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Effectiveness of Nurse's Intentional Presence as a Holistic Modality on Depression, Anxiety, and Stress of Cardiac Surgery Patients

Khajian Gelogahi, Zeynab, MSc; Aghebati, Nahid, PhD; Mazloum, Seyed Reza, MSc; Mohajer, Samira, MSc

doi: 10.1097/HNP.0000000000000294

One of the important aspects of recovering after bypass surgery is mental disorders of patients. Despite the importance of intentional presence in interpersonal interactive space in holistic nursing, a few experimental and clinical trial studies are conducted on this subject. This study determines the effect of intentional presence of a holistic nurse on anxiety, stress, and depression in patients undergoing coronary artery bypass graft surgery. The study used a randomized clinical trial conducted on 80 patients referred to heart surgery department from March 2016 to June 2017, who were allocated to the control and intervention groups randomly. DASS 21 (Depression, Anxiety, Stress scale) questionnaire and a checklist to determine stressor resources were used to measure the variables. Four 30- to 45-minute sessions of nursing intentional presence were conducted for each patient individually in the intervention group. The results showed homogeneity between 2 groups in demographic variables (P > .05). But there was heterogeneity between 2 groups (P < .05) for some stressors. By using analysis of covariance and excluding the effect of stressors and the first scores before the intervention, statistics represented a significant decrease in stress, anxiety, and depression scores in the intervention group compared with the control group (P < .0001). The results of this study indicated that the intentional presence of a nurse as an effective nursing procedure can reduce the depression, stress, and anxiety of the patients undergoing coronary artery bypass surgery.

Evidence-Based Research Center (Dr Aghebati, Mr Mazloum, and Ms Mohajer), Medical Surgical Department (Ms Gelogahi, Dr Aghebati, Mr Mazloum, and Ms Mohajer), School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

Correspondence: Nahid Aghebati, PhD, Evidence-Based Research Center, Medical Surgical Department, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Ebne Sina St, Mashhad, Iran (

This study was extracted from a thesis of Mashhad University of Medical Science with IRMUMSREC13940234 ethics committee code and IRCT2015112925288N1 recording code. The researchers appreciate the School of Nursing and Midwifery of Mashhad University of Medical Sciences, dear management of nursing services and educational supervisor, matron of Cardiac Surgery and Cardiac ICU of Dr Shariati hospital of Mashhad, and all participants in the study.

The authors have received honoraria from the vice president research and are currently receiving a grant from Mashhad University of Medical Sciences.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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