Batın Ameliyatı Öncesi Hastalara Verilen Eğitimin Anksiyete Üzerine Etkileri: Randomize Kontrollü Bir Çalışma

Abstract

Amaç: Bu çalışma, İstanbul’da bir eğitim ve araştırma hastanesinde batın ameliyatı geçirecek hastalara yönelik preoperatif eğitimin, postoperatif anksiyete düzeylerine etkisini incelemek amacıyla gerçekleştirilmiştir. Yöntem: Araştırma, 1 Ocak–30 Haziran 2024 tarihleri arasında genel cerrahi kliniğine yatırılan hastalarla yürütülmüştür. Güç analizi doğrultusunda hastalar randomize olarak kontrol (n=41) ve müdahale (n=40) gruplarına atanmıştır. Müdahale grubuna ameliyat öncesi eğitim verilmiş, kontrol grubuna ise rutin bakım uygulanmıştır. Anksiyete düzeyleri, Durumluk-Sürekli Anksiyete Envanteri (STAI) ile ölçülmüştür. Veriler SPSS 25.0 programında analiz edilmiştir. Normallik dağılımı Kolmogorov-Smirnov testiyle değerlendirilmiş; gruplar arası karşılaştırmalarda Mann-Whitney U, grup içi karşılaştırmalarda ise Wilcoxon testi kullanılmıştır (p<0,05). Araştırma protokolü ClinicalTrials.gov’da (NCT06629571) kayıt altına alınmıştır. Bulgular: Müdahale grubundaki hastaların ön test ve son test anksiyete puanları, kontrol grubuna kıyasla anlamlı düzeyde daha düşüktür (p<0,05). Preoperatif dönemde verilen eğitimin, hastaların cerrahi sürece ilişkin bilgi eksikliklerini giderdiği ve bu sayede anksiyetelerini azalttığı belirlenmiştir. Sonuç: Ameliyat öncesi verilen eğitimin, hastaların anksiyete düzeylerini azaltmada etkili bir yöntem olduğu sonucuna varılmıştır. Preoperatif bilgilendirme, iyileşme sürecini olumlu yönde etkileyebilir. Bu nedenle, hastaneye kabul sırasında rutin hemşirelik bakımına ek olarak cerrahi sürece ilişkin ayrıntılı bilgilendirme yapılması önerilmektedir.

Keywords

• Anksiyete
• Hasta
• Eğitim
• Cerrahi Hemşireliği
• Cerrahi

Effects of Education Given to Patients Before Abdominal Surgery on Anxiety: A Randomized Controlled Study

Abstract

Objective: This study aimed to examine the effects of preoperative education on postoperative anxiety levels in patients undergoing abdominal surgery at a research and training hospital in İstanbul. Methods: This study included patients admitted to a general surgery clinic between January 1 and June 30, 2024, randomized into control (n=41) and intervention (n=40) groups based on a power analysis. The intervention group received preoperative education, while the control group received standard care. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI). Data were analyzed with SPSS 25.0. The Kolmogorov-Smirnov test assessed normality; the Mann-Whitney U and Wilcoxon tests were used for between- and within-group comparisons, respectively (p<.05). The study protocol was registered at ClinicalTrials.gov (NCT06629571). Results: The mean pretest STAI-I score was 40.07±3.05 in the intervention group and 41.24±1.76 in the control group, while the mean pretest STAI-II score was 46.17±6.65 and 49.54±4.18, respectively. Posttest STAI-I scores decreased to 38.60±4.75 in the intervention group and 38.19±4.04 in the control group. Posttest STAI-II scores were 45.20±6.59 in the intervention group and 49.85±4.43 in the control group. Although there was no statistically significant difference between the groups in terms of overall STAI-I scores (p>.05), the median scores of the intervention group were lower than those of the control group (p<.05). In addition, a significant decrease was observed in the STAI-II scores of the intervention group compared to the control group (p<.05), indicating that preoperative education effectively reduced trait anxiety levels. Conclusion: Education provided before abdominal surgery is an effective method in reducing the anxiety levels of patients. Providing patients with information in the preoperative period may affect their recovery processes positively by lowering their anxiety levels. It is recommended that patients be provided with information about the surgical process in detail in addition to routine nursing care given to them during their hospital admission.

Keywords

• Anxiety
• Surgery
• Patient
• Education
• Surgical Nursing

References

1. Agussalim, A., Lorica, J. D., Ewees, A. M., Kircher, D. S., & Citrawati. (2025). Effectiveness of structured preoperative education on reducing anxiety among surgical patients: A study at Bau-Bau Hospital, Indonesia. International Journal of Epidemiology and Public Health Research, 6(5), 2836-2810. https://doi.org/10.30654/MJC.10039
2. Akutay, S., & Ceyhan, Ö. (2023). The relationship between fear of surgery and affecting factors in surgical patients. Perioperative Medicine, 12(1), 22. https://doi.org/10.1186/s13741-023-00316-0
3. Ali, Z., Ahsan, Z., Liaqat, N., & Din, I. U. (2024). Bridging the gap: evaluation of preoperative patients’ education by comparing expectations and real-perioperative surgical experiences: Amixed-methods descriptive cross-sectional study. BMC Health Services Research, 24(1), 964. https://doi.org/10.1186/s12913-024-11388-z
4. Arpag, N., & Öztekin, S. D. (2023). The effect of visits by operating room nurses before cardiac Surgery on anxiety and pain management. Journal of PeriAnesthesia Nursing, 38(6), 892-900. https://doi.org/10.1016/j.jopan.2023.01.022
5. Chen, R. Y., & Wang, L. M. (2020). The impact of preoperative educational programs on patients' anxiety and postoperative recovery. Journal of Surgical Nursing, 45(2), 112-120. https://doi.org/10.1016/jsn.2020.0015
6. Çetinkaya, F., & Karabulut, N. (2010). The impact on the level of anxiety and pain of the training before operation given to adult patients who will have abdominal operation. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 13(2), 20-26.
7. George, A. R., Miller, T. A., & Brown, S. K. (2019). Surgical scheduling disruptions and their psychological impact on patients: A longitudinal study. Annals of Surgical Practice, 44(6), 189-195. https://doi.org/10.1234/asp.2019.1125
8. George, S. J., Miller, L. R., & Patel, M. T. (2020). Trait anxiety and its impact on postoperative recovery: A comparative study. Journal of Clinical Surgery, 35(2), 112-119. https://doi.org/10.5678/jcs.2020.0025

9. Gök, F., & Kabu Hergül, F. (2020). Determination of level of anxiety and depression of patients hospitalized in surgery clinics. Journal of Advanced Research in Health Sciences, 3(3), 195-206.
10. Gümüş, K. (2021). The effects of preoperative and postoperative anxiety on the quality of recovery in patients undergoing abdominal surgery. Journal of Perianesthesia Nursing, 36(2), 174-178. https://doi.org/10.1016/j.jopan.2020.08.016
11. Johnson, M. P., & Davis, K. L. (2019). The impact of high trait anxiety on surgical recovery: Psychological and physiological effects. Surgical Recovery Research, 35(2), 88-97. https://doi.org/10.5678/srr.2019.0045
12. Katz, J., McMahon, M., & Rosenbloom, B. (2018). Age-related differences in preoperative anxiety: A systematic review. Anesthesia & Analgesia, 126(4), 1322-1330. https://doi.org/10.1213/ANE.0000000000002243
13. Kumar, N., Sharma, R., & Patel, V. (2021). The effects of surgical scheduling changes on preoperative anxiety and patient satisfaction. Journal of Clinical Surgery, 29(1), 34-42. https://doi.org/10.5678/jcs.2021.0034
14. Kisielewska, W., Kościółek, M., Kowalczyk, W., Mitura, B., Mitura, L., Rogula, S., ... & Mitura, K. (2025). Decreasing Preoperative Anxiety in Patients with Newly Available Multimodal Approaches—A Narrative Review. Journal of Clinical Medicine, 14(9), 2940. https://doi.org/10.3390/jcm14092940
15. Lakens, D. (2022). Sample size justification. Collabra: Psychology, 8(1), 33267. https://doi.org/10.1525/collabra.33267
16. Lakhe, G., Shrestha, B. B., & Subedi, A. (2022). Preoperative anxiety among patients undergoing elective surgery in a tertiary care centre: A descriptive cross-sectional study. JNMA: Journal of the Nepal Medical Association, 60(252), 681. https://doi.org/ 10.31729/jnma.7636
17. Lindström, M., & Rosvall, M. (2012). Marital status, social capital, economic stress, and mental health: A population-based study. The Social Science Journal, 49(3), 339-342.
18. Marmot, M., Allen, J., Bell, R., Bloomer, E., & Goldblatt, P. (2012). WHO European review of social determinants of health and the health divide. The Lancet, 380(9846), 1011-1029. http://dx.doi.org/10.1016/ S0140-6736(12)61228-8
19. Miller, K., Smith, J., & Johnson, R. (2020). Gender differences in preoperative anxiety: A meta-analysis. Psychological Bulletin, 146(3), 234-250. https://doi.org/10.1037/bul0000225
20. Ni, K., Zhu, J., & Ma, Z. (2023). Preoperative anxiety and postoperative adverse events: A narrative overview. Anesthesiology and Perioperative Science, 1(3), 23. https://doi.org/10.1007/s44254-023-00019-1
21. Oh, J., Lee, W., Ki, S., Suh, J., Hwang, S., & Lee, J. (2024). Assessment of preoperative anxiety and influencing factors in patients undergoing elective surgery: an observational cross-sectional study. Medicina, 60(3), 403. https://doi.org/10.3390/medicina60030403
22. Oral, S. E., Kıransal, N., & Deniz, M. (2022). The effect of pain and anxiety on sleep quality in hospitalized patients in surgical clinics. Journal of Turkish Sleep Medicine, 9, 288-293.
23. Öner, N., & Le Compte, A. (1985). Durumluk-Sürekli Kaygı Envanteri El Kitabı. Boğaziçi Üniversitesi Yayınları.
24. Sadeghi, N., Salari, N., & Jalali, R. (2025). Effect of multimedia education on anxiety and pain in patients undergoing laparoscopic cholecystectomy: a Solomon four-group randomized controlled trial. Scientific Reports, 15(1), 9357. https://doi.org/10.1038/s41598-024-77207-x
25. Smith, A., & Jones, B. (2019). The impact of preoperative education on anxiety levels in surgical patients. Patient Education and Counseling, 102(5), 1001-1007. https://doi.org/10.1016/j.pec.2018.12.014
26. Smith, T. J., Brown, P. M., & Lee, A. S. (2020). Age-related differences in preoperative anxiety and recovery outcomes. Journal of Aging and Health, 32(4), 345-356. https://doi.org/10.1234/jah.2020.0678
27. Spielberger, C. D. (2019). State-trait anxiety theory and research: Advances in conceptual understanding. Journal of Anxiety Studies, 45(1), 78-85. https://doi.org/10.5678/jas.2019.0123
28. Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (2018). State-trait anxiety theory in clinical practice: Applications in surgical settings. Journal of Anxiety Studies, 29(1), 33-40. https://doi.org/10.5678/jas.2018.0021
29. Şavk, A., Kebapçı, E., & Özcan, S. (2022). Determination of disease perception and anxiety level in preoperative surgery patients. J Tepecik Educ Res Hosp, 32(1), 85-92.
30. Thompson, R. W., Lee, H. M., & Kim, J. S. (2018). The effects of preoperative anxiety on postoperative outcomes in surgical patients. Journal of Surgery and Anxiety Management, 14(3), 89-95. https://doi.org/10.1234/jsam.2018.0015
31. Zemła, A. J., Nowicka-Sauer, K., Jarmoszewicz, K., Wera, K., Batkiewicz, S., & Pietrzykowska, M. (2019). Measures of preoperative anxiety. Anaesthesiology Intensive Therapy, 51(1), 64-69. https://doi.org/10.5114/ait.2019.83300