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Lee and Park: The Effect of Visual Information Blocking Nursing Intervention on Stress and Anxiety during Chemoport Insertion in Adult Cancer Patients of Operation Rooms
Original Article

Korean J Adult Nurs 2018;30(2):194-205.

Published online: 21 April 2018

DOI: https://doi.org/10.7475/kjan.2018.30.2.194

The Effect of Visual Information Blocking Nursing Intervention on Stress and Anxiety during Chemoport Insertion in Adult Cancer Patients of Operation Rooms

Mimi Lee1, Wanju Park2,

1National Health Insurance Service, Wonju, Korea

2College of Nursing · The Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea

Corresponding author: Park, Wanju https://orcid.org/0000-0002-6452-9056 College of Nursing, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea. Tel: +82-53-420-4977, Fax: +82-53-421-2758, E-mail: wanjupark@knu.ac.kr

Received 31 January 201825 March 2018       Accepted 11 April 2018

Copyright © 2018 Korean Society of Adult 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

The purpose of this study was to test the effect of visual information blocking nursing intervention (VIBNI) on stress and anxiety of patients undergo chemoport insertion in operating rooms.

Methods

A non-equivalent control quasi-experimental design was used. Forth eight participants were enrolled and randomized to experimental group (VIBNI group, n=24) and control group (n=24). All participants received chemoport insertion under local anesthesia. During chemoport insertion, participants allocated to the VIBNI group had their both eyes covered with gamma-sterilized white gauze (5cm × 20cm, 0.5cm in thickness and 4g in weight) that can transmit light of 330Lux. Data from 43 participants were analysed after excluding 5 participants who withdrew (3 in the VIBNI group, and 2 in the control group) due to hypertension and anxiety history. Blood pressure and pulse were measured for stress. Blood sample (3 mL) was obtained before and during the procedure to measure serum cortisol level. State anxiety and VAS was measured for anxiety.

Results

The difference of cortisol level between two groups was statistically significant after VIBNI intervention (p=.007). In terms of systolic blood pressure (p=.005) and pulse (p<.001), interaction of two groups appeared to be significant over time.

Conclusion

In our sample, participants received the VIBNI reported lower stress responses (cortisol level, systolic blood pressure and pulse) during chemoport insertion. Based upon our preliminary results, further evaluation in a larger sample and objective anxiety is warranted.

Keywords: Local anesthesia, Stress, Anxiety, Operating rooms

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Figure 1.
Flow diagram for reporting parallel group randomized trials (CONSORT statement).
kjan-30-194f1.tif
Figure 2.
Comparison of stress level and anxiety level change between experimental and control groups.
kjan-30-194f2.tif
Table 1.
Homogeneity of General, Operation-related Characteristics, Stress, and Axiety between Experimental and Control Groups (N=43)
Variables Categories Exp. (n=21) Cont. (n=22) x2 or t or Z p
n (%) or M± SD n (%) or M± SD
General Age (year) 57.48±11.74 54.27±12.24 0.88 .386
Gender Male 11 (54.2) 18 (81.8) -2.04 .042
Female 10 (47.6) 4 (18.2)
Spouse Yes 4 (19.0) 3 (13.6) -0.48 .635
No 17 (81.0) 19 (86.4)
Religion Yes 12 (57.1) 11 (50.0) -0.46 .643
No 9 (42.9) 11 (50.0)
Occupation Yes 12 (57.1) 12 (57.1) -0.16 .865
No 9 (42.9) 10 (45.5)
Chronic disease Yes 7 (33.3) 4 (18.2) .1.13 .261
No 14 (66.7) 18 (81.8)
Pain Yes 9 (42.9) 13 (59.1) -1.05 .293
No 12 (57.1) 9 (40.9)
Education level ≤ Middle school 6 (28.6) 6 (27.3) -0.62 .538
High school 11 (52.4) 9 (40.9)
≥ College 4 (19.0) 7 (31.8)
Operation Operation hours (mins) 40.81±8.21 39.64±9.76 -0.61 .542
Operation history (times) 1.33±0.97 1.23±0.69 -0.37 .709
History of local anesthesia Yes 11 (52.4) 11 (50.0) -0.15 .877
No 10 (47.6) 11 (50.0)
Surgeons A 7 (33.3) 7 (33.3) -0.34 .731
B 9 (42.9) 12 (54.5)
C 5 (23.8) 3 (13.6)
Diagnosis Colon cancer 11 (52.4) 11 (50.0) -0.15 .877
Rectal cancer 10 (47.6) 11 (50.0)
Stress Cortisol (㎍/dL)† 15.36±7.72 12.17±5.07 1.63 .386
SBP (mmHg) 126.43±14.28 125.95±14.78 0.11 .915
DBP (mmHg) 77.10±13.07 76.64±7.10 0.14 .886
Pulse (beats/min) 76.19±13.11 76.95±12.67 -0.10 .919
Anxiety SAI (total score)† 51.10±10.68 48.27±10.74 -0.38 .704
VAS (cm)† 4.76±3.08 4.23±2.31 -.1.17 .242

Exp.=experimental group; Cont.=control group; A, B. C=initial of individual surgeons; SBP=systolic blood pressure; DBP=diastolic blood pressure; SAI=state anxiety inventory; VAS=visual analogue scale;

† Mann Whitney U test.

Table 2.
Comparison of real-time SBP, DBP, and Pulse between Experimental and Control Groups (N=43)
Variables Real-time Exp. (n=21) Cont. (n=22) F† (p) Time Group Group∗Time
M± SD M± SD F† (p) F† (p) F† (p)
SBP (mmHg) Pre-test 126.43±14.28 125.95±14.78 0.07 (.800) 1.65 (.206) 0.03 (.865) 9.02 (.005)
Pre-op 123.76±16.55 119.64±13.78 0.93 (.341)
Intra-op 118.71±13.00 118.32±12.96 0.14 (.712)
Post-op 116.00±15.47 119.18±13.37 0.20 (.657)
Post-test 118.38±16.25 125.41±13.10 1.98 (.167)
DBP (mmHg) Pre-test 77.10±13.07 76.64±7.10 0.04 (.849) 0.54 (.466) 0.01 (.942) 2.85 (.099)
Pre-op 75.57±10.24 73.36±7.79 0.89 (.352)
Intra-op 72.33±9.44 71.73±7.99 0.09 (.764)
Post-op 70.62±11.29 73.09±9.75 0.28 (.602)
Post-test 71.48±10.98 75.41±8.51 1.36 (.251)
Pulse (rate/min) Pre-test 76.19±13.11 76.59±12.66 0.31 (.861) 3.11 (.085) 1.55 (.220) 16.60 (＜.001)
Pre-op 76.43±10.90 75.00±11.34 0.01 (.950)
Intra-op 75.10±10.99 76.50±10.18 1.02 (.318)
Post-op 74.57±10.29 76.95±9.09 1.89 (.177)
Post-test 70.19±11.72 78.09±12.06 5.77 (.021)

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

† =after adjusted by covariate (gender).

Table 3.
Comparison of Cortisol and Anxiety between Experimental and Control Groups (N=43)
Variables Groups Pre-test Post-test Difference
M± SD M± SD M± SD Z (p)
Cortisol Exp. (n=21) 15.36±7.72 14.93±7.33 -0.45±1.98 -2.42 (.007)
Cont. (n=22) 12.17±5.07 13.95±7.19 1.77±2.22
SAI Exp. (n=21) 51.10±10.68 41.33±7.72 -9.76±11.96 -1.29 (.101)
Cont. (n=22) 48.27±10.74 43.09±9.52 -5.18±8.96
VAS Exp. (n=21) 4.76±3.08 1.76±2.10 -3.00±2.57 -0.86 (.199)
Cont. (n=22) 4.23±2.31 2.09±1.69 -2.14±2.80

Exp.=experimental group; Cont.=control group; SAI=state anxiety inventory; VAS=visual analogue scale; Z=Mann Whitney U test.

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