title: Effects of anxiety reduction training on physiological indices and serum cortisol levels before elective surgery.
abstract: BACKGROUND
  Patients awaiting surgery typically experience significant physical and psychological stress. Vital signs and serum cortisol level are altered in response to anxiety. The aim of this study was to assess the effects of preoperative education on physiological indices and cortisol level of female patients undergoing elective surgeries.
  
  
  METHODS
  In this single-blinded randomized controlled trial, 60 women undergoing gynecological elective surgeries in Kowsar Hospital (Qazvin, Iran) were randomly assigned to either control or intervention group. The patients of the intervention group were assessed based on the nursing process after admission. Subjects with anxiety, inadequate awareness, and fear received necessary training on anxiety reduction techniques. The control group merely received routine care. A questionnaire including demographic characteristics, baseline and preoperative vital signs, and serum cortisol level was completed for all subjects. Data were analyzed by descriptive and inferential statistics (Fisher's exact test, paired and independent t-tests, and Mann-Whitney U test) in SPSS17. P values less than 0.05 were considered significant.
  
  
  RESULTS
  The two groups were homogeneous in terms of age (P = 0.20), marital status (P = 0.50), education (P = 0.10), employment status (P = 0.13), and admission history (P = 0.30). There were no significant differences in baseline vital signs between the intervention and control groups. Before surgery, the mean values of vital signs increased in both the groups. However, the increments were less in the experimental group than in the control group. Serum cortisol levels were also lower in the experimental group compared to the control group (P < 0.01).
  
  
  CONCLUSIONS
  Education based on the nursing process is a non-pharmaceutical and effective method to minimize changes in vital signs and decrease serum cortisol level in patients undergoing gynecological elective surgeries.
authors.affiliation: Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, and PhD candidate in Reproductive Health at Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Bahrami
authors.affiliation: Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Soleimani
authors.affiliation: Faculty of Nursing and Midwifery of Amol, Mazandaran University of Medical Sciences, Sari, and PhD candidate in Nursing, Baqiayatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Sharifnia
authors.affiliation: Faculty of Nursing and Midwifery, Guilan University of Medical Sciences, Langaroud, Iran.
authors.forename: Hoorieh
authors.initials: H
authors.lastname: Shaigan
authors.affiliation: Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, and PhD candidate at University of Social Welfare and Rehabilitation Science, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Sheikhi
authors.affiliation: School of Allied Medical Sciences, Islamic Azad University of Urmia, Urmia, Iran.
authors.forename: Zhila
authors.initials: Z
authors.lastname: Mohammad-Rezaei
keywords: Anxiety; cortisol; education; nursing process; vital signs