The effectiveness of information sharing interventions as a means to reduce anxiety in families waiting for surgical patients undergoing an elective surgical procedure: a systematic review protocol

Background: Information provision, preoperative preparation and anxiety reduction for surgical patients has been the dominant focus in surgical care literature, however the care of the families of surgical patients, for whom anxiety is common, also deserves attention. During busy surgical lists the waiting family can be overlooked while care is provided to the patient. As health care providers we should strive to ensure that the human side of patient care does not get lost amongst routine and technology: family members should be kept informed as to the health status of patients and the progress of surgery.
By addressing family members' anxiety, surgical patients will benefit from greater involvement of and support from the family. Anxiety can be exacerbated by a lack of communication between health care staff and family, particularly when families are not informed of unexpected delays. Numerous studies have sought to test informational interventions and their ability to alleviate anxiety for waiting families during surgery. Personal and individualised interventions, as provided by face-to-face information reports during surgery, have been widely used. Less individualised or more remote interventions (such as informational cards or telephone calls) have also been tested. The merits, including the appropriateness and effectiveness of all types of interventions, need to be evaluated. This is a subject not yet addressed by systematic review.

Objectives: To assess the effectiveness of information sharing interventions to reduce anxiety for families waiting for patients undergoing an elective surgical procedure.

Methods: Family members, over 18 years of age, waiting for patients undergoing an elective adult or paediatric surgical procedure were included. All information sharing Interventions for families of patients undergoing an elective adult or paediatric surgical procedure are included, such as surgical nurse liaison services, intraoperative reporting either by face-to-face or telephone delivery, informational cards, visual information screens, and intraoperative paging devices for families. The primary outcome of interest was the level of anxiety amongst family members or close relatives whilst waiting for patients undergoing surgery, as measured by a validated instrument (such as the S-Anxiety portion of the State-Trait Anxiety Inventory). Secondary outcomes include family satisfaction and other measurements that may be considered indicators of stress and anxiety, such as mean arterial pressure (MAP) and heart rate. Study designs for inclusion are all randomised controlled trial (RCTs) quasi-experimental studies, case-controlled and descriptive studies.
A three step search strategy aimed to find both published and unpublished literature in English language from 1990 until May 2013 using a wide range of databases. Two reviewers assessed studies meeting the criteria using the appropriate standardized JBI-MASTARI instrument. A customised data extraction form was used to extract data. JBI-MASTARI software was used to analyse results.

Results: There were a number of studies identified and included in the review. The studies included make several recommendations for practice.

Conclusion: The recommendations from this review emphasize the need for adoption by health care providers to ensure the most appropriate and effective methods of providing information to reduce anxiety in family members of patients undergoing surgical procedures are utilised.