***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 & 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 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 Background and Objective : Anxiety and depression are among the psychological disorders in heart surgeries . Establishing a simple communication is essential to reduce anxiety and depression . Hence , the objective of the present study was to examine the impact of Peplau therapeutic communication model on anxiety and depression in patients , who were c and i date for coronary artery bypass in Al-Zahra Heart Hospital , Shiraz during 2012 - 2013 . Methods : This is a clinical trial in which 74 patients were r and omly divided into intervention and control groups , each consisted of 37 patients .  Anxiety and depression levels were assessed before , and two and four months after intervention using the Hospital Anxiety and Depression Scale ( HADS ) . Seven therapeutic communication sessions were held in four stages . Data were analyzed with the SPSS ( version 16 ) using analysis of covariance . Results : The mean anxiety and depression levels decreased in the intervention group after the therapeutic communication ( p<0.01 ) . Anxiety scores in the intervention group before and after intervention were 10.23 and 9.38 , respectively . While the corresponding scores in the control group were 10.26 and 11.62 , respectively . Depression scores in the intervention group before and after intervention were 11 and 9.13 , respectively . The corresponding scores in the control group were 11.30 and 12.08 , respectively . Conclusion : The results demonstrated the positive role of therapeutic communication in reducing anxiety and depression of the patients . Therefore , the therapeutic communication is recommended as a simple , cost effective and efficient method in this area During general anesthesia the possibility of subconscious perception of intraoperative events is a controversial subject . Some studies found that positive verbal suggestions , or music improved intraoperative relaxation and postoperative recovery . The aim of the current study was to evaluate the effect of prayer and relaxation technique applied while patients are under general anesthesia for open-heart surgery . A r and omized , controlled , double-blind trial study included 78 patients who underwent cardiac surgery .  During the surgery the patients used a headphone connected to a CD player . They were r and omly divided into three groups . One group listened to prayer during the surgery , the other listened to relaxation technique and one , placebo . There was only one significant finding : the prayer group is less likely to believe that prayer would assist conventional medical treatments . Although not statistically significant , we discussed the length of stay ( LOS ) after surgery and the incidence of sternal wound infection The effectiveness of in-hospital self-care patient education , delivered to patients following heart surgery , is question able , as evidence indicates individuals are not able to absorb and /or retain information at this time . In the absence of adequate instruction , individuals will not have the relevant information to engage in specific self-care behaviors , result ing in the onset of complications and /or hospital readmissions . The purpose of this pilot study was to collect preliminary evidence to demonstrate the impact of an individualized education intervention given above and beyond usual care , delivered , at two points in time , following hospital discharge . A r and omized controlled trial was used in which 34 patients were r and omly assigned to one of two groups . Chi-square analyses to examine differences between groups on complications and hospital readmission rates were conducted . Findings point to the impact of the intervention in reducing the number of hospital readmissions and complications at 3 months following hospital discharge Background : The effect of preoperative education on anxiety and postoperative outcomes of cardiac surgery patients remains unclear . Aim : The aim of the study was to estimate the effectiveness of a nurse-led preoperative education on anxiety and postoperative outcomes . Methods : A r and omised controlled study was design ed . All the patients who were admitted for elective cardiac surgery in a general hospital in Athens with knowledge of the Greek language were eligible to take part in the study . Patients in the intervention group received preoperative education by specially trained nurses . The control group received the st and ard information by the ward personnel . Measurements of anxiety were conducted on admission-A , before surgery-B and before discharge-C by the state – trait anxiety inventory . Results : The sample consisted of 395 patients ( intervention group : 205 , control group : 190 ) . The state anxiety on the day before surgery decreased only in the intervention group ( 34.0 ( 8.4 ) versus 36.9 ( 10.7 ) ; P=0.001 ) . The mean decrease in state score during the follow-up period was greater in the intervention group ( P=0.001 ) . No significant difference was found in the length of stay or readmission . Lower proportions of chest infection were found in the intervention group ( 10 ( 5.3 ) versus 1 ( 0.5 ) ; P=0.004 ) . Multivariate linear regression revealed that education and score in trait anxiety scale on admission are independent predictors of a reduction in state anxiety . Conclusion : Preoperative education delivered by nurses reduced anxiety and postoperative complications of patients undergoing cardiac surgery , but it was not effective in reducing readmissions or length of stay Background : Patients undergoing coronary artery bypass graft surgery often experience a range of problems and symptoms such as immobility , pain and insufficient sleep . Results from trials investigating testing in-hospital physical exercise or psychological intervention have been promising . However , no r and omized clinical trials have tested a comprehensive rehabilitation programme consisting of both physical exercise and psycho-education in the early rehabilitation phase . Aims : The aims of the present SheppHeart pilot r and omized clinical trial were to evaluate the feasibility of patient recruitment , patient acceptance of the intervention , safety and tolerability of the intervention . Methods and design : Sixty patients admitted for coronary artery bypass graft were r and omized 1:1:1:1 to : 1 ) physical exercise plus usual care , or 2 ) psycho-educational intervention plus usual care , or 3 ) physical exercise and psycho-educational plus usual care , or 4 ) usual care alone during a four week period after surgery . Results : The acceptability of trial participation was 67 % during the three month recruitment period . In the physical exercise groups , patients complied with 59 % of the total expected training sessions during hospitalization . Nine patients ( 30 % ) complied with > 75 % and nine patients ( 30 % ) complied with 50 % of the planned exercise sessions . Eleven patients ( 42 % ) participated in ⩾75 % of the four consultations and six patients ( 23 % ) participated in 50 % of the psycho-educational programme . Conclusion : Comprehensive phase one rehabilitation combining physical exercise and psycho-education in coronary artery bypass graft patients shows reasonably high inclusion , feasibility and safety Background : Relevant discharge information about the use of analgesic medication and other strategies may help patients to manage their pain more effectively and prevent postoperative persistent pain . Aims : To examine patients ’ pain characteristics , analgesic intake and the impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery . Concerns about pain and pain medication prior to surgery will also be described . Methods : From March 2012 to September 2013 , 416 participants ( 23 % women ) were consecutively enrolled in a r and omized controlled trial . The intervention group received usual care plus an educational booklet at discharge with supportive telephone follow-up on postoperative day 10 , and the control group received only usual care . The primary outcome was worst pain intensity ( The Brief Pain Inventory – Short Form ) . Data about pain characteristics and analgesic use were collected at 2 weeks and at 1 , 3 , 6 and 12 months post-surgery . General linear mixed models were used to determine between-group differences over time . Results : Twenty-nine percent of participants reported surgically related pain at rest and 9 % reported moderate to severe pain at 12 months post-surgery . Many participants had concerns about pain and pain medication , and analgesic intake was insufficient post-discharge . No statistically significant differences between the groups were observed in terms of the outcome measures following surgery . Conclusion : Postoperative pain and inadequate analgesic use were problems for many participants regardless of group allocation , and the current intervention did not reduce worst pain intensity compared with control . Further examination of supportive follow-up monitoring and /or self-management strategies post-discharge is required Background : Human and animal laboratory studies have shown that stress delays healing of st and ardized punch biopsy wounds . Purpose : This 5-week prospect i ve study of 17 women who underwent elective gastric bypass surgery  addressed the association between postsurgical pain intensity and subsequent healing of a st and ard 2.0-mm punch biopsy wound . Methods : Participants were assessed 1 week before surgery , within 3 hr before surgery , 1 to 3 days postsurgery , and at weekly intervals for 4 weeks following surgery . Results : Patient ratings of greater acute postsurgical pain , averaged over Days 1 and 2 postsurgery , and greater persistent postsurgical pain , averaged over 4 weekly postsurgery pain ratings , were significantly associated with subsequent delayed healing of the punch biopsy wound . Presence of depressive symptoms on the day of surgery , pre-existing persistent pain , and medical complications following initial discharge from the hospital were not related to wound healing . Depressive symptoms on the day of surgery and pre-existing persistent pain did predict persistent postsurgical pain intensity . Conclusions : These findings extend the previous laboratory models of wound healing to a surgical population , providing the first evidence that pain plays an important role in postsurgery wound healing , a key variable in postsurgical recovery AIM This study aim ed to investigate the effects of a peer education on cardiac self-efficacy ( CSE ) and readmission of the patients undergoing bypass surgery . BACKGROUND Self-efficacy is an antecedent vital factor in both initiating and maintaining healthy behaviours . It significantly improves after effects of heart attacks , anxiety and diminishes the possibility of readmission . DESIGN This study is a r and omized-controlled trial . METHOD Sixty patients undergoing bypass surgery were chosen and assigned equally into the control and intervention groups . While routine education was presented to the patients in the control group , intervention group were taught using the peer education in two sessions .  CSE of all the selected patients was assessed orderly in 5 days , 4 weeks and 8 months after surgery . Moreover , their readmission was investigated after 8 months from surgery . Data was collected using demographic and the CSE scale . Data were also analysed by using 
    Output:
    
In line with the conclusions of our previous review , there is a lack of evidence to support or refute psychological interventions in order to reduce postoperative pain in participants undergoing open heart surgery .
We found moderate- quality evidence that psychological interventions reduced mental distress in participants undergoing open heart surgery .
Given the small numbers of studies , it is not possible to draw robust conclusions on the efficacy of psychological interventions on outcomes such as analgesic use , mobility , and time to extubation respectively on adverse events or harms of psychological interventions