Jhoanna Anuran-Torres, DNP, RN, ACNP-BC

Abstract:

Background: The diagnosis of cancer can increase the risk of anxiety severe enough to interfere with treatment compliance, quality of life, and treatment outcomes (Lee et al., 2017). Anxiety is a common problem in patients scheduled for a procedure, and their level of anxiety increases as the procedure date approaches (Musa et al., 2020); pre-procedural anxiety is observed in hepatocellular carcinoma patients scheduled for liver ablation treatment. There is currently a lack of standardized education provided to patients about liver ablation treatment, which may contribute to patients’ anxiety.Objectives: To test the effectiveness of a pre-procedural video educational tool to reduce patient anxiety and increase knowledge in hepatocellular carcinoma patients in an interventional radiology clinic setting. Methods: This was a quasi-experimental, single-arm study, with a pre-test/post-test. Participant recruitment was based on a convenience sample. Inclusion criteria included: patients ages 18 and older; have biopsy-proven HCC or have a liver mass suspicious for HCC based on LI-RADS criteria imaging; no prior liver ablation treatment within three months of study onset. Exclusion criteria included patients under the age of 18 or those who have had prior liver ablation treatment within the last three months of study onset. Participants watched a 7:04 minutes video and completed a 40-item State-Trait Anxiety Inventory and 10-item Knowledge Questionnaire before and after the video intervention to assess changes in anxiety and knowledge. Demographic variables evaluated included age, gender, education, and primary language. Results: There were 16 participants who met inclusion criteria. The state anxiety scores were significantly lower after the intervention (Md = 33.50, n = 16) compared to before (Md = 47.50, n = 16), z = - 2.67, p = 0.009, with a medium effect size, r = 0.47. The trait anxiety scores did not show sufficient evidence for a difference after the intervention (Md = 40.00, n = 16) compared to before (Md = 39.50, n = 16), z = - 0.71, p = 0.50, with a small effect size, r = 0.13. The knowledge scores were significantly higher after the intervention (Md = 9.00, n = 16) compared to before (Md = 2.00, n = 16), z = - 3.53, p = 0.0005, with a large effect size, r = 0.62. A nonparametric bootstrap and nonparametric permutation test also showed evidence for a difference in mean between the distributions of the state anxiety and knowledge pre- and post-intervention scores. Conclusion: The results of this study showed evidence for the effectiveness of video education in decreasing anxiety and increasing knowledge in hepatocellular carcinoma patients. A standardized pre-procedural video educational tool can be a useful practice across all interventional radiology departments as it is associated with improved quality of care and positive health outcomes. 

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