standards of what is acceptable and when and how patients should express their pain [17].…”