An experimental pilot study was conducted to investigate the effects of preoperative massage and music therapy on patients' preoperative, intraoperative, and postoperative experiences. Participants were assigned randomly to one of four groups--a group that received massage with music therapy, a group that received massage only, a group that received music therapy only, or a control group. Hemodynamics, serum cortisol and prolactin levels, and anxiety were measured preoperatively and postoperatively. Postoperative anxiety levels were significantly lower and postoperative prolactin levels were significantly higher for all groups.

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The aim of this study was to investigate the effects of preoperative massage on intra-and postoperative outcomes in 105 female subjects who had a laparoscopic gynecologic surgery procedure done. The subjects received a 30-minute massage (massage group) or 30 minutes of passive touch (control group). There was no difference between the groups in the average dose of inhaled anesthetics received. Patients in the massage group received significantly less intraoperative narcotics (2.2 ؎ 1.1 versus 2.8 ؎ 2.0 mcg of fentanyl/kg/hour). Patients in the massage group had significantly less postoperative anxiety (massage group, 9.83 ؎ 2.9 vs. control group 11.24 ؎ 3.6). The findings suggest that preoperative massage decreased intraoperative narcotic requirements and postoperative anxiety levels. (J GYNOL SURG 23:97)

An impending policy change in Medicare will provide reimbursement for the end-of-life conversation. The rise in numbers of older adults who face serious illness coupled with advances in healthcare technology are increasing the need for providers to address end of life issues in the acute care setting. Doctoral-level nurse practitioners who specialize in acute care of older adults are poised to be leaders and facilitators of this conversation in a particularly challenging context-the intensive care unit. The focus of this article is the new end-of-life policy in relation to the particular contributions that adult gerontology acute care nurse practitioners offer in the acute care setting.