The effect of the hand massage using baby oil with lavender application on the procedural pain and state anxiety of women undergoing brachytherapy: A parallel-group randomized controlled study

OBJECTIVE

This parallel-group randomized controlled study evaluated the effect of the hand massage practiced using baby oil with lavender on reducing pain and situational anxiety in women with brachytherapy.

METHODS

The study was completed with 36 patients. The treatment group included 18 patients, and the control group had 18. The data were collected through patient information form, visual analog scale, and state anxiety scale. Before the brachytherapy, three sessions of hand massages, each lasting 10 min (5 min for each hand), were performed using baby oil with lavender. Data collection forms were repeated after each session. The control group received routine treatment. Study groups were similar and homogeneous in terms of socio-demographic characteristics. The data obtained were assessed using Shapiro Wilk, Repeated Measures ANOVA, chi-square, and paired samples t-test.

RESULTS

At the end of the brachytherapy, the pain and state anxiety scores of the group that applied hand massage   were determined to be lower than the control group's at each three-time point (1st, 2nd, and 3rd-time points) (p<0.001).

CONCLUSION

It was determined that hand massage using baby oil with lavender effectively reduced pain and anxiety. It can be practiced by certified nurses in clinics that perform brachytherapy as a noninvasive, safe, and affordable practice.

Effects of Integrated Music-Video Therapy on Pain and Anxiety During High-Dose-Rate Brachytherapy

PURPOSE

This study aimed to examine the effect of integrated music-video therapy on pain and anxiety of gynecologic cancer patients at different stages of brachytherapy.

DESIGN

This study used a single-group crossover design.

METHODS

Data on 27 patients diagnosed with gynecologic cancer and receiving brachytherapy were collected from February 2018 to January 2019. Participants' pain and anxiety levels were measured four times using a numerical rating scale (before, during, after applicator insertion, and during the radiation). In addition, vital signs were measured three times (before, after applicator insertion, and during radiation). Data were analyzed for frequency and percentage. The normality and homogeneity of the dependent variables were tested using the Kolmogorov-Smirnov and Mann-Whitney U tests, respectively.

RESULTS

Significant differences were found between the experimental and control phases in pain degree during radiation exposure (Z = -1.68, p = .046) and anxiety degree during applicator insertion (Z=-4.42, p = .000), after applicator insertion (Z = -4.85, p = .000), and during radiation exposure (Z = -5.38, p = .000). However, no significant difference was found between the changes in blood pressure, pulse, and respiration at any time point.

CONCLUSIONS

The findings suggest the need to actively employ integrated music-video therapy to reduce acute pain and anxiety in gynecologic cancer patients undergoing brachytherapy.

CLINICAL IMPLICATIONS

This study provides insights into the methodological approaches for implementing integrated music-video therapy in clinical practice, targeting the reduction of acute pain and anxiety triggered by gynecological surgeries and procedures.

The Effect of Music on Anxiety, Pain Levels, and Physiological Parameters in Women Undergoing Brachytherapy: A Randomized Controlled Trial

OBJECTIVES

This study was conducted to investigate the effect of music on anxiety, pain, and physiologic parameters in women undergoing brachytherapy.

DATA SOURCES

The study was conducted with a randomized controlled design between June and December 2022. Music intervention was practiced to the patients in the experimental group (n = 30), while no practice was given to the control group (n = 25). In the study, the data were collected using the Descriptive Information Form, Hospital Anxiety and Depression Scale, visual analog scale, and vital signs (temperature, pulse rate, blood pressure, respiratory rate, SpO2) recording form. Intergroup and intragroup averages were evaluated by the mixed-design analysis of variance. Variables with pre-post intervention designs were evaluated with the one-way analysis of covariance. There was no significant difference in physiological parameters between the groups (P > . 05). Although the mean anxiety scores decreased in the music group and increased in the control group, there was no statistically significant difference (P > .05). A significant difference was found in the pain levels of the patients in repeated measurements made in intragroup evaluations (P < .001). The depression mean of the music intervention group was significantly lower than the control group (P ≤ .05).

CONCLUSION

It was concluded that the music played during the brachytherapy process had positive effects on feeling less pain and management of depressive symptoms but did not affect anxiety and physiological parameters. Since each patient is different, the effects of music therapy can vary individually.

IMPLICATIONS FOR NURSING PRACTICE

Nurses should apply different strategies to investigate session frequencies and durations for different patient groups and treatment stages in cancer care.

Effectiveness of different music interventions on managing symptoms in cancer survivors: A meta-analysis

PURPOSE

Music-based interventions can provide non-pharmacological, low-cost treatment for symptoms. This meta-analysis's purpose is to examine music-based interventions' effectiveness on psychological distress symptoms (anxiety, stress, and depressive symptoms), aspects of positive psychology (benefit-finding and resilience), and quality of life (QoL).

METHODS

This meta-analysis was conducted according to PRISMA guidelines and meta-analytic methods suggested by Hedges and Olkin (1985). A systematic literature search between 2000 and 2020 was conducted using CINAHL, MEDLINE, PsycINFO, PubMed, and Web of Science databases. Studies and intervention characteristics were independently coded. The Quality Assessment Tool for Quantitative Studies, Cochrane Collaboration's Tool for Assessing Risk of Bias, Begg and Mazumdar's rank correlation, and Egger's regression test evaluated publication bias.

RESULTS

Twenty-nine of thirty-five eligible studies were included in the statistical analysis. The overall (g = 0.34, SE = 2.27, p < 0.05) and psychological distress symptoms sub-outcome type (g = 0.47, SE = 0.18, p < 0.05) models with moderator analyses were statistically significant.

CONCLUSIONS

Culturally appropriate music-based interventions conducted in the clinical setting that used passive listening with headphones, occurring ≥ 3-times a week over ≥ 2 months, positively impacted gynecology survivors undergoing chemotherapy and surgical treatments. Specifically, interventions that were ≥ 35-minutes, listening to folk or mixed-music positively impacted psychological distress symptoms, whereas new-age music negatively impacted psychological distress symptoms, positive psychology, and QoL outcomes. Future research should examine positive psychology characteristics (perceived levels of positive adjustment, change, and coping) and include larger cohorts with various cancer populations across all cancer survivorship continuum. Culturally appropriate interventions could lead to greater adherence, compliance, and clinical effectiveness and increase the findings' significance and generalizability.

Hypnosedation for endocavitary uterovaginal applications: A pilot study

PURPOSE

Implantations for uterovaginal brachytherapy are usually performed under general or spinal anesthesia, which are not without risk. As it is a rather short procedure and since postoperative pain is minimal, hypnosedation was proposed to selected patients requiring endocavitary applications as part of their routine treatment.

METHODS AND MATERIALS

Consecutive patients requiring intracavitary uterovaginal brachytherapy from January to October 2019 were included if they accepted the procedure. A premedication was systematically administered. Hypnosedation was based on an Ericksonian technique. The procedure was immediately interrupted if the patient requested it, in cases of extreme anxiety or pain. Procedure was in that case rescheduled with a "classical" anesthesia technique.

RESULTS

A total of 20 patients were included. Four patients had to be converted toward a general anesthesia: one because of a fibroma on the probe's way and three young patients with a very anteverted/retroverted uterus that was painful at every mobilization. Mean and maximum pain scores during implant were 2.9/10 and 5.1/10, respectively. The most painful maneuver was cervical dilation for 45% of the patients, followed by mold insertion in 40% of cases. About 85% of the patients declared that hypnosis helped them relax; 90% of the patients would recommend the technique. No procedure-related complication occurred.

CONCLUSION

With a 70% success rate (correct implant with mean pain and anxiety scores < 5), one can conclude that uterovaginal brachytherapy implantation under hypnosedation is feasible and received a high satisfaction rate from the patients. This technique may reduce overall treatment time in a context of difficult access to the OR and to anesthesiologists, while reducing anesthetic drugs resort and postoperative nausea.