EFFECTIVENESS OF INFORMATION PAMPHLET REGARDING LIVER BIOPSY ON ANXIETY AMONG PATIENTS UNDERGOING LIVER BIOPSY

Background: Providing information to the patients before liver biopsy level of patient during procedure.To reduce the anxiety level, coping used as an procedure may decrease the level of anxiety and can improve tolerance alternatives. There are two types of coping present: Monitoring coping style- Individuals who seek information in response to stressful situation and Blunting coping style- Individuals who avoids informationin response to stressful situation. Methods: Convenient sampling was used to enroll 80 patients, randomly assigned to Experimental and Comparison group based on Randomized days using Hospital Anxiety and Depression-sub scale and Miller-Behavioral Style Scale. Results: Out of 40 subjects 24 were monitors and 16 were blunters in the Experimental group and in the Comparison group 25 were monitors and 15 were blunters. There was significant difference found between mean anxiety score of experimental group (6.9) and comparison group (9.03) at t value = 7.557 and p = 0.01. biopsy via transjugular route during the time of data collection.

To reduce the anxiety level, coping used as an alternatives. There are two types of coping present: Monitoring coping style-Individuals who seek information in response to stressful situation and Blunting coping style-Individuals who avoids informationin response to stressful situation. Information can be given in any forms such as Pamphlet, Booklet, Video, verbal instructions, flashcards etc.

Need for the study:
Liver biopsy is the surgical intervention which can create some degree of anxiety in the patients. Poor co-operation causes more difficulty and painful procedure, incomplete or prolonged procedure, they may cancel the examinations and the financial burden of the patient may be increased. In daily practice it is observed that patients do not understand clearly information given by the healthcare team due to anxiety. In this context of waiting and anxiety, relatives are also stressed and share feelings and uncertainties with the patients, thus turning the situation more complex for the nursing team, since these experiences are mainly witnessed by nurses.
There is a great need to conduct this study because there is no such study in India most of the studies were conducted out of India. So, researcher wants to conduct the study on anxiety of patients undergoing liver biopsy procedure.

Problem Statement:
A study to evaluate the effectiveness of information pamphlet regarding liver biopsy on anxiety among patients undergoing liver biopsy at ILBS, New Delhi.

Objectives of the Study:-Primary objective:
To evaluate the effectiveness of information pamphlet regarding liver biopsy on anxiety of patients undergoing liver biopsy.
Secondary objectives: 1. To find association between anxiety and coping style of patients undergoing liver biopsy. 2. To find association of anxiety and coping style of the patients undergoing liver biopsy with their selected demographic and clinical variables.

Section-B: Clinical Variables:
Previous history of liver biopsy procedure, Indications, Diagnosis.

Section-C: Bio-physiological Parameters:
Blood pressure and Pulse Rate at three times: Before, during and after the procedure.

Tool II:Miller Behavioural Style Scale:
Standardized tool, designed to measure the inclination of people to seek out or avoid information about threatening uncontrollable events.  Mean anxiety scoreof Experimental group was 6.9 and Mean Anxiety Score of Comparison group was 9.03. The pvalue was found to be <0.05, which means there was a significant difference between mean anxiety score of experimental group and comparison group.

Scoring
Anxiety distribution among patient undergoing Liver Biopsy: In experimental group, 47.5 percent of patients had no anxiety, 40 percent of patients had mild anxiety however only 12.5 percent had moderate anxiety and none of the patient had severe anxiety compared to the findings in the comparison group.
In comparison group, Forty five percent had no anxiety, 22.5% had mild anxiety, 17.5% had moderate anxiety and 15% had severe anxiety. The p-value was found to be <0.05, which means there is a significant difference between anxiety of both groups.     The p-value is significant at 0.05 level, hence it can be interpreted that there was significant difference between anxiety of Monitors of experimental group and comparison group. The t value was not found to be significant at p value of 0.05 level, which means there was no significant association between anxiety and coping style.