Pre-procedural education on anxiety levels during intravitreal injections

Abstract

Aim This paper aims to explore the role of pre-procedural education on the anxiety and/or pain levels of macular degeneration patients during intravitreal injections. Background The significance of pre-procedural education has been debated for many years, with many authors/clinicians alleging that informative preparation reduces pre-surgery anxiety levels and peri/post-procedural pain levels experienced by patients. Methods A comprehensive methodological analysis was employed in order to critically evaluate relevant research. A range of electronic databases and ancestry resources were searched for current contemporary articles published between January 2000 and March 2010. Search terms incorporating ‘anxiety’ ‘education’ ‘fear’ ‘discomfort’ ‘pain’ ‘ranibizumab’ and ‘macular degeneration’ were combined. The types of methodological studies were not specified in the strategy in order to prevent elimination of potentially applicable literature, therefore, both anecdotal and empirical articles were considered pertinent. Results Seven articles met the identified inclusion/exclusion criteria. Data abstraction was undertaken and all eligible studies were evaluated for quality, validity and reliability. Collectively, each of the studies reviewed placed emphasis on the importance on pre-procedural patient education and counselling. Nevertheless, individual differences exist in the amount, type and specificity of information provision provided. In general, the research articles reviewed also demonstrate the assumed existence of high anxiety levels pre-ophthalmic surgery commonly relating to patient anticipation and apprehension. Conclusion Greater understanding of the context within which educational provision impacts on patient anxiety and/or pain levels during intravitreal injections will facilitate the design of effective education and support systems for macular degeneration patients throughout the disease process.