Yanes AF, et al. - In patients undergoing excisional surgery of head or neck skin cancer, Researchers investigated if hand-holding or holding a stress ball during the procedure while the patient is under local anesthesia attenuates anxiety; pain and patient satisfaction were also measured. In the above-mentioned patient population, no incremental anxiety was not reduced as a result of hand-holding or squeezing a stress ball. Being able to choose their preferred anxiety reduction method could elicit a better response among some subgroups of patients.

Methods

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

Results

• Without any withdrawals or dropouts, this study included a total of 135 participants, 45 per study arm (mean [SD] age, 65.5 [13.9] years; 84 [62.2%] male; 134 [99.3%] white).
• Reduction in anxiety was observed over time in all groups, but the three groups displayed no significant differences in the 3 anxiety measures (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]).
• Also, postprocedure pain scores were not significantly different in the three groups (control group, 0.78; hand-holding group, 0.64; stress ball group, 0.67; P=.85), and high satisfaction was reported by nearly all participants (134 [99.2%]).
• Higher preoperative VAS anxiety scores were shown by those who had done research (researched, 3.84; did not research, 2.62; P=.04).