Pain following abdominal colorectal surgery is an intensely unpleasant sensory and affective experience that is often excessive and may increase complications and postoperative stay. Although opiate medication is provided, it does not always provide sufficient relief, and it can cause undesired side effects. However, studies of the effects of relaxation and music on postoperative pain have produced conflicting results due to methodological problems. The proposed study will correct the shortcomings of prior studies with more rigorous methods.
The aims are to determine if relaxation and music are effective in reducing sensory and affective components of pain in colorectal surgical patients receiving patient controlled analgesia (PCA) during different -activities and postoperative days. An experimental pretest-posttest design will be used with one control level and three experimental levels of self-care actions: relaxation, music and a combination of relaxation and music. The sample will consist of 388 adults, aged 21 to 65 years scheduled for abdominal colorectal surgery in a large midwestern hospital. With tape recorded instructions, the interventions will be taught preoperatively. Postoperatively, according to group assignment, subjects will listen to intervention tapes of the jaw relaxation technique, choice of sedative music, or both as adjuvants to intravenous patient controlled analgesia (PCA). The taped interventions will be tested during two activities (ambulation and rest), on two postoperative days (Day 1 and Day 2). Dependent variables of sensation and distress of pain will be measured with the Sensation and Distress of pain scales (Johnson, 1973). A similar amount of time will be spent with subjects in the control group who will receive all study procedures except the taped interventions. Data will be analyzed using orthogonal a priori contrasts and multivariate analysis of variance and covariance controlling for pretest measures. Results of this project will contribute to future refinements of the Acute Pain Management Guidelines (Acute Pain Management Guidelines Panel, 1992). Demonstration that non-pharmacological, non-invasive adjuvant therapies are effective in reducing pain is a step toward determining their effect during longitudinal use. The long-term goal is to test a non- pharmacological intervention in combination with improved nursing delivery of a pharmaceutical intervention for their effect on complications, patient satisfaction and length of stay.

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National Institute of Nursing Research (NINR)
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Special Emphasis Panel (SRC)
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Case Western Reserve University
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Good, Marion; Albert, Jeffrey M; Arafah, Baha et al. (2013) Effects on postoperative salivary cortisol of relaxation/music and patient teaching about pain management. Biol Res Nurs 15:318-29
Good, Marion; Albert, Jeffrey M; Anderson, Gene Cranston et al. (2010) Supplementing relaxation and music for pain after surgery. Nurs Res 59:259-69
Good, Marion; Anderson, Gene Cranston; Ahn, Sukhee et al. (2005) Relaxation and music reduce pain following intestinal surgery. Res Nurs Health 28:240-51
Good, Marion; Wotman, Stephen; Anderson, Gene Cranston et al. (2004) Obtaining parotid saliva specimens after major surgery. Biol Res Nurs 6:110-6
Good, Marion; Anderson, Gene Cranston; Stanton-Hicks, Michael et al. (2002) Relaxation and music reduce pain after gynecologic surgery. Pain Manag Nurs 3:61-70
Good, M; Stanton-Hicks, M; Grass, J A et al. (2001) Pain outcomes after intestinal surgery. Outcomes Manag Nurs Pract 5:41-6
Good, M; Stiller, C; Zauszniewski, J A et al. (2001) Sensation and Distress of Pain Scales: reliability, validity, and sensitivity. J Nurs Meas 9:219-38
Good, M; Stanton-Hicks, M; Grass, J A et al. (2001) Relaxation and music to reduce postsurgical pain. J Adv Nurs 33:208-15
Good, M; Picot, B L; Salem, S G et al. (2000) Cultural differences in music chosen for pain relief. J Holist Nurs 18:245-60
Good, M; Stanton-Hicks, M; Grass, J A et al. (2000) Pain after gynecologic surgery. Pain Manag Nurs 1:96-104

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