Nursing Research March/April 2004 Vol 53, No 2 116 Beneficial Effects of Noetic Therapies on Mood Before Percutaneous Intervention for Unstable Coronary Syndromes Jon E. Seskevich ▼ Suzanne W. Crater ▼ James D. Lane ▼ Mitchell W. Krucoff  Background: Many common medical, surgical, and diagnostic procedures performed for conscious patients can be accompa- nied by significant anxiety.Mind-body-spirit interventions could serve as useful adjunctive treatments for the reduction of stress.  Objective: To evaluate the effects of stress management, imagery, touch therapy, remote intercessory prayer, and stan- dard therapy on mood in patients awaiting percutaneous inter- ventions for unstable coronary syndromes as part of the Mon- itoring and Actualization of Noetic Training (MANTRA) trial, which explored the feasibility and efficacy of noetic interven- tions on clinical outcomes in a randomized clinical trial.  Methods: A total of 150 patients were randomized to one of the five treatment conditions. Stress management, imagery, and touch therapy were administered in 30-minute treatment sessions immediately before the cardiac intervention. Inter- cessory prayer was not necessarily contemporaneous with these treatments. Mood was assessed by a set of visual analog scales before and after treatment for a similar length of time for the standard therapy and prayer groups.  Results: Analysis of complete data from 108 patients showed that stress management, imagery, and touch therapy all pro- duced reductions in reported worry, as compared with stan- dard therapy, whereas remote intercessory prayer had no effect on mood. The ratings of other similar moods were not affected, perhaps because of the relatively positive emo- tional state observed in the participants before treatment.  Conclusions: The results suggest that at least some noetic therapies may have beneficial effects on mood in the course of medical and surgical interventions. Administration of these interventions was feasible even in the hectic environment of the coronary intensive care unit. Given their relatively low cost and limited potential for adverse effects, these interven- tions merit further study as therapeutic adjuncts.  Key Words: preoperative care  psychological  relaxation tech- niques  stress any common medical, diagnostic, and surgical procedures performed on the conscious patient can be accompanied by substantial levels of worry. The threat of pain and the risks and discomforts associated with invasive procedures, especially when conducted in the context of life-threatening medical conditions, can elicit strong emotional reactions with negative psychological and physiologic consequences (Linn, Linn, & Klimas, 1988; McCleane & Cooper, 1990). Sedation is used widely in these circumstances, although the sedative-narcotic reg- imens can have adverse effects and compromise critical homeostatic mechanisms. Many mind-body-spirit tech- niques known to elicit relaxation and reduce stress could have application in these circumstances. Techniques such as stress management and relaxation, imagery, touch-ther- apy, and intercessory prayer could reduce patient worry without the risk of adverse effects. Clinical applications of mind-body-spirit therapies have been reported for cardiovascular diseases (Byrd, 1988; Harris et al., 1999; Mandle et al., 1990; Tusek, Cwynar, & Cosgrove, 1999). The cited studies examined a variety of interventions that relieve stress associated with a broad range of clinical procedures. Results to date have been mixed. Although some of the trials have involved car- diac patients, none has investigated the feasibility and effi- cacy of these treatments for patients undergoing the com- M Jon E. Seskevich, RN, BSN, BA, CHTP, is Nurse Clinician, Department of Advanced Practice Nursing, Duke University Hos- pital, Durham, North Carolina. Suzanne W. Crater, RN, MSN, ANP-C, is Nurse Practitioner, Division of Cardiology, Department of Medicine, Duke Univer- sity Medical Center/Duke Clinical Research Institute, Durham, North Carolina. James D. Lane, PhD, is Associate Research Professor, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina. Mitchell W. Krucoff, MD, is Associate Professor, Division of Car- diology, Department of Medicine, Duke University Medical Cen- ter/Duke Clinical Research Institute, Durham, North Carolina. nu530107.qxd 3/12/2004 2:36 PM Page 116