Preparing for successful surgery: an implementation study.

OBJECTIVES To evaluate the implementation of a mind-body program for surgical patients in a community hospital, assessing patient participation, patient perception, and program impact on anxiety, pain, and quality of sleep during the perioperative period. METHODS Two hundred thirty patients having total hip replacement, total knee replacement, hysterectomy, or colectomy participated in this investigation. One hundred fifteen patients were assigned to the control group before the start of the mind-body program and received routine care. The subsequent 115 patients were assigned to the intervention group and were given an audio CD (containing guided imagery, affirmations, and relaxation music) and a brochure three to seven days before surgery. The brochure recommended that patients listen to the CD twice a day before and after surgery. Anxiety, pain at rest, pain with movement, quality of sleep, and program participation were assessed for the first two postoperative days, and patient perception of the program was assessed at the end of the two days. RESULTS Anxiety scores were lower in the intervention group on the evening of surgery. Despite a trend toward lower pain scores in the intervention group, no difference between the intervention and control groups reached statistical significance, including quality of sleep. Of patients in the intervention group, 74% listened to the CD at least once after surgery, and 37% listened to the program three or more times. Most patients who used the CD at least once rated it as helpful, and 87% said they would use it for future operations. CONCLUSIONS Patient response to a perioperative mind-body program was favorable. Most patients listened to the program CD at least once, and a third used the CD repeatedly, as recommended. The majority of patients who used the CD felt it had been helpful and would use it again. Program participants experienced less anxiety on the night of surgery.