Evaluation of Preoperative Nursing Intervention on Anxiety State and Post Operative Pain Among Surgical Patients of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife Osun State
Preoperative anxiety is a challenging concept in the preoperative care of patients and its incidence varies with different settings. The experience of anxiety state has been linked with the aggravation of pain intensity experienced by surgical patients after their procedures. The study evaluated nursing intervention on the relief of anxiety state and post-operative pain among surgical patients in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
A Quasi-experimental study was conducted among thirty booked adult surgical patients (age=25-80 years) for abdominal surgeries from February 10th and March 15th, 2017. Convenient sampling technique was used to select the surgical patients by “first come first serve” into control and experimental groups, each group having 15 surgical patients. Two standardized assessment tools (State Anxiety Inventory scale and Numeric Rating scale) were adopted in the questionnaire used for the collection of data of anxiety state and pain intensity among patients before and after their procedures respectively. A planned training module was pre-tested and found suitable for the study. The data were processed through statistical package for social sciences (SPSS), version 20 using descriptive statistics such as mean, standard deviation, and inferential statistics such as Chi-square, to determine the relationship of the variables and test the hypothesis at 0.05 level of significance.
The findings revealed that no standard assessment tool for measurement of anxiety state and pot-operative pain before or after their surgical. The mean baseline anxiety levels of the surgical patients (both experimental (1.74) and control (1.79)) were high before surgery but reduced after their surgeries respectively (1.66 and 1.64 respectively). The surgical patients experienced moderate and severe levels of pain intensity before surgery with mean baseline pain intensity of 3.47 in experimental and 2.95 in the control surgical patients. There was an aggravation of pain intensity experienced by the surgical patients postoperatively with mean values of 4.46 in the experimental and 4.92 in the control groups respectively. There was no significant relationship between nursing intervention for the relief of preoperative anxiety and control of postoperative pain (p=0.514 and 0.413 respectively), even though the preoperative nursing intervention administered on the experimental group brought about reduction of post-operative pain, the rate of reduction was not as marked as compared with the control group without the planned preoperative intervention. There was no significant relationship between gender of surgical patients and their response to nursing intervention for the relief of anxiety (p=0.744) and postoperative pain (p=0.105). Likewise, there was no significant relationship between educational levels of surgical patients and their response to nursing intervention for the relief of anxiety (p=0.163) and postoperative pain (p=0.604) respectively.
The study concluded that the experience of anxiety and pain among surgical patients is a common phenomenon. The study recommended that patient-centered approach should be employed in the assessment and intervention for the relief of anxiety states and post-operative pain.
Keywords: Anxiety state, Preoperative anxiety, Nursing intervention, Post-operative pain