Evaluation of the Efficacy of Nursing Orientation to Reduce the Anxiety of Patients with Acute Coronary Syndrome Undergoing Bed Bath

Wednesday, 24 July 2013: 8:50 AM

Juliana de Lima Lopes, RN
Nursing Department, Federal University of São Paulo, são paulo, Brazil
Alba Lucia Bottura Leite de Barros, PhD
Nursing Department, Federal University of São Paulo, São Paulo, Brazil
Luiz Antônio Nogueira-Martins, PhD
Federal University of São Paulo, São Paulo, Brazil

Learning Objective 1: The leaner will be able to identify the importance of nursing orientation to reduce the anxiety of the patients that receive bed bath.

Learning Objective 2: The learner will be able to identify the antecedents variables that influence in anxiety of these patients and the correlation of physiological variables with anxiety.

Purpose: The objectives were to evaluate the efficacy of nursing orientation to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath; the development and validation of an informative manual concerning bed bath; correlation of physiological variables with the patients’ state anxiety; correlation of antecedent variables with the patients’ state anxiety.

Methods: This randomized clinical trial study. The first phase comprised the development and validation of an informative manual by nurses and patients. The study’s second phase comprised assessment of the efficacy of nursing orientation to reduce the anxiety of patients with acute coronary syndrome undergoing bed baths. The sample population was composed of 120 patients with acute coronary syndrome hospitalized in coronary care units divided into two groups: control group and the intervention group. The STAI-state was used to assess anxiety. It was applied immediately after informing the patients about the bed bath, immediately after orientation or unit’s routine information, and immediately after the bath.

Results: In the first phase were required four rounds to obtain consensus among nurses and one round to obtain consensus among patients. We observed in the second phase that nursing orientation was effective to reduce anxiety of the patients with acute coronary syndrome undergoing bed bath (p<0.001). No correlation was found between anxiety and the physiological variables in any of the tree evaluations. The variables that correlated with state anxiety were: stress (p=0.016), depression (p<0.001), obesity (p=0.024), trait anxiety (p=0.012), fear (p=0.001), and embarrassment (p<0.001). Logistic regression revealed that depression (OR=17.218, p<0.001) and embarassment (OR=2.772, p<0.001) were independently associated with state anxiety.

Conclusion: The conclusion is that nursing orientation is efficient to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath. The results also revealed that the variables associated with anxiety were stress, obesity, trait anxiety, fear, especially depression and embarassment, while physiological variables were not correlated with the patients’ state anxiety.