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Cho and Chun: Effect of Structured Information on Immediate Preoperative Anxiety and Uncertainty for Women Undergoing Laparoscopic Hysterectomy
Original Article

Korean J Women Health Nurs 2015;21(4):321-331.

Published online: 17 December 2015

DOI: https://doi.org/10.4069/kjwhn.2015.21.4.321

Effect of Structured Information on Immediate Preoperative Anxiety and Uncertainty for Women Undergoing Laparoscopic Hysterectomy

Youn Hee Cho1, Nami Chun2,

1Uijeongbu St. Mary's Hospital, Uijeongbu, Korea

2Department of Nursing, Sungshin Women's University, Seoul, Korea

Corresponding author: Chun, Nami Department of Nursing, Sungshin Women's University, 55 Dobongro, 76ga-guil, Gangbuk-gu, Seoul 01133, Korea. Tel: +82-2-920-7523, Fax: +82-2-920-2092, E-mail: nmchun@sungshin.ac.kr

Received 18 November 20153 December 2015       Accepted 9 December 2015

Copyright © 2015 Korean Society of Women Health Nursing

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

Purposeof this studywas toidentifythe effect of structuredinformationonimmediatepreoperative anxiety anduncertainty for womenundergoingtotal laparoscopic hysterectomy.

Methods

Sixtywomen who wereadmitted fortotal laparoscopic hysterectomywere recruitedatauniversityhospital inGyeonggi-do fromJunetoOctober 2014. Thirty womenwere assignedto either theexperimentalor the control group. Womenintheexperimentalgroupwere providedstructuredinformation, whichconsistedof visualandauditorymaterialsabout surgical preparationandproc-ess, practical experience ondevices suchas IV-PCA pumpand Inspirometer and actual experienceonroute togo to the operating room. State-anxiety, uncertainty, and blood pressure and pulse rate as biological indicators were measuredbefore and after the intervention to examinetheeffect.

Results

Significant group differenceswere found onstate anxiety, uncertainty, includingambiguity, inconsistency, andunpredictabilityat theholdingarea. There was a significant difference onpulse rate in the operating room between the two groups.

Conclusion

Findings demonstrated that the structured information provided for women undergoing laparoscopic hysterectomy preoperatively was effectiveonimmediatepreoperativeanxietyanduncertainty. Nursesmaycontributetodecreasingpatients'anxiety and uncertainty by utilizing this structured information preoperatively.

Keywords: Hysterectomy, Anxiety, Uncertainty

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Table 1.
Program Content
Classification Contents Method Subjects/time
Anatomy · Anatomy of female reproductive system Presentation  
Operation · Indication of laparoscopic hysterectomy Presentation Subjects: group or individual
· Procedure of laparoscopic hysterectomy
Preoperative preparation · Surgical gowning Presentation Time Presentation: 15 min
· Removal of accessaries and denture
· Preoperative NPO
Actual experience of route to the operating room · Preoperative preparation immediately before Presentation practice, actual route experience Practice: 15minActual route experience: 15min
leaving patient room
· Environment of operating area
· Tour to the operation room
· Operation hour
· Location of family waiting area
· Location of recovery room
Holding area · Patient safety: checking patient name and surgery site Presentation  
Operating room · Patient monitoring Presentation
· Induction of anesthesia
· Operation preparation
Recovery area · Recovery environment Presentation
· Recovery room care
· Recovery time
· Transferring to patient room
Post operative care · Inspirometer, IV-PCA Presentation, practice
· Care of drain and removal time
· Foley catheter
· Deep breathing and active coughing
· Early ambulation
Table 2.
Homogeneity test for General Characteristics and Research Variables (N=60)
Characteristics Categories Exp. (n=30) Cont. (n=30) x2 or t p
n (%) or M±SD n (%) or M±SD
Age (year)   54.67±6.74 54.57±7.86 0.05 .958
Education Primary school 2 (6.7) 0 (0.0) 5.19 .158
  Middle school 13 (43.3) 11 (36.7)    
  High school 15 (50.0) 16 (53.3)    
  College ≥ 0 (0.0) 3 (10.0)    
Job Yes 6 (20.0) 5 (16.7) 0.11 .739
  No 24 (80.0) 25 (83.3)    
Religion Catholic 9 (30.0) 5 (16.7) 2.42 .659
  Protestant 9 (30.0) 8 (26.7)    
  Buddhism 7 (23.3) 8 (26.7)    
  None 4 (13.3) 7 (23.3)    
  Other 1 (3.3) 2 (6.7)    
Marital status Not married 2 (6.7) 0 (0.0) 2.37 .306
  Married 25 (83.3) 28 (93.3)    
  Other 3 (10.0) 2 (6.7)    
History of previous Yes 6 (20.0) 7 (23.4) 0.13 .936
operation No 24 (80.0) 23 (76.7)    
Menopause Yes 22 (70.0) 23 (76.7) 0.34 .559
  No 8 (30.0) 7 (23.3)    
State anxiety   46.00±3.06 45.67±3.96 -0.37 .717
Uncertainty   99.43±7.42 99.50±8.65 0.03 .975
Ambiguity   46.57±3.53 46.40±4.78 -0.15 .879
Complexity   17.97±3.04 17.10±3.85 -0.97 .338
Inconsistency   18.73±3.16 19.16±3.33 0.52 .607
Unpredictability   16.17±2.70 16.83±2.78 0.94 .350
Systolic BP (mmHg)   125.93±16.19 126.70±15.28 0.19 .851
Diastolic BP (mmHg)   76.60±13.26 78.23±13.00 0.48 .632
Pulse rate (beat per minute) 69.43±11.46 69.33±10.12 -0.04 .972

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

Table 3.
Differences in State Anxiety and Uncertainty Between Two Groups (N=60)
Variables Groups Pretest Posttest Difference (pre-post) t p
M+SD M±SD
State anxiety Exp. 46.00±3.06 40.90+2.42 5.10+3.14 11.86 .001
Cont. 45.67±3.96 50.47+3.69 -4.80+3.99    
Uncertainty Exp. 99.43±7.42 81.23+10.50 18.20+10.70 10.67 <.001
Cont. 99.50±8.65 105.00+6.20 -5.50+5.82    
Ambiguity Exp. 46.57±3.53 30.83+9.97 15.74+9.64 9.60 <.001
Cont. 46.40±4.78 49.40+3.57 -3.00+2.81    
Complexity Exp. 17.97±3.04 17.63+2.78 0.34+1.06 0.97 .335
Cont. 17.10±3.85 18.33+2.80 -1.23+2.10    
Inconsistency Exp. 18.73±3.16 18.17+2.76 0.56+2.01 3.00 .004
Cont. 19.16+3.33 20.63+3.55 -1.47+1.66    
Unpredictability Exp. 16.17±2.70 14.60+2.17 1.57+2.27 3.49 .001
Cont. 16.83 + 2.78 16.63+2.34 0.20+2.51    

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

Table 4.
Differences in Blood Pressure and Pulse Rate Between Two Groups (N=60)
Variables Site taken Exp. Cont. t p
M±SD M±SD
Systolic BP (mmHg) Patient room 125.93±16.19 126.70±15.28 0.18 .851
  Holding area 123.67±13.55 128.70±19.12 1.17 .244
  Operating room 127.60±12.16 133.77±13.45 1.86 .068
Diastolic BP (mmHg) Patient room 76.60±13.26 78.23±13.00 0.48 .632
  Holding area 76.70±13.36 79.23±12.70 0.75 .455
  Operating room 76.33±11.96 82.57±16.87 1.65 .104
Pulse rate Patient room 69.43±11.46 69.33±10.12 -0.03 .972
(beat per minute) Holding area 69.43±11.46 75.17±17.50 1.50 .139
  Operating room 70.57±9.98 82.60±18.66 3.12 .003

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

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