title: Pre-operative education and counselling are associated with reduced anxiety symptoms following carotid endarterectomy: a randomized and open-label study.
abstract: BACKGROUND
  Post-operative anxiety is common and may have significant impact on the post-operative recovery of the patients. Theatre nurse visits before surgery has been shown to reduce patient's anxiety levels following general surgery.
  
  
  OBJECTIVE
  To investigate the effect of pre-operative visits and counselling by intensive care unit (ICU) nurses on patient's anxiety levels following carotid endarterectomy.
  
  
  METHODS
  This is an open-label and randomized clinical trial. Patients undergoing carotid endarterectomy were divided into study (n=60) and control group (n=60). For the study group, in addition to routine pre-operational counselling by the surgeons, ICU nurses visited the patients and provided a structured counselling the day before surgery. For the control group, only routine pre-operative counselling was provided. Anxiety levels were assessed by Zung self-rating anxiety scale (SAS) the day before surgery and on the day after being discharged from ICU to the ward.
  
  
  RESULTS
  The two groups were comparable in age, sex, surgical methods, and duration of ICU stays. Following the surgery, the mean SAS score in the control group increased from 50.5±5.4 to 58.5±7.3 (p=0.03), whereas the mean SAS score in the study group reduced from 51.5±4.3 to 45.1±6.5 (p=0.02). The proportion of patients with anxiety symptoms in the control group was higher than in the study group following the surgery (58.3% vs. 33.3%, p=0.001).
  
  
  CONCLUSIONS
  Pre-operative visits and counselling by ICU nurses could reduce patient's anxiety levels following carotid endarterectomy.
authors.affiliation: Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, PR China.
authors.forename: Chun-Ling
authors.initials: CL
authors.lastname: Yang
authors.forename: Yan-Hua
authors.initials: YH
authors.lastname: Tan
authors.forename: Xiu-Xia
authors.initials: XX
authors.lastname: Jiang
authors.forename: Feng-Ying
authors.initials: FY
authors.lastname: Meng
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Wu
authors.forename: Qiu-Lan
authors.initials: QL
authors.lastname: Chen
authors.forename: Long-Le
authors.initials: LL
authors.lastname: Ma
authors.forename: Le-Xin
authors.initials: LX
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000517:prevention & control*; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D016022:Case-Control Studies; D003422:Critical Care / Q000379:methods / Q000523:psychology; D037001:Directive Counseling / Q000379:methods*; D016894:Endarterectomy, Carotid / Q000451:nursing*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control* / Q000523:psychology; D011300:Preoperative Care / Q000451:nursing*