Numerous studies have documented the efficacy of a variety of psychoeducational interventions for pain and other symptom relief including patient education strategies that provide information, skills training, or psychosocial support in limited populations. These interventions have variously been found to decrease symptoms such as pain and anxiety as well as enhance coping skills and yield cost effective outcomes by reducing length of stay. However, significant knowledge gaps exist and it is not understood how efficacy of the interventions varies among diverse social and ethnic populations. This project seeks to address the efficacy of two interventions within the purview of nursing practice: relaxation training and sensory information preparation, compared with standard procedural preoperative preparation, in Anglo and Hispanic women undergoing unilateral mastectomy or abdominal hysterectomy and/or salpingo-oophorectomy. Another factor to be addressed is patient preference. This will be studied by offering a choice of interventions as recommended by the Agency for Health Care Policy and Research (AHCPR) acute pain management guidelines (1992). The study consists of an experimental design with subjects randomized to a group in which a menu of interventions are offered, or the control group in which subjects will receive the current, standard preoperative procedural preparation. The dependent variables to be assessed include: pain and pain relief, anxiety, analgesic usage, and patient satisfaction. By addressing these issues it is anticipated that this study will add to our understanding of cultural differences and guide clinical interventions for pain and symptom management. Additionally, knowledge gained regarding the significance of patient choice and preferences will enable more effective and individually tailored approaches to preoperative preparation of patients.
