The Effects of Structured Preoperative Instruction on Anxiety and Self-care Compliance in Patients with Cataract Surgery

Mi Jung Choi; Jeong Sook Park

doi:10.7475/KJAN.2013.25.4.473

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Choi and Park: The Effects of Structured Preoperative Instruction on Anxiety and Self-care Compliance in Patients with Cataract Surgery

Original Research

Korean J Adult Nurs 2013;25(4):473-482.

Published online: 18 August 2013

DOI: https://doi.org/10.7475/KJAN.2013.25.4.473

The Effects of Structured Preoperative Instruction on Anxiety and Self-care Compliance in Patients with Cataract Surgery

Mi Jung Choi¹, Jeong Sook Park^2,

^¹Department of Nursing, Daekyung College, Gyeongsan

^²College of Nursing, Keimyung University, Daegu, Korea

Corresponding author: Park, Jeong Sook College of Nursing, Keimyung University, 1095 Shindang-dong, Dalsseo-gu, Daegu 704-701, Korea. Tel: +82-53-580-3907, Fax: +82-53-580-3904, E-mail: jsp544@kmu.ac.kr

Received 25 January 201331 July 2013 Accepted 19 August 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate the effects of a structured preoperative instruction upon anxiety and postoperative self-care compliance.

Methods

A randomized control group pre-post design was used. Sixty subjects undergoing cataract surgery were randomly assigned to one of two groups. The instruction consisted of cataract surgery procedure, sensory information, deep breathing, use of eye drop, and post op self-care regimen and was provided to the experimental group with control group receiving an usual treatment. State anxiety NRS, pulse, BP, and self-care compliance scale developed by Cho & Rho were used. Data were collected at two time periods: on the day of surgery in the clinic and prior to anesthesia in the operating room. The postoperative self-care compliance scores were measured at their second visits to the hospital after surgery. Data were analyzed using Kolmogorov Smirnov test, t-test, and Mann-Whitney U test.

Results

There were significant differences between the two groups in the postoperative state anxiety (t=-3.57, p=.001) and the postoperative self-care compliance score (t=3.92, p<.001). There were no significant difference between the two groups in the postoperative blood pressure and pulse rate.

Conclusion

The results of this study suggest that the structured preoperative instruction could be a nursing intervention for cataract surgery patients.

Keywords: Structured preoperative instruction, Anxiety, Self-care compliance, Cataract surgery

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Table 1.

Homogeneity Test of General Characteristics and Pretest Dependent Variables (N=60)

Characteristics or variables	Categories	Exp. (n=30)	Cont. (n=30)	x² or t	p
Characteristics or variables	Categories	n (%) or M±SD	n (%) or M±SD	x² or t	p
Gender	Male	13 (43.3)	13 (43.3)	0.00	1.000
Gender	Female	17 (56.7)	17 (56.7)	0.00	1.000
Age (year)	＜60	7 (23.3)	8 (26.7)	2.75	.252
	60~69	8 (26.7)	13 (43.3)	1.30	.197
	≥70	15 (50.0)	9 (30.0)
	Mean age	68.13±11.12	64.77±8.74
Education level	≤Elementary school	19 (63.3)	12 (40.0)	8.06	.073^†
	Middle school	2 (6.7)	4 (13.3)
	≥High school	9 (30.0)	14 (46.7)
Occupation	Yes	10 (33.3)	8 (26.6)	10.39	.065
Occupation	No	20 (66.7)	22 (73.4)	10.39	.065
Monthly income (10,000 won)	＜100	23 (76.7)	20 (66.7)	6.20	.105^†
	100~200	3 (10.0)	9 (30.0)
	＞200	4 (13.3)	1 (3.3)
Accompanier	Spouse	8 (26.7)	11 (36.7)	3.39	.372^†
	Son or Daughter	15 (50.0)	17 (56.7)
	Relative	3 (10.0)	1 (3.3)
	None	4 (3.3)	1 (3.3)
Smoking	Yes	8 (26.7)	5 (16.7)	0.88	.532^†
Smoking	No	22 (73.3)	25 (83.3)	0.88	.532^†
Knowledge of cataract	Do not know	19 (63.3)	17 (56.7)	0.27	.598
Knowledge of cataract	Know a little bit	11 (36.7)	13 (43.3)	0.27	.598
Type of anesthesia	Topical	15 (50.0)	13 (43.3)	0.26	.605
Type of anesthesia	Retrobulbar	15 (50.0)	17 (56.7)	0.26	.605
Anxiety	Trait anxiety	43.47±8.98	45.60±7.33	-1.00	.318
Anxiety	State anxiety	4.53±2.65	3.67±2.36	1.33	.187
Blood pressure	SBP	135.23±20.48	135.27±20.70	438.00	.859^‡
Blood pressure	DBP	78.03±10.96	81.00±12.89	-0.96	.341
Pulse rate		76.80±12.96	79.30±16.10	-0.66	.510

Exp.=experimental group; Cont.=control group; SBP=systolic blood pressure; DBP=diastolic blood pressure.

^† Fisher's exact test;

^‡ Mann-Whitney U test.

Table 2.

Mean Differences in Dependent Variables between Experimental and Control Group (N=60)

Variables	Groups	Pretest	Posttest	Difference	t or U	p
Variables	Groups	M±SD	M±SD	M±SD	t or U	p
State anxiety	Exp. (n=30)	4.53±2.65	3.53±2.47	-1.00±2.32	-3.57	.001
State anxiety	Cont. (n=30)	3.67±2.37	4.47±2.39	0.80±1.49	-3.57	.001
SBP	Exp. (n=30)	135.23±20.48	146.70±30.65	11.47±22.79	384.50	.333^†
SBP	Cont. (n=30)	135.27±20.70	152.13±27.29	16.87±18.34	384.50	.333^†
DBP	Exp. (n=30)	78.03±10.96	77.83±11.18	-0.20±14.31	-0.33	.743
DBP	Cont. (n=30)	81.00±12.89	81.90±14.65	0.90±11.37	-0.33	.743
Pulse rate	Exp. (n=30)	76.80±12.96	66.37±12.48	-10.43±6.21	-1.78	.079
Pulse rate	Cont. (n=30)	79.30±16.11	72.17±16.21	-7.13±7.99	-1.78	.079

Exp.=experimental group; Cont.=control group; SBP=systolic blood pressure; DBP=diastolic blood pressure.

^† Mann-Whitney U test.

Table 3.

Comparison of Self-care Compliance Score between Experimental and Control Group (N=60)

Variables	Exp. (n=30)	Cont. (n=30)	t	p
Variables	M±SD	M±SD	t	p
Total	4.39±0.41	3.90±0.54	3.92	＜.001
Eyedrop	4.36±0.54	3.74±0.73	3.69	＜.001
1. I have washed my hands before the eyedrops	4.20±0.92	3.20±1.29	3.43	.001
2. I have not let the tip of bottle touch the eye or eyelid	4.30±0.79	3.60±1.00	2.99	.004
3. I have instilled eyedrops as indicated frequency	4.67±0.60	4.47±0.77	1.11	.271
4. I have instilled different eyedrops at 5-minute intervals	4.27±1.23	3.70±1.39	1.67	.100
Hygene	4.01±1.25	3.39±1.38	1.82	.073
5. I have washed my hair but did not wet in my operated eye	3.37±1.97	2.47±1.96	1.77	.082
6. I have washed my face but did not wet in my operated eye	4.87±0.73	4.57±1.22	1.15	.254
7. I have washed shower but did not wet in my operated eye	3.80±1.86	3.13±2.03	1.32	.190
Protection of operation site	4.40±0.86	3.96±0.93	1.87	.066
8. I have applied protective eye shield during bedtime	3.97±1.52	3.37±1.60	1.48	.143
9. I have refrained from rubbing or compressing the eye	4.83±0.37	4.57±0.67	1.87	.065
Daily life	4.79±0.34	4.52±0.42	2.70	.009
10. I have visited the clinic on the reservation date	5.00±0.00	4.90±0.40	1.36	.179
11. I have continued normal daily actives, included watching TV, cooking, cleaning	4.37±1.03	3.93±0.82	1.79	.078
12. I have avoided strenuous exercise like soccer and swimming	5.00±0.00	4.73±0.69	2.11	.039

Exp.=experimental group; Cont.=control group.

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