Implementing a Paced Deep Breathing Module to Decrease Preoperative Anxiety in Gynecological Surgery Patients

Preoperative anxiety is a common occurrence for many patients undergoing all types of
surgery. Patients with a high level of anxiety before surgery have been shown to have
numerous negative outcomes both intra-operatively and post-operatively. Many studies have
shown that preoperative psychological interventions that aim to reduce anxiety also result in
improved post-operative behavioral and clinical recovery. Currently, the most common method
to treat preoperative anxiety is the administration of a prescription benzodiazepine.
However, there is limited clinical evidence that supports the use of sedative premedication,
such as with a benzodiazepine, before surgery. Complementary integrative medical therapies
including music, massage, guided imagery, and deep breathing have been proposed to minimize
stress and pain in surgical patients. These therapies are thought to be effective by evoking
the relaxation response through stimulation of the parasympathetic nervous system and
engagement of the patient in the healing process. Relaxation and deep breathing,
particularly, have been shown to reduce pain, anxiety, and "tension-anxiety" in hospitalized
patients. Based on this evidence, a guided paced deep breathing module has been proposed to
reduce preoperative anxiety in patients undergoing gynecological surgery at Mayo Clinic
Rochester Methodist Hospital. In this study, patients' anxiety will be assessed
pre-intervention on a 0-10 numeric rating scale, as well as post-intervention and a paired
t-test will be used to assess effectiveness. Additionally, qualitative questions will be
administered via a questionnaire post-intervention to gain more insight on the effectiveness
of the intervention. The feasibility of the intervention in the busy preoperative setting
will be evaluated by assessing how many times a patient is interrupted while participating in
the paced deep breathing module. If this module is found to be effective in reducing
patients' anxiety, it will be implemented into practice so that every patient undergoing
gynecological surgery, at the institution, will be offered the module preoperatively.