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Surgery Research (29)

17 Mar

In this RCT (randomized, controlled trial) researchers from the Mayo Clinic evaluated the effect of post-operative massage in patients who had undergone abdominal colorectal surgery, and found that it had a consistent, statistically significant, positive effect.

One hundred twenty-seven patients were randomized to receive either a 20-min massage (n = 61) or a social visit and relaxation session with no massage; n = 66) on the second and third day after surgery.

Vital signs and psychological well-being (pain, tension, anxiety, satisfaction with care, relaxation) were assessed before and after each intervention.

15 Oct

Researchers from Saint Clare Health Systems in Dover, New Jersey investigated the effectiveness of the "M" Technique of structured touch (M), compared with guided imagery and usual care, for the reduction of pain and anxiety in patients undergoing elective total knee or hip replacement surgery.

"M" is a registered method of structured touch using a set sequence and number of strokes, and a consistent level of pressure on hands and feet,

09 Apr

Researchers from Wilford Hall Medical Center at Lackland Air Force Base in San Antonio, Texas, looked at the impact of guided imagery on postoperative outcomes in patients undergoing same-day surgical procedures.

Forty-four adults scheduled for head and neck procedures were randomly assigned to 2 groups for this single-blind investigation.

Anxiety and baseline pain levels were documented pre-operatively. Both groups received 28 minutes of privacy, during which subjects in the experimental group listened to a guided imagery compact disk (CD), but control group patients received no intervention.

05 Mar

In this pilot study, researchers from the University of Montreal investigated the impact of a guided imagery intervention on post-op pain intensity, anxiety, coping and daily activities in adolescents and young adults, ages 11-20, after undergoing orthopedic surgery (spinal fusion) for idiopathic scoliosis.

Participants were randomized to standard care or standard care with the guided imagery intervention. The intervention consisted of a DVD with information and guided imagery/relaxation exercises to practice at least three times a week at home.

A nurse screened the DVD with the patient pre-operatively and at discharge (T1) and telephoned 2 weeks post-discharge (T2) to reinforce the use of the technique.

23 Oct

Researchers from the UCLA School of Nursing evaluated a program of early, home based cognitive behavioral therapy (CBT) program to remediate depression in patients recovering from cardiac surgery.

They conducted a randomized controlled trial and enrolled 808 patients who were screened for depressive symptoms, using the Beck Depression Inventory (BDI) in the hospital and 1 month later. Patients were also interviewed using the Structured Clinical Interview for DSM-IV; those who met criteria for clinical depression (n = 81) were randomized to CBT (n = 45) or usual care (UC; n = 36). After completion of the UC period, 25 individuals were offered later CBT (UC + CBT).

The outcomes were evaluated after 8 weeks. Compared with the Usual Care group, the CBT group had greater decline in depression scores and greater remission of clinical depression.

30 Dec

Researchers from the University of Melbourne and St Vincent's Hospital, in Melbourne, Australia, evaluated the efficacy of pre-operative mind-body based interventions on post-operative outcomes with elective surgical patients.

A systematic review of the published literature was conducted using the electronic databases MEDLINE, CINAHL and PsychINFO. Randomized controlled trials (RCTs) with a prospective before-after surgery design were included.

Twenty studies involving 1297 patients were included. Mind-body therapies were categorized into relaxation, guided imagery and hypnotic interventions. The majority of studies did not adequately account for the risk of bias thus undermining the quality of the evidence.
 
Relaxation was assessed in eight studies, with partial support for improvements in psychological well-being measures, but a lack of evidence for beneficial effects for analgesic intake and length of hospital stay.

03 Jun

Investigators from the University of Michigan School of Nursing in Ann Arbor examined the effects of using our Healthful Sleep guided imagery on post-cardiac surgery sleep disturbances (problems with sleep quality, time taken to fall asleep and total sleep time) and systemic inflammatory response, as measured by stress hormones and inflammatory markers, including cortisol and C-reactive proteins.  These post-surgical difficulties are exacerbated when a patient is put on a bypass machine, and are predictors of post-op morbidity and mortality.

Of the 52 patients who provided informed consent, 27 were randomly assigned to the guided imagery group and 25 to usual care only during the ICU and step-down phases of post-op recovery.  Of these, 5 in each group were lost to follow-up.

25 Jun

Researchers from the Department of Surgery at Columbia University in New York examined whether guided imagery could reduce depression and therefore post-op cardiac events and even deaths (associated with depression) in patients who’d undergone coronary artery bypass graft (CABG) surgery.

Traci Stein and her team hypothesized that this low cost and easy-to-implement technique could reduce post-op distress in CABG patients.  Fifty-six patients were randomized into 3 groups: guided imagery, music therapy, and standard care control.
 
Patients in the imagery and music groups listened to Health Journeys audiotapes preoperatively and intraoperatively.  All patients completed psychological, complementary medicine therapies use, and other assessments preoperatively and at 1 week and 6 months postoperatively.

04 Jun

Researchers at the University of Auckland in New Zealand investigated whether a brief psychological intervention, using relaxation and guided imagery, could reduce stress and improve wound healing in surgical patients.

The randomized controlled trial was conducted with 60 patients (15 male, 45 female). Inclusion criteria were English-speaking patients over 18 years of age, scheduled to undergo elective laparoscopic gallbladder removal.  Exclusion criteria were cancellation of surgery, medical complications, and refusal of consent.

Participants received standard care or standard care plus a 45-minute psychological intervention that included relaxation and guided imagery, with take-home relaxation CDs for listening for 3 days before and 7 days after surgery.

05 Jun

Researchers from MD Anderson Cancer Center at the University of Texas, Houston, assessed whether stress management (SM) improved immune outcomes in men undergoing surgery for prostate cancer.

A total of 159 men were assigned randomly to a two-session pre-surgical stress management intervention, a two-session supportive attention (SA) group, or a standard care (SC) group.
 
Men in the SM group discussed their concerns about the upcoming surgery and were taught diaphragmatic breathing, guided imagery, imaginal exposure to the day of surgery and additionally learned adaptive coping skills.
 
Men in the SA group discussed their concerns about the upcoming surgery and had a semistructured medical interview.