For adults facing surgery, assessing alternatives for managing anxiety and pain

Adults facing heart surgery may understandably experience significant anxiety leading up to the procedure, and may also have pain, sometimes severe, to deal with afterward.

“Comfort coaches” are certified healthcare professionals who use distraction techniques, guided imagery, music, and art to guide patients through potentially uncomfortable or stressful medical procedures, effectively reducing both anxiety, and acute and chronic pain.

Often referred to as Certified Child Life specialists, these professionals typically serve pediatric patients and children of adult patients, but their potential to reduce pain and associated anxiety among adults in surgical setting has so far not been evaluated.

Now, a new randomized controlled trial will assess whether non-pharmacologic comfort measures delivered by a dedicated, trained "comfort coach" can affect adult cardiac surgery patients’ pain control, anxiety, and satisfaction, post-surgical opioid use, and use of healthcare services following surgery. The study is led by G. Michael Deeb, M.D., a Michigan Medicine cardiac surgeon, child life specialist Julie Piazza, M.S., CCLS, from the Michigan Medicine Office of Patient Experience, and Alex Brescia, M.D., M.Sc., a cardiothoracic surgery resident at Michigan Medicine and a health services researcher with the Institute for Healthcare Policy & Innovation.

The investigators note that anxiety and pain can significantly influence patient experience and the success of surgical procedures, and the need to establish the evidence base for non-pharmacologic means to help patients through surgery and recovery is a pressing one.

While opioids do not always relieve the pain and stress that may accompany surgery, they can also carry the risk of dependence, particularly for cardiac surgery patients, who have one of the highest rates of persistent postoperative opioid use – meaning they’re more likely to still be using opioids many months beyond surgery, after their pain would be expected to have resolved.

The project team’s work is supported by an Investigator Initiated Research Program Grant awarded to Dr. Brescia by the Blue Cross Blue Shield of Michigan Foundation and support from the Department of Cardiac Surgery.

Other IHPI members involved in the project include Donald Likosky, Ph.D., and Jennifer Waljee, M.D., M.P.H., M.S.

Learn more about Child & Family Life at U-M's C.S. Mott Children's Hospital.