title: Strategies to Alleviate Anxiety Before the Placement of a Stereotactic Radiosurgery Frame.
abstract: BACKGROUND
  Patients scheduled for stereotactic radiosurgery (SRS) need the placement of a head frame for accurate treatment of brain metastases and other abnormalities in the brain. These patients frequently experience anxiety before frame placement. Although there is evidence that preprocedure education can alleviate anxiety, less is known about education for patients undergoing head frame placement.
  
  
  OBJECTIVE
  The aim of this study was to determine whether a preprocedure educational intervention can reduce/alleviate anxiety for patients undergoing head frame placement for SRS.
  
  
  METHODS
  This study was a practice improvement project using a nonrandomized controlled design to evaluate patients (N = 28) diagnosed with metastasized brain cancer or other abnormalities in the brain. Patients aged ≥19 and <75 years were recruited, and all participants had been radiographically diagnosed and were dispositioned for SRS. The control group (n = 14) received the standard preprocedure teaching, and the intervention group (n = 14) received both the standard preprocedure teaching and an additional educational intervention. Data collecting tools included the Hospital Anxiety and Depression Scale and a visual analog scale to measure the patient's anxiety.
  
  
  RESULTS
  It was found that, on average, anxiety levels were lower in the intervention group on both the visual analog scale and Hospital Anxiety and Depression Scale. However, the findings did not reach statistical significance, p < .05.
  
  
  CONCLUSIONS
  On the basis of existing literature, preprocedure education has been shown to decrease patient anxiety. This study aimed to determine whether an additional educational intervention impacted anxiety in patients undergoing SRS for metastatic cancer. Although we found that anxiety levels were decreased in the intervention group, this finding did not reach statistical significance. A larger randomized study is needed to confirm the efficacy of such an intervention in this unique patient population.
authors.affiliation: Questions or comments about this article may be directed to Ufuoma E. Avbovbo, DNPAPRN NP-C, at UEAvbovbo@mdanderson.org. Family Nurse Practitioner, Department of Neurosurgery, Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL. Susan J. Appel, PhD ACNP-BC FNP-BC CCRN FAHA, Professor, Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL.
authors.forename: Ufuoma E
authors.initials: UE
authors.lastname: Avbovbo
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Appel
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000517:prevention & control* / Q000523:psychology; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D058996:Quality Improvement; D016634:Radiosurgery / Q000706:statistics & numerical data*