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The effect of therapeutic listening on anxiety and fear among surgical patients: randomized controlled trial.

ABSTRACT: OBJECTIVE:To investigate the effect of therapeutic listening on state anxiety and surgical fears in preoperative colorectal cancer patients. METHOD:A randomized controlled trial with 50 patients randomly allocated in the intervention group (therapeutic listening) (n = 25) or in the control group (n = 25). The study evaluated the changes in the variables state anxiety, surgical fears and physiological variables (salivary alpha-amylase, salivary cortisol, heart rate, respiratory rate and blood pressure). RESULTS:In the comparison of the variables in the control and intervention groups in pre- and post-intervention, differences between the two periods for the variables cortisol (p=0.043), heart rate (p=0.034) and surgical fears (p=0.030) were found in the control group, which presented reduction in the values ??of these variables. CONCLUSION:There was no reduction in the levels of the variables state anxiety and surgical fears resulting from the therapeutic listening intervention, either through the physiological or psychological indicators. However, the contact with the researcher during data collection, without stimulus to reflect on the situation, may have generated the results of the control group. Clinical Trial Registration: NCT02455128.

SUBMITTER: Garcia ACM

PROVIDER: S-EPMC6091387 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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The effect of therapeutic listening on anxiety and fear among surgical patients: randomized controlled trial.

Garcia Ana Cláudia Mesquita ACM Simão-Miranda Talita Prado TP Carvalho Ana Maria Pimenta AMP Elias Paula Condé Lamparelli PCL Pereira Maria da Graça MDG Carvalho Emilia Campos de EC

Revista latino-americana de enfermagem 20180809

<h4>Objective</h4>To investigate the effect of therapeutic listening on state anxiety and surgical fears in preoperative colorectal cancer patients.<h4>Method</h4>A randomized controlled trial with 50 patients randomly allocated in the intervention group (therapeutic listening) (n = 25) or in the control group (n = 25). The study evaluated the changes in the variables state anxiety, surgical fears and physiological variables (salivary alpha-amylase, salivary cortisol, heart rate, respiratory rat ...[more]

PMID: 30110103

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Project description:BackgroundAnxiety may adversely impact mother and her newborn. Music listening is a safe and efficacious treatment that may to reduce perioperative anxiety. The effect on acute pain and pain catastrophizing scores remains unclear. We aimed to determine whether perioperative music listening reduces anxiety, acute pain, and pain catastrophizing scale (PCS) scores following elective cesarean delivery under spinal anesthesia.MethodsAfter randomization into music listening and control groups, baseline patient characteristics, visual analog scale-anxiety (VAS-A) scores, pain scores, PCS total and sub-scores, and music preferences were collected preoperatively. Before surgery, parturients in the experimental group listened to music of their own choice for 30 min. Music listening was continued during administration of spinal anesthesia and cesarean delivery, and for 30 min following surgery. Postoperative VAS-A score, acute pain score, PCS scores, music preferences, satisfaction score, and feedback were recorded.ResultsWe analyzed 108 parturients (music: n = 53; control: n = 55). Music listening was associated with reduced postoperative VAS-A (mean difference (MD) -1.43, 95%CI -0.63 to -2.22), PCS total score (MD -6.39, 95%CI -2.11 to -10.66), PCS sub-scores on rumination (MD -1.68, 95%CI -0.12 to -3.25), magnification (MD -1.53, 95%CI -0.45 to -2.62), and helplessness (MD -3.17, 95%CI -1.29 to -5.06) sub-scores. There was no significant difference in postoperative acute pain scores. The majority (> 95%) of parturients reported "excellent" and "good" satisfaction with music listening, and most provided positive feedback.ConclusionPerioperative music listening was associated with reduced postoperative anxiety and lower pain catastrophizing. Based on the good patient satisfaction and positive feedback received, the use of music listening in the obstetric setting is recommended.Trial registrationThis study was registered on Clinicaltrials.gov NCT03415620 on 30/01/2018.

Project description:ObjectivesThe present study aimed to calculate the estimated size and confidence interval for the effects of adding visual aid to counselling on anxiety, stress and fear of patients undergoing upper gastrointestinal endoscopy. The secondary aim was to calculate confidence interval for endoscopy-related variables that predict which patients are likely to benefit from visual aids.MethodIn a randomized, single-blind, two arm, parallel group, superiority trial, 232 consecutive patients who were scheduled to undergo either gastroscopy or colonoscopy were randomly divided into two intervention groups; counselling with video of endoscopic procedure and counselling with no-video (n = 116 in each group). Primary outcome was anxiety and secondary outcomes were stress and fear.ResultsOne-way ANCOVA showed that there was significant between group differences of anxiety, stress and fear after controlling for the effect of covariates. Planned contrasts revealed that counselling along with visual aid of endoscopy procedure significantly decreased anxiety [Mean difference at post; -4.26 (-4.47, -4.05), p < .001, partial η2 = 0.88], stress [-5.35 (-5.63, -5.07), p < .001, partial η2 = 0.86] and fear [-2.82 (-2.97, -2.67), p < .001, partial η2 = 0.86] compared to counselling alone. Linear regression showed that gender, nature of complaints and concern over seniority of endoscopist were significant negative predictors, however, satisfaction on briefing of endoscopy procedure was significant positive predictor of outcome variables in visual aid condition.ConclusionThe increase in anxiety, acute stress and fear related to endoscopic procedures can be alleviated with psychological counselling coupled with visual aids before the procedure. Visual aid could lead to supplementary benefits in reducing anxiety scores.Trial registrationClinicalTrial.gov Number: NCT05241158. Registered 16/11/2022; https://clinicaltrials.gov/ct2/show/NCT05241158KEY MESSAGESCounselling along with visual aid of endoscopy procedure significantly decreased anxiety, stress and fear as compared to counselling alone.Male patients were less stressed after visual aid intervention as compared to female patients. Patients who had chronic GI symptoms were less stressed after visual aid intervention as compared to those who had acute GI symptoms. Patients who had concern over seniority of endoscopist were less stressed after visual aid intervention as compared to those who had no concerns over seniority.Satisfaction on briefing of endoscopy procedure was significant positive predictor of stress and fear.

Project description:Aims/hypothesis: Dietary restriction (DR) reduces adiposity and improves metabolism in patients with one or more symptoms of the metabolic syndrome. Nonetheless, it remains elusive whether the benefits of DR in humans are mediated by calorie or nutrient restriction. This study was conducted to identify whether isocaloric dietary protein restriction is sufficient to confer the beneficial effects of dietary restriction in patients with metabolic syndrome. Methods: We performed a prospective, randomized controlled dietary intervention under constant nutritional and medical supervision. A total of 21 individuals diagnosed with the metabolic syndrome was randomly assigned for caloric restriction (CR; n = 11, mean age 49 ± 8.5 years, female 63%; diet of 5,941 ± 686 KJ per day) or isocaloric dietary protein restriction (PR; n = 10, mean age 51.6 ± 8.9 years, female 50%; diet of 8,409 ± 2,360 KJ per day) and followed for 27 days. Results: Like CR, PR promoted weight loss (-6.6%, P= 0.0041) due to reduction in adiposity (-9.9%, P= 0.0007), associated with reductions in blood glucose (-52.7%, P= 0.0002), lipid levels (cholesterol, -35.4%, P= 0.0010; triglycerides, -39.5% P= 0.0022) and blood pressure (systolic, -37.7 P< 0.0001; diastolic, -73.2% P< 0.0001). PR resulted in enrichment of metabolic pathways related to the immune system such as B cell proliferation, lymphocyte proliferation and leukocyte proliferation in subcutaneous adipose tissue. Hence, a reduction in calorie intake or changes in the gut microbiome are not necessary to confer the metabolic benefits of DR. Instead, a reduction in protein intake with a mild increase in carbohydrate intake to maintain the isocaloric balance of the diet is sufficient to improve metabolic control. Conclusions/interpretation: Protein restriction is sufficient to confer almost the same clinical outcomes as calorie restriction without the need for a reduction in calorie intake. The isocaloric characteristic of the PR intervention makes this approach a more attractive and less drastic dietary strategy in clinical settings and has greater potential to be used as adjuvant therapy for people with the metabolic syndrome.

Project description:Introduction:The fear of childbirth (FOC) has an adverse effect on the physical and mental health of pregnant women and increases adverse maternal and fetal outcomes. Previous research reported the effect of psychological interventions such as cognitive behavioral therapy, relaxation therapies, and short-term psycho-educational intervention on FOC. We examined whether adding motivational interviewing (MI) psychotherapy to prenatal usual care (PUC) is superior to PUC alone to reduce the scores of FOC, pregnancy stress, and self-efficacy. Materials and Methods:An RCT with two-arm parallel groups and 1:1 allocation ratio assigned 70 pregnant women (aged 18-50) attending public health centers in an education hospital in Iran to receive five sessions of group MI psychotherapy plus PUC (N = 35) or to receive PUC alone (N = 35). The primary outcomes were the FOC scores (Wijma Delivery Expectancy/Experience Questionnaire, W-DEQ), pregnancy-specific stress (Prenatal Distress Questionnaire, NuPDQ), anxiety (Spielberger state anxiety), and Childbirth Self-Efficacy Index (CBSI) at 5 weeks post-randomization. Additional measures included subscales of the W-DEQ and the NuPDQ, patients' compliance, and satisfaction with psychotherapy intervention at 5 weeks post-randomization as secondary outcomes. Main Results:The post-trial results indicated that the outcome scores diminished more considerably in psychotherapy than in PUC for total FOC scale with a large effect size (B = -23.54, p = < 0.001, ?2?2 = 0.27), for total pregnancy stress with a large effect size (B = -4.51, p = < 0.001, ?2 = 19), and for state anxiety with a large effect size (B = -12.42, p = < 0.001, ?2 = 0.22). However, the score of self-efficacy and concern about physical symptoms did not differ between the psychotherapy and PUC groups (P < 0.05). Discussion:Adding 5 weeks of group psychotherapy to PUC could be considered as an adjunctive care option for reducing FOC, pregnancy stress, and general anxiety in pregnant women in the third trimester. Future research may focus on sustaining the effects and evaluating the economic impacts of adding psychotherapy to PUC.

Project description:Survivors of cardiac arrest (CA) and their family members often experience significant fear-based distress (cardiac fear; i.e., fear about the CA survivor's heart). Fear-based distress after CA is associated with higher rates of cardiac event recurrence and mortality in CA survivors. As posited in Dyadic Disruption Theory (DDT), cardiac fear in family members may contribute to the development of distress in CA survivors via socially-based mechanisms. Thus, interventions to reduce family distress may improve CA survivors' outcomes. ICU diaries are easy to implement and scalable and show promise for reducing distress after CA but are primarily targeted towards survivors. The primary aim of the Family-Authored ICU Diaries to reduce Fear in Patients Experiencing a CA (FAID Fear) pilot randomized controlled trial was to test feasibility of an ICU diary intervention targeted towards family member distress alone. Family members of patients hospitalized after CA (N = 16) were randomized 2:1 to receive the FAID Fear intervention or usual care. Intervention participants were provided brief instructions and were asked to write in the diary twice per week until the end of hospital care. Assessments occurred at baseline enrollment, end of hospital care, and 30 days later. Participants' mean age was 50.73 years (SD = 13.41; 80% cis-gender female; 60% White). Recruitment (16/25 referred; 64.0%), retention (14/16 enrolled; 87.5%), and intervention adherence (7/10 completed; 70%) were promising. Most agreed that the ICU diary intervention was appropriate (7/10 completed; 70.0%), feasible (9/10 completed; 90.0%]), and acceptable (8/10 completed; 80.0%). Fear was nonsignificantly lower in intervention participants (v. control) at end of hospital care and 30 days later. FAID Fear represents a first step in building theory-based dyadic interventions that can be implemented to support family members of CA survivors in the ICU, with potential to improve outcomes in CA survivors.

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The effect of therapeutic listening on anxiety and fear among surgical patients: randomized controlled trial.

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The effect of therapeutic listening on anxiety and fear among surgical patients: randomized controlled trial.

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