Clinical Trial Summary
Research methods
1 Data collection and evaluation tools
1. The general data record sheet was self-designed by the research team, and the collected
content included age, gender, BMI, occupation, general family status, economic
situation, history of hypertension and cardiovascular diseases, history of anxiety and
depression, self-rating anxiety scale (SAS) score, blood pressure and heart rate before
and after intervention, disease diagnosis and severity, etc.
2. The anxiety was self-scored using the VAS-A (0-10 points), with 0 point as no anxiety
and 10 as severe anxiety.
3. Negative emotional intensity was scored using the subjective unit of disturbance scale
(SUDS, 0-10 points), with 0 point as no and 10 points as severe.
4. Nursing satisfaction was scored by the self-designed questionnaire (1-5 points): 5
points, very satisfied; 4 points, relatively satisfied; 3 points, satisfied; 2 points,
medium; 1 point, dissatisfied.
2 Intervention method of the control group The control group was given routine nursing. After
entering the pre-anesthesia room, the patients were scored using the VAS-A, and those with
VAS-A score ≥ 5 were considered to meet the inclusion criteria. After identity
authentication, the preoperative precautions and reasons for waiting in the pre-anesthesia
room were explained to the patients, and answers were provided to the questions raised by the
patients. After routine nursing, VAS-A score was recorded, blood pressure and heart rate were
monitored, and nursing satisfaction was inquired. The survey of patient satisfaction with
nursing was completed before entering the operating room.
3 Intervention method of the experimental group 3.1 Researcher training Before intervention,
4 nurses were trained for 5 d by a nurse with EFT qualification certificate, 1 h per day. The
training content included: theoretical knowledge of EFT, tapping techniques, etc. After
training, two assessments were conducted. Only those who scored above 90 points in both
assessments could participate in the study.
3.2 Operating instructions The acupoint diagram was distributed to the experimental group by
nurses, and the essentials and precautions of acupoint tapping were explained. The nurses
demonstrated and tapped the acupoints on the patients while explaining, and then instructed
them to tap on their own until they were able to complete the task independently and
proficiently. For patients with upper limb vein puncture, proper fixation and close
observation were needed, and the flexible nature of the puncture needle that would not affect
operations was explained to the patients to eliminate their concerns.
3.3 Intervention content After routine nursing, the patients received EFT intervention. In
addition, subjective anxiety was scored, blood pressure and heart rate were monitored, and
nursing satisfaction was surveyed after admission and intervention. The specific methods are
as follows.
1. Preparation stage The patients with VAS-A score ≥ 5 meeting the inclusion criteria were
in a comfortable position with eyes closed, and adopted breathing exercise to relax
their whole body. The patients were guided to summarize the main current distresses,
such as fear, tension, pain, surgical prognosis, economic burden, etc., name the caused
negative emotions, and use the SUDS to evaluate the intensity of negative emotions. The
patients were asked to recite silently the prompt "Although I am very ** (a negative
emotional word) now, I still deeply and completely love and accept myself" while
tapping.
2. Tapping stage The patients were guided to gently massage the sore points on both sides
of the body (2-3 fingers below the midpoint of the clavicle) with their five fingers
together in a clockwise direction, while silently reciting the prompt 3 times. Then, the
patients were guided to close their index and middle fingers together and gently tap the
Zanzhu, Tongziliao, Chengqi, Renzhong, Chengjiang, Shufu, Dabao and Baihui acupoints
successively with their fingertips at 2-3 times/s and the force they can bear. The
prompt was recited silently when tapping each acupoint. After 3-5 rounds of tapping, 3
deep breaths were taken to re-evaluate the intensity of negative emotions.
3. Feedback stage After tapping, the patients communicated with the nurses at least once
about their evaluated negative emotional intensity score and whether the score was
accepted. If the tapping effect was not obvious, the evaluation was conducted by nurses,
and the patients were guided to massage the sore points while silently reciting the
prompt 3 times. To relieve reverse psychological drive, tapping was continued until the
intensity of negative emotions reduced.
