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Music for stress and anxiety reduction in coronary heart disease patients
Abstract
Background:
Individuals with coronary heart disease (CHD) often suffer from severe distress due to diagnosis, hospitalization, surgical procedures, uncertainty of outcome, fear of dying, doubts about progress in recovery, helplessness and loss of control. Such adverse effects put the cardiac patient at greater risk for complications, including sudden cardiac death. It is therefore of crucial importance that the care of people with CHD focuses on psychological as well as physiological needs.Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients; however its efficacy for people with CHD needs to be evaluated.
Objectives:
To update the previously published review that examined the effects of music interventions with standard care versus standard care alone on psychological and physiological responses in persons with CHD.
Search methods:
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (2012, Issue 10), MEDLINE (OvidSP, 1950 to October week 4 2012), EMBASE (OvidSP, 1974 to October week 5 2012), CINAHL (EBSCOhost, 1982 to 9 November 2012), PsycINFO (OvidSP, 1806 to October week 5 2012), LILACS (Virtual Health Library, 1982 to 15 November 2012), Social Science Citation Index (ISI, 1974 to 9 November 2012), a number of other databases, and clinical trial registers. We also conducted handsearching of journals and reference lists. We applied no language restrictions.
Selection criteria:
We included all randomized controlled trials and quasi-randomized trials that compared music interventions and standard care with standard care alone for persons with confirmed CHD.
Data collection and analysis:
Two review authors independently extracted data and assessed methodological quality, seeking additional information from the trial researchers when necessary. We present results using weighted mean differences for outcomes measured by the same scale, and standardized mean differences for outcomes measured by different scales. We used post-intervention scores. In cases of significant baseline difference, we used change scores (changes from baseline).
Main results:
We identified four new trials for this update. In total, the evidence for this review rests on 26 trials (1369 participants). Listening to music was the main intervention used, and 23 of the studies did not include a trained music therapist.Results indicate that music interventions have a small beneficial effect on psychological distress in people with CHD and this effect is consistent across studies (MD = -1.26, 95% CI -2.30 to -0.22, P = 0.02, I² = 0%). Listening to music has a moderate effect on anxiety in people with CHD; however results were inconsistent across studies (SMD = -0.70, 95% CI -1.17 to -0.22, P = 0.004, I² = 77%). Studies that used music interventions in people with myocardial infarction found more consistent anxiety-reducing effects of music, with an average anxiety reduction of 5.87 units on a 20 to 80 point score range (95% CI -7.99 to -3.75, P < 0.00001, I² = 53%). Furthermore, studies that used patient-selected music resulted in greater anxiety-reducing effects that were consistent across studies (SMD = -0.89, 95% CI -1.42 to -0.36, P = 0.001, I² = 48%). Findings indicate that listening to music reduces heart rate (MD = -3.40, 95% CI -6.12 to -0.69, P = 0.01), respiratory rate (MD = -2.50, 95% CI -3.61 to -1.39, P < 0.00001) and systolic blood pressure (MD = -5.52 mmHg, 95% CI - 7.43 to -3.60, P < 0.00001). Studies that included two or more music sessions led to a small and consistent pain-reducing effect (SMD = -0.27, 95% CI -0.55 to -0.00, P = 0.05). The results also suggest that listening to music may improve patients' quality of sleep following a cardiac procedure or surgery (SMD = 0.91, 95% CI 0.03 to 1.79, P = 0.04).We found no strong evidence for heart rate variability and depression. Only one study considered hormone levels and quality of life as an outcome variable. A small number of studies pointed to a possible beneficial effect of music on opioid intake after cardiac procedures or surgery, but more research is needed to strengthen this evidence.
Authors' conclusions:
This systematic review indicates that listening to music may have a beneficial effect on anxiety in persons with CHD, especially those with a myocardial infarction. Anxiety-reducing effects appear to be greatest when people are given a choice of which music to listen to.Furthermore, listening to music may have a beneficial effect on systolic blood pressure, heart rate, respiratory rate, quality of sleep and pain in persons with CHD. However, the clinical significance of these findings is unclear. Since many of the studies are at high risk of bias, these findings need to be interpreted with caution. More research is needed into the effects of music interventions offered by a trained music therapist.
... The Cochrane review rated the trial by Schou at low risk of performance bias but it adds that "music therapist and participants could not be blinded given the interactive nature of the music therapy session." Elsewhere the review notes that "since participants cannot be blinded in a music intervention trial, we did not downgrade studies for not blinding the participants" (Bradt et al., 2013). ...
... In several comparisons, the results depend on the ambiguous blinding status of one trial. An illustrative example is the review "Music for stress and anxiety reduction in coronary heart disease patients" (CD006577) (Bradt et al., 2013). Five trials were included from this review but the comparison strongly depends on the trial by Karen Schou as it was the only one rated as blinded. ...
... Due to an increase of anxiety and discomfort in two cases, for the second year until the conclusion of the data collection the RTM stayed in the room in the NM group in a role similar to that of the RTM in the ML group." (Schou, 2008) The associated Cochrane review commented on this study that "music therapist and participants could not be blinded given the interactive nature of the music therapy session" (Bradt et al., 2013). ...
MetaBLIND is the largest meta-epidemiological study on the impact of blinding in randomized trials to date. We examined MetaBLIND data on the impact of blinding patients on patient-reported outcomes. 68 out of 132 included trials tested knowledge recall and had questionable relevance to clinical trials. In 17 out of 18 comparisons, the number of trials in the blinded or nonblinded group was 2 or lower. In several key trials, the blinding status was uncertain. Effect sizes compared in MetaBLIND appear to reflect random differences in study design and setting rather than the impact of blinding trial participants.
... Although the general levels of anxiety proved to be relatively low in this study, the anxiety variable reflected the various stress responses of the patients. The overall positive influence of music therapy on anxiety in this study is in line with previous meta-analyses and literature reviews of music interventions in cardiac patients (Bradt et al., 2013) and patients undergoing surgery more generally (Kühlmann et al., 2018;Palmer et al., 2017). Previous findings of distinct trends within subgroups are mixed. ...
... Previous findings of distinct trends within subgroups are mixed. Bradt et al. (2013) noted a significant heterogeneity in pain and anxiety across subgroups of varied cardiac diseases, suggesting that increased focus of subgroup differences might be clinically relevant. However, in recent meta-analyses by De Witte et al. (2020) and Kühlmann et al. (2018), no moderating effects of gender or age were found on psychological stress-related outcomes of music interventions. ...
... The heterogeneous findings of anxiety levels in subgroups in this study draw attention to existing challenges involved in measuring, interpreting and addressing the complexity of patient stress and anxiety (Aldwin, 2007), and this may also be the reason for previously inconsistent findings related to music interventions and anxiety (Bradt et al., 2013). Although an exact knowledge of variations in anxiety levels is hard to achieve, indications of subgroup differences in gender, age and baseline anxiety suggest that more attention to this subject would be relevant for clinical practice. ...
There is a need for more research on the effect and practical application of music therapy in perioperative settings. With this in mind, a randomized controlled trial was performed to evaluate the stress-regulatory effects of a specific music therapy intervention on patients ( n = 64) during cardiac device lead extraction procedures. This article presents a supplementary analysis of the randomized controlled trial to expand the perspective on the impact of the music therapy intervention related to patient anxiety and self-reported experiences. In this substudy, we analysed patients’ self-reported numeric-rated anxiety levels in relation to time and subgroups. The results were further illuminated through scores of the patients’ satisfaction with the music therapy intervention, and qualitative written patient reflections. Descriptive statistical analyses were used, and a supplementary content analysis addressed the written patient material. Results showed that levels of anxiety varied over time in all subgroups. Across different timeline profiles, most patients reported the highest anxiety levels preoperatively and the lowest postoperatively. Independent of anxiety levels, the patients reported positive experiences with music therapy related to coping with the procedure, wellbeing and satisfaction, expressed within the following four categories: (1) bodily sensations of wellbeing, (2) positive feelings, (3) presence of mind and (4) useful intervention elements.
... It is known that approximately 50% of the patients have anxiety that requires preoperative support [2]. The level of this anxiety may be variable according to age, gender, marital status, education level, pain threshold, and type of surgery [3,4]. Psychiatric disorders are more likely to be seen in cancer patients and the most common psychiatric disorders are major depression and anxiety disorders [5,6]. ...
... Data were collected by using a questionnaire median of 12.5 days (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) prior to scheduled surgery, in the outpatient clinic. The questionnaire consisted of two subparts. ...
Anxiety disorder is observed in half of the patients in the preoperative period. Psychological disorders are also frequently observed in cancer patients and need to be supported. The aim of the present study is to determine the level of preoperative anxiety in patients with malignant and benign diagnoses who were planned for elective surgery and to reveal its relationship with socio-demographic data. A tertiary hospital-based cross-sectional study was conducted in the general surgery clinic between June 1, 2021- March 31, 2022, on 158 patients who underwent elective surgery. Participants were evaluated in two groups depending on their diagnosis; the cancer group and the benign group. The socio-demographic data were recorded and the level of anxiety was determined by the Beck Anxiety Inventory (BAI). The median age of participants was 55 (19-78) years. There were 72 (45.6%) patients in the cancer group and 86 (54.4%) patients in the benign group. There was no significant difference in age, gender, marital status, job, level of income, and family cancer history between the two groups. There were significant differences between the groups in level of education, and previous surgical history (p=0.035, and p=0.037, respectively). BAI scores of the cancer group and control group were 10.5 (0-35) and 5 (0-49), respectively (p<0.001). The level of anxiety in the cancer group was also significantly higher than in the benign group (p<0.001). Cancer patients have more anxiety during the preoperative period than patients who were with benign diseases. We believe that previous surgical history and education level are other factors that affect anxiety.
... La sedació profunda augmenta l'estada del pacients a cures intensives i s'associa al deliri, i a un pitjor pronòstic del pacient augmentant les complicacions agudes (Reade & Finfer, 2014;Barr, et al., 2013;Mehta, Cook, Devlin, & al, 2015). Algunes estratègies comunicatives com la música, o el contacte tàctil han demostrat ser efectives en aquest tipus de malat reduint l'ansietat i l'estrès dels pacients (Kober, et al., 2003;Adomat & Killingwort, 1994;Bradt, Dileo, Grocke, & Magill, 2011;Hetland, Lindquist, & Chlan, 2015;Bradt & Dileo, 2014;Bradt, Dileo, & Potvin, 2013). Aquestes dues accions comunicatives estan incloses dins l'estratègia 3 de la intervenció CONECTEM, plantejada a l'estudi. ...
... Així, trobem que en pacients crítics d'UCI s'apliquen diferents estratègies que contribueixen cadascuna d'elles a millorar el símptoma. Per exemple, en pacients intubats i sedats, hi ha evidència científica que la música relaxant influeix sobre l'hipotàlem generant endorfines i reduint el grau d'ansietat(Bradt & Dileo, 2014;Sanjuán, Via-Claveroa, Vázquez-Guillameta, Moreno-Durana, & Martínez-Estella, 2013;Bradt, Dileo, & Potvin, 2013). Però la majoria d'estudis es basen en intervencions psicològiques i ...
ABSTRACT
Communication is the key to understanding the emotional vulnerability of patients in critical condition. A suddently change in health experienced by these individuals due to an accident or illness, cause a serious psycho-emotional outcomes that adversely affect in their health. MAIN OBJECTIVE: To conduct an augmentative assistive comunication training (CONCETEM) for pre-hospital nurses and applying this communication intervention (CONECTEM) to critical patients transferred by ambulance to check if the variables pain, anxiety and postraumatic estress disorder, associated with these patients decreased. METHODS: The study presents a quasi-experimental desing and was conducted in two phases. Phase I, with a sample of 10 nurses selected by inclusion criteria. Post training evaluation was conducted by the research team so that nurses could perform the communicative intervention in the ambulance during Phase II. Phase II present a sample of 120 patients (68 intervention group (IG), 50 control group (CG)). Pre-Post model was used to evaluate the three intervention study variables. RESULTS: 100% of nurses who performed training CONECTEM were apt to implement communicative intervention in the ambulance. 60% of nurses considered that training was useful and 40% considered it quite useful for improving the quality of care in critically ill patients transferred by ambulance. Nurse’s perceptions of satisfaction in communication training was good. The results showed statistically significant differences between IG (p<0,05) when compared with CG(p>0,05). In the IG, pain decreased by 20%, mild pain goes from 41% to 37%, moderate pain from 23% to 7% and intensive pain from 9% to 0. Anxiety is reduced by 86% and symptoms of PTSD are reduced by 12% (38% vrs 50%). CONCLUSIONS: The results support the hypothesis of investigation and claim that communicative intervention CONECTEM was effective in reducing psycho-emotional outcomes of critically ill patients in the ambulance. However is believed that more research and more resources in communication and critical patient is needed to consolidate the importance of augmentative assistive communication strategies. This study only shows the potential of alternative assistive communication.
Key words: Alternative assistive communication, critical patients, ambulance, nurse-patient interrelationship.
... 25 Indeed, there are studies that have shown that a slower rhythm, and a slower decibel music harmonizes the heartbeat to the rhythm. 14,15,26,27 As a result, we decided to employ Turkish music in this study because of the above mentioned advantages, and because it is a type of music belonging to the patients' own culture. 20−23 Another important nursing care intervention to minimize preoperative anxiety is patient education. ...
... Low tempo music types with 60 to 80 beats, synchronized with heartbeat, or relaxing music lower blood pressure and heart rate. 15,16,27,47 There are studies suggesting that classical Turkish music reduces anxiety and thus systolic and diastolic blood pressure, heart rate, and cortisol levels. 20−23 Results of this study demonstrated that the type and duration of the music played twice in this study and repeated measurements and averages taken from 24-hour measurements in the clinic created a positive effect on physiological parameters. ...
Purpose:
The aim of this study was to evaluate the effectiveness of music and preoperative education on anxiety, physiological responses, length of hospital stay, and quality of life in Coronary Artery Bypass Graft Surgery (CABG) patients.
Design:
This was a non-randomized quasi-experimental study.
Methods:
For this study, 214 patients were separated into an experimental and control group. A dual intervention using preoperative education and a CD with classical Turkish music was applied to the experimental group. The control group was provided with an uninterrupted rest period at the same time. The primary outcome was the difference in anxiety of the patients. Other outcomes included differences in the physiological responses, length of hospital stay, and quality of life.
Findings:
Anxiety decreased in the preoperative and postoperative periods in both groups (P = .000), and patients' anxiety level in the experimental group was lower than the control group (P = .000). The experimental group patients had a decrease in systolic blood pressure, diastolic blood pressure, and heart rate in the preoperative period (P = .000), and all physiological responses in the postoperative period were lower than the control group (P = .000). Furthermore, the experimental group's length of hospital stay was shorter (5.8 ± 1 days), and their quality of life was better (P = .000).
Conclusions:
The dual integrative nursing intervention (music and preoperative education) was effective in reducing anxiety in CABG patients. The results of the study will contribute to nonpharmacological approaches in the management of anxiety in CABG patients.
... The lack of adequate pain management during the procedure often results in an uncomfortable situation for both the patient and the treating physician; urologists tend to hesitate to indicate cystoscopy, whereas patients often refuse to accept this necessary diagnostic urological assessment. Previous studies already demonstrated the positive effect of listening to music during cystoscopy and the beneficial effect on patients' heart rate and blood pressure [5]. Music appears to be a reputable complementary therapy for many diseases, allowing reduction of pharmacological treatment to a calming measure. ...
... Pre-procedural characteristics Perceived waiting time by patients until the procedure.5 Beck Anxiety Inventory before the procedure. ...
Background:
This study investigates the effect of classical music, music of patients' own choice, or no music on pain reduction during elective cystoscopy.
Objectives:
The aim of the study was to describe the effect of listening to classical music, music of patients' own choice, or no music on patient's pain and satisfaction rates when carrying out an elective cystoscopy and the effect on the assessment capability of the performing urologist.
Design, setting, and participants:
This randomized trial included 127 patients undergoing elective cystoscopy at the Urological Department of the University Clinic of Munich between June 2019 and March 2020. Outcome Measurements and Statistical Analysis: Patients were assigned randomly to 3 groups: group I: listening to standardized classical music (n = 35), group II: listening to music according to the patients' choice (n = 34), and control group III: no music (n = 44). Prior to cystoscopy, anxiety levels were assessed by the Beck Anxiety Inventory (BAI). The Visual Analog Scale (VAS, range 1-100) was used for a self-assessment of pain, discomfort, and satisfaction. Statistical analysis was done with Spearman's rank correlation and t-tests.
Results and limitations:
The median age was 63 (range 27-91) years. The duration of cystoscopy was 5.7 (1-30) min. Patients had undergone a median of 2.3 cystoscopies in the past. Between giving informed consent and cystoscopy, patients had to wait for a median of 64 (0-260) min. The median VAS pain score was significantly lower in group I at 1.7 and group II at 2.3 versus 5.2 in the control group III (p < 0.001). The control group III had significantly worse pain and patient satisfaction rates compared with groups I and II. Group I had a significant lower VAS pain score than groups II and III (p < 0.001). Classical music also increased the assessment capability of the preforming urologist.
Conclusions:
Listening to music during elective cystoscopy significantly reduces pain and distress and leads to higher patient and surgeon satisfaction. We recommend listening to classical music or music chosen by the patients during outpatient flexible/rigid cystoscopy in daily clinical routine. Patient Summary: In this study, we found that patients who listened to classical music or music of their own choice while undergoing a cystoscopy showed significant reduction of pain and distress.
... Various social service agencies propose different methods to reduce stress, including having social activity, practicing mindfulness, listening to music, exercising and playing art. Previous studies have confirmed the effectiveness of music to relieve stress (Antony et al., 2018;Bradt & Dileo, 2009;Linnemann et al., 2018). Music is one of the activities that has been considered as providing significant power to help to reduce stress and anxiety, as music have the power of healing and relaxing (Bally et al., 2003). ...
... In the last two decades, MT and MBIs have been increasingly recognized as useful options for the treatment of several complex conditions, such as stroke, schizophrenia, dementia, autism spectrum disorder, anxiety, depression, and Parkinson's disease [27][28][29][30][31][32][33], and neuroscientific investigations concerning aspects of MT and MBIs are becoming more and more frequent [34]. Musical interactions in a group or individual therapeutic setting could include, but are not limited to, free improvisation, structured musical activities, playing pre-composed songs as chosen by the client, and listening to pre-recorded music. ...
Recent findings indicate that Music Therapy (MT) and Music-Based Interventions (MBIs) may reduce craving symptoms in people with Substance Use Disorders (SUD). However, MT/MBIs can lead SUD clients to recall memories associated with their drug history and the corresponding strong emotions (addiction memories). Craving is a central component of SUD, possibly linked to relapse and triggered by several factors such as the recall of memories associated with the drug experience. Therefore, to address the topic of what elements can account for an improvement in craving symptoms after MT/MBIs, we conducted a narrative review that (1) describes the brain correlates of emotionally salient autobiographical memories evoked by music, (2) outlines neuroimaging and neurophysiological studies suggesting how the experience of craving may encompass the recall of emotionally filled moments, and (3) points out the role of perineuronal nets (PNNs) in addiction memory neuroplasticity. We highlight how autobiographical memory retrieval, music-evoked autobiographical memories, and craving share similar neural activations with PNNs which represent a causal element in the processing of addiction memory. We finally conclude by considering how the neuroplastic characteristics of addiction memory might represent the ground to update and/or recalibrate, within the therapy, the emotional content related to the recall.
... Similarly, the practice of yoga for 12 weeks has been shown to reduce blood pressure in patients with hypertension. 7 A systematic review was done by Bradt and Dileo (2013) to investigate the effect of music on stress and anxiety reduction in coronary disease patients. 14 Blood pressure and heart rate were studied as secondary outcomes. ...
Introduction: Prevalence of hypertension in Malaysia has been increasing over the years. Despite varieties of treatment, a large proportion of hypertensive patients still have uncontrolled blood pressure. Several non-pharmacological approaches have been used as non-pharmacological management to reduce blood pressure. This study intended to determine the effect of listening to Quran recitation on blood pressure among Muslim patients with uncontrolled hypertension. Material and Method: This study was a randomized controlled trial involving 202 Muslim patients with uncontrolled hypertension. They were randomly allocated to either listening to Quran recitation group or control group. Blood pressure (BP) and heart rate were measured at baseline and after the intervention. Results: In the intervention group, the mean changes in systolic BP and diastolic BP were -5.9 and -3.8mmHg respectively while for heart rate was -4.06 bpm. In the control group, the mean changes in systolic BP and diastolic BP were -1.68 and -1.84 mmHg respectively while for heart rate was -1.39 bpm. ANCOVA analysis showed that the mean changes in systolic blood pressure, diastolic blood pressure and heart rate between intervention and control group were statistically significant (P values = 0.001). Conclusions: This study showed a reduction of blood pressure immediately after listening to Quran recitation. However, a longer study on listening to Quran needs to be done to show a sustained decrease of BP of the patient.
... In addition to alleviating pain (51), a Cochrane meta-analysis found that listening to music helped patients with coronary heart disease regulate their systolic blood pressure, heart rate, and breathing rate. Positive but modest benefits of music therapy for pain have been shown in two further Cochrane meta-analyses (52). (53)(54) 4 Further study is needed to determine the pharmacological and neurological pathways responsible for these benefits and the particular indications and contraindications of music therapy. ...
Music permeates our modern lives in every imaginable way. Whether we like it or not, all of us are constantly exposed to various frequencies and noises. A few listen to electronic music, while others listen to oldies. We can employ music as a treatment for disorders ranging from the inorganic to the organic, regardless of the genre. Everyone can benefit from music therapy, whether it is music alone or a combination of other therapies. This systematic review organizes and discusses the available literature on music therapy for common medical conditions.
... It is likely that the reward system plays a key role in these functions, which is consistent with the view of music as a transformative technology of the mind (Patel, 2008(Patel, , 2018Loughridge, 2021) in the sense that music both emerges as a creative product of the mind and can shape the mind by affecting its function. This underlying mechanism may therefore explain why music can be used to improve mood, reduce anxiety, and enhance well-being in many different clinical groups, including psychiatric disorders (Gebhardt et al., 2014), depression (Maratos et al., 2011), stroke (Särkämö et al., 2008), heart disease (Bradt et al., 2013), and dementia (Guétin et al., 2011; for systematic reviews and meta-analysis, see Sihvonen et al., 2017;de Witte et al., 2020). ...
The neuroscience of music and music-based interventions (MBIs) is a fascinating but challenging research field. While music is a ubiquitous component of every human society, MBIs may encompass listening to music, performing music, music-based movement, undergoing music education and training, or receiving treatment from music therapists. Unraveling the brain circuits activated and influenced by MBIs may help us gain better understanding of the therapeutic and educational values of MBIs by gathering strong research evidence. However, the complexity and variety of MBIs impose unique research challenges. This article reviews the recent endeavor led by the National Institutes of Health to support evidence-based research of MBIs and their impact on health and diseases. It also highlights fundamental challenges and strategies of MBI research with emphases on the utilization of animal models, human brain imaging and stimulation technologies, behavior and motion capturing tools, and computational approaches. It concludes with suggestions of basic requirements when studying MBIs and promising future directions to further strengthen evidence-based research on MBIs in connections with brain circuitry.
SIGNIFICANCE STATEMENT Music and music-based interventions (MBI) engage a wide range of brain circuits and hold promising therapeutic potentials for a variety of health conditions. Comparative studies using animal models have helped in uncovering brain circuit activities involved in rhythm perception, while human imaging, brain stimulation, and motion capture technologies have enabled neural circuit analysis underlying the effects of MBIs on motor, affective/reward, and cognitive function. Combining computational analysis, such as prediction method, with mechanistic studies in animal models and humans may unravel the complexity of MBIs and their effects on health and disease.
... To date, music interventions have been widely used in health care. Cochrane reviews have demonstrated beneficial effects of listening to music on anxiety in patients with cancer, coronary heart disease, or preoperative anxiety [19][20][21]. ...
Purpose
To evaluate the evidence from randomized clinical trials (RCTs) about the effect of music intervention in reducing patients’ anxiety during breast biopsy.
Methods
Electronic databases including PubMed, Cochrane Library, Scopus, and Web of Science were searched using the relevant MeSH terms. The inclusion criteria were all RCTs assessing the effect of music therapy versus no music in reducing anxiety during breast biopsy. The extracted outcomes were anxiety and pain during breast biopsy. They were pooled as mean difference (MD) with a 95% confidence interval (CI) in a fixed-effects model, using Review Manager 5.3 software for windows. The quality of included studies was assessed with the Cochrane risk of bias assessment tool (RoB 1.0). Then, the outcomes of our meta-analyses were independently evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to know the grade of their evidence.
Results
The final analysis included five RCTs. We found a positive effect of music therapy in reducing anxiety levels compared with control group (MD = − 2.11; 95% CI (− 4.16 to − 0.06); p = 0.04). No difference between music and control groups regarding pain associated with breast biopsy (MD = 0.22; 95% CI (− 0.81 to 1.25); p = 0.68). The GRADE rating of our outcomes was low for anxiety levels and very low for pain during the biopsy.
Conclusions
Music therapy could be an effective, simple, non-pharmacological option in relieving anxiety during breast biopsy; however, it had no effect on procedure-associated pain. More large and high-quality studies are needed to confirm our results.
... Listening to music is an intervention that is widely accepted by dental and medical patients to reduce anxiety. 9 The type of music varies and is based on the choice of the individual or the population, condition of the individual, and setting, such as the environment or method of delivery. 10 Passive and active are the two types of music-based interventions. ...
Background: Compliance with preventive health behavior is crucial during dental visits. This study investigated using an audio device to increase dental patients’ preventive health behavior.
Methods: A randomized control study was conducted in private dental practices. The test group listened to an audio device containing public health messages related to COVID-19 and preventive health behavior. The control group listened to relaxing instrumental music with no public health messages.
Results: A total of 65 participants (age 18–77 years) were allocated to each group. About 63% of the participants in the test group performed preventive health behaviors compared to the control group, but the difference was not significant. Significant differences in preventive health behavior were observed in both groups before and after treatment (p < 0.001). A significant difference in the awareness level was detected between the test and control group (p < 0.01). No significant differences were found in the knowledge and self-efficacy scores between the two groups (p > 0.05).
Conclusions: An audio device used during dental treatment effectively delivered public health messages to improve preventive health behavior. Hence, an audio device can be used as alternative media to deliver public health information during dental visits.
... Music has found its application during various out-patient or minor procedures, ICU stay, in cancer wards, labour rooms, or other hospital settings and has been seen to reduce stress and anxiety levels in patients. Several experimental studies have evaluated the effects of music therapy in improving the quality of perioperative care [13][14][15] Music listening has been consistently reported to bring down anxiety in patients through stress reducing effects [16][17][18]and more specifically in cardiac patients as per the latest Consistent review of patients with coronary heart disease [19].The results of our study is in consonance with these findings. Another mechanism put-forth for music listening to bring down anxiety is that music can help people focus their attention away from distressing situations and generate positive moods and emotions which in turn reduces the anxiety levels [20].Both the reduction of anxiety and the regularisation of the physiological responses could also be attributed to the music listening intervention suppressing the sympathetic activity leading to reduced adrenergic activity and regulation of the autonomic cardiovascular rhythms [21,22].We tried in this study to evaluate effects of music under spinal anaesthesia on these parameters patient satisfaction, intraoperative sedation, incidence of nausea vomiting, and the intensity of pain during recovery from lower limb surgery Our results show a significant improvement in patient satisfaction in group M. Palmer et al. evaluated patient satisfaction with a five-item score. ...
... It is now recognised as a very effective therapy for people with a wide variety of diagnoses and conditions. For example, it is used to reduce pain or anxiety and stress symptoms both during surgery and in recovery from surgery, as well as in heart disease (McCaffrey and Good, 2000;Kuhlmann et al., 2018;Bradt, Dileo and Potvin, 2013) or in neurodegenerative diseases like dementia, for both behavioural and cognitive symptoms (Langhammer et al., 2019;Onieva-Zafra et al., 2018;Perez-Ros et al., 2019). ...
... In recent years, studies have identified anxiety as one of the risk factors for heart disease [22]. Many meta-analyses of community cohorts and patient cohorts have shown that anxiety symptoms increase the risk of heart disease [23]. ...
The irreversible termination of individual life activities and metabolism means all fatal problems ultimately terminate the heart function. It’s very important to protect the patient’s life if we have treatment to maintain heart function and care about patients’ heart response. It is known that many diseases induced heart dysfunction including Chagas disease, burn injury, smoking and other bad stresses. Chronic stress causes these physical symptoms and emotional symptoms. Due to the awareness created by the media and internet, patients are generally aware that they should seek help immediately for chest pain. Therefore, attention and studies on stress-induced heart dysfunction would help uncover the pathophysiological mechanisms of cardiac response to non-heart diseases and provide an insight of heart-protection drugs. At the same time, physicians should be aware of this new condition and how to diagnose and treat it, even though the causal mechanisms are not yet fully understood. This special chapter will discuss on the cardiac response to the stresses especially on our associated research in recent decades such as Trypanosoma cruzi (T. cruzi)-induced cardiomyopathy and burn injury–induced cardiomyopathy, and on some very popular stresses such as behavior, motion, mental, and smoking.
... Internal and external sounds turn the womb into an acoustically diverse environment for the developing kid [5] . According to certain research, the fetus can listen to music [6] . ...
Even before birth, music may have a significant impact on your child's development. Music stimulates all aspects of a child's growth when they are exposed to it. And doing so at a young age may assist guarantee that your child grows up to be healthy. In several psychological conditions, music therapy is known to be effective, but not much research has been done to ascertain the effect of classical Indian music on psychiatric disorders. The ascendant is the antenatal musical practice. With reference to evidence-based study, the paper supports 5 primary objectives: music therapeutic modulation of pre- and perinatal stress, anxiety, and depression; mental and physical birth planning related to music, including cognitive change, emotional regulation, physical exercise, maintenance of relaxation and discomfort, and social inclusion; music-related bonding and self-efficacy; prenatal sound enhancement. Traditional therapeutic tools include Raga Chikitsa, Vedic chanting, Garbha Sanskara (Learning in the Womb), Time theory of ragas (combining ancient Ayurvedic notions) and Cakra activation (music and breathing approach using ragas). Outcomes in clinical are studied to see how they impact biological, physiological, psychological, chronobiological, as well as spiritual factors.
... The music has been reported to decrease blood pressure, heart rate (HR), respiration rate, anxiety and pain with improved quality of sleep, pre competition stress in athletes etc. in many research studies. (3,4) Its therapeutic effects can be used under various psychiatric disorders. (5) Further, the genre of music has been reported to have different effect on ANS e.g. ...
Background: Indian Classical Music (ICM) has a structured and combinational classification basis. It has a time tasted philosophy of different notes for different time and mood called, ‘Raaga’. Each ‘Raaga’ has unique combinational rules of notes, and it is associated with different essence, feeling, and emotions. Aim & Objective: The aim of the present study is to explore the effect of one popular ICM Raaga ‘Bhairavi’ on heart rate variability (HRV) as compared to the results with pop music of their choice. Settings & Design: HRV analysis was carried out in three cases; in silent environment, with classical music and with pop music for each subject on same time but different days. Methods & Material: Fifty three young adults participated in the non-invasive and benign study. Electrocardiogram (ECG) was recorded in silent environment and with classical and pop music and HRV parameters were extracted. Statistical analysis used: Student paired t test was used to compare the difference between HRV parameters during silent and music states. Results: The parasympathetic activity was increased whereas sympathetic activity decreased with classical music. Conclusions: Raaga ‘Bhairavi’ has been long considered as soft and soothing composition and thereby reducing stress, better compared to other popular music, like pop. The same study can be extended with other ‘Raagas’ using HRV parameters.
... Apart from its widespread application in neurological disorders, music therapy is being increasingly used as one of the treatment modalities for chronic illnesses (Gallagher, 2011). Research in this area indicates the beneficial effects of music therapy with respect to psychological distress, anxiety, sleep quality, depressive symptoms, pain and various physical symptoms in persons with cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, etc. (Bradt, Dileo & Potvin, 2013;Li et al., 2011;Canga et al., 2015;Mandel et al., 2013). This paper is a comprehensive review of music therapy: its aspects, efficiency, outcomes, when it is administered to individuals suffering with various chronic illnesses (hypertension, diabetes, cancer, chronic obstructive pulmonary disease, arthritis). ...
Chronic illnesses result in several undesirable physiological and psychological outcomes in patients which are seldom addressed in clinical settings. The transition from the biomedical model to the biopsychosocial model has led to the development of novel interventions for chronic illness management. Music therapy is a non-pharmacological intervention used to address patient needs in the aftermath of treatment. This review highlights the application of music therapy across chronic illnesses. Both, active and receptive music therapy have shown positive results across chronic illnesses; on physiological, physical and psychological parameters. The efficacy of music therapy interventions is enhanced when used in combination with other non-pharmacological interventions. However, contradictory results have also emerged and there is an urgent need to execute well-designed randomized studies with an adequate sample size to arrive at a definite conclusion.
... , afirma que ésta favorece el aprendizaje, la plasticidad cerebral y la reorganización del sistema nervioso, es por ello, que su uso ha demostrado ser un recurso muy efectivo al momento de prevenir y tratar a niños con trastornos cognitivos, como el trastorno generalizado del desarrollo ( ). En este sentido, la música también ha mostrado ser muy útil en el tratamiento del estrés y la ansiedad (Bradt & Dileo, 2009), así como de la depresión, (Maratos, Gold, Wang, & Crawford, 2008). Del mismo modo, el aprendizaje de la música, durante la infancia aporta beneficios intelectuales permanentes (Schellenberg.,2005), ...
... Tarih boyunca müziğin insanlar üzerinde psikolojik bir etkisinin olduğu vurgulanmaktayken son yıllarda araştırmacılar müziğin psikolojik etkisinin yanı sıra insan bedeninde yol açtığı fizyolojik değişimler üzerine etkisini irdelemektedir [4,5]. Yapılan güncel çalışmalara göre müzik hastaların kan basıncı, nabız, solunum hızı gibi fizyolojik parametrelerinin ve ağrı, uykusuzluk gibi rahatsız edici bulguların azalmasına neden olmaktadır [6]. Günümüzde sunulan sağlık hizmetinde fiziksel, psikolojik ve sosyal etkilerinden yararlanılan bir yöntem olan müzik terapisi uygulamasında, bireyin yaşam kalitesini artırmak hedeflenmektedir [7][8][9]. ...
... UPMT aims to transfer symbolic input music to a new piece of symbolic music that meets a user's preferences based on features of their favorite music (Fig.1). UPMT can be examined in numerous applications, such as anxiety reduction [4], [5], personality studies [6], [7], and music recommender systems [8], [9]. For example, in the music therapy domain, individuals have been found to be more engaged when listening to their favorite music [10]. ...
User preference music transfer (UPMT) is a new problem in music style transfer that can be applied to many scenarios but remains understudied.
... To measure the participants' anxiety, we consider users' self-reports, a standard indicator that has proven to be suitable [52]. As measurement procedure, we chose an adaptation of the six-item short-form of the Spielberger State-Trait Anxiety Inventory (STAI: Y-6 item [68]), a self-perception-based instrument extensively used to assess anti-anxiety interventions [69], particularly when investigating the effect of musical treatments [10,11,20,29,30,52,63,70,71]. The STAI: Y-6 scale encompasses six statements rated by the user according to a four-point-Likert scale, from 1 (not at all) to 4 (very much): three out of the six statements are positive and three negative. ...
Musical listening is broadly used as an inexpensive and safe method to reduce self-perceived anxiety. This strategy is based on the emotivist assumption claiming that emotions are not only recognised in music but induced by it. Yet, the acoustic properties of musical work capable of reducing anxiety are still under-researched. To fill this gap, we explore whether the acoustic parameters relevant in music emotion recognition are also suitable to identify music with relaxing properties. As an anxiety indicator, the positive statements from the six-item Spielberger State-Trait Anxiety Inventory, a self-reported score from 3 to 12, are taken. A user-study with 50 participants assessing the relaxing potential of four musical pieces was conducted; subsequently, the acoustic parameters were evaluated. Our study shows that when using classical Western music to reduce self-perceived anxiety, tonal music should be considered. In addition, it also indicates that harmonicity is a suitable indicator of relaxing music, while the role of scoring and dynamics in reducing non-pathological listener distress should be further investigated.
... For example, hospital-wide interventions have been shown effective in screening for and addressing domestic violence and nutritional needs, issues that are present in patient populations across the hospital [18,19]. Further, interventions such as music therapy [20,21] and mindfulness [17] have been effectively deployed hospital-wide to reduce anxiety and distress across multiple units and disease types. Hospital-wide stressors could be similarly addressed. ...
Anxiety is prevalent among hospital inpatients and it has harmful effects on patient well-being and clinical outcomes. We aimed to characterize the sources of hospital distress and their relationship to anxiety. We conducted a cross-sectional study of inpatients (n = 271) throughout two Southeastern U.S. metropolitan hospitals. Participants completed a survey to identify which of 38 stressors they were experiencing. They also completed the State Trait Anxiety Inventory six-item scale. We evaluated the prevalence of stressors, their distribution, and crude association with anxiety. We then used multivariate logistic regression to estimate the association between stressors and clinically relevant anxiety, with and without adjusting for demographic variables. We used factor analysis to describe the interrelationships among stressors and to examine whether groups of stressors tend to be endorsed together. The following stressors were highly endorsed across all unit types: pain, being unable to sleep, feelings of frustration, being overwhelmed, and fear of the unknown. Stressors relating to isolation/meaninglessness and fear/frustration tend to be endorsed together. Stressors were more frequently endorsed by younger, female, and uninsured or Medicaid-insured patients and being female and uninsured was associated with anxiety in bivariate analysis. After controlling for the sources of distress in multivariate linear analysis, gender and insurance status no longer predicted anxiety. Feelings of isolation, lack of meaning, frustration, fear, or a loss of control were predictive. Study results suggest that multiple stressors are prevalent among hospital inpatients and relatively consistent across hospital unit and disease type. Interventions for anxiety or emotional/spiritual burden may be best targeted to stressors that are frequently endorsed or associated with anxiety, especially among young and female patients.
... Results of a recent meta-analytic review (de Witte, da Silva Pinho et al., 2020), including 47 quantitative controlled studies, showed an overall medium-to-large effect of music therapy on stress-related outcomes (d = 0.723, [.51-0.94]). This is in line with previous reviews and meta-analyses, which show positive effects of music interventions on the reduction of stress or state-anxiety (Bradt & Dileo, 2014;Bradt, Dileo, & Shim, 2013;Bradt, Dileo, Grocke, & Magill, 2011;Bradt, Dileo, Potvin et al., 2013;Carr, Odell-Miller, & Priebe, 2013;de Witte, Sprui et al., 2020;Gold, Solli, Krüger, & Lie, 2009;Kamioka et al., 2014). ...
Negative stress is a serious risk factor for the onset and progression of a wide range of physical illnesses and emotional problems. In the literature, an increasing examination of music therapy interventions for stress reduction over the past decade is seen, yet music therapy interventions for stress reduction have not been systematically developed and described. Moreover, there is a growing need for micro-interventions, which are defined as short-term interventions in which the therapist uses specific therapeutic techniques to work on a client’s goals. In this study, a music therapy micro-intervention for stress reduction was developed based on both empirical and practice-based knowledge. First, the micro-intervention was described based on both findings from empirical studies (N = 52) focused on the effects of music therapy on stress reduction, and from a previously conducted focus group study focused on the perspectives of music therapists. Second, the Delphi technique was applied to collect feedback on the micro-intervention described, by surveying a panel of 16 music therapy experts. This procedure resulted in an improved description of the music therapy micro-intervention for stress reduction, including a receptive and an active intervention variant. Implications for clinical practice and recommendations for future research are discussed.
... Both music therapy (provided by a credentialed music therapist) and music medicine (provided by other health care professionals) interventions are widely used in intensive care. Multiple meta-analyses highlight the benefits of using music for reducing anxiety levels in mechanically ventilated and in preoperative patients [14,15], improving sleep patterns and insomnia [16], reducing stress and anxiety levels in coronary patients [17], or rehabilitating motor functioning in patients with brain injuries [18]. Regarding pain, music interventions have shown to significantly reduce pain levels across a variety of medical populations and settings [19,20]. ...
Background
Pain is one of the most common and most difficult symptoms to manage in adult burn patients in the Intensive Care Unit (ICU). Insufficient or unsuccessful pain management can negatively affect physiological, psychological and social health in burn patients, both during and after hospitalization. Music therapy and music medicine interventions have been shown to positively affect pain and mental health in this population. This systematic review and meta-analysis provide an update of Randomized Controlled Trials (RCTs) using music therapy or music medicine interventions in adult burn patients.
Methods
A variety of databases were searched from their beginning to June 2020, including PsycINFO and PsycArticles (via APAsycNET), PubMed and MEDLINE (via OvidSP), Scopus, Web of Science, and the Cochrane Library. Data of all articles meeting the inclusion criteria were extracted, organized and processed according to the PRISMA guidelines. Statistical analysis was performed using Q-test and I2 statistics.
Results
10 RCTs with a total of 1,061 participants were included. The results of the meta-analysis showed a statistically significant reduction of pain (I² = 96.03%, P < 0.001) and anxiety levels (I² = 98.85%, P < 0.002), and improved relaxation (I² = 87.19%, P < 0.001) favoring music interventions compared to control groups.
Conclusions
This review provides preliminary evidence for the effectiveness of music interventions for adult burn patients. However, more high-quality RCTs are needed to safely establish guidelines for music therapists and other health care professionals in using music for health purposes with this population.
... Studies on patients diagnosed with mental disorders such as anxiety, depression, and schizophrenia have shown a visible improvement in their mental health after general music and Music therapy interventions (Fancourt et al., 2016;McCaffrey et al., 2011;M€ ossler et al., 2011;Erkkil€ a et al., 2011). Moreover, studies have demonstrated other benefits of music and Music therapy, including improved heart rate, motor skills, stimulation of the brain (Bradt et al., 2013;Magee et al., 2017;Norton et al., 2009) and enhancement of the immune system (Taylor, 1997;Fancourt et al., 2014;Li et al., 2021). ...
Music is a crucial element of everyday life and plays a central role in all human cultures: it is omnipresent and is listened to and played by persons of all ages, races, and ethnic backgrounds. But music is not simply entertainment: scientific research has shown that it can influence physiological processes that enhance physical and mental wellbeing. Consequently, it can have critical adaptive functions. Studies on patients diagnosed with mental disorders have shown a visible improvement in their mental health after interventions using music as primary tool. Other studies have demonstrated the benefits of music, including improved heart rate, motor skills, brain stimulation, and immune system enhancement. Mental and physical illnesses can be costly in terms of medications and psychological care, and music can offer a less expansive addition to an individual's treatment regimen. Interventions using music offers music-based activities in both a therapeutic environment (Music therapy) with the support of a trained professional, and non-therapeutic setting, providing an atmosphere that is positive, supportive, and proactive while learning non-invasive techniques to treat symptoms associated with various disorders – and possibly modulate the immune system.
... Listening to music may induce a favourable effect on anxiety, systolic BP, heart rate, RR, sleep quality and pain in patients with coronary heart disease 12 . Music of interest is known to reduce depression and aid higher cognitive factors; it also improves molecular and structural flexibility in stroke patients recovering from brain injury 13,14 . ...
... No estudo de Nieto-Romero (2017), o efeito de musicoterapia sobre o nível de ansiedade do adulto cardiopata submetido à ressonância magnética, que teve como metodologia a seguinte intervenção: um grupo escutou música clássica e o outro, escutou músicas de sua preferência por 30 minutos antes da ressonância e, durante a realização do exame (≥20 minutos).Foi verificado que a terapia com música reduziu a frequência cardíaca, a frequência respiratória e tensão arterial sistólica, em ambos os grupos; porém o nível de ansiedade teve maior redução no grupo de pacientes que escutaram as músicas de sua preferência.Segundo o estudode Mandel (2007), que testou a eficácia da musicoterapia na melhoria dos resultados relacionados à saúde de pacientes na fase II da RC, houve uma maior diminuição da pressão arterial sistólica no grupo da musicoterapia tanto pré como pós-tratamento; em relação as medidas psicológicas, algumas diferenças foram encontradas em quatro meses após o tratamento, tais como melhora na saúde geral e uma no funcionamento social. Na revisão sistemática realizada porBradt, Dileo & Potvin(2013), com enfoque em indivíduos com doença arterial coronariana, a qual analisou o efeito das intervenções musicais usadas com o intuito de reduzir a ansiedade e o sofrimento e a melhorar o funcionamento fisiológico destes pacientes, os resultados indicaram que as intervenções musicais têm um pequeno efeito benéfico no sofrimento psíquico nessa população, sendo esse efeito consistente entre os estudos. Além disso, como resultados principais, a revisão aponta que o efeito musical consegue reduzir a frequência cardíaca, frequência respiratória e pressão arterial sistólica. ...
A música ocasiona diferentes respostas fisiológicas, algumas delas são alterações na pressão arterial, na frequência cardíaca e respiratória. Na literatura pesquisada foram encontrados poucos estudos que avaliam os efeitos da música na modulação autonômica cardíaca, sobretudo em pacientes cardiopatas ativos. Assim, o objetivo do presente estudo foi avaliar a modulação autonômica da frequência cardíaca sob o efeito de estímulo musical, por meio da análise da variabilidade da frequência cardíaca pelos métodos lineares e não-lineares. Metodologia: Participaram do estudo 11pacientes cardiopatas ativos. Os voluntários permaneceram, antes do início do teste, em repouso por cinco minutos e 30 segundos e foram expostos a quatro músicas com ritmos diferentes, de forma aleatória, durante cinco minutos e 30 segundos cada uma; com um intervalo de 15 segundos entre elas. Foram analisados os índices lineares e não lineares, estatísticos e geométricos no domínio do tempo e os índices no domínio da frequência. Para análise dos dados foi realizado o teste de Friedman, com post-teste de Bonferroni, com nível de significância de 5%. Resultados: Foram encontrados valores médios de batimentos cardíacos repetitivos significativamente maiores (p<0,05) durante a música "Send my love" quando comparado ao repouso. Foi observado que não foram encontrados valores estatisticamente significantes nos diferentes espectros de potência, na razão BF/AF e nos índices não-lineares, quando comparadas as diferentes exposições musicais e ao repouso. Conclusão: Os índices de variabilidade de frequência cardíaca não foram alterados pela exposição musical nessa população estudada.
... Imagine you are in a beautiful, peaceful rainforest See the trees, rising into the sky See the water, deep and soothing Listen to the birds, crickets and the gentle sounds of nature You feel calm and tranquil Take a slow, deep breath, inhale and exhale Continue to breath in and out, take your time Feel the cool air of the forest, come gently in through your nose and all the way down to your belly. Feel your belly move up and down as you breathe deeply Let your mind be free Listen to the sounds, breath with the sounds Feel the tension in your shoulders, your arms, your feet Gradually relaxing, one by one (Ross & Amir, 2019) Music is made up of organized sounds and it can reduce stress and anxiety among cardiac patients (Bradt et al., 2013). Sounds are made up of a complicated mixture of vibrations. ...
... [6,7] It's also used in heart attack and stroke rehabilitation. [8,9] Randomized controlled trials suggest listening to vocal music is a successful intervention to support cognitive recovery following stroke. Listening to vocal music is additionally shown to enhance early language recovery in aphasia. ...
Though rarely a standalone treatment, music’s ability as an adjunct to standard treatment in increasing the quality of life has been acknowledged for decades. At first glance, the role of music in medicine may seem amorphous; however, with advancements in science, our understanding of the physiology and neurochemistry of music in relation to the human brain has expanded. Listening to and playing music involves an intriguing combination of virtually every human cognitive function. Music’s inherent ability to evoke emotions is the rationale behind musicinduced goosebumps and ‘chills of euphoria’. The psychoneuroendocrinology of music is a fascinating and growing field of research. In the last decade, there has been burgeoning clinical evidence on the measurable effects of music therapy over a broad spectrum of medical specialties including neurology, cardiology, psychiatry, and palliative oncology. Perhaps it is time for physicians to consider an evidencebased musical intervention as routine adjunctive therapy.
https://www.rhime.in/ojs/index.php/rhime/article/view/488/394
https://www.rhime.in/ojs/index.php/rhime/article/view/488
... Further analyses revealed that after 30 min of the experimental treatment, the stress index scores in the HBMG decreased significantly compared to those in the PMG and CG. Music therapy has been successfully employed for the treatment of stress and anxiety in coronary heart disease patients, 11 and Cervellin and Lippi reported that heartbeat-based stimuli can be utilized for stress reduction. 5 However, the antistress effects of these auditory interventions were typically measured via assessments before and after stress exposure, not continuously, as in this study. ...
Background: Musical auditory stimulation can affect the brain and autonomic nervous system, resulting in psychological and physical relaxation. In particular, listening to healing beat music with a tempo synchronized with an individual's heart rate can make a person feel comfortable. This study investigated whether healing beat music, utilized as a heartbeat-matched auditory stimulus, could be employed to improve patient recovery after exposure to stressful stimuli.
Methods: This study was a randomized controlled trial and participants were adults over the age of 20 who voluntarily participated. As outcome variables, stress index, BIS index, sympathetic nerve activity, and blood pressure were measured and compared at 5-minute intervals.
Results: Following treatment, the stress index (F=3.78, p<.001), BIS index (F=5.61, p<.001), and systolic blood pressure (F=3.14, p=.019) in the a healing beat music listening group(HBMG) were significantly lower than in the a control group(CG). More specifically, the stress index (P <.05) and the BIS index (P <.05) of the HBMG were lower than the indices of the preferred music listening group (PMG) and the CG at 30 minutes.
Conclusions: Listening to healing beat music with a tempo synchronized with the heart rates of the participants had the effect of lowering stress index and systolic pressure. Thirty minutes into the experimental treatment, the healing and stabilizing effect of listening to healing beat music was more effective than listening to preferred music. Accordingly, healing beat music may be utilized as a treatment method to relieve stress in both clinical and daily life contexts.
Individuals with low-density lipoprotein cholesterol ≥190 mg/dL are at high risk for atherosclerotic cardiovascular disease events. Our goal was to determine if adults with this condition would express important psychological, health, and motivation themes when generating lyrics during music therapy. Thirty-one participants each created their own original song with the help of a music therapist. The lyrics were analyzed using a deductive approach guided by Self-Determination Theory (specifically the satisfaction or frustration of basic psychological needs): (1) for each entire song (macro-analysis) and (2) line-by-line (micro-analysis). Song lyrics generated during music therapy sessions by patients with a low-density lipoprotein cholesterol ≥190 mg/dL revealed the presence of the three basic needs (autonomy, competence, and relatedness) of Self-Determination Theory. The most prevalent theme identified in the macro-analysis of songs was autonomy satisfaction, coded in 25 songs (27.17% of all macro codes), and followed by competence satisfaction in 17 songs (18.48%) and relatedness satisfaction in 15 songs (16.3%). Line-by-line micro-analysis of lyrics revealed that at least one basic need of Self-Determination Theory was present in 277 of the unique lyric lines (50%); 107 (19%) for relatedness, 101 (18%) for autonomy, and 69 (13%) for competence. Need satisfaction occurred more frequently than need frustration in both analyses. However, depending on the level of analysis (macro or micro), results differed as to which themes were most prevalent. These results indicate that therapeutic songwriting may be a unique way to identify the basic psychological needs that, when satisfied, indicate self-determination.
Objectives
This study aims to explore the effect of music therapy on pain, anxiety and physiologic parameters in patients undergoing prostate biopsy.
Design and setting
A systematic review and meta-analysis of randomized controlled trials.
Interventions
Five databases were systematically searched. The included studies reported randomized controlled trials comparing the effects of music therapy and non-music therapy on pain, anxiety, and physiologic parameters in patients undergoing prostate biopsy. The random-effects meta-analyses were performed for data synthesis.
Main outcome measures
The primary outcome was pain; secondary outcomes included anxiety and physiologic parameters.
Results
We analyzed seven eligible studies involving 662 males undergoing prostate biopsy. We synthesized the mean difference between music and control groups in different outcomes. Compared with control groups, music therapy reduced pain (visual analog scale score, mean difference [95% CI]: -0.92 [-1.68 to -0.17], P=0.017, low quality) and anxiety (State-Trait Anxiety Inventory equivalent scale score, mean difference [95% CI]: -4.37 [-7.72 to -1.03], P=0.010, low quality) after the prostate biopsy. In terms of the physiological parameters, music therapy only slightly reduced heart rate, but not blood pressure and respiratory rate after the prostate biopsy.
Conclusions
Low quality of evidence showed that music therapy during prostate biopsy might reduce pain and anxiety. However, a good standard of music intervention was lacking. Cost-effective analyses are warranted to better delineate the value of music therapies for prostate biopsy.
Keywords
Amaç: Bu çalışmada, Klasik Türk Müziği makamlarının hastalıklar ve semptomlar üzerine etkilerini araştıran, deneysel hemşirelik doktora tezlerinin sistematik incelenmesi amaçlanmıştır.Yöntem: Retrospektif ve tanımlayıcı tipteki çalışma, rehber PRISMA-P 'ye göre Ulusal Tez Merkezi taranarak, Ekim 2021-Mart 2022 tarihleri arasında yapılmıştır. Tezlerin alınma ölçütlerinde başlıkta “müzik terapi” “müzik tedavi” “müzikle tedavi” “müzikle terapi” kelimelerinin bulunması, hemşirelik alanında yapılması ve tezde Klasik Türk Müziği makamlarının uygulanması aranmıştır. Ölçütleri karşılayan 1999- 2021 yılları arasında yapılmış, 14 hemşirelik doktora tezi amaç, yöntem, bulgular ve sonuç değişkenleri açısından kronolojik sırayla değerlendirilmiştir. Çalışmanın analizinde sayısal değerlendirmeler kullanılmıştır.Bulgular: Tezlerin % 85.6’sı 2012- 2021 yılları arasında, en fazla oranla %21.42’si İç Hastalıkları Hemşireliği ve Cerrahi Hastalıkları Hemşireliği’nde, %14.28’i Psikiyatri Hemşireliği alanında yapıldığı belirlenmiştir. Hastalara sıklıkla Acemaşiran, Nihavent, Uşşak, Rast, Hüseyni, Segah, Buselik, Zirgüleli Hicaz ve Zirefkend Makamlarının dinletildiği ve çoğunlukla psikolojik semptomlar üzerine makamların etkisinin incelendiği görülmüştür. Tezlerde en fazla Rast, Acemaşiran ve Hüseyni makamları uygulanmıştır. Çalışmalarda Rast ve Uşşak makamı’nın kaygı, korku gibi anksiyete faktörlerini azalttığı ve gevşemeye yardımcı olduğu; Zirgüleli Hicaz ve Zirefkend makamları’nın uyku kalitesini etkilediği ve yorgunluğu azalttığı, Nihavent ve Rast makamları’nın hasta memnuniyetini ve yaşam kalitesini artırdığı, Acemaşiran, Hüseyni ve Nihavent makamlarının ağrı ve fizyolojik parametrelerde olumlu etkilerinin olduğu bulunmuştur. Sonuç: Tezlerin sonuçları doğrultusunda, Klasik Türk Müziği makamlarının öncelikle psikolojik semptomlar ve ağrı olmak üzere, uyku kalitesinin arttırılması ve yaşam bulgularının iyileştirilmesinde uygulanabileceği belirlenmiştir. Türk Müziği makam terapisinin deneysel çalışmalarla güçlendirilmesine ihtiyaç vardır. Bilimsel sonuçlar, makamların semptomlara yönelik tedavisinde kullanılabileceği gibi, Türk Müziği makamları’nın kültürlerarası hemşirelik ve sağlık uygulamalarına yön verebileceğine inanılmaktadır.
Effective stress recovery is crucial to prevent the long-term consequences of stress exposure. Studies have suggested that listening to music may be beneficial for stress reduction. Thus, music listening stands to be a promising method to promote effective recovery from exposure to daily stressors. Despite this, empirical support for this opinion has been largely equivocal. As such, to clarify the current literature, we conducted a systematic review with meta-analysis of randomized, controlled experimental studies investigating the effects of music listening on stress recovery in healthy individuals. In fourteen experimental studies, participants ( N = 706) were first exposed to an acute laboratory stressor, following which they were either exposed to music or a control condition. A random-effects meta-regression with robust variance estimation demonstrated a non-significant cumulative effect of music listening on stress recovery g = 0.15, 95% CI [-0.21, 0.52], t (13) = 0.92, p = 0.374. In healthy individuals, the effects of music listening on stress recovery seemed to vary depending on musical genre, who selects the music, musical tempo, and type of stress recovery outcome. However, considering the significant heterogeneity between the modest number of included studies, no definite conclusions may currently be drawn about the effects of music listening on the short-term stress recovery process of healthy individuals. Suggestions for future research are discussed.
While scientific research has been largely engaged with untangling the psychological and emotional factors contributing to comfort eating, the potential impact of the physical eating environment on comfort eating behaviour has not been investigated. A limited amount of literature suggests that relaxing background music may lead to healthier food choices. However, it remains to be seen how the integration between visual and auditory elements of physical context – and their respective associations with comfort eating – might moderate the putative healthy effects of relaxation due to sound alone. The present study examined how evoked consumption contexts comprised of music (relaxing vs. stressful) in combination with location (at home vs. outside), influenced comfort eating desire, simulated energy intake, and expected hedonic reward. In an online experiment, participants (N=399) performed a simulated pasta dish assembly and eating task in one of four audio-visual contexts. Results showed that desire to eat comfort food and expected hedonic reward were dependent on the interaction between music and location: more specifically, the presence of either relaxing music or home location significantly increased the desire to eat comfort food and expected hedonic reward, compared to when both music and location were not associated with comfort-eating. Furthermore, desire to eat comfort food was a significant predictor of the calorie content of the dishes. Our results highlight the importance of the interplay between multisensory elements and challenge the view that a relaxing atmosphere necessarily supports healthy food choices. This work provides insights for both industry and private consumers to promote healthier behaviour and more enjoyable food experiences through a holistic consideration of different components in the eating environment.
Integrative medicine provides an effective, affordable, and safe adjunct to contemporary approaches to the maintenance of mental health and the treatment of mental illness. Rather than relying on any single modality or theoretical model, integrative mental healthcare (IMH) incorporates allopathic, psychological, and complementary and alternative approaches tailored to each person's particular needs. This requires an interdisciplinary approach that empowers patients and provides them with knowledge and specific skills intended to support their inherent capacity for resilience.
Introduction
This study evaluated the effect of music intervention on the anxiety and stress responses of patients who underwent an interventional cardiac catheterisation.
Methods
The study design was a pre- and post-test randomised controlled trial that included 94 patients who underwent a transcatheter atrial septal defect closure. Patients were allocated to receive either music intervention (n = 47) or usual care (n = 47) during the interventional cardiac catheterisation. Music intervention effectiveness was examined in terms of anxiety, salivary cortisol level, and heart rate variability.
Results
The average age of participants was 45.40 years (±16.04) in the experimental group and 47.26 years (±13.83) in the control group. Two-thirds (66.0%) of the participants in each group were women. State anxiety (F = 31.42, p < 0.001), anxiety-numerical rating scale (F = 20.08, p < 0.001), salivary cortisol levels (F = 4.98, p = 0.021), and low-frequency component/high-frequency component ratio (F = 17.31, p < 0.001) in the experimental group were significantly reduced compared with those in the control group at the end of the music intervention.
Conclusion
This study provides practical evidence of a reduction in anxiety and stress response from music intervention preceding an interventional cardiac catheterisation, indicating that this intervention should be considered in clinical management.
Objectives
This review aimed to determine the pooled prevalence of preoperative anxiety and its associated factors among patients undergoing surgery in low/middle-income countries (LMICs).
Methods
We searched PubMed, SCOPUS, CINAHL, Embase and PsychINFO to identify peer-reviewed studies on the prevalence and factors associated with preoperative anxiety among patients undergoing surgery using predefined eligibility criteria. Studies were pooled to estimate the prevalence of preoperative anxiety using a random-effect meta-analysis model. Heterogeneity was assessed using I² statistics. Funnel plot asymmetry and Egger’s regression tests were used to check for publication bias.
Result
Our search identified 2110 studies, of which 27 studies from 12 countries with 5575 participants were included in the final meta-analysis. Of the total 27 studies, 11 used the State-Trait Anxiety Inventory to screen anxiety, followed by the Amsterdam Preoperative Anxiety and Information scale, used by four studies. The pooled prevalence of preoperative anxiety among patients undergoing surgery in LMICs was 55.7% (95% CI 48.60 to 62.93). Our subgroup analysis found that a higher pooled prevalence of preoperative anxiety was found among female surgical patients (59.36%, 95% CI 48.16 to 70.52, I ² =95.43, p<0.001) and studies conducted in Asia (62.59%, 95% CI 48.65 to 76.53, I ² =97.48, p<0.001).
Conclusion
Our meta-analysis indicated that around one in two patients undergoing surgery in LMICs suffer from preoperative anxiety, which needs due attention. Routine screening of preoperative anxiety symptoms among patients scheduled for surgery is vital.
PROSPERO registration number
CRD42020161934.
Purpose
This study was designed to investigate the effects of music therapy provided to patients who would undergo Coronary Angiography before the invasive procedure on pain, anxiety, and vital signs to reduce the administration of sedatives and to ask the views of the patients regarding the music to which they listened.
Design
This study was a randomized controlled study.
Methods
The research sample included 62 patients; 31 in the experimental group and 31 in the control group, who were waiting for having femoral angiography in the waiting room of the invasive procedure and diagnostic laboratory of a training and research hospital in Izmir. Data were collected using “Patient Information Form”, “Vital Signs Inspection Form”, “State-Trait Anxiety Inventory”, and “Visual Analog Scale”. The experimental group listened to nonverbal and instrumental music in the forms of taqsim, saz semai, and peshrev at the speeds of 60 (Adagio) and 100 (Andante). Nihavend mode is the most used mode in music therapy and is suitable for the Turkish Cultural structure. The scale of nihavend mode has the same structure with the g minor scale of classical western music. For both groups, pain and anxiety levels were simultaneously measured before and after the process; vital signs were measured before, during, and after the process.
Findings
The findings obtained in this study showed that there was a statistically significant difference between the means of anxiety (P = .000) and pain (P = .001) of the patients in experimental and control groups after the procedure. A significant difference was determined between the means before and after the procedure for diastolic (P = .002) blood pressure and pulse wave velocity (P = .002) in vital signs. A significant difference was not determined between the mean of patients’ systolic blood pressures (P = .082) and respiration rates (P = .836) before and after the procedure.
Conclusions
The findings suggest that music therapy is effective in reducing blood pressure, respiration rate, anxiety, pain level, and sedative application for the patients. Music therapy within the scope of the nonpharmacological complementary therapies can be administered by the healthcare providers, given that the patients have no adverse effects or additional costs and thanks to ease of implementation.
The problem of the study and its significance:
Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease.
That is interested psychologists and doctors searching for ways to find other treatment be more useful with these patients in terms of material and physical, including music therapy.
The studies revealed the modern power of music to lift the mood, and get rid of some emotional disorders, causing an improvement in blood pressure in patients, as well as improving communication skills of their own, as the music's ability to make the patient in a state of joy and happiness, as well as working to increase self-confidence and get rid of the fear of the disease.
Aims of the research: -
1-Identify the type of emotional responses for patients with blood pressure, type two (high and low) on a scale type specification in the circumstances of the music (taking drugs, work), and compared with the responses of healthy patients in the same conditions depending on the variable (sex, and function).
2 - identify the type of emotional responses for patients with blood pressure, type two (high and low) on a scale type specifications of music in the circumstances (not taking drugs, vacation work), and compared with the responses of healthy patient's in the same conditions depending on the variable (sex, and function).
The limits of the study:
Limited research on the study of type responses emotional music for patients with hypertension (high and low) and responses healthy patients with some minor illnesses (flu and cough) among a sample of students and staff of the University of Belarusian government in the province (Minsk) for the academic year 2012
Research procedures: -
Adopted researcher in this study approach to the comparative study, in order to achieve the objectives of the research has built scale measures the kinds of music and specifications, which translated to Russian language commensurate with the community discussed (Belarus). The measure of a damaged (29) item, and damaged the meter itself of three musical notes in order to identify the extent of emotional responses to the sample of the music. These melodies are ((Dvork, Mozart, Straus).
The study sample consisted (comparison) of (56) individuals who were divided into two groups. Each group consisted of (28) individuals. The first group included patients who suffer from hypertension (high and low), and the second group consisted of patients who suffer from diseases flu and cough. Each group was divided in turn according to the sex variable, and function to (14) patients were male and (14) of the women, and (14) patients and staff (14) of the students. The researcher applied the measure with them to listen to the music composed by the two conditions: -
1 - The first envelope (taking drugs, and work)
2 - The second envelope (not taking drugs, and vacation work).
In order to apply the scale, the researcher extracted validity and reliability him. Where the researcher offered items scale with melodies on a group of experts in order to extract the face validity, as well as the extracted researcher construct validity and discrimination power, plus it was extracted reliability of the scale Cronbach alpha. And thus became the scale in favor of the application.
Results of the study: -
First - the emotional responses of patients with blood pressure similar to the emotional responses of patients suffering from diseases (flu, cough). Except two conditions: -
1-characterized by a group of male disease ill blood pressure responses emotional range of top male ill (flu and cough) in the second phase of the music (Dvork)
2-characterized by a group of male patients suffering from diseases blood pressure responses emotional range of top male ill (flu and cough) in the first phase of the music (Mozart).
Second: -The types of music used in the current research on the impact responses of patients in general.
After obtaining the results of the study researcher presented a number of recommendations and suggestions for the use of music for patients with blood pressure.
Music therapy can decrease illness- and treatment-related symptoms for adults in medical settings. In these environments, service users often decide to accept or decline music therapy after a brief introduction by the music therapist. As there is limited literature exploring the challenges related to these introductions, the purpose of this interpretivist study was to describe how music therapists introduce music therapy in the form of patient-preferred live music (MT-PPLM) in adult medical settings to augment the likelihood of patients accepting treatment. We conducted semi-structured interviews with nine participants who had experience providing MT-PPLM in adult medical settings. In this exploratory interpretivist study, we used an inductive approach to thematic analysis and incorporated member-checking to augment trustworthiness and credibility of the results. We identified three themes (supported by eight subthemes depicted in parentheses): (A) Offer patient a unique interaction through verbal and nonverbal techniques (Provide opportunities for patient control; Engage patient through nonmedical dialogue; and Use affect and body language to convey a different demeanor); (B) Clarify expectations related to patient and session (Avoid the word “therapy”; Use the music to explain the intervention; and Mention clinical benefits to describe what the patient can expect from the session); and (C) Respond to patient’s verbal and nonverbal communication (Assess patient and adapt introduction; and Validate patient’s response). The findings offer introductory techniques for music therapists that may increase the likelihood of adults in medical settings accepting MT-PPLM. Implications for clinical practice, ethical considerations, limitations, and suggestions for future research are provided.
Background
This study explores live and recorded music listening in the outpatient pain clinic. There is evidence demonstrating the effectiveness of live and recorded music in a hospital setting but a comparison study of this kind has yet to be conducted.
Methods
A multimethod survey study design was used. A questionnaire utilizing rating scales was self-administered across two outpatient pain clinic waiting rooms. Patients were included through convenience sampling. In one clinic, a playlist of recorded music curated by two of the authors was provided. In the second clinic, a music therapy student played live music using guitar, flute, and voice. The questionnaire gathered data on music's impact on pain and emotional states, as well as attitudes toward music in the waiting room. Quantitative data was analyzed using descriptive statistics and qualitative data, gathered in the questionnaires open ended question, was analyzed using thematic analysis.
Results
The questionnaire was completed by 200 adult patients. Patients reported lowered levels of anxiety, stress, and pain in both clinics, as well as a shorter waiting time and more caring experience. Patients in the live music clinic reported that music lowered levels of stress, nervousness, agitation, and pain more than in the recorded music clinic.
Conclusions
Participants in this study identified that music is a useful tool in the pain clinic waiting room. This study contributes to evidence that music should be considered as a complimentary treatment for people living with pain and in the wider hospital setting. Additional research is warranted with a control group, pre- and posttesting, and studies of music in hospitals in a range of cultural contexts.
Με τον όρο ψυχική ανθεκτικότητα ορίζουμε την ικανότητα του ατόμου να ξεπερνά καταστάσεις κρίσης που του δημιουργούν έντονο άγχος και ανασφάλεια και να συνεχίζει την εξέλιξή του. Η ψυχική ανθεκτικότητα εμπεριέχει τη δύναμη της θετικής σκέψης, καθώς και την ικανότητα του ατόμου να αναγνωρίζει τα δυνατά του σημεία και να τα χρησιμοποιεί για την επίλυση των ποικίλων αντιξοοτήτων που αντιμετωπίζει. Επιπλέον, σχετίζεται και με την αναζήτηση κατάλληλης βοήθειας. Για τα παιδιά η ψυχική ανθεκτικότητα είναι ένας ουσιαστικός μηχανισμός που μπορεί να τα βοηθήσει σημαντικά στην πρόληψη ψυχικών διαταραχών και στην ανάπτυξη γνωστικών και κοινωνικών δεξιοτήτων, ως παραγόντων προστατευτικών για την ψυχοσωματική τους υγεία. Ειδικότερα για τα παιδιά που έχουν υποστεί οποιασδήποτε μορφής κακοποίηση ή/και παραμέληση, η ανάπτυξη ψυχικής ανθεκτικότητας είναι ιδιαίτερα σημαντική ώστε να βοηθηθούν να ξεπεράσουν τα άσχημα τραυματικά γεγονότα που έχουν υποστεί και να αναπτύξουν αισιόδοξη στάση απέναντι στη ζωή.
Σκοπός της εισήγησης αυτής είναι να εξετάσει πώς η ανάπτυξη ψυχικής ανθεκτικότητας μπορεί να βοηθήσει ανηλίκους που βρίσκονται υπό την εποπτεία των συστημάτων παιδικής προστασίας σε Ελλάδα και Κύπρο, λόγω του ότι έχει αφαιρεθεί από τους βιολογικούς τους γονείς η επιμέλεια και η γονική μέριμνα, να αποβάλλουν τα αρνητικά βιώματά τους και να επανακτήσουν μια θετική στάση για τη ζωή. Συγκεκριμένα στην εισήγηση αυτή θα μελετηθεί η συμβολή της θετικής κοινωνικής εργασίας και της θεωρίας των δυνατών σημείων ώστε να χτιστεί η ψυχική ανθεκτικότητα σε ανηλίκους που έχουν υποστεί βία, κακοποίηση και παραμέληση, με αποτέλεσμα να παρέμβει η κοινωνική πρόνοια και η δικαιοσύνη και να απομακρυνθούν από το οικογενειακό τους περιβάλλον. Επίσης, θα διερευνηθούν οι προστατευτικοί παράγοντες εκείνοι που ενισχύουν τους ανηλίκους με τραυματικά βιώματα να αναπτύξουν τα δυνατά τους σημεία, να αποκτήσουν ψυχική ανθεκτικότητα και κατ’ επέκταση να μετατρέψουν την ευαλωτότητά τους σε κοινωνική προσαρμοστικότητα, απόδοση θετικότερου νοήματος στην καθημερινότητα και ελπίδα για τη μελλοντική τους πορεία.
We assessed the association between anxiety and hypertension in adults via a systematic review/meta-analysis. We searched PubMed, Ovid, and PsycINFO through 27 March 2020 with no language or publication type restrictions and systematically contacted study authors for unpublished information/data. We meta-analysed 59 studies including a total of 4,012,775 participants. Study quality was rated with the Newcastle-Ottawa Scale and random-effects analyses were performed. A significant anxiety-hypertension association was found in cross-sectional (OR = 1.37, 95% CI = 1.21-1.54) and prospective studies (OR = 1.40, 95% CI = 1.23-1.59). In sensitivity analyses, results were influenced by method of hypertension diagnosis, but not by study quality, method of anxiety diagnosis, study population, and effect size type. In subgroup analyses, study location, in particular country economic status, but not participant age, influenced the results. Longitudinal data and theoretical literature indicate that anxiety may precede hypertension. These findings have important clinical implications for the early detection and treatment of both anxiety and hypertension. Suggestions for future research are discussed.
The aim of this study was to evaluate the effect of music on patients’ heart rate, blood pressure, nausea and vomiting in the intraoperative and perioperative period. We searched randomised clinical trials (RCT) and controlled clinical trials and abstracts of major conferences comparing music with placebo from Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed, Google Scholar, Embase and Scopus using key words music, surgery, intraoperative, postoperative pain, heart rate, blood pressure, nausea and vomiting. Our last search was on 30th May 2020. We included patients of all ages admitted for any kind of surgery. Quality of trials was assessed using Cochrane collaboration tools. Results and data were screened and assessed independently. Outcome parameters were levels of pain, heart rate, systolic/diastolic blood pressure, nausea and vomiting during and after surgery.We included 67 trials. Music reduced pain (mean difference random effects − 0.72, 95% CI − 1.01 to − 0.42) and heart rate (Std mean difference random effects − 0.37, 95% CI − 0.66 to − 0.08) compared to controls. However, there was no association between music and systolic/diastolic blood pressure, nausea or vomiting.The reduction of pain sensation and heart rate in the perioperative period may indicate a positive effect of playing music to patients in a surgical setting. Further research is needed to specify how such measures could be best integrated into anaesthesiological procedures to alleviate stress for patients.
This study aims to evaluate the efficacy of music therapy on anxiety from randomized controlled trials (RCTs). The following electronic databases were utilized for selecting eligible studies that were published from inception to March 2021: PubMed, Cochrane Library, PsycINFO, Medline, Web of Science, and Embase. Standard mean difference (SMD) with 95% confidence interval (CI) values were used to evaluate the efficacy of music therapy on anxiety. Thirty-two studies with 1,924 participants were included in the meta-analysis. Music therapy lasted an average of 7.5 sessions (range, 1-24 sessions), while the average follow-up duration was 7.75 weeks (range, 1-16 weeks). Music therapy significantly reduced anxiety compared to the control group at post-intervention (SMD = -0.36, 95% CI: -0.54 to -0.17, p < 0.05), but not at follow-up (SMD = -0.23, 95% CI: -0.53 to 0.08, p >0.05). Subgroup analysis found a significantly positive effect of music therapy on anxiety in < 60 and ≥ 60 age-group (SMD = -0.31, 95% CI: -0.52 to -0.09, p < 0.05; SMD = -0.45, 95% CI: -0.85 to -0. 05, p < 0.05), developed and developing country group (SMD = -0.28, 95% CI: -0.51 to -0.06, p < 0.05; SMD = -0.49, 95% CI: -0.80 to -0.17, p < 0.05), < 12 and ≥ 12 sessions group (SMD = -0.24, 95% CI: = -0.44 to -0.03, p < 0.05; SMD = -0.59, 95% CI: -0.95 to -0.22, p < 0.05), respectively. Our study indicated that music therapy can significantly improve anxiety during treatment. But given that only eight RCTs reported the effects of music therapy at follow-up and the duration of follow-up was inconsistent, further researches are needed on the lasting effects after the intervention is discontinued.
Zusammenfassung. Hintergrund: Herzkatheteruntersuchungen sind mittlerweile Routineverfahren. Da viele Patienten die Untersuchung als belastend empfinden, wurden begleitende psychosoziale Interventionen vorgeschlagen. Ziel der vorliegenden Studie war die Überprüfung der Wirksamkeit von Musiktherapie bei Herzkatheteruntersuchungen auf das subjektive und objektive Angsterleben sowie eine daraus folgende Reduktion von Sedativa. Methoden: Eine dreiarmige (Musikexposition während der HKU; Musikexposition + ergänzendes musiktherapeutisches Coaching; Kontrollgruppe mit Standardbehandlung) randomisierte Studie mit N = 83 Patienten (48 männlich, 35 weiblich, Alter 66 ± 11 Jahre). Zielvariablen waren subjektiv empfundene Angst (STAI-S) sowie physiologische Variablen (Blutdruck, Puls, Cortisol, IgA). Ergebnisse: In der Expositionsgruppe konnte die subjektive Angst (STAI-S) gegenüber den beiden anderen Gruppen prä-post signifikant gesenkt werden (Exposition 11 P, Coaching 4 P, Kontrolle 6 P; p = .033). Die physiologischen Werte unterschieden sich jedoch nicht, ebenso wenig die Medikation. Diskussion: Durch musikalische Stimulation kann das subjektive Angsterleben beeinflusst werden. Auf physiologische Parameter nimmt die Musikintervention nicht so gezielt Einfluss. In der klinischen Anwendung lässt sich der Einsatz adjuvanter Musiktherapie in Form der Exposition rechtfertigen und empfehlen.
Objective: The purpose of the current study was to investigate the effect of music therapy on preoperative anxiety levels in Turkish men undergoing urogenital surgery. Design: The study employed a quasi-experimental design. Patients were selected using randomized controlled sampling. Setting: The study was conducted in a urology clinic in Aziziye Research Hospital, Süleyman Demirel Medical Centre, Atatürk University, Erzurum, a city in the east of Turkey. Subjects: The study was conducted with a total of 64 patients; 32 in the experimental group; 32 in the control group; aged between 18 and 65; and able to speak, read and write Turkish. Intervention: The control group received routine preoperative care while the experimental group listened to their choice of music for 30 minutes in their room while they awaited surgery. Main outcome measures: Pre and post test anxiety was measured using the State Trait Anxiety Inventory (STAI) to assess anxiety before and after listening to the music preferred by the patient. Results: Anxiety score averages between the groups following the music therapy were statistically significant (p<0.001); 33.68 (SD=8.03) for the experimental group and 44.43(SD=10.42) for the control group. Conclusions: These findings support the use of music as an independent nursing intervention to manage preoperative anxiety in patients undergoing urogenital surgery. Listening to self-selected music during the preoperative period can effectively reduce anxiety levels and should be a useful tool for preoperative nursing.
Depression and anxiety are associated with increased risk of postoperative cardiac events and death in patients who have undergone coronary artery bypass graft surgery. These risks persist even several months after the procedure. Guided imagery has been used with cardiac surgery patients for some time and with numerous anecdotal reports of considerable benefit. In addition, this therapy is low-cost and easy to implement, and the literature holds ample evidence for its efficacy in symptom reduction in various patient populations. It was thus hypothesized that preoperative use of guided imagery would reduce postoperative distress in patients undergoing coronary artery bypass graft. Fifty-six patients scheduled to undergo coronary artery bypass graft at Columbia University Medical Center were randomized into 3 groups: guided imagery, music therapy, and standard care control. Patients in the imagery and music groups listened to audiotapes preoperatively and intraoperatively. All patients completed psychological, complementary medicine therapies use, and other assessments preoperatively and at 1 week and 6 months postoperatively. Only preoperative distress was predictive of postoperative distress at follow-up. Use of complementary medicine therapies was high in all groups and this fact, in addition to the small sample size, may have accounted for the lack of significant relationship between imagery and postoperative distress. Regardless, this complementary and alternative medicine therapy remains palatable to patients. Given its efficacy in other patient populations, it is worth exploring its potential utility for this population with a larger sample.
Control of stress and anxiety and the promotion of comfort are challenges facing health practitioners involved in catheterization. The aim of this case-control study was to examine the effect of music on the levels of anxiety, stress, and depression experienced by patients undergoing coronary angiography, as measured by the 21-item Depression Anxiety Stress Scales. Differences in pre- and post-intervention scores demonstrated that there were significant decreases in mean scores of state anxiety (P = 0.006), stress (P = 0.001) and depression P = 0.02) in the intervention group, who listened to 20 minutes of relaxing music, as compared with the control group who had 20 minutes of bed rest.
To evaluate the effect of bed rest with music on relaxation for patients who have undergone heart surgery on postoperative day one.
Music intervention has been evaluated as an appropriate nursing intervention to reduce patients 'pain, stress and anxiety levels in several clinical settings, but its effectiveness in increasing patients' subjective and objective relaxation levels has not been examined.
A randomised controlled trial.
Forty patients undergoing open coronary artery bypass grafting and/or aortic valve replacement surgery were randomly allocated to either music listening during bed rest (n = 20) or bed rest only (n = 20). Relaxation was assessed during bed rest the day after surgery by determining the plasma oxytocin, heart rate, mean arterial blood pressure, PaO2 SaO2 and subjective relaxation levels.
In the music group, levels of oxytocin increased significantly in contrast to the control group for which the trend over time was negative i.e., decreasing values. Subjective relaxation levels increased significantly more and there were also a significant higher levels of PaO2 in the music group compared to the control group. There was no difference in mean arterial blood pressure, heart rate and SaO2 between the groups.
Listening to music during bed rest after open-heart surgery has some effects on the relaxation system as regards s-oxytocin and subjective relaxations levels. This effect seems to have a causal relation from the psychological (music makes patients relaxed) to the physical (oxytocin release).
Music intervention should be offered as an integral part of the multimodal regime administered to the patients that have undergone cardiovascular surgery. It is a supportive source that increases relaxation.
Several studies have evaluated music interventions prior and after coronary angiography and percutaneous coronary intervention (PCI), but there is no clear evidence showing that music has an effect on patients during these procedures. The purpose was to investigate the effects of music on anxiety, angina, pain, relaxation, and comfort in patients during angiographic procedures and to evaluate gender differences. The study was a four-armed, prospective randomized controlled trial included 240 patients undergoing coronary angiography and/or PCI. Patients were allocated to receive relaxing music, MusiCure or standard care during the procedure. Outcome measures were; puncture pain and the discomfort related to it, angina and the discomfort related to it, anxiety, experience of the sound environment, discomfort of lying still, and the doses of anxiolytics and analgesics during the procedure. No differences were found between the music and control groups regarding any of the trial endpoints or gender-related differences. The overall rating of the sound environment and feeling of relaxation was high. In conclusion, music intervention in patients undergoing angiographic procedures was highly feasible, but not effective in this study though the delivery of music went smoothly and did not disturb the examination and patients and staff alike looked favorably on it.
The purpose of this study was to determine whether relaxation and music therapy were effective in reducing stress in patients in a coronary care unit admitted with the presumptive diagnosis of acute myocardial infarction. In this experimental study, 80 patients were randomly assigned to a relaxation, music therapy, or control group. The relaxation and music therapy groups participated in three sessions over a two-day period. Stress was evaluated by apical heart rates, peripheral temperatures, cardiac complications, and qualitative patient evaluative data. Data analysis revealed that lowering apical heart rates and raising peripheral temperatures were more successful in the relaxation and music therapy groups than in the control group. The incidence of cardiac complications was found to be lower in the intervention groups, and most intervention subjects believed that such therapy was helpful. Both relaxation and music therapy are effective modalities to reduce stress in these patients.
A randomized, single-blinded, placebo-controlled trial examined the benefits of taped therapeutic suggestions and taped music in coronary-artery-bypass patients. Sixty-six patients listened to either suggestion tapes or music tapes, intraoperatively and postoperatively; 29 patients listened to blank tapes intraoperatively and listened to no tapes postoperatively. Half the patients who listened to a tape found it helpful. There were no significant differences between groups in length of SICU or postoperative hospital stay, narcotic usage, nurse ratings of anxiety and progress, depression, activities of daily living, or cardiac symptoms. There were no significant differences in these same outcomes between the patients who were helped by the tapes and the patients not helped. These results suggest that if taped therapeutic suggestions have a measurable effect upon cardiac surgery patients, demonstrating this effect will require more detailed patient evaluations to identify subgroups of patients responsive to this type of intervention.
Music has been used in the acute clinical care setting as an adjunct to current treatment modalities. Previous studies have indicated that some types of music may benefit patients by reducing pain and anxiety, and may have an effect on physiological measures.
To evaluate the scientific foundation for the implementation of a complementary therapy, harp playing. The research questions for this pilot study were: Does live harp playing have an effect on patient perception of anxiety, pain, and satisfaction? Does live harp playing produce statistically and clinically significant differences in physiological measures of heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation?
A prospective, quasiexperimental, repeated measures design was used with a convenience sampling.
Orlando Regional Medical Center, Orlando Fla.
Subjects wer eligible for the study if they were postoperative and admitted to a hard-wired-bedside-monitored room of the Vascular Thoracic Unit within the 3 days of the study period.
A singl e20-minute live harp playing session.
Visual analog scales (VAS) were used to measure patient anxiety and pain. Patient satisfaction was measured with a 4-item questionnaire. Physiological measures (heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation) were recorded from the bedside monitor.
Visual analog scales (VAS) were completed just before harp playing, 20 minutes after harp playing was started, and 10 minutes after completion. Patient satisfaction with the experience was measured with a 4-item questionnaire. Physiological measures (heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation) were recorded from the bedside monitor at baseline (5 minutes before study setup), at zero, 5, 10, 15, and 20 minutes after harp playing began, and at 5 and 10 minutes after harp playing stopped.
Seventeen patients were used in this study, with a retrospective power of .91. Results indicate that listening to live harp music has a positive effect on patient perception of anxiety (P=.000), pain (P=.000) and satisfaction. Live harp playing also produced statistically significant differences in physiological measures of systolic blood pressure (P=.046), and oxygen saturation (P=.011). Although all values over time trended downward, the changes of other variables were not adequate to achieve statistical or clinical significance.
Subjects in this study experienced decreased pain and anxiety with the harp intervention, and slight reductions in physiologic variable values. It is not possible in this study to determine if the results were due to the harp music, the presence of the harpist and data collector, or both. Future research is recommended using a control group and comparison of live versus recorded harp music with a wider variety of diagnoses and procedures.
Cochrane Reviews have recently started including the quantity I 2 to help readers assess the consistency of the results of studies in meta-analyses. What does this new quantity mean, and why is assessment of heterogeneity so important to clinical practice?
Systematic reviews and meta-analyses can provide convincing and reliable evidence relevant to many aspects of medicine and health care.1 Their value is especially clear when the results of the studies they include show clinically important effects of similar magnitude. However, the conclusions are less clear when the included studies have differing results. In an attempt to establish whether studies are consistent, reports of meta-analyses commonly present a statistical test of heterogeneity. The test seeks to determine whether there are genuine differences underlying the results of the studies (heterogeneity), or whether the variation in findings is compatible with chance alone (homogeneity). However, the test is susceptible to the number of trials included in the meta-analysis. We have developed a new quantity, I 2, which we believe gives a better measure of the consistency between trials in a meta-analysis.
Assessment of the consistency of effects across studies is an essential part of meta-analysis. Unless we know how consistent the results of studies are, we cannot determine the generalisability of the findings of the meta-analysis. Indeed, several hierarchical systems for grading evidence state that the results of studies must be consistent or homogeneous to obtain the highest grading.2–4
Tests for heterogeneity are commonly used to decide on methods for combining studies and for concluding consistency or inconsistency of findings.5 6 But what does the test achieve in practice, and how should the resulting P values be interpreted?
A test for heterogeneity examines the null hypothesis that all studies are evaluating the same effect. The usual test statistic …
To investigate the effect of a specially selected music sound environment on the feeling of wellbeing of adult, lightly sedated patients in a Cardiac Catheter Laboratory undergoing invasive procedures.
Patients (n=193) were randomly assigned to either a music group, who listened to music during the procedure (n=99) or to a non-music group (n=94). Immediately after the procedure all patients were interviewed by a questionnaire about their opinion of the sound environment in the room and about their feeling of wellbeing.
In the music group 91% of the patients defined the sound environment as very pleasant/pleasant - compared to 56% in the non-music group. The number of patients with 'no opinion' on the sound environment was lower in the music group than in the non-music group (8% vs. 42%). In the non-music group only 34% of the patients would have liked to listen to music, if possible, whereas 82% of the patients in the music group were very pleased/pleased with the music. Both groups noticed basic sounds and noises with similar frequencies. In the music group 62% of the patients noticed the music spontaneously. Sixty-eight patients (68%) reported that music was of major positive importance to their feeling of wellbeing. These patients expressed that music made them feel less tense, more relaxed and safe. The results were not related to age, sex or procedure.
Specially selected music had a positive effect on the wellbeing of patients and their opinion on the sound environment during invasive cardiac procedures. Based on the negative expectations and the positive experience of the patients with regard to music environment, we suggest that specially selected music should be a part of the sound environment in the Cardiac Catheter Laboratory.
To investigate, both objectively and subjectively, the effect of music on children in a pediatric cardiac intensive care unit following heart surgery, in conjunction with standard care.
Randomized clinical trial with placebo, assessing 84 children, aged 1 day to 16 years, during the first 24 hours of the postoperative period, given a 30 minute music therapy session with classical music and observed at the start and end of the session, recording heart rate, blood pressure, mean blood pressure, respiratory rate, temperature and oxygen saturation, plus a facial pain score. Statistical significance was set at 5%.
Five of the initial 84 patients (5.9%) refused to participate. The most common type of heart disease was acyanotic congenital with left-right shunt (41% of cases: 44.4% of controls). Statistically significant differences were observed between the two groups after the intervention in the subjective facial pain scale and the objective parameters heart rate and respiratory rate (p < 0.001, p = 0.04 and p = 0.02, respectively).
A beneficial effect from music was observed with children during the postoperative period of heart surgery, by means of certain vital signs (heart rate and respiratory rate) and in reduced pain (facial pain scale). Nevertheless, there are gaps to be filled in this area, and studies in greater depth are needed.
Background: Receptive music therapy is widely applied in patients with cardiovascular diseases. We studied the impact of listening to music on physiological variables. Patients and methods: In a prospective clinical intervention study 40 patients (mean age 56+/-10 years) with angiographically proven coronary artery disease (n=20) or arterial hypertension (n=20) and 20 healthy control subjects (26+/-3 years) were investigated before and after listening meditative music (by R. Shankar), rhythmic music (by J. Strauss) and non-rhythmic music (by H. W. Henze). Adrenaline, noradrenaline, cortisol, prolactin, atrionatriuretic peptide and tissue plasminogen activator were measured. Hemodynamic data were recorded including heart rate, blood pressure and various parameters of left ventricular diastolic function by means of Doppler echocardiography. The actual mood of the participants was assessed by a psychometric score (Zerssen). Results: Systolic blood pressure was significantly lower after the music of Shankar in patients (-5 mmHg, p=0.011). Cortisol levels fell after all three pieces of music in patients but only after Shankar in controls. In patients, adrenaline (-6.1 ng(.)l(-1), p=0.015) and noradrenaline (-42.7 ng(.)l(-1), p=0.082) were lower after Shankar, and noradrenaline decreased (-40.4 ng(.)l(-1), p=0.015) in controls after this music. The changes of mood were inversely linear correlated with adrenaline (r=-0.384, p=0.017) and noradrenaline (r=-0.375, p=0.02) in patients after music of Shankar. Conclusions: A short period of listening to different types of music lowers stress in patients and controls. Listening to music has a potential as adjuvant stress reducing therapy and the effects seem to be independent of the individual music perception.
A broadcast music system has evolved at Piedmont Hospital in Atlanta, Georgia, that brings music into the intensive care units (ICUs), operating rooms, perioperative areas, gastrointestinal lab, and labor and delivery. A number of years ago, Piedmont Hospital extended its 10-channel music system to the open-heart ICU area, and a pilot study using headphone music was done on a convenience sample of 67 patients admitted to this particular ICU area who recovered from coronary artery bypass graft surgery (without valve repair). Patients receiving the treatment (music) spent significantly less time in the ICU (1,357 minutes vs. 1,657 minutes, F = 4.29, p = .02). There was a trend for lower sedative charges and ICU charges, but these were not significant. The financial cost of incorporating music in the care of cardiac and cardiac surgery ICU patients is relatively small compared to the potential economic benefits.
A unique environmental situation, often stressful for patient and staff alike, is found in intensive coronary care units.
This study was designed to test the effectiveness of programmed taped music in reducing stress for the patient and in creating
an auxiliary treatment approach for the nursing personnel. Four programs of carefully selected sequenced music were produced
to be played either “free field” or through earphones. The music was chosen by the investigator. At two different intensive
coronary care units, four measures were taken of the physiological, psychological, and social reactions of patients and personnel
to the introduction of music of a sedative nature. The results included significant findings in the direction of decreased
heart rate, greater tolerance of pain and suffering, lessened anxiety and depression in patients, and positive changes in
target behaviors pre- to post-music, as reported by nurse evaluators.
Objective:
To examine the influence during the early postoperative period of selected nursing interventions on mood and anxiety of patients undergoing heart surgery.
Design:
Prospective, repeated measures, quasiexperimental, random assignment.
Setting:
The cardiovascular intensive care and progressive care units of a midwestern community hospital were used as the setting for this study.
Patients:
Ninety-six patients who underwent elective, heart bypass surgery; the mean age of the subjects was 67 years, with an age range of 37 to 84 years. Most subjects were men (n = 65, 68%).
Outcome measures:
Physiologic measures of anxiety and mood include blood pressure and heart rate. Additional measures included the use of Spielberger's state-trait anxiety inventory (STAI) and patient verbal ratings of both mood and anxiety with use of a numeric rating scale (NRS).
Intervention:
Patients were randomly assigned to one of three groups: (1) music therapy, (2) music-video therapy, or (3) scheduled rest group. Subjects in the groups received their assigned 30-minute intervention at two episodes on postoperative days 2 and 3. Subjects had physiologic measures of blood pressure and heart rate measured immediately before the intervention and at 10-minute intervals throughout the intervention. Mood and anxiety were evaluated by having subjects use a NRS (i.e., 0 to 10) to give rating of mood and anxiety immediately before and after each session. Anxiety was further measured with the STAI. A baseline measure of STAI was taken before surgery; patients also completed the "state" anxiety tool before the intervention session on postoperative day 2 and on completion of the session on postoperative day 3.
Results:
With use of an analysis of covariance (ANCOVA), subjects' mood ratings showed significant improvement in mood among subjects in the "music intervention" group after the second intervention when controlling for the preintervention rating of mood, F(2, 87) = 4.33, p = 0.016. However, no significant differences were reported for anxiety ratings as measured by the NRS and state anxiety instruments. With use of repeated measures analysis of variance (ANOVA), there were no significant interactions between the intervention groups and time for any of the physiologic variables. However, there were significant main effects over time for heart rate and systolic and diastolic blood pressure, which indicated a generalized physiologic relaxation response.
Conclusions:
Although none of the three interventions was overwhelmingly superior, the overall response by all intervention groups demonstrated a generalized relaxation response. It is also important to note that there was reduced anxiety and improved mood within all three groups.
Unlabelled:
EXECUTIVE SUMMARY:
Background:
Anticipation of an invasive procedure in hospital is likely to provoke feelings of anxiety and stress in patients. An unfamiliar environment, loss of control, perceived or actual physical risk, dependence on strangers and separation from friends and family are all factors that can contribute to the development of such feelings. Recently, there has been considerable interest in the anxiolytic potential of music listening in a variety of clinical settings, yet thus far, little is known about the impact of music listening on the pre-procedural patient population. A systematic review of all literature to date was indicated to improve understanding of outcomes and impact of music listening on pre-procedural anxiety, thus helping nurses decide whether or not to incorporate music listening into practice and to highlight a need, or otherwise, for a related primary research agenda.
Objective:
The objective of this review was to determine the best available evidence on the effectiveness of music listening in reducing adult hospital patients' pre-procedural state anxiety.
Inclusion criteria:
Types of studies This review included randomised controlled trials and quasi-experimental research designs that examined the efficacy of music listening in reducing state anxiety among pre-procedural hospital patients published between January 1985 and February 2006. The search was limited to publications after 1985 to coincide with the increasing interest and use of complementary therapies within health care during the 1980s and 1990s. Types of participants Participants of interest to the review were adult day patients, ambulatory patients and inpatients who were about to undergo any type of clinical procedure. Types of intervention The review focused on studies that investigated pre-procedural music listening employed and prescribed as a potentially therapeutic activity. It excluded any other form of music therapy. Types of outcome measures The primary outcome measures examined were alterations in state anxiety and a variety of physiological variables such as blood pressure and respiration and heart rates.
Search strategy:
A search for published and unpublished literature between January 1985 and February 2006 was conducted using all major electronic databases. A three-step search strategy was devised which consisted of using high-precision MeSH terminology and keywords to ensure that all material relevant to the review was captured. CRITICAL APPRAISAL: The methodological quality of included studies was assessed by two reviewers, who appraised each study independently, using the standard Joanna Briggs Institute (JBI) critical appraisal tools.
Data extraction and synthesis:
Data were extracted from the studies that were identified as meeting the criteria for methodological quality using a data-extraction tool developed for the review. Studies were grouped by outcome measure and summarised using tabular and narrative formats.
Results:
The review demonstrated that state anxiety is defined and measured using both psychological and physiological parameters. Music listening had a consistently positive and statistically significant effect on reducing psychological parameters of pre-procedural state anxiety. However, the results from the measurement of various pre-procedural physiological parameters failed to reveal any consistent positive changes in patients who had listened to music. This calls into question the adequacy of the theories in this area which link anxiety and the automated and central nervous systems and the effect that music listening may have on these processes and physiological responses.
Conclusions/implications for practice:
1 In order to reduce anxiety, it is likely that patients will benefit psychologically from having the opportunity to listen to music in the immediate pre-procedural period. 2 Patients do not appear to experience any alteration in physiological status as a result of listening to music. 3 Further research is indicated in order to replicate existing studies, to strengthen the evidence to support such interventions and to establish intervention parameters. 4 Further research is needed analysing the physiological mechanisms by which music listening is believed to reduce state anxiety and the contribution of the automated and other nervous systems to this reduction.
Background:
Mechanical ventilation often causes major distress and anxiety in patients. The sensation of breathlessness, frequent suctioning, inability to talk, uncertainty regarding surroundings or condition, discomfort, isolation from others, and fear contribute to high levels of anxiety. Side effects of analgesia and sedation may lead to the prolongation of mechanical ventilation and, subsequently, to a longer length of hospitalization and increased cost. Therefore, non-pharmacological interventions should be considered for anxiety and stress management. Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients; however, their efficacy for mechanically ventilated patients needs to be evaluated. This review was originally published in 2010 and was updated in 2014.
Objectives:
To update the previously published review that examined the effects of music therapy or music medicine interventions (as defined by the authors) on anxiety and other outcomes in mechanically ventilated patients. Specifically, the following objectives are addressed in this review.1. To conduct a meta-analysis to compare the effects of participation in standard care combined with music therapy or music medicine interventions with standard care alone.2. To compare the effects of patient-selected music with researcher-selected music.3. To compare the effects of different types of music interventions (e.g., music therapy versus music medicine).
Search methods:
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 2), MEDLINE (1950 to March 2014), CINAHL (1980 to March 2014), EMBASE (1980 to March 2014), PsycINFO (1967 to March 2014), LILACS (1982 to March 2014), Science Citation Index (1980 to March 2014), www.musictherapyworld.net (1 March 2008) (database is no longer functional), CAIRSS for Music (to March 2014), Proquest Digital Dissertations (1980 to March 2014), ClinicalTrials.gov (2000 to March 2014), Current Controlled Trials (1998 to March 2014), the National Research Register (2000 to September 2007), and NIH CRISP (all to March 2014). We handsearched music therapy journals and reference lists, and contacted relevant experts to identify unpublished manuscripts. There was no language restriction. The original search was performed in January 2010.
Selection criteria:
We included all randomized and quasi-randomized controlled trials that compared music interventions and standard care with standard care alone for mechanically ventilated patients.
Data collection and analysis:
Two review authors independently extracted the data and assessed the methodological quality of included studies. We contacted authors to obtain missing data where needed. Where possible, results for continuous outcomes were presented in meta-analyses using mean differences and standardized mean differences. Post-test scores were used. In cases of significant baseline difference, we used change scores. For dichotomous outcomes, we presented the results as risk ratios.
Main results:
We identified six new trials for this update. In total, the evidence for this review rests on 14 trials (805 participants). Music listening was the main intervention used, and 13 of the studies did not include a trained music therapist. Results indicated that music listening may be beneficial for anxiety reduction in mechanically ventilated patients. Specifically, music listening resulted, on average, in an anxiety reduction that was 1.11 standard deviation units greater (95% CI -1.75 to -0.47, P = 0.0006) than in the standard care group. This is considered a large and clinically significant effect. Findings indicated that listening to music consistently reduced respiratory rate and systolic blood pressure, suggesting a relaxation response. Furthermore, one large-scale study reported greater reductions in sedative and analgesic intake in the music listening group compared to the control group, and two other studies reported trends for reduction in sedative and analgesic intake for the music group. One study found significantly higher sedation scores in the music listening group compared to the control group.No strong evidence was found for reduction in diastolic blood pressure and mean arterial pressure. Furthermore, inconsistent results were found for reduction in heart rate with seven studies reporting greater heart rate reductions in the music listening group and one study a slightly greater reduction in the control group. Music listening did not improve oxygen saturation levels.Four studies examined the effects of music listening on hormone levels but the results were mixed and no conclusions could be drawn.No strong evidence was found for an effect of music listening on mortality rate but this evidence rested on only two trials.Most trials were assessed to be at high risk of bias because of lack of blinding. Blinding of outcome assessors is often impossible in music therapy and music medicine studies that use subjective outcomes, unless the music intervention is compared to another treatment intervention. Because of the high risk of bias, these results need to be interpreted with caution.No studies could be found that examined the effects of music interventions on quality of life, patient satisfaction, post-discharge outcomes, or cost-effectiveness. No adverse events were identified.
Authors' conclusions:
This updated systematic review indicates that music listening may have a beneficial effect on anxiety in mechanically ventilated patients. These findings are consistent with the findings of three other Cochrane systematic reviews on the use of music interventions for anxiety reduction in medical patients. The review furthermore suggests that music listening consistently reduces respiratory rate and systolic blood pressure. Finally, results indicate a possible beneficial impact on the consumption of sedatives and analgesics. Therefore, we conclude that music interventions may provide a viable anxiety management option to mechanically ventilated patients.
Music therapy is increasingly used in end-of-life care, with a growing number of music therapists being employed in hospices and hospital-based palliative care programs each year. Music therapy in end-of-life care aims to improve a person's quality of life by helping relieve symptoms, addressing psychological needs, offering support and comfort, facilitating communication, and meeting spiritual needs. In addition, music therapists assist family and caregivers with coping, communication, and grief/bereavement. Music therapy requires the implementation of a music intervention by a trained music therapist, the presence of a therapeutic process, and the use of personally tailored music experiences. These music experiences may include listening to live, therapist-composed, improvised, or pre-recorded music, performing music on an instrument, improvising music spontaneously using voice or instruments, composing music, and music combined with other modalities (e.g. movement, imagery, art). Results indicate that music therapy may have a beneficial effect on the quality of life of people in end-of-life care. However, the results stem from a limited number of studies and the quality of the evidence is not strong. More research is needed. No evidence of effect was found for pain or anxiety. This may be due to the fact that only two studies with very small samples examined the effects of music therapy on these outcomes. There were insufficient data to examine the effect of music therapy on other physical, psychological, or social outcomes. More research is needed.
The purpose of this study was to investigate the influence of preferred music on the perceived exertion, mood, and time estimation of subjects exercising in a Cardiac Rehabilitation Program. Detailed descriptive data, under the conditions of music and no-music, were collected over 15 sessions of an established exercise program for four male patients who had been diagnosed with Cardiovascular Disease (CVD). Sessions consisted of three 10-minute exercise segments separated by 15-second breaks. Subjects alternated between exercising in a control (no-music) condition and an experimental (preferred-music) condition throughout the course of the 15 sessions. Data, in the form of perceived exertion, mood, and time estimation scores were collected immediately prior to, and after, each exercise segment. Results suggest that preferred-music listening may decrease perceived exertion, increase positive mood, and decrease estimations of time duration for some subjects.
To evaluate the effect of bed rest with music on the first postoperative day to decrease stress for patients who have undergone heart surgery.
A repeated-measures randomized controlled trial was used. The study took place in a cardiothoracic intermediary unit of a university hospital in Sweden. Fifty-eight patients who had undergone open coronary artery bypass grafting or aortic valve replacement surgery were included. Stress response was assessed by determining the serum cortisol, heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels. At 12:00 noon on postoperative day 1, patients were allocated to receive 30 minutes of uninterrupted bed rest with music and then 30 minutes of bed rest or alternatively 60 minutes of uninterrupted bed rest. The music was soft and relaxing, included different melodies in new-age style, played with a volume at 50 to 60 dB, and distributed through a music pillow connected to an MP3 player.
After 30 minutes of bed rest, there was a significant difference in s-cortisol levels between the groups; 484. 4 mmol/L in the music group versus 618.8 mmol/L in the control group (P < .02). However, this difference in s-cortisol levels was not found 30 minutes later (ie, after a total of 60 minutes). There was no difference in heart rate, respiratory rate, mean arterial pressure, arterial oxygen tension, arterial oxygen saturation, and subjective pain and anxiety levels between the groups.
There is sufficient practical evidence of stress reduction to suggest that a proposed regimen of listening to music while resting in bed after open heart surgery be put into clinical use.
Music therapy (MT) has been used in geriatric nursing hospitals, but there has been no extensive research into whether it actually has beneficial effects on elderly patients with cerebrovascular disease (CVD) and dementia. We investigated the effects of MT on the autonomic nervous system and plasma cytokine and catecholamine levels in elderly patients with CVD and dementia, since these are related to aging and chronic geriatric disease. We also investigated the effects of MT on congestive heart failure (CHF) events.Eighty-seven patients with pre-existing CVD were enrolled in the study. We assigned patients into an MT group (n = 55) and non-MT group (n = 32). The MT group received MT at least once per week for 45 minutes over 10 times. Cardiac autonomic activity was assessed by heart rate variability (HRV). We measured plasma cytokine and catecholamine levels in both the MT group and non-MT group. We compared the incidence of CHF events between these two groups. In the MT group, rMSSD, pNN50, and HF were significantly increased by MT, whereas LF/HF was slightly decreased. In the non-MT group, there were no significant changes in any HRV parameters. Among cytokines, plasma interleukin-6 (IL-6) in the MT group was significantly lower than those in the non-MT group. Plasma adrenaline and noradrenaline levels were significantly lower in the MT group than in the non-MT group. CHF events were less frequent in the MT group than in the non-MT group (P < 0.05). These findings suggest that MT enhanced parasympathetic activities and decreased CHF by reducing plasma cytokine and catecholamine levels.
The purpose of this study was to examine the effects of relaxing music on elevated state anxiety in patients with a confirmed medical diagnosis of acute myocardial infarction. In addition, the relationship between trait anxiety and state anxiety was analyzed. A purposive sample of 40 myocardial infarction patients was randomly assigned to an experimental or control group. Statistically significant reduction in heart rate, respiratory rate, and state anxiety scores were found in the group that listened to relaxing music. A statistically significant positive correlation was found between trait anxiety scores and baseline state anxiety scores. Statistically significant negative correlations were found between trait anxiety scores and the degree of change in posttreatment state anxiety scores when examined as a net change, as well as a percent change. Results suggested that music therapy may be an effective intervention to reduce state anxiety levels in the acute myocardial infarction patient.
Psychosocial adjustment following myocardial infarction (MI) has received significant research attention during the past 20 years. This article highlights research addressing the relationship of anxiety, depression, and denial in influencing specific outcomes following MI. Additional research describing patterns of emotional response to MI is also included. Based on reported research, specific nursing interventions, in a care plan format, are suggested to foster positive psychosocial outcomes in the post-MI patient. Even though a significant amount of research has been completed on this subject, definitive conclusions regarding patient management supportive of positive outcomes are not possible. Suggestions for future research focus on this topic area are identified.
In this experimental study we examined the effects of listening to relaxation-type music on self-reported anxiety and on selected physiologic indices of relaxation in patients with suspected myocardial infarction. Seventy-five patients were randomly assigned to one of two experimental groups, one listening to music and the other to "white noise," or to a control group. The State Anxiety Inventory was administered before and after each testing session, and blood pressure, heart rate, and digital skin temperature were measured at baseline and at 10-minute intervals for the 30-minute session. There was no significant difference among the three groups for state anxiety scores or physiologic parameters. Because no differences were found, analyses were conducted of the groups combined. Significant improvement in all of the physiologic parameters was found to have occurred. This finding reinforces the need for nurses to plan care that allows for uninterrupted rest for patients in the coronary care unit.
To test the efficacy of music and muscle relaxation techniques in reducing the anxiety of patients admitted to a coronary care unit with ischemic heart disease.
Randomized, controlled trial.
Seven-bed coronary care unit of an Australian tertiary care hospital.
Fifty-six patients admitted to a coronary care unit with unstable angina pectoris or acute myocardial infarction.
Psychologic (State Trait Anxiety Inventory, Hospital Anxiety and Depression Scale, Linear Analogue Anxiety Scale) and physiologic (systolic and diastolic blood pressure and heart rate) variables were measured as indicators of anxiety.
Two or three 30-minute sessions of audiotape interventions were conducted with portable tape players with headphones. The two intervention tapes consisted of light classical music and verbal instructions for muscle relaxation.
With analysis of variance procedures, the null hypotheses were supported. No significant differences (p < 0.05) between groups were demonstrated for the psychologic or physiologic variables; that is, no significant reductions in anxiety were achieved for patients using music or muscle relaxation interventions when compared with the control group. The effect size of the interventions on the outcome measures was 0.19 to 0.22, indicating a small effect. Resultant power was at a low level.
These results differ from those of similar studies but may be related to the high probability of a type II error. Further investigation with longer intervention sessions and larger sample sizes is indicated. Similar studies should incorporate power analysis when reporting their results.
The purpose of this experimental study was to determine the effects of second and third day postoperative music interventions (music, music video) on pain and sleep in 96 postoperative patients having CABG surgery. The Verbal Rating Scale scores obtained before and after each 30-minute session showed that pain decreased over time for all three groups with no difference across groups. The McGill Pain Questionnaire (MPQ) was administered before session 1 and after session 2, and results indicated that Sensory, Affective, and Present Pain Intensity subscales showed no group difference for pain; however, pain decreased from Day 2 to Day 3 for all three groups. For the evaluative component of pain, those in the music group had significantly (F[2,93] = 4.74, p < .05) lower scores on postoperative Day 2 than the rest period control group. Effects of the intervention on sleep as measured by the Richard Sleep Questionnaire indicated that the video group had significantly (F[2, 92] = 3.18, p < .05) better sleep scores than the control group on the third morning. These findings lend some support for selected music interventions.
To test the effects of music therapy on relaxation and anxiety reduction for patients receiving ventilatory assistance.
Two-group, pretest-posttest experimental design with repeated measures. Subjects randomized to either a 30-minute music condition or a rest period.
Four urban midwestern intensive care units.
Fifty-four alert, nonsedated patients receiving mechanical ventilation.
State anxiety (pretest and posttest), heart rate, and respiratory rate obtained every 5 minutes for 30 minutes.
Subjects who received music therapy reported significantly less anxiety posttest (10.1) than those subjects in the control group (16.2). Heart rate and respiratory rate decreased over time for those subjects in the music group as compared with the control group subjects.
A single music therapy session was found to be effective for decreasing anxiety and promoting relaxation, as indicated by decreases in heart rate and respiratory rate over the intervention period with this sample of patients receiving ventilatory assistance.
This project collected data on the use of auditory tapes to reduce acute distress in pediatric patients during cardiac catheterization. Observations by the medical staff as well as patients' subjective experience indicated that the tapes were a useful adjunct in helping young patients tolerate the distress of the medical procedure. Differences in benefits were noted depending on the age of the patients. The greatest benefits were seen in the less than 1-year-old and 7- to 12-year-old age groups.
This article is a comprehensive analysis and application of music therapy research in the general field of music in medicine,
and consists of a thorough review of the literature and a meta-analysis of all empirical studies using music in actual medical/dental
treatments. It also transfers research results to clinical applications of music therapy techniques and program development
in a general hospital setting.
Acute myocardial infarction places additional demands on an already compromised myocardium. Relaxing music can induce a relaxation response, thereby reversing the deleterious effects of the stress response.
To compare the effects of relaxing music; quiet, uninterrupted rest; and "treatment as usual" on anxiety levels and physiological indicators of cardiac autonomic function.
A 3-group repeated measures experimental design was used. Forty-five patients, 15 per group, with acute myocardial infarction were assigned randomly to 20 minutes of (1) music in a quiet, restful environment (experimental group); (2) quiet, restful environment without music (attention); or (3) treatment as usual (control). Anxiety levels and physiological indicators were measured.
Immediately after the intervention, reductions in heart rate, respiratory rate, and myocardial oxygen demand were significantly greater in the experimental group than in the control group. The reductions in heart rate and respiratory rate remained significantly greater 1 hour later. Changes in heart rate, respiratory rate, and myocardial oxygen demand in the attention group did not differ significantly from changes in the other 2 groups. The 3 groups did not differ with respect to systolic blood pressure. Increases in high-frequency heart rate variability were significantly greater in the experimental and attention groups than in the control group immediately after the intervention. State anxiety was reduced in the experimental group only; the reduction was significant immediately and 1 hour after the intervention.
Patients recovering from acute myocardial infarction may benefit from music therapy in a quiet, restful environment.
Pain associated with chest tube removal is a major problem for patients who undergo open heart surgery. Because this pain is short-lived, timing the administration of pharmacological agents for pain relief is difficult and is therefore done inconsistently.
To examine the effect of music as an intervention for pain relief during chest tube removal after open heart surgery.
In an experimental design, 156 subjects (mean age, 66 years; 69% men) were randomly assigned to 1 of 3 groups: control, white noise, or music. All subjects preselected the type of music they preferred hearing. Ten minutes before the chest tube was removed, the patient's heart rate and blood pressure were measured, the patient rated pain intensity by using a numeric rating scale, and the prerecorded audiotape of music was begun. The patients rated their pain again immediately after chest tube removal and 15 minutes later. Physiological variables were assessed every 5 minutes until 15 minutes after the chest tubes were removed.
Self-reported pain intensity, physiological responses, and narcotic intake after chest tube removal did not differ significantly among the 3 groups.
Although the findings were not statistically significant, most subjects enjoyed listening to the music, and therefore the use of music as an adjuvant to other therapies may be an appropriate nursing intervention.