Effect of Emotional Freedom Technique Applied to Patients Before Laparoscopic Cholecystectomy on Surgical Fear and Anxiety: A Randomized Controlled Trial

October 31, 2023 Anxiety, EFT and surgery, Fear, gallbladder, gallstone, surgical anxiety, surgical fear, Turkey

Citation:Menevse, S. & Yavla, A.  (2023).  Effect of Emotional Freedom Technique applied to patients before laparoscopic cholecystectomy on surgical fear and anxiety: A randomized controlled trial.  Journal of PeriAnesthesia Nursing, 6 October 2023.  https://doi.org/10.1016/j.jopan.2023.07.006

Abstract

Purpose
No studies have investigated the effect of the Emotional Freedom Technique (EFT) on the surgical fears and anxieties of patients before laparoscopic cholecystectomy. This study aimed to determine the effect of EFT on patients’ surgical fears and anxieties before laparoscopic cholecystectomy.

Design
The research was conducted using a pretest, post-test, and randomized controlled experimental research design.

Methods
A total of 112 patients (56 in the intervention group and 56 in the control group) were included in the study. While routine care and treatment practices were applied to the control group, EFT was applied to the intervention group. A Patient Information Form, an Anxiety Specific to Surgery Questionnaire, a Surgical Fear Questionnaire, and Subjective Units of Disturbance (SUD) were used to collect the research data.

Findings
There was no significant difference between the groups in terms of descriptive and clinical features (P > .05). The post-test score averages of EFT group in the Surgical Fear Questionnaire, Anxiety Specific to Surgery Questionnaire, and SUD were significantly lower than in the control group (P < .001). The EFT significantly reduced the SUD scores of the patients by 54.4% (η2 = 0.544, P < .001).

Conclusions
EFT was found to be useful in clinical practice in the preoperative period, reducing surgery-specific anxiety and surgical fear. EFT can be recommended for application during the preoperative period in clinics.

Craig’s Comments:

This is the first study and clinical trial that I am aware of to measure the effectiveness of EFT for surgery specific fear and anxiety. The surgery is apparently now the gold standard surgery for gallstones and bile duct obstructions. The trial was performed in Tukey and conducted with 112 patients, measuring standard care vs EFT intervention. (The abstract does not report the length or number of sessions). You will find some valuable snippets below, but my personal favorite exerpt is: 

This practice supports the holistic implementation of modern health care. In line with these results, the following are recommended: providing training to nurses on EFT, applying EFT in clinics to reduce anxiety and fear during the preoperative period, and conducting further studies on EFT …

Elements of the published report per Science Direct’s snippets from the original paper:

• The research was conducted between September 2021 and April 2022 at the General Surgical Clinics of the Malatya Training and Research Hospital.
• The study population consisted of patients undergoing laparoscopic cholecystectomy in the General Surgical Clinics of a training and research hospital (in Turkey) between September 2021 and April 2022 with a sample size of 82 participants
• Discussion: Nonpharmacological strategies have been developed in recent years to reduce anxiety and fear before surgical intervention. One nonpharmacological method is EFT. This study was the first research conducted to determine the effect of EFT on surgical fear and anxiety when applied to patients before laparoscopic cholecystectomy. The findings of this study are interpreted and discussed in line with similar research findings and related literature.

In this study, it was found that:

• EFT, opioids, serotonin, and gamma-aminobutyric acid are associated with lowering fear and anxiety levels.18, 19
• Following taps on an acupuncture point used in EFT, positive changes occur in brain wave activity.49
• EFT application does not require any equipment, is easily applied and taught, and positively affects care outcomes.17, 49
• It can be used in the preoperative period to reduce fear of and anxiety about surgery.

Conclusion
The results obtained from this study reveal the effectiveness of EFT application before laparoscopic cholecystectomy in reducing surgery-specific anxiety and surgical fear in patients. This practice supports the holistic implementation of modern health care. In line with these results, the following are recommended: providing training to nurses on EFT, applying EFT in clinics to reduce anxiety and fear during the preoperative period, and conducting further studies on EFT …