Using massage and music therapy to improve postoperative outcomes

AORN Journal, Sept, 2003 by Laura D. McRee, Stacie Noble, Alice Pasvogel

SETTING AND PARTICIPANTS. Data were collected at the University Medical Center (UMC), Tucson. A private room was provided for the researcher to meet with study participants. Approval for the study was obtained from the human subjects committee of the University of Arizona and from the Institutional Review Board of UMC.

Selection criteria included that participants be at least 18 years of age and able to read English. In addition, participants needed to be low-risk surgical patients as determined via preoperative assessment by the anesthesia care provider using the standards of American Society of Anesthesiologists scale. This scale is based on the number and severity of preexisting medical conditions. The range is from a normal healthy patient (ie, one) to a patient who is declared brain dead and whose organs are being removed for donation (ie, six). (25) The surgical schedule provided information to identify potential participants who then were recruited for the study the morning of surgery. All patients who met the criteria were invited to participate in the study by the nurse researcher. Data were collected during a one-year period.

DEFINITIONS AND INSTRUMENTS. This study was concerned with participants' state anxiety. State anxiety was defined as the intensity of apprehensive feelings experienced at a particular moment as measured by the STAI six-item short form (STAI-6). The STAI is one of the most frequently used measures of anxiety. The STAI-6 was developed for use in circumstances in which the full form is inappropriate due to its length. (26)

The range of scores for the STAI-6 is zero to 36. The concurrent validity of the short form was determined by comparing prorated scores from the six-item scale with those from the full scale. No differences in scores were reported. The reliability for the six-item scale was 0.82. (26) In the present study, the reliability of the instrument was tested using Cronbach's alpha to determine the internal consistency of the items. The alpha was 0.79 for this study.

Systolic blood pressure is maximum blood pressure that occurs during contraction of the ventricle. (27 (p2126)) Diastolic blood pressure refers to the period of cardiac relaxation alternating with systole or contraction. (27 (p587)) Pulse is defined as the rate, rhythm, condition of arterial walls, compressibility and tension, and shape of the fluid wave of blood traveling through the arteries as a result of each heart beat. (27 (p1794)) Intraoperative measurement for blood pressure and pulse was obtained by the anesthesia care provider using automatic monitoring equipment. Postoperative blood pressure and pulse were obtained by the primary investigator or research assistant using automatic monitoring equipment.

Cortisol is a glucocortical hormone of the adrenal cortex. (27 (p492)) The method used for cortisol determination was chemiluminescent immunoassay using a polyclonol rabbit antibody specific for cortisol. Prolactin is a hormone produced by the anterior pituitary gland. (27 (p176)) The method used to determine prolactin levels was a two-site sandwich antibody assay (ie, a specific chemiluminescent assay). Blood was sent to a regional laboratory for processing. The same laboratory processed all samples. Instruments at all laboratory were calibrated monthly or based on reagent stability.