Learning Objective #1: Identify various sources of anxiety for patients experiencing a day-operation/ECT

Learning Objective #2: Identify a number of measures to deal with and prevent the anxiety

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Electroconvulsive Therapy (ECT) can provide a useful informational model for nurses who care for patients dealing with anxiety. Production of convulsion by applying electricity to one's head, although performed under total anesthesia, for twelve consecutive times, often generates high levels of patient anxiety, before, during and after treatment. In the past several years, ECT has evolved to a well-controlled medical procedure with very limited risks. Yet with the environmental factors like confinement to the unfamiliar surroundings in the hospital, loss of personal space and privacy or the separation from home and love ones, specially with the consideration that anxiety often is a component of depression, nurses' struggle to comfort patient is highly compromised. Anxiety often burdens learning and our study indicates at p<0.001 there is negative correlation of 0.48 for score of anxiety verses change, indicating those with the higher levels of anxiety tend to learn least. Surprisingly patients who had previous experience in ECT were more anxious, and the mean value of their anxiety score was 7.5 point higher than the scores of the first timers (F=5.7, df=1, p=0.021). Observing and interviewing the first timers while in treatment indicated that these patients in the beginning suffered from the same level of anxiety as many other day operation patients who worry about loss of control under anesthesia, fear of unknown or possible death. Patients' anxiety dropped by gaining the experience of the first treatment, giving the first timers the impression that ECT was not life threatening and dangerous while it actually reduced their depression. They tend to lose that feeling of comfort with the gradual onset of amnesia (temporary side effect of ECT). The memory lose is perhaps the most important source of anxiety that remains with the patient who may return for the future treatment.