Hospital worker holding the hand of a surgery patient

Researchers Studying New Ways to Manage Pain, Anxiety for Cardiac Surgery Patients

For adults facing heart surgery, anxiety before the procedure and pain afterward are common.

When children are hospitalized, Certified Child Life Specialists work with kids and their parents to deploy interventions such as distraction techniques, guided imagery, mindfulness, music and art to help ease unpleasant side effects. The techniques have been found to be an effective complement to pain medication but have never been studied or evaluated for adults undergoing surgery.

A $70,000 grant from the Blue Cross Blue Shield of Michigan Foundation is helping University of Michigan researchers determine whether a Certified Child Life Specialist serving as a “comfort coach” could play the same beneficial role for adults as they do for children.

Dr. Alexander Brescia is a cardiothoracic surgery resident at Michigan Medicine and a health services researcher with the Institute for Healthcare Policy & Innovation. Brescia, along with co-principal investigator Julie Piazza and a team of U of M researchers are conducting a randomized controlled trial with adult cardiac surgery patients to determine if comfort coaches and their interventions influence pain control, anxiety, post-surgical opioid use and the use of health care services following surgery.

A total of 160 patients will be studied, randomized into one of two groups. Outcomes for patients assigned a comfort coach will be compared to those without. Patients will complete surveys at four intervals: before surgery, before leaving the hospital post-surgery, at their first post-operative appointment and three months after surgery. Interventions used by the comfort coaches will be individualized to each patient, although to standardize the study, will be delivered at the same six points during the surgical experience.

Of surveys and interviews conducted so far, Brescia said patients with a comfort coach often note feeling increased support before and after their surgery. The team hypothesizes the data will show measurable reductions in stress and anxiety, which can affect how often patients access follow-up emergency care and their dependence on opioids to manage pain. Cardiac surgery patients have one of the highest rates of post-operative opioid use, which carries risk for long-term dependence.

“There’s a lot more to undergoing cardiac surgery than pain and we also think that that’s why this is an ideal population to study the use of comfort coaches,” he said.

Ultimately, if comfort coaches prove to be an effective way to better prepare patients mentally and help them cope with post-surgical pain, more consideration could be given to their role in health care overall, Brescia said.

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