Journal List > Korean J Adult Nurs > v.25(5) > 1076211

Korean J Adult Nurs. 2013 Oct;25(5):494-503. Korean.
Published online October 31, 2013.
© 2013 Korean Society of Adult Nursing
Effects of a Simulation-based Educational Program for Gastroendoscopic Surgery Patients
Su Young Kwon,1 and Jia Lee2
1Education Graduate School, Kyung Hee University, Seoul, Korea.
2College of Nursing Science, Kyung Hee University, Seoul, Korea.

Corresponding author: Lee, Jia. College of Nursing Science, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Korea. Tel: +82-2-961-0894, Fax: +82-2-961-9398, Email:
Received May 20, 2013; Revised October 23, 2013; Accepted October 25, 2013.



The purpose of this study was to examine the effects of a simulation-based educational program on anxiety and discomfort in patients with early stage of stomach cancer or stomach adenoma undergoing gastroendoscopic surgery.


The study employed a non-equivalence control group and non-synchronized design to prevent diffusion of treatment. Data were collected from 110 patients (experimental group=55, control group=55) admitted to a department of gastroenterology to undergo gastroendoscopic surgery for early stage of stomach cancer or stomach adenoma. The program was conducted as a 30-minute simulation-based education including 12 processes which patients would experience. Outcome variables were state anxiety, objective discomfort, and subjective discomfort.


The scores of state anxiety in the experimental group significantly decreased over time compared to those in the control group. The scores of objective and subjective discomfort after surgery in the experimental group were significantly lower than those in the control group.


The study findings suggested that the simulation-based educational program making a person feel sense of real experiences could reduce anxiety and discomfort in gastroendoscopic surgery patients.

Keywords: Anxiety; Surgery; Endoscopy; Program


Figure 1
Research design.
Click for larger image


Table 1
Simulation-based Educational Program for Gastroendoscopic Surgery Patients
Click for larger image

Table 2
Homogeneity Test of General Characteristics and Anxiety of Participants (N=110)
Click for larger image

Table 3
Changes of State Anxiety over Time and after Age Control (N=110)
Click for larger image

Table 4
Comparison of Objective and Subjective Discomfort after Surgery (N=110)
Click for larger image


This article is a revision of the first author's master's thesis from Kyung Hee University.

The study was partially funded by the New Faculty Research Grant by Kyung Hee University (No. 20061245).

1. Cherla DV, Sanghvi S, Choudhry OJ, Liu JK, Eloy JA. Readability assessment of internet-based patient education materials related to endoscopic sinus surgery. Laryngoscope 2012;122:1649–1654. [doi: 10.1002/lary.23309]
2. Choi JY, Kim JI, Choi YC, Jun SY. Two cases of histopathologically advanced (stage 4) early gastric cancer. The Korean Journal of Gastroenterology 2005;45:64–67.
3. Classen M, Tytgat GNJ, Lightdale CJ. In: Gastroenterological endoscopy. New York: Thieme;
4. Cline ME, Herman J, Shaw ER, Morton RD. Standardization of the visual analogue scale. Nursing Research 1992;41:378–380.
5. Dean C, Whitlock Q. In: Handbook of computer based training. London: Kogan Page Ltd; 1994.
6. Faul F, Erdfelder E, Buchner A, Lang AG. In: Statistical power analyses using G. Power 3.1: Tests for correlation and regression analyses. 41. Behavior Research Methods; 2009. pp. 1149-1160.
7. Jang SY. Effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer. Journal of Korean Academy of Nursing 2008;38:493–502.
8. Jo YS. In: The effect of information and behavioral training on endoscopy patient's anxiety and distress. Busan: Dong A University; 2012.
Unpublished master's thesis.
9. Kanto JH. Midazolam: The first water-soluble benzodiazepine. Pharmacology, pharmacokinetics and efficacy in insomnia and anesthesia. Pharmacotherapy 1985;5:138–155.
10. Kim HS. Effects of web-based diabetics education in obese diabetic patients. Journal of Korean Academy of Nursing 2005;35:924–930.
11. Kim JT, Shin DK. A study based on the standardization of the STAI for Korea. The New Medical Journal 1978;21(11):69–75.
12. Korean Society of Gasgtrointestinal Endoscopy. Atlas of gastrointestinal endoscopy. Seoul: Korean Medbook; 2011.
13. Lee HS. The effects of aromatherapy hand massage on anxiety before gastroscopy. The Journal of Korean Academic Society of Nursing Education 2006;12:36–42.
14. Lee JH. Endoscopic resection of early gastric cancer in Korea: Recent results and future directions. Journal of Korean Gastric Cancer Association 2009;9(2):39–45.
15. Lee OJ. In: Influence of video pre-education on the anxiety, biological change and physical reaction of the patients. Seongnam: Gachon University; 2012.
Unpublished master's thesis.
16. Lian J, Chen S, Zhang Y, Qiu F. A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer. Gastrointestinal Endoscopy 2012;76:763–770. [doi: 10.1016/j.gie.2012.06.014]
17. Park CS, Kang KY. Effect of visual biofeedback simulation training for balance in patients with incomplete spinal cord injury. Journal of Korea Contents Association 2011;11(11):194–203. [doi: 10.5392/JKCA.2011.11.11.194]
18. Park IS. In: Gastroenterological endoscopy. Seoul: Koonja Publishing Inc; 2003.
19. Park JH, Kim YJ, Cho JY, Kang GH, Jeong GA, Cho GS, et al. Surgical strategies after incomplete endoscopic resection in early gastric cancer. Korean Journal of Clinical Oncology 2010;6:27–32.
20. Park KS, Na MJ. The effect of music therapy on reduction of anxiety before gastroscopy. Korean Journal of Adult Nursing 2003;15:247–255.
21. Statistics Korea. Cancer rate 2010. 2012 Jan 01; [Retrieved May 6, 2012].
22. Suh HJ. In: The effects of relaxation technique on anxiety and distress of patients with gastrofibroscopy. Seoul: Ewha Womans University; 1990.
Unpublished master's thesis.
23. Wolpe J. In: The practice of behavior therapy. New York: Pergamon Press; 1990.
24. Won YD. Analysis of basic life support performance according to video simulation training of EMT students. The Journal of the Korean Society of Emergency Medical Technology 2011;15(3):5–17.
25. Yoo MS, Lee H, Yoon JA. Effects of a cognitive-behavioral nursing intervention on anxiety and depression in women with breast cancer undergoing radiotherapy. Journal of Korean Academy of Nursing 2009;39:157–165. [doi: 10.4040/jkan.2009.39.2.157]
Similar articles

Effects and Adequacy of High-Fidelity Simulation-Based Training for Obstetrical Nursing

Development and Evaluation of a Web-based Simulation Program on Patient Rights Education using Integrated Decision Making Model for Nurse Students

Medical Simulation

Development and Effectiveness of an Oncology Nursing Standardized Patient Simulation Program for Nursing Students

Development and Effects of a Simulation-based Education Program for Newborn Emergency Care