Anxiety levels of psychiatric patients during a course of electroconvulsive therapy
Creators: name: Talbot, Karen
Publisher: name: University of Utah
Year: 2012

description: Electroconvulsive therapy (ECT) is a method of treatment for some psychiatric patients.  One disadvantage of ECT is that it seems to be a source of anxiety for some patients who receive it.  The purpose of this investigation were to validate the observations that ECT is a source of anxiety, to measure the anxiety levels and describe any changes of anxiety level from treatment to treatment, and to study possible causative factors of the anxiety.  By describing the nature of the occurrence of anxiety it should be possible eventually to devise effective nursing intervention methods to help alleviate it.  Anxiety levels were measured by the 8-Parallel-Form Anxiety Battery formulated by the Institute for Personality and Ability Testing (IPAT).  This consists of eight equivalent forms of 50 items each and is constructed to measure changes in anxiety level over time.  The sample tested consisted of all patients receiving ECT on the psychiatric units of three general hospital over an eight-week period.  The only patients not tested were those who were too disturbed to complete the test forms and a total of 21 patients were tested.  The first test (form A) was administered to each patient as soon as the nursing staff were made aware that the patient would be receiving ECT.  The purpose of the first test was to establish a baseline from which to gauge subsequent anxiety levels.  The next six tests (forms B through G) were given the evening or morning prior to the first six treatments (unless of course the treatments were discontinued earlier).  The final test (form H) was administered to each patient after he had had the last treatment and was ware that he would have not more.  In addition to the anxiety tests, data on the following variables were collected:  hospital, doctor, previous courses of ECT, frequency of current treatments, age, sew, marital status, religion, and socioeconomic status of the patient.  The relationships to be analyzed were anxiety level and number of treatments, and anxiety level and number of treatments, and anxiety level and other variables.  The anxiety test scores were analyzed by analysis of variance.  The F ratio was significant at the .01  level of confidence which indicated that there was indeed a change in the anxiety level over time.  A Ducan Multiple Ranace Test was then used to determine where the significant difference was.  The only significant difference discovered was a sharp decrease in the mean scores from test form E to test form F.  Therefore, the hypothesis that anxiety levels of patients receiving ECT would show a significant increase over the initial or base anxiety level was not confirmed.  The mean scores for each test did show an increase in anxiety before the third and fourth treatments but the increase was not significant.  Only three of the ten variables were amenable to statistical analysis.  The relationship of age, sex, and previous courses of ECT to initial anxiety levels were check on a two by two Chi-square table but the relationships were not significant.  The other variables were used for description of the sample and as bases for recommending a further study.  Possible reasons for not achieving the expected results are:  1. The discomfort the patients suffer may be fear rather than anxiety and a differentiation would need to be made between these two factors.  2.  The sample was very small and few controls were used.  A larger, more controlled sample could produce more meaningful results.  Patients still seem to experience unpleasant feeling associated with ECT, but the feelings must yet be identified and explored before appropriate action can be taken to help alleviate them.