Effects of preoperati̇ve anxi̇ety management on postoperati̇ve anxi̇ety and pai̇n severi̇ty i̇n pati̇ents undergoi̇ng open heart surgery

Open heart surgery may produce emotional, cognitive, and physiological side effects. Training is essential in preoperative physical and psychological preparation of patients. This study aims to investigate the effects of preoperative anxiety management on postoperative anxiety and pain severity in patients undergoing open heart surgery. This quasi-experimental study included 109 volunteers who were admitted to Baskent University Ankara Hospital, Adult Cardiovascular Surgery Clinic and Cardiovascular Surgery Intensive Care Unit between January and October 2014. Data were collected using the "Data Collection Form", "State-Trait Anxiety Inventory (STAI)", and "Visual Analogue Scale (VAS)". The mean age was 59.62 years. Of the patients, 69.7% were males and 92.7% were married, and 49.5% were graduated from primary school. Majority of the patients (71.6% ) had concomitant coronary artery disease. Anxiety was mostly originated from lack of knowledge on surgery (70.6% ), leaving the relatives (21.1% ), fear of death (16.5% ), and pain (15.6% ). The mean preoperative state and trait anxiety scores were 34.34±9.03 and 37.98±8.28, respectively. The mean postoperative state anxiety scores were 35.94±8.92. There was no statistically significant difference in the mean pre- and postoperative state anxiety scores (p>0.05). However, the mean pre- and postoperative state anxiety scores were statistically significantly associated with the mean pain score (p<0.05). In conclusion, preoperative anxiety management based on individual patient's characteristics in combination with individualized patient-centered education may reduce the degree of anxiety and improve postoperative healing. Visual materials such as leaflets, images, and video can be used to increase the effectiveness of patient education. In addition, the nursing curriculum can be expanded by the addition of patient-centered care and patient education. Nursing skills of the students should be improved and comprehensive patient education should be reinforced with postgraduate continuous education programs. Keywords: open heart surgery, anxiety, pain, nursing, patient education.