Nabighadim Mahsan, Mirghafourvand Mojgan, Maghalian Mahsa
Medical School, Ardabil University of Medical Sciences, Ardabil, Iran.
Social Determinants of Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
Nurs Open. 2025 Jan;12(1):e70122. doi: 10.1002/nop2.70122.
The present study was conducted to determine the effect of non-pharmacological interventions before cataract surgery on preoperative anxiety.
Systematic review and meta-analysis.
Five databases were systematically searched until 9 June, 2024. The risk of bias was evaluated using the ROBIN-I instrument for non-randomised studies and risk of bias 1 (ROB1) for RCTs. For cases with heterogeneity, random effects, rather than fixed effects, were reported, and subgroup analysis was performed based on the type of intervention. The investigation of publication bias was done in the form of a funnel plot, the Egger regression test and the Trim-and-Fill test. Meta-regression analysis was performed to examine the impact of possible confounding factors on the effect size. Sensitivity analysis evaluated the robustness of our findings by excluding quasi-experimental studies and applying the Knapp-Hartung method to assess their influence on the overall results.
A random-effects meta-analysis of 22 studies and 1998 participants revealed that non-pharmacological interventions (back massage, hand massage, foot massage, music, educational video, patient education, aromatherapy and relaxation techniques) significantly reduced mean preoperative anxiety compared to the control group. The subgroup analysis indicated that all interventions were effective in reducing preoperative anxiety; however, hand and foot massage did not yield significant effects. Meta-regression analysis showed a significant correlation between the percentages of women with effect size. The sensitivity analysis confirmed the robustness of non-pharmacological interventions, while the Knapp-Hartung method maintained the overall effect size but indicated wider confidence intervals. More high-quality research is needed to validate these interventions and establish clearer guidelines.
No Patient or Public Contribution.
本研究旨在确定白内障手术前非药物干预对术前焦虑的影响。
系统评价和荟萃分析。
系统检索了五个数据库，直至2024年6月9日。使用针对非随机研究的ROBIN-I工具和针对随机对照试验的偏倚风险1（ROB1）评估偏倚风险。对于存在异质性的病例，报告随机效应而非固定效应，并根据干预类型进行亚组分析。以漏斗图、Egger回归检验和Trim-and-Fill检验的形式进行发表偏倚调查。进行Meta回归分析以检验可能的混杂因素对效应大小的影响。敏感性分析通过排除准实验研究并应用Knapp-Hartung方法评估其对总体结果的影响来评估我们研究结果的稳健性。
对22项研究和1998名参与者进行的随机效应荟萃分析显示，与对照组相比，非药物干预（背部按摩、手部按摩、足部按摩、音乐、教育视频、患者教育、芳香疗法和放松技巧）显著降低了术前平均焦虑水平。亚组分析表明，所有干预措施在降低术前焦虑方面均有效；然而，手部和足部按摩未产生显著效果。Meta回归分析显示效应大小与女性百分比之间存在显著相关性。敏感性分析证实了非药物干预的稳健性，而Knapp-Hartung方法维持了总体效应大小，但表明置信区间更宽。需要更多高质量的研究来验证这些干预措施并制定更明确的指南。
无患者或公众贡献。
