Efficacy of Nursing Orientation to Reduce the Anxiety of Patients Undergoing Bed Bath
Condition: Acute Coronary Syndrome
MeSH terms: Acute Coronary Syndrome; Syndrome
Study type: Interventional

Summary: 
      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: 
      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.
    

Intervention name(s): Nursing Orientation
Intervention type(s): Other
Intervention description(s): 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 model: Single Group Assignment
Masking: None (Open Label)
Keywords: Baths; Anxiety; Acute Coronary Syndrome; Education, Nursing