Effects of Pre-Op Education on Surgery-Induced Anxiety: A Meta-Analysis

Monday, 30 July 2012

Chun-Chen Lin, BSN, RN1
Hui-Mei Lee, BSN, RN2
Pei-Fang Kuo, BSN, RN2
Yueh-Yen Fang, PhD, RN3
(1)No 68 chunghwa 3rd Road, Cianjin District, 80145 Kaohsiung City, Taiwan, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
(2)No 68 chunghwa 3rd Road, Cianjin District, 80145 Kaohsiung City, Taiwan, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City, Taiwan
(3)School of Nursing, Fooyin University, Kaohsiung, Taiwan

Learning Objective 1: The learner will be able to describe the effect of pre-op education on surgery-induced anxiety.

Learning Objective 2: The learner will be able to point out knowledge gap in relation to pre-op education and surgery-induced anxiety

Purpose: The purpose of this study was to compare the effect of pre-op education on surgery-induced anxiety across various educational instructions.  
Methods:    Meta-analyses with random-effects model were conducted to compare pooled effects of surgery-induced anxiety between various pre-op educational instructions and the routine instruction. Three English and two Chinese databases were used to search English and Chinese literature published up to April, 2011. The search term used was ‘anxiety and operation and education.’ Data were extracted by two researchers independently. Disagreement among data extraction was resolved by complete consensus between researchers. Study quality was evaluated by the Johns Hopkins Nursing Evidence-based practice Quality Rating Scale.
Results: Six randomized controlled trials (RCTs) and five nonrandomized controlled trials (NRCT) were located from 596 articles and included for analysis. The total subjects involved in the analysis were 961 patients. Study quality of included studies ranged from IA to IIA. Results showed there were four distinct types of pre-op education: multi-media, pamphlet, structured education, and visiting (QB = 18.17, p < .001). Except for the structured education, other types of education presented a significant decrease in anxiety level than routine practice (Std diff in Mean = .493-.619, p < .05).

Conclusion: Meta-analyses supported that multimedia, pamphlet, and visiting were better strategies than routine practice in lowering down surgery-induced anxiety. Presence of publication bias in the funnel plot suggested a need for more studies in each education group before the evidence can be built.