Integrative review of non‐pharmacological intervention and multidimensional evaluation for intraoperative anxiety under spinal anaesthesia

Abstract

Introduction Patients under spinal anaesthesia experience high levels of anxiety during surgery. Clinical nurses tried to manage patient's anxiety under spinal anaesthesia using non‐pharmacological interventions for its benefit. Thus, it is required to identify comprehensive evidences of various non‐pharmacological interventions and of how to measure anxiety under spinal anaesthesia. Aims This study aims to review current research on the non‐pharmacological interventions to relieve intraoperative anxiety under spinal anaesthesia and to identify subjective and objective measures of intraoperative anxiety under spinal anaesthesia. Methods Wittemore and Knafl's integrative review methodology was used. Researchers conducted five scientific rigor steps; problem identification, searching literature, evaluation of literature, analysis of literature and presentation of results. The PRISMA checklist was used. To evaluate the level of evidence, critical appraisal tools of Joanna Briggs Institute were used. Results Eleven studies were included in this integrative review. Delivering music is the most frequently used as non‐pharmacological intervention by researchers. They tried to manage intraoperative anxiety under spinal anaesthesia with using diverse genre and application of music. In addition, dry cupping method, progressive muscle relaxation (PMR) exercise and virtual reality (VR) goggles were used in included studies. Researchers measured intraoperative anxiety under spinal anaesthesia with objective or subjective way. The State‐Trait Anxiety Inventory and visual analogue scale were used as subjective method to approach intraoperative anxiety. In contrary, researchers tried to obtain objective evidence of intraoperative anxiety with vital signs, cortisol, blood glucose, alpha‐amylase and adrenocorticotropic hormone. Conclusion Various types of non‐pharmacological interventions are effective to manage patient's intraoperative anxiety under spinal anaesthesia. It is recommended to measure intraoperative anxiety under spinal anaesthesia with using both objective and subjective methods. Relevance to Clinical Practice Clinical nurses can use non‐pharmacological interventions to manage intraoperative anxiety under spinal anaesthesia by comprehensive monitoring with diverse measures.

Barriers and facilitators to medication adherence in patients after PCI surgery: A mixed-methods systematic review

“…Following the example of other systematic reviews, the reviewers predetermined that studies would be assessed as weak (high risk of bias) if up to 49% of the critical appraisal items received positive (yes) scores, adequate (medium risk of bias) if 50%-69% received positive scores, moderate (low risk of bias) if 70%-85% received positive scores, and strong (low risk of bias) if 86%-100% received positive scores. It was decided to exclude studies containing weak evidence [22][23] .…”

Barriers and facilitators to medication adherence in patients after PCI: A mixed-methods systematic review

“…Following the example of other systematic reviews, the reviewers predetermined that studies would be assessed as weak (high risk of bias) if up to 49% of the critical appraisal items received positive (yes) scores, adequate (medium risk of bias) if 50%-69% received positive scores, moderate (low risk of bias) if 70%-85% received positive scores, and strong (low risk of bias) if 86%-100% received positive scores. It was decided to exclude studies containing weak evidence [22,23] .…”