The interactive effect of preoperative consultation and operating room admission by a counselor on anxiety level and vital signs in patients undergoing Coronary Artery Bypass Grafting surgery. A clinical trial study

  • Zandi Shirdel M.Sc. Student, Department of Operating Room, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran. Email:
  • Imani Behzad Assistant professor, Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
  • Babak Manaf Assistant professor, Department of heart surgery, School of medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Email:
  • Mehdi Saheb BSc. Operating Room. Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. Email:
Keywords: coronary artery bypass, respiratory rate, blood pressure, temperature, heart rate, operating rooms, counselors, anxiety, control groups


Objective. The purpose of this study was to provide
appropriate preoperative supportive conditions to improve
anxiety and vital signs for patients undergoing Coronary
Artery Bypass Grafting -CABG- surgery.

Methods. This clinical trial study was performed on 90 patients undergoing
CABG surgery in Farshchian Hospital of Hamadan, Iran
in 2019. Sample was selected by convenience and were
randomly divided into three groups: control (n=30),
intervention1 (n=30), and intervention2 (n=30). The
control group received only the routine preoperative
counseling of ward and admitted to the operating room
as usual; the intervention1 and intervention2 groups in
addition received another two counseling sessions, then
the intervention1 group was admitted in the operating room as usual, but the intervention2 group was admitted by the counselor in the operating
room. Data were collected using a three-part questionnaire including demographic
characteristics, vital signs chart, and the Spielberger’s State-Trait Anxiety Inventory.

Results. The results showed that there was a significant difference in the mean
anxiety of the three groups after admission in the operating room (intervention2 was
lower than intervention1 and control groups, p<0.001; and intervention 1 group
was lower than control group, p<0.001) and also there was a significant difference
between the mean systolic blood pressure, heart rate and respiratory rate of the
three groups (p<0.001) but the mean of the variables of temperature and diastolic
blood pressure in the three groups were not significantly different (p=0.59 and
p=0.225, respectively).

Conclusion. Our results revealed preoperative consultation
and admission in the operating room by the consultant can reduce the level of
anxiety and stability of vital signs of patients undergoing CABG.

= 75 veces | PDF
= 35 veces|


Download data is not yet available.


1. Calabresi L, Nofer JR, Norata GD. Announcement: HDL biology: new insights in metabolism, function and
translation. Cardiovasc. Res. 2014;103(3):337-40.
2. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, et al. Heart disease and stroke statistics--2012 update:
a report from the American Heart Association. Circulation. 2012;125(1):e2-e220.
3. World Health Organization. Noncommunicable diseases country profiles 2018 [Internet]. Geneve: WHO; 2019.
Available from:
4. Forouzanfar MH, Sepanlou SG, Shahraz S, BESc PN, Pourmalek F, Lozano R, et al. Evaluating causes of death and
morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010. Arch. Iran. Med. 2014;17(5):304.
5. Seifi Z, Bikmoradi A, Bazrafshan M-R, Poorolajal J, Araghchian M, Kashfi SH, et al. The effect of inhalation
aromatherapy with lavender essential oil on pain severity of patients after coronary artery bypass surgery: A singleblind randomised clinical trial. J. Clin. Diagn. Res. 2018;12(7):LC01-LC05.
6. Malmir M, Teimouri F, Pishgooie A, Dabaghi P. ‎ The Role of Benson´ s relaxation on reducing state anxiety on
candidate of open heart surgery patient’s‏ .Mil. Caring Sci. J. 2015; 2(3):182-90.
7. Brunner LS, Smeltzer S, Suddarth’s D. Brunner & Suddarth’s textbook of medical-surgical nursing. 12th Ed.
Philadelphia: Lippincott Williams & Wilwins; 2010.
8. Gonçalves KKN, da Silva JI, Gomes ET, de Souza Pinheiro LL, Figueiredo TR, da Silva Bezerra SMM. Anxiety in the
preoperative period of heart surgery. Rev. Braz. Enferm. 2016; 69(2):374.
9. Ghasemi S, Darzi HB, Ebadi A. Comparison of the effects of aromatherapy with rose and lavender on physiological
parameters of patients undergoing open heart surgery: A clinical trial. J. Crit. Care Nurs. 2017;10(2):e10029.
10. Ko JS, Whiting Z, Nguyen C, Liu RW, Gilmore A. A randomized prospective study of the use of Ipads in reducing
anxiety during cast room procedures. Iowa Orthop. J. 2016; 36:128-32.
11. Tully PJ, Winefield HR, Baker RA, Denollet J, Pedersen SS, Wittert GA, et al. Depression, anxiety and major adverse
cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: a five year
longitudinal cohort study. BioPsychoSoc. Med. 2015; 9(1):14.
12. Matthias AT, Samarasekera DN. Preoperative anxiety in surgical patients-experience of a single unit. Acta
Anaesthesiol. Taiwan. 2012; 50(1):3-6.
13. Ko CH, Chen YY, Wu KT, Wang SC, Yang JF, Lin YY, et al. Effect of music on level of anxiety in patients undergoing
colonoscopy without sedation. J. Chin. Med. Assoc. 2017; 80(3):154-60.
14. Babaii A, Abbasinia M, Hejazi SF, Tabaei SRS, Dehghani F. Effect of Rosa Aromatherapy on Anxiety before Cardiac
Catheterization: A Randomized Controlled Trial. Health, Spiritual. Med. Ethics. 2015; 2(3):2-8.
15. Mobini-Bidgoli M, Taghadosi M, Gilasi H, Farokhian A. The effect of hand reflexology on anxiety in patients
undergoing coronary angiography: A single-blind randomized controlled trial. Complement. Ther. Clin. Pract. 2017;
16. Heidari S, Babaii A, Abbasinia M, Shamali M, Abbasi M, Rezaei M. The effect of music on anxiety and cardiovascular
indices in patients undergoing coronary artery bypass graft: a randomized controlled trial. Nurs. Midwifery Stud.
2015; 4(4): e31157.
17. Bagheri H, Ebrahimi H, Abbasi A, Atashsokhan G, Salmani Z, Zamani M. Effect of preoperative visitation by
operating room staff on preoperative anxiety in patients receiving elective hernia surgery. J. Perianesth. Nurs. 2019;
18. Bagheri H, Ebrahimi H, Abbasi A, Atashsokhan G, Salmani Z, Zamani M. Effectiveness of Preoperative Visitation
on Postanesthesia Complications. J. Perianesth. Nurs. 2018; 35(5):651-7.
19. Camponogara S, Soares S, Silveira M, Viero C, Barros C, Cielo C. Preoperative patients’ perceptions of cardiac
surgery. Rev. Min. Enferm. 2012; 16(3):382-90.
20. Roohy G, Rahmany A, Abdollahy A, GhR M. The effect of music on anxiety level of patients and some of physiological
responses before abdominal surgery. J. Gorgan Univ. Med. Sci. 2005; 7(1):75-8.
21. Safara M, Salmabadi M, Edalatkhah Z, Rostami N. Examining the Relationship between Religiosity with Anxiety of
Mothers and Number of Children. Asian Soc. Sci. 2016; 12:23-8.
22. Akbarzadeh F, Ranjbar KF, Bagheri Z, Ghezel M. Effect of preoperative information and reassurance in decreasing
anxiety of patients who are candidate for coronary artery bypass graft surgery. Eur. Psychiatr. 2010; 25(Supp
23. Fazlollahpour-Rokni F, Shorofi SA, Mousavinasab N, Ghafari R, Esmaeili R. The effect of inhalation aromatherapy
with rose essential oil on the anxiety of patients undergoing coronary artery bypass graft surgery. Complement.
Ther. Clin. Pract. 2019; 34:201-7.
24. Fomani FK, Amiri M, Karimooi MH, Rejeh N, Khani F. The Effects of applying Nursing Counseling Program on the
Anxiety and Vital Signs of Patients undergoing Colonoscopy admitted in Imam Khomeini Hospital, Tehran. Iran. J.
Nurs. Res. 2018; 13(5): 80-7.
25. Adib-Hajbaghery M, Abasi A, Rajabi-Beheshtabad R. Whole body massage for reducing anxiety and stabilizing vital
signs of patients in cardiac care unit. Med. J. Islam. Repub. Iran. 2014; 28:47.
26. Orujlu S, Hemmati-Maslakpak M. Effect of nursing interventions on anxiety and vital signs in patients undergoing
endoscopy: a randomized clinical trial study. J. Clin. Nurs. Midwifery. 2014;3(3): 36-43.
27. Karaman Özlü Z, Tuğ Ö, Çay Yayla A. Inevitable problems of older people: presurgery information effect on anxiety
levels in patients undergoing cataract surgery. J. Clin. Nurs. 2016; 25(9-10):1388-94.
28. Rosiek A, Kornatowski T, Rosiek-Kryszewska A, Leksowski Ł, Leksowski K. Evaluation of stress intensity and
anxiety level in preoperative period of cardiac patients. BioMed Res Int. 2016; 2016:1248396
29. Genc H, Saritas S. The effects of lavender oil on the anxiety and vital signs of benign prostatic hyperplasia patients
in preoperative period. EXPLORE. 2020;16(2):116-22.
30. Degirmen N, Ozerdogan N, Sayiner D, Kosgeroglu N, Ayranci U. Effectiveness of foot and hand massage in
postcesarean pain control in a group of Turkish pregnant women. App. Nurs. Res. 2010; 23(3):153-8.
31. García R, Caballero Y, Mena Sánchez R. Anxiety in gastroscopies: Comparison of two nursing interventions in
endoscopy without sedation. Enferm. Glob. 2013; 32:41-50.
32. Zarei B, Valiee S, Nouri B, Khosravi F, Fathi M. The effect of multimedia-based nursing visit on preoperative anxiety
and vital signs in patients undergoing lumbar disc herniation surgery: A randomised clinical trial. J. Perioper. Pract.
How to Cite
Shirdel, Z., Behzad, I., Manaf, B., & Saheb, M. (2020). The interactive effect of preoperative consultation and operating room admission by a counselor on anxiety level and vital signs in patients undergoing Coronary Artery Bypass Grafting surgery. A clinical trial study. Investigación Y Educación En Enfermería, 38(2).