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Abstract

Music is widely used to enhance well-being, reduce stress, and distract patients from unpleasant symptoms. Although there are wide variations in individual preferences, music appears to exert direct physiologic effects through the autonomic nervous system. It also has indirect effects by modifying caregiver behavior. Music effectively reduces anxiety and improves mood for medical and surgical patients, for patients in intensive care units and patients undergoing procedures, and for children as well as adults. Music is a low-cost intervention that often reduces surgical, procedural, acute, and chronic pain. Music also improves the quality of life for patients receiving palliative care, enhancing a sense of comfort and relaxation. Providing music to caregivers may be a cost-effective and enjoyable strategy to improve empathy, compassion, and relationship-centered care while not increasing errors or interfering with technical aspects of care.

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... clinics (for reviews in children, see [13][14][15][16][17] ; for reviews in adults, see [18][19][20]. The majority of reviews conclude that music interventions have a positive effect on pain, mood, and anxious or depressive symptoms in both children and adults in clinical settings. ...
... Results from the self-reported mental health outcomes further supported this; individuals playing an instrument report more depressive, burnout and schizotypal symptoms. This is in contrast with previous epidemiological and clinical studies reporting positive effects of musical engagement on anxious and depressive symptoms [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . Further, a recent study by Fancourt and Steptoe 35 found cultural engagement to decrease the development of depression in older ages. ...
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The association between active musical engagement (as leisure activity or professionally) and mental health is still unclear, with earlier studies reporting contrasting findings. Here we tested whether musical engagement predicts (1) a diagnosis of depression, anxiety, schizophrenia, bipolar or stress-related disorders based on nationwide patient registers or (2) self-reported depressive, burnout and schizotypal symptoms in 10,776 Swedish twins. Information was available on the years individuals played an instrument, including their start and stop date if applicable, and their level of achievement. Survival analyses were used to test the effect of musical engagement on the incidence of psychiatric disorders. Regression analyses were applied for self-reported psychiatric symptoms. Additionally, we conducted co-twin control analyses to further explore the association while controlling for genetic and shared environmental confounding. Results showed that overall individuals playing a musical instrument (independent of their musical achievement) may have a somewhat increased risk for mental health problems, though only significant for self-reported mental health measures. When controlling for familial liability associations diminished, suggesting that the association is likely not due to a causal negative effect of playing music, but rather to shared underlying environmental or genetic factors influencing both musicianship and mental health problems.
... Music has been used since ancient times to enhance wellbeing and reduce pain and suffering [140]. Steady rhythms entrain regular respiratory patterns, and listening to classical music increases heart rate variability (a measure of cardiac autonomic balance), whereas listening to noise or rock music decreases heart rate variability [141,142]. ...
Chapter
About 285 million people are estimated to be visually impaired worldwide, amongst them 39 million are blind. In contrast to refractive deficits caused by diseases of the cornea or lens which can be corrected by optic means or surgery, diseases affecting the visual nervous system (retina, optic nerve, brain) are widely assumed to be irreversible. If patients are informed of such a grim diagnosis and poor prognosis, they typically experience anxiety and fear of becoming blind. This creates a psychological double-burden: not only do they experience fear-inducing difficulties in daily life with reading, orienting or mobility, but a negative prognosis typically has a severe emotional impact, leading to worries, anxiety, fear, depression, and social isolation. Therefore, vision loss and emotional responses go hand-in-hand, creating a long lasting psychosocial and socioeconomic burden to the affected individuals and society at large.
... Music is a highly complex combination of amplitude and frequency patterns that interacts with the human brain, modulating some of its processes, such as synaptic plasticity, the neuronal learning process and world perception [43]. Therefore, as a consequence, different types of music elicit different physical modifications, such as reduction of pain and blood pressure, and psychological modifications as well, like stress attenuation, relaxation and good mental moods [36]. ...
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Anxiety disorders afflict more than 7 percent of the population of the world. When associated with mood disorders, anxiety can also trigger or increase other symptoms and effects of mental diseases, like depression and suicidal behavior. Binaural beats are low-frequency acoustic stimuli perceived when a given voluntary is subjected to two slightly different wave frequencies, from 200Hz to 900Hz. Binaural beats are able to reduce anxiety and modify other psychological conditions and states, significantly changing cognitive processes and mood states. In this work, we applied a 5Hz binaural beat to 6 different subjects, to detect a relevant change in their brainwaves before and after the stimuli. We applied 20 minutes stimuli in 10 separated sessions. We assessed the differences using a single hidden layer Multi-Layer Perceptron neural network in comparison with non-parametric tests and Low-Resolution Brain Electromagnetic Tomography (eLORETA). Our main results on eLORETA point to a strong increase in the current distribution, mostly in Alpha 2 band, at the Anterior Cingulate, related to the monitoring of mistakes regarding social conduct, recognition and expression of emotions. Artificial neural networks, particularly Multi-Layer Perceptrons, proved to be able to evince the main differences with high separability in Delta and Theta spectral bands.
... In such a condition the parasympathetic predominance is established. 7. Music appears to exert physiologic effects through the autonomic nervous system music effectively reduces anxiety [13] . The exact mechanism by which music modifies brain function is not clear. ...
... At present, most of the music therapy uses VCD and Walkman, and most of the patients are passively listening. Music therapy for post-stroke depression has been reported more and more in China, especially for the study of national conditions and regional differences, the application of different populations and the efficacy [12] [17] [18] [19]. ...
Article
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Personality Disorders (PDs) are psychiatric conditions involving maladaptive personality traits and behaviours. Previous research has shown that musical preferences and the use of music may be related to personality traits. Additionally, music therapy is increasingly being used as a treatment option for people with PDs. Using the PRISMA guidelines, a systematic literature search was undertaken using three databases: PubMed, Web of Science, and PsycInfo. The following search terms were used: PubMed: “personality disorder” AND (music OR “music therapy”); Web of Science (advanced search): TS = (personality disorder) AND TS = (music or “music therapy”); PsycInfo: “personality disorder” AND (music OR “music therapy”). A total of 24 studies were included in this review and summarised into four categories: music preference, music therapy, music performance, and music imagery, all in relation to PDs or traits associated with PDs. The analysis found that individuals with personality traits associated with PDs may prefer different types or genres of music or interact with music differently than those without these traits. Additionally, music therapy (MT) was found to offer a potentially useful treatment option for PDs. The power of these findings was limited by the small number of included studies. This review offers a useful foundation upon which further research looking at MT as a potential treatment option for PDs can be built.
Conference Paper
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Recently, researchers in the field of affective neuro-science have taken a keen interest in identifying patterns in brain activities that correspond to specific emotions. The relationship between music stimuli and brain waves has been of particular interest due to music's disputed effects on brain activity. While music can have an anticonvulsant effect on the brain and act as a therapeutic stimulus, it can also have proconvulsant effects such as triggering epileptic seizures. In this paper, we take a computational approach to understand the effects of different types of music on the human brain; we analyse the effects of 3 different genres of music in participants electroencephalograms (EEGs). Brain activity was recorded using a 14-channel headset from 24 participants while they listened to different music stimuli. Statistical features were extracted from the signals and useful features and channels were identified using various feature selecting techniques. Using these features we built classification models based on K-nearest Neighbour (KNN), Support Vector Machine (SVM) and Neural Network (NN). Our analysis shows that NN, along with Genetic Algorithm (GA) feature selection, can reach the highest accuracy of 97.5% in classifying the 3 music genres. The model also reaches 98.6% accuracy in classifying music based on participants' subjective rating of emotion. Additionally, the recorded brain waves identify different gamma wave levels, which are crucial in detecting epileptic seizures. Our results show that these computational techniques are effective in distinguishing music genres based on their effects on human brains.
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Examining factors that protect against the negative repercussions of stress on everyday functioning is paramount. This experimental study investigated the effects of music listening and personality on the reduction of perceived stress and cognitive performance. Seventy adults (18-45 years, M = 22.8, SD = 6.6) completed measures of the Dark Triad traits (psychopathy, narcissism, and Machiavellianism), music preferences, and music uses, and undertook a stress-inducing procedure. Participants were randomly allocated to three groups: hip-hop/rap, classical music, control, being exposed to the respective genre or silence for 20 minutes after the predicted peak in stress. Results showed that classical and hip-hop/rap music equally facilitated stress reduction. Narcissism predicted lower stress when classical music preference was high. Narcissism also predicted enhanced performance but also greater stress, when paired with infrequent stress-management through music. These novel findings demonstrate how particular genres and traits, despite being predominantly negatively perceived, can enhance stress reduction or cognitive performance.
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Music therapy is increasingly being used as an intervention for stress reduction in both medical and mental healthcare settings. Music therapy is characterized by personally tailored music interventions initiated by a trained and qualified music therapist, which distinguishes music therapy from other music interventions, such as 'music medicine', which concerns mainly music listening interventions offered by healthcare professionals. To summarize the growing body of empirical research on music therapy, a multilevel meta-analysis, containing 47 studies, 76 effect sizes and 2.747 participants, was performed to assess the strength of the effects of music therapy on both physiological and psychological stress-related outcomes, and to test potential moderators of the intervention effects. Results showed that music therapy showed an overall medium-to-large effect on stress-related outcomes (d = .723, [.51-.94]). Larger effects were found for clinical controlled trials (CCT) compared to randomized controlled trials (RCT), waiting list controls instead of care as usual (CAU) or other stress-reducing interventions, and for studies conducted in Non-Western countries compared to Western countries. Implications for both music therapy and future research are discussed.
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Purpose: Music therapy is widely used to enhance well-being, reduce pain, and distract patients from unpleasant symptoms in the clinical setting. However, the degree to which music modulates pain perception is unknown. The medial pain pathway including the limbic system is associated with emotion, but how music alters pathway activity is unclear. The aim of the study was to investigate pain thresholds and pain-related responses in the anterior cingulate cortex (ACC) and whether they were modulated when subjects listened to their favorite music genre. Subjects and methods: First, 30 subjects were examined for left forearm pain threshold using electrical stimulation with Pain Vision PS-2011N. The pain thresholds with and without music were compared. Second, when an 80-μA current from Pain Vision was applied to the left ankle of eight women, the pain-related responses of the ACC with and without music were observed with functional magnetic resonance device (fMRI). The changes in the pain-related activity in both parameters were discussed. Results: The median pain threshold with favorite music was 38.9 μA, compared to 29.0 μA without, which was significantly different (p<0.0001). The men's thresholds were significantly higher than women's both with music (p<0.05) and without music (p<0.01). The pain threshold in women was more strongly affected by music than in men. The fMRI results showed that the pain-related response in the ACC in five of eight subjects was attenuated while they listened to their favorite music. No change was observed in the other three subjects. Conclusion: The present findings suggest that pain perception might be strongly affected by listening to favorite music, possibly through modulation of pain-related responses in the ACC.
Article
Objective: Music interventions have been analysed for their use in many surgical specialties, but they have not yet been reviewed in relation to abdominal surgery. This systematic review and meta-analysis examines the effect that listening to music perioperatively has on the postoperative pain of abdominal surgery patients. Methods: A systematic search of PubMed, Cochrane Library and Scopus was undertaken to identify randomised controlled trials comparing a music intervention with standard care, where self-reported postoperative pain was included as an outcome. Study quality was then assessed by the author in conjunction with Robot Reviewer software based on the Cochrane bias methodology, and a meta-analysis was performed using standard mean difference and a random-effects model. Results: Twelve studies met the inclusion criteria for review, and eight studies (2217 subjects) had appropriate data reporting to be included in the meta-analysis. Half of the reviewed studies concluded a significant positive impact on postoperative pain and the meta-analysis reinforced this hypothesis (p < 0.001). There was minimal difference in impact between intra and postoperative interventions, or between patient or researcher selected music. Conclusions: This review supports the use of music in the perioperative period for abdominal surgery patients as a low cost adjunct to pharmaceutical pain relief.
Article
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Students' subjective well-being is not only an important prerequisite for positive development but also a desired outcome of education. Music concert attendance could be a critical factor in enhancing students' subjective well-being. This study investigates the effect of music concert attendance on subjective well-being through an examination of the different effects of music concert attendance according to students' initial subjective well-being. Data from 3,633 middle school students in two waves of the Seoul Education Longitudinal Study (seventh grade, eighth grade) were utilized. Hierarchical linear modeling shows that both student-and school-level music concert attendance predicted subsequent subjective well-being after controlling for initial subjective well-being, peer relation, grade point average, and gender. Furthermore, school-level music concert attendance facilitated increases in subjective well-being among students who showed low subjective well-being during the first wave of the study. The results indicated that student-and school-level music concert attendance could improve students' subjective well-being, especially for students with lower levels of subjective well-being. Educational contexts or policies to encourage both school and student participation in music concerts should be developed and implemented.
Chapter
Affective algorithmic composition systems are emotionally intelligent automatic music generation systems that explore the current emotions or mood of a listener and compose an affective music to alter the person's mood to a predetermined one. The fusion of affective algorithmic composition systems and smart spaces have been identified to be beneficial. For instance, studies have shown that they can be used for therapeutic purposes. Amidst these benefits, research on its related security and ethical issues is lacking. This chapter therefore seeks to provoke discussion on security and ethical implications of using affective algorithmic compositions systems in smart spaces. It presents issues such as impersonation, eavesdropping, data tempering, malicious codes, and denial-of-service attacks associated with affective algorithmic composition systems. It also discusses some ethical implications relating to intensions, harm, and possible conflicts that users of such systems may experience.
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Personal digital media such as photos, music and films play a pervasive part in contemporary life by helping us to remember the past, communicate with each other and represent our identity to others. In this chapter, we explore the value of such media for supporting well-being in older age, drawing on concepts from literatures on art, reminiscence and music therapy. Theoretically, we argue for a new category of assistive technologies involving media creation and consumption to enhance well-being. We propose a framework for understanding and designing such assistive media systems which highlights the interaction between media item, author and audience. This framework is then illustrated through early attempts to explore a new kind of digital story therapy for people with dementia in a residential care setting. We conclude with recommendations for the design of future ‘assistive media’ systems and experiences that might enhance not only the lives of people with dementia, but also those around them.
Objective This study investigated the effects of three auditory interventions; white noise, recorded mother's voice, and MiniMuffs, applied during a heel lance on pain and comfort in premature infants in the neonatal intensive care units. Design and methods This experimental, parallel, randomised controlled research was conducted in a state hospital tertiary-level neonatal intensive care unit. The sample comprised sixty-four premature infants with gestational ages of 31–36 weeks. The infants were randomly assigned to four groups: i) white noise, ii) recorded mother’s voice, iii) MiniMuffs, and iv) control. Pain and comfort of newborns were evaluated according to the Neonatal Infant Pain Scale (NIPS) and the COMFORTneo scale. Oxygen saturation, heart rate, and crying time were also measured. Results The mean of oxygen saturation levels in the white noise, recorded mother's voice, and MiniMuffs group were higher than the control group. The heart rate, crying time, mean NIPS score, COMFORTneo score of the premature neonates in the white noise, recorded mother’s voice, and MiniMuffs groups were significantly lower than the control group (p < .001). Conclusion Auditory interventions used during heel lance reduce the pain and increase the comfort of the premature infants. White noise is extremely effective in preventing infants’s pain.
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Although there is a strong consensus that music listening is a common and effective means to induce states of relaxation, little attention has been given to the physical effects of such states and the potential health-related applications. In this article, we investigated whether music listening could induce affective states of relaxation and accelerate the recovery of fatigued muscles, through the analysis of quality of movement. Twenty healthy participants were asked to perform a fatigue induction protocol of the non-dominant arm followed by a resting period and the execution of a drinking task. During recovery periods, all participants were exposed to three experimental conditions: listening to relaxing music; arousing music; and no music. 3D motion capture and surface electromyography were used to record upper limb movements and muscle activity when performing the drinking task before and after the recovery periods. Movement quality was assessed by means of movement smoothness (jerk index) and muscle recovery (motor unit recruitment). Results showed that recovery of movement smoothness in the relaxing music condition was significantly greater (-35%) than in the relaxing music condition (compared to arousing music, -25%, and silence, -16%) which demonstrates that listening to relaxing music speeds up the recovery process of (fatigued) muscles. We discuss our findings in the context of potential applications of music listening for reducing muscle tension in people suffering from hypertonia.
Article
Background: The diagnosis and the treatment for cancer are significant stressors for the patients. It can affect physical as well as psychological well-being. Variations in salivary amylase indicate physiological responses to the stressful experience during chemotherapy. Music therapy is witnessed to decrease psychosocial distress in the oncology setting. Listening to music can positively benefit neurophysiologic and emotional responses as well as promote relaxation, especially beneficial for cancer patients undergoing painful and anxiety-inducing chemotherapy. It is, therefore nurses, who are so familiar with this environment, not only to be aware of this anxiety-producing process but to cope with it and to alleviate it for the patient as much as possible. Objective: The objective of the study was to determine the salivary amylase levels in patients undergoing chemotherapy before and after listening to preferred music. Design: Quasi-experimental repeated measure design. Setting; Experimental and control group were recruited from two oncology units of selected multispecialty hospitals. Participants: Purposive sampling techniques were used to select the study participants. Patients of age group eighteen and above, undergoing first time chemotherapy treatment and the chemotherapy infusion lasts for minimum of 3 hours duration was the inclusion criteria whereas Patients who were unable to listen to music due to hearing problems, those who were with head and neck cancer, diabetes, hypertension, and thyroid problems were excluded from the study. 168 eligible participants were recruited among which 8 were unable to continue. Methods: Saliva was collected from both the study groups before and after the chemotherapy administration. The patient preferred instrumental music intervention was administered for the duration of 3 hours during chemotherapy with the help of mp3 player and musical pillow in the experimental group where the control group had a routine oncology unit care and they were rested on a bed during the chemotherapy administration. The post-tests were done on day 3 and day 5. Results: Significant changes in mean salivary amylase were observed in the experimental group compared to the control group (p˂0.05). Repeated measure ANOVA also showed a significant difference (p˂0.05) in the experimental group at different time points of observation. There was a significant association between the baseline amylase level and stage of cancer in both the experimental and control group (p˂0.05). Conclusion: Music was effective in patients undergoing chemotherapy in terms of reduction in salivary amylase level.
Research
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ABSTRACT: In order to give a modern and pratical solution for public speaking anxiety problems in this industrial era 4.0., the researcher proposes an alternative method for intervention with virtual reality hypnosis (VRH). This intervention will lead someone to enter a state of hypnosis with the help of three dimensional virtual environment which was created by the researcher to face the experiences which caused of public speaking anxiety. This study used single subject AB design experiment and conduct measurement three times for baseline condition and two times for post intervention condition. Those measurement used personal report of public speaking anxiety (PRPSA) which was translated into indonesian, and which was tested (N=30, α=0.98). Research subjects were selected from undergraduate first-year students of the Faculty of Psychology of Diponegoro University 2019 who had high public speaking anxiety level (N=4). Descriptive statistical analysis showed that there were some significant reduction on public speaking anxiety level scores for all subjects who paticipated in this study. While inferential statistical analysis using Friedman test showed that Chi-Square were 13.128 (Chi-Square > 9.488) and Asymp. Sig were 0.011 (Asymp. Sig < 0,05). Based on that result, this study conclude that virtual reality hypnosis intervention is effective to reduce public speaking anxiety level among first-year undergraduate student. https://ejournal3.undip.ac.id/index.php/empati/article/view/26495
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Introduction: Augmented incidence of anxiety is associated with Coronary Artery Bypass Graft (CABG) compared to other surgeries; it affects the function of vital organ. Preoperative anxiety may persist after surgery and affects health related quality of life. Music therapy is found to have an impact on patient’s anxiety. Aim: To find the effect of music therapy on hospital induced anxiety and Health Related Quality of Life (HRQoL) in patients after CABG. Materials and Methods: Forty participants were recruited for the study, (age group 30-80 years) and randomised into two groups. The intervention group received music therapy along with cardiac rehabilitation and control group received cardiac rehabilitation alone once in a day. The primary outcome measure was Hospital Anxiety and Depression Score (HADS) was measured by a trained physiotherapist on preoperative day and postoperative day 2 and 7. The secondary outcome measures were SF-36 and 6 minute walk distance, measured by a trained physiotherapist on preoperative day and post operative day 7. Results: HADS anxiety score showed significant difference within the intervention as well as control group, with p-value 0.05, but showed significant difference in control group. Physical component of SF-36 outcome did not show significant difference between the groups with p-value >0.05. Mental component of SF-36 did not established significant improvement between the groups. There was significant improvement in Physical component of SF-36 within the intervention group. Conclusion: Both Phase I cardiac rehabilitation and music therapy has positive impact on anxiety, with music therapy being the most advisable.
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Aim: To synthesize the effect of music intervention on patients with cancer-related pain in randomized controlled trials. Design: A systematic review and meta-analysis of randomized controlled trials following Cochrane methods. Data resources: Systematic searches were conducted in Science Direct, Web of Science, Springer Link, Networked Digital Library of Theses & Dissertations, Ovid, CINAHL, Pubmed, Cochrane Library, Proquest, Council of Higher Education National Thesis Center, ULAKBIM Turkish National Databases for studies published in English and Turkish without year limitation. The review period covered 1978-March 2018. Review methods: The risk of bias of eligible studies was evaluated by two researchers using the Cochrane Collaboration tool. Results: Six studies with 593 participants met the inclusion criteria. Music intervention was generally applied by the passive listening method, which ranged from 30-60 minutes and 1-3 sessions. No significant publication bias was found in the main outcomes. As a result of the meta-analysis, it was found that music interventions have a moderate effect on cancer-related pain. Conclusion: Music intervention can have a positive effect on the management of cancer pain. The studies reported no adverse events. Nurses can use music intervention to manage cancer-related pain. Impact: The meta-analysis addressed the effect of music intervention on cancer-related pain. The statistical result indicates that music intervention was moderately effective in cancer-related pain. The findings of this study will contribute to the application of effective music intervention by nurses and will provide guidance for the development of studies related to the effect of music intervention on cancer-related pain. This article is protected by copyright. All rights reserved.
Article
A large number of people suffer from anxiety in modern society. As an effective treatment with few side effects, music therapy has been used to reduce anxiety for decades in clinical practice. Yet therapists continue to perform music selection, a key step in music therapy, manually. Considering the growing need for music therapy services and social distancing amid public emergencies, an automatic method for music selection would be of great practical utility. This paper marks the first effort to identify music with therapeutic effects on anxiety reduction via a novel music scoring model. We formulate the calculation of a therapeutic score as a quadratic programming problem, which minimizes score variance among known therapeutic songs while maintaining their superiority over other songs. The proposed model can uncover common features that contribute to anxiety reduction by learning from small and unbalanced data. Using a music therapy experiment, we find that the proposed model outperforms existing techniques in predicting therapeutic songs. Feature analysis is also conducted, revealing that high-frequency spectrums are important in therapeutic scoring.
Article
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Music and empathy are components of social experience. Similar and adjacent functional brain systems are required in the production and understanding of music, the processing of emotion, and engagement in social behavior. Activity in these brain systems is often reflected in autonomic features, including dynamic behavior of the parasympathetic and sympathetic nervous systems. Music may influence prosocial behavior and this effect may be reflected by the behavior of the autonomic nervous system. This experiment was designed to evaluate these relationships. Healthy undergraduate students ( N = 60) participated in Cyberball, a task sensitive to differences in prosocial behavior, while listening to or not listening to different types of music. Results indicated that music positively affects prosocial behavior, but autonomic activity does not reflect the degree of music’s effect on prosocial behavior.
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Music is used for emotional control purposes and has been helpful in stress management and enhancing general well-being. Music could favourably affect consumers’ perceptions. The subject of this research is to see the connection between the music in Pakistani restaurants, as well as to analyse its impact on customer behaviour, and whether the music in the restaurant makes the customer pay more attention and make them spend more time in a restaurant. This study involved data collection and analysis from 395 Customers in a Pakistan restaurant industry. Smart PLS software was used to analyse the outcomes after data collection, and the conceptual framework was validated using structural equation modelling (SEM) and factor analysis. Based on our findings, background music and customers’ emotions are positively related. Further, results indicate that music is favourably connected to spending more time and money in the restaurant of Pakistan, with the mediation from consumers’ emotions. Background Music may aid in the growth of the Pakistan Restaurant industry since the findings of this study imply that customers will spend more money and time there due to the music. This study also suggests future research subjects on the evolution of the restaurant industry as a result of consumer emotions
Chapter
Relaxation is at the core of managing our stress. Sleep is our natural form of relaxation, conserving and restoring energy. Physiologically, sleep is composed of two phases: nonrapid eye movement sleep and rapid eye movement sleep. Oftentimes, stress disrupts our sleep patterns. Relaxation techniques provide us with excellent methods that can be practiced with awareness anytime at our discretion. These techniques include yogic breathing, progressive muscle relaxation, autogenic training, and visual imagery. Biofeedback, self-hypnosis, humor (laughter), music, and massage can also contribute to a relaxed state. Optimism and introspective meditations help in achieving happiness and relaxation. The chapter includes Thoughts for Reflection about relaxing. Important terms are defined along with five websites to explore. Worksheets provide practice of relaxation techniques for yogic breathing, progressive muscle relaxation, autogenic training, imagery, meditation, and readiness for determining change toward developing relaxation behavior in daily life.
Article
Electroacupuncture is an effective therapy method in Traditional Chinese Medicine (TCM), but the monotonic repeatability of stimulus signals may face problems due to the body’s tolerance. Music therapy is a widely used method for targeting mental and neurological diseases. Music electroacupuncture combines the advantages of these two therapies by using the variability of music to deal with the tolerance problem. Presently, the stimulus signals of the music electroacupuncture devices are filtered from music, and the frequency of the electric plus is not easy to control. In this pursuit, a new processing circuit of music electroacupuncture signal was proposed using a novel portable music electroacupuncture apparatus based on the Chinese Medical music therapy. Specifically, as the stimulus signal changes synchronously with the music, the frequency of the stimulus plus signal can be flexibly controlled. Using headphones, a selected synchronous intervention music and electrical stimulation worked synchronously to achieve the therapeutic effect of physical and mental harmony. Experiments and measurements confirmed that the stimulation parameters of the proposed electroacupuncture apparatus in this study met the provisions of relevant standards, and the stimulation output was safe and reliable. Furthermore, it offered better and more comfortable body feelings, compared to other music electroacupuncture methods.
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The authors of this work, noticing that opera is a combination of music and theater, examined the relationship between listening to opera music and mood changes in people over 50 years of age. The study took the form of a quasi-experiment. Recipients were invited to the previously prepared room, where the audiovisual material – a recording of the opera “La Traviata” – was presented for the first time. This was preceded by the respondents completing the SUPIN C30 and S30 questionnaires and a short survey by the authors. After the presentation of the stimulus, the subjects again filled in the SUPIN S30 questionnaire scale and the GEMS scale. The described procedure was carried out twice, using two different music materials. The procedure remained unchanged, while the audiovisual material changed. The second time, the participants were presented with a recording from the opera “The Barber of Seville”. The participants of the study were 30 people. In the studied group, there are no significant changes in emotional states in response to the opera “La Traviata”. In turn, the opera “The Barber of Seville” has no effect on a positive emotional state. Instead, it caused a statistically significant change in the level of negative emotional states. The results of this study are largely consistent with the results of other studies examining the relationship between music and mood, but there are also limitations – only two pieces of opera music were used and no control group was included. Research has shown that opera, as a specific musical genre, despite its peculiar form, affects mood and emotions.
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Our study examines the acceptability and feasibility of Moshi, an audio-based mobile application, among children 3–8 years old using a parent–child dyadic approach. Our 10-day within-subject pre–post study design consisted of five nights of a normal bedtime routine and a subsequent five nights exposed to one story on the Moshi application during the intervention. Each five-night period spanned three weeknights and two weekend nights. The Short-Form Children’s Sleep Habits Questionnaire (SF-CSHQ) was used to measure children’s sleep at baseline and post-intervention. The PROMIS, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were used to assess parents’ sleep. Among the 25 child–parent dyads, the mean child age was 4 (SD = 1.23) and 63% were male (n = 15). Mean parent age was 35 (SD = 5.83), 84% were female (n = 21), and 48.0% were Black (n = 12). For child-only comparisons, mean post-SF-CSHQ measures were lower compared to baseline. A trend in parent sleep is reported. This study shows the potential of an audio-based mobile sleep aid to improve sleep health in a racially diverse parent and child dyad sample.
Article
Purpose: This study carried out in order to reveal the current status of the theses about the effect of music intervention on pain in children in the field of nursing in Turkey and to guide the aspects that need to be developed. Materials and Methods: This systematic review carried out by scanning the National Thesis Center database without any year limitation. Various combinations of the keywords 'pain', 'child', 'listen', 'auditory' and 'music' and/or conjunctions were used in the screening, and 135 recorded theses from 2008-2019 found. The theses evaluated by the researchers according to the inclusion criteria. Results: There 8 theses in Turkey in the field of nursing examining the use of music in pain management among children. All studies master's theses using passive music attempts as a method. Most of the theses in the study belonged to the department of nursing (62.5%). All of the theses within the scope of the study performed by experimental method, most of which were conducted by randomized controlled experimental method (62.5%), while some of them (37.5%) were performed by quasi-experimental method. The analyses on the selection of the sample group by the age period showed that the experiences of children aged 3-6 were mostly discussed (37.5%). While 5 theses (62.5%) had been published, 3 theses (37.5) were not published yet. Conclusion: The use of music in pain management in postgraduate theses was seen in master theses only and was less in number, which indicates that studies with high levels of evidence are needed.
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Sound has enormous influence on human organism. Different types of sound vibrations have both positive and negative effects on peoples health. This review highlights that sound is important factor for health regulation with the emphasis on cognitive functions and mental activity. Also, we describe strategies of using sound in treatment of neurological diseases, anxiety disorders, depressions, and social rehabilitation. Sound influence and its exploit are examined on different levels: ultrasound, infrasound, white noise, music and nature sounds. Finally, our review has shown sound great potential in treatment of neurodegenerative and psychiatric disorders, carpal tunnel syndrome, postoperative rehabilitation, and cognitive functions improvement. We propose the implementation of acoustic monitoring and music therapy as substantial components of rehabilitation medicine.
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Pain is a universal human experience,yet no two individuals experience and respond to pain exactly the same way and also pain is the predominant complaint patients have after surgery. Anxiety is an emotional state characterized by feelings of apprehension, discomfort, restlessness, or worry. Music therapy is one of the non-pharmacological interventions to reduce postoperative pain and anxiety.AIM: To assess the effectiveness of music therapy in controlling postoperative pain and anxiety among surgical patients. MATERIAL AND METHODS: Quasi-experimental design Time series with multiple institutions of treatment) was adopted. A total of 40 patients 20 in experimental and 20 in control group chosen by convenient sampling technique. The instrument consisted of two sections: First section comprises of demographic and clinical variables of the patient. Second section was Speilberger State-Trait Anxiety Scale Form Y-1 and Numerical Pain Rating Scale.Reiki instrumental music was selected for intervention. Music therapy was provided through head phone on second and third postoperative day to the experimental group in two sessions in each day totaling four sessions lasting for 30 minutes each. Assessment was done periodically for two sessions at a interval of 2 hours per day after music therapy. RESULTS: The postoperative pain intensity score of the experimental group was significantly reduced from severe to mild level,where as in the control group pain intensity score was reduced from moderate to mild level. (p< 0.001).The postoperative anxiety level reduction for experimental group was from moderate to mild level, where as in the control group anxiety level remained constantly at moderate level. (p< 0.001). There was no significant association between preoperative anxiety with previous experience of surgery. CONCLUSION:Music therapy is a simple,safe and effective method for reducing postoperative pain and anxiety
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Social robots hold potential for supporting children’s well-being in classrooms. However, it is unclear which robot features add to a trustworthy relationship between a child and a robot and whether social robots are just as able to reduce stress as traditional interventions, such as listening to classical music. We set up two experiments wherein children interacted with a robot in a real-life school environment. Our main results show that regardless of the robotic features tested (intonation, male/female voice, and humor) most children tend to trust a robot during their first interaction. Adding humor to the robots’ dialogue seems to have a negative impact on children’s trust, especially for girls and children without prior experience with robots. In comparing a classical music session with a social robot interaction, we found no significant differences. Both interventions were able to lower the stress levels of children, however, not significantly. Our results show the potential for robots to build trustworthy interactions with children and to lower children’s stress levels. Considering these results, we believe that social robots provide a new tool for children to make their feelings explicit, thereby enabling children to share negative experiences (such as bullying) which would otherwise stay unnoticed.
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The authors of the article, based on the analysis of theoretical approaches accumulated in psychological and pedagogical science and conducting a pilot empirical study, attempt to comprehend the possibilities of developing the creative potential of a person when writing reflexive essays about listened musical works. The most important link that ensures the development of creative potential is the process of creating an essay: a person must use their personal life experience, actualize value orientations, show creative activity associated with the creation of a designed product, carry out self-action to extract the potentials of their own personality, discover opportunities that they themself may not even suspect. The conditions that must be observed when selecting works and writing an essay are outlined. Arguments are given in favor of the fact that writing an essay is not an interpretation of a musical work, and the work itself is not a psychotherapeutic method. A test questionnaire and qualitative analysis were used as psychodiagnostic methods in the study. The results of a pilot empirical study (n = 22) are presented, which with a certain probability indicate that writing an essay had an impact on the development of the creative potential of the subjects. Keywords creative potential, reflective essay, musical composition
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Background This study aimed to investigate the effect of relaxation therapy on hypoxia during intravenous propofol anesthesia in patients with pre-operative anxiety. Methods Two-hundred and eighty patients were randomly categorized in the experimental group (relaxation therapy group) and control group. The Spielberger State-Trait Anxiety Inventory (S-STAI) was administered 30 to 60 min pre-operatively to assess the patient's current anxiety status and select appropriate patients. Patients in the experimental group received pre-surgical relaxation therapy. Decrease in oxygen saturation during the procedure was recorded for each patient group, and the relevant data were compared between the two groups. Results The basic S-STAI scores of the experimental and control groups were 56.88 ± 2.91 and 57.27 ± 3.56, respectively ( p = 0.331). The difference was not statistically significant. The incidence of hypoxia in the experimental group during painless artificial abortion [routine blood oxygen saturation (SpO 2 ) <95%, duration >15 s] decreased from 30 to 12.3%. Conclusion Relaxation therapy may effectively reduce the incidence of hypoxia during painless artificial abortion by using less dose of propofol. It may help patients relieve their anxiety and improve perioperative safety. Trial Registration Chinese Clinical Trial Registry (ChiCTR2000032109).
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Many young people are potentially at risk of noise-induced hearing loss due to unsafe use of personal listening devices. The aim of this cross-sectional study was to examine the association of sociodemographic factors and risk behavior with unsafe use of personal listening devices in adolescents to identify a target group for prevention. A smartphone application was developed to objectively measure music listening habits among 314 adolescents with a mean age of 13 years and 7 months (SD ±5 months). Listening habits were characterized as safe or unsafe based on the weekly noise dose. Data on sociodemographic factors and traditional health risk behaviors were obtained by questionnaires. Within the study group, 10.5% of the participants exceeded the 50%, and 4.8% the 100% recommended weekly noise dose. Adolescents with a lower socioeconomic status were more likely to engage in unsafe listening habits as compared to adolescents with a higher socioeconomic status. Additionally, risk behavior was associated with higher odds of having unsafe listening habits as compared to no risk behavior. Age, sex and educational levels were not significantly associated with unsafe listening habits. The findings of the present study indicate that interventions to promote safe listening habits should target adolescents with a lower socioeconomic status and higher risk behavior. Future research is needed to investigate how these adolescents can be motivated to adopt safe listening habits.
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Clinical-experimental considerations and an approach to understanding the autonomic basis of improved surgical outcomes using Perioperative Music Medicine (PMM) are reviewed. Combined surgical, psycho-physiological, and experimental perspectives on Music Medicine (MM) and its relationship to autonomic nervous system (ANS) function are discussed. Considerations are given to the inter-related perioperative effects of MM on ANS, pain, and underlying vagal and other neural circuits involved in emotional regulation and dysregulation. Many surgical procedures are associated with significant pain, which is routinely treated with post-operative opioid medications, which cause detrimental side effects and delay recovery. Surgical trauma shifts the sympathetic ANS to a sustained activation impairing physiological homeostasis and causing psychological stress, as well as metabolic and immune dysfunction that contribute to postoperative mortality and morbidity. In this article, we propose a plan to operationalize the study of mechanisms mediating the effects of MM in perioperative settings of orthopedic surgery. These studies will be critical for the implementation of PMM as a routine clinical practice and to determine the potential limitations of MM in specific cohorts of patients and how to improve the treatment.
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Sustainability is not just a trend, but an important part of our everyday life including the satisfaction of human needs and preservation of a healthy business environment for present and future generations. The objective of this study is to provide an empirical approach for how to achieve the sustainable success in the music industry. As consumers’ utility toward a certain music product can be shifted up or down depending on the elements that constitute the music, we investigate the effect of musical elements on the consumer’s choice of music. We quantitatively measure the effects using hierarchical Bayesian logit choice model allowing for the individual heterogeneity. Based on the results, we find that utilizing musical components plays critical roles in understanding and predicting consumer choice. In addition, our findings suggest how music marketers can come up with a desirable configuration for music products. Sustainability in the music industry can be justified by whether musical components are well aligned, consistent with consumers’ preference.
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Music is currently used as a method of therapy in different areas of medicine, as it can reduce stress and anxiety, increase the level of relaxation and improve the patients’ mood. This paper presents a prototype music recommendation system, which provides a result based on the correlation of the user’s emotional states. The prototype was implemented and developed using Python and the Google Colab environment. Preliminary results were obtained using a free music samples data set, but the algorithm can be scaled and optimized for larger, more complex data sets. Mobile versions of the algorithm can be included in apps designed to improve the user’s mood.
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Sport-related concussion is a serious public health issue affecting millions of individuals each year. Among the many negative side effects, emotional symptoms, such as stress, are some of the most common. Stress management is repeatedly cited by expert groups as an important intervention for this population. It was shown that music has relaxing effects, reducing stress through the activation of brain areas involved in emotions and pleasure. The objective of this study was to explore the effects of a music-listening intervention compared with silence on experimentally induced stress in concussed and non-concussed athletes. To this aim, four groups of athletes (non-concussed music, non-concussed silence, concussed music, and concussed silence) performed the Trier Social Stress Test, for which both physiological (skin conductance level) and self-reported stress measurements were taken. No significant difference was found in the pattern of stress recovery for self-reported measurements. However, the skin conductance results showed greater and faster post-stress recovery after listening to music compared with silence for concussed athletes only. Taken together, these results suggest that music could be an efficient stress management tool to implement in the everyday life of concussed athletes to help them prevent stress accumulation.
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Depression is one of the most common mental disorders, predicted to be the leading cause of disease burden by the next decade. There is great deal of emphasis on the central origin and potential therapeutics of depression whereby the symptomatology of depression has been interpreted and treated as brain generated dysfunctions filtering down to the periphery. This top‐down approach has found strong support from clinical work and basic neuroscientific research. Nevertheless, despite great advances in our knowledge of the etiology and therapeutics of depression, success in treatment is still by no means assured.. As a consequence, a wide net has been cast by both clinicians and researchers in search of more efficient therapies for mood disorders. As a complementary view, the present integrative review advocates approaching mood and depression from the opposite perspective: a bottom‐up view that starts from the periphery. Specifically, evidence is provided to show that sensory stimulation via the visual, auditory, olfactory and gustatory systems can modulate depression. The review shows how ‐depending on several parameters‐ unisensory stimulation via these modalities can ameliorate or aggravate depressive symptoms. Moreover, the review emphasizes the bidirectional relationship between sensory stimulation and depression. Just as peripheral stimulation can modulate depression, depression in turn affects‐and in most cases impairs‐sensory reception. Furthermore, the review suggests that combined use of multisensory stimulation may have synergistic ameliorative effects on depressive symptoms over and above what has so far been documented for unisensory stimulation.
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This study aimed to analyze the influence of patient-selected music listening on the pain and anxiety levels of hemodialysis patients after undergoing a vascular access operation. Methods: Sixty five patients were randomly assigned to the experimental group (n = 32) or the control group (n = 33). The experimental group was instructed to listen to their favorite music using headphones during their operations at the center. The control group underwent the operations without listening to any music. The pain measurement during vascular access operation was measured by subjective pain and objective pain behavior; anxiety was measured by subjective anxiety and anxiety states. Results: The experimental group reported significantly lower subjective pain levels than the control group (t = 9.36, p = 0.003). Regarding objective pain behaviors, the experimental group had a significantly lower score than the control group (t = 4.59, p = 0.036). The experimental group had significantly lowered subjective anxiety compared to the control group (F = 10.10, p = 0.002). Regarding anxiety states, the experimental group had significantly lower scores than the control group (F = 23.34, p < 0.001). Conclusion: The results suggest that patient-selected music listening reduced hemodialysis patients' pain and anxiety levels during vascular access operations. Therefore, music medicine can be included as a new clinical intervention.
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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.
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Objectives Migraine headaches are a prevalent and burdening disorder for the public worldwide. Both traditional preventive drugs and behavioral-based interventions have been used as treatment in the prevention of migraine attacks. However, benefits of alternative interventions in patients with primary headache disorders have not yet been fully explored. The present investigation sought to examine the impact of a patient controlled music intervention (MUSIC CARE) on episodic migraine headache. Design A sample of 20 episodic migraine patients (17 females, mean age of 42 years) was included in the pilot trial. Patients completed a pre-treatment assessment on headache severity, associated psychopathological distress (anxiety and depression) and functional impairment, and provided reports on their medication intake. During the 3-months intervention period, patients required 1-2 music sessions (based on the “U” sequence) per day with a minimum of 15 per month. Results Following the intervention, patients reported a significant reduction in the frequency of migraine attacks (MDiff = -2.8, p = 0.01). Ten patients reported a 50% reduction in the frequency of migraine attacks. Additionally, there was a significant reduction in medication intake (MDiff = -2.85, p = 0.02), the duration of migraine attacks (MDiff = -5.45, p = 0.002), anxiety (MDiff = -1.65 (2.88), p = 0.02) and depression (MDiff = -2.45 (3.5), p = 0.002). Conclusion These data provide evidence that music intervention may significantly prevent migraine attacks. Moreover, this method is easily accessible and administered. Future well-controlled clinical trials are necessary to further explore the efficiency of the intervention.
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Stress is a physiological and psychological response to the perception of danger and threat. Stress can occur due to a physical injury, mechanical disturbance, chemical change, or emotional factor. Stress can occur at all ages, including children and adolescents. Various physical and psychological events can cause stress in children, for example suffering from an illness, injury/trauma, parental divorce, parental death, sexual abuse, natural disasters, war, etc. Various exposures to physical and psychological stress harmful to the body can cause it to carry out defense mechanisms against these threats, one of which is changes in the cortisol hormone. Cortisol hormone is used as a biochemical marker for acute and chronic stress. The increase in this hormone as an indicator of stress can be changed through psychosocial interventions, one of which is by the provision of music therapy. Music therapy can manage stress problems of people at various ages with minimal side effects and a small amount of money. It is also easy to apply and does not require any intellectual ability to interpret. There are no limitations for users to use music therapy.
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updated Systematic Cochrane review. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008036.pub5/full?highlightAbstract=singing%7Cwithdrawn%7Csing
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The purpose of this study was to evaluate the effectiveness of music and white noise in the management of sensitive children treated using electronic dental anesthesia for restorative care. Sound (music and random noise) was used in combination with electronic dental anesthesia in 16 pediatric patients, who have been found to have low pain tolerances during operative procedures under electronic anesthesia alone. Pain was assessed by means of two scales, the color scale and the sound, eye and motor scale. Behavior was assessed through use of the North Carolina Behavior Rating Scale. The comfort was evaluated mainly during penetration of the dentin-enamel junction of the tooth. A procedure involving music and "noisy" music has been effective in 14 children. The music promoted relaxation, whereas the "noise" in combination with electronic signals suppressed pain. It has been demonstrated that audio analgesia and electronic dental anesthesia are quite compatible and may be used with considerable success in combination in difficult circumstances.
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A partnership between The Cleveland Clinic Foundation and The Cleveland Music School Settlement has resulted in music therapy becoming a standard part of the care in our palliative medicine inpatient unit. This paper describes a music therapy program and its impact on patients, their families, and staff. A service delivery model is suggested for implementation and integration of music therapy within palliative medicine. Specific music therapy interventions, evaluation and documentation techniques are also mentioned. A description of patient and family responses to music therapy, staff satisfaction, and effectiveness of interventions is presented.
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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.
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This study investigated the impact of different types of music on tension, mood, and mental clarity. A total of 144 subjects completed a psychological profile before and after listening for 15 minutes to four types of music (grunge rock, classical, New Age, and designer). With grunge rock music, significant increases were found in hostility, sadness, tension, and fatigue, and significant reductions were observed in caring, relaxation, mental clarity, and vigor. In contrast, after listening to the designer music (music designed to have specific effects on the listener), significant increases in caring, relaxation, mental clarity, and vigor were measured; significant decreases were found in hostility, fatigue, sadness, and tension. The results for New Age and classical music were mixed. Feeling shifts among subjects were observed with all types of music. Designer music was most effective in increasing positive feelings and decreasing negative feelings. Results suggest that designer music may be useful in the treatment of tension, mental distraction, and negative moods.
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The physiological and behavioural effects of music during recovery from heel lance were examined in 14 preterm infants at 29 to 36 weeks post-conceptual age (PCA). Infants were tested on 2 occasions: during a music condition and during a no-music control condition. Each condition was videotaped during 3 periods: baseline, heel lance, and recovery. Infants were divided into 2 age groups for data analyses: less than and greater than 31 weeks PCA. Mixed model ANOVAs showed that heel lance elicited a stress response (i.e., increased heart rate, decreased oxygen saturation, increased state-of-arousal, and increased facial actions indicative of pain) in both age groups. The stress response was greater in the older group. During recovery, the older group had a more rapid return of heart rate, behavioural state, and facial expressions of pain to baseline levels in the presence of compared to the absence of music. It was concluded that music is an effective NICU intervention following a stress-provoking stimulus in infants older than 31 weeks PCA.
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The management of pain is one of the primary issues in burn care. Pain is not only a physiologic experience, but a psychological one as well. With this in mind, the treatment of burned patients must incorporate a holistic view of pain management and healing. Cognitive, behavioral, and pharmacologic interventions all have a role in pain management. Studies, as well as clinical experience, have shown that musical intervention has been helpful in assisting patients with pain management in a variety of medical settings. Music is an element of normal life that can be easily adapted for the needs of individual patients and their current environment while providing a means for self expression and for normalizing the environment. This article examines the rationale for using music therapy with burned patients, describes several protocols that have been adapted to meet the specific needs of burned patients, and summarizes our preliminary findings, which demonstrate significant response to music therapy protocols employed on our patients.
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This article describes the process and results of a three-month music therapy clinical effectiveness study conducted with terminally ill patients. The purpose of this study was to quantify and evaluate the effectiveness of single-session music therapy interventions with hospice patients in three patient problem areas: pain control; physical comfort; and relaxation. Data from a total of 90 sessions conducted with a total of 80 subjects served by Hospice of Palm Beach County, Florida, were included in the study. Music therapy services were provided by five board-certified music therapists and one music therapist eligible for board certification. The subjects in this study were receiving regularly scheduled music therapy services from the hospice organization. The study used both behavioral observation and subject's self-reporting as methods of data reporting and recording. Subjects were observed for, or self-reported, their levels of pain control, physical comfort, and relaxation, both before and after each music therapy session. The subjects were served in the environments where music therapy services would normally be delivered (i.e., home, hospital, nursing home, or inpatient acute-care unit of the hospice organization). Music therapy services included live active and passive music-based experiences. These were designed to build and to establish rapport with patient or family, to facilitate family interaction and patient control, to provide support and comfort, to facilitate relaxation, to enable reminiscence and life review, to provide a frame-work for spiritual exploration and validation, and to encourage the identification and expression of feelings of anticipatory mourning and grief. A total of six hypotheses stated that there would be significant pre- to postsession differences in each of the three variables: pain control, physical comfort, and relaxation, as measured during two different session and data collection scenarios. These scenarios included the independent observation and recording of the three subject variables and the subject's self-report of each variable. Reliability correlation coefficients were calculated for each of the different session and data-collection scenarios to help assess the correlation between primary and reliability observers. Pearson product moment correlations indicated reliability agreement coefficients of r = .85 and r = .90. One-tailed t-tests were performed on the collected data for subject pain control, physical comfort, and relaxation. Results of the t-tests were significant at the p < or = .001 (for observed pain control, physical comfort, and relaxation) and p < or = 005 (for self-reported pain control, physical comfort, and relaxation) levels. These results suggest that single-session music therapy interventions appear to be effective in increasing subject pain control, physical comfort, and relaxation during both data collection scenarios. Based on the results of these tests of the analyzed data, the hypotheses were all accepted. Tables illustrate pre- to post-session changes in levels of all three variables from both session and data-collection scenarios. Copies of the data-collection forms are also included in the Appendix. The discussion section addresses limitations of this study and suggestions for future studies.
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Routine chest physiotherapy (CPT) is an important component of prophylactic therapy in children with cystic fibrosis (CF) and requires a significant commitment of time and energy. It is important, therefore, to establish CPT as a positive experience. In this study, we evaluated the effect of recorded music as an adjunct to CPT. Specifically, we compared the use of newly composed music, familiar music, and the family's usual routine on children's and parents' enjoyment of CPT and the parents' perception of time taken to complete CPT. Enjoy ment and perception of time were evaluated via questionnaires designed specifically for this study. Participants were caregivers of one or more children with CF who were aged between 4% months and 24 months at the commencement of the clinical trial and required CPT on a daily basis. Participants were randomly allocated into control and treatment groups. Control group participants experienced two conditions consecutively: no audiotape (NT; control) and familiar music tape (FT; placebo control). Treatment group participants were given the treatment music tape (TT), which was composed and compiled by a music therapist. After baseline assessment, evaluation occurred at two 6-weekly intervals. Children's enjoyment increased significantly after use of the TT (+1.25 units) compared to NT (-0.5 units; P = 0.03), as did parents' enjoyment (+1.0 vs. 0.0 units, P = 0.02). Children's enjoyment did not change significantly after use of the FT (+0.75 units) compared to NT (n.s.). Likewise, parents' enjoyment did not change significantly after use of the FT (+1.0 units, n.s.). There was no change in perception of time after use of the TT (-4.5 vs. +0.2 min, n.s.) or the FT (+3.3 min, n.s.). These results indicate that children's and parents' enjoyment of CPT significantly increased after the use of specifically composed and recorded music as an adjunct. We therefore recommend that recorded music, such as that provided in this study, be given to parents to use as an adjunct to CPT when their young children are diagnosed with CF, in order to assist the establishment of a positive routine. Pediatr Pulmonol, 2000; 29:371-331, (C) 2000 Wiley-iiss, Inc.
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Objective. —To determine the effects of surgeon-selected and experimenter-selected music on performance and autonomic responses of surgeons during a standard laboratory psychological stressor.Design. —Within-subjects laboratory experiment.Setting. —Hospital psychophysiology laboratory.Participants. —A total of 50 male surgeons aged 31 to 61 years, who reported that they typically listen to music during surgery, volunteered for the study.Main Outcome Measurements. —Cardiac responses, hemodynamic measures, electrodermal autonomic responses, task speed, and accuracy.Results. —Autonomic reactivity for all physiological measures was significantly less in the surgeon-selected music condition than in the experimenter-selected music condition, which in turn was significantly less than in the no-music control condition. Likewise, speed and accuracy of task performance were significantly better in the surgeon-selected music condition than in the experimenter-selected music condition, which was also significantly better than the no-music control condition.Conclusion. —Surgeon-selected music was associated with reduced autonomic reactivity and improved performance of a stressful nonsurgical laboratory task in study participants.(JAMA. 1994;272:882-884)
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The management of pain is one of the primary issues in burn care. Pain is not only a physiologic experience, but a psychological one as well. With this in mind, the treatment of burned patients must incorporate a holistic view of pain management and healing. Cognitive, behavioral, and pharmacologic interventions all have a role in pain management. Studies, as well as clinical experience, have shown that musical intervention has been helpful in assisting patients with pain management in a variety of medical settings. Music is an element of normal life that can be easily adapted for the needs of individual patients and their current environment while providing a means for self expression and for normalizing the environment. This article examines the rationale for using music therapy with burned patients, describes several protocols that have been adapted to meet the specific needs of burned patients, and summarizes our preliminary findings, which demonstrate significant response to music therapy protocols employed on our patients.
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Management of pain is a primary concern in the treatment of burn patients. The intent of this study was to test the efficacy of music-based imagery and musical alternate engagement in assisting burn patients in managing their pain and anxiety during debridement. Twenty-five patients, 7 years of age and older, who were admitted to the Comprehensive Burn Care Center were enrolled in the study, which used a repeated-measures design with subjects serving as their own control. Subjects were randomly assigned to 1 of 2 groups. Those placed in Group A received music therapy intervention during their first dressing change, and no music therapy on the following day. Group B received no music therapy intervention during their first dressing change and music therapy during their next dressing, on the following day. Data were collected at 4 intervals in the medical procedure; in the patient's room before transfer to the treatment room, in the treatment room during debridement, in the treatment room after debridement, and upon returning to the patient's room. The measurements taken were pulse, patients' self-report of pain, patients' self-report of anxiety, and the nurse's observation of patients' tension. There was a significant reduction in the self-reporting of pain in those who received music therapy in contrast to those who did not receive music therapy (P < .03). Music therapy is a valuable noninvasive intervention for the treatment of pain after burn injury.
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Postoperative patients differ in their response to pain and opioids It is therefore important that nurses offer other options as adjuvants to medication Relaxation and music may reduce pain by interrupting the postoperative cycle of pain, muscle tension and sympathetic activity This review summarizes and critiques studies on the effectiveness of relaxation and music use during postoperative pain Relaxation and music were effective in reducing affective and observed pain in the majority of studies, but they were less often effective in reducing sensory pain or opioid intake However, the between-study differences in surgical procedures, experimental techniques, activities during testing, measurement of pain, and amount of practice make comparisons difficult Furthermore, within studies, the problems of inadequate sample size, lack of random assignment, no assurance of pretest equivalence, delayed post-test administration and no control for opiates at the time of testing reduces the validity of the studies' conclusions Randomized controlled studies of the types of relaxation and music that are most helpful to postoperative patients should be explored in various contexts
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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.
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2nd Ed, Repr Bibliogr. s. 149-150
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The purpose of this experimental crossover study was to evaluate to what extent the therapeutic use of music would decrease pain in patients with cancer who were receiving scheduled analgesics. Baseline data were collected for three days. Subjects then were assigned randomly to listen to their preference of seven types of relaxing music or a control (a 60-cycle hum) twice daily for three days. Then they crossed over into the alternate group for the next three days. Finally, each subject returned to a follow-up baseline period. Pain, the dependent variable, and mood, which was proposed as an intervening variable, were measured by visual analogue scales. The convenience sample included 15 outpatients with cancer, 12 female and 3 male, ages 20 through 87. Results of the McGill Pain Questionnaire (MPQ), a reliable and valid multidimensional instrument administered upon entry into the study, indicated that the study sample was comparable to other samples of patients with cancer who were in pain. There was an inconsistent relation between pain and mood. The effect of the music on pain varied by individual; 75% had at least some response and 47% had a moderate or great response. Multivariate Analysis of Variance (MANOVA) indicated a statistically significant decrease in pain from using either the music or sound, but there was no effect on mood. Although the mean percentage of change in pain for music was twice that for sound, the results did not differ statistically. The findings support the use of music as an independent nursing intervention to relieve pain.
Article
To determine whether music significantly reduces the pain and anxiety associated with laceration repair in the emergency department. Adult patients presenting to the ED at an urban teaching hospital for laceration repair. Exclusion criteria included patients less than 18 years old, having received analgesics, with suspected alcohol or substance intoxication, and in whom laceration repair was complicated by treatment of a more serious medical condition. This was a randomized, controlled trial. After giving informed consent, patients were randomly assigned to receive standard laceration repair without music (control) or standard laceration repair with music. Patients assigned to the music group chose an audio tape from 50 available styles and artists. Patients received the music through a headset, and they controlled the volume. Intradermal lidocaine was used in all patients. Data were collected on heart rate, blood pressure, and respirations just before and immediately after wound repair. Psychological variables included the state subscale of the Spielberger State Trait Anxiety Inventory (STAI), a visual analog pain scale rating, and a brief questionnaire. STAI and pain scale ratings were analyzed with Wilcoxon's rank-sum test with an alpha error of .05. Thirty-eight patients (19 per group) completed the protocol. Pain scores were significantly (P less than .05) lower in the music group (mean, 2.09) than in controls (mean, 3.31). Anxiety after the procedure was reduced in both groups, but STAI reduction scores were not significantly different between groups (music, 17.7; control, 18.5). Seventeen of 19 patients (89%) rated music "very beneficial," and 100% said they would use music again. Music provides a safe, inexpensive, and effective adjunct for the management of pain in the ED but does not significantly affect anxiety.
Article
To determine the effect of music during bronchoscopy on patient perception of the procedure. Prospective randomized trial. University-based bronchoscopy suite. Twenty-one patients received music (M+), and 28 patients served as controls (M-). Physiologic responses, subjective patient perceptions, and administered medications were monitored. After the procedure, the technician and the physician both rated their impression of the patients' comfort levels to see how accurately they correlated with actual patient reports. There was no difference in physiologic responses between the M+ and M- groups. The M+ patients reported significantly greater comfort (p = 0.02) and less cough (p = 0.03) than the M- group, while there was no difference in reported dyspnea P = 0.21). Both physicians and technicians were very inaccurate in their assessments of patient level of comfort. Medications given did not differ for the two groups. Music during bronchoscopy is a simple and inexpensive nonpharmacologic way to improve patient comfort.
Article
To determine the effects of surgeon-selected and experimenter-selected music on performance and autonomic responses of surgeons during a standard laboratory psychological stressor. Within-subjects laboratory experiment. Hospital psychophysiology laboratory. A total of 50 male surgeons aged 31 to 61 years, who reported that they typically listen to music during surgery, volunteered for the study. Cardiac responses, hemodynamic measures, electrodermal autonomic responses, task speed, and accuracy. Autonomic reactivity for all physiological measures was significantly less in the surgeon-selected music condition than in the experimenter-selected music condition, which in turn was significantly less than in the no-music control condition. Likewise, speed and accuracy of task performance were significantly better in the surgeon-selected music condition than in the experimenter-selected music condition, which was also significantly better than the no-music control condition. Surgeon-selected music was associated with reduced autonomic reactivity and improved performance of a stressful nonsurgical laboratory task in study participants.
Article
Music therapy is a profession which meets multiple physical, social, and psychological needs. Music therapists can facilitate health objectives by reducing the intensity or duration of pain, alleviating anxiety, and decreasing the amount of analgesic medication needed. Rehabilitative objectives can include activities which incorporate exercise, range of motion therapy, or gait training. Reduction of fear, anxiety, stress, or grief are common psychological objectives. Music therapy is particularly effective in promoting social objectives such as increased interaction, verbalization, independence, and cooperation; enhanced relationships with health care personnel and family members; and increased stimulation during long-term hospitalization or isolation. Counseling techniques are often paired with music to achieve emotional objectives such as expression, adjustment, stability, or locus of control. The purpose of this article is to synthesize the extant music/medical research literature and clarify how music therapy can provide a quintessential combination of physical, social, and psychological benefits to enhance the health care of pediatric oncology patients.
Article
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.
Article
The authors investigated music as a method to reduce ambulatory surgery patients' preoperative anxiety. They assigned 42 patients to either an experimental or a control group and compared the patients' vital signs and self-reports of anxiety, which were measured using the state portion of the State-Trait Anxiety Inventory. The study results indicate that music can be more beneficial than preoperative instruction alone in reducing ambulatory surgery patients' anxiety. Patients who listened to their choice of music before surgery in addition to receiving preoperative instruction had significantly lower heart rates than patients in the control group who received only preoperative instruction. Differences in experimental and control group patients' blood pressure measurements and respiratory rates approached significance. The authors suggest that perioperative nurses offer music as a viable option to reduce anxiety in ambulatory surgery patients who believe music is a method of relaxation.
Article
Aversive environment auditory stimuli is a common concern in neonatal intensive care. Recently, interest has developed regarding the use of music applications to mask such stimuli and to reduce the high risk for complications or failure to thrive. In this study of 20 oxygenated, low birth weight infants in a Newborn Intensive Care Unit of a regional medical center in the Southeastern United States, 10 infants listened to lullabies and 10 infants to recordings of their mother's voice through earphones for 20 minutes across three consecutive days. Oxygen saturation levels and frequency of oximeter alarms were recorded. Results indicated a differential response to the two auditory stimuli as listening time progressed. On Day 1, the infants listening to music had significantly higher oxygen saturation levels, but these effects disappeared by Days 2 and 3. On Days 2 and 3, however, the babies hearing music had significantly depressed oxygen saturation levels during the posttest intervals after the music was terminated. Infants hearing music had significantly fewer occurrences of Oximeter alarms during auditory stimuli than did those listening to the mothers' voice. Implications for the therapeutic use of auditory stimuli in the Newborn Intensive Care Unit are discussed.
Article
This article reviews research on the role of psychological stress, personality, social support and other psychosocial factors in bacterial, viral and parasitic infections. After 100 years of research on man and animals, psychological stress is considered as a potential cofactor in the pathogenesis of infectious disease. Psychological stress seems able to alter the susceptibility of animals and man to infectious agents, influencing the onset, course and outcome of certain infectious pathologies. Many experiments have identified in neuroimmunomodulation the principal mediator of the alterations associated with conditions of stress. The development of psychoneuroimmunology has fostered in-depth study of the complex relationship between psychosocial factors, the central nervous system, the immune system and infectious disease. Although antimicrobial drugs have certainly remained the basis of all anti-infective therapy, this type of study has already led some authors to propose and experiment protocols of psychological intervention or psychoimmunotherapy in pathologies such as tuberculosis, or herpes simplex virus or human immunodeficiency virus infections. The psychoneuroimmunological approach to infectious diseases will probably grow in importance in the future not only in the setting of research in psychosomatic medicine but also in that of clinical microbiology.
Article
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.
Article
To determine whether music influences intraoperative sedative and analgesic requirements, two randomized controlled trials were performed. In phase 1, 35 adults undergoing urologic procedures with spinal anesthesia and patient-controlled intravenous propofol sedation were randomly assigned to hear favorable intraoperative music via headset or to have no music. In phase 2, 43 adults undergoing lithotripsy treatment of renal or ureteral calculi and receiving patient-controlled intravenous opioid analgesia were randomly assigned to either a music or no-music group. The effect of music on sedatives and analgesics requirements, recovery room duration, and adverse outcomes was assessed. In phase 1, patients in the music group required significantly less propofol for sedation than patients in the control group (0 [0-150] mg vs. 90 [0-240] mg, median[range]; P < 0.001). These findings persisted after adjusting for duration of surgery (0.3+/-0.1 mg/min vs. 1.6+/-0.4 mg/min; P < 0.001). Similarly, in phase 2, patients who listened to music had a significant reduction in alfentanil requirements (1,600 [0-4,250] microg vs. 3,900 [0-7,200] microg; P = 0.005). This persisted after adjusting for duration of surgery (52+/-9 microg/min vs. 119 +/-16 microg/min, mean +/- SD, P < 0.001). Duration of stay in the postanesthesia care unit and the rate of adverse events was similar in both groups (P = NS). Use of intraoperative music in awake patients decreases patient-controlled sedative and analgesic requirements. It should be noted, however, that patients in the no-music group did not use a headset during operation. Thus, the decrease in sedative and analgesic requirements could be caused by elimination of ambient operating room noise and not by the effects of music.
Article
To examine the effect of listening to self-selected music versus an intradermal injection of normal saline solution on the intensity and distress of intravenous (IV) catheter insertion pain. Prospective, randomized, controlled study. Inpatient and outpatient units in 2 university-affiliated southwestern medical centers. One hundred ten adult inpatients and outpatients undergoing IV therapy. Outcome Measures: Pain intensity, pain distress, and IV insertion difficulty visual analog scales. Patients were randomly assigned to receive an intradermal injection of normal saline solution, listen with headphones to self-selected music, or be in a control group for IV insertion. A MANOVA revealed no statistically significant multivariate or univariate differences in pain by treatment group, but significantly higher pain distress scores with failed IV insertions. The pain intensity and distress scores were significantly higher in the saline solution group when compared with the music and control groups combined. Insertion difficulty was significantly positively correlated with pain intensity and distress for the entire sample, with weak, nonsignificant correlations in the music group. Intradermal unpreserved saline solution contributes to greater pain intensity and distress, greater insertion difficulty, and a higher failure rate than the use of music or routine IV insertion. Listening to preferred music attenuates the effect of insertion difficulty on IV insertion pain. Intravenous insertion attempts were unsuccessful in more than one third of the subjects, resulting in higher pain distress scores. Further research is needed on interventions to reduce IV insertion pain and on factors contributing to IV insertion failure.
Article
To assess the benefits of lullaby singing and multimodal stimulation on premature infants in neonatal intensive care, 40 infants in a Level III Newborn Intermediate Care Unit were divided into control (n = 20) and experimental (n = 20) groups by pair matching on the basis of gender, birthweight, gestational age at birth and severity of medical complications. Participants met these project criteria: (a) corrected gestational age > 32 weeks; (b) age since birth > 10 days; and (c) weight > 1700 g. All participants had been referred for developmental stimulation by the medical staff. Experimental infants received reciprocal, multimodal (ATVV) stimulation paired with line singing of Brahms' Lullaby. Stimulation was provided for 15-30 minutes, one or two times per week from referral to discharge. Dependent variables were (a) days to discharge, (b) weight gain/day, and (c) experimental infants' tolerance for stimulation. Results showed that music and multimodal stimulation significantly benefited females' days to discharge and increased weight gain/day for both males and females. Both male and female infants' tolerance for stimulation showed marked and steady increase across the stimulation intervals with females' tolerance increasing more rapidly than males.
Article
The purpose of this study was to examine the effects of music on selected stress behaviors, weight, caloric and formula intake, and length of hospital stay. Subjects were 52 preterm and low birth weight newborns in a newborn intensive care unit (NBICU) who were in stable condition and restricted to isolettes. Subjects in the experimental and control groups were matched for equivalency based on sex, birth weight, and diagnostic criticality. Eleven males and 15 females were assigned to the control group and received routine auditory stimulation. The experimental group of 11 males and 15 females received music stimulation, which consisted of approximately 60 minutes of tape recorded vocal music, including lullabies and children's music, and routine auditory stimulation. Thirty-minute segments of the recording were played alternatively with 30 minutes of routine auditory stimulation three times daily. Exposure to music stimulation occurred only during the infants' stay in the NBICU. Results suggest music stimulation may have significantly reduced initial weight loss, increased daily average weight, increased formula and caloric intake, significantly reduced length of the NBICU and total hospital stays, and significantly reduced the daily group mean of stress behaviors for the experimental group. Data analyses suggest the length of hospital stay may be correlated with the amount of stress experienced by the neonate and not with weight gains. Theoretical and practical aspects of these results are discussed.
Article
The aim of this randomized controlled trial was to determine the effect of jaw relaxation, music and the combination of relaxation and music on postoperative pain after major abdominal surgery during ambulation and rest on postoperative days 1 and 2. Opioid medication provided for pain, following abdominal surgery, does not always give sufficient relief and can cause undesired side effects. Thus, additional interventions such as music and relaxation may provide more complete relief. Previous studies have found mixed results due to small sample sizes and other methodological problems. In a rigorous experimental design, 500 subjects aged 18-70 in five Midwestern hospitals were randomly assigned by minimization to a relaxation, music, relaxation plus music, or control group. Interventions were taught preoperatively and tested postoperatively. The same amount of time was spent with subjects in the control group. Pain was measured with the visual analogue sensation and distress of pain scales. Demographic and surgical variables, and milligrams of parenteral or oral opioids in effect at the time of testing were not significantly different between the groups, nor did they correlate with pain scores. Controlling for pretest sensation and distress, orthogonal a priori contrasts and multivariate analysis of covariance indicated that the three treatment groups had significantly less pain than the controls, (P = 0.028-0.000) which was confirmed by the univariate analysis of covariance (P = 0.018-0.000). Post hoc multivariate analysis revealed that the combination group had significantly less sensation and distress of pain than the control group on all post-tests (P = 0.035-0.000), and the relaxation and music groups had significantly less on all tests (P = 0.022-0.000) except after ambulation. At post ambulation those using relaxation did not have significantly less pain than the controls on both days and those using music did not on day 1, although there were some univariate effects. A corresponding significant decrease in mastery of the interventions from pre to post ambulation suggests the need for reminders to focus on the intervention during this increased activity. Physicians and nurses preparing patients for surgery and caring for them afterward, should encourage patients to use relaxation and music as adjuvants to medication for postoperative pain.
Article
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.
Article
To study the effect of music on state anxiety levels in patients undergoing flexible fiberoptic bronchoscopy (FFB). Randomized clinical trial using pretests, posttests, and two groups. Pulmonary special-procedures unit of a tertiary-care referral center. Sixty adult patients: 30 patients received music during bronchoscopy and 30 control subjects received no music. The study population had baseline state anxiety levels similar to those previously reported in surgical patients (42.6 +/- 13 vs 42.7 +/- 14; p value, not significant [NS]) and higher than those reported in normal working adults (42.6 +/- 13 vs 34.4 +/- 10; p < 0.001). Experimental and control groups were similar in patient and procedure-related characteristics and baseline pre-FFB state and trait anxiety scores. Although trait anxiety scores decreased significantly after the procedure (pooled post-FFB scores of 32.6 +/- 10 vs pre-FFB scores of 35.5 +/- 11; p < 0.001), no reductions were noted in state anxiety (pooled post-FFB scores of 42.8 +/- 13 vs pre-FFB scores of 42.6 +/- 13; p value, NS). More importantly, playing music through headphones during FFB did not result in a statistically or clinically significant reduction in either state or trait anxiety when compared to control subjects. Relaxation music administered through headphones to patients during flexible bronchoscopy does not decrease procedure-related state anxiety.
Article
The purpose of this study was to investigate the effects of audiotaped lullabies on physiological and behavioral distress and perceived pain among children during routine immunization. An experimental design was used to study 99 healthy children ages 3 to 6 years. Half the children received the musical intervention during the immunizations, while the other half did not. Groups were assessed during five phases: baseline, preimmunizations, during the immunization, after Band-Aid application, and 2 min after phase 4. Physiological variables (heart rate, blood pressure) were obtained in phases 1, 4, and 5. Behavioral distress was measured using the Observational Scale of Behavioral Distress during phases 1, 2, 3, and 4. Pain perception was measured using the Oucher in phases 1 and 4. No significant differences were found between experimental and control groups for heart rate, blood pressure, or Oucher scores. However, total distress scores were significantly less for the experimental group. These results indicate that immunization is a stressful experience for children. Recommendations include further study incorporating pharmacological and nonpharmacological interventions.
Article
Routine chest physiotherapy (CPT) is an important component of prophylactic therapy in children with cystic fibrosis (CF) and requires a significant commitment of time and energy. It is important, therefore, to establish CPT as a positive experience. In this study, we evaluated the effect of recorded music as an adjunct to CPT. Specifically, we compared the use of newly composed music, familiar music, and the family's usual routine on children's and parents' enjoyment of CPT and the parents' perception of time taken to complete CPT. Enjoyment and perception of time were evaluated via questionnaires designed specifically for this study. Participants were caregivers of one or more children with CF who were aged between 4½ months and 24 months at the commencement of the clinical trial and required CPT on a daily basis. Participants were randomly allocated into control and treatment groups. Control group participants experienced two conditions consecutively: no audiotape (NT; control) and familiar music tape (FT; placebo control). Treatment group participants were given the treatment music tape (TT), which was composed and compiled by a music therapist. After baseline assessment, evaluation occurred at two 6-weekly intervals.
Article
Management of pain is a primary concern in the treatment of burn patients. The intent of this study was to test the efficacy of music-based imagery and musical alternate engagement in assisting burn patients in managing their pain and anxiety during debridement. Twenty-five patients, 7 years of age and older, who were admitted to the Comprehensive Burn Care Center were enrolled in the study, which used a repeated-measures design with subjects serving as their own control. Subjects were randomly assigned to 1 of 2 groups. Those placed in Group A received music therapy intervention during their first dressing change, and no music therapy on the following day. Group B received no music therapy intervention during their first dressing change and music therapy during their next dressing, on the following day. Data were collected at 4 intervals in the medical procedure; in the patient's room before transfer to the treatment room, in the treatment room during debridement, in the treatment room after debridement, and upon returning to the patient's room. The measurements taken were pulse, patients' self-report of pain, patients' self-report of anxiety, and the nurse's observation of patients' tension. There was a significant reduction in the self-reporting of pain in those who received music therapy in contrast to those who did not receive music therapy (P < .03). Music therapy is a valuable noninvasive intervention for the treatment of pain after burn injury.
Article
Pain is a common problem in the PACU, resulting in negative respiratory, cardiovascular, gastrointestinal, renal, neuroendocrine, and autonomic nervous system consequences for patients. Pain relief contributes to improved patient outcomes and is also an important component of patient satisfaction, particularly in light of today's environment of high competition among hospitals for patients. Music and quiet conversation by staff, contributing to low noise levels in the PACU environment, have the potential to provide pain relief and improve patient satisfaction with the PACU experience. This study investigated the effect of soothing music and lowering noise levels on the pain experience of patients during their PACU stay. A quasiexperimental study was conducted with 2 groups of patients, one who listened to music on a day when staff kept extraneous noise at a minimum in the PACU (the experimental group) and one who experienced the typical PACU day (the control group). The study was conducted at a large Veterans Administration hospital in the Midwest. The sample consisted of 97 individuals undergoing same-day surgery from all surgery services except open heart. Pain was measured by using the 11-point Numerical Rating Scale (NRS). The experimental group experienced a significant reduction in pain from admission to the PACU until discharge. There was no significant decrease for the control group. Approximately 65% of both groups reported no pain on admission to PACU. The percentage of those in the experimental group with no pain increased to 74% at time of discharge. The percentage of those in the control group who reported no pain on discharge had decreased to 58%. A total of 99% of the participants remembered their PACU stay. When asked to remember aspects of comfort during the PACU stay, the experimental group reported (1) significantly less noise caused by staff voices and equipment, (2) greater perception of availability of nurses, and (3) significantly more positive perception of their PACU stay. The study findings support the potential for music played throughout the PACU stay to positively affect the pain experience and improve comfort among patients having surgery.
Article
Screening flexible sigmoidoscopy (FS) is an effective tool for the detection of colon cancer. Nonetheless, persons are reluctant to undergo FS for a variety of reasons such as anxiety, discomfort, and the possibility of abnormal findings. Nurses caring for FS patients can implement interventions to allay anxiety and promote comfort in an effort to enhance satisfaction and future compliance. Music therapy is one nonpharmacologic intervention that has been shown to be effective in allaying anxiety, reducing discomfort, and promoting satisfaction in other patient populations. A two-group pretest, posttest experimental design with repeated measures study recruited 64 subjects undergoing FS from one Midwestern tertiary care center. Subjects were randomly assigned to a control condition of usual procedural care or to an experimental condition of music therapy during the examination. State and trait anxieties were measured at pretest. State anxiety, discomfort, satisfaction, and perceived compliance with future screening were measured after the procedure. Subjects in the music group reported less anxiety and discomfort than subjects in the control group. There were no differences on satisfaction ratings or perceived compliance with screening guidelines. Nurses caring for patients undergoing screening FS can offer music therapy as one nonpharmacologic intervention to ameliorate anxiety and reduce discomfort.
Article
The purpose of the study was to determine the efficacy of music and eutectic mixture of local anesthetics (EMLA) on pain responses of neonates undergoing circumcision. A randomized, double-blind experimental design was used with 23 neonates. Pain response was measured using an observational pain intensity rating scale and the physiologic parameters of heart rate, respiratory rate, oxygen saturation levels, salivary cortisol levels, and length of cry. Each infant's state was examined for a potential contribution to the pain response. Infant state, salivary cortisol levels, and respiratory rates were not significant. Pain ratings had considerable variability for all treatment conditions, but both single treatment groups had less pain by the end of the procedure. The heart rate was significantly lower for the EMLA group and remained stable for the music group. Oxygen saturation differences were statistically significant for the music group (P =.02) and approached significance for the EMLA group. Preliminary support was provided for the efficacy of EMLA and music to contribute to the pain relief of neonates undergoing circumcision. Further study is warranted. Neonates deserve interventions that will provide them with a less painful start in life.
Article
Cancer patients continue to experience elevated levels of emotional distress, even after cancer treatment. Elevated emotional distress negatively impacts immune and endocrine functions and decreases life quality. This study explored the effectiveness of GIM in alleviating mood disturbance and improving quality of life in cancer patients. Eight volunteers with a cancer history were randomly assigned to either an experimental or a wait-list control group. Experimental subjects individually participated in 10 weekly GIM sessions. All subjects completed the Profile of Mood States (POMS) and Quality of Life—Cancer (QOL-CA) questionnaires pretest, posttest, and at a 6-week follow-up. Individuals who participated in GIM sessions scored better on both mood scores and quality of life scores at posttest than those participating in the control group. Additionally, mood and quality of life scores continued to improve in the experimental group, even after sessions were complete. Results indicate that GIM was effective in improving mood and quality of life in these cancer patients.
Article
To determine whether music moderates the level of anxiety that patients experience during radiation therapy. Experimental, longitudinal, random assignment to music or no music therapy. Urban radiation oncology center in a Department of Veterans Affairs hospital in the southeastern United States. Forty-two men (19 in the experimental group, 23 in the control group) aged 39-80 years (74% white, 12% African American, 12% Hispanic, and 2% other) receiving definitive external beam radiation therapy for pelvic or abdominal malignancies. Patients in the experimental group listened to music of their choice provided via audiotapes and headphones before and during their simulation and daily treatments for the duration of the planned course of therapy. The control group received standard care. The State-Trait Anxiety Inventory was administered initially to participants in both groups at the time of evaluation (time 1), post-simulation (time 2), at the end of the first week (time 3), at the end of the third week (time 4), and at the end of the fifth week or end of radiation therapy (time 5). State anxiety. No significant difference existed between the two groups to suggest that music moderated the level of anxiety during radiotherapy. However, post-hoc analyses identified changes and trends in state anxiety scores, suggesting a possible benefit of music therapy during radiotherapy. Despite a lack of group differences, early intervention with music therapy for patients with high levels of anxiety may be beneficial. Nurses and other clinicians may administer state anxiety scales at the initial visit or prior to pretreatment radiation planning (simulation). Individuals who have high state anxiety scores may receive nursing interventions tailored to reduce anxiety during simulation and the early part of radiotherapy.
Article
Unlabelled: Ambulatory surgery can create significant anxiety. This prospective study measured whether music can influence anxiety and perioperative sedative requirements in outpatients undergoing surgery with spinal anesthesia. We also evaluated the correlation between two anxiety measures, the State-Trait Anxiety Inventory test (STAI) and the 0- to 10-cm visual analog scale (VAS 0-10), with 0 meaning complete relaxation and 10 the worst feeling of anxiety possible. Fifty unpremedicated patients were randomly assigned to listen to music of their choice via headset during the perioperative period (Group I) or to have no music (Group II). All participants used patient-controlled IV midazolam sedation and underwent repeated evaluations of their anxiety level with the STAI and the VAS 0-10. Midazolam requirements during surgery (Group I, 0.6 +/- 0.7 versus Group II, 1.3 +/- 1.1 mg; P < 0.05) and for the whole perioperative period (Group I, 1.2 +/- 1.3 versus Group II, 2.5 +/- 2.0 mg; P < 0.05) were smaller in patients listening to music. Anxiety levels, measured with STAI or VAS 0-10, were similar in both groups. The Spearman's coefficient values between STAI and VAS 0-10 ranged from 0.532 to 0.687. We conclude that patients listening to music require less midazolam to achieve a similar degree of relaxation as controls and that measures of anxiety obtained from the STAI and the VAS 0-10 are positively, but only moderately, correlated. Implications: It is possible to decrease sedative requirements during surgery under spinal anesthesia by allowing patients to listen to music to reduce their anxiety.
Article
By considering three kinds of music and noise, this research investigates the influence of music on the living body by comparing the difference of influence on heart rate variability and comfort when subjects listen to music and are exposed to noise. We used two pieces of classical music, rock music, and noise recorded by a tape recorder. The following conclusions were made from the findings of the research: 1) Hearing classical music results in a small variance of Mayer Wave related Sinus Arrhythmia (MWSA) component and Respiratory Sinus Arrhythmia (RSA) component compared with a body being at rest. This is because the sympathetic nerve is suppressed by the sound of classical music. With rock music and noise, however, the MWSA component increases and the RSA component decreases. 2) From a psychological evaluation, we found that classical music tends to cause comfort and rock music and noise tend to cause discomfort. 3) A correlation was found between the balance of the MWSA component and the RSA component and the psychological evaluation. As the comfort increases, the variance of MWSA decreases; as discomfort increases, the variance of MWSA increases.
Article
The purpose of this study was to assess the effectiveness of music therapy in decreasing anxiety in ventilator-dependent patients. A crossover repeated measures design with random assignment was used. The intensive care unit of a university hospital in Hong Kong was used as the setting for this study. Twenty patients who were ventilator-dependent were recruited for the study. They were all Chinese with a mean age of 58.25 years (range, 19-84 y). Most (75%) were men. Outcome Measures: Physiologic measures of anxiety assessed in this study were mean blood pressure and respiratory rate. An additional measure was the Chinese version of the Spielberger State-Trait Anxiety Inventory. Patients were randomized to receive either 30 minutes of uninterrupted rest and then 30 minutes of music therapy or the music therapy first and then the uninterrupted rest period. Patients listened to relaxing music by using audiocassette players and headphones. Subjects selected the music of their choice from a selection including both Chinese and Western music. Subjects had physiologic measures taken immediately before the intervention (or rest period) and at 5-minute intervals throughout the intervention. The Chinese version of Spielberger's State-Trait Anxiety Inventory was completed before the intervention and immediately after the intervention. Findings indicated that music therapy was more effective in decreasing state anxiety than was an uninterrupted rest period (P <.01). As measured by analysis of variance with repeated measures, blood pressure and respiratory rate showed no significant differences in the 2 conditions over time. However, significant differences were observed at the end of the intervention (after 30 minutes) between the 2 conditions, with music therapy being superior to the rest period. Music therapy is an effective nursing intervention in decreasing anxiety in ventilator-dependent patients and its use should be incorporated into the care of mechanically ventilated patients. For the Chinese patients, culture and language were the predominant factors in their choice of music.
Article
Over the past few decades there has been a growing interest in the use of music, which has seen it used to achieve a diverse range of outcomes. While music as an intervention for hospital patients has subject to considerable evaluation, many of these studies are small and findings are therefore often contradictory. This systematic review was conducted to investigate the effectiveness of music as an intervention for hospital patients. A comprehensive search was undertaken involving all major health care databases. For studies to be included in the review they must have investigated the effect of music, involved adult hospital patients and used a randomized controlled trial design. These studies must also have used outcome measures such as anxiety, satisfaction, pain, mood and vital signs. Identified studies were critically appraised, and then categorized according to whether music was evaluated during normal care delivery or during invasive and unpleasant procedures. When appropriate, studies were combined in a meta-analysis. A total of 29 studies were identified that fulfilled the inclusion criteria, of which 10 were subsequently excluded following critical appraisal. Music played via headphones reduces anxiety of patients during normal care deliver, but it has no impact on the anxiety of patients undergoing procedures such as bronchoscopy, sigmoidoscopy or surgery with a spinal anaesthetic. Music produces a small reduction in respiratory rate during normal care delivery, but appears to have little effect on other vital sign parameters. It has no impact on the vital signs of patients undergoing procedures. Although the evidence is limited, music also appears improve the mood and tolerance of patients. This review demonstrates the effectiveness of music for the reduction of anxiety during normal care deliver. Given the inexpensive nature of this intervention, and the lack of adverse events, it is recommended as an adjunct to normal care practices. This review also highlights the need for further research into many aspect of this intervention.