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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 25, No 6, November/December 2014
AFRICA
261
group 2 (
p
<
0.001). On the other hand, trait anxiety decreased
significantly with education in both groups (
p
<
0.001 for both
groups) (Tables 2, 3).
Socio-demographic variables had a limited effect on the
change in STAI scores with education in both study groups
(Table 4). In the standard-education group (group 1), none of
the socio-demographic variables had an effect on the education-
induced change in state and trait anxiety scores, except gender;
in male patients, a larger change in trait anxiety was found with
education (
p
=
0.017).
In the individualised-education group (group 2), only working
status had a significant effect on the education-induced change in
state anxiety (
p
=
0.029). Marital status (
p
=
0.017) and exercise (
p
=
0.048) had significant effects on the education-induced change
in trait anxiety.
In both study groups, there was no significant correlation
between education-induced change in state or trait anxiety
scores and age, weight or income of patients, except a slight
significant negative correlation between change in trait anxiety
score and weight of patients in group 1 (
r
=
–0.257;
p
=
0.011). Accordingly, as weight increased, the education-induced
reduction of trait anxiety decreased in patients receiving
standard education (Table 5).
Discussion
In this prospective, hospital-based, blind-analysis study, we found
that in-patient education was effective in decreasing anxiety
levels of patients who were hospitalised in a cardiovascular
clinic for coronary artery bypass surgery. More remarkably, our
findings showed that in-patient education targeted to the patient’s
particular needs provided more benefit than standard education
in decreasing anxiety of patients about self-care after discharge.
Patients hospitalised for coronary artery bypass surgery in
cardiovascular surgery clinics are usually under psychological
pressure about the surgery and their new life after discharge.
This pressure is greater if they are not aware of and ready for
the problems that may develop during home care after discharge.
Studies have shown that patients for whom cardiac surgery is
planned, want to know about their disease and its treatment,
complications and measures that should be taken, and lifestyle
after surgery.
9
Goodman
10
evaluated what information and
support patients feel they need in the six-week rehabilitation
period following discharge after cardiac surgery, and pointed to
the need for improvements in the psychological preparation of
patients for discharge after cardiac surgery.
In this study, therefore, we focused on the effect of in-patient
education on patients’ anxiety levels. We used the STAI, a
well-established anxiety tool, to determine their anxiety about
the period after discharge (presented as state anxiety) and
general level of anxiety (presented as trait anxiety). Our study
population had high levels of both state and trait anxiety on the
first day of hospitalisation before in-patient education.
Table 1. Socio-demographic characteristics
of the study patients
Group 1
(standard
education)
(
n
=
98)
Group 2
(individualised
education)
(
n
=
100)
p
-value
Gender
Male
73 (75)
72 (72)
0.407
Female
25 (26)
28 (28)
Age (years)
62.1
±
10.2
59.1
±
9.8
0.038
Weight (kg)
75.6
±
11.2
80.3
±
13.5
0.008
Marital status
Married
92 (94)
94 (94)
0.602
Single
6 (6)
6 (6)
Having children
Yes
96 (98)
94 (94)
0.146
No
2 (2)
6 (6)
Education
Primary school
78 (80)
68 (68)
0.025
Middle school
10 (10)
13 (13)
High school
7 (7)
6 (6)
University
3 (3)
3 (3)
Illiterate
0 (0)
10 (10)
Working status
Working
30 (31)
30 (30)
0.524
Not working
68 (69)
70 (70)
Income ($
*
/TL
#
per month) 624.0
±
418.6 406.7
±
202.3
<
0.001
Smoking
Yes
27 (28)
31 (31)
0.353
No
71 (72)
69 (69)
Alcohol consumption
Yes
12 (12)
18 (18)
0.176
No
86 (88)
82 (82)
Exercise
Yes
18 (18)
48 (48)
<
0.001
No
80 (82)
52 (52)
Frequency of exercise
None
56 (57)
52 (52)
0.002
3–4 times/week
12 (12)
9 (9)
Daily
10 (10)
30 (30)
1–2 times/week
20 (20)
9 (9)
On a diet
Yes
24 (25)
36 (36)
0.054
No
74 (76)
64 (64)
Data are given as
n
(%) or mean
±
standard deviation.
*
$, US Dollar;
#
TL, Turkish Lira (the exchange rate was 1 TL = $1.9961).
Table 2. State anxiety scores from the STAI
Group 1
(standard
education)
(
n
=
98)
Group 2
(individualised
education)
(
n
=
100)
t
-value
p
-value
Before education 54.34
±
5.06 55.23
±
3.94 1.38 0.168
After education 54.96
±
4.47 26.93
±
2.56 –54.01
<
0.001
t
-value
0.50
65.77
p
-value
0.275
<
0.001
Table 3. Trait anxiety scores from the STAI
Group 1
(standard
education)
(
n
=
98)
Group 2
(individualised
education)
(
n
=
100)
t
-value
p
-value
Before education 47.36
±
6.71 46.91
±
4.48 –0.55 0.583
After education 43.41
±
5.79 34.45
±
4.83 –11.82
<
0.001
t
-value
4.71
33.83
p
-value
<
0.001
<
0.001