School of Nursing, College of Nursing, Taipei Medical University, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
J Clin Nurs. 2012 Mar;21(5-6):601-8. doi: 10.1111/j.1365-2702.2010.03406.x. Epub 2011 Feb 9.
To examine the effect of relaxation therapy on reducing patient anxiety and pain before and after total joint replacement.
Despite the use of analgesics, patients may feel anxiety and pain before and after surgery, delaying their recovery.
An experimental control group pretest-post-test quasi-experimental design was employed.
Subjects (n = 93) recruited from a medical centre in Taipei, Taiwan, from November 2006-March 2007 were randomly assigned to experimental (n = 45) and control (n = 48) groups. Subjects in the experimental group received relaxation therapy from the day before surgery to the third postoperative day. Researchers helped participants listen to a breath relaxation and guided imagery tape for 20 minutes daily. A pain and anxiety scale questionnaire, the State-Trait Anxiety Inventory questionnaire, blood pressure and heart rate were monitored before and after intervention.
The average age of the 93 patients was 71·0 (SD 11·1) years. The least pain severity scores in the experimental were lower than those in the control group (p < 0·05) but both experienced the same level of worst or average pain (p > 0·05). The mean difference in the pain score before and after intervention in the experimental group on the pre-op day (t = 2·675, p = 0·009) and post-op day one (t = 3·059, p = 0·003) was greater than that in the control group (0·48 SD 0·94 vs. 0·10 SD 0·30 and 0·93 SD 1·46 vs. 0·20 SD 0·71, respectively). The two groups differed significantly in systolic blood pressure (F = 6·750, p < 0·05) but not in mean blood pressure, heart rate, or State-Trait Anxiety Inventory scores (p > 0·05). Patients reported that relaxation therapy helped them relax and promoted sleep.
Relaxation therapy could complement analgesics to help postoperative patients better manage pain and anxiety.
Clinical practice should include complementary relaxation therapy to alleviate pain and anxiety in patients with joint replacement.
探讨放松疗法对减轻全关节置换术前和术后患者焦虑和疼痛的影响。
尽管使用了镇痛药,患者在手术前后仍可能感到焦虑和疼痛,从而影响康复。
采用实验对照的预试验后测试准实验设计。
2006 年 11 月至 2007 年 3 月,从台湾台北的一家医疗中心招募了 93 名受试者,他们被随机分配到实验组(n=45)和对照组(n=48)。实验组患者从手术前一天到术后第 3 天接受放松治疗。研究人员帮助参与者每天听 20 分钟的呼吸放松和引导意象磁带。在干预前后监测疼痛和焦虑量表问卷、状态-特质焦虑量表问卷、血压和心率。
93 名患者的平均年龄为 71.0(SD 11.1)岁。实验组的最低疼痛严重程度评分低于对照组(p<0.05),但两组的最痛或平均疼痛程度相同(p>0.05)。实验组患者在术前日(t=2.675,p=0.009)和术后第 1 天(t=3.059,p=0.003)的疼痛评分的平均差值大于对照组(0.48 SD 0.94 对 0.10 SD 0.30 和 0.93 SD 1.46 对 0.20 SD 0.71)。两组患者的收缩压差异有统计学意义(F=6.750,p<0.05),但平均血压、心率和状态-特质焦虑量表评分差异无统计学意义(p>0.05)。患者报告说,放松疗法帮助他们放松,促进了睡眠。
放松疗法可以补充镇痛药,帮助术后患者更好地管理疼痛和焦虑。
临床实践应包括补充放松疗法,以减轻关节置换患者的疼痛和焦虑。