A Randomized Controlled Trial of Music for Pain Relief after Arthroplasty Surgery.

PURPOSE: Effective pain management for patients undergoing orthopedic surgery, using pharmacological and nonpharmacological strategies, is essential. This pilot study evaluated music as an adjuvant therapy with prescribed analgesics to reduce acute pain and analgesic use among patients undergoing arthroplasty surgery. DESIGN: Prospective randomized controlled trial of 50 participants scheduled for arthroplasty surgery at a large university-affiliated hospital. METHODS: Participants were randomly assigned to treatment (music and analgesic medication; n = 25) or control (analgesic medication only; n = 25) groups. The intervention consisted of listening to self-selected music for 30 minutes, three times per day postoperatively in hospital and for 2 days postdischarge at home. Participants rated pain intensity and distress before and after music listening (treatment group) or meals (control group). Analgesic medication use was assessed via medical records in hospital and self-report logs postdischarge. RESULTS: Forty-seven participants completed the study. Participants who listened to music after surgery reported significantly lower pain intensity and distress in hospital and postdischarge at home. There were no statistically significant differences in analgesic medication use after surgery between groups. CONCLUSIONS: Study findings provide further evidence for the effectiveness of music listening, combined with analgesics, for reducing postsurgical pain, and extend the literature by examining music listening postdischarge. Music listening is an effective adjuvant pain management strategy. It is easy to administer, accessible, and affordable. Patient education is needed to encourage patients to continue to use music to reduce pain at home during the postoperative recovery period.

Adult Protective Services workers' experiences with serious illness and death.

This study examined the emerging issue of experiences with end-of-life issues in adult protection. A national survey of adult protective services (APS) workers (N=508) examined encounters with serious illness, injury, death, and bereavement and how these situations were handled professionally and personally. APS workers often encountered clients and caregivers with life-threatening illnesses, and clients receiving hospice services. About three-quarters had worked on at least one case involving a client's death. Overall, more education and training about serious and terminal illness, death, grief, and bereavement is needed to prepare APS workers to work with clients and their families facing a variety of end-of-life situations.

Consortium for research in elder self-neglect of Texas research: advancing the field for practitioners.

An external advisory board consisting of members from the fields of geriatric internal medicine, family practice geriatrics, criminal prosecution, civil law, police force, adult protective services, and victims advocacy was created to advise and guide the research conducted by the Consortium for Research in Elder Self-neglect of Texas (CREST). This panel of experts performed site visits and facilitated the research through responses to every-other-week fact sheets and quarterly conference calls. This paper provides the perspective of five of the board members regarding the research findings that were presented at the CREST National Conference in 2006. The discussions outline the successes of the CREST research, describe obstacles and the necessary next steps for continuance of the scientific exploration of this syndrome, and highlight the practice implications of the current and proposed research.

Enhancing victim safety through collaboration.

Elder abuse is associated with morbid and lethal outcomes. In some cases of elder abuse, particularly involving domestic violence, uninformed or improperly executed interventions can result in serious harm to the victims. Professionals from various disciplines may themselves be at risk during encounters with perpetrators. This chapter provides an overview of potentially dangerous scenarios of elder abuse such as homicide, homicide/suicide, strangulation, and stalking. Intervention strategies such as lethality assessments and safety planning are described. A case scenario illustrates the value of an interdisciplinary response to enhance victim safety. This chapter reviews potential lethality factors and the steps that can be taken to enhance the safety of victims, their families, and the professionals who serve them.