The effects of handholding on anxiety in cataract surgery patients under local anaesthesia

AIM OF THE STUDY: To assess the effectiveness of handholding on the anxiety of patients undergoing planned cataract surgery under local anaesthesia. BACKGROUND: Anxiety concerning anaesthesia, pain, physical injuries, isolation, prognosis, possibilities of deformity, or loss of self-control may be stressful to patients undergoing surgery. Anxiety activates the sympathetic nervous system, characterized by an increase in catecholamine concentration, heart rate and blood pressure and increased glucocorticoid levels; it also affects immune responses. Therefore, there is a need for nursing interventions to reduce the anxiety of patients under local anaesthesia who are conscious. METHODS: An untreated control group design with pre and post-test was used. Among 62 patients, 30 were randomly assigned to the handholding group and 32 to the control group. Handholding was provided to subjects of the handholding group during surgery. Visual analogue scales and interviews were used to measure anxiety, and pulse rate and systolic and diastolic blood pressure were used as physiological measures of stress. Blood was taken for analysis of levels of epinephrine, norepinephrine, cortisol, neutrophils, lymphocytes and natural killer cells. RESULTS: The number of subjects who reported decreased anxiety during operation was significantly higher in the handholding group compared with the control group and most of the subjects reported that handholding during operation was very helpful in reducing anxiety. Epinephrine levels in the handholding group were significantly lower than in the control group. CONCLUSIONS: Results suggest that this noninvasive intervention has potential for reducing anxiety in patients having cataract surgery under local anaesthesia.