Development of Nursing Practice Guidelines to Reduce Anxiety in First-Time Cesarean Section Patients: A Perioperative Nursing Project at Phon Thong Hospital, Roi Et Province

Abstract

Purposes: This study aimed to develop appropriate nursing practice guidelines for reducing anxiety in primigravida women undergoing non-emergency cesarean section at Phon Thong Hospital, Roi Et Province.

Study design: This study is a Research and Development (R&D) divided into three phases: 1) the phase of studying the situation and related factors, 2) the phase of developing nursing practice guidelines, and 3) the phase of pilot testing and evaluating the guidelines.

Materials and Methods: The sample consisted of 1) 60 primiparous patients who underwent non-emergency cesarean section, and 2) 15 professional nurses working in the operating room and obstetric ward at Phon Thong Hospital. The research was conducted in three phases: 1) Situation assessment using questionnaires and interviews with 30 primiparous patients and 15 professional nurses; 2) Development of nursing practice guidelines with expert input from 5 specialists (an obstetrician, an anesthesiologist, and 3 professional nurses); and 3) Pilot testing of the guidelines with 30 patients in the experimental group and 30 in the control group, comparing results using Paired t-test, Independent t-test, and ANCOVA. Data collection instruments included a personal and obstetric information questionnaire, the Thai version of the State-Trait Anxiety Inventory (STAI), in-depth interviews regarding patient experiences and care needs to reduce anxiety, a satisfaction questionnaire on nursing practice guidelines, and a feasibility assessment of guideline adherence. Data were analyzed using descriptive statistics such as frequency, percentage, mean, and standard deviation, as well as inferential statistics including Paired t-test, Independent t-test, and ANCOVA (to control for confounding variables).

Main findings: Quantitative findings revealed that the experimental group who received the nursing practice guidelines had significantly lower levels of anxiety, vital signs, and incidence of clinical complications compared to the control group (p < 0.05). The most effective anxiety-reducing activities were providing clear information and guidance, as well as involving family members. Qualitative results supported that comprehensive information delivery and emotional support helped patients feel confident and effectively reduced anxiety. Therefore, it can be concluded that the developed nursing practice guidelines are appropriate and effective for reducing anxiety in first-time cesarean section patients.

Conclusion and Recommendations: The developed nursing practice guidelines effectively reduce anxiety in first-time cesarean section patients. It is recommended to promote the implementation of these guidelines in maternity care units. Further development should be made to encompass holistic care, and additional studies are needed to explore personal factors affecting anxiety.