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27.22 Relaxation and anxiety management

Pre‐procedure

ActionRationale

  1. 1.
    Introduce self to patient, either in the inpatient or outpatient setting.
    To establish professional and clinical rapport. E
  2. 2.
    Gain consent from the patient for the intervention.
    To ensure the patient understands the procedure and provides verbal consent (NMC [202]; E).

Procedure

  1. 3.
    Assess baseline of the patient's anxiety and sleep pattern using visual analogue scale Insomnia Severity Index Sleep Assessment (Morin et al. [178]):
    Sleep problem5 being most difficult
    Difficulty falling asleep0–5
    Difficulty staying asleep0–5
    Problem waking up early0–5
    To establish the patient's perception of their anxiety level. C
  2. 4.
    Establish triggers for anxiety.
    To identify causes for anxiety. C
  3. 5.
    Discuss how to use relaxation techniques in daily routine and how to apply them in practice.
    To enable the patient to use relaxation techniques as part of a toolkit of skills to cope with fatigue and anxiety. C
  4. 6.
    Provide simple advice on managing poor sleep in the form of a written leaflet, in conjunction with a session at which the information is discussed and explained thoroughly (see information in Figure 27.35).
    To enable the patient to use the advice at home (RCP [184]).
  5. 7.
    Provide a recording of each session for the patient to continue practising (e.g. on their smart phone, MP3 download or compact disc of the session).
    To provide ownership of sessions to patient and enable ongoing practice. C
  6. 8.
    Encourage use of a sleep diary (Figure 27.34).
    To enable the patient to measure the success of sleep strategies. C

Post‐procedure

  1. 9.
    Document the consultation.
    Legal requirement of professional body and employing institution (NMC [202], E).
  2. 10.
    Have one final therapy session to ensure the patient understands all instructions and the healthcare professional can answer any remaining questions before discharging the patient.
    To demonstrate progress to the patient and refer on to further support if required. C
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