Effect of the calming anxiety and relaxation emergency (Abdominal) surgery (CARES) program on patients’ pre- and postoperative anxiety management and outcomes: a prospective quasi-experimental study

Background Patients undergoing emergency abdominal surgery often have limited time to prepare. This may lead to anxiety, which can adversely affect postoperative recovery. A structured intervention, Calming Anxiety and Relaxation for Emergency (Abdominal) Surgery (CARES) program, was developed to address this concern. Methods In this prospective quasi-experimental study, the effects of the CARES program on pre- and postoperative anxiety were evaluated among adult patients undergoing emergency abdominal surgery at a regional hospital in Hong Kong. Participants were allocated to either the intervention group (IG) or the control group (CG) based on bed availability. The IG received the CARES program (pre- and postoperative counseling sessions plus daily self-practiced body–mind exercises for five consecutive days) in addition to usual care, while the CG received usual care alone. Pre- and postoperative anxiety and postoperative pain were measured using a visual analog scale and analyzed over time using a generalized estimating equation model. Postoperative analgesic consumption, time to first flatus, and length of hospital stay were compared between the groups using independent t-tests or Mann–Whitney U tests. All analyses adhered to the intention-to-treat principle. Results A total of 120 participants were enrolled and allocated equally to the IG and CG ( n = 60 per group). The overall discontinuation rate was 3.33%. Compared with the CG, the IG demonstrated significantly lower anxiety immediately before transfer to the operating theatre ( β = −1.67; 95% confidence interval [CI]: −2.18 to − 1.15; p < .01) and on postoperative days one ( β = −1.29; 95% CI: −2.30 to − 0.27; p = .01) and three ( β = −1.47; 95% CI: −2.58 to − 0.35; p = .01). Additionally, the IG demonstrated a significantly shorter time to first postoperative flatus ( p = .01) and length of hospital stay ( p = .02). No significant between-group differences were observed in postoperative pain reduction or analgesic consumption. Conclusion The CARES program was found to be feasible for clinical implementation and significantly reduced pre- and postoperative anxiety, time to first postoperative flatus, and length of hospital stay in patients undergoing emergency abdominal surgery. Trial registration Chinese Clinical Trial Registry (NO. ChiCTR2300076274) on September 28, 2023.