2.50
Hdl Handle:
http://hdl.handle.net/10755/158111
Type:
Presentation
Title:
A Trial of Distraction for Pain and Anxiety During Cataract Surgery
Abstract:
A Trial of Distraction for Pain and Anxiety During Cataract Surgery
Conference Sponsor:Western Institute of Nursing
Conference Year:2004
Author:Simmons, Doris, RN
P.I. Institution Name:VA Puget Sound Health Care System
Contact Address:1660 Columbian Way SO, Seattle, WA, 98108, USA
Co-Authors:Chabal, C; Griffith, J; Rausch, M; Steele, B
Purpose: The purpose of this study was to evaluate whether or not distraction interventions reduce the amount of discomfort and anxiety experienced during ocular block injections of anesthetic administered prior to cataract removal. Background. Cataract extraction is carried out on an estimated 1.4 million of patients per year in the United States. Local anesthesia usually includes an injection behind the eye followed by another below the eyelid. The injections produce anxiety and discomfort in most patients. Local anesthesia is usually preferred to general anesthesia because of the higher incidence of complications and longer hospital stays associated with the latter. Distraction techniques for pain and anxiety relief are used in a wide range of patient populations but have not been carried out in this setting. Methods. A four group, randomized trial was carried out on a convenience sample of veterans having cataract surgery under local anesthesia at the VAPSHCS, Seattle Division. Eighty veterans were studied over a period of 14 months. Inability to provide informed consent, current substance abuse, clinical depression or severe anxiety and panic were exclusion criteria. Separate interval scales (0-10) were used to measure discomfort and anxiety. Similar scales are currently used throughout the VAPSHCS to measure pain and are therefore widely familiar. The four groups included: usual care during injection without any distraction (UC), usual care and local, light finger massage (UCM), usual care and verbal coaching (UCVC), and usual care, Light finger massage and verbal coaching (UCMVC). Results. The sample included 80 subjects (2women, 78 men; mean age 70 years, sd=+10) with twenty subjects in each group. Mean (+sd) ratings for discomfort were: UC-5.95 (1.9), UCM-4.3 (2.0), UCVC-3.5 (2.2), UCMVC-4.15 (2.3);mean (+sd) ratings for anxiety were:UC-5.85 (1.9), UCM-3.65 (1.7),UCVC-3-1 (2.2), UCMVC-2.75 (1.5). A one-way ANOVA with Tukey HSD post hoc analysis showed all distraction groups to be superior to usual care in the reduction of anxiety (F=38.7;p=0.0001) and discomfort (21.8;p=0.04) with no significant difference between treatment groups. Implications: The distraction interventions described her were effective in reducing both discomfort and anxiety in patients undergoing cataract surgery, although the degree to which pain/anxiety reduction is clinically significant is not clear. Noninvasive nursing interventions to allay pain and anxiety enhance patient satisfaction with care and are cost-effective, safe, and readily applicable to an array of clinical settings. Continued application and further study of these strategies is therefore warranted.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Trial of Distraction for Pain and Anxiety During Cataract Surgeryen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158111-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Trial of Distraction for Pain and Anxiety During Cataract Surgery</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Simmons, Doris, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">VA Puget Sound Health Care System</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1660 Columbian Way SO, Seattle, WA, 98108, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Chabal, C; Griffith, J; Rausch, M; Steele, B</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The purpose of this study was to evaluate whether or not distraction interventions reduce the amount of discomfort and anxiety experienced during ocular block injections of anesthetic administered prior to cataract removal. Background. Cataract extraction is carried out on an estimated 1.4 million of patients per year in the United States. Local anesthesia usually includes an injection behind the eye followed by another below the eyelid. The injections produce anxiety and discomfort in most patients. Local anesthesia is usually preferred to general anesthesia because of the higher incidence of complications and longer hospital stays associated with the latter. Distraction techniques for pain and anxiety relief are used in a wide range of patient populations but have not been carried out in this setting. Methods. A four group, randomized trial was carried out on a convenience sample of veterans having cataract surgery under local anesthesia at the VAPSHCS, Seattle Division. Eighty veterans were studied over a period of 14 months. Inability to provide informed consent, current substance abuse, clinical depression or severe anxiety and panic were exclusion criteria. Separate interval scales (0-10) were used to measure discomfort and anxiety. Similar scales are currently used throughout the VAPSHCS to measure pain and are therefore widely familiar. The four groups included: usual care during injection without any distraction (UC), usual care and local, light finger massage (UCM), usual care and verbal coaching (UCVC), and usual care, Light finger massage and verbal coaching (UCMVC). Results. The sample included 80 subjects (2women, 78 men; mean age 70 years, sd=+10) with twenty subjects in each group. Mean (+sd) ratings for discomfort were: UC-5.95 (1.9), UCM-4.3 (2.0), UCVC-3.5 (2.2), UCMVC-4.15 (2.3);mean (+sd) ratings for anxiety were:UC-5.85 (1.9), UCM-3.65 (1.7),UCVC-3-1 (2.2), UCMVC-2.75 (1.5). A one-way ANOVA with Tukey HSD post hoc analysis showed all distraction groups to be superior to usual care in the reduction of anxiety (F=38.7;p=0.0001) and discomfort (21.8;p=0.04) with no significant difference between treatment groups. Implications: The distraction interventions described her were effective in reducing both discomfort and anxiety in patients undergoing cataract surgery, although the degree to which pain/anxiety reduction is clinically significant is not clear. Noninvasive nursing interventions to allay pain and anxiety enhance patient satisfaction with care and are cost-effective, safe, and readily applicable to an array of clinical settings. Continued application and further study of these strategies is therefore warranted.</td></tr></table>en_GB
dc.date.available2011-10-26T20:31:12Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:31:12Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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