The effect of music and aromatherapy on anxiety and pain in patients undergoing surgery

Dissertation:

To obtain a master's degree in nursing

(internal-surgery training orientation)

Summary

Title: The effect of music and aroma therapy on anxiety and pain in patients undergoing cholecystectomy surgery: a single-blind clinical trial

Introduction: Today, controlling or reducing pain and anxiety after surgery is one of the most important components of post-surgery care. Due to the side effects of other methods, there is a lot of emphasis on the use of complementary medicine treatments. Therefore, the present study was conducted with the aim of investigating the effect of music and aromatherapy on the anxiety and pain of cholecystectomy patients. Methodology: The present study is a clinical trial study that was conducted on 90 male and female patients undergoing general surgery (cholecystectomy) in 2013. This study was conducted in three groups: music therapy, aromatherapy and control. In the aromatherapy group, 8 and 16 hours after surgery, patients inhaled 10 drops of rose water with a concentration of 12%, after rubbing their palms together, at a distance of 2.5-5 cm from the nose for three minutes. In the music therapy group, for patients 8 and 16 hours after the operation, nature music (water, birds) was played for 15-30 minutes using Marshall headphones. The control group also received the routine interventions of the ward. The data was analyzed using SPSS/13 software and descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (one-way analysis of variance (ANOVA test) and Tukey's post-test).

Findings: Comparing the changes in pain and anxiety scores in the three groups showed that the changes in the amount of pain (average pain reduction of 8 hours) (1.26 ± 0.16) and 16 hours (1.01 ± 0.86) after surgery) and in the case of anxiety, the average reduction of anxiety 8 hours (4.5 ± 2.37) and 16 hours after surgery (1.93 ± 1.81) in the aromatherapy group is significantly different from the control and music therapy groups (0.05) and the reduction in pain and anxiety 8 and 16 hours after surgery in the group Aromatherapy is more than the control and music therapy groups.

Conclusion: The results show the positive effect of aromatherapy on reducing the pain and anxiety of the patient 8 and 16 hours after surgery, and the effect of aromatherapy on reducing the pain and anxiety of the patient 8 and 16 hours after the surgery is greater than the effect of music therapy.

Key words: anxiety, pain, music therapy, Aromatherapy, general surgery

Field of research

Complementary and alternative medicine treatments include a set of practices and beliefs that are used by patients to prevent and treat diseases or to raise the level of health and improve the general condition along with conventional treatments (1). Due to the differences in viewpoints and cultural backgrounds of each nation and nationality, the way of using complementary medicine methods is very different (2, 3). Some experts believe that all complementary and alternative medicine methods are not safe, contrary to public opinion, and many therapeutic methods and prescribed drugs have dangerous and sometimes fatal side effects (4). Some others consider the use of these methods to delay the patient in performing diagnostic and treatment procedures. On the other hand, many patients do not inform their doctors about complementary medicine treatments, and as a result, the risk of complications such as drug interactions and errors in the interpretation of test results increases (5).

The use of complementary medicine methods as treatment methods is increasing, but the standards of these methods and how they relate to the principles of conventional medicine are still unclear (6). The prevalence of using at least one of the complementary medicine methods in the world are; England (33%), Australia (46%), America (34%), Belgium (66-75%), France (49%), Netherlands (18%) and Germany (20-30%) (5). Complementary medicine is defined by the National Center for Complementary and Alternative Medicine as a group of different types of medicine and health care systems and experiences and technologies.Complementary medicine is defined by the National Center for Complementary and Alternative Medicine as a group of different types of medicine and health care systems and experiences and technologies that are not currently defined as part of conventional medicine (7). Alternative medicine or complementary medicine includes a variety of treatment or disease prevention methods whose methods and effectiveness are different from conventional or biological medicine. In alternative medicine, the doctor treats the patient as a whole, rather than emphasizing a particular disorder or disease (7).

Treatment with alternative medicine is gaining more acceptance day by day, and it is estimated that one out of three people will use these treatments during their lifetime for common diseases such as back problems, headaches, anxiety and depression (8). Many nurses and doctors do not know much about this medicine or do not believe in it, and on the other hand, many doctors and even non-doctors seek benefits from this method in the treatment of diseases (8). Therefore, in addition to people's acceptance of these methods, the information and attitude of nurses and doctors on this matter is of particular importance (9).

Some branches of complementary medicine that are more used by patients include acupuncture, traditional medicine, homeopathy, atopopathy, reflexology, chiropractic, hypnosis, energy therapy, exercise therapy, movement therapy, music therapy, massage therapy, image therapy, Herb therapy, aromatherapy [1], yoga, use of vitamins, meditation, face-to-face or telephone counseling, support groups, etc. (10, 11).

Every year, tens of millions of patients in the world undergo surgery. Surgery is a stress that causes physiological reactions (endocrine), psychological stress (fear and anxiety) (12). If anxiety remains unknown for a long time, it causes stress that results Harmful, it causes delayed recovery of patients (13). A patient who enters the hospital can be anxious to a mild, moderate or severe level, which can be planned for the implementation of medical and nursing care by knowing and determining the level of anxiety (14). Yoniama (1998) and Dercrotrombeck (2006) write: 60% of patients and 75% of families who Their patients need surgery, they are anxious about surgery and anesthesia (15). Anxiety before surgery stimulates the sympathetic, parasympathetic, and endocrine systems, which leads to an increase in heart rate, blood pressure, and heart excitability, thus causing arrhythmia. The extent and increase of the period of anxiety can lead to an increase in protein breakdown, a decrease in wound healing and immune response, an increase in the risk of infection and an imbalance of water and electrolytes (16). The results of numerous researches indicate that the complications caused by preoperative anxiety include: increased postoperative pain, more demand for painkillers, delayed recovery and discharge, exorbitant costs, and prolonged hospitalization (17). Pain after surgery, including cholecystectomy, is one of the most common complaints of patients during the first 48 hours after surgery, and it is mostly in the incision site, and this pain can reduce cough, followed by atelectasis and sputum accumulation, and also reduce gastric emptying and decrease bowel movement, followed by ileus and constipation.

Pain and anxiety control after surgery is one of the important issues of post-surgery care. In addition to increasing the patient's satisfaction, the reduction of pain causes the patient to recover faster and improve the functioning of the cardiovascular, respiratory, and digestive systems (19). The issue of pain is one of the important issues in post-surgery care, which has received a lot of attention in recent years. Today, pain is considered as the fifth vital sign and is one of the most important problems in patients undergoing surgery (19). Control or reduction of pain after surgery is one of the important components of post-surgery care, and this seemingly simple problem of how to completely or partially eliminate pain after surgery remains (20).

Pain reduction, in addition to being effective on patient satisfaction, is associated with direct effects on most of the body's physiological systems with manifestations on body organs and can affect the course of surgery after surgery (19).