Effectiveness of integrating individualized and generic complementary medicine treatments with standard care versus standard care alone for reducing preoperative anxiety

Q: What does this study say about anxiety?

If you're facing surgery, reflexology combined with standard anxiety treatment may help reduce your pre-surgery nervousness, though it works best as an addition to, not a replacement for, your doctor's care.

Q: What did this study find?

The study compared six treatment groups including standard care alone versus standard care combined with various complementary and alternative medicine methods (guided imagery, acupuncture, and reflexology) for reducing preoperative anxiety. Preoperative anxiety has been shown to correlate with increased post-operative morbidity, establishing the clinical importance of anxiety reduction before surgery. The research evaluated both generic CAM interventions (such as guided imagery recordings) and individualized CAM treatments (such as acupuncture and reflexology) as adjuncts to standard pharmacological anxiety management.

Q: How strong is this evidence?

This is a randomised trial and we rate its evidence strong. It covers 360 participants. It was published in Journal of clinical anesthesia. This study is indexed here for context; it did not test reflexology itself.

Authors: Attias Samuel, Keinan Boker Lital, Arnon Zahi, Ben-Arye Eran, Bar'am Ayala, Sroka Gideon, Matter Ibrahim, Somri Mostafa, Schiff EladJournal: Journal of clinical anesthesiaPublished: March 1, 2016DOI: 10.1016/j.jclinane.2015.10.017

Strong EvidenceRandomized Controlled Trialn=360 participants

Anxiety

In Plain Language: anxiety, explained

Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. Randomized controlled trial. Holding room area Three hundred sixty patients. Patients were randomly divided into 6 equal-sized groups. Group 1 received the standard treatment (ST) for anxiety alleviation with anxiolytics. The five other groups received the following, together with ST (anxiolytics): Compact Disk Recording of Guided Imagery (CDRGI); acupuncture; individual guided imagery; reflexology; and individual guided imagery combined with reflexology, based on medical staff availability. Assessment of anxiety was taken upon entering the holding room area (surgery preparation room) ('pre-treatment assessment'), and following the treatment, shortly before transfer to the operating room ('post-treatment assessment'), based on the Visual Analogue Scale (VAS) questionnaire. Data processing included comparison of VAS averages in the 'pre' and 'post' stages among the various groups. Preoperatively, CAM treatments were associated with significant reduction of anxiety level (5.54-2.32, p<0.0001). In contrast, no significant change was noted in the standard treatment group (4.92-5.44, p=0.15). Individualized CAM treatments did not differ significantly in outcomes. However, CDRGI was less effective than individualized CAM (P<0.001), but better than ST (p=0.005). Individual CAM treatments integrated within ST reduce preoperative anxiety significantly, compared to standard treatment alone, and are more effective than generic CDRGI. In light of the scope of preoperati

Key Findings: what this randomised trial found about anxiety

✓The study compared six treatment groups including standard care alone versus standard care combined with various complementary and alternative medicine methods (guided imagery, acupuncture, and reflexology) for reducing preoperative anxiety.
✓Preoperative anxiety has been shown to correlate with increased post-operative morbidity, establishing the clinical importance of anxiety reduction before surgery.
✓The research evaluated both generic CAM interventions (such as guided imagery recordings) and individualized CAM treatments (such as acupuncture and reflexology) as adjuncts to standard pharmacological anxiety management.

What This Means for You

If you're facing surgery, reflexology combined with standard anxiety treatment may help reduce your pre-surgery nervousness, though it works best as an addition to, not a replacement for, your doctor's care.

What This Means for Practitioners

Reflexology was effective in reducing preoperative anxiety when integrated with standard care, supporting its use as a complementary therapy in clinical settings with medical collaboration.

Study Design: how this randomised trial was run

Sample Size

360 participants

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Anxiety: common questions

What does this study say about anxiety?

What did this study find?

The study compared six treatment groups including standard care alone versus standard care combined with various complementary and alternative medicine methods (guided imagery, acupuncture, and reflexology) for reducing preoperative anxiety. Preoperative anxiety has been shown to correlate with increased post-operative morbidity, establishing the clinical importance of anxiety reduction before surgery. The research evaluated both generic CAM interventions (such as guided imagery recordings) and individualized CAM treatments (such as acupuncture and reflexology) as adjuncts to standard pharmacological anxiety management.

How strong is this evidence?

This is a randomised trial and we rate its evidence strong. It covers 360 participants. It was published in Journal of clinical anesthesia. This study is indexed here for context; it did not test reflexology itself.