Effects of music listening on preoperative state anxiety and physiological parameters in patients undergoing general surgery: a randomized quasi-experimental trial

Effect of an early mobilisation programme on pain intensity after laparoscopic surgery: a randomised clinical trial

BACKGROUND

Pain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery.

METHODS

A randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient's perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher's exact tests and the repeated measures analysis.

RESULTS

The repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05).

CONCLUSION

Early mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.

A randomized controlled trial on the effects of different music genres on physiologic parameters and emotion

BACKGROUND

Listening to music has psychophysiological effects on individuals' body and emotions, and it is known as one of the most influential stimuli to create emotions. The aim of this study was to explore the effect of different music genres on some physiological parameters and emotion.

METHODS

This was a randomized controlled trial. For 5 days, forty-six healthy undergraduate students were randomly assigned to several types of music (pop, rock, western classical, and Persian traditional), as well as silence. Physiologic parameters were checked five times (before, during, immediately, 15, and 30 min after the interventions). Before and after the interventions, the Self-Assessment Manikin questionnaire was completed.

RESULTS

There was no statistically significant difference in heart rate, diastolic blood pressure, temperature, silence, or other approaches between the groups. Silence and other ways did not reduce systolic blood pressure as much as listening to the pop. Peripheral oxygen saturation increased significantly only when listening to Persian traditional music, and when there was silence however, the differences were not statistically significant. In terms of valence, arousal, and dominance, none of the five treatments were shown to be more effective.

CONCLUSION

The results of the present study showed that statistically and clinically, there was no difference between silent music and other types of music, including pop, rock, western classical, and Persian traditional, in reducing physiological parameters. Different genres of music had no additional impact on emotion when compared to silence.

Effectiveness of music therapy and progressive muscle relaxation in reducing stress before exams and improving academic performance in Nursing students: A randomized trial

BACKGROUND

Nursing students experiencing high stress levels before exams could suffer worse academic performance.

OBJECTIVE

We evaluated an intervention combining Progressive Muscle Relaxation (PMR) and music therapy on the decrease of before exams stress and the improvement of academic results.

DESIGN AND METHODS

Randomized controlled trial including students from the Nursing Degree during the first semester of the 2017-2018 academic year. All participants were randomized to the control (CG) or the experimental group (EG). The CG took the exam as usual whereas in the EG, PMR and music therapy were performed before exams. Blood samples were drawn to investigate variations in biochemical parameters. The academic performance was assessed by the score obtained in the "Clinical Nursing" exam.

RESULTS

We included 112 students (75% females, mean age 24.3 ± 6.2 years, 56 students in every group). There were no differences in any parameter during the first measurement. Regarding the second measurement, we observed a reduction in heart rate for the EG and an increase in blood pressure, heart rate, and cortisol for the CG. Indeed, these parameters were significantly higher compared to the EG. The EG had a mean score of 5.07 ± 1.59 in the Clinical Nursing exam, which was significantly higher compared to the CG (4.42 ± 1.58, p = 0.033). The proportion of fails in the CG was also higher (62.5% vs. 42.9%, p = 0.037).

CONCLUSION

In this study including students from the Nursing degree, the combination of PMR and music therapy was effective for the control and decrease of stress before exams, and also demonstrated improvements in academic results.

The effects of foot reflexology on depression during menopause: A randomized controlled clinical trial

OBJECTIVE

The purpose of this study was to determine the effects of foot reflexology on depression during menopause.

DESIGN

Randomized controlled clinical trial.

SETTING

Gynecology outpatient clinic.

INTERVENTIONS

We enrolled 90 menopausal women with depression. Participants were assigned to the intervention (n = 45) and control (n = 45) groups by block randomization. Participants in the intervention group received 15 min of foot reflexology on each foot for a total of 30 min in evenings, twice a week for six weeks. Participants in the control group received only the routine care for menopause patients.

MAIN OUTCOME MEASURES

The Beck Depression questionnaire was completed by all participants at the beginning of the trial and the end of the intervention and two months after completion of the intervention.

RESULTS

A total of 121 patients were assessed for eligibility to participate in the study. One-hundred patients met the criteria to participate, and 90 participants-45 participants in each group-completed the study. In the intervention group, the mean scores of depression before, immediately after, and two months after the study were 26.97 ± 4.47 (95% CI = 25.3-28.3), 22.55 ± 5.18 (95% CI = 20.9-24.1), and 21.20 ± 5.74 (95% CI = 19.4-22.9), respectively. In the control group, these scores were 26.15 ± 5.01 (95% CI = 24.6-27.6), 26.22 ± 5.14 (95% CI = 24.7-27.7), and 26.66 ± 3.87 (95%CI = 25.5-27.8), respectively. Using Repeated Measures ANOVA, the comparison of the mean scores of depression in the two groups indicated that the scores were decreased over time.

CONCLUSION

The findings indicated that the foot reflexology technique can be effective for reducing women's depression during menopause. However, considering the study's limitations, including a small sample size and no intervention in the control group, more studies are needed to verify the findings.

Effectiveness of Lifestyle Modification Education on Knowledge, Anxiety, and Postoperative Problems of Patients With Benign Perianal Diseases

PURPOSE

The aim of this study was to evaluate the effectiveness of preoperative planned education about lifestyle modifications on knowledge, anxiety level, and postoperative problems of the patients with benign perianal disease.

DESIGN

The study was a quasi-experimental design.

METHODS

The sample was a total of 102 patients undergoing surgical procedure for hemorrhoid and fissure in the general surgery unit of a state hospital in Turkey. Data were collected using the Descriptive Characteristics Determination Questionnaire, the Knowledge Determination Questionnaire, the Postoperative Problems Determination Questionnaire, and the State and Trait Anxiety Inventory.

FINDINGS

Preoperative written and verbal planned education about lifestyle modifications improved knowledge and decreased anxiety levels of the patients. There were no statistically significant differences between the control and study groups in postoperative problems other than leakage.

CONCLUSIONS

Results of the present study showed that nurse-conducted education on lifestyle modification of hemorrhoid and fissure was effective.

Musical intervention on anxiety and vital parameters of chronic renal patients: a randomized clinical trial

OBJECTIVE

to evaluate the therapeutic effect of music on anxiety and vital parameters in patients with chronic kidney disease when compared to patients receiving conventional care in hemodialysis clinics.

METHOD

randomized clinical trial conducted in three renal replacement therapy clinics. Sixty people with chronic kidney disease undergoing hemodialysis were randomly allocated to an experimental group and a control group, 30 persons per group). State anxiety was evaluated in both groups by the State-Trait Anxiety Inventory. A t-test was used to verify the effect of the experimental manipulation on the variables.

RESULTS

we found a statistically significant difference between the groups regarding the degree of anxiety experienced during hemodialysis sessions. The experimental group presented a statistically significant reduction of anxiety scores (p = 0.03), systolic blood pressure (p < 0.002), diastolic blood pressure (p < 0.002), heart rate (p < 0.01) and respiratory rate (p < 0.006) after listening to music.

CONCLUSION

music represents a potential resource for nursing intervention to reduce state anxiety during hemodialysis sessions. Brazilian Registry of Clinical Trials: RBR-64b7x7.

Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia

BACKGROUND

In a review and meta-analysis conducted in 1993, psychological preparation was found to be beneficial for a range of outcome variables including pain, behavioural recovery, length of stay and negative affect. Since this review, more detailed bibliographic searching has become possible, additional studies testing psychological preparation for surgery have been completed and hospital procedures have changed. The present review examines whether psychological preparation (procedural information, sensory information, cognitive intervention, relaxation, hypnosis and emotion-focused intervention) has impact on the outcomes of postoperative pain, behavioural recovery, length of stay and negative affect.

OBJECTIVES

To review the effects of psychological preparation on postoperative outcomes in adults undergoing elective surgery under general anaesthetic.

SEARCH METHODS

We searched the Cochrane Register of Controlled Trials (CENTRAL 2014, Issue 5), MEDLINE (OVID SP) (1950 to May 2014), EMBASE (OVID SP) (1982 to May 2014), PsycINFO (OVID SP) (1982 to May 2014), CINAHL (EBESCOhost) (1980 to May 2014), Dissertation Abstracts (to May 2014) and Web of Science (1946 to May 2014). We searched reference lists of relevant studies and contacted authors to identify unpublished studies. We reran the searches in July 2015 and placed the 38 studies of interest in the `awaiting classification' section of this review.

SELECTION CRITERIA

We included randomized controlled trials of adult participants (aged 16 or older) undergoing elective surgery under general anaesthesia. We excluded studies focusing on patient groups with clinically diagnosed psychological morbidity. We did not limit the search by language or publication status. We included studies testing a preoperative psychological intervention that included at least one of these seven techniques: procedural information; sensory information; behavioural instruction; cognitive intervention; relaxation techniques; hypnosis; emotion-focused intervention. We included studies that examined any one of our postoperative outcome measures (pain, behavioural recovery, length of stay, negative affect) within one month post-surgery.

DATA COLLECTION AND ANALYSIS

One author checked titles and abstracts to exclude obviously irrelevant studies. We obtained full reports of apparently relevant studies; two authors fully screened these. Two authors independently extracted data and resolved discrepancies by discussion.Where possible we used random-effects meta-analyses to combine the results from individual studies. For length of stay we pooled mean differences. For pain and negative affect we used a standardized effect size (the standardized mean difference (SMD), or Hedges' g) to combine data from different outcome measures. If data were not available in a form suitable for meta-analysis we performed a narrative review.

MAIN RESULTS

Searches identified 5116 unique papers; we retrieved 827 for full screening. In this review, we included 105 studies from 115 papers, in which 10,302 participants were randomized. Mainly as a result of updating the search in July 2015, 38 papers are awaiting classification. Sixty-one of the 105 studies measured the outcome pain, 14 behavioural recovery, 58 length of stay and 49 negative affect. Participants underwent a wide range of surgical procedures, and a range of psychological components were used in interventions, frequently in combination. In the 105 studies, appropriate data were provided for the meta-analysis of 38 studies measuring the outcome postoperative pain (2713 participants), 36 for length of stay (3313 participants) and 31 for negative affect (2496 participants). We narratively reviewed the remaining studies (including the 14 studies with 1441 participants addressing behavioural recovery). When pooling the results for all types of intervention there was low quality evidence that psychological preparation techniques were associated with lower postoperative pain (SMD -0.20, 95% confidence interval (CI) -0.35 to -0.06), length of stay (mean difference -0.52 days, 95% CI -0.82 to -0.22) and negative affect (SMD -0.35, 95% CI -0.54 to -0.16) compared with controls. Results tended to be similar for all categories of intervention, although there was no evidence that behavioural instruction reduced the outcome pain. However, caution must be exercised when interpreting the results because of heterogeneity in the types of surgery, interventions and outcomes. Narratively reviewed evidence for the outcome behavioural recovery provided very low quality evidence that psychological preparation, in particular behavioural instruction, may have potential to improve behavioural recovery outcomes, but no clear conclusions could be reached.Generally, the evidence suffered from poor reporting, meaning that few studies could be classified as having low risk of bias. Overall,we rated the quality of evidence for each outcome as 'low' because of the high level of heterogeneity in meta-analysed studies and the unclear risk of bias. In addition, for the outcome behavioural recovery, too few studies used robust measures and reported suitable data for meta-analysis, so we rated the quality of evidence as `very low'.

AUTHORS' CONCLUSIONS

The evidence suggested that psychological preparation may be beneficial for the outcomes postoperative pain, behavioural recovery, negative affect and length of stay, and is unlikely to be harmful. However, at present, the strength of evidence is insufficient to reach firm conclusions on the role of psychological preparation for surgery. Further analyses are needed to explore the heterogeneity in the data, to identify more specifically when intervention techniques are of benefit. As the current evidence quality is low or very low, there is a need for well-conducted and clearly reported research.