Abstract
Objective to evaluate the effect of relaxation therapy with guided imagery on state anxiety and cortisol in the immediate preoperative period in patients submitted to bariatric surgery by videolaparoscopy.Method a randomized, triple-blind clinical trial in a large teaching hospital in the interior of Minas Gerais. Twenty-four patients who would undergo video-laparoscopic bariatric surgery were randomly allocated in two groups, namely 12 in the control group and 12 in the experimental group. State anxiety was assessed by the State-Trait Anxiety Inventory, and blood cortisol levels were measured before and after the intervention or standard care. Descriptive analyzes were used for the quantitative variables and Student’s t-test for independent samples, in the analysis of the differences between the state anxiety scores and cortisol levels.Results the experimental group presented a statistically significant reduction of the state anxiety scores (p = 0.005) as well as of cortisol levels (p <0.001) after the intervention.Conclusion guided imagery relaxation therapy is an effective nursing intervention for the reduction of state anxiety and blood cortisol levels in the preoperative period in patients undergoing video-laparoscopic bariatric surgery. Brazilian Registry of Clinical Trials: RBR-5qywrf.
Highlights
Anxiety can be defined as an unpleasant emotional state involving feelings of apprehension and nervousness, being known to cause abnormal hemodynamics as a consequence of sympathetic, parasympathetic and endocrine stimulation[1]
In view of the above, this study aimed to evaluate the effect of guided imagery relaxation therapy on state anxiety and cortisol in the immediate preoperative period in patients submitted to bariatric surgery by videolaparoscopy
Eight participants did not receive the intervention: four gave up surgery because they had lost weight with diets and exercises proposed by the bariatric team; one gave up because he moved to another state; and three underwent laparotomy surgery because of adhesions from previous surgeries that did not allow the accomplishment of bariatric surgery by videolaparoscopy
Summary
Anxiety can be defined as an unpleasant emotional state involving feelings of apprehension and nervousness, being known to cause abnormal hemodynamics as a consequence of sympathetic, parasympathetic and endocrine stimulation[1]. Most patients awaiting elective surgery experience anxiety, since the preoperative phase is considered the period when the patient is most vulnerable, becoming prone to emotional imbalances[1,2]. A large elective procedure for morbidly obese individuals, results, in the long term, in weight loss, improvement or resolution of comorbidities, better quality of life and greater survival. This surgery is indicated for adults with Body Mass Index (BMI) ≥ 35 kg/m2, with one or more significant obesity-related comorbidities[6].
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