Advertisement

Evaluating the Effect of Preoperative Provision of Information on Salivary Cortisol in Patients Undergoing Breast Cancer Surgery: A Randomized Controlled Study

      Abstract

      Purpose

      Surgery is considered to be an anxious experience and most patients experience preoperative anxiety. Preoperative awareness has long been one of the most effective ways to reduce fear and anxiety caused by surgery. The aim of this study was to determine the effect of preoperative provision of information on salivary cortisol in candidates for breast cancer surgery.

      Design

      This randomized clinical trial was conducted on 80 patients (divided into control group and intervention group; 40 patients in each group) admitted to the surgery department of the Cancer Institute of Imam Khomeini hospital in Iran. Samples were selected using random allocation method with a block size of four. Data were collected on participants' demographic characteristics and salivary cortisol.

      Methods

      The educational intervention for patients in the control group was routine training and for patients in the intervention group was based on the training booklet approved by cancer specialists. Findings were analyzed using SPSS software version 21.

      Findings

      The mean age of participants in the intervention and control groups was 44.00 ± 11.45 and 42.62 ± 12.83 years, respectively . The mean score of anxiety in the intervention group was 18.85± 6.19 before intervention, and decreased to 7.40± 3.68 after intervention . The mean score of anxiety in the control group was 19.75 ± 7.26 and significantly decreased to 14.25 ± 5.73 at the end of the study.

      Conclusions

      The results showed that preoperative anxiety significantly decreased in both groups, but was lower overall in the intervention group. In fact, using an educational booklet to raise awareness about patients' health, surgery knowledge and postoperative care as well as how to adapt to postsurgery physical changes and to promote psychological support can reduce patients' anxiety. Hence, providing education to patients may be integrated as a complementary method in patients' routine education.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of PeriAnesthesia Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Meshkat M
        • Baghestani AR
        • Zayeri F
        • Khayamzadeh M
        • Akbari ME.
        Survival rate and prognostic factors among Iranian breast cancer patients.
        Iranian J Public Health. 2020; 49: 341
        • Bray F
        • Ferlay J
        • Soerjomataram I
        • Siegel RL
        • Torre LA
        • Jemal A.
        Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.
        CA: A Cancer J Clin. 2018; 68: 394-424
        • Tao Z
        • Shi A
        • Lu C
        • Song T
        • Zhang Z
        • Zhao J.
        Breast cancer: epidemiology and etiology.
        Cell Biochem Biophys. 2015; 72: 333-338
        • Tsaras K
        • Papathanasiou IV
        • Mitsi D
        • et al.
        Assessment of depression and anxiety in breast cancer patients: prevalence and associated factors.
        Asian Pac J Cancer Prev. 2018; 19: 1661
        • Xin W
        • Jieru W
        • Reuben Cofie ACK
        • Aizhong L
        Prevalence of posttraumatic stress disorder among breast cancer patients: a meta-analysis.
        Iranian J Public Health. 2016; 45: 1533
        • Derakhshan MK
        • Karbassian MH.
        Psychiatric and psychosocial aspects of breast cancer diagnoses and treatments.
        Cancer Genetics and Psychotherapy. Springer, 2017: 45-77
        • Lawenda BD
        • Blumberg JB.
        Response: re: should supplemental antioxidant administration be avoided during chemotherapy and radiation therapy?.
        J Natl Cancer Inst. 2009; 101: 125-126
        • Hoyt MA
        • Marin-Chollom AM
        • Bower JE
        • Thomas KS
        • Irwin MR
        • Stanton AL.
        Approach and avoidance coping: diurnal cortisol rhythm in prostate cancer survivors.
        Psychoneuroendocrinology. 2014; 49: 182-186
        • Bevers TB
        • Helvie M
        • Bonaccio E
        • et al.
        Breast cancer screening and diagnosis, version 3.2018, NCCN clinical practice guidelines in oncology.
        J Natl Compr Canc Netw. 2018; 16: 1362-1389
        • Tong CW
        • Wu M
        • Cho W
        • To KK.
        Recent advances in the treatment of breast cancer.
        Front Oncol. 2018; 8: 227
        • ten Wolde B
        • Kuiper M
        • de Wilt JH
        • Strobbe LJ.
        Postoperative complications after breast cancer surgery are not related to age.
        Ann Surg Oncol. 2017; 24: 1861-1867
        • Ota D
        • Fukuuchi A
        • Iwahira Y
        • et al.
        Identification of complications in mastectomy with immediate reconstruction using tissue expanders and permanent implants for breast cancer patients.
        Breast Cancer. 2016; 23: 400-406
        • Lemos MF
        • Lemos-Neto SV
        • Barrucand L
        • Verçosa N
        • Tibirica E.
        Preoperative education reduces preoperative anxiety in cancer patients undergoing surgery: usefulness of the self-reported Beck anxiety inventory.
        Revista brasileira de anestesiologia. 2019; 69: 1-6
      1. Thiel KJ, Dretsch MN. The basics of the stress response: a historical context and introduction. 2011.

        • Fulford AJ
        • Harbuz MS.
        An introduction to the HPA axis.
        Techniques in the Behavioral and Neural Sciences. 15. Elsevier, 2005: 43-65
        • Hellhammer DH
        • Wüst S
        • Kudielka BM.
        Salivary cortisol as a biomarker in stress research.
        Psychoneuroendocrinology. 2009; 34: 163-171
        • Pernambuco AP
        • Carvalho LdSC
        • Schetino LPL
        • Polese JC
        • Viana RdS
        • Reis DdÁ
        Effects of a health education program on cytokines and cortisol levels in fibromyalgia patients: a randomized controlled trial.
        Adv Rheumatol. 2018; 58: 21
        • Kalogianni A
        • Almpani P
        • Vastardis L
        • Baltopoulos G
        • Charitos C
        • Brokalaki H
        Can nurse-led preoperative education reduce anxiety and postoperative complications of patients undergoing cardiac surgery?.
        Eur J Cardiovasc Nurs. 2016; 15: 447-458
        • Jamsahar M
        • Navab E
        • Yekaninejad MS
        • Navidhamidi M.
        The effect of provision of information on serum cortisol in patients transferred from the coronary care unit to the general ward: a randomised controlled trial.
        Intensive Crit Care Nurs. 2018; 46: 38-43
        • Webster S
        • Chandrasekaran S
        • Vijayaragavan R
        • Sethu G.
        Impact of emotional support on serum cortisol in breast cancer patients.
        Indian J Palliat Care. 2016; 22: 141
        • Al-Sorkhy M
        • Fahl Z
        • Ritchie J
        Cortisol and breast cancer: a review of clinical and molecular evidence.
        Ann Cancer Res Ther. 2018; 26: 19-25
        • De Brabander B
        • Gerits P.
        Chronic and acute stress as predictors of relapse in primary breast cancer patients.
        Patient Educ Couns. 1999; 37: 265-272
        • Turner-Cobb JM
        • Sephton SE
        • Koopman C
        • Blake-Mortimer J
        • Spiegel D.
        Social support and salivary cortisol in women with metastatic breast cancer.
        Psychosom Med. 2000; 62: 337-345
        • Kang G
        • Oh S.
        Effects of mindfulness meditation program on perceived stress, ways of coping, and stress response in breast cancer patients.
        J Korean Acad Nurs. 2012; 42: 161-170
        • Rao MR
        • Raghuram N
        • Nagendra H
        • et al.
        Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial.
        Complement Ther Med. 2009; 17: 1-8