***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study evaluated whether  preoperative preparations for cardiac surgery  ( a ) reduced psychological distress and facilitated physical recovery , ( b ) reduced preoperative anxiety by making patients feel well-informed or by increasing their sense of control over recovery , and ( c ) reduced the incidence of sympathetically mediated , acute postoperative hypertension . Information-only and informationplus-coping preparations were compared with a contact-control preparation . Preoperatively ( 1 day after preparation ) , both experimental groups were significantly less anxious and fearful than the control group . The experimental groups did not differ from each other . Both experimental preparations increased patients ' belief in control over recovery . Consistent with Lazarus 's theory of stress , belief in control over recovery best predicted preoperative anxiety . Regression analyses indicated that information reduced anxiety by increasing feelings of control , Postoperatively , both experimental groups ( a ) reported less emotional distress , ( b ) were judged by nurses as making better physical and psychological recoveries , and ( c ) had a 32.5 % lower incidence of postoperative hypertension Abstract Each year , hundreds of thous and s of women undergo excisional breast biopsies for definitive diagnosis . Not only do these patients experience pain associated with the procedure , but they also endure distress associated with the threat of cancer . Hypnosis has been demonstrated as effective for controlling patients ' pain in other surgical setting s , but breast surgery patients have received little attention . To determine the impact of brief presurgical hypnosis on these patients ' postsurgery pain and distress and to explore possible mediating mechanisms of these effects , 20 excisional breast biopsy patients were r and omly assigned to a hypnosis or control group ( st and ard care ) . Hypnosis reduced postsurgery pain and distress . Initial evidence suggested that the effects of hypnosis were mediated by presurgery expectations Background Improving functional status preoperatively through exercise may improve postoperative outcome . Previous knowledge on preoperative exercise in knee osteoarthritis is insufficient . The aim of the study was to compare the difference in change between groups in lower extremity function from baseline to 3 months after Total Knee Replacement ( TKR ) following a neuromuscular exercise programme ( NEMEX-TJR ) plus a knee school educational package ( KS ) or KS alone . Methods 45 patients ( 55–83 years , 53 % male , waiting for TKR ) were r and omized to receive a minimum of 8 sessions of NEMEXTJR plus 3 sessions of KS or 3 sessions of KS alone . Function was assessed with the  Chair St and Test ( CST , primary endpoint ) and the Knee Injury and Osteoarthritis Outcome Score ( KOOS ) subscales focusing on daily living function ( ADL ) and pain ( secondary endpoints ) . Assessment s were performed immediately before and after the intervention , and at 6 weeks , 3 months and 12 months after surgery by a physiotherapist , blinded to group allocation . Results After intervention before surgery we observed a small improvement for primary and secondary endpoints in both groups , which did not differ significantly between groups : comparing the exercise to the control group the treatment effect for the CST was −1.5 seconds ( 95 % CI : −5.3 , 2.2 ) , for KOOS ADL and KOOS pain the treatment effect was 1.3 points ( −10.1 , 12.8 ) and −2.3 ( −12.4 , 7.9 ) respectively . At 3 months after surgery we observed a small improvement in the primary endpoint in the control group and a significant improvement in the secondary endpoints in both exercise and control groups , which did not differ significantly between groups : comparing the exercise group to the control group the treatment effect in the CST was 2.0 seconds ( −1.8 , 5.8 ) , for KOOS ADL and KOOS pain the treatment effect was −4.9 points ( −16.3 , 6.5 ) and −3.3 points ( −13.5 , 6.8 ) respectively . Conclusions A median ( IQR ) of 10 ( 8 , 14 ) exercise sessions before surgery showed an additional small but non-significant improvement in all functional assessment s compared to patient education alone . These benefits were not sustained after TKR . Our trial does n’t give a conclusive answer to whether additional preoperative exercise on postoperative functional outcomes is beneficial & NA ; Cardiovascular diseases cause more disability and economic loss in industrialized nations than any other group of diseases . In previous work [ Nurs Res 49 ( 2000a ) 1 ] , most coronary artery bypass graft patients ( CABG , N=225 ) reported unrelieved pain and received inadequate analgesics . This study proposed to evaluate a preadmission education intervention to reduce pain and related activity interference after CABG surgery . Patients ( N=406 ) were r and omly assigned to ( a )  st and ard care or ( b ) st and ard care+pain booklet group . Data were examined at the preadmission clinic and across days 1–5 after surgery . Outcomes were pain‐related interference ( BPI‐I ) , pain ( MPQ‐SF ) , analgesics ( chart ) , concerns about taking analgesics ( BQ‐SF ) , and satisfaction ( American Pain Society‐POQ ) . The impact of sex was explored related to primary and secondary outcomes . The intervention group did not have better overall pain management although they had some reduction in pain‐related interference in activities ( t(355)=2.54 , P<0.01 ) and fewer concerns about taking analgesics ( F(1,313)=2.7 , P<0.05 ) on day 5 . Despite moderate 24‐h pain intensity across 5 days , patients in both groups received inadequate analgesics ( i.e. 33 % prescribed dose ) . Women reported more pain and pain‐related interference in activities than men . The booklet was rated as helpful , particularly by women . In conclusion , the intervention did not result in a clinical ly significant improvement in pain management outcomes . In future , an intervention that considers sex‐specific needs and also involves educating the health professionals caring for these patients may influence these results UNLABELLED Hip osteoarthritis ( OA ) is a degenerative disease , and total hip arthroplasty ( THA ) is one of the surgical procedures of choice to improve the OA patient 's quality of life . Without a rehabilitation program , THA patients will develop functional limitations . A r and omized double-blind trial was performed between July 2009 and October 2011 to compare in a short follow-up time two groups of patients who underwent THA for OA . The THA protocol ( THAP ) group received verbal instructions and physiotherapy exercise demonstrations , and the THA physiotherapy care protocol ( THAPCP ) group received the same verbal instructions and demonstrations associated with daily exercise practice guided by a physiotherapist . The outcomes that were assessed preoperatively and 15 d postoperatively in 106 patients were muscle strength force , goniometry , Medical Outcomes Study 36-Item Short Form Health Survey , and Merle d'Aubigné and Postel score . Higher muscle strength force scores and degrees in range of motion were found in the THAPCP group . Higher improvements were also observed for the THAPCP group compared with the THAP group in the Merle d'Aubigné and Postel score . At the end of the follow-up period , the intervention in the THAPCP group improved functional capacity , quality of life , mobility , muscle strength , goniometry , and pain . It appears to be a safe tool for accelerating recovery in THA patients . CLINICAL TRIAL REGISTRATION Clinical Trials.gov ; NCT01491048 In investigating the effects of a treatment or experience on a group of patients , it is usually necessary to observe a control group . The comparison between the two groups may be influenced by the characteristics of the subjects : for example , their sex , age , body weight , and original clinical state . In order to secure comparability for such relevant " extraneous " factors , the controls are frequently matched with the experimental subjects . An alternative is to select the controls at r and om from an appropriate population , and to rely on statistical analysis to make allowance for the effects of concomitant variables . Medical research workers often prefer to select matched instead of r and omly selected controls . The usual reasons seem to be that The current trial compared patient education before total hip arthroplasty with the usual verbal information . A r and omized , controlled 24-month prospect i ve single-center study was done . Patients scheduled for a first elective total hip arthroplasty for primary hip osteoarthritis were enrolled . All patients were given the usual information and an information leaflet and completed a  self-evaluation question  naire ( Spielberger State and Trait Anxiety Inventory ) . The patients were assigned r and omly to two groups : Group 1 attended a collective multidisciplinary information session 2 to 6 weeks before surgery and the control group did not attend . All patients completed another State Anxiety Inventory just before surgery and then 1 and 7 days after surgery . One hundred patients were r and omized . Forty-eight attended the collective information session . Patients receiving education were significantly less anxious just before surgery than patients in the control group , in linear regression after adjustment for gender , trait and state anxiety at baseline , depression score , and health assessment question naire score . They experienced less pain before surgery and were able to st and sooner . However , the trend toward lower anxiety scores was not statistically significant after surgery . Patient education decreases preoperative anxiety and pain in patients having hip surgery The study attempted a clinical evaluation of the efficacy of stress inoculation training for postoperative pain control using patients undergoing coronary artery graft surgery . A treatment group receiving stress inoculation training was compared to attention-education and no-treatment control groups . No differences were found between the groups on two pain rating measures , analgesic intake , or measures of state anxiety and depression . The ineffectiveness of stress inoculation in this study may be due to the difference between experimental and clinical pain , the multiple dem and s of the preoperative period , possible memory difficulties which some patients may have experienced , or the possibility that the procedure is not sufficiently potent for the intensity of this type of pain OBJECTIVE The aims of the study were to assess factors responsible for the reduction of preoperative anxiety in patients undergoing breast and abdominal surgeries . In particular , we investigated whether question prompt lists ( QPL ) , patients ' knowledge , or the communication skills of surgeons had effects on anxiety reduction . METHODS Patients were r and omly assigned to QPL and control groups .  Anxiety was assessed on the State Trait Anxiety Inventory . RESULTS Both groups showed significant reduction in anxiety between initial consultation and one day prior to surgery , with QPL patients showing a trend towards a greater reduction of anxiety after surgery and a significant reduction at the first outpatient follow-up . Satisfaction with consultation and the doctor 's ability to answer questions concerning diagnosis , and treatment were significantly associated with anxiety reduction . CONCLUSION Effective anxiety reduction hinged on doctors ' communication abilities and patients ' satisfaction with the consultation Objective : To evaluate the feasibility and preliminary effectiveness of therapeutic exercise before total hip replacement in frail elderly . Design : A single-blind , r and omized clinical pilot trial . Setting : Outpatient physiotherapy department . Subjects : Frail elderly with hip osteoarthritis awaiting total hip replacement . Interventions : A short ( 3—6 weeks ) tailor-made , therapeutic exercise programme was compared with usual care . Main measures : Feasibility was assessed through patient satisfaction , adherence , occurrence of adverse events and the number of eligible non-volunteers . Preliminary preoperative effectiveness was assessed with performance and self-reported measures of pain , functioning , physical activity and quality of life . Postoperatively we measured functional recovery and length of hospital stay . Results : Sixty-two eligible patients were approached of whom 21 ( mean age 76 years ) agreed to participate . Exercisers ( n = 10 ) , rated the intervention as very good 8.9 ( 8—10 ) ( 10-point rating scale ) . No serious adverse events occurred . Forty-one ( 66 % ) eligible patients did not participate , mainly because of logistic considerations , result ing in selection bias . The intervention group ( trainings sessions participated 91 % ) showed relevant preoperative improvements on the chair-rise time ( delta —2.9 seconds ; 95 % confidence interval ( CI ) —6.2 to 0.4 ) and timed-up- and -go ( delta —4.4 seconds ; 95 % CI —9.3 to 0.5 ) . Postoperatively , no significant differences were seen . Conclusions : A short , tailor-made , exercise programme is well tolerated and appreciated in elderly patients awaiting total hip replacement . However , a larger r and omized clinical trial in the same setting is not warranted , because of the high number of eligible non-volunteers Purpose To examine whether patients who received an empowerment model of education for preoperative orthopaedic teaching  had improved outcomes compared to patients who received the traditional education .  Design An experimental ( empowerment teaching method ) group vs. comparison ( traditional teaching method ) group posttest design . Sample Seventy-four patients undergoing elective orthopaedic surgery . Methods Following the preoperative teaching session , patients in both groups completed a question naire design ed to measure their perceptions of the teaching ( empowerment ) and self-efficacy ( belief in their ability to carry out perioperative tasks ) . A chart audit and phone interview was done after discharge to assess length of stay , pain management , complications , and patient perceptions of the ability to complete perioperative tasks . Findings Patients in the empowerment group felt the educational approach was more empowering and had significantly higher self-efficacy scores than those in the traditional teaching group . There was much less variation in empowerment and self-efficacy scores in the empowerment group . The empowerment group reported feeling greater confidence in performing perioperative tasks . There were no differences in length of stay , complications or pain control . Conclusion Use of an empowerment teaching approach enabled patients to become more confident in their ability to carry out perioperative tasks and become a more integral part of the preoperative teaching process . Implication s for Nursing Research The theoretical model will be used to structure other 
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Results tended to be similar for all categories of intervention , although there was no evidence that behavioural instruction reduced the outcome pain .
Narratively review ed evidence for the outcome behavioural recovery provided very low quality evidence that psychological preparation , in particular behavioural instruction , may have potential to improve behavioural recovery outcomes , but no clear conclusions could be reached .
The evidence suggested that psychological preparation may be beneficial for the outcomes postoperative pain , behavioural recovery , negative affect and length of stay , and is unlikely to be harmful .
However , at present , the strength of evidence is insufficient to reach firm conclusions on the role of psychological preparation for surgery .