Effectiveness of motivational interviews for alleviating pre- and postoperative anxiety and postoperative pain among patients undergoing surgery: A systematic review and meta-analysis. (Preprint)

BACKGROUND Anxiety can influence the intensity of postoperative pain, anesthesia and the need for analgesia. Likewise, proper anxiety management can reduce hospital stays. Therefore, it is important to review the actions of nursing professionals and estimate the effect size of nursing interventions to reduce anxiety in the pre- and postsurgical processes. OBJECTIVE the objective of this study is to analyze the effectiveness of preoperative motivational interviews by nursing to reduce pre- and postoperative anxiety and postoperative pain after surgery. METHODS A systematic review was carried out according to the PRISMA guide, with a record in PROSPERO using DeCS and Boolean operators OR and AND to increase the specificity of the search. In the EBSCOST, Pubmed, Cochrane Library and Scopus databases, 184 studies were obtained. Patients ≥18 years of age with scheduled surgeries, communication skills, clinical trials or quasi experimental studies were included. The risk of bias 2 (RoB2) tool was used to assess the risk of bias in the studies. A random effects meta-analysis was performed to analyze pre- and post-operative anxiety and post-operative pain. RESULTS A total of 6 studies were included (4 clinical trials and 2 quasi experimental studies). All studies analyzed preoperative anxiety, which was significantly lower (OR = -1.53; 95% CI: - 4.01 to -0.95; I² = 40%). There was also a decrease in postoperative pain (OR = -0.74; 95% CI: - 0.94 to -0.54; I² = 35%) and postoperative anxiety (OR = -0.48; 95% CI: - 0.78 to -0.19; I² = 0%). CONCLUSIONS Motivational interviews by nurses effectively offered clear information and allowed patients to express doubts, reducing their fear of anesthesia, pain and the recovery process. Emotional control improved adaptation to the surgical environment, reducing postoperative pain. With respect to implications for clinical practice, it is necessary to use the same scales to measure anxiety to better compare the studies.