The Effect of Electronical Film on the Anxiety of Patients Candidate for Lumbar Disc Surgery

Mohamadreza Abdi, Zahra Ghazavi, Saied Abrishamkar


Background: This study aimed at investigating the effect of showing surgery educational documentary film on the anxiety of patients candidate for lumbar disc surgery.

Materials and Methods: This study, as a randomized clinical trial, was conducted in 2018 on 60 patients undergoing lumbar disc surgery, Iran. The patients were divided into two groups of intervention and control (N = 30). An educational film was shown to the patients of the intervention group for 20 min and the control group was provided with the ward’s routine trainings. All patients completed demographic characteristics questionnaire and the Spielberger State‑Trait Anxiety Inventory (SSTAI) on the admission day, 1 day before the surgery, and 2 h before the surgery. SSTAI was recompleted by the patients. Data analysis was performed using independent t‑test, Chi‑square, Mann–Whitney test, and paired t‑test.

Results: Before the intervention, the mean score of the state (obvious) and trait (hidden) anxieties was not significantly different between the two groups, but after the intervention, the mean [standard deviation (SD)] score of the state anxiety in the intervention group was significantly lower than that of the control group [mean (SD) = 40.78 (10.34) vs. 47.45 (10.33), F 10,33 = 58, p = 0.01]. In addition, after the intervention, the mean (SD) anxiety score of the patients in the intervention group was significantly lower than that of the control group [mean (SD) = 38.65 (11.01) vs. 44.71 (10.34), F 10,34 = 58, p = 0.03).

Conclusions: The results showed that educational film reduces the patients’ level of anxiety before the surgery. As such, it is recommended that these trainings be included in preoperative nursing practices.



Anxiety, film protocol, intervertebral disc, Iran, surgery

Full Text:



Ghazi E, Rahighi S. Comparison the diagnostic value of SLR and slump tests in clinical evaluation of patients with lumbar disc herniation. Medical Journal of Mashhad University of Medical Sciences 2015;58:211‑6.

Samadi R, Kazempour E, Tonekabon I. Impact of back school program on patients with low back pain in Amlash Central Physiotherapy. Sciences Journal Rehabilitation Medical 2016;5:69‑75.

Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M. The risk associated with spinal manipulation: An overview of reviews. Syst Rev 2017;6:64.

Lotfi HR, Ibrahimi AA, Hashemi JSAA, Norouzi K. Comparison of two aquatic exercise therapy protocols on disability and pain in the middle‑aged men with chronic low back pain. Anesthesiol Pain Med 2015:6;64‑73.

Panjali Z, Zakerian S, Abedinlo R, Rezaee E. Assessment of manual material handling using Iranian MMH regulations and comparison with NIOSH equation and MAC method in one of the metal casting industries in Tehran, 2011. J Health Saf Work 2013;3:27‑34.

Maher C, Underwood M, Buchbinder R. Non‑specific low back pain. Lancet 2017;389:736‑47.

Aliakbari Dehkordi M, Kakojoibari AA, Mohtashami T, Yektakhah S. Stress in mothers of hearing impaired children compared to mothers of normal and other disabled children. Bimonthly Audiology‑Tehran University of Medical Sciences 2011;20:128‑36.

Marback RF, Espíndola RFd, Santhiago MRd, Temporini ER, Kara‑Junior N. Cataract surgery: Emotional reactions of patients with monocular versus binocular vision. Rev Bras Oftalmol 2012;71:385‑9.

Farmahini Farahani M, Shamsikhani S, Norouzi Zamenjani M, Pourfarzad Z, Qolami M. The Effect of of hand massage on anxiety and physiological indicators before surgery. Complement Med J Fac Nurs Midwifery 2017;7:1758‑66.

Kim WS, Byeon GJ, Song BJ, Lee HJ. Availability of preoperative anxiety scale as a predictive factor for hemodynamic changes during induction of anesthesia. Korean J Anesthesiol 2010;58:328‑33.

Ghanei RG, Rezaei K, Mahmoodi R. The relationship between preoperative anxiety and postoperative pain after cesarean section. The Iranian Journal of Obstetrics, Gynecology and Infertility 2013;15:16‑22.

Black JM, Hawks JH, Keene AM. Clinical Management for Positive Outcomes. Medical‑Surgical Nursing. 7th ed. St. Louis: Saunders Elsevier; 2009. p. 227‑80.

Fayazi S, Babashahi M, Rezaei M. The effect of inhalation aromatherapy on anxiety level of the patients in preoperative period. Iran J Nurs Midwifery Res 2011;16:278.

Pereira L, Figueiredo‑Braga M, Carvalho IP. Preoperative anxiety in ambulatory surgery: The impact of an empathic patient‑centered approach on psychological and clinical outcomes. Patient Educ Couns 2016;99:733‑8.

Tadayonfar M, Mohebbi M, Koushan M, Rakhshani M. The effects of guided imagery on anxiety level of the patients undergoing appendectomy. J Sabzevar Univ Med Sci 2014;20:681‑8.

Beiramijam M, Anoosheh M, Mohammadi E. Effect of designed self‑care educational program on anxiety, stress, and depression in patients with benign prostatic hyperplasia undergoing prostate surgery. Chronic Dis J 2013;1:55‑62.

Wilson CJ, Mitchelson AJ, Tzeng TH, El‑Othmani MM, Saleh J, Vasdev S, et al. Caring for the surgically anxious patient: A review of the interventions and a guide to optimizing surgical outcomes. Am J Surg 2016;212:151‑9.

Izadi‑Tameh A, Sadeghi R, Safari M, Esmaeili‑Douki Z. Effect of verbal and audio methods of training on pre‑surgery anxiety of patients. J Qazvin Univ Med Sci 2011;15:21‑5.

Saleh‑Moghaddam A, Mazloum SR, Zoka A. The effect of educational videos on preoperation anxiety among patients before undergoing open heart surgery without pump. J Urmia Nurs Midwifery Fac 2016;14:648‑57.

Burns DS, Robb SL, Phillips‑Salimi C, Haase JE. Parental perspectives of an adolescent/young adult stem cell transplant and a music video intervention. Cancer Nurs 2010;33:20‑7.

Jlala H, French J, Foxall G, Hardman J, Bedforth N. Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia. Br J Anaesth 2010;104:369‑74.

Momeni L, Najaf Yarandi A, Haqani H. Comparison of two methods of teaching VCD and booklets at two different times on preoperative anxiety in patients undergoing coronary artery bypass graft. J Nurs Midwifery Iran Univ Med Sci 2006;56:105‑10.

Tou S, Tou W, Mah D, Karatassas A, Hewett P. Effect of preoperative two‑dimensional animation information on perioperative anxiety and knowledge retention in patient undergoing bowel surgery: A randomized pilot study. Colorectal Dis 2013;15:256‑65.

Moonaghi HK, Hasanzadeh F, Shamsoddini S, Emamimoghadam Z, Ebrahimzadeh S. A comparison of face to face and video‑based education on attitude related to diet and fluids: Adherence in hemodialysis patients. Iran J Nurs Midwifery Res 2012;17:360‑4.

Fahami F, Mohamadirizi S, Bahadoran P. Effect of electronic education on the awareness of women about post partum breast feeding. Int J Pediatr 2014;2:57‑63.

Kimiafar K, Sarbaz M, Naseri P, Ahmadi SS, Abazari F. The relationship between neurosurgery patients’ awareness of surgery procedures and complications on preoperative stress level. J Paramed Sci Rehabil 2017;5;33‑42.

Hashim E, Hasyila WW, Ang Y, Helmy AA, Husyairi H. Psychometric properties of the Malay Translated Spielberger State‑Trait Anxiety Inventory in exploring parental anxiety. Med Health 2018;13:106‑16.

Khanipour H, Mohammadkhani P, Tabatabaei S. Thought control strategies and trait anxiety: Predictors of pathological worry in non‑clinical sample. J Behav Sci 2011;5:173‑8.

Mohamadirizi S, Fahami F, Bahadoran P. Comparison of the effect of multimedia and illustrated booklet educational methods on women’s knowledge of prenatal care. Iran J Nurs Midwifery Res 2014;19:127‑31.

Ruffinengo C, Versino E, Renga G. Effectiveness of an informative video on reducing anxiety levels in patients undergoing elective coronarography: An RCT. Eur J Cardiovasc Nurs 2009;8:57‑61.

Najafi M, Ahmadi M, Reza M, Kheiri S, Hosseini Mirzaei Z, Erfan A. Effect of face‑to‑face training and pamphlets in reducing anxiety in 7‑25 years old clients referred to echocardiography. Iran J Med Educ 2011;10:6‑1251.


  • There are currently no refbacks.