Effectiveness of Auditory Distraction and Brief Relaxation Therapy in Reducing Anxiety in Dental Patients Undergoing Extraction: A Randomized Controlled Trial

Objective: This study compared the effectiveness of auditory distraction and brief relaxation therapy for reducing anxiety in patients undergoing tooth extraction. Methods: A non-blind, three-armed, randomized control trial was carried out. The targeted study population were patients who needed extraction of a non-restorable and non-mobile molar tooth. Eighty-six patients were recruited; the brief relaxation therapy and auditory distraction groups had 32 participants each, while 10 of the 22 participants in the control group were excluded due to missing data. The Hierarchical Anxiety Questionnaire was used to assess the anxiety level. The Mann–Whitney U or Kruskal–Wallis test was performed to compare means between the groups. The before and after comparisons in each group were carried out using the Wilcoxon Signed-Rank test. The alpha value was set at 0.05, and data were analyzed using SPSS version 24. Results: The mean anxiety score after brief relaxation therapy and auditory distraction had significantly decreased (p < 0.001). Although not significant (p = 0.13), there was a slight increase in the anxiety score of the study participants in the control group just before the extraction procedure. Brief relaxation therapy was significantly effective in reducing anxiety scores in comparison to the control group (MD = 5.87, 95% CI = 2.58, 9.17; p = 0.001), but auditory distraction was not (p = 0.14). Conclusion: Both auditory distraction and brief relaxation therapy were effective in reducing patient anxiety before a dental procedure. Furthermore, it would be interesting to learn if these findings remain consistent for more complex dental procedures, such as surgical removal of an impacted third molar.

A randomized controlled trial of three different local anesthetic methods for minor hand surgery

Purpose: Hemostasis and local anesthetic injection are essential for minor hand surgeries under local anesthesia (LA). Wide awake local anesthesia no tourniquet (WALANT) became popular for achieving hemostasis without a tourniquet. However, a recent study reported that injection is more painful than tourniquet use in minor hand surgery. Therefore, this study aimed to compare three LA methods that differ according to injection and hemostasis, namely, the combination of a tourniquet and buffered lidocaine solution (CTB), WALANT, and conventional LA. Methods: This randomized prospective single-center study included 169 patients who underwent minor hand surgery between 2017 and 2020. We randomly allocated the patients to each group and recorded the pain and anxiety score during the surgery, as well as satisfaction after the surgery. Results: Pure lidocaine injection was significantly more painful than buffered lidocaine and WALANT solution injection ( p < 0.001). Local anesthesia injection was significantly more painful than tourniquet use in all groups ( p < 0.001). The intraoperative anxiety score was significantly lower in the CTB group than in the conventional LA and WALANT groups ( p < 0.001). The satisfaction score was significantly higher in the CTB and WALANT groups than in the conventional LA group ( p < 0.001). Conclusion: CTB for minor hand surgery under LA is associated with less injection pain and patient anxiety. The tourniquet is tolerable without much pain and waiting time. Thus, CTB in minor hand surgery is a good alternative to WALANT and conventional LA.

Death and COVID-19 Anxiety in Home-Quarantined Individuals Aged 65 and Over During the Pandemic

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.

Gambaran Penerapan Terapi Bermain Mewarnai Gambar Terhadap Tingkat Kecemasan Anak Usia Prasekolah Akibat Hospitalisasi

Hozpitalization is a process that requires children to be hospitalized to receive therapy during the healing process. The children often experience various problem during hospitalization. One of them is anxiety that may be reduced through play therapy. This study aims to describe the implementation of play therapy by coloring pictures in reducing anxiety. This case study involved two preschool-aged children who experienced anxiety due to hospitalization. Anxiety level was measured by using Faces Anxiety Scale (FAS). Two patients were asked to play coloring pictures during hospitalization. Anxiety level was measured before and after the intervention. The results show that before the intervention the anxiety score in first patient was 3 while second patient was 2. After the intervention the anxiety score in both cases was 1. This case study indicate that play therapy can resolve anxiety among children undergoing hospitalization. This study suggests for nurses to implement play therapy by coloring pictures as an alternative way to reduce anxiety levels in preschool children due to hospitalization.Keywords: Hospitalization; anxiety; preschool; play therapy coloring picture AbstrakHospitalisasi adalah suatu proses yang mengharuskan anak dirawat di rumah sakit untuk mendapat terapi sampai proses penyembuhan. Masalah yang sering dialami oleh anak saat menjalani hospitalisasi adalah kecemasan. Salah satu cara untuk menurunkan kecemasan yaitu melalui terapi bermain. Penelitian ini bertujuan untuk menggambarkan penerapan terapi bermain mewarnai gambar dalam menurunkan tingkat kecemasan pada anak prasekolah akibat hospitalisasi. Desain penelitian berupa studi kasus pada 2 anak usia prasekolah yang mengalami kecemasan akibat hospitalisasi. Alat ukur kecemasan menggunakan Faces Anxiety Scale (FAS). Fokus intervensi berupa penerapan terapi bermain mewarnai gambar. Cara mengevaluasi dengan membandingkan skor kecemasan FAS sebelum dan sesudah intervensi. Hasil menunjukkan sebelum intervensi skor kecemasan pada kasus satu yaitu 3 sedangkan pada kasus dua yaitu 2. Setelah intervensi skor kecemasan pada kedua kasus yaitu 1. Hasil studi kasus ini menunjukan masalah kecemasan pada dua kasus teratasi. Kesimpulan terapi bermain mewarnai gambar terbukti dapat menurunkan kecemasan pada anak hospitalisasi. Saran bagi perawat diharapkan dapat menerapkan terapi bermain mewarnai gambar sebagai salah satu cara alternatif dalam meurunkan tingkat kecemasan pada anak prasekolah akibat hospitalisasi.Kata kunci: Hospitalisasi; kecemasan; terapi bermain; prasekolah

Maternal Anxiety and Infants Birthweight and Length of Gestation. A sibling design

Background The overall aim of this study is to examine the effect of prenatal maternal anxiety on birthweight and gestational age, controlling for shared family confounding using a sibling comparison design. Methods The data on 77,970 mothers and their 91,165 children from the population-based Mother, Father and Child Cohort Study and data on 12,480 pairs of siblings were used in this study. The mothers filled out questionnaires for each unique pregnancy, at 17th and 30th week in pregnancy. Gestational age and birth weight was extracted from the Medical Birth Registry of Norway (MBRN). Associations between prenatal maternal anxiety (measured across the 17th and 30th weeks) and birth outcomes (birthweight and gestational age) were examined using linear regression with adjustment for shared-family confounding in a sibling comparison design. Results In the population level analysis the maternal anxiety score during pregnancy was inversely associated with new-born’s birthweight (Beta = -63.8 95% CI: -92.6, -35.0) and gestational age (Beta = -1.52, 95% CI: -2.15, -0.89) after adjustment for several covariates. The association of the maternal anxiety score with birthweight was no longer significant, but remained for maternal anxiety at 30th week with gestational age (Beta = -1.11, 95% CI: -1.82, -0.4) after further adjusting for the shared-family confounding in the sibling comparison design. Conclusion No association was found for maternal prenatal anxiety with birth weight after multiple covariates and family environment were controlled. However, there was an association between prenatal maternal anxiety at 30th week only with gestational age, suggesting a timing effect for maternal anxiety in third trimester.

Effects of comfort care on joint function, pain degree and Baird score after minimally invasive ankle fracture

Objectives: To explore the effect of comfort nursing on joint function, pain degree and Baird score after minimally invasive ankle fracture. METHODS: A total of 62 patients with minimally invasive fracture of ankle joint treated in our hospital from July 2019 to July 2020 were selected as the research subjects. According to random number method, all patients were divided into observation group and control group, with 31 cases in each group. Conventional nursing intervention was carried out in the control group and comfort nursing intervention was given in the observation group. After surgery, the recovery of bare joint function was compared between the two groups. Pain scale (VAS) was used to evaluate the degree of pain in the two groups, the Hamilton Anxiety Scale (HAMA) was used to assess patients' anxiety levels, and the comparison was made before, 3 months and 6 months after surgery. The postoperative Baird scores of the two groups were compared. The incidence of postoperative complications between the two groups was statistically analyzed and compared. The nursing satisfaction of the two groups of patients was compared. RESULTS: Compared with the control group, the number of excellent and good cases in observation group was significantly increased (P<0.05), while the number of poor cases was significantly decreased (P<0.05). There was no significant difference in the degree of pain and anxiety between the two groups before operation (P>0.05). Compared with preoperation, the pain degree, body anxiety degree and mental anxiety degree in 2 groups at 3 and 6 months after operation were significantly decreased (P<0.05); The pain score, somatic anxiety score and mental anxiety score of the observation group were significantly lower than those of the control group at 3 and 6 months after surgery (P<0.05); The pain scores of observation group at 3 months and 6 months after surgery were significantly lower than those of control group (P<0.05). Compared with the control group, the postoperative Baird score in observation group was significantly increased (P<0.05); The incidence of pressure sores, wound infection and complications of lower extremity deep vein thrombosis in the observation group was significantly lower than that in the control group (P<0.05). Compared with the control group, the nursing satisfaction of the observation group was significantly increased (P<0.05). Conclusion: The postoperative nursing of patients with minimally invasive fracture of ankle joint, taking comfortable nursing can effectively improve the joint function and nursing satisfaction of patients, relieve thepain of patients, improve their prognosis, has certain advantages, worthy of further clinical promotion and application.

PSYCHOEDUCATION REDUCES ANXIETY IN ELDERLY WITH HYPERTENSION IN NAMBAKOR VILLAGE SARONGGI DISTRICT SUMENEP

Introduction: The problems in hypertension will cause emotional or mental disorders, one of which is anxiety. Feelings arise due to the fear and ignorance of an individual about hypertension experienced and the impact that will occur in the future. Psychoeducation is the provision of information about disease management and individual psychological aspects. This study aims to determine the effect of psychoeducation on the anxiety level of elderly patients with hypertension in Nambakor Village, Saronggi District.Methods: This research method is pre-experimental with the research design is one group pre test post test. The sampling technique used is Random Sampling and the number of samples is 30 respondents. Data collection using a questionnaire on the level of anxiety Depression Anxiety and Stress Scale.Result: The results showed that the mean of the anxiety score before the psychoeducation intervention was 24,43±7,60 and the mean of the anxiety score after the psychoeducation intervention was was 23,23 ± 7,83. The results of the paired t test of anxiety score was p = 0.002, means that there is significant difference in anxiety scores before and after psychoeducation.Conclusion: There is an influence of psychoeducation on the level of anxiety in the elderly with hypertension. The conclusion obtained is that psychoeducation can increase knowledge in patients with hypertension so that it is expected to be one form of intervention that can be applied.

The Effect of Exercise on Death Anxiety

Aim: This research is planned to identify the effect of exercise on death anxiety in women in the post-menopausal period. Methods: This research is an experiment patterned study (Pre-test/post-test control group model). This model is a two-factor experimental design that shows repetitive measurements (pre-test- post-test) and subjects (experiment-control) in different categories. A total of 36 women voluntarily participated in the study in Erzincan, including 18 women in the experimental group who go through menopause and exercise, and 18 women in the control group who go through menopause and never exercise. The experimental group were given Pilates exercises 3 days a week for 8 weeks, and the control group were asked to preserve their daily lives without regular exercise. In the research, personal information form containing sociodemographic variables of individuals and the Templer Death Anxiety Scale (DAS) form adapted to Turkish by Akça, Köse (2008) were used as data collection tools. After identifying the distribution characteristics in the analysis of the data, paired t-test was used for in-group comparisons and independence sample t-test was used for intergroup comparisons in order to identify the effectiveness of the exercise program and to discover the difference between the first and last test scores of the groups. Results: In the Death Anxiety Scale, the mean death anxiety score was found to be 8.66 as a result of the pre-test performed in the experimental group. And after the exercise, the mean score was 8.38. Although there was no statistically significant difference, there was a decrease in the death anxiety score averages. The mean pre-exercise death anxiety score of the control group was found to be 8.33. The mean post-exercise score was found to be 8.22. Conclusion: There was no significant effect of 8 weeks of exercise on death anxiety. It is understood that even if exercise has some positive physical and psychological contributions on the subjects during this period, a strong anxiety such as death cannot be eliminated in such a short time. Keywords: Exercise, Death Anxiety, Menopause

To Assess the Level of Anxiety of Parents Regarding Invasive Procedures among Hospitalized Children

Background: Hospitalization is a completely new experience to infants and young children. Some parents know the illness about their child but some have not but most of them don’t know the treatment regimen on illness of child through which he/ she is going through. When the child is admitted in patient department he or she has go through. As they don’t know about the procedures through which their child undergone; that responsible for the increase in anxiety level of father and mother both. Various questions are there in their mind; about which kind of procedure is this, my child is bearing or not? How painful it is? Is my child crying? All these questions are arises. As they don’t know about the procedures so these questions are increasing the stress level and anxiety level of parents. Objective: To assess the level of anxiety of parents regarding invasive procedures among hospitalized children 2. To compare the level of anxiety of mother and father regarding invasive procedures among hospitalized children 3. To associate the level of anxiety of parents regarding invasive procedures with selected demographic variables. Methods and Materials: Descriptive survey method. Tool: Standardized and validated STAI anxiety tool. Research Approach: Descriptive approach. Sample Size: 100. Sampling technique: Non convenient sampling technique Sample: Parents of hospitalized child. Setting: Selected hospital. Results: In these study the level of anxiety were seen into 4 categories; no anxiety, mild, moderate and severe anxiety. No anxiety had been seen in parents having score range (0 - 25%), mild anxiety is assessed in 15 parents having anxiety score (26 – 50%) while in 80 parents an moderate anxiety is assessed having score range in between (51 – 75%) and severe anxiety was assessed in 5 parents of an hospitalized child who were undergoing selected invasive procedures and having anxiety score in between (76 – 100%) on Comparison of level of anxiety of mother and father regarding invasive procedures in hospitalized children shows that mother had more anxiety level than father. Conclusion: In the study, moderate anxiety is assessed in 80% of parents while shown an association in between anxiety level and knowledge of a parents as well as the age of hospitalized child.