The Effect of Nonpharmacological Methods on Preoperative Anxiety in Breast Surgery Patients: A Meta-analysis

Abstract

Purpose: To investigate the effect of nonpharmacological methods on anxiety before breast surgery, using the meta-analysis method.

Design: A meta-analysis.

Methods: Nine electronic databases were searched to identify studies published up to October 2023. The study was carried out in accordance with Preferred Reporting Items for Systematic Review and Meta-analyses 2020 and Cochrane 2021 recommendations. The Risk of Bias 2 tool was used to assess the risk of bias. Heterogeneity and publication bias were also assessed.

Findings: A search of 9 electronic databases identified 280 records. Six studies that met the inclusion criteria were eligible for meta-analysis. All the trials explained how the randomization was done. The studies selected were published between 2016 and 2022. A total of 519 female patients were included in the selected trials, 303 in the intervention group and 216 in the control group. The studies included aromatherapy, music, electro-acupuncture, and Yokukansan Kampo medicine practices. A meta-analysis was performed with anxiety levels measured immediately before surgery. In addition, a subgroup analysis was performed with trials that used anxiety-specific scales before surgery and trials that used aromatherapy.

Conclusions: The results of this meta-analysis indicated a moderate efficacy of nonpharmacological approaches, whereas aromatherapy showed a relatively lower efficacy in reducing preoperative anxiety in breast surgery patients.

Keywords: anxiety; breast surgery; cancer; nonpharmacological methods; preoperative.