Effect of Pre-ICU Video-based Teaching on Patients and Families undergoing Craniotomy: a Quasi-Experimental study

Effect of Pre-ICU Video-based Teaching on Patients and Families undergoing Craniotomy: a Quasi-Experimental study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of Pre-ICU Video-based Teaching on Patients and Families undergoing Craniotomy: a Quasi-Experimental study Jimin Park, Nah-Mee Shin This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7599750/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background This study examined the effect of video-based teaching (VBT) program for the patients and families undergoing craniotomy on their pain, anxiety and nursing service satisfaction. Methods A non-equivalent control group, non-synchronized pre- and post-test design was used. A total of 120 participants with 60 pairs of patients and their family were recruited. After the data collection from the control group was completed, pre-test and VBT were offered to the intervention group the day before surgery and post-test was conducted before discharge from ICU. Numerical rating scale (NRS), the State-Trait Anxiety Inventory (STAI) and the Critical Care Family Needs Inventory (CCFNI) were used. Results The frequency of pain complaints (t=-8.88, p < 0.001), NRS score (t=-8.79, p < 0.001), and the number of additional analgesic administration (t=-10.64, p < 0.001) were lower in the intervention group than in the control group. This is thought to be attributable to the more use of PCA in the intervention group (χ²=16.48, p < 0.001). State anxiety score in the intervention group was decreased from pre-test to post-test (t = 7.67, p < 0.001) and the score at the post-test was even lower than in the control group (t=-5.14, p < 0.001). State anxiety score of family in the intervention group was also reduced at the post-test (t = 7.31, p < 0.001) and the score at the post-test was even lower than in the control group (t=-6.39, p < 0.001). Satisfaction with nursing service reported by family in the intervention group was improved after the VBT program (t=-8.41, p < 0.001), and was higher than one in the control group (t = 6.92, p < 0.001). Conclusions The VBT program was found to be effective to decrease anxiety and pain of patients and to increase nursing service satisfaction their families. The VBT program might be a strategy to reduce anxiety and pain of patients admitted to the ICU after brain surgery and in reducing anxiety and improving nursing service satisfaction of their families. Craniotomy Intensive Care Unit Education Anxiety Pain Family Satisfaction Figures Figure 1 Background Critically ill patients in intensive care units often complain anxiety caused by not only pain from severe conditions but also stress from exposure to their environment surrounded by unfamiliar medical staff and equipment [ 1 ]. Conscious patients in the ICU may manifest negative experiences such as anxiety, pain, cognitive change due to a variety of reasons [ 2 , 3 ]. In particular, post-operative patients going to the ICU instead of the general ward where they can be seen by their loved ones, may experience anxiety triggered by a lack of understanding of the ICU environment that might have a negative impact on their recovery after surgery [ 4 ]. During the COVID-19 pandemic, most ICUs have imposed further restrictions on family visiting to prevent infection, therefore ICU patients and their family members experienced increased levels of stress and anxiety [ 5 ]. The confined environment of the ICU and postoperative physical and emotional symptoms of critically ill patients also affect their family members who go through emotional difficulties for being unable to stay with their loved ones during their crisis [ 3 , 6 , 7 ]. They are in a state of tension and complain anxiety due to the lack of information about ICU environment and uncertain prognosis of the patients [ 8 ]. For these reasons, previous studies reported that when patients and their families are informed with ICU admission/discharge procedures, surrounding environment including various types of medical devices, and nursing care to be offered in the ICU, their anxiety was reduced and satisfaction on nursing service was improved [ 9 , 10 ]. Especially, patients having craniotomy ahead and their family members experience significant stress, anxiety, and depression because craniotomy is a type of brain surgery [ 11 ]. Therefore, nurses should help patients having craniotomy and their families to understand ICU environment and nursing service to be provided after surgery in advance [ 12 ]. Although the importance of preoperative patient teaching has been well recognized in South Korea, educational programs for patients to be admitted to the ICU after craniotomy rarely exist. Nowadays, teaching methods for patients' better understanding is critical, however most information is provided in a form of brochures or booklets [ 13 , 14 ]. A recent study described that video-based teaching (VBT) accompanied by visual and audio elements was effective in promoting attention-concentration, understanding and memory, improving satisfaction, and reducing anxiety [ 15 – 17 ]. Therefore, this study provided patients and their family caregiver with information about the ICU the day before craniotomy by using VBT. This study aimed to assess the effect of VBT program on patients’ pain and anxiety and family caregivers’ anxiety and nursing service satisfaction. Methods Design and ethical approval This quasi-experimental study was conducted using a non-equivalent control group, non-synchronized pre- and post-test design to compare pain, anxiety, and nursing service satisfaction between the control group provided with a conventional brochure and the intervention group provided with pre-ICU VBT among patients planned to be admitted to the ICU after craniotomy and their family caregivers. This study was initiated after obtaining IRB approval from Seoul National University Bundang Hospital in Korea, where the research was conducted (IRB No. B-2103-673-306). 2. Participants This study recruited patients scheduled to be admitted to the ICU after undergoing craniotomy. The patients and their family caregivers were selected from March to April, 2021. Inclusion criteria were adults aged 21 years or older and with 15, the highest score of Glasgow Coma Scale (GCS) before scheduled craniotomy. Those patients who had a history of ICU stay or prior craniotomy were excluded. Sample size was calculated based on a similar previous study [ 18 ] with a 0.7 effect size, a significance level of .05, and a 0.8 power. Sample size calculations indicated that the appropriate sample size was 26 participants per group using G*Power software version 3.1.9.7. Assuming a 25% withdrawal rate before and after the intervention, a total of 120 participants were recruited including 30 patients and 30 family caregivers in each group. To avoid the spread of VBT influence from one to the other group, the intervention group was started two weeks after the last one of the control group left the ICU. Data collection 1) Sociodemographic characteristics Sociodemographic characteristics comprised gender, age, education level completed, religion, marital status, job, monthly income, relationship with patients, history of hospital admission, and family caregivers' experiences of caring for patients. 2) Clinical characteristics To determine clinical characteristics, current diagnosis, past medical history, operation undergone, time taken for operation, past hospitalization, route for admission, medications to take were investigated. The Acute Physiology and Chronic Health Evaluation II (APACHE Ⅱ) scores, duration of ventilator use, length of restraints use, incidence rate of delirium, onset of first delirium episode, duration of delirium in the first 24 hours after ICU admission were collected. 3) Patient's pain The NRS scale is used to assess pain severity. Higher the NRS scores, the greater the pain intensity. The number of pain complaints and the mean pain score were evaluated twice, the day before surgery and within the first 24 hours in the ICU after surgery. The use of PCA and the frequency of analgesics given were assessed from the patient's medical record. 4) Anxiety of patients and family caregivers Modified Korean version by Kim [ 19 ] of the State Trait Anxiety Inventory (STAI) that was originally designed by Spielberger [ 20 ] was used to measure their anxiety levels. This was measured the day before craniotomy and on the day of ICU discharge. The state anxiety scale comprised a total of 20 items to be rated on a four-point Likert scale with a total score ranging from 20 to 80. The higher the score, the greater the state anxiety. In this study, Cronbach's α was .89 in patients and .88 in family caregivers. 5) Satisfaction with nursing services This study used a modified questionnaire based on the Critical Care Family Needs Inventory (CCFNI) developed by Molter [ 21 ] with a total of 45 items. The Korean version of the CCFNI [ 22 ] with 43 items were revised for the purpose of this study. The revised version comprises a total of 29 items to be rated on a four-point Likert scale to measure satisfaction with nursing services. The higher scores indicate the higher satisfaction. This study eliminated overlapping items and revised some items to make more appropriate for the ICU environment in Korea. The tool consisted of 9 items on ‘information satisfaction’ with being informed of patient’s condition and treatment and nursing care, another 9 items on ‘emotional satisfaction’ with psychological consolidation and support, 7 items on ‘resource satisfaction’ including waiting areas and convenient facilities, and the last 4 items on 'participation satisfaction' such as care decision making and visiting their loved ones. Content validity of the tool was verified by eight specialists including a nursing professor, neuro-ICU nurse managers, a professor of neurosurgery department, two neurosurgeons, and three nurses with more than five years of ICU background. The content validity index of each item measured 0.97. Reliability calculated with Cronbach's α was 0.90 in this study. 4. Procedure and intervention The intervention process is illustrated in Fig. 1 . The day before surgery, the investigator of this research visited patient rooms of participants satisfying the inclusion criteria among patients scheduled to receive craniotomy by confirming the date of surgery. 1) Intervention (1) Pre-ICU VBT program The continuity of the content of the VBT program was created based on investigator’s clinical experience in the ICU, findings from earlier studies [ 23 – 25 ], and ICU information leaflets with nurse managers and fellow nurses working in the related departments. The video was filmed and edited after nurses took the roles of patients, family members and medical practitioners. The finished education data are shown in Table 1 . Table 1 Video-based teaching content for patients expecting ICU admission after craniotomy Order Topic Purpose Content Time 1 Introduction Welcoming - Explaining the purpose and need of supportive information - Rapport building with patients and family 43 sec 2 ICU admission Informing of ICU admission procedure - Reviewing the ICU admission procedure after leaving the operating room - Explaining about patient’s right and duty - Showing items needed for stay in the ICU 1 min and 33 sec 3 ICU environment Orientating ICU environment - Showing ICU bed and surrounding environment - Emphasizing privacy protection - Showing ICU equipment and anticipating noises (monitor devices, ventilator, oxygen supplier, fluid injector and others) 1 min and 13 sec 4 Postoperative care in the ICU Understanding of nursing care provided in the ICU - Measuring vital signs - Checking neurological status (GCS, pupil check, motor power, orientation, EOM, and CMS check) - Showing ventilators and steps of extubation of endotracheal tubes - Demonstrating nursing care with explaining the purposes (suction, applying and removing of restraints, postoperative postures, position changes, chest physiotherapy, appropriate time of water and food intake, PCA use, indwelling urinary catheter, blood sample collection, management of surgical incision sites, hygiene including oral care and bathing in bed, and others) 2 min and 33 sec 5 Visiting policy Informing of visiting regulation - Explaining hospital visiting policy about in-person visiting hours and request a call for or a meeting with attending physician - Guiding family to the waiting area 55 sec 6 Ending Informing ICU discharge procedure - Showing how to discharge from the ICU to other nursing unit - Encouraging presence of family at the time of ICU discharge 48 sec VBT = Video based teaching ICU = Intensive care unit GCS = Glasgow coma scale EOM = External ocular movement CMS = Circulation, Motion, Sensation PCA = Patient Controlled Analgesia Video length was limited to eight minutes considering the conditions of patients scheduled for brain surgery because a previous study [ 15 ] on the effect of VBT before hysterectomy kept educational videos under fifteen minutes in length. Video-based content validity of the tool was verified by 8 specialists including a nursing professor specialized in caring for critically ill patients, nurse managers of the neuro-ICU, a professor in charge of critically ill patients in neurosurgery, two neurosurgeons, a ICU-specialized nurse, and two charge nurses with more than 5 years of work experience at the neuro-ICU. The content validity index (CVI) was 0.99. 5. Data Analysis All data were analyzed by using SPSS/WIN 22.0 program. Descriptive statistics (frequency, percentage, and standard deviation) was performed on each data element of sociodemographic and Clinical characteristics in the intervention and control groups. Chi-square test and t-test were used to verify homogeneity between the two groups. The mean difference between pre- and post-test scores on dependent variables was determined using t-test. The difference between pre- and post-test results of state anxiety and nursing service satisfaction was compared using paired t-test, and the difference between pain was tested using chi-square test and t-test between the two groups. Results 1. Homogeneity Test of Patients Of total 60 patients, the proportion of female was higher than that of male in both groups, 63.6% in the intervention group and 76.7% in the control group. Their mean age was 56.80 ± 8.43 years old in the intervention group and 57.90 ± 10.75 in the control group. The most common diagnosis and surgery of the patients was cerebral aneurysm (70.0%) and cerebral aneurysm clipping (68.3%). Hypertension was the most common comorbidity (63.3%), followed by dyslipidemia (46.7%). The mean duration (range, 2hr25min-8hr5min) of surgery taken less than 6 hours was 76.7% of patients. Homogeneity test on patients' sociodemographic and clinical characteristics, preoperative pain, and state anxiety revealed no significant difference between the two groups (Table 2 ). Table 2 Homogeneity Test of Patients in Intervention and Control Groups (N = 60) Sociodemographic characteristics Intervention Control Total χ² /t p Variable Category n = 30 n = 30 Gender Male 11(36.7) 7(23.3) 18(30.0) 1.27 0.260 Female 19(63.3) 23(76.7) 42(70.0) Age (year) < 50 8(26.7) 6(20.0) 14(23.3) 2.13 0.545 50∼60 10(33.3) 10(33.3) 20(33.3) 60∼70 11(36.7) 10(33.3) 21(35.1) ≥ 70 1(3.3) 4(13.3) 5(8.3) Mean (range) 56.80 ± 8.43 (38–79) 57.90 ± 10.75 (37–77) -0.44 0.661 Educational level completed ≤ Junior high school 9(30.0) 7(23.3) 16(26.7) 0.63 0.718 High school 11(36.7) 14(46.7) 25(41.6) ≥ Bachelor 10(33.3) 9(30.0) 19(31.7) Marital status Married 26(86.7) 25(83.3) 51(85.0) 1.02 0.601 Not married (bereavement, divorce included) 4(13.3) 5(16.7) 9(15.0) Job Housewife 15(50.0) 16(53.3) 31(51.6) 1.65 0.648 Employed 10(33.4) 7(23.4) 17(37.4) Retired 5(16.7) 7(23.3) 12(20.0) Monthly household income (won) < 2 million 4(13.3) 7(23.3) 11(18.3) 1.10 0.776 ≥ 2 million, <4million 9(30.0) 7(23.3) 16(26.7) ≥ 4million 17(56.7) 16(53.3) 33(55.0) Clinical characteristics Variable Category Diagnosis Cerebral aneurysm 19(63.3) 23(76.7) 2.79 0.425 Brain tumor 7(23.3) 6(20.0) 13(21.7) Moyamoya disease 2(6.7) 1(3.3) 3(5.0) Other cerebrovascular diseases 2(6.7) 0(0.0) 2(3.3) Past medical history Hypertension Yes 17(56.7) 21(70.0) 38(63.3) 1.14 0.284 Hyperlipidemia Yes 13(43.3) 15(50.0) 28(46.7) 0.26 0.605 Cerebrovascular disease Yes 7(23.3) 2(6.7) 9(15.0) 3.26 0.071 Diabetes mellitus Yes 4(13.3) 5(16.7) 9(15.0) 0.13 0.718 Others Yes 7(23.3) 10(33.3) 17(28.3) 0.73 0.390 Operation undergone Clipping of aneurysm 18(60.0) 23(76.7) 41(68.3) 3.35 0.187 Brain tumor removal 7(23.3) 6(20.0) 13(21.7) Cerebral artery bypass 5(16.7) 1(3.3) 6(10.0) Taken time for operation < 6 hours 24(80.0) 22(73.3) 46(76.7) 2.67 0.444 ≥ 6 hours 6(20.0) 8(26.7) 14(23.3) Past hospitalization Yes 27(90.0) 25(83.3) 52(86.7) 0.57 0.448 Medications taking (Multiple choice) Anti-hypertensive agents Yes 12(40.0) 16(53.3) 28(46.7) 1.07 0.301 Lipid-lowering agents Yes 12(40.0) 15(50.0) 27(45.0) 0.60 0.436 Analgesics Yes 11(36.7) 7(23.3) 18(30.0) 1.27 0.260 Hypoglycemic agents Yes 4(13.3) 6(20.0) 10(16.7) 0.48 0.488 Others Yes 9(30.0) 15(50.0) 24(40.0) 2.50 0.114 Preoperative Pain and State Anxiety Variable M ± SD (range) M ± SD (range) t p The number of pain complaints 0.46 ± 0.98 (0 ~ 3) 0.30 ± 0.59 (0 ~ 3) 0.80 0.427 NRS (0–10) 0.33 ± 0.66 (0 ~ 2) 0.36 ± 0.66 (0 ~ 2) -0.19 0.847 State Anxiety 50.80 ± 0.37 (20 ~ 80) 49.40 ± 0.479 (20 ~ 80) 0.62 0.537 Other diseases = Thyroid disease, Cancer, Lung disease Other drugs = Thyroid drugs, Psychoactive drugs, anticonvulsants, Steroids NRS: Numerating Rating Scale, rated from 0 − no pain to 10 − maximum pain, an NRS ≥ 3 indicates significant pain 2. Homogeneity Test of Family caregivers Of total 60 family caregivers, the proportions of female were 50.0% in the intervention group and 60.0% in the control group. Their mean age was 46.56 ± 14.83 years old in the intervention group and 44.03 ± 11.86 in the control group, at least 10 years younger than patients. Homogeneity test on caregivers' sociodemographic characteristics, state anxiety, and nursing service satisfaction showed no significant difference between the intervention and control groups (Table 3 ). Table 3 Homogeneity Test of Family Caregivers in Intervention and Control Groups (N = 60) Sociodemographic characteristics Intervention Control Total χ² /t p Variable Category n = 30 n = 30 Gender Male 15(50.0) 12(40.0) 27(45.0) 0.60 0.436 Female 15(50.0) 18(60.0) 33(55.0) Age (year) 60 7(23.3) 5(16.7) 12(20.0) Mean (range) 46.56 ± 14.83 (23–76) 44.03 ± 11.86 (22–68) 0.73 0.468 Education level completed ≤Junior High School 3(10.0) 3(10.0) 6(10.0) 0.91 0.634 High school 8(26.7) 5(16.7) 13(21.7) ≥Bachelor 19(63.3) 22(73.3) 41(68.3) Marital status Married 24(80.0) 23(76.7) 47(78.3) 0.09 0.754 Single 6(20.0) 7(23.3) 13(21.7) Job Housewife 3(10.0) 6(20.0) 9(15.0) 4.54 0.208 Employment 17(56.7) 10(33.4) 27(45.0) Others 10(33.3) 14(46.7) 24(40.0) Relationship to the patient Spouse 14(46.7) 14(46.7) 28(46.7) 0.00 > 0.999 Descendent 15(50.0) 15(50.0) 30(50.0) Sibling 1(3.3) 1(3.3) 2(3.3) Past hospitalization Yes 12(40.0) 17(56.7) 29(48.3) 1.66 0.196 No 18(60.0) 13(43.3) 31(51.7) Caregiver experience in the past Yes 12(40.0) 13(43.3) 25(41.7) 0.06 0.793 No 18(60.0) 17(56.7) 35(58.3) Preoperative State Anxiety and Nursing service satisfaction Variable Category M ± SD (range) M ± SD (range) t p State Anxiety 51.40 ± 0.27 (20 ~ 80) 53.20 ± 0.41 (20 ~ 80) -0.95 0.344 Nursing service satisfaction Total 81.49 ± 0.13 (29 ~ 116) 82.36 ± 0.29 (29 ~ 116) -0.51 0.607 Information satisfaction 24.03 ± 0.24 (9 ~ 36) 25.38 ± 0.44 (9 ~ 36) -1.65 0.104 Emotional satisfaction 27.27 ± 0.32 (9 ~ 36) 26.64 ± 0.37 (9 ~ 36) 0.82 0.415 Resource satisfaction 18.90 ± 0.26 (7 ~ 28) 19.32 ± 0.28 (7 ~ 28) -0.74 0.462 Participation satisfaction 11.36 ± 0.35 (4 ~ 16) 11.36 ± 0.36 (4 ~ 16) 0.09 0.929 3. Effect of the pre-ICU Intervention program 1) First 24 hours of postoperative ICU stay Their APACHE Ⅱ score 31 (51.7%) patients scored between 25 and 31, indicating 55% or higher death rate. Ventilator (48.3%) and restraints (45.0%) applied to all patients was removed in half of patients within the first hour in the ICU. Postoperative delirium was found in 14 patients (23.3%), five (16.7%) in the intervention group and 9 (30.0%) in the control group. Eleven out of fourteen patients (78.6%) had onset within the first four hours of ICU stay, four (28.6%) in the intervention group and seven (50.0%) patients in the control group (Table 4 ). Table 4 Patient’s APACHE Ⅱ score, use of ventilator and restraints, delirium, and pain Variable Category Intervention Control Total χ² p n = 30 n = 30 APACHE Ⅱ (score) < 20 4(13.3) 4(13.3) 8(13.3) 0.08 0.994 20–24 11(36.7) 10(33.3) 21(35.0) 25–29 13(43.3) 14(46.7) 27(45.0) ≥ 30 2(6.7) 2(6.7) 4(6.7) Ventilator applied (hour) < 1 14(46.7) 15(50.0) 29(48.3) 0.92 0.629 1∼2 13(43.3) 10(33.3) 23(38.3) ≥ 2 3(10.0) 5(16.7) 8(13.3) Restraints applied (hour) < 1 13(43.3) 14(46.7) 27(45.0) 2.72 0.256 1∼2 14(46.7) 9(30.0) 23(38.3) ≥ 2 3(10.0) 7(23.3) 10(16.7) Incidence of delirium Yes 5(16.7) 9(30.0) 14(23.3) 1.49 0.222 No 25(83.3) 21(70.0) 46(76.7) Onset of delirium (hour) < 4 4(28.6) 7(50.0) 11(78.6) 1.49 0.473 4∼8 1(7.1) 2(14.3) 3(21.4) Duration of delirium (hour) 8 4(28.6) 6(42.9) 10(71.5) 2.74 0.432 16 0(0.0) 2(14.3) 2(14.3) 24 1(7.1) 1(7.1) 2(14.2) Pain & Use of PCA & Number of analgesics Variable Category M ± SD M ± SD t/ χ² p Frequency of pain complaints 3.13 ± .62 5.96 ± 1.62 -8.88 < 0.001 NRS (0–10) 3.10 ± .40 5.86 ± 1.67 -8.79 < 0.001 Use of PCA Yes 27(90.0) 12(40.0) 16.48 < 0.001 No 3(10.0) 18(60.0) Number of analgesics Total analgesics (IV) 0.63 ± 0.71 2.80 ± 0.87 -10.64 < 0.001 Fentanyl 25/50mcg 0.43 ± 0.62 3.46 ± 1.33 -11.28 < 0.001 Tramadol 100mg 0.13 ± 0.43 1.06 ± 0.73 -5.96 < 0.001 Meperidine 12.5/25mg 0.20 ± 0.40 0.30 ± 0.59 -0.75 0.451 Paracetamol 1g 1.56 ± 1.19 5.13 ± 1.59 -9.81 < 0.001 Acetaminophen 1g 0.66 ± 0.75 4.03 ± 0.88 -15.77 < 0.001 NRS: Numerating Rating Scale, rated from 0 − no pain to 10 − maximum pain, an NRS ≥ 3 indicates significant pain PCA: Patient Controlled Analgesia PCA components: Fentanyl 1500mcg + Nasea 0.3mg + Normal saline 100ml mixed. IV: Intravenous APACHE II(Acute Physiology and Chronic Health Evaluation II): Interpretation of APACHE II scores (predicted mortality rate). 0–4 = 4% death rate, 10–14 = 15% death rate, 20–24 = 40% death rate, 30–34 = 75% death rate, 5–9 = 8% death rate, 15–19 = 25% death rate, 25–29 = 55% death rate Over 34 = 85% death rate. (Minimum score = 0; maximum score = 71, Increasing score is associated with increasing risk of hospital death) 2) Postoperative Pain A number of pain complaints for the first 24 hours in ICU was significantly less in the intervention group with 3.13 ± 0.62 than control group with 5.96 ± 1.62 ( p < 0.001). The mean NRS score was significantly lower in the intervention group with 3.10 ± 0.40 than control group with 5.86 ± 1.67 ( p < 0.001). The PCA was used by most of the intervention group (90.0%) compared to the control group used by only 40% ( p < 0.001). The mean of analgesics other than PCA given was significantly less in the intervention group with 0.63 ± 0.71 than control group with 2.80 ± 0.87 ( p < 0.001) (Table 4 ). 3) State anxiety of patients and family caregivers The mean score of state anxiety in patients measured before ICU discharge was significantly lower in the intervention group with 1.82 ± 0.34 than control group with 2.44 ± 0.56 ( p < 0.001). Intervention group showed a significant decrease in their anxiety after the VBT intervention ( p < 0.001), while the control group showed no change in their anxiety level ( p = .708) (Table 5 ). Table 5 State anxiety of patients and family caregivers & Nursing service satisfaction of family caregivers Variable Pre-test Post-test paired-t( p ) Difference t( p ) M ± SD M ± SD M ± SD State anxiety of patients Intervention 50.80 ± 0.37 36.40 ± 0.34 7.67(< 0.001) 0.72 ± 0.51 -5.14(< 0.001) Control 49.40 ± .47 48.80 ± 0.56 0.37(0.708) 0.03 ± 0.43 State anxiety of family caregivers -6.39(< 0.001) Intervention 51.40 ± 0.27 38.60 ± 0.46 7.31(< 0.001) 0.64 ± 0.48 Control 53.20 ± 0.41 51.80 ± 0.31 1.84(0.075) 0.07 ± 0.21 Nursing service satisfaction (total) Intervention 81.49 ± 0.13 99.18 ± 0.39 -8.41(< 0.001) -0.61 ± 0.39 6.92(< 0.001) Control 82.36 ± 0.29 81.49 ± 0.27 0.51(0.609) 0.03 ± 0.30 Information satisfaction Intervention 24.03 ± 0.24 32.49 ± 0.40 -11.04(< 0.001) -0.94 ± 0.46 8.38(< 0.001) Control 25.38 ± 0.44 25.11 ± 0.35 0.41(0.684) 0.03 ± 0.44 Emotional satisfaction Intervention 27.27 ± 0.32 32.22 ± 0.44 -5.64(< 0.001) -0.55 ± 0.52 6.14(< 0.001) Control 26.64 ± 0.37 27.18 ± 0.21 -0.96(0.340) -0.06 ± 0.33 Resource satisfaction Intervention 18.90 ± 0.26 23.10 ± 0.51 -5.52(< 0.001) -0.60 ± 0.59 4.41(< 0.001) Control 19.32 ± 0.28 19.25 ± 0.46 0.10(0.918) 0.01 ± 0.50 Participation satisfaction Intervention 11.36 ± 0.35 12.80 ± 0.47 -3.61(0.001) -0.36 ± 0.55 3.92(< 0.001) Control 11.36 ± 0.36 10.80 ± 0.52 1.18(0.245) 0.13 ± 0.61 The mean score of state anxiety in caregivers measured ICU discharge was significantly lower in the intervention group with 1.93 ± 0.46 than control group with 2.59 ± 0.31 ( p < 0.001). Intervention group showed a significant decrease in caregivers’ anxiety after the VBT program ( p < 0.001), while the control group showed no significant difference (Table 5 ). 4) Nursing service satisfaction of family caregivers Family caregivers in the intervention group reported significantly higher satisfaction with nursing services they experienced before their loved one's ICU discharge ( p < 0.001). Their satisfaction was increased significantly after the VBT intervention (p < 0.001), while their counterparts showed no change over time. The intervention group showed significant increases in the all sub-categories after the VBT program, especially in information satisfaction. On the other hand, the control group showed no changes in the sub-categories (Table 5 ). Discussion 1. Pain and anxiety in patients after craniotomy The frequency of pain complaints and NRS scores were significantly lower in the intervention group than in the control group. Pain anticipated following craniotomy and information given about the use of PCA in this VBT program appears to influence on the pain management in the intervention group. This finding is aligned with results from a study that the degree of pain after spinal surgery was lower in the group provided with preoperative video-based education than in the control group [ 25 ]. A significant difference in the use of PCA within the first 24 hours of ICU stay, 90.0% in intervention group and 40.0% in the control group, seems to be associated with a significant difference in the frequency of pain complaints and NRS scores. In addition, the number of additional analgesics administered within the first 24 hours of ICU stay after surgery was significantly lower in the intervention group than in the control group. Although the total number of PCA use was not collected, initiation of the PCA use within the first 24 hours after craniotomy might be a strategy for the better pain management. Therefore, preoperative VBT program was effective on the patients' use of PCA leading to postoperative pain control. The mean score of state anxiety showed a significant decrease in the intervention group, while had no difference in the control group. The results of this study may contradict the findings of a previous study that provision of information about ICU environment using visual aids such as a booklet in advance had no influence on patient’s anxiety [ 26 ]. Our results imply that VBT using audio-visual materials was an effective teaching method other than visual only method. Therefore, VBT combined with visual and auditory stimuli is an effective teaching strategy in enhancing attention-concentration and understanding of learners [ 27 ]. Since the VBT program in this study showed ICU environment and machines such as ventilator needed for patient care and explained purpose of each device including restraints for the patient's safety. As a result, decreased anxiety reported in the intervention group is thought to be attributable to the preoperative teaching about unfamiliar ICU environment that helped the patients lower their anxiety during the ICU stay than the control group. 2. Anxiety and nursing service satisfaction of family caregivers of craniotomy patients Family caregivers in the intervention group showed a significant decrease in their state anxiety level after the VBT intervention while control group showed no decrease. Contradicting results were reported in previous studies on anxiety among ICU patients' caregivers [ 11 , 28 ]. They offered ICU information to caregivers by sending brief text messages before admission or using guidebook prior to their loved ones' transfer to ICU. Reduction in caregivers' anxiety level in this study might have been accounted for different approach with audiovisual teaching method. Since this study showed the highest anxiety on day before surgery reported by the participants, offering VBT program that can be watched as many as they want might help lowering anxiety levels. Moreover, more than half of family caregivers in this study had no previous experience as an inpatient or a caregiver for ICU patients. Therefore, the VBT program consisted of content about ICU environment, guide for hospital stay, and ICU nursing care to be provided after craniotomy videotaped in the real ICU seemed useful for the patients and caregivers. Although relationship between number of video watching and the levels of anxiety is not investigated this study, the VBT program that allow repeated viewing and encourage information acquisition without space-time constraints appeared efficient. These strategies of the VBT seem effective in reduction of anxiety in the intervention group. Also, when family caregivers experience the same as they were informed in the video about patient’s conditions in the ICU after craniotomy, they reported higher satisfaction with nursing service they received. Finally, in addition to a significant increase in satisfaction with nursing services perceived by family caregivers in intervention group, their higher satisfaction at post-test that was significantly different from control group implied a clinical implication. This finding supported a previous study using VBT for family members of critically ill patients [ 8 ]. Recently, increased patient education about introducing to ICU is heading to a good direction, however teaching has been limited to general information on ICU environment and nursing care. In contrast, the VBT developed in this study appears to offer psychological safety with adequate emotional support in the time when tension is growing highest in patients and their family members by providing realistic processes from patient’s ICU admission to discharge after craniotomy and consecutively presenting intensive care provided for critically ill patients after ICU stay. Limitations There are several limitations to note in the present study. First, caution is needed to generalize the study findings because this investigation was performed by involving three ICUs at University Hospital located in Korea. Second, this study involved patients admitted to the hospital to undergo scheduled craniotomy and their family caregivers. For this reason, a follow-up study is warranted to apply study findings to patients who receive emergency craniotomy. Third, pain relief was determined with the use of PCA. The effect of dosage and frequency of PCA on pain management and the influence of the VBT program according to the number of times of viewing need to be assessed in the future. Conclusions The pre-ICU VBT program developed in the study was identified to reduce pain and anxiety in patients undergoing craniotomy, and to be effective in decreasing anxiety and increasing satisfaction with nursing services in family caregivers. The repeated viewing of VBT using audio-visual information is a learning approach for information acquisition and an effective strategy for emotional support. Abbreviations VBT video-based teaching ICU intensive care unit NRS Numerical rating scale STAI State-Trait Anxiety Inventory CCFNI Critical Care Family Needs Inventory IRB Institutional Review Board GCS Glasgow Coma Scale APACHE Ⅱ Acute Physiology and Chronic Health Evaluation II EOM External ocular movement CMS Circulation, Motion, Sensation PCA Patient Controlled Analgesia Declarations Ethics approval and consent to participate This study was initiated after obtaining IRB approval from Seoul National University Bundang Hospital (IRB No. B-2103-673-306). All participants were fully informed about the research objectives and procedures by the investigator and provided written consent to participate. Participants had the right to withdraw from the study at any time. Data were collected using structured questionnaires and electronic medical records (EMRs). The study ensured the confidentiality and anonymity of all data, with personally identifiable information encrypted and securely stored. This research was conducted in compliance with the Declaration of Helsinki. Consent for publication Not applicable. Competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Funding source information This research was supported by Seoul National University Bundang Hospital and Institute of Nursing Research Korea University. Author Contribution All authors have agreed with the content of the manuscript and contributed to the work as follows: J.P.: conceptualization; data collection; methodology; statistical analysis; drafting the initial manuscript and revising/editing the final version, N.S.: conceptualization; data collection; methodology; drafting the initial manuscript and revising/editing the final version. Acknowledgement We acknowledge Hye-young Kim, the head nurse of the SNUBH Neurological ICU who supported this study with invaluable help. Data Availability The data that support the findings of this study are available from the corresponding author upon reasonable request. References Beesley SJ, Hopkins RO, Holt-Lunstad J, Wilson EL, Butler J, Kuttler KG, et al. Acute physiologic stress and subsequent anxiety among family members of ICU patients. Crit Care Med. 2018;46(2):229–35. https://doi.org/10.1097/CCM.0000000000002835 . Halvorsen K, Jensen JF, Collet MO, Olausson S, Lindahl B, Saetre Hansen B, et al. Patients’ experiences of well-being when being cared for in the intensive care unit—An integrative review. J Clin Nurs. 2022;31(1–2):3–19. https://doi.org/10.1111/jocn.15910 . Danesh V. Patient and family response to the critical care experience. In: Sole ML, Klein DG, Moseley MJ, editors. Sole’s introduction to critical care nursing. 8th ed. St. Louis: Elsevier; 2024. Sharma G, Maben EVS, Kotian MS, Ganaraja B. Psychological evaluation of patients in critical care/intensive care unit and patients admitted in wards. J Clin Diagn Res. 2014;8(12):MC04–7. https://doi.org/10.7860/JCDR/2014/10293.5297 . Montauk TR, Kuhl EA. COVID-related family separation and trauma in the intensive care unit. Psychol Trauma. 2020;12(S1):S96–7. https://doi.org/10.1037/tra0000839 . Day A, Haj-Bakri S, Lubchansky S, Mehta S. Sleep, anxiety and fatigue in family members of patients admitted to the intensive care unit: a questionnaire study. Crit Care. 2013;17(3):R91. https://doi.org/10.1186/cc12736 . Baharoon S, Al Yafi W, Al Qurashi A, Al Jahdali H, Tamim H, Alsafi E, et al. Family satisfaction in critical care units: Does an open visiting hours policy have an impact? J Patient Saf. 2017;13(3):169–74. https://doi.org/10.1097/PTS.0000000000000140 . Lee M, Yi M. Experiences of families in the intensive care unit: Interactions with health care providers. Korean J Adult Nurs. 2017;29(1):76–86. https://doi.org/10.7475/kjan.2017.29.1.76 . Lee MK, Lee YM. The effects of video-based admission education on environmental stress, anxiety and nursing needs satisfaction among family members with patient in ICU. J Korean Crit Care Nurs. 2012;5(1):1–11. Kang J, Shin EJ. The relationship between person-centered nursing and family satisfaction in ICUs. J Korean Crit Care Nurs. 2019;12(3):1–12. https://doi.org/10.34250/jkccn.2019.12.3.1 . Norup A, Welling KL, Qvist J, Siert L, Mortensen EL. Depression, anxiety and quality-of-life among relatives of patients with severe brain injury: the acute phase. Brain Inj. 2012;26(10):1192–200. https://doi.org/10.3109/02699052.2012.672790 . Stumpo V, Staartjes VE, Quddusi A, Corniola MV, Tessitore E, Schröder ML, et al. Enhanced recovery after surgery strategies for elective craniotomy: a systematic review. J Neurosurg. 2021;135(6):1857–81. https://doi.org/10.3171/2020.10.JNS203160 . Choi JH, Kim J, Hong NS, Lee BH, Lee EH. The effects of preparatory nursing information and information offered by short message service on anxiety and nursing satisfaction among family members of ICU inpatients. J Korean Clin Nurs Res. 2013;19(3):383–94. https://doi.org/10.22650/JKCNR.2013.19.3.383 . Kim SH, Lee ES. The effects of comprehensive education program on anxiety, uncertainty and athletic performance of patients undergoing spinal nerve block. Korean J Adult Nurs. 2017;29(2):143–52. https://doi.org/10.7475/kjan.2017.29.2.143 . Jeon S, Park H. Effect of preoperative education using multimedia on pain, uncertainty, anxiety and depression in hysterectomy patients. Korean J Women Health Nurs. 2016;22(1):39–47. https://doi.org/10.4069/kjwhn.2016.22.1.39 . Kaur H, Singh G, Singh A, Sharda G, Aggarwal S. Evolving with modern technology: Impact of incorporating audiovisual aids in preanesthetic checkup clinics on patient education and anxiety. Anesth Essays Res. 2016;10(3):502–7. https://doi.org/10.4103/0259-1162.177187 . Kim MK, Kim J. The effects of educational video program delivered using tablet PC on physical discomfort, uncertainty, state anxiety, and nursing education satisfaction among early gastric cancer patients undergoing endoscopic submucosal dissection. J Korean Clin Nurs Res. 2018;24(2):147–58. https://doi.org/10.22650/JKCNR.2018.24.2.147 . Kwon YE, Kim BH. The effects of video-audio information provision on physical discomfort, anxiety, and nursing satisfaction of the clients for gastroscopy. Korean J Adult Nurs. 2013;25(2):231–40. https://doi.org/10.7475/kjan.2013.25.2.231 . Kim JT. A study based on the standardization of the STAI for Korea. New Med J. 1978;21:69–75. Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA, Szafraniec R, et al. Manual for the state-trait anxiety inventory. Palo Alto (CA): Consulting Psychologists; 1983. Molter NC. Needs of relatives of critically ill patients: a descriptive study. Heart Lung. 1979;8(2):332–9. Kang H. Comparison between nurses and family members of patients in ICUs in critical care family needs and the needs satisfaction [master’s thesis]. Seoul: Yonsei University; 2006. Oh YH, Choi EJ. The effects of information service program by media on anxiety and educational satisfaction in patients with cataract surgery. J Korean Clin Nurs Res. 2016;22(3):305–13. https://doi.org/10.22650/JKCNR.2016.22.3.305 . Lee HI, Park JS. The effect of preoperative information through audiovisual media on self-care knowledge, self-efficacy, and state anxiety of patients before bariatric surgery. Korean J Adult Nurs. 2020;32(4):421–31. https://doi.org/10.7475/kjan.2020.32.4.421 . Lee HO, Seo JY. The effects of repeated information using visual and video-audio media on uncertainty and anxiety in patients undergoing thyroidectomy. Asian Oncol Nurs. 2020;20(2):92–9. https://doi.org/10.5388/aon.2020.20.2.92 . Kazmi S, McCullough M, Sheth K, Lazaridis C, Dejesus-Alvelo I, O’phelan K, et al. Cerebral herniation syndromes and intracranial hypertension. New Brunswick (NJ): Rutgers University Press; 2016. Choi GY, Kim JS. Effects of patient controlled analgesia convergence education on postoperative pain management in spinal surgery patients. J Korea Converg Soc. 2018;9(2):371–80. https://doi.org/10.15207/JKCS.2018.9.2.371 . Shin KM, Choi HR. Effects of prior information about intensive care unit environment on anxiety and environmental stress in patients undergoing open heart surgery. J Korean Acad Soc Nurs Educ. 2015;21(1):28–35. https://doi.org/10.5977/jkasne.2015.21.1.28 . Dahodwala M, Geransar R, Babion J, de Grood J, Sargious P. The impact of the use of video-based educational interventions on patient outcomes in hospital settings: A scoping review. Patient Educ Couns. 2018;101(12):2116–24. https://doi.org/10.1016/j.pec.2018.06.019 . Lee HJ, Lee YM. The effects of education using a relocation information guidebook on relocation stress, anxiety, and education satisfaction in family caregivers of patients in neurosurgical intensive care units. J Korean Crit Care Nurs. 2015;8(2):43–54. Additional Declarations No competing interests reported. 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1","display":"","copyAsset":false,"role":"figure","size":123267,"visible":true,"origin":"","legend":"\u003cp\u003eFlow diagram of research design and data collection process\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7599750/v1/6d04377a768ad489f55ac5d5.png"},{"id":94460745,"identity":"b370e36c-ec79-4411-82d0-b420cf206be7","added_by":"auto","created_at":"2025-10-27 14:57:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2372861,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7599750/v1/25c97d5c-378e-4d63-ad25-8848ac5ef139.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of Pre-ICU Video-based Teaching on Patients and Families undergoing Craniotomy: a Quasi-Experimental study","fulltext":[{"header":"Background","content":"\u003cp\u003eCritically ill patients in intensive care units often complain anxiety caused by not only pain from severe conditions but also stress from exposure to their environment surrounded by unfamiliar medical staff and equipment [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Conscious patients in the ICU may manifest negative experiences such as anxiety, pain, cognitive change due to a variety of reasons [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In particular, post-operative patients going to the ICU instead of the general ward where they can be seen by their loved ones, may experience anxiety triggered by a lack of understanding of the ICU environment that might have a negative impact on their recovery after surgery [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. During the COVID-19 pandemic, most ICUs have imposed further restrictions on family visiting to prevent infection, therefore ICU patients and their family members experienced increased levels of stress and anxiety [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe confined environment of the ICU and postoperative physical and emotional symptoms of critically ill patients also affect their family members who go through emotional difficulties for being unable to stay with their loved ones during their crisis [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. They are in a state of tension and complain anxiety due to the lack of information about ICU environment and uncertain prognosis of the patients [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. For these reasons, previous studies reported that when patients and their families are informed with ICU admission/discharge procedures, surrounding environment including various types of medical devices, and nursing care to be offered in the ICU, their anxiety was reduced and satisfaction on nursing service was improved [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Especially, patients having craniotomy ahead and their family members experience significant stress, anxiety, and depression because craniotomy is a type of brain surgery [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Therefore, nurses should help patients having craniotomy and their families to understand ICU environment and nursing service to be provided after surgery in advance [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAlthough the importance of preoperative patient teaching has been well recognized in South Korea, educational programs for patients to be admitted to the ICU after craniotomy rarely exist. Nowadays, teaching methods for patients' better understanding is critical, however most information is provided in a form of brochures or booklets [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. A recent study described that video-based teaching (VBT) accompanied by visual and audio elements was effective in promoting attention-concentration, understanding and memory, improving satisfaction, and reducing anxiety [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Therefore, this study provided patients and their family caregiver with information about the ICU the day before craniotomy by using VBT. This study aimed to assess the effect of VBT program on patients\u0026rsquo; pain and anxiety and family caregivers\u0026rsquo; anxiety and nursing service satisfaction.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eDesign and ethical approval\u003c/b\u003e\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003eThis quasi-experimental study was conducted using a non-equivalent control group, non-synchronized pre- and post-test design to compare pain, anxiety, and nursing service satisfaction between the control group provided with a conventional brochure and the intervention group provided with pre-ICU VBT among patients planned to be admitted to the ICU after craniotomy and their family caregivers. This study was initiated after obtaining IRB approval from Seoul National University Bundang Hospital in Korea, where the research was conducted (IRB No. B-2103-673-306).\u003c/p\u003e\n\u003ch3\u003e2. Participants\u003c/h3\u003e\n\u003cp\u003eThis study recruited patients scheduled to be admitted to the ICU after undergoing craniotomy. The patients and their family caregivers were selected from March to April, 2021. Inclusion criteria were adults aged 21 years or older and with 15, the highest score of Glasgow Coma Scale (GCS) before scheduled craniotomy. Those patients who had a history of ICU stay or prior craniotomy were excluded.\u003c/p\u003e\u003cp\u003eSample size was calculated based on a similar previous study [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] with a 0.7 effect size, a significance level of .05, and a 0.8 power. Sample size calculations indicated that the appropriate sample size was 26 participants per group using G*Power software version 3.1.9.7. Assuming a 25% withdrawal rate before and after the intervention, a total of 120 participants were recruited including 30 patients and 30 family caregivers in each group. To avoid the spread of VBT influence from one to the other group, the intervention group was started two weeks after the last one of the control group left the ICU.\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eData collection\u003c/b\u003e\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003e1) Sociodemographic characteristics\u003c/p\u003e\u003cp\u003eSociodemographic characteristics comprised gender, age, education level completed, religion, marital status, job, monthly income, relationship with patients, history of hospital admission, and family caregivers' experiences of caring for patients.\u003c/p\u003e\n\u003ch3\u003e2) Clinical characteristics\u003c/h3\u003e\n\u003cp\u003eTo determine clinical characteristics, current diagnosis, past medical history, operation undergone, time taken for operation, past hospitalization, route for admission, medications to take were investigated. The Acute Physiology and Chronic Health Evaluation II (APACHE Ⅱ) scores, duration of ventilator use, length of restraints use, incidence rate of delirium, onset of first delirium episode, duration of delirium in the first 24 hours after ICU admission were collected.\u003c/p\u003e\n\u003ch3\u003e3) Patient's pain\u003c/h3\u003e\n\u003cp\u003eThe NRS scale is used to assess pain severity. Higher the NRS scores, the greater the pain intensity. The number of pain complaints and the mean pain score were evaluated twice, the day before surgery and within the first 24 hours in the ICU after surgery. The use of PCA and the frequency of analgesics given were assessed from the patient's medical record.\u003c/p\u003e\n\u003ch3\u003e4) Anxiety of patients and family caregivers\u003c/h3\u003e\n\u003cp\u003eModified Korean version by Kim [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] of the State Trait Anxiety Inventory (STAI) that was originally designed by Spielberger [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] was used to measure their anxiety levels. This was measured the day before craniotomy and on the day of ICU discharge. The state anxiety scale comprised a total of 20 items to be rated on a four-point Likert scale with a total score ranging from 20 to 80. The higher the score, the greater the state anxiety. In this study, Cronbach's α was .89 in patients and .88 in family caregivers.\u003c/p\u003e\n\u003ch3\u003e5) Satisfaction with nursing services\u003c/h3\u003e\n\u003cp\u003eThis study used a modified questionnaire based on the Critical Care Family Needs Inventory (CCFNI) developed by Molter [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] with a total of 45 items. The Korean version of the CCFNI [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] with 43 items were revised for the purpose of this study. The revised version comprises a total of 29 items to be rated on a four-point Likert scale to measure satisfaction with nursing services. The higher scores indicate the higher satisfaction. This study eliminated overlapping items and revised some items to make more appropriate for the ICU environment in Korea. The tool consisted of 9 items on \u0026lsquo;information satisfaction\u0026rsquo; with being informed of patient\u0026rsquo;s condition and treatment and nursing care, another 9 items on \u0026lsquo;emotional satisfaction\u0026rsquo; with psychological consolidation and support, 7 items on \u0026lsquo;resource satisfaction\u0026rsquo; including waiting areas and convenient facilities, and the last 4 items on 'participation satisfaction' such as care decision making and visiting their loved ones. Content validity of the tool was verified by eight specialists including a nursing professor, neuro-ICU nurse managers, a professor of neurosurgery department, two neurosurgeons, and three nurses with more than five years of ICU background. The content validity index of each item measured 0.97. Reliability calculated with Cronbach's α was 0.90 in this study.\u003c/p\u003e\n\u003ch3\u003e4. Procedure and intervention\u003c/h3\u003e\n\u003cp\u003eThe intervention process is illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The day before surgery, the investigator of this research visited patient rooms of participants satisfying the inclusion criteria among patients scheduled to receive craniotomy by confirming the date of surgery.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\n\u003ch3\u003e1) Intervention\u003c/h3\u003e\n\u003cp\u003e(1) Pre-ICU VBT program\u003c/p\u003e\u003cp\u003eThe continuity of the content of the VBT program was created based on investigator\u0026rsquo;s clinical experience in the ICU, findings from earlier studies [\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], and ICU information leaflets with nurse managers and fellow nurses working in the related departments. The video was filmed and edited after nurses took the roles of patients, family members and medical practitioners. The finished education data are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eVideo-based teaching content for patients expecting ICU admission after craniotomy\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOrder\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTopic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePurpose\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eContent\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntroduction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWelcoming\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e- Explaining the purpose and need of supportive information\u003c/p\u003e \u003cp\u003e- Rapport building with patients and family\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e43 sec\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eICU admission\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInforming of ICU admission procedure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e- Reviewing the ICU admission procedure after leaving the operating room\u003c/p\u003e \u003cp\u003e- Explaining about patient\u0026rsquo;s right and duty\u003c/p\u003e \u003cp\u003e- Showing items needed for stay in the ICU\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1 min and 33 sec\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eICU environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOrientating ICU environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e- Showing ICU bed and surrounding environment\u003c/p\u003e\u003cp\u003e- Emphasizing privacy protection\u003c/p\u003e\u003cp\u003e- Showing ICU equipment and anticipating noises (monitor devices, ventilator, oxygen supplier, fluid injector and others)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1 min and 13 sec\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePostoperative care in the ICU\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUnderstanding of nursing care provided in the ICU\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e- Measuring vital signs\u003c/p\u003e\u003cp\u003e- Checking neurological status (GCS, pupil check, motor power, orientation, EOM, and CMS check)\u003c/p\u003e\u003cp\u003e- Showing ventilators and steps of extubation of endotracheal tubes\u003c/p\u003e\u003cp\u003e- Demonstrating nursing care with explaining the purposes (suction, applying and removing of restraints, postoperative postures, position changes, chest physiotherapy, appropriate time of water and food intake, PCA use, indwelling urinary catheter, blood sample collection, management of surgical incision sites, hygiene including oral care and bathing in bed, and others)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2 min and 33 sec\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVisiting policy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInforming of visiting regulation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e- Explaining hospital visiting policy about in-person visiting hours and request a call for or a meeting with attending physician\u003c/p\u003e \u003cp\u003e- Guiding family to the waiting area\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e55 sec\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEnding\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInforming ICU discharge procedure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e- Showing how to discharge from the ICU to other nursing unit\u003c/p\u003e \u003cp\u003e- Encouraging presence of family at the time of ICU discharge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e48 sec\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eVBT\u0026thinsp;=\u0026thinsp;Video based teaching\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eICU\u0026thinsp;=\u0026thinsp;Intensive care unit\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eGCS\u0026thinsp;=\u0026thinsp;Glasgow coma scale\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eEOM\u0026thinsp;=\u0026thinsp;External ocular movement\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eCMS\u0026thinsp;=\u0026thinsp;Circulation, Motion, Sensation\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003ePCA\u0026thinsp;=\u0026thinsp;Patient Controlled Analgesia\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eVideo length was limited to eight minutes considering the conditions of patients scheduled for brain surgery because a previous study [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] on the effect of VBT before hysterectomy kept educational videos under fifteen minutes in length. Video-based content validity of the tool was verified by 8 specialists including a nursing professor specialized in caring for critically ill patients, nurse managers of the neuro-ICU, a professor in charge of critically ill patients in neurosurgery, two neurosurgeons, a ICU-specialized nurse, and two charge nurses with more than 5 years of work experience at the neuro-ICU. The content validity index (CVI) was 0.99.\u003c/p\u003e\n\u003ch3\u003e5. Data Analysis\u003c/h3\u003e\n\u003cp\u003eAll data were analyzed by using SPSS/WIN 22.0 program. Descriptive statistics (frequency, percentage, and standard deviation) was performed on each data element of sociodemographic and Clinical characteristics in the intervention and control groups. Chi-square test and t-test were used to verify homogeneity between the two groups. The mean difference between pre- and post-test scores on dependent variables was determined using t-test. The difference between pre- and post-test results of state anxiety and nursing service satisfaction was compared using paired t-test, and the difference between pain was tested using chi-square test and t-test between the two groups.\u003c/p\u003e"},{"header":"Results","content":"\n\u003ch3\u003e1. Homogeneity Test of Patients\u003c/h3\u003e\n\u003cp\u003eOf total 60 patients, the proportion of female was higher than that of male in both groups, 63.6% in the intervention group and 76.7% in the control group. Their mean age was 56.80\u0026thinsp;\u0026plusmn;\u0026thinsp;8.43 years old in the intervention group and 57.90\u0026thinsp;\u0026plusmn;\u0026thinsp;10.75 in the control group. The most common diagnosis and surgery of the patients was cerebral aneurysm (70.0%) and cerebral aneurysm clipping (68.3%). Hypertension was the most common comorbidity (63.3%), followed by dyslipidemia (46.7%). The mean duration (range, 2hr25min-8hr5min) of surgery taken less than 6 hours was 76.7% of patients. Homogeneity test on patients' sociodemographic and clinical characteristics, preoperative pain, and state anxiety revealed no significant difference between the two groups (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eHomogeneity Test of Patients in Intervention and Control Groups (N\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eSociodemographic characteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eχ\u0026sup2;\u003c/em\u003e/t\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(36.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18(30.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e1.27\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.260\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(63.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23(76.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e42(70.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003cp\u003e(year)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;50\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8(26.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14(23.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e2.13\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.545\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e50\u0026sim;60\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20(33.3)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e60\u0026sim;70\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(36.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e21(35.1)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;70\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1(3.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4(13.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5(8.3)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003cp\u003e(range)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.80\u0026thinsp;\u0026plusmn;\u0026thinsp;8.43\u003c/p\u003e\u003cp\u003e(38\u0026ndash;79)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e57.90\u0026thinsp;\u0026plusmn;\u0026thinsp;10.75\u003c/p\u003e\u003cp\u003e(37\u0026ndash;77)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.44\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.661\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eEducational level completed\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026le; Junior high school\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(30.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16(26.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.718\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(36.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14(46.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e25(41.6)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026ge; Bachelor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9(30.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e19(31.7)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26(86.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25(83.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e51(85.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e1.02\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.601\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNot married\u003c/p\u003e\u003cp\u003e(bereavement, divorce included)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4(13.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5(16.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9(15.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eJob\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eHousewife\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16(53.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e31(51.6)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e1.65\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.648\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10(33.4)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7(23.4)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17(37.4)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eRetired\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5(16.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e12(20.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eMonthly household income\u003c/p\u003e\u003cp\u003e(won)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;2\u0026nbsp;million\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4(13.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11(18.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e1.10\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.776\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;2\u0026nbsp;million, \u0026lt;4million\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(30.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16(26.7)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;4million\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(56.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16(53.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e33(55.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eClinical characteristics\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eVariable\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCategory\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eDiagnosis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eCerebral aneurysm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(63.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23(76.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e2.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.425\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eBrain tumor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13(21.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eMoyamoya disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2(6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1(3.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3(5.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eOther cerebrovascular diseases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2(6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0(0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2(3.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003ePast medical history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(56.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e21(70.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e38(63.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.284\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHyperlipidemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13(43.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28(46.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.605\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCerebrovascular disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2(6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9(15.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.071\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiabetes mellitus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4(13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5(16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9(15.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.718\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17(28.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.390\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eOperation undergone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eClipping of aneurysm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18(60.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23(76.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e41(68.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e3.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.187\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eBrain tumor removal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13(21.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eCerebral artery bypass\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5(16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1(3.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6(10.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTaken time for operation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;6 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24(80.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e22(73.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e46(76.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e2.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.444\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;6 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8(26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14(23.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePast hospitalization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27(90.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25(83.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e52(86.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.448\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eMedications taking\u003c/p\u003e\u003cp\u003e(Multiple choice)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAnti-hypertensive agents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12(40.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16(53.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28(46.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.301\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLipid-lowering agents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12(40.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27(45.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.436\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAnalgesics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(36.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18(30.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.260\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHypoglycemic agents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4(13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10(16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.488\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(30.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e24(40.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.114\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePreoperative Pain and State Anxiety\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eVariable\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(range)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(range)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003et\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eThe number of pain complaints\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.46\u0026thinsp;\u0026plusmn;\u0026thinsp;0.98\u003c/p\u003e\u003cp\u003e(0\u0026thinsp;~\u0026thinsp;3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e\u003cp\u003e(0\u0026thinsp;~\u0026thinsp;3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.427\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eNRS (0\u0026ndash;10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e\u003cp\u003e(0\u0026thinsp;~\u0026thinsp;2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e\u003cp\u003e(0\u0026thinsp;~\u0026thinsp;2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.847\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eState Anxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e\u003cp\u003e(20\u0026thinsp;~\u0026thinsp;80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e49.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.479\u003c/p\u003e\u003cp\u003e(20\u0026thinsp;~\u0026thinsp;80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.537\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eOther diseases\u0026thinsp;=\u0026thinsp;Thyroid disease, Cancer, Lung disease\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eOther drugs\u0026thinsp;=\u0026thinsp;Thyroid drugs, Psychoactive drugs, anticonvulsants, Steroids\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eNRS: Numerating Rating Scale, rated from 0\u0026thinsp;\u0026minus;\u0026thinsp;no pain to 10\u0026thinsp;\u0026minus;\u0026thinsp;maximum pain, an NRS\u0026thinsp;\u0026ge;\u0026thinsp;3 indicates significant pain\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e2. Homogeneity Test of Family caregivers\u003c/h3\u003e\n\u003cp\u003eOf total 60 family caregivers, the proportions of female were 50.0% in the intervention group and 60.0% in the control group. Their mean age was 46.56\u0026thinsp;\u0026plusmn;\u0026thinsp;14.83 years old in the intervention group and 44.03\u0026thinsp;\u0026plusmn;\u0026thinsp;11.86 in the control group, at least 10 years younger than patients. Homogeneity test on caregivers' sociodemographic characteristics, state anxiety, and nursing service satisfaction showed no significant difference between the intervention and control groups (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eHomogeneity Test of Family Caregivers in Intervention and Control Groups (N\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eSociodemographic characteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eχ\u0026sup2;\u003c/em\u003e/t\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e12(40.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27(45.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.436\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e18(60.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e33(55.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003cp\u003e(year)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;40\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11(36.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e21(35.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"3\" nameend=\"c8\" namest=\"c7\" rowspan=\"4\"\u003e\u003cp\u003e2.25\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.522\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40\u0026sim;50\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e11(36.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17(28.3)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50\u0026sim;60\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e4(13.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10(16.7)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e5(16.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e12(20.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003cp\u003e(range)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46.56\u0026thinsp;\u0026plusmn;\u0026thinsp;14.83\u003c/p\u003e\u003cp\u003e(23\u0026ndash;76)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e44.03\u0026thinsp;\u0026plusmn;\u0026thinsp;11.86\u003c/p\u003e\u003cp\u003e(22\u0026ndash;68)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.73\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.468\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eEducation level completed\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;Junior High School\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(10.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e3(10.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6(10.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c8\" namest=\"c7\" rowspan=\"3\"\u003e\u003cp\u003e0.91\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.634\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8(26.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e5(16.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13(21.7)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;Bachelor\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19(63.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e22(73.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e41(68.3)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24(80.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e23(76.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e47(78.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.754\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13(21.7)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eJob\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHousewife\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(10.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e6(20.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9(15.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c8\" namest=\"c7\" rowspan=\"3\"\u003e\u003cp\u003e4.54\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.208\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmployment\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17(56.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e10(33.4)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27(45.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e14(46.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e24(40.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eRelationship to the patient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14(46.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e14(46.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28(46.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c8\" namest=\"c7\" rowspan=\"3\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.999\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDescendent\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30(50.0)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSibling\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1(3.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e1(3.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2(3.3)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePast hospitalization\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12(40.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e17(56.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e29(48.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e1.66\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.196\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18(60.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e13(43.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e31(51.7)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCaregiver experience in the past\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12(40.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e13(43.3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e25(41.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.793\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18(60.0)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e17(56.7)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e35(58.3)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePreoperative State Anxiety and Nursing service satisfaction\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eVariable\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCategory\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(range)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(range)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003et\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eState Anxiety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.27\u003c/p\u003e\u003cp\u003e(20\u0026thinsp;~\u0026thinsp;80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e53.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41\u003c/p\u003e\u003cp\u003e(20\u0026thinsp;~\u0026thinsp;80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e-0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.344\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eNursing service satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.13\u003c/p\u003e\u003cp\u003e(29\u0026thinsp;~\u0026thinsp;116)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e82.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29\u003c/p\u003e\u003cp\u003e(29\u0026thinsp;~\u0026thinsp;116)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e-0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.607\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInformation satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.24\u003c/p\u003e\u003cp\u003e(9\u0026thinsp;~\u0026thinsp;36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e25.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44\u003c/p\u003e\u003cp\u003e(9\u0026thinsp;~\u0026thinsp;36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e-1.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.104\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmotional satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.32\u003c/p\u003e\u003cp\u003e(9\u0026thinsp;~\u0026thinsp;36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e26.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e\u003cp\u003e(9\u0026thinsp;~\u0026thinsp;36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.415\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eResource satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.26\u003c/p\u003e\u003cp\u003e(7\u0026thinsp;~\u0026thinsp;28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e19.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e\u003cp\u003e(7\u0026thinsp;~\u0026thinsp;28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e-0.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.462\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eParticipation satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.35\u003c/p\u003e\u003cp\u003e(4\u0026thinsp;~\u0026thinsp;16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e11.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.36\u003c/p\u003e\u003cp\u003e(4\u0026thinsp;~\u0026thinsp;16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.929\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e3. Effect of the pre-ICU Intervention program\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e1) First 24 hours of postoperative ICU stay\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTheir APACHE Ⅱ score 31 (51.7%) patients scored between 25 and 31, indicating 55% or higher death rate. Ventilator (48.3%) and restraints (45.0%) applied to all patients was removed in half of patients within the first hour in the ICU. Postoperative delirium was found in 14 patients (23.3%), five (16.7%) in the intervention group and 9 (30.0%) in the control group. Eleven out of fourteen patients (78.6%) had onset within the first four hours of ICU stay, four (28.6%) in the intervention group and seven (50.0%) patients in the control group (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePatient\u0026rsquo;s APACHE Ⅱ score, use of ventilator and restraints, delirium, and pain\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eχ\u0026sup2;\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;30\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eAPACHE Ⅱ\u003c/p\u003e\u003cp\u003e(score)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e4(13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e4(13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8(13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.994\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u0026ndash;24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e11(36.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e21(35.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25\u0026ndash;29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e13(43.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e14(46.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e27(45.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e2(6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e2(6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e4(6.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eVentilator applied\u003c/p\u003e\u003cp\u003e(hour)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e14(46.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e15(50.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e29(48.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.629\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026sim;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e13(43.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e10(33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e23(38.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e3(10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e5(16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8(13.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eRestraints applied\u003c/p\u003e\u003cp\u003e(hour)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e13(43.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e14(46.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e27(45.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e2.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.256\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026sim;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e14(46.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9(30.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e23(38.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e3(10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e7(23.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10(16.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eIncidence of delirium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e5(16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9(30.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e14(23.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e1.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.222\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e25(83.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e21(70.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e46(76.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOnset of delirium\u003c/p\u003e\u003cp\u003e(hour)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e4(28.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e7(50.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e11(78.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e1.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.473\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4\u0026sim;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e1(7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e2(14.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3(21.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eDuration of delirium\u003c/p\u003e\u003cp\u003e(hour)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e4(28.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e6(42.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10(71.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e2.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.432\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e0(0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e2(14.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2(14.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e1(7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e1(7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2(14.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePain \u0026amp; Use of PCA \u0026amp; Number of analgesics\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eVariable\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCategory\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003et/\u003c/b\u003e\u003cb\u003eχ\u0026sup2;\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eFrequency of pain complaints\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e3.13\u0026thinsp;\u0026plusmn;\u0026thinsp;.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e5.96\u0026thinsp;\u0026plusmn;\u0026thinsp;1.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-8.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eNRS (0\u0026ndash;10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e3.10\u0026thinsp;\u0026plusmn;\u0026thinsp;.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e5.86\u0026thinsp;\u0026plusmn;\u0026thinsp;1.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-8.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eUse of PCA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e27(90.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e12(40.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e16.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e3(10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e18(60.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eNumber of analgesics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal analgesics (IV)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e0.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e2.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-10.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eFentanyl 25/50mcg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e0.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e3.46\u0026thinsp;\u0026plusmn;\u0026thinsp;1.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-11.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTramadol 100mg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e1.06\u0026thinsp;\u0026plusmn;\u0026thinsp;0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-5.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eMeperidine 12.5/25mg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e0.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e0.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.451\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eParacetamol 1g\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e1.56\u0026thinsp;\u0026plusmn;\u0026thinsp;1.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e5.13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-9.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eAcetaminophen 1g\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e0.66\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e4.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-15.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003eNRS: Numerating Rating Scale, rated from 0\u0026thinsp;\u0026minus;\u0026thinsp;no pain to 10\u0026thinsp;\u0026minus;\u0026thinsp;maximum pain, an NRS\u0026thinsp;\u0026ge;\u0026thinsp;3 indicates significant pain\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003ePCA: Patient Controlled Analgesia\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003ePCA components: Fentanyl 1500mcg\u0026thinsp;+\u0026thinsp;Nasea 0.3mg\u0026thinsp;+\u0026thinsp;Normal saline 100ml mixed.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003eIV: Intravenous\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003eAPACHE II(Acute Physiology and Chronic Health Evaluation II): Interpretation of APACHE II scores (predicted mortality rate). 0\u0026ndash;4\u0026thinsp;=\u0026thinsp;4% death rate, 10\u0026ndash;14\u0026thinsp;=\u0026thinsp;15% death rate, 20\u0026ndash;24\u0026thinsp;=\u0026thinsp;40% death rate, 30\u0026ndash;34\u0026thinsp;=\u0026thinsp;75% death rate, 5\u0026ndash;9\u0026thinsp;=\u0026thinsp;8% death rate, 15\u0026ndash;19\u0026thinsp;=\u0026thinsp;25% death rate, 25\u0026ndash;29\u0026thinsp;=\u0026thinsp;55% death rate Over 34\u0026thinsp;=\u0026thinsp;85% death rate. (Minimum score\u0026thinsp;=\u0026thinsp;0; maximum score\u0026thinsp;=\u0026thinsp;71, Increasing score is associated with increasing risk of hospital death)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e2) Postoperative Pain\u003c/h3\u003e\n\u003cp\u003eA number of pain complaints for the first 24 hours in ICU was significantly less in the intervention group with 3.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62 than control group with 5.96\u0026thinsp;\u0026plusmn;\u0026thinsp;1.62 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The mean NRS score was significantly lower in the intervention group with 3.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40 than control group with 5.86\u0026thinsp;\u0026plusmn;\u0026thinsp;1.67 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The PCA was used by most of the intervention group (90.0%) compared to the control group used by only 40% (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The mean of analgesics other than PCA given was significantly less in the intervention group with 0.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71 than control group with 2.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003e3) State anxiety of patients and family caregivers\u003c/h3\u003e\n\u003cp\u003eThe mean score of state anxiety in patients measured before ICU discharge was significantly lower in the intervention group with 1.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.34 than control group with 2.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Intervention group showed a significant decrease in their anxiety after the VBT intervention (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while the control group showed no change in their anxiety level (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.708) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eState anxiety of patients and family caregivers \u0026amp; Nursing service satisfaction of family caregivers\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePre-test\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePost-test\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003epaired-t(\u003cem\u003ep\u003c/em\u003e)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eDifference\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003et(\u003cem\u003ep\u003c/em\u003e)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eState anxiety of patients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e36.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7.67(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e-5.14(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49.40\u0026thinsp;\u0026plusmn;\u0026thinsp;.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e48.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.37(0.708)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.43\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eState anxiety of family caregivers\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e-6.39(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7.31(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.84(0.075)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNursing service satisfaction (total)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e81.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e99.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-8.41(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e6.92(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e82.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.51(0.609)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eInformation satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-11.04(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e8.38(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.41(0.684)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eEmotional satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-5.64(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e6.14(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.96(0.340)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.06\u0026thinsp;\u0026plusmn;\u0026thinsp;0.33\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eResource satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-5.52(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e4.41(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.10(0.918)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eParticipation satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-3.61(0.001)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e3.92(\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.18(0.245)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe mean score of state anxiety in caregivers measured ICU discharge was significantly lower in the intervention group with 1.93\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46 than control group with 2.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.31 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Intervention group showed a significant decrease in caregivers\u0026rsquo; anxiety after the VBT program (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while the control group showed no significant difference (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003e4) Nursing service satisfaction of family caregivers\u003c/h3\u003e\n\u003cp\u003eFamily caregivers in the intervention group reported significantly higher satisfaction with nursing services they experienced before their loved one's ICU discharge (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Their satisfaction was increased significantly after the VBT intervention (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while their counterparts showed no change over time. The intervention group showed significant increases in the all sub-categories after the VBT program, especially in information satisfaction. On the other hand, the control group showed no changes in the sub-categories (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e"},{"header":"Discussion","content":"\n\u003ch3\u003e1. Pain and anxiety in patients after craniotomy\u003c/h3\u003e\n\u003cp\u003eThe frequency of pain complaints and NRS scores were significantly lower in the intervention group than in the control group. Pain anticipated following craniotomy and information given about the use of PCA in this VBT program appears to influence on the pain management in the intervention group. This finding is aligned with results from a study that the degree of pain after spinal surgery was lower in the group provided with preoperative video-based education than in the control group [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. A significant difference in the use of PCA within the first 24 hours of ICU stay, 90.0% in intervention group and 40.0% in the control group, seems to be associated with a significant difference in the frequency of pain complaints and NRS scores. In addition, the number of additional analgesics administered within the first 24 hours of ICU stay after surgery was significantly lower in the intervention group than in the control group. Although the total number of PCA use was not collected, initiation of the PCA use within the first 24 hours after craniotomy might be a strategy for the better pain management. Therefore, preoperative VBT program was effective on the patients' use of PCA leading to postoperative pain control.\u003c/p\u003e\u003cp\u003eThe mean score of state anxiety showed a significant decrease in the intervention group, while had no difference in the control group. The results of this study may contradict the findings of a previous study that provision of information about ICU environment using visual aids such as a booklet in advance had no influence on patient\u0026rsquo;s anxiety [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Our results imply that VBT using audio-visual materials was an effective teaching method other than visual only method. Therefore, VBT combined with visual and auditory stimuli is an effective teaching strategy in enhancing attention-concentration and understanding of learners [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Since the VBT program in this study showed ICU environment and machines such as ventilator needed for patient care and explained purpose of each device including restraints for the patient's safety. As a result, decreased anxiety reported in the intervention group is thought to be attributable to the preoperative teaching about unfamiliar ICU environment that helped the patients lower their anxiety during the ICU stay than the control group.\u003c/p\u003e\n\u003ch3\u003e2. Anxiety and nursing service satisfaction of family caregivers of craniotomy patients\u003c/h3\u003e\n\u003cp\u003eFamily caregivers in the intervention group showed a significant decrease in their state anxiety level after the VBT intervention while control group showed no decrease. Contradicting results were reported in previous studies on anxiety among ICU patients' caregivers [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. They offered ICU information to caregivers by sending brief text messages before admission or using guidebook prior to their loved ones' transfer to ICU. Reduction in caregivers' anxiety level in this study might have been accounted for different approach with audiovisual teaching method.\u003c/p\u003e\u003cp\u003eSince this study showed the highest anxiety on day before surgery reported by the participants, offering VBT program that can be watched as many as they want might help lowering anxiety levels. Moreover, more than half of family caregivers in this study had no previous experience as an inpatient or a caregiver for ICU patients. Therefore, the VBT program consisted of content about ICU environment, guide for hospital stay, and ICU nursing care to be provided after craniotomy videotaped in the real ICU seemed useful for the patients and caregivers. Although relationship between number of video watching and the levels of anxiety is not investigated this study, the VBT program that allow repeated viewing and encourage information acquisition without space-time constraints appeared efficient. These strategies of the VBT seem effective in reduction of anxiety in the intervention group. Also, when family caregivers experience the same as they were informed in the video about patient\u0026rsquo;s conditions in the ICU after craniotomy, they reported higher satisfaction with nursing service they received.\u003c/p\u003e\u003cp\u003e Finally, in addition to a significant increase in satisfaction with nursing services perceived by family caregivers in intervention group, their higher satisfaction at post-test that was significantly different from control group implied a clinical implication. This finding supported a previous study using VBT for family members of critically ill patients [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Recently, increased patient education about introducing to ICU is heading to a good direction, however teaching has been limited to general information on ICU environment and nursing care. In contrast, the VBT developed in this study appears to offer psychological safety with adequate emotional support in the time when tension is growing highest in patients and their family members by providing realistic processes from patient\u0026rsquo;s ICU admission to discharge after craniotomy and consecutively presenting intensive care provided for critically ill patients after ICU stay.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThere are several limitations to note in the present study. First, caution is needed to generalize the study findings because this investigation was performed by involving three ICUs at University Hospital located in Korea. Second, this study involved patients admitted to the hospital to undergo scheduled craniotomy and their family caregivers. For this reason, a follow-up study is warranted to apply study findings to patients who receive emergency craniotomy. Third, pain relief was determined with the use of PCA. The effect of dosage and frequency of PCA on pain management and the influence of the VBT program according to the number of times of viewing need to be assessed in the future.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe pre-ICU VBT program developed in the study was identified to reduce pain and anxiety in patients undergoing craniotomy, and to be effective in decreasing anxiety and increasing satisfaction with nursing services in family caregivers. The repeated viewing of VBT using audio-visual information is a learning approach for information acquisition and an effective strategy for emotional support.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eVBT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003evideo-based teaching\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eICU\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eintensive care unit\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eNRS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eNumerical rating scale\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSTAI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eState-Trait Anxiety Inventory\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCCFNI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCritical Care Family Needs Inventory\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eIRB\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eInstitutional Review Board\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eGCS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eGlasgow Coma Scale\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eAPACHE Ⅱ\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eAcute Physiology and Chronic Health Evaluation II\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEOM\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eExternal ocular movement\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCMS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCirculation, Motion, Sensation\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePCA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePatient Controlled Analgesia\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003cp\u003eThis study was initiated after obtaining IRB approval from Seoul National University Bundang Hospital (IRB No. B-2103-673-306). All participants were fully informed about the research objectives and procedures by the investigator and provided written consent to participate. Participants had the right to withdraw from the study at any time. Data were collected using structured questionnaires and electronic medical records (EMRs). The study ensured the confidentiality and anonymity of all data, with personally identifiable information encrypted and securely stored. This research was conducted in compliance with the Declaration of Helsinki.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding source\u003c/h2\u003e\u003cp\u003einformation\u003c/p\u003e\u003cp\u003eThis research was supported by Seoul National University Bundang Hospital and Institute of Nursing Research Korea University.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAll authors have agreed with the content of the manuscript and contributed to the work as follows: J.P.: conceptualization; data collection; methodology; statistical analysis; drafting the initial manuscript and revising/editing the final version, N.S.: conceptualization; data collection; methodology; drafting the initial manuscript and revising/editing the final version.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe acknowledge Hye-young Kim, the head nurse of the SNUBH Neurological ICU who supported this study with invaluable help.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBeesley SJ, Hopkins RO, Holt-Lunstad J, Wilson EL, Butler J, Kuttler KG, et al. 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J Korean Crit Care Nurs. 2015;8(2):43\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Craniotomy, Intensive Care Unit, Education, Anxiety, Pain, Family Satisfaction","lastPublishedDoi":"10.21203/rs.3.rs-7599750/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7599750/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThis study examined the effect of video-based teaching (VBT) program for the patients and families undergoing craniotomy on their pain, anxiety and nursing service satisfaction.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA non-equivalent control group, non-synchronized pre- and post-test design was used. A total of 120 participants with 60 pairs of patients and their family were recruited. After the data collection from the control group was completed, pre-test and VBT were offered to the intervention group the day before surgery and post-test was conducted before discharge from ICU. Numerical rating scale (NRS), the State-Trait Anxiety Inventory (STAI) and the Critical Care Family Needs Inventory (CCFNI) were used.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe frequency of pain complaints (t=-8.88, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), NRS score (t=-8.79, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the number of additional analgesic administration (t=-10.64, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were lower in the intervention group than in the control group. This is thought to be attributable to the more use of PCA in the intervention group (χ\u0026sup2;=16.48, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). State anxiety score in the intervention group was decreased from pre-test to post-test (t\u0026thinsp;=\u0026thinsp;7.67, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and the score at the post-test was even lower than in the control group (t=-5.14, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). State anxiety score of family in the intervention group was also reduced at the post-test (t\u0026thinsp;=\u0026thinsp;7.31, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and the score at the post-test was even lower than in the control group (t=-6.39, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Satisfaction with nursing service reported by family in the intervention group was improved after the VBT program (t=-8.41, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and was higher than one in the control group (t\u0026thinsp;=\u0026thinsp;6.92, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe VBT program was found to be effective to decrease anxiety and pain of patients and to increase nursing service satisfaction their families. The VBT program might be a strategy to reduce anxiety and pain of patients admitted to the ICU after brain surgery and in reducing anxiety and improving nursing service satisfaction of their families.\u003c/p\u003e","manuscriptTitle":"Effect of Pre-ICU Video-based Teaching on Patients and Families undergoing Craniotomy: a Quasi-Experimental study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-26 13:25:47","doi":"10.21203/rs.3.rs-7599750/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-03T10:39:15+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-01T10:43:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"226273438694010264492808753779844106537","date":"2025-10-16T09:33:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-13T08:28:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"308791881040743177421593385704524013834","date":"2025-10-13T07:53:10+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-10T12:26:46+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-23T04:29:06+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-22T00:30:42+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-09-22T00:27:38+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e10c5198-05b0-4c0f-917b-f893682b99fd","owner":[],"postedDate":"October 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-17T07:23:37+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-26 13:25:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7599750","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7599750","identity":"rs-7599750","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}