Critical care nursing practice regarding patient anxiety assessment and management

Moser, Debra K.; Chung, Misook L.; McKinley, Sharon; Riegel, Bárbara; An, Kyungeh; Cherrington, Candace C.; Blakely, W. Paul; Biddle, Martha J; Frazier, Susan K.; Garvin, Bonnie J.

doi:10.1016/s0964-3397(03)00061-2

Cited by 68 publications

(36 citation statements)

References 32 publications

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“…Therefore, the communication and time spent with patients as well as the use of a targeted and coordinated communication by a nurse can highly affect treatment outcomes. Results of a study conducted on 30 burn patients showed that establishing appropriate and targeted communication with patients is an important strategy to reduce anxiety severity, to support burn patients, and to increase their information (32). The study by Reynolds and Carnwell regarding the importance of nurse and patient communication in care was also consistent with the results of this study (20).…”

Section: Discussionsupporting

confidence: 83%

The Effect of Using Peplau's Therapeutic Relationship Model on Anxiety of Coronary Artery Bypass Graft Surgery Candidates

Maghsoodi

Zarea

Haghighizadeh

et al. 2014

Jundishapur J Chronic Dis Care

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Background: Anxiety is a one of the psychological aftereffect of cardiac surgery, which affects the outcome of treatment. One of the most effective ways to reduce anxiety is to train and establish a targeted relationship based on a functional model. Objectives: The present study aimed to determine the effect of Peplau's therapeutic relationship model on anxiety of patients who were candidate for coronary artery bypass graft surgery (CABG). Patients and Methods:In this clinical trial, 74 patients were enrolled according to eligibility criteria and were randomly allocated to intervention and control groups of 37 people. We evaluated anxiety of the patients using the Beck anxiety inventory before, immediately after, and two and four months after intervention. Based on Peplau's therapeutic relationship model, therapeutic communication sessions were conducted in four phases during seven sessions. Data analysis was performed with the statistical test of covariance analysis using SPSS version 16. Results:The results of our study showed that after therapeutic communication, the mean score of anxiety decreased from 30.35 to 25.38 in the intervention group (P < 0.001), while the scores decreased from 33.22 to 31.46 in the control group. Furthermore, the mean score of anxiety in the intervention group decreased at two and four months after the intervention. Conclusions: The findings showed a positive effect of therapeutic relationship based on Peplau's model on reducing anxiety of patients undergoing CABG. Therefore, health care teams, including nurses, should take advantage of appropriate communication with patients in their care procedures. In that regard, Peplau's communication model is recommended as a simple, low-cost, and efficient method.

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Section: Discussionsupporting

confidence: 83%

The Effect of Using Peplau's Therapeutic Relationship Model on Anxiety of Coronary Artery Bypass Graft Surgery Candidates

Maghsoodi

Zarea

Haghighizadeh

et al. 2014

Jundishapur J Chronic Dis Care

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“…[5][6][7][8] The main obstacles hindering assessment of anxiety include the lack of standardized protocols for diagnosis of anxiety, poor use of assessment tools, lack of confidence and skill in psychological assessment, and lack of time. 9 ICU professionals generally assess anxiety in 1 of 2 ways: (1) subjectively 8,10 or (2) on the basis of physiological indicators.…”

mentioning

confidence: 99%

Reliability and Validity of Shortened State Trait Anxiety Inventory in Spanish Patients Receiving Mechanical Ventilation

Perpiñá‐Galvañ

Cabañero‐Martínez

Richart‐Martínez

2013

American Journal of Critical Care

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Background In order to measure anxiety in physically and cognitively debilitated patients, such as patients receiving invasive mechanical ventilation, the use of reliable and valid instruments is recommended; however, these instruments should be short. Objective To analyze the reliability and validity of a short version of the state subscale from the Spielberger State-Trait Anxiety Inventory, developed by Chlan and colleagues and translated into Spanish (STAI-E6), in patients receiving invasive mechanical ventilation. Methods An instrumental study was conducted of 80 patients receiving invasive mechanical ventilation in the intensive care unit at the Hospital of Alicante (Spain). The patients completed the 6-item STAI-E6 scale. Before the patients completed the scale, the interviewers indicated their impression of each patient's level of anxiety by using a linear scale. Internal consistency, construct validity, and convergent validity of the scale were analyzed. Results The scale did not present a floor/ceiling effect, the Cronbach α was 0.79, and the single-factor structure of the original scale was maintained. Scores on the scale correlated positively with the subjective assessment of the health professional. Significant differences were found only between anxiety level and duration of intubation. Conclusions The 6-item version of the state subscale from the STAI-E6 shows satisfactory reliability and validity for Spanish patients receiving invasive mechanical ventilation.

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“…When asked, nurses indicated psychological and cognitive indicators as most relevant in assessing anxiety. In clinical practice, however, these indicators were used to a much lesser degree 23 than were physiological indicators (increased heart rate and blood pressure), 24 even though the last 2 do not accurately reflect the level of anxiety in cardiac patients. 11,13,30,39,[62][63][64] Furthermore, the effect on the cardiovascular system of the many drugs (eg, β-blockers, sedatives) routinely administered in an ICU is widely acknowledged.…”

Section: Discussionmentioning

confidence: 99%

“…23 Although assessment of anxiety is important, patients' anxiety is not routinely evaluated by ICU staff. 24,25 When evaluation is done, it tends to be subjective, and the results typically do not match the patient's own perceptions.…”

mentioning

confidence: 99%

Scales for Evaluating Self-Perceived Anxiety Levels in Patients Admitted to Intensive Care Units: A Review

Perpiñá‐Galvañ

Richart‐Martínez

2009

American Journal of Critical Care

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Objective To review studies of anxiety in critically ill patients admitted to an intensive care unit to describe the level of anxiety and synthesize the psychometric properties of the instruments used to measure anxiety. Methods The CUIDEN, IME, ISOC, CINAHL, MEDLINE, and PSYCINFO databases for 1995 to 2005 were searched. The search focused on 3 concepts: anxiety, intensive care, and mechanical ventilation for the English-language databases and ansiedad, cuidados intensivos, and ventilación mecánica for the Spanish-language databases. Information was extracted from 18 selected articles on the level of anxiety experienced by patients and the psychometric properties of the instruments used to measure anxiety. Results Moderate levels of anxiety were reported. Levels were higher in women than in men, and higher in patients undergoing positive pressure ventilation regardless of sex. Most multi-item instruments had high coefficients of internal consistency. The reliability of instruments with only a single item was not demonstrated, even though the instruments had moderate-to-high correlations with other measurements. Conclusion Midlength scales, such the anxiety subscale of the Brief Symptom Inventory or the shortened state version of the State-Trait Anxiety Inventory are best for measuring anxiety in critical care patients.

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Critical care nursing practice regarding patient anxiety assessment and management

Cited by 68 publications

References 32 publications

The Effect of Using Peplau's Therapeutic Relationship Model on Anxiety of Coronary Artery Bypass Graft Surgery Candidates

The Effect of Using Peplau's Therapeutic Relationship Model on Anxiety of Coronary Artery Bypass Graft Surgery Candidates

Reliability and Validity of Shortened State Trait Anxiety Inventory in Spanish Patients Receiving Mechanical Ventilation

Scales for Evaluating Self-Perceived Anxiety Levels in Patients Admitted to Intensive Care Units: A Review

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