title: Supplementing relaxation and music for pain after surgery.
abstract: BACKGROUND
  Most postoperative patients have unrelieved pain despite the use of patient-controlled analgesia. Nurses need additional effective modalities. Relaxation and music (RM), in addition to analgesics, have been shown to reduce pain more than do analgesics alone.
  
  
  OBJECTIVE
  The objectives of the study were to test an intervention of patient teaching for pain management (PT) and compare it with RM for immediate and general effects on postoperative pain.
  
  
  METHODS
  Patients having abdominal surgery and receiving patient-controlled analgesia aged 18-75 years (n = 517) were randomized to four groups: PT, RM, a combination (PTRM), and a control. A 2 x 2 factorial design was used to assess PT-Effects and RM-Effects. Immediate effects on pain were measured on visual analogue sensation and distress scales before and after five 20-min tests in the first 2 days. Because participants also listened independently, general nonimmediate effects were examined at eight other times.
  
  
  RESULTS
  Using multivariate analysis of covariance with contrasts and pretest control, immediate RM-Effects on pain were found at Day 1 a.m. (p < .001), Day 1 p.m. (p = .04), and Day 2 a.m. (p = .04). No PT-Effects or nonimmediate RM-Effects were found.
  
  
  CONCLUSIONS
  Patient teaching did not result in less pain and did not support the theoretical proposition that PT reduces pain. However, the immediate RM-Effects supported the proposition that nonpharmacological adjuvants to analgesics can ease pain without adding side effects.
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, USA. mpg@case.edu
authors.forename: Marion
authors.initials: M
authors.lastname: Good
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Albert
authors.forename: Gene Cranston
authors.initials: GC
authors.lastname: Anderson
authors.forename: Stephen
authors.initials: S
authors.lastname: Wotman
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Cong
authors.forename: Deforia
authors.initials: D
authors.lastname: Lane
authors.forename: Sukhee
authors.initials: S
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods / Q000451:nursing / Q000523:psychology; D001294:Attitude to Health; D015400:Clinical Nursing Research; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D015999:Multivariate Analysis; D009147:Music Therapy / Q000193:education / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D011182:Postoperative Care / Q000379:methods / Q000451:nursing / Q000523:psychology; D012064:Relaxation Therapy / Q000193:education / Q000379:methods* / Q000523:psychology; D016896:Treatment Outcome