Nature sights and sounds for reducing pain and anxiety during nail surgery: randomised controlled trial and qualitative interviews with staff

Objective

1. To investigate the efficacy of nature sights and sounds in reducing pain and anxiety during nail surgery.
2. To gain an understanding of staff views towards using a distraction therapy in practice.

Materials and methods

1. Patients were randomised to receive a natural scene photomural with associated sounds of nature (n = 78) or normal environment (n = 74) during surgery. Pain of the anaesthetic injection and patients’ anxiety before and after surgery was measured using validated tools.
2. Following the trial, one-to-one, audio-taped, semi-structured interviews were held with staff. Interviews were analysed using thematic content analysis.

Results

1. The two groups did not differ significantly regarding pain or post-treatment anxiety, even after controlling for other factors.
2. Interviews with staff revealed a range of positive and negative attitudes towards the distraction. Important processes emerged that may have influenced the effectiveness and appropriateness of the distraction therapy during nail surgery. Findings from the staff interviews may explain the non-significant results of the trial.

Conclusion

This study used a mixed methods approach to assess both the effectiveness and process of using a distraction therapy during nail surgery. Taking this approach has led to an understanding of both the breadth and depth of the issue.

Acknowledgements

The Dunhill Medical Trust.