Study designs of evaluations included in the review
Randomised controlled trials (RCTs), published as full reports and reporting pain outcomes, were included. Studies with unconcealed treatment allocation, or treatment groups of less than 10 participants, were excluded. Abstracts, review articles, and evaluations of laboratory experiments were not considered for inclusion.
Specific interventions included in the review
Evaluations of relaxation strategies used alone and not in combination with other interventions, such as cognitive behaviour therapy or imagery, were eligible. Relaxation techniques included the following: modified Jacobson method; Flaherty and Fitzpatrick jaw relaxation; relaxation tape; tape with structured breathing, muscle relaxation and pleasant imagery; progressive muscle relaxation with cognitive relaxation; pleasant memory, jaw relaxation and breathing techniques; and taped information and relaxation. The follow-up and treatment periods varied across the trials. The control regimens included no intervention, blank tape, routine or standard care, taped information, reading, and listening to music.
Participants included in the review
Patients undergoing fractured hip repair, removal of malignant skin lesions, major elective abdominal surgery, elective cholecystectomy, abdominal hysterectomy, and femoral angiography, were included.
Outcomes assessed in the review
The outcomes of pain sensation and pain distress were used. The most common instruments used to measure these were the McGill Pain Questionnaire, the Spielberger Stale-Trait Anxiety scale, and assessment of analgesic consumption.
How were decisions on the relevance of primary studies made?
Each study was read by both authors independently.