Effects of Non-pharmacological Interventions for Preoperative Anxiety in Surgical Patient: A Systematic Review and Meta-analysis

Kim, Hyeon Young; Lee, Myung Nam

Abstract

PURPOSE
The purpose of this study was to examine the effects of non-pharmacological interventions for preoperative anxiety in surgical patient.
METHODS
The search included the following: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL EMBASE, and Korean electronic databases (2000 to November 2018). Risk of bias in randomized studies was assessed using the Cochrane's Risk of Bias (RoB) tool for randomized studies and for non-randomized studies, the Risk of Bias Assessment tool for Non-randomized studies (RoBANS) was used. To estimate the effect size, meta-analysis of the studies was performed using the R program (version 3.5.1).
RESULTS
Nineteen trials were included (1,685 participants). The non-pharmacological interventions for preoperative anxiety in surgical patient were music intervention, aromatherapy, and patient education. Specifically, the twelve studies showing the effect of music intervention on anxiety were heterogeneous (Ï‡²=23.42, p=.05, I²=40%). The effect size was âˆ’0.77 (95% CI:âˆ’0.93, âˆ’0.60). The four studies showing the effect of aromatherapy on anxiety were heterogeneous (Ï‡²=8.95, p=.03, I²=66%). The effect size was âˆ’0.83 (95% CI: âˆ’1.30, âˆ’0.36). The three studies measuring the effect of patient education on anxiety identified as homogeneous (Ï‡²=1.95, p=.38, I²=0%). The effect size was âˆ’2.85 (95% CI: âˆ’5.00, âˆ’0.71).
CONCLUSION
This meta-analysis indicates that non-pharmacological interventions including music intervention, aromatherapy and patient education may have a beneficial effect on preoperative anxiety. Therefore, the findings of this study provide evidence to incorporate various non-pharmacological interventions into nursing practice to reduce preoperative anxiety.