***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: AIM AND OBJECTIVES The aim of the research is to determine the effect of cold application on the pain owing to chest tube removal for patients with single pleural chest tube . BACKGROUND Removal of chest tubes causes patients to feel pain and interventions used for reducing the pain owing to the removal of chest tubes are not sufficient . DESIGN Controlled clinical trial with repeated measures . METHODS This study was conducted with 140 patients , of whom 70 patients were in the experimental group and 70 patients were in the control group , in a thoracic hospital in Turkey . Data were collected using a data collection form consisting of patients ' demographic and health history and Visual Analogue Scale . Cold was applied to patients in the experimental group prior to chest tube removal . In the experimental group , skin temperature and pain intensity was measured for each patient at four time points . In the control group , pain intensity was evaluated for each patient at three time points . Data were evaluated using Chi-square and Repeated Measurements two-way anova tests . RESULTS The Visual Analogue Scale score was measured immediately after the chest tube removal in the experimental group was 3·85 , compared with 5·60 in the control group . There were significant differences on pain with cold application between the two groups prior and after the intervention . Age , gender , the number of days the chest tube was inserted and the chest tube insertion indication had no effect on the pain owing to chest tube removal . CONCLUSION Cold application is effective in reducing the pain owing to chest tube removal . RELEVANCE TO CLINICAL PRACTICE Cold application was recommended prior to chest tube removal to reduce the pain owing to removal of chest tube The aim of this study was to investigate the effect of Reiki on pain , anxiety , and hemodynamic parameters on postoperative days 1 and 2 in patients who had undergone cesarean delivery . The design of this study was a r and omized , controlled clinical trial . The study took place between February and July 2011 in the Obstetrical Unit at Odemis Public Hospital in Izmir , Turkey . Ninety patients equalized by age and number of births were r and omly assigned to either a Reiki group or a control group ( a rest without treatment ) . Treatment applied to both groups in the first 24 and 48 hours after delivery for a total of 30 minutes to 10 identified regions of the body for 3 minutes each . Reiki was applied for 2 days once a day ( in the first 24 and 48 hours ) within 4 - 8 hours of the administration of st and ard analgesic , which was administered intravenously by a nurse . A visual analog scale and the State Anxiety Inventory were used to measure pain and anxiety . Hemodynamic parameters , including blood pressure ( systolic and diastolic ) , pulse and breathing rates , and analgesic requirements also were recorded . Statistically significant differences in pain intensity ( p = .000 ) , anxiety value ( p = .000 ) , and breathing rate ( p = .000 ) measured over time were found between the two groups . There was a statistically significant difference between the two groups in the time ( p = .000 ) and number ( p = .000 ) of analgesics needed after Reiki application and a rest without treatment . Results showed that Reiki application reduced the intensity of pain , the value of anxiety , and the breathing rate , as well as the need for and number of analgesics . However , it did not affect blood pressure or pulse rate .  Reiki application as a nursing intervention is recommended as a pain and anxiety-relieving method in women after cesarean delivery The aim of this r and omized controlled trial was to determine the effect of jaw relaxation , music and the combination of relaxation and music on  postoperative pain after major abdominal surgery during ambulation and rest on postoperative days 1 and 2 . Opioid medication provided for pain , following abdominal surgery , does not always give sufficient relief and can cause undesired side effects . Thus , additional interventions such as music and relaxation may provide more complete relief . Previous studies have found mixed results due to small sample sizes and other method ological problems . In a rigorous experimental design , 500 subjects aged 18 - 70 in five Midwestern hospitals were r and omly assigned by minimization to a relaxation , music , relaxation plus music , or control group . Interventions were taught preoperatively and tested postoperatively . The same amount of time was spent with subjects in the control group .  Pain was measured with the visual analogue sensation and distress of pain scales . Demographic and surgical variables , and milligrams of parenteral or oral opioids in effect at the time of testing were not significantly different between the groups , nor did they correlate with pain scores . Controlling for pretest sensation and distress , orthogonal a priori contrasts and multivariate analysis of covariance indicated that the three treatment groups had significantly less pain than the controls , ( P = 0.028 - 0.000 ) which was confirmed by the univariate analysis of covariance ( P = 0.018 - 0.000 ) . Post hoc multivariate analysis revealed that the combination group had significantly less sensation and distress of pain than the control group on all post-tests ( P = 0.035 - 0.000 ) , and the relaxation and music groups had significantly less on all tests ( P = 0.022 - 0.000 ) except after ambulation . At post ambulation those using relaxation did not have significantly less pain than the controls on both days and those using music did not on day 1 , although there were some univariate effects . A corresponding significant decrease in mastery of the interventions from pre to post ambulation suggests the need for reminders to focus on the intervention during this increased activity . Physicians and nurses preparing patients for surgery and caring for them afterward , should encourage patients to use relaxation and music as adjuvants to medication for postoperative pain The purpose of this study was to examine the effects of relaxation techniques and back massage on postoperative pain , anxiety , and vital signs on postoperative days 1 - 3 in patients who had undergone total hip or knee arthroplasty ( THA , TKA ) . Sixty patients having a THA or TKA were r and omly assigned to either a experimental group or a control group . The  McGill Pain Question naire Short Form ( MPQ-SF ) and  State Anxiety Inventory ( SAI ) were used to measure pain and anxiety , respectively . Vital signs , including blood pressure ( systolic and diastolic ) , pulse , and respiratory rate , were also obtained . Statistically significant differences in pain intensity ( F = 14.50 ; p = .000 ) , anxiety level ( F = 19.13 ; p = .000 ) , and vital signs ( F = 169.61 , 9.14 , 14.23 , 65.64 ; p = .000 ) measured over time were found between the experimental and the control group . Results of this research provide evidence to support the use of relaxation techniques and back massage at bed rest times of patients to decrease pain and anxiety . The interventions helped them to forget about their pain for a while and improved their anxiety state . After an evaluation of the conclusions , use of these interventions should be implemented by nurses into routine plans of care for patients OBJECTIVES In surgery clinics , postoperative pain is a common occurrence and care is needed in its treatment . One form of treatment is various acupuncture techniques . This study investigated the effect of acupuncture on postoperative analgesia in patients undergoing laparoscopic cholecystectomy . METHODS A total of 59 patients undergoing laparoscopic cholecystectomy were included in the study ; 31 comprised the acupuncture group ( Group A ) , and 29 constituted the  control group ( group C ) . All patients underwent st and ard anesthesia procedures . Patient-controlled analgesia with tramadol was administered postoperatively . Patients ' postoperative pain scores , results of the satisfaction question naire and amounts of tramadol used were recorded . Postoperative 0 , 1st , 2nd , 6th , 12th and 18th hour controls were performed . RESULTS A comparison of the groups showed Group A pain scores to be significantly lower statistically than those of Group C at all postoperative controls . There was no statistically significant difference for postoperative analgesic consumption and satisfaction level between the groups . CONCLUSION Despite detection of a reduction in postoperative pain scores , the application of acupuncture did not cause any change in the consumption of tramadol The aim of this study was to investigate the effect of cold application on pain and anxiety during chest tube removal ( CTR ) in patients who had undergone cardiac surgery . A single-blinded r and omized design was used in this study . Ninety patients aged 18 - 74 years , hospitalized in the intensive care unit ( ICU ) , who had a chest tube for a duration of at least 24 hours were used for this convenience sample . The application of cold , placebo , or control therapies was r and omized into three different groups . Sixty minutes before CTR was scheduled , an ICU nurse administered 10mg/kg paracetamol intravenously to all study subjects . Cold and warm packs covered with gauze dressing were applied to the area surrounding the chest tubes for 20 minutes . Pain intensity , pain quality and situational anxiety for CTR were measured . Variance analysis and the latent growth model were used in the analysis of the data . Patients in the cold group had significantly lower pain intensity than the placebo group . The perception of pain intensity measured by visual analog scores of patients in the cold group showed the least variation . There was no statistically significant difference in McGill Melzack Pain Question naire scores or in change of anxiety level between the three groups . The application of cold prolonged the length of time until analgesics were needed after CTR . Results showed that cold application reduced patients ' intensity of pain due to CTR but did not affect anxiety levels or the type of pain .  Cold application is recommended as a pain-relieving technique during CTR The aim of this study was to investigate the effect of listening to personal choice of music on self-report of pain intensity and the physiologic parameters in patients who have undergone open heart surgery . The study design was quasiexperimental . Patients were selected through convenience sampling in the Cardiovascular Surgery Intensive Care Unit at a university hospital . The study was conducted with a total of 87 patients who underwent open heart surgery : 44 in the music group , 43 in the control group , ages between 18 and 78 years . Through pretest-posttest design , postoperative first-day data were collected . First , physiologic parameters ( blood pressure , heart rate , oxygen saturation , and respiratory rate ) were recorded and a unidimensional verbal pain intensity scale applied to all participants . Later , the control group had a rest in their beds while the music group listened to their choice of music for 30 minutes .  Physiologic data were then collected and the pain intensity scale applied once more . In the music group , there was a statistically significant increase in oxygen saturation ( p = .001 ) and a lower pain score ( p = .001 ) than in the control group . There was no difference between the groups in the other physiologic parameters . Results of this research provide evidence to support the use of music . Music might be a simple , safe , and effective method of reducing potentially harmful physiologic responses arising from pain in patients after open heart surgery 
    Output:
    
Non-pharmacologic pain management is an effective way to reduce pain severity and it can be independently used by nurses .
Research ers of dissertations often choose non-pharmacologic practice s that have no side effects , have minimum risk , are not detrimental to patients , are easy to administer , and are cost-efficient .