Effect of Preoperative Education using Multimedia on Pain, Uncertainty, Anxiety and Depression in Hysterectomy Patients

Sooran Jeon; Hyojung Park

doi:10.4069/kjwhn.2016.22.1.39

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Jeon and Park: Effect of Preoperative Education using Multimedia on Pain, Uncertainty, Anxiety and Depression in Hysterectomy Patients

Original Article

Korean Journal of Women Health Nursing 2016; 22(1): 39-47.

Published online: 26 March 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.1.39

Effect of Preoperative Education using Multimedia on Pain, Uncertainty, Anxiety and Depression in Hysterectomy Patients

Sooran Jeon, Hyojung Park

College of Nursing, Ewha Womans University, Seoul, Korea.

Corresponding author: Park, Hyojung. College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea. Tel: +82-2-3277-2824, Fax: +82-2-3277-2850, hyojungp@ewha.ac.kr

Received 13 January 2016 Revised 6 March 2016 Accepted 12 March 2016

(open-access):

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 examine the effect of preoperative education using multimedia on level of pain, uncertainty, anxiety and depression in hysterectomy patients.

Methods

A non-equivalent control group, with a pretest-posttest design was used in this study. The level of post operation pain, pre and post operation uncertainty, anxiety and depression of both the groups was measured. The experimental group was provided with preoperative education using multimedia on the preoperative day at the hospital. The control group was only given usual care. Data were analyzed using SPSS/WIN version 22.0 program.

Results

Experimental group showed lower level of post-operation pain in 1 hour (t=-5.08, p<.001) and 24 hours (t=-5.20, p<.001) but not 48 hours (t=-0.91, p=.368). Uncertainty showed significant interaction effect of Group by Time (F=4.16, p=.018).

Conclusion

Preoperative education using multimedia for patients with hysterectomy would be effective in lowering patients' level of pain, uncertainty, anxiety and depression.

Keywords: Hysterectomy, Multimedia, Pain, Uncertainty, Anxiety

Figures and Tables

Table 1

Homogeneity Test of Characteristics between Two Group (N=60)

Characteristics	Categories	Exp. (n=30)	Cont. (n=30)	x² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	x² or t	p
Age (year)		49.3±4.4	48.0±3.7	1.24	.221
Type of operation^†	TAH	1 (3.3)	6 (20.0)	4.04	.103
Type of operation^†	TLH	29 (97.7)	24 (80.0)	4.04	.103
Education	High school	22 (73.3)	23 (76.7)	0.09	.766
Education	≥University	8 (26.7)	7 (23.3)	0.09	.766
Occupation	Have	15 (50.0)	15 (50.0)	0.00	1.000
Occupation	Do not have	15 (50.0)	15 (50.0)	0.00	1.000
Marital status	Married	27 (90.0)	29 (96.7)	1.07	.301
Marital status	Other	3 (10.0)	1 (3.3)	1.07	.301
Religion^†	Christianity	8 (26.7)	8 (26.7)	1.22	.814
	Buddhism	3 (10.0)	5 (16.7)
	Catholic	1 (3.3)	2 (6.7)
	None	18 (60.0)	15 (50.0)
Hospitalization experience	No	1 (3.3)	1 (3.3)	-0.65	.519
Hospitalization experience	Once and more	29 (96.7)	29 (96.7)	-0.65	.519
Surgery experience	No	9 (30.0)	5 (16.7)	-0.92	.364
Surgery experience	Once and more	21 (70.0)	25 (83.3)	-0.92	.364
Past history	No	23 (76.7)	20 (62.5)	3.88	.567
Past history	Yes	7 (23.3)	10 (37.5)	3.88	.567

^†Fisher's exact test; Exp.=experimental group; Cont.=control group; TAH=total abdominal hysterectomy; TLH=total laparoscopic hysterectomy.

Table 2

Homogeneity Test of Dependent Variable between Two Group (N=60)

Variables	Exp. (n=30)	Cont. (n=30)	t	p
Variables	M±SD	M±SD	t	p
Uncertainty	83.00±12.78	80.00±15.21	0.81	.422
Anxiety and depression	12.73±05.96	13.77±07.85	-0.57	.568

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

Table 3

Comparison and Difference of Pain between the Experimental and Control Group (N=60)

Pain		Exp. (n=30)	Cont. (n=30)	t	p
Pain		M±SD	M±SD	t	p
Postoperative pain	1 hour	5.87±1.46	7.87±1.59	-5.08	.001
	24 hours	2.03±0.93	3.73±1.53	-5.20	.001
	48 hours	1.77±0.86	1.97±0.85	-0.91	.368

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

Table 4

Comparison and Difference of Uncertainty between the Experimental and Control Group (N=60)

Uncertainty		Exp. (n=30)	Cont. (n=30)	F (p)
Uncertainty		M±SD	M±SD	F (p)
Pretest	Admission day	80.53±12.21	77.80±14.75	Group	0.06 (.814)
Posttest	Operation day 7AM	76.87±12.49	81.00±13.73	Time	6.34 (.002)
	Post operation 2nd day	74.97±12.23	75.80±14.07	Group·Time	4.16 (.018)

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

Table 5

Comparison and Difference of Anxiety and Depression between the Experimental and Control Group (N=60)

Anxiety and depression		Exp. (n=30)	Cont. (n=30)	F (p)
Anxiety and depression		M±SD	M±SD	F (p)
Pretest	At admission day	12.73±5.96	13.77±7.85	Group	1.43 (.237)
Posttest	Operation day 7AM	12.47±5.41	15.77±6.35	Time	7.06 (.001)
Posttest	Post operation 2nd day	11.17±5.22	12.07±7.26	Group·Time	1.99 (.141)

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

Notes

This article is a condensed form of the first author's master's thesis from Ewha Womans University.

Summary Statement

▪ What is already known about this topic?

Women who underwent hysterectomy have faced various psychological challenges such as anxiety and depression, because for women, historically; the uterus is regarded as the symbol of women-hood.

▪ What this paper adds?

Preoperative education using multimedia is an effective method in alleviating postoperative pain and pre and post operation uncertainty in patients with hysterectomy.

▪ Implications for practice, education and/or policy

Preoperative education using multimedia may be a useful educational method in hospital.

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