title: A feasibility pilot study on the use of complementary therapies delivered via mobile technologies on Icelandic surgical patients' reports of anxiety, pain, and self-efficacy in healing.
abstract: BACKGROUND
  Complementary therapies (CT), such as relaxation technique, massage, guided imagery, and accupuncture have shown to benefit patients undergoing surgery. The aim of this study was to determine the feasibility of using audio relaxation technique (ART), music intervention (MI), nature video application with music (NVAM), and nature video application without music (NVA) delivered via mobile technologies in a clinical setting. Secondary, the effects of ART, MI, NVAM and NVA on patients' state anxiety, pain perception, and perceived self-efficacy in healing were determined.
  
  
  METHODS
  A randomized clinical trial (RCT) involving 105 same day surgery (SDS) patients, who were assigned to an ART (n = 25), MI (n = 25), NVAM (n = 15), NVA (n = 16), or a control group (n = 24) were assessed for state anxiety, self-reported pain, and self-efficacy four days prior to surgery, immediately prior and following a surgical intervention, and day five post-operative.
  
  
  RESULTS
  ANOVA found no statistically significant differences in anxiety scores; pain, or perceived self-efficacy between the five groups. Matched pairs t-Test revealed all participants had an increase in anxiety from pre-op to day 10 follow-up; a significant change in pain levels from pre-op to day 10 follow-up; and all participants had a significant increase in general self-efficacy from pre-op to day 10 follow-up. Mean pain level scores from day 1 to pre-op showed a significant decrease in pain for the ART group and NVAM group. Matched pairs t-Test for self-efficacy scores indicated the MI group and the NVA group had significant increases in self-efficacy. A significant decrease in anxiety from pre-op to day 10 for participants reporting a prior history of anxiety and for those reporting prior history of taking anti-anxiety medications.
  
  
  CONCLUSIONS
  Despite the non-significant findings between the five groups, at any measurement point, there were valuable trends toward significance and confirmed feasibility in a clinical setting. Among the groups there were statistically significant findings for all interventions on anxiety, pain, and self-efficacy. The feasability of the implementation of novel interventions of NVAM and NVAM adds to clinical practice and the CT literature.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT02236455 (September 4, 2014).
authors.affiliation: School of Nursing and Health Professions, University of San Francisco, 2130 Fulton Street, San Francisco, CA, USA. mhansen@usfca.edu.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Hansen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy*; D000529:Complementary Therapies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007055:Iceland; D055539:MP3-Player; D008297:Male; D008875:Middle Aged; D009146:Music; D009147:Music Therapy; D019368:Nature; D010146:Pain; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010361:Patients; D010865:Pilot Projects; D011183:Postoperative Complications / Q000628:therapy*; D011184:Postoperative Period; D012063:Relaxation; D012064:Relaxation Therapy / Q000379:methods*; D020377:Self Efficacy; D000068997:Smartphone; D017216:Telemedicine