Effects Of Therapeutic Touch And Music Therapy On Preoperative Anxiety, Postoperative Pain And Outcomes Among Cesarean Section Women

Objectives: This study was to explore the effects of therapeutic touch (TT) and music therapy (MT) on preoperative anxiety, blood pressure, heart rate, postoperative pain and recovery among women undergoing cesarean section (CS), and to evaluate the patient's perception of receiving therapeutic touch and music therapy.Methods: A four-group quasi-experimental design was utilized in the study. A total of 200 eligible women planning cesarean delivery were recruited by convenience sampling. Participants were randomly divided into one control group that received 15-20min quiet time, and three experimental groups---one group that received 15-20min therapeutic touch only, one group that received 15-20min music therapy only, and the other group received 15-20min therapeutic touch with music therapy. The treatments were performed in the surgery waiting room before CS and in the maternity ward 24 hours after CS. The measurements included Visual Analog Scale for Anxiety (VASA), Numerical Rating Scale for Pain Intensity (NRS), self-designed Patient Perception Questionnaire, and physiologic measurements, such as heart rate and blood pressure. Postoperative analgesic requests within 24 hours after CS was required. The initiation time of postoperative ambulation and passing of flatus, the beginning time and frequency of breastfeeding were recorded 72 hours after CS. The levels of anxiety and pain, blood pressure, heart rate, postoperative outcome variables and patients'subjective perception were compared among the groups. All data were analyzed by SPSS16.0.Results: 1. One hundred and eighty six subjects completed the study, 48 in the control group, 47 in the TT group,46 in the MT group and 45 in the combined(T&M) group. 2. There was no significant difference in pre-intervention VASA scores among TT group (5.51±1.60), MT group (5.84±1.52), T&M group (5.64±1.19) and control group (5.70±1.29). In the TT group, MT group and T&M group, the post-intervention VASA scores decreased to 3.09±0.82, 3.14±0.83 and 2.74±0.50, respectively, and were significantly lower than that of the control group. Blood pressure and heart rate were statistically decreased in all the three experimental groups, while there was no statistical difference in control group. 3. The experimental groups had significantly lower pain scores after treatments in comparison to the control group, while postoperative analgesic requests did not differ among the four groups. 4. The initiation time of postoperative ambulation, exhaust and breastfeeding were earlier and breastfeeding was more frequent for all experimental groups than the control group. 5. The total score of Patient Perception Questionnaire was higher in T&M group than that of the TT group and MT group.Conclusions: Therapeutic touch and music therapy may significantly relieve preoperative anxiety and postoperative pain, improve postoperative outcomes and optimize the nursing care of women undergoing cesarean section surgery. The utilization of TT and MT to promote the comfort of cesarean delivery women is strongly recommended.