Soothing Surgery Jitters…Could A Stressball or Hand-Holding Help?

Many skin cancer surgeries are performed using a local anesthetic. While this is preferable to full sedation, there may be more patient anxiety associated with being alert and awake during procedures. In other surgical fields, there is some indication that hand-holding and other relaxation methods help patients feel more at ease.

A recent study looked at whether hand-holding or holding a stress ball reduced patient anxiety during a nonmelanoma skin cancer excision. Patients were randomized into three groups: hand-holding, stress ball use, or control (treatment as usual). Anxiety level was measured for all groups both before and right after the procedure began using a visual analog scale (VAS), the 6-item State Trait Anxiety Inventory (STAI), and physiologic measures such as blood pressure and heart rate.

The results showed that for all patients’ anxiety was reduced immediately after the procedure began, but there was no significant difference between the three groups. Anecdotally, some patients in the hand-holding or stressball groups did report feeling less anxiety, but the data did not support significant differences in the interventions. There were also no significant differences in how the patients ranked their post procedure pain levels or patient satisfaction. Patients were also asked how many hours they spent researching their procedure beforehand; those that had researched had significantly increased levels of anxiety before the procedure.

The authors conclude that although the study did not show a cohort-wide effect, some subgroups may still benefit from these low cost interventions. In addition, patients may appreciate reassuring preoperative informational materials before procedures to help counter any anxiety-producing information they may find during their own research.