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Presented by: Carol Lewallen BSN, RN, BC Introduction It is well known that: Surgical procedures may cause patients to experience pain and anxiety. Music has the ability to affect moods and emotions. Adolescents listen to music as a form of relaxation. Statement of the Problem There is a direct correlation between preoperative anxiety, postoperative pain, and increased risk of infection. - Vaughn et al, (2007) There are many negative side effects to taking pain medications. Pain can increase lengths of stay and increase costs. Limited research is available related to adolescent pain. Purpose of the Study To improve the recovery experience for adolescent same day surgery patients age 13-18. Research Question Does Listening to Music Improve the Recovery Experience of Adolescent Same Day Surgery Patients Age 13-18 years old? Significance Decreased post-operative pain Decreases risk of infection Decreases the need pain medications Decreases costs Improves satisfaction Literature Review Music was used an early nursing intervention. - McCaffey & Locsin (2002) Music diverts feelings of anxiety, fear, and pain. - Cooke et al (2005) Music relieves postoperative pain. - Engwall & Duppils (2009) Literature Review Cont. Music reduces the need for medications. -Nilsson (2008) Music offers comfort and familiarity. - McCaffrey & Good (2000) Music reduces the effects of stress in adolescents. - Yahaw and Cohen (2008) Respecting musical choice needs to be considered. - Wong & Mok (2003) Clinical Research Project IRB approval through Briar Cliff University and Spencer Hospital Experimental project – 8 participants and 8 controls Parental consent and adolescent assent obtained Similar outpatient surgical procedures Both groups were injected with Marcaine or Ropivicaine in OR by the surgeon. Clinical Research Project Research measures: 1. Amount of time in recovery (PACU and SDS). 2. Pain rating 0/10 scale (1st, highest, DC scores) 3. Postop medication requirements. Clinical Research Project Control Group Participant Group 5 females, 3 males ages 13-18. 6 females, 2 males ages 13-18. 3 of 8 had femoral nerve 2 of 8 had femoral nerve blocks. 7 of 8 had pain med blocks. 7 of 8 had pain med in OR. in the OR. Information was gathered Information was obtained during the patient’s flow through retrospective chart through the recovery process. audits. Average time listening to music = 35.25 min. Results -Medication Requirements Control Group Participant Group 7 of 8 = 88% were 3 of 8 = 38% were administered additional pain medication in PACU. administered additional pain medication in PACU. Results for Recovery Times 160 141.5 140 120 108.625 100 80 63.25 60 47.625 40 20 0 Control PACU Time Participant PACU Time Control SDS Time Participant SDS Time Average Times in PACU and SDS Postop Minutes Statistical Significance Two-tail t-test PACU RECOVERY TIME p = .15 SDS RECOVERY TIME p = .27 Results of Pain Scores Pain Scores 1st Score High Score DC Score 5.5 4.125 4.125 3.375 3.125 2.5 2.375 1.875 1.75 1.625 1.5 0.875 PACU Control Pain Score PACU Pain Score SDS Control Pain Score SDS Pain Score Statistical Significance Two-tail t-test PACU PAIN SCORES 1st score--- p= .12 high score ---p=.037, (p<.05) DC score--- p= .09 SDS PAIN SCORES 1st score--- p=.15 high score--- p=.06 DC score--- p=.058 References Canon Communications LLC (2008). Nearly half of teen activities are driven by technology. Retrieved November 25, 2008, from http://www.appliancemagazine.com/news_print.php?artic le=122567 Cooke, M., Chaboyer, W., & Hiratos, M. A. (2005). Music and its effect on anxiety in short waiting periods: A critical appraisal. Journal of Clinical Nursing, 14(2), 145-155. McCaffrey, R., & Locsin, R. C. (2002). Music listening as a nursing intervention: A symphony of practice. Holistic Nursing Practice, 16(3), 70-77. Engwall, M. & Duppils, G. (2009). Music as a nursing intervention for postoperative pain: A systematic review. Journal of Perianesthesia Nursing, 24(6), 370-383. References Kemper, K. & Danhauer, S. (2005). Music as Therapy. Southern Medical Journal, 98(3),282-288. Maranets, I., & Kain, Z. N. (1999). Preoperative anxiety and intraoperative anesthetic requirements. Anesthesia Analgesia, 89(6), 1346-1351. Mitchell, M. (2003). Patient anxiety and modern elective surgery: a literature review. Journal of Clinical Nursing, 12(6), 806-815. Mok, E., & Wong, K. (2003). Effects of music on patient anxiety. Association of Perioperative Registered Nurses (AORN) Journal, 77(2), 401-4, 406. References Nilsson, U. (2008). The anxiety and pain reducing effects of music interventions: A systematic review. Association of Perioperative Registered Nurses (AORN) Journal, 87(4), 780, 782, 785-794, 797-807. Parris, W., Matt, D., Jamison, R. N., & Maxon, W. (1988). Anxiety and postoperative recovery in ambulatory surgery patients. Anesthesia Progress, 35(2), 61-64. Yahaw, R., & Cohen, M. (2008). Evaluation of a cognitivebehavioral intervention for adolescents. International Journal of Stress Management, 15(2), 173-188.