Yanes AF, et al. - Authors evaluated if hand-holding or holding a stress ball reduces patient anxiety during excisional surgery of head or neck skin cancer with the patient under local anesthesia and measured pain and patient satisfaction. In patients during excisional skin cancer surgery, incremental anxiety reduction was not provided by hand-holding and squeezing a stress ball. They noted a possibility of better response of some subgroups or patients may respond better when able to select and tailor their preferred anxiety reduction method.

Methods

• Experts randomized and studied a consecutive sample of 135 adults who required excisional removal of nonmelanoma skin cancer of the head or neck in this nonblinded, single-center randomized clinical trial, performed from January 24 through April 26, 2017, at a dermatology outpatient service in an urban, academic medical center.
• They randomized the participants 1:1:1 to 3 groups: hand-holding, stress ball, or control (treatment as usual).
• A female researcher held one of the hands of the participants in the hand-holding group during administration of anesthesia and extirpation, and those in the stress ball group held a round compressible ball and squeezed it as desired during the same period.
• Anxiety, measured by a visual analog scale (VAS), 6-item State Trait Anxiety Inventory (STAI), and physiologic measures (blood pressure and heart rate) was the primary outcome.
• Pain during the procedure and overall participant satisfaction were included in the secondary outcomes.
• Moreover, they asked the participants how many hours they spent researching the procedure before surgery.

Results

• As per data, a total of 135 participants, 45 per study arm, were enrolled (mean [SD] age, 65.5 [13.9] years; 84 [62.2%] male; 134 [99.3%] white).
• Findings did not suggest any withdrawals or dropouts.
• Results demonstrated that over time, anxiety decreased in all groups, but no significant differences were found in the 3 anxiety measures across the 3 groups (VAS anxiety score before: control group, 3.11; hand-holding group, 3.04; stress ball group, 3.09 [P > .99]; VAS anxiety score during: control group, 1.89; hand-holding group, 2.31; stress ball group, 2.47 [P=.55]; STAI score: control group, 8.91; hand-holding group, 8.93; stress ball group, 8.76 [P=.96]).
• Significant difference in postprocedure pain scores was not seen in the 3 groups (control group, 0.78; hand-holding group, 0.64; stress ball group, 0.67; P=.85).
• They noted almost all participants (134 [99.2%]) to be very satisfied.
• Higher preoperative VAS anxiety scores were seen in participants who had done research (researched, 3.84; did not research, 2.62; P=.04).