Efficacy of Nursing Orientation to Reduce the Anxiety of Patients Undergoing Bed Bath

NCT ID: NCT01724762

Last Updated: 2012-11-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-04-30

Study Completion Date

2011-10-31

Brief Summary

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This study's general objective was to evaluate the efficacy of nursing orientation to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath. The specific objectives included: the development and validation of an informative manual concerning bed bath; correlation of physiological variables (systolic and diastolic blood pressure and heart and respiratory rate) with the patients' state anxiety; correlation of antecedent variables (age, gender, cardiovascular risk factor, use of beta blockers, trait anxiety, depression, prior hospitalization, prior experience with bed baths, the patients' preference for a female or male professional to perform the bath, pain, fear, and embarrassment) with the patients' state anxiety.

Detailed Description

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Patients with acute coronary syndrome present many physiological and psychological changes, especially anxiety, which can be more intense when the patient expects or experiences certain procedures, such as bed bath. The association of anxiety and acute myocardial infarction has shown negative impact on the prognosis of these patients. The anxiety causes activation of the sympathetic nervous system by increasing cardiac contractility, blood pressure, heart rate and oxygen consumption, worsening disease progression. Thus, minimizing the effects of patients' anxiety in the face of various nursing procedures is essential to quality care. The anxiety can be reduced using medications and/or nursing orientation.

This study was conducted in the Coronary Care Units, Brazilian Heart Institute. The study was divided into two phases. The first comprised the development and validation of an informative manual by nurses and patients. The manual was developed by the researchers and then submitted to validation by five nursing professors from the field of nursing fundamentals and five nurses with experience in coronary care units. The Delphi Technique was used to validate the manual in this phase. After validation by nurses, the manual was validated by 35 patients hospitalized in the coronary care unit who experienced bed bath at least once. A score above 4 should be achieved for the manual to be considered comprehensible and validated by patients. The statistical analysis at this phase was performed through the Wilcoxon rank-sum test and percentage of score 5 with its confidence interval. 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 (patients who did not read the informative manual concerning bed bath and received only the unit's routine information) and the intervention group (patients who received nursing orientation and read the informative manual concerning bed bath). The STAI-state was used to assess anxiety. It was applied immediately after informing the patients about the bed bath, immediately after orientation (intervention group) or immediately after the unit's routine information (control group), and immediately after the bath.

Conditions

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Acute Coronary Syndrome

Keywords

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Baths Anxiety Acute Coronary Syndrome Education, Nursing

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Blinding Strategy

NONE

Study Groups

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Nursing orientation

Patients who received nursing orientation and read the informative manual concerning bed bath

Group Type EXPERIMENTAL

Nursing Orientation

Intervention Type OTHER

* Control group: patients who did not read the informative manual concerning bed bath and received only the unit's routine information
* Intervention group: patients who received nursing orientation and read the informative manual concerning bed bath

Interventions

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Nursing Orientation

* Control group: patients who did not read the informative manual concerning bed bath and received only the unit's routine information
* Intervention group: patients who received nursing orientation and read the informative manual concerning bed bath

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of acute coronary syndrome Killip 1
* Patients who were undergoing the bed bath for the first time in the current hospitalization
* Literate and at least 4 years of study
* Patients with age less than 75 years
* Patients who agreed to participate

Exclusion Criteria

* Patients with vascular diseases or arteriovenous fistulas in the left arm
* Situations that could influence patients' anxiety and / or vital signs (arrhythmias such as ventricular tachycardia, second or third-degree atrioventricular block ; ischemic pain before, during or after bath; patients with Killip 2, 3 and 4; invasive procedures on the day of data collection, such as catheterization and surgery, and use of benzodiazepines and / or anxiolytics
* Situations in which patients were not able to complete the questionnaires (altered level of consciousness, visual impairment and / or patients who could not read and / or write)
* Situations in which the patient requested information about bed bath, previously the beginning of the evaluation.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Conselho Nacional de Desenvolvimento Científico e Tecnológico

OTHER_GOV

Sponsor Role collaborator

Federal University of São Paulo

OTHER

Sponsor Role lead

Responsible Party

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Juliana de Lima Lopes

Master Degree

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Juliana L Lopes, Ms

Role: PRINCIPAL_INVESTIGATOR

Federal University of São Paulo

Alba LB Barros, PhD

Role: STUDY_DIRECTOR

Federal University of São Paulo

Luiz A Nogueira-Martins

Role: STUDY_DIRECTOR

Federal University of São Paulo

Locations

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Federal University of São Paulo

São Paulo, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Lopes Jde L, Nogueira-Martins LA, Goncalves MA, de Barros AL. Comparing levels of anxiety during bed and shower baths in patients with acute myocardial infarction. Rev Lat Am Enfermagem. 2010 Mar-Apr;18(2):217-23. doi: 10.1590/s0104-11692010000200012.

Reference Type RESULT
PMID: 20549121 (View on PubMed)

Barsevick A, Llewellyn J. A comparison of the anxiety-reducing potential of two techniques of bathing. Nurs Res. 1982 Jan-Feb;31(1):22-7.

Reference Type RESULT
PMID: 6922456 (View on PubMed)

Tel H, Tel H. The effect of individualized education on the transfer anxiety of patients with myocardial infarction and their families. Heart Lung. 2006 Mar-Apr;35(2):101-7. doi: 10.1016/j.hrtlng.2005.09.001.

Reference Type RESULT
PMID: 16543038 (View on PubMed)

Related Links

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http://www.heart.org/HEARTORG/

American Heart Association

Other Identifiers

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UNIFESP0447

Identifier Type: -

Identifier Source: org_study_id