Tags

Type your tag names separated by a space and hit enter

A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: a randomized controlled trial.
Int J Nurs Stud 2012; 49(2):129-37IJ

Abstract

BACKGROUND

Patients awaiting cardiac surgery typically experience significant physical and psychological stress. However, although there is evidence that preoperative education interventions can lead to positive postoperative outcomes for surgical patients in general, less is known about the effectiveness among patients undergoing cardiac surgery, especially Chinese cardiac patients.

OBJECTIVES

To determine whether a preoperative education intervention designed for Chinese cardiac patients can reduce anxiety and improve recovery.

DESIGN

Randomized controlled trial.

SETTINGS

Cardiac surgical wards of two public hospitals in Luoyang, China.

METHODS

153 adult patients undergoing cardiac surgery were randomized into the trial, 77 to a usual care control group and 76 to preoperative education group comprising usual care plus an information leaflet and verbal advice. Measurement was conducted before randomization and at seven days following surgery. The primary outcome was change in anxiety measured by the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes were change in depression (HADS), change in pain as measured by subscales of the Brief Pain Inventory-short form (BPI-sf), length of Intensive Care Unit stay and postoperative hospital stay.

RESULTS

Of 153 participants randomized, 135 (88.2%) completed the trial. Participants who received preoperative education experienced a greater decrease in anxiety score (mean difference -3.6 points, 95% confidence interval -4.62 to -2.57; P<0.001) and a greater decrease in depression score (mean difference -2.1 points, 95% CI -3.19 to -0.92; P<0.001) compared with those who did not. There was no difference between groups in average pain, current pain, and interference in general activity, mood and walking ability. Patients randomized to the preoperative education group reported less interference from pain in sleeping (mean difference -0.9 points, 95% CI -1.63 to -0.16; P=0.02). There was some evidence to suggest a reduced number of hours spent in the Intensive Care Unit among preoperative education patients (P=0.05) but no difference in length of postoperative hospital stay (P=0.17).

CONCLUSIONS

This form of preoperative education is effective in reducing anxiety and depression among Chinese cardiac surgery patients. Based upon existing evidence and international practice, preoperative education should be incorporated into routine practice to prepare Chinese cardiac patients for surgery.

Authors+Show Affiliations

School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Nottingham, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21943828

Citation

Guo, Ping, et al. "A Preoperative Education Intervention to Reduce Anxiety and Improve Recovery Among Chinese Cardiac Patients: a Randomized Controlled Trial." International Journal of Nursing Studies, vol. 49, no. 2, 2012, pp. 129-37.
Guo P, East L, Arthur A. A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: a randomized controlled trial. Int J Nurs Stud. 2012;49(2):129-37.
Guo, P., East, L., & Arthur, A. (2012). A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: a randomized controlled trial. International Journal of Nursing Studies, 49(2), pp. 129-37. doi:10.1016/j.ijnurstu.2011.08.008.
Guo P, East L, Arthur A. A Preoperative Education Intervention to Reduce Anxiety and Improve Recovery Among Chinese Cardiac Patients: a Randomized Controlled Trial. Int J Nurs Stud. 2012;49(2):129-37. PubMed PMID: 21943828.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: a randomized controlled trial. AU - Guo,Ping, AU - East,Linda, AU - Arthur,Antony, Y1 - 2011/09/22/ PY - 2011/04/04/received PY - 2011/08/11/revised PY - 2011/08/22/accepted PY - 2011/9/28/entrez PY - 2011/9/29/pubmed PY - 2012/6/29/medline SP - 129 EP - 37 JF - International journal of nursing studies JO - Int J Nurs Stud VL - 49 IS - 2 N2 - BACKGROUND: Patients awaiting cardiac surgery typically experience significant physical and psychological stress. However, although there is evidence that preoperative education interventions can lead to positive postoperative outcomes for surgical patients in general, less is known about the effectiveness among patients undergoing cardiac surgery, especially Chinese cardiac patients. OBJECTIVES: To determine whether a preoperative education intervention designed for Chinese cardiac patients can reduce anxiety and improve recovery. DESIGN: Randomized controlled trial. SETTINGS: Cardiac surgical wards of two public hospitals in Luoyang, China. METHODS: 153 adult patients undergoing cardiac surgery were randomized into the trial, 77 to a usual care control group and 76 to preoperative education group comprising usual care plus an information leaflet and verbal advice. Measurement was conducted before randomization and at seven days following surgery. The primary outcome was change in anxiety measured by the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes were change in depression (HADS), change in pain as measured by subscales of the Brief Pain Inventory-short form (BPI-sf), length of Intensive Care Unit stay and postoperative hospital stay. RESULTS: Of 153 participants randomized, 135 (88.2%) completed the trial. Participants who received preoperative education experienced a greater decrease in anxiety score (mean difference -3.6 points, 95% confidence interval -4.62 to -2.57; P<0.001) and a greater decrease in depression score (mean difference -2.1 points, 95% CI -3.19 to -0.92; P<0.001) compared with those who did not. There was no difference between groups in average pain, current pain, and interference in general activity, mood and walking ability. Patients randomized to the preoperative education group reported less interference from pain in sleeping (mean difference -0.9 points, 95% CI -1.63 to -0.16; P=0.02). There was some evidence to suggest a reduced number of hours spent in the Intensive Care Unit among preoperative education patients (P=0.05) but no difference in length of postoperative hospital stay (P=0.17). CONCLUSIONS: This form of preoperative education is effective in reducing anxiety and depression among Chinese cardiac surgery patients. Based upon existing evidence and international practice, preoperative education should be incorporated into routine practice to prepare Chinese cardiac patients for surgery. SN - 1873-491X UR - https://www.unboundmedicine.com/medline/citation/21943828/A_preoperative_education_intervention_to_reduce_anxiety_and_improve_recovery_among_Chinese_cardiac_patients:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-7489(11)00331-2 DB - PRIME DP - Unbound Medicine ER -