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Tharwani ZH, Kumar P, Kumar A, Javaid S, Kumar R, Shah MA, Shaeen SK, Sunita F, Ladhwani NK, Malikzai A. Effects of music therapy on anxiety among patients undergoing cardiac procedures: a systematic review and meta-analysis. Ann Med Surg (Lond) 2025; 87:2904-2913. [PMID: 40337439 PMCID: PMC12055049 DOI: 10.1097/ms9.0000000000003226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Accepted: 03/09/2025] [Indexed: 05/09/2025] Open
Abstract
Objective The article aims to assess impact of music therapy on anxiety in patients undergoing cardiac procedures. Methods MEDLINE, Embase, and Cochrane Central were searched to identify relevant cohorts and randomized controlled trials (RCTs). We evaluated anxiety, heart rate (HR), systolic and diastolic blood pressures (SBP and DBP), respiratory rate, mean arterial pressure (MAP), and mean oxygen saturation (SaO2) using weighted random-effects models, reporting mean difference (MD) with 95% confidence intervals. Results In total, 1706 patients from 18 RCTs and one cohort study were analyzed. Music therapy recipients showed significantly lower anxiety measured by the State-Trait Anxiety Inventory (MD: -4.75; P = 0.002). The music therapy group demonstrated improved HR (MD: -4.90, P = 0.02), SBP (MD: -5.14, P = 0.01), and respiratory rate (MD: -1.15, P = 0.01). No significant differences were observed in anxiety measured by the Numerical Anxiety Rating Scale (MD: -1.09, P = 0.14), DBP (MD: -2.61, P = 0.15), MAP (MD: -4.71, P = 0.47), or SaO2 (MD: 0.93, P = 0.61). Conclusion Music therapy significantly reduces anxiety and enhances post-procedural HR, SBP, and respiratory rates in cardiac procedure patients.
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Affiliation(s)
- Zoaib Habib Tharwani
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Prince Kumar
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Avinash Kumar
- Bahria University Medical and Dental College, Karachi, Pakistan
| | - Saad Javaid
- Lahore Medical and Dental College, Lahore, Pakistan
| | - Rohet Kumar
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan
| | - Mohsin Ali Shah
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan
| | - Sean Kaisser Shaeen
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Fnu Sunita
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, UK
| | - Naresh Kumar Ladhwani
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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Siddiqi AK, Shafiq A, Ahmed M, Anwer A, Maniya MT, Ahmed A, Chachar MA, Hasibuzzaman MA. Therapeutic use of music listening in patients undergoing invasive coronary procedures: A meta-analysis. World J Cardiol 2025; 17:97406. [PMID: 39866216 PMCID: PMC11755124 DOI: 10.4330/wjc.v17.i1.97406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 09/20/2024] [Accepted: 11/27/2024] [Indexed: 01/21/2025] Open
Abstract
BACKGROUND Listening to music has been shown to reduce pain and anxiety before, during, and after invasive coronary procedures. AIM To perform a systematic review and meta-analysis to explore the effect of therapeutic use of music on both, perioperative and postoperative outcomes of invasive coronary procedures. METHODS An exhaustive literature search of 3 electronic databases (MEDLINE, Scopus, Cochrane CENTRAL) was conducted from inception until 10th December 2023. The results of our analyses are presented as standard mean difference (SMD) or weighted mean difference, with 95%CI and pooled using a random effects model. A P value < 0.05 was considered significant in all cases. RESULTS From 21 studies, 2141 participants were included in our analysis. The pooled analysis demonstrated that music listening significantly improves post-procedural pain (SMD = -0.78, 95%CI: -1.34 to -0.23; P = 0.006), anxiety (SMD = -0.86, 95%CI: -1.43 to -0.29; P = 0.003), heart rate [mean difference (MD) = -3.38, 95%CI: -5.51 to -1.25; P = 0.002], and systolic blood pressure (MD = -5.89, 95%CI: -9.75 to -2.02; P = 0.003). There was no significant improvement in diastolic blood pressure (MD = -3.22, 95%CI: -6.58 to 0.14; P = 0.06) or respiratory rate (MD = -0.97, 95%CI: -1.98 to 0.03; P = 0.06). CONCLUSION Music listening can be used in healthcare settings for patients undergoing invasive coronary procedures to reduce anxiety levels and improve their physiological parameters.
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Affiliation(s)
- Ahmed Kamal Siddiqi
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, United States
| | - Aimen Shafiq
- Department of Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Mushood Ahmed
- Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi 74200, Pakistan
| | - Anusha Anwer
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi 74200, Pakistan
| | | | - Aymen Ahmed
- Department of Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan
| | | | - Md Al Hasibuzzaman
- Department of Medicine, Niramoy Hospital, Panchagarh 5010, Bangladesh
- Department of Medicine, The First Affiliated Hospital of Ningbo University, Ningbo 315211, Zhejiang Province, China.
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Wang YR, Hung YY, Lu SF. Effect of music-based interventions on anxiety and stress-related vital signs in patients undergoing cardiac catheterization: A systematic review and meta-analysis. Complement Ther Med 2024; 85:103078. [PMID: 39209008 DOI: 10.1016/j.ctim.2024.103078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 08/01/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVES This work aimed to evaluate the effect of music-based intervention (MBI) on anxiety and stress-related vital signs (heart rate, respiratory rate and blood pressure) in patients undergoing cardiac catheterization. DESIGN A systematic review and meta-analysis. METHODS This systematic review and meta-analysis was conducted according to PRISMA guidelines. PubMed, Cochrane Library, Embase and CINAHL were systematically searched from inception to October 31, 2023. Two authors independently searched electronic databases, selected literature, extracted data and assessed the risk of bias according to the eligibility criteria. The Review Manager software (RevMan version 5.4.1) was used to perform meta-analysis. RESULTS Eleven randomized controlled trials (RCTs) with adult patients (n = 1204) (passive music therapy, 8 studies; passive music listening, 3 studies) were enrolled and brought into qualitative assessment. Nine of these RCTs (n = 868) were taken into quantitative analysis. Meta-analysis using the random-effects model revealed that the difference in the pre-post anxiety level in the music group was significantly greater than that in the control group. However, meta-analysis results for heart rate, respiratory rate, systolic blood pressure and diastolic blood pressure did not show significant differences. CONCLUSION The findings suggested that MBI had a significant effect on reducing anxiety in patients undergoing cardiac catheterization. However, the limited quantity and quality of included studies highlight the need for additional research to comprehensively analyze the influence of MBI on anxiety reduction in this patient population.
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Affiliation(s)
- Yu-Ru Wang
- Department of Intensive Care Unit, Hualien, Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yan-Ye Hung
- Department of Vascular Surgery, Peking University People's Hospital, Beijing, China; The Institute of Cardiovascular Sciences and Institute of Systems Biomedicine, School of Basic Medical Sciences, Key Laboratory of Molecular Cardiovascular Science of Ministry of Education, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Beijing Key Laboratory of Cardiovascular Receptors Research, Health Science Center, Peking University, Beijing, China
| | - Shiou-Fang Lu
- Department of Nursing, College of Nursing, Tzu Chi University, Hualien, Taiwan.
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Effectiveness of Hypnosis for the Prevention of Anxiety During Coronary Angiography (HYPCOR study): a prospective randomized study. BMC Complement Med Ther 2022; 22:315. [PMID: 36447198 PMCID: PMC9707301 DOI: 10.1186/s12906-022-03792-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Coronary angiography is the gold standard for the diagnosis of coronary artery disease. This intervention is nevertheless a source of anxiety for the patient both by its discomfort and by the consequences linked to the discovery of potential diseases. OBJECTIVES The aim of this study was to determine the effectiveness of hypnosis in reducing anxiety in patients undergoing coronary angiography. METHODS One hundred sixty-nine patients with planned coronary angiography and no history of coronary angiography were randomized to a hypnosis or control group. Patients in the hypnosis group underwent a hypnosis session with self-hypnosis posthypnotic suggestions, while those in the control group had a conversational interview with the hypnotherapist. The primary endpoint was pre-exam anxiety level assessed by the Spielberger State-Trait Anxiety Inventory (STAI-Y A). RESULTS Performing a hypnosis session did not result in a significant decrease in anxiety before the intervention. Age, high trait anxiety, high state anxiety the day before, and belief that hypnosis works in general were associated with increased anxiety before the procedure. No adverse events were reported after hypnosis. There was no statistically significant difference between the 2 groups for the occurrence of complications of the intervention. CONCLUSION In this study, performing a hypnosis session before coronary angiography did not reduce the state of anxiety measured just before the intervention. In all cases, the hypnotic experience appears to be positive for the patient, encouraging further research efforts. TRIAL REGISTRATION The research protocol has been registered on the ClinicalTrials.gov registry (NCT02818101; 29/06/2016) and with the ANSM (IDRCB 2016-A00205-46; 02/02/2016).
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Batista LDC, Melo MN, Cruz DDALMD, Gengo e Silva Butcher RDC. Characteristics of music intervention to reduce anxiety in patients undergoing cardiac catheterization: scoping review. Heliyon 2022; 8:e11894. [PMID: 36468133 PMCID: PMC9712553 DOI: 10.1016/j.heliyon.2022.e11894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/30/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022] Open
Abstract
The characteristics of music interventions for reducing anxiety in patients undergoing cardiac catheterization were mapped. A scoping review was conducted according to the Joanna Briggs Institute methodology. Searches were performed in electronic portals and databases PubMed, CINAHL, PsycINFO, Cochrane, EMBASE, Scopus, LILACS, CAPES Thesis Portal (Brazil), DART-Europe E-theses Portal, Theses Canada Portal, Pro-Quest, and Google Scholar databases, gray literature, with no limitation on the year of publication. Eighteen articles were included in the search. The characteristics of the interventions were heterogeneous and not comprehensively described in the primary studies. The songs were predominantly of a single genre, instrumental, and selected by the interventionist, with a rhythm between 60 and 80 beats per minute. The interventions were delivered in a single session, mostly in the catheterization laboratory, before or during the procedure, by means of digital audio and earphones for over 20 min. The heterogeneity of interventions and incompleteness of information in the studies compromises the advancement of knowledge on the effects of music on health outcomes.
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Affiliation(s)
- Letícia de Carvalho Batista
- Graduate Program in Adult Health Nursing (PROESA), School of Nursing, University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 419, São Paulo/SP 05403-000, Brazil
| | - Michele Nakahara Melo
- Graduate Program in Adult Health Nursing (PROESA), School of Nursing, University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 419, São Paulo/SP 05403-000, Brazil
| | - Diná de Almeida Lopes Monteiro da Cruz
- Graduate Program in Adult Health Nursing (PROESA), School of Nursing, University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 419, São Paulo/SP 05403-000, Brazil
| | - Rita de Cassia Gengo e Silva Butcher
- Graduate Program in Adult Health Nursing (PROESA), School of Nursing, University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 419, São Paulo/SP 05403-000, Brazil
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Keshvari M, Yeganeh MR, Paryad E, Roushan ZA, Pouralizadeh M. The effect of virtual reality distraction on reducing patients' anxiety before coronary angiography: a randomized clinical trial study. Egypt Heart J 2021; 73:98. [PMID: 34735643 PMCID: PMC8568743 DOI: 10.1186/s43044-021-00224-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/25/2021] [Indexed: 11/24/2022] Open
Abstract
Background Coronary angiography is used as a qualified method to diagnose coronary heart disease. However, patients undergoing coronary angiography experience a great deal of anxiety. The present study is aimed at investigating the effect of virtual reality on anxiety before coronary angiography. In a randomized controlled trial, 60 candidates for coronary angiography were randomly assigned to two intervention and control groups from April to July 2019. Data were collected by Spielberger’s situational anxiety questionnaire. The participants’ anxiety level and their heart rate, respiratory rate, and blood pressure were measured before and immediately after the intervention. The Intervention group received virtual reality intervention, and the control group was cared for based on the hospital routine. Data were entered into the SPSS version 24.0 software (SPSS Inc.) and analyzed using Chi-square, Paired samples, and independent sample t tests. Results The majority of participants were male (71.25%) and the Mean ± SD age of them in the intervention and control groups was 50.95 ± 4.120 and 52.08 ± 4.002 years, respectively. The mean score of anxiety (p < 0.01), heart rate (p = 0.001), and systolic blood pressure (p = 0.016) after the intervention in the intervention group decreased significantly. Conclusions This study indicated the implementation of a VR distraction protocol in the patients could effectively reduce perioperative anxiety and its indices. It showed that VR is a safe method without any complications related to the device and with good acceptability. Registration code IRCT201 40515017693N3.
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Affiliation(s)
- Mostafa Keshvari
- Department of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
| | - Mohammad Reza Yeganeh
- Department of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
| | - Ezzat Paryad
- Department of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
| | - Zahra Atrkar Roushan
- Department of Biostatistics, Medical School, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
| | - Moluk Pouralizadeh
- Department of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran. .,Shahid Dr. Beheshti Nursing and Midwifery School, Hamidyan suburb,Shahid Beheshti Ave., Guilan, Rasht, Islamic Republic of Iran.
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Ho CY, Wexberg P, Schneider B, Stöllberger C. Effect of music on patients with cardiovascular diseases and during cardiovascular interventions : A systematic review. Wien Klin Wochenschr 2021; 133:790-801. [PMID: 33296028 DOI: 10.1007/s00508-020-01782-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The therapeutic effects of music have been known for thousands of years. Recently, studies with music interventions in patients with cardiovascular diseases yielded controversial results. The aim of this review is to provide an overview of the effects of receptive music intervention on the cardiovascular system. METHODS We searched in PubMed, SCOPUS and CENTRAL for publications between January 1980 and May 2018. Primary endpoints were heart rate, heart rate variability and blood pressure. Secondary endpoints comprised respiratory rate, anxiety and pain. The quality of the studies was assessed by using the CONSORT statement and the Cochrane risk of bias assessment tool. A meta-analysis and subgroup analyses concerning music style, gender and region were planned. RESULTS A total of 29 studies comprising 2579 patients were included and 18 studies with 1758 patients investigated the effect of music on patients undergoing coronary angiography or open heart surgery. Other studies applied music to children with congenital heart diseases, pregnant women with hypertension or patients with unstable angina. Due to high methodological study heterogeneity, a meta-analysis was not performed. The study quality was assessed as medium to low. In ten studies with higher quality comprising 1054 patients, music intervention was not associated with significant changes in the cardiovascular endpoints compared to the control group. The subgroup analyses did not demonstrate any relevant results. CONCLUSION Currently no definite effect of receptive music intervention on the cardiovascular system can be verified. Further research is needed to assess music as an inexpensive and easy applicable form of therapy.
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Affiliation(s)
- Chen-Yu Ho
- Klinik Landstraße, Juchgasse 25, 1030, Vienna, Austria.
- , Liechtensteinstr. 8/12, 1090, Vienna, Austria.
| | - Paul Wexberg
- Klinik Landstraße, Juchgasse 25, 1030, Vienna, Austria
| | - Birke Schneider
- Sana Kliniken Lübeck, Kahlhorststr. 17, 23562, Lübeck, Germany
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Chair SY, Zou H, Cao X. A systematic review of effects of recorded music listening during exercise on physical activity adherence and health outcomes in patients with coronary heart disease. Ann Phys Rehabil Med 2021; 64:101447. [PMID: 33130038 DOI: 10.1016/j.rehab.2020.09.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 07/05/2020] [Accepted: 09/11/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Exercise training is a key facet of cardiac rehabilitation and is associated with irrefutable benefits for individuals with coronary heart disease. However, compliance with and adherence to such interventions are challenging among this population. The incorporation of music into exercise training may be a potential approach to address this issue. OBJECTIVES This study aimed to evaluate the effects of recorded music listening during exercise on adherence to physical activity and health outcomes in individuals with coronary heart disease. METHODS A systematic review was conducted by searching 7 English databases for reports of randomized controlled trials and quasi-experimental studies evaluating the effects of recorded music listening during exercise on adherence to physical activity and physical, psychological, and cognitive outcomes in adults with coronary heart disease. Two reviewers independently screened records for eligibility, extracted data, and assessed the quality of reports by using the Effective Public Health Practice Project Quality Assessment Tool tool. RESULTS We identified 7 studies involving 293 participants (mean age 62.6 to 72 years, men: 57% to 80%). All but one study included relatively small samples (17 to 56). The overall quality was weak for 3 studies, moderate for 2, and strong for 2. Several reviewed studies showed significant effects of music on attendance at exercise-based cardiac rehabilitation (1 of 2 studies), maintenance of physical activity after intervention (1 study), perceived exertion (2 of 3 studies), exercise capacity (1 of 3 studies), heart rate during exercise (1 of 2 studies), male waist circumference (1 of 2 studies), mood (2 of 3 studies), and cognitive function (1 study) as compared with controls. CONCLUSIONS This review provides relatively limited evidence for the potential benefits of recorded music listening during exercise in individuals with coronary heart disease. The findings should be carefully interpreted and generalised. Further rigorous-designed research addressing the limitations of current literature is needed.
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Affiliation(s)
- Sek Ying Chair
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Huijing Zou
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
| | - Xi Cao
- Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
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Chou CC, Provost JJ, Waye MMY, Yu GFB, Macaulay JO. Tools for teaching biochemistry and molecular biology: A parallel session at the IUBMB/PSBMB 2019 "Harnessing Interdisciplinary Education in Biochemistry and Molecular Biology" conference. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2020; 48:608-614. [PMID: 33129227 DOI: 10.1002/bmb.21445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 06/11/2023]
Abstract
Approaches to learning and teaching have been undergoing massive changes. Technology has enabled many innovations while other methods have embedded authentic research approaches or looked to other disciplines. The tools in education session of the conference looked at tools being used to teach biochemistry and molecular biology ranging from online platforms, authentic research experiences to the use of music.
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Affiliation(s)
- Chia-Cheng Chou
- National Center for High-performance Computing, National Applied Research Laboratories, Hsinchu, Taiwan
| | - Joseph J Provost
- Department of Chemistry and Biochemistry, University of San Diego, California, USA
| | - Mary Miu Yee Waye
- Faculty of Medicine, The Nethersole School of Nursing, Croucher Laboratory for Human Genomics, Shatin, Hong Kong
| | - Gracia Fe B Yu
- Department of Biochemistry and Molecular Biology, University of the Philippines Manila, Manila, Philippines
| | - Janet O Macaulay
- Biomedicine Discovery Institute, Monash University, Melbourne, Australia
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Wang Y, Wei J, Guan X, Zhang Y, Zhang Y, Zhang N, Mao M, Du W, Ren Y, Shen H, Liu P. Music Intervention in Pain Relief of Cardiovascular Patients in Cardiac Procedures: A Systematic Review and Meta-analysis. PAIN MEDICINE 2020; 21:3055-3065. [PMID: 32472142 DOI: 10.1093/pm/pnaa148] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Numerous meta-analyses have been conducted on music and pain, but no studies have investigated music and cardiac procedural pain. OBJECTIVE To assess the effects of music intervention on pain in cardiac procedures in the published randomized controlled trials. METHODS This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All the included randomized controlled studies were published between 1999 and 2016. Studies were obtained from electronic databases or by hand-searching of related journals and reference lists. The main outcome was pain intensity, and the secondary outcomes were vital signs such as heart rate, respiration rate, systolic blood pressure, and diastolic blood pressure. Risk of bias of the included studies was evaluated according to the Cochrane Collaboration guidelines. RESULTS Analysis of 14 studies indicated that music interventions had statistically significant effects on decreasing pain scales (mean deviation [MD] = -1.84), heart rate (MD = -2.62), respiration rate (MD = -2.57), systolic blood pressure (MD = -5.11), and diastolic blood pressure (MD = 0.44). The subgroup analysis method was used in all five outcomes. CONCLUSIONS Considering all the possible benefits, music intervention may provide an effective complement for the relief of cardiac procedural pain.
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Affiliation(s)
- Yiru Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Wei
- Shanghai Xuhui Central Hospital, Shanghai, China
| | - Xinzhu Guan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yifan Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yiyi Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Na Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Meijiao Mao
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenting Du
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yajuan Ren
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hong Shen
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ping Liu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Abstract
To clarify the effectiveness of music intervention for improving the well-being of patients undergoing coronary procedures for coronary heart disease, we conducted full-text searches of various databases (MEDLINE, Cochrane Library, CINAHL, ProQuest, and Airiti Library; 1966-2019) to identify randomized controlled trials and quasi-experimental studies of music intervention in recipients of angiography or percutaneous coronary intervention. Outcome measures included anxiety, discomfort, pain, heart rate, and blood pressure. The Cochrane methodology, Jadad Quality Score, and ROBINS-I were employed to evaluate evidence from 10 studies. Music intervention reduced anxiety (effect size: Z = 2.15, p = .03; six studies) and discomfort of lying (Z = 2.40, p = .02; two studies), but did not affect pain (Z = 0.94; two studies), heart rate (Z = 0.94; five studies), or blood pressure (systolic, Z = 1.27; diastolic, Z = 1.32; four studies) (all p > .05). The heterogeneity among studies was high. Large-scale, transcultural, high-quality trials are warranted to confirm the benefit of music intervention in patients undergoing coronary procedures.
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Affiliation(s)
- Shu-Fen Su
- Department of Nursing, National Taichung University of Science and Technology, Taichung City, Taiwan
| | - Wen-Ting Yeh
- Department of Nursing, Taichung Veterans General Hospital, Taichung City, Taiwan
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13
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Lieber AC, Bose J, Zhang X, Seltzberg H, Loewy J, Rossetti A, Mocco J, Kellner CP. Effects of music therapy on anxiety and physiologic parameters in angiography: a systematic review and meta-analysis. J Neurointerv Surg 2018; 11:416-423. [DOI: 10.1136/neurintsurg-2018-014313] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/02/2018] [Accepted: 10/08/2018] [Indexed: 11/03/2022]
Abstract
BackgroundGiven the anxiety patients experience during angiography, evidence supporting the efficacy of music therapy during these angiographic procedures is potentially of clinical value.ObjectiveTo analyze the existing literature forthe use of music therapy during cerebral, coronary, and peripheral angiography to determine whether it improves patient anxiety levels, heart rate, and blood pressure during the procedure.MethodsPubMed, Embase, and Scopus were searched to identify studies of interest. Inclusion criteria included studies reporting using music therapy in either cerebral, coronary, or peripheral angiography. Studies focused on a pediatric population; animal studies and case reports were excluded. Participant demographics, interventions, and outcomes were collected by two study authors. Bias and study quality of randomized controlled trials (RCTs) were assessed using the Cochrane Risk of Bias Tool. Separate meta-analyses of the RCTs were performed to compare State Trait Anxiety Inventory (STAI), heart rate (HR), and systolic and diastolic blood pressure (SBP and DBP) in the music intervention group versus control group. Heterogeneity was determined by calculating I2 values, and a random-effects model was used when heterogeneity exceeded 50%.ResultsThe preprocedure to postprocedure improvement in STAI was significantly greater in the experimental group than the control group (p=0.004), while the decrease in HR, SBP, and DBP was not significant.ConclusionsRecorded music and/or music therapy in angiography significantly decreases patients’ anxiety levels, while it has little to no effect on HR and BP. This meta-analysis is limited by the relatively few RCTs published on this subject.PROSPERO registration numberCRD42018099103
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Abstract
Examination of the relationship between patients' coping style, pregastroscopy information, and anxiety associated with gastroscopy in China was the aim of this study. A pretest, post-test, nonrandom assignment study with a two by two design was conducted. One hundred forty-five patients who underwent initial gastroscopy without sedation were classified into 2 groups on the basis of the coping style: information seekers or information avoiders using the Information Subscale of the Krantz Health Opinion Survey (KHOS-I). All participants were given standardized procedural information about gastroscopy as routine care. Half of each group was assigned to receive additional sensory information describing what sensation they would experience and how to cooperate to alleviate the discomfort. State anxiety assessed by the State Anxiety Scale of Spielberg's State-Trait Anxiety Inventory, blood pressure, and pulse were measured at enrollment and before gastroscopy. The information seekers and avoiders who received additional sensory information experienced significantly less state anxiety after the intervention. In contrast, the information seekers and avoiders who received standardized procedural information maintained their preintervention state anxiety level. Most patients reported their preference for sensory information. In conclusion, the provision of sensory information could significantly reduce patients' pregastroscopy anxiety regardless of patients' information coping style.
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Çetinkaya F, Aşiret GD, Yilmaz CK, İnci S. Effect of listening to music on anxiety and physiological parameters during coronary angiography: A randomized clinical trial. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Pouyesh V, Amaniyan S, Haji Mohammad Hoseini M, Bashiri Y, Sieloff C, Griffiths P, Vaismoradi M. The effects of environmental factors in waiting rooms on anxiety among patients undergoing coronary angiography: A randomized controlled trial. Int J Nurs Pract 2018; 24:e12682. [PMID: 30058744 DOI: 10.1111/ijn.12682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 03/21/2018] [Accepted: 06/15/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND According to Florence Nightingale's hypothesis, the environment can play a central role in the healing of the patient's body and mind. The nurse should, therefore, strive to provide a healing and stress-reducing environment for patients about to undergo invasive procedures. AIMS This study aimed to investigate the effects of environmental factors on anxiety as experienced by patients in waiting rooms prior to coronary angiography. METHODS In this randomized controlled trial, 200 patients undergoing coronary angiography in an urban area of Iran were assigned randomly to the following intervention groups: (1) nature sounds; (2) nature sounds and daylight; (3) nature sounds, daylight, and colour enhancements; and (4) control. Portable monitors were used to measure the patients' physiological indices upon admission and 30 and 60 minutes thereafter. RESULTS Patients who experienced environmental affecting interventions had significantly lower physiological indices of anxiety than the control group (P < 0.001). Some significance was demonstrated between the three interventions groups, with patients in the intervention group that experienced maximum environmental interventions demonstrating the most overall reduction in anxiety indices. CONCLUSION Environmental factors were shown to have a positive effect on the indices of anxiety experienced by patients waiting for the procedure of coronary angiography; this is therefore an area of study and practice worthy of further development.
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Affiliation(s)
- Vahideh Pouyesh
- Faculty of Nursing and Midwifery, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Sara Amaniyan
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Yousef Bashiri
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Pauline Griffiths
- College of Human and Health Sciences, Swansea University, Swansea, UK
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Heidari F, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M. Effect of short-term hand reflexology on anxiety in patients before coronary angiography: A randomized placebo controlled trial. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.09.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Jayakar JP, Alter DA. Music for anxiety reduction in patients undergoing cardiac catheterization: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract 2017; 28:122-130. [PMID: 28779919 DOI: 10.1016/j.ctcp.2017.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/23/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Medical diagnostic procedures, such as cardiac catheterization, can cause significant patient anxiety. Patient anxiety can have negative implications for compliance with healthcare visits, medical tests, and treatments. Music interventions may have a role in reducing anxiety related to cardiac catheterization procedures. OBJECTIVE To perform a comprehensive systematic review and meta-analysis evaluating whether musical interventions reduce anxiety in patients undergoing cardiac catheterization. DATA SOURCES MEDLINE, EMBASE, CENTRAL, AMED, and PsychINFO from inception to May 2015. Reference lists of included articles were further hand searched for additional eligible studies. STUDY SELECTION Randomized controlled trials evaluating the effectiveness of music interventions for anxiety reduction in patients undergoing cardiac catheterization. DATA EXTRACTION AND SYNTHESIS Data on trial design, baseline characteristics and outcomes was extracted using a data extraction table. Study quality and risk of bias were assessed using the JADAD scale. MAIN OUTCOMES AND MEASURES The main outcome was the effectiveness of music interventions in reducing anxiety in this patient population. Meta-analysis was pursued using data from studies that had used the Spielberger state anxiety inventory (STAI-S) to measure anxiety reduction. Other outcomes qualitatively reported include the use of anxiolytic medications and effect on physiological parameters such as blood pressure and heart rate. RESULTS A total of 15 studies were found to be eligible for inclusion (14 published trials and one conference abstract) in this review. Two-thirds of these studies showed statistically significant reduction in measures of patient anxiety or well-being with musical interventions. Meta-analysis included six studies (n = 695) and showed statistically significant reduction in mean STAI-S scores with music (-3.95 points; 95% confidence -5.53 and -2.37; p value less than 0.005). CONCLUSION AND RELEVANCE In conclusion, music is a safe and easily administered intervention that can be used for anxiety reduction among patients undergoing cardiac catheterization. Further research is needed to better evaluate the clinical implications associated with the anxiolytic effects of music interventions during cardiac catheterization.
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Affiliation(s)
- Jai P Jayakar
- Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David A Alter
- University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada; The Institute for Clinical Evaluative Sciences of Ontario, Toronto, Ontario, Canada.
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Mobini-Bidgoli M, Taghadosi M, Gilasi H, Farokhian A. The effect of hand reflexology on anxiety in patients undergoing coronary angiography: A single-blind randomized controlled trial. Complement Ther Clin Pract 2017; 27:31-36. [DOI: 10.1016/j.ctcp.2017.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 01/19/2023]
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Mobini Bidgoli M, Taghadosi M, Gilasi H, Farokhian A. The effect of sukha pranayama on anxiety in patients undergoing coronary angiography: a single -blind randomized controlled trial. J Cardiovasc Thorac Res 2016; 8:170-175. [PMID: 28210473 PMCID: PMC5304100 DOI: 10.15171/jcvtr.2016.34] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/25/2016] [Indexed: 02/04/2023] Open
Abstract
Introduction: Anxiety is among the most common problems experienced by coronary
angiography (CA) candidates. Different modalities are used to manage anxiety. This study sought
to examine the effects of a pranayama exercise on CA candidates’ anxiety.
Methods: This double-blind randomized controlled trial was undertaken in 2015 on 80 eligible
patients. The patients were randomly allocated to a control and an experimental group. Before
undergoing angiography, patients in the experimental group performed sukha pranayama
exercises. They were trained to breathe slowly and rhythmically at a rate of ten breathing per
minute for five consecutive minutes. Patients in the control group only received routine preangiography
care. Data collection tools were a demographic questionnaire and the Spielberger
State Anxiety Inventory. The level of patients’ anxiety in both groups was measured before, half
an hour after, and one hour after the intervention. The data were analyzed through doing the
independent-sample t and the chi-square tests.
Results: Before the intervention, the mean of anxiety score in the experimental group was 53.37,
which significantly decreased to 40.75 after the intervention (P = 0.0001). In the control group, the
mean of anxiety score decreased from 54.27 to 51.4. This decrease was not statistically significant.
Moreover, between-group comparisons revealed significant differences between the groups
regarding between-measurement mean differences of anxiety score (P < 0.01).
Conclusion: Sukha pranayama is effective in alleviating CA candidates’ anxiety.
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Affiliation(s)
- Maryam Mobini Bidgoli
- Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghadosi
- Department of Medical Surgical, Fculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamidreza Gilasi
- Department of Biostatistics and Epidemiology, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Farokhian
- Department of Cardiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Carroll DL, Malecki-Ketchell A, Astin F. Non-pharmacological interventions to reduce psychological distress in patients undergoing diagnostic cardiac catheterization: a rapid review. Eur J Cardiovasc Nurs 2016; 16:92-103. [DOI: 10.1177/1474515116670596] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Diane L Carroll
- Yvonne L. Munn Center for Nursing Research, Institute for Patient Care, Massachusetts General Hospital, USA
| | | | - Felicity Astin
- University of Huddersfield and Calderdale and Huddersfield NHS Trust, UK
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Iyendo TO. Exploring the effect of sound and music on health in hospital settings: A narrative review. Int J Nurs Stud 2016; 63:82-100. [PMID: 27611092 DOI: 10.1016/j.ijnurstu.2016.08.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 08/13/2016] [Accepted: 08/14/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sound in hospital space has traditionally been considered in negative terms as both intrusive and unwanted, and based mainly on sound levels. However, sound level is only one aspect of the soundscape. There is strong evidence that exploring the positive aspect of sound in a hospital context can evoke positive feelings in both patients and nurses. Music psychology studies have also shown that music intervention in health care can have a positive effect on patient's emotions and recuperating processes. In this way, hospital spaces have the potential to reduce anxiety and stress, and make patients feel comfortable and secure. This paper describes a review of the literature exploring sound perception and its effect on health care. DATA SOURCES AND REVIEW METHODS This review sorted the literature and main issues into themes concerning sound in health care spaces; sound, stress and health; positive soundscape; psychological perspective of music and emotion; music as a complementary medicine for improving health care; contradicting arguments concerning the use of music in health care; and implications for clinical practice. Using Web of Science, PubMed, Scopus, ProQuest Central, MEDLINE, and Google, a literature search on sound levels, sound sources and the impression of a soundscape was conducted. The review focused on the role and use of music on health care in clinical environments. In addition, other pertinent related materials in shaping the understanding of the field were retrieved, scanned and added into this review. RESULTS The result indicated that not all noises give a negative impression within healthcare soundscapes. Listening to soothing music was shown to reduce stress, blood pressure and post-operative trauma when compared to silence. Much of the sound conveys meaningful information that is positive for both patients and nurses, in terms of soft wind, bird twitter, and ocean sounds. CONCLUSIONS Music perception was demonstrated to bring about positive change in patient-reported outcomes such as eliciting positive emotion, and decreasing the levels of stressful conditions. Whilst sound holds both negative and positive aspects of the hospital ecosystem and may be stressful, it also possesses a soothing quality that induces positive feelings in patients. Conceptualizing the nature of sound in the hospital context as a soundscape, rather than merely noise can permit a subtler and socially useful understanding of the role of sound and music in the hospital setting, thereby creating a means for improving the hospital experience for patients and nurses.
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Affiliation(s)
- Timothy Onosahwo Iyendo
- Department of Architecture, Eastern Mediterranean University, Gazimağusa, North Cyprus, Via Mersin 10, Turkey.
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Al-Yateem N, Brenner M, Shorrab AA, Docherty C. Play distraction versus pharmacological treatment to reduce anxiety levels in children undergoing day surgery: a randomized controlled non-inferiority trial. Child Care Health Dev 2016; 42:572-81. [PMID: 27080806 DOI: 10.1111/cch.12343] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 11/24/2015] [Accepted: 03/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Perioperative experience can be one of the most distressful experiences in a child's life if not managed properly by healthcare professionals. Its consequences can extend well beyond surgery and recovery into the child's future life. Healthcare professionals have a responsibility to decrease the anxiety associated with this experience, improve the child's and the parent's experience and prevent negative consequences. This has traditionally been performed through pharmacological treatment which might have negative side effects. More developmentally appropriate distraction methods are currently being trialled globally to augment the evidence that supports their use as a similarly efficient alternative. OBJECTIVES The aim of this study was to explore the efficiency of storytelling, pictures and colouring activities as an anxiolytic intervention in comparison to the traditional pharmacological premedication technique in a non-inferiority study. STUDY DESIGN A randomized non-inferiority controlled trial was carried out in 168 children scheduled for day surgery. Children's perioperative anxiety was assessed by a trained anaesthetist using the modified Yale Preoperative Assessment Scale and by parents using the State-Trait Anxiety Inventory for Children. Children's vital signs were also collected preoperatively during the induction period and during the recovery period. RESULTS The primary endpoint, which is non-inferiority in terms of anxiety as per Yale Preoperative Assessment Scale survey between play distraction and preoperative medication, was met [average score 10.95 vs. 10.94, respectively, 95% confidence interval (-0.35; 0.37); P = 0.941]. Moreover, anxiety scores of both the intervention and the control group were quite comparable as per STAIC survey [20.90 vs. 20.73, respectively, 95% confidence interval (-0.52; 0.88); P = 0.708] and in terms of vital signs. CONCLUSION The results indicate that the distraction technique employed can be considered as an efficient alternative to traditional pharmacological premedication for children undergoing day surgery.
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Affiliation(s)
- N Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - M Brenner
- College of Health Sciences, University College Dublin, Dublin, Ireland
| | - A A Shorrab
- University Hospital Sharjah, Sharjah, United Arab Emirates
| | - C Docherty
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Ferreira NDC, Ramalho EDS, Lopes JDL. Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review. Rev Bras Enferm 2015; 68:1093-102. [PMID: 26676432 DOI: 10.1590/0034-7167.2015680614i] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 10/06/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization. METHOD this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed) and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients' anxiety, and the results obtained. RESULTS the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure) was found. Other strategies identified in this review were educational videos, massage, and palm therapy. CONCLUSION the results found suggest that anxiety can be reduced using non-pharmacological strategies.
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Liu Y, Petrini MA. Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery. Complement Ther Med 2015; 23:714-8. [PMID: 26365452 DOI: 10.1016/j.ctim.2015.08.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 07/15/2015] [Accepted: 08/01/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To examine the effectiveness of music listening on pain, anxiety, and vital signs among patients after thoracic surgery in China. DESIGN AND SETTING A randomized controlled clinical trial was conducted in the thoracic surgery department of two tertiary hospitals in Wuhan, China. 112 patients were recruited and randomly assigned to either experimental (n=56) or control (n=56) group respectively. INTERVENTION The experimental group received standard care and a 30-min soft music intervention for 3 days, while the control group received only standard care. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate), patient controlled analgesia, and diclofenac sodium suppository use. RESULTS The experimental group showed statistically significant decrease in pain, anxiety, systolic blood pressure and heart rate over time compared to the control group, but no significant difference were identified in diastolic blood pressure, respiratory rate, patient controlled analgesia and diclofenac sodium suppository use. CONCLUSION The findings provide further evidence to support the practice of music therapy to reduce postoperative pain and anxiety, and lower systolic blood pressure and heart rate in patients after thoracic surgery in China.
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Affiliation(s)
- Yang Liu
- HOPE School of Nursing, Wuhan University, Wuhan, China.
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Forooghy M, Mottahedian Tabrizi E, Hajizadeh E, Pishgoo B. Effect of Music Therapy on Patients' Anxiety and Hemodynamic Parameters During Coronary Angioplasty: A Randomized Controlled Trial. Nurs Midwifery Stud 2015; 4:e25800. [PMID: 26339666 PMCID: PMC4557407 DOI: 10.17795/nmsjournal25800] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 04/26/2015] [Accepted: 04/26/2015] [Indexed: 11/25/2022] Open
Abstract
Background: A cardiac catheterization laboratory can be a frightening environment and music can be a supportive source of environmental sound that stimulates and maintains relaxation. However, the results of studies are conflicting in this regard. Objectives: The aim of this study was to investigate the effect of music therapy on patients’ anxiety and hemodynamic parameters during percutaneous transluminal coronary angioplasty. Patients and Methods: This was a randomized controlled trial, conducted in the Catheterization Laboratory Unit of Baqiyatallah Hospital, in Tehran, Iran. A sample of 64 patients, who were planned to undergo coronary angioplasty, was recruited. Patients were randomly allocated to either the control or the experimental groups. In the experimental group, patients received a 20 to 40-minute music therapy intervention, consisting of light instrumental music albums by Johann Sebastian Bach and Mariko Makino. Patients in the control group received the routine care of the study setting, which consisted of no music therapy intervention. Study data were collected by a demographic questionnaire, the Spielberger’s State Anxiety Inventory, and a data sheet for documenting hemodynamic parameters. Chi-square, independent-samples t tests, paired-samples t-test and repeated measures analysis of variance were used to analyze the data. Results: Before the intervention, the study groups did not differ significantly in terms of anxiety level and hemodynamic parameters. Moreover, the differences between the two groups, regarding hemodynamic parameters, were not significant after the intervention (P > 0.05). However, the level of post-intervention anxiety in the experimental group was significantly lower than the control group (32.06 ± 8.57 and 38.97 ± 12.77, respectively; P = 0.014). Compared with the baseline readings, the level of anxiety in the control group did not change significantly after the study (41.91 ± 9.88 vs. 38.97 ± 12.77; P = 0.101); however, in the experimental group, the level of post-intervention anxiety was significantly lower than the pretest readings (32.06 ± 8.57 vs. 41.16 ± 10.6; P = 0.001). Conclusions: Music therapy is a safe, simple, inexpensive, and non-invasive nursing intervention, which can significantly alleviate patients’ anxiety during coronary angioplasty.
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Affiliation(s)
- Masoumeh Forooghy
- Department of Critical Care Nursing, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Elaheh Mottahedian Tabrizi
- Behavioral Sciences Research Center (BSRC), Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ebrahim Hajizadeh
- Department of Bio-Statistics, School of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | - Bahram Pishgoo
- Department of Cardiology, School of Medical Sciences, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Abstract
Music therapy is a service that has become more prevalent as an adjunct to medical practice-as its evidence base expands and music therapists begin to join the cardiology team in every phase of care, from the most serious cases to those maintaining good heart health. Although applications of music medicine, primarily listening to short segments of music, are capable of stabilizing vital signs and managing symptoms in the short-term, music therapy interventions by a qualified practitioner are showing promise in establishing deeper and more lasting impact. On the basis of mind-body approaches, stress/coping models, the neuromatrix theory of pain, and entrainment, music therapy capitalizes on the ability of music to affect the autonomic nervous system. Although only a limited number of randomized controlled trials pinpoint the efficacy of specific music therapy interventions, qualitative research reveals some profound outcomes in certain individuals. A depth of understanding related to the experience of living with a cardiovascular disease can be gained through music therapy approaches such as nonverbal music psychotherapy and guided imagery and music. The multifaceted nature of musical responsiveness contributes to strong individual variability and must be taken into account in the development of research protocols for future music therapy and music medicine interventions. The extant research provides a foundation for exploring the many potential psychosocial, physiological, and spiritual outcomes of a music therapy service for cardiology patients.
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Abstract
BACKGROUND Individuals with coronary heart disease (CHD) often suffer from severe distress due to diagnosis, hospitalization, surgical procedures, uncertainty of outcome, fear of dying, doubts about progress in recovery, helplessness and loss of control. Such adverse effects put the cardiac patient at greater risk for complications, including sudden cardiac death. It is therefore of crucial importance that the care of people with CHD focuses on psychological as well as physiological needs.Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients; however its efficacy for people with CHD needs to be evaluated. OBJECTIVES To update the previously published review that examined the effects of music interventions with standard care versus standard care alone on psychological and physiological responses in persons with CHD. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (2012, Issue 10), MEDLINE (OvidSP, 1950 to October week 4 2012), EMBASE (OvidSP, 1974 to October week 5 2012), CINAHL (EBSCOhost, 1982 to 9 November 2012), PsycINFO (OvidSP, 1806 to October week 5 2012), LILACS (Virtual Health Library, 1982 to 15 November 2012), Social Science Citation Index (ISI, 1974 to 9 November 2012), a number of other databases, and clinical trial registers. We also conducted handsearching of journals and reference lists. We applied no language restrictions. SELECTION CRITERIA We included all randomized controlled trials and quasi-randomized trials that compared music interventions and standard care with standard care alone for persons with confirmed CHD. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed methodological quality, seeking additional information from the trial researchers when necessary. We present results using weighted mean differences for outcomes measured by the same scale, and standardized mean differences for outcomes measured by different scales. We used post-intervention scores. In cases of significant baseline difference, we used change scores (changes from baseline). MAIN RESULTS We identified four new trials for this update. In total, the evidence for this review rests on 26 trials (1369 participants). Listening to music was the main intervention used, and 23 of the studies did not include a trained music therapist.Results indicate that music interventions have a small beneficial effect on psychological distress in people with CHD and this effect is consistent across studies (MD = -1.26, 95% CI -2.30 to -0.22, P = 0.02, I² = 0%). Listening to music has a moderate effect on anxiety in people with CHD; however results were inconsistent across studies (SMD = -0.70, 95% CI -1.17 to -0.22, P = 0.004, I² = 77%). Studies that used music interventions in people with myocardial infarction found more consistent anxiety-reducing effects of music, with an average anxiety reduction of 5.87 units on a 20 to 80 point score range (95% CI -7.99 to -3.75, P < 0.00001, I² = 53%). Furthermore, studies that used patient-selected music resulted in greater anxiety-reducing effects that were consistent across studies (SMD = -0.89, 95% CI -1.42 to -0.36, P = 0.001, I² = 48%). Findings indicate that listening to music reduces heart rate (MD = -3.40, 95% CI -6.12 to -0.69, P = 0.01), respiratory rate (MD = -2.50, 95% CI -3.61 to -1.39, P < 0.00001) and systolic blood pressure (MD = -5.52 mmHg, 95% CI - 7.43 to -3.60, P < 0.00001). Studies that included two or more music sessions led to a small and consistent pain-reducing effect (SMD = -0.27, 95% CI -0.55 to -0.00, P = 0.05). The results also suggest that listening to music may improve patients' quality of sleep following a cardiac procedure or surgery (SMD = 0.91, 95% CI 0.03 to 1.79, P = 0.04).We found no strong evidence for heart rate variability and depression. Only one study considered hormone levels and quality of life as an outcome variable. A small number of studies pointed to a possible beneficial effect of music on opioid intake after cardiac procedures or surgery, but more research is needed to strengthen this evidence. AUTHORS' CONCLUSIONS This systematic review indicates that listening to music may have a beneficial effect on anxiety in persons with CHD, especially those with a myocardial infarction. Anxiety-reducing effects appear to be greatest when people are given a choice of which music to listen to.Furthermore, listening to music may have a beneficial effect on systolic blood pressure, heart rate, respiratory rate, quality of sleep and pain in persons with CHD. However, the clinical significance of these findings is unclear. Since many of the studies are at high risk of bias, these findings need to be interpreted with caution. More research is needed into the effects of music interventions offered by a trained music therapist.
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Affiliation(s)
- Joke Bradt
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, 1505 Race Street, rm 1041, Philadelphia, PA, USA, 19102
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Wu KL, Chen SR, Ko WC, Kuo SY, Chen PL, Su HF, Chang WY. The effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction of patients undergoing cardiac catheterisation. J Clin Nurs 2013; 23:2063-73. [PMID: 24372795 DOI: 10.1111/jocn.12469] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2013] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction with the information and materials received by patients undergoing cardiac catheterisation. BACKGROUND Cardiac catheterisation is one of the most anxiety-provoking invasive procedures for patients. However, informational education using multimedia to inform patients undergoing cardiac catheterisation has not been extensively explored. DESIGN A randomised experimental design with three-cohort prospective comparisons. METHODS In total, 123 consecutive patients were randomly assigned to one of three groups: regular education; (group 1), accessibility-enhanced multimedia informational education (group 2) and instructional digital videodisc education (group 3). Anxiety was measured with Spielberger's State Anxiety Inventory, which was administered at four time intervals: before education (T0), immediately after education (T1), before cardiac catheterisation (T2) and one day after cardiac catheterisation (T3). A satisfaction questionnaire was administrated one day after cardiac catheterisation. Data were collected from May 2009-September 2010 and analysed using descriptive statistics, chi-squared tests, one-way analysis of variance, Scheffe's post hoc test and generalised estimating equations. RESULTS All patients experienced moderate anxiety at T0 to low anxiety at T3. Accessibility-enhanced multimedia informational education patients had significantly lower anxiety levels and felt the most satisfied with the information and materials received compared with patients in groups 1 and 3. A statistically significant difference in anxiety levels was only found at T2 among the three groups (p = 0·004). CONCLUSIONS The findings demonstrate that the accessibility-enhanced multimedia informational education was the most effective informational educational module for informing patients about their upcoming cardiac catheterisation, to reduce anxiety and improve satisfaction with the information and materials received compared with the regular education and instructional digital videodisc education. RELEVANCE TO CLINICAL PRACTICE As the accessibility-enhanced multimedia informational education reduced patient anxiety and improved satisfaction with the information and materials received, it can be adapted to complement patient education in future regular cardiac care.
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Affiliation(s)
- Ka-Lai Wu
- Nursing Department, Cathay General Hospital, Taipei, Taiwan; School of Nursing, Taipei Medical University, Taipei, Taiwan
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Molavi Vardanjani M, Masoudi Alavi N, Razavi NS, Aghajani M, Azizi-Fini E, Vaghefi SM. A randomized-controlled trial examining the effects of reflexology on anxiety of patients undergoing coronary angiography. Nurs Midwifery Stud 2013; 2:3-9. [PMID: 25414869 PMCID: PMC4228540 DOI: 10.5812/nms.12167] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 06/22/2013] [Indexed: 11/16/2022] Open
Abstract
Background: The anxiety reduction before coronary angiography has clinical advantages and is one of the objectives of nursing. Reflexology is a non-invasive method that has been used in several clinical situations. Applying reflexology might have effect on the reduction of anxiety before coronary angiography. Objectives: The aim of this randomized clinical trial was to investigate the effect of reflexology on anxiety among patients undergoing coronary angiography. Patients and Methods: This trial was conducted in Shahid Beheshti Hospital, in Kashan, Iran. One hundred male patients who were undergoing coronary angiography were randomly enrolled into intervention and placebo groups. The intervention protocol was included 30 minutes of general foot massage and the stimulation of three reflex points including solar plexus, pituitary gland, and heart. The placebo group only received the general foot massage. Spielbergers state trait anxiety inventory was used to assess the anxiety experienced by patients. Data was analyzed using Man-Witney, Wilcoxon and Chi-square tests. The stepwise multiple regressions used to analyze the variables that are involved in anxiety reduction. Results: The mean range of anxiety decreased from 53.24 to 45.24 in reflexology group which represented 8 score reduction (P = 0.0001). The reduction in anxiety was 5.9 score in placebo group which was also significant (P = 0.0001). The anxiety reduction was significantly higher in reflexology group (P = 0.014). The stepwise multiple regression analysis showed that doing reflexology can explain the 7.5% of anxiety reduction which made a significant model. Conclusions: Reflexology can decrease the anxiety level before coronary angiography. Therefore, reflexology before coronary angiography is recommended.
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Affiliation(s)
| | - Negin Masoudi Alavi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding author: Negin Masoudi Alavi, Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel.: +98-3615550021, Fax: +98-3615556633, E-mail:
| | - Narges Sadat Razavi
- Department of Cardiology, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mohammad Aghajani
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Esmail Azizi-Fini
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
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Gillen E, Biley F, Allen D. Effects of music listening on adult patients' pre-procedural state anxiety in hospital. INT J EVID-BASED HEA 2012; 6:24-49. [PMID: 21631813 DOI: 10.1111/j.1744-1609.2007.00097.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED EXECUTIVE SUMMARY: BACKGROUND Anticipation of an invasive procedure in hospital is likely to provoke feelings of anxiety and stress in patients. An unfamiliar environment, loss of control, perceived or actual physical risk, dependence on strangers and separation from friends and family are all factors that can contribute to the development of such feelings. Recently, there has been considerable interest in the anxiolytic potential of music listening in a variety of clinical settings, yet thus far, little is known about the impact of music listening on the pre-procedural patient population. A systematic review of all literature to date was indicated to improve understanding of outcomes and impact of music listening on pre-procedural anxiety, thus helping nurses decide whether or not to incorporate music listening into practice and to highlight a need, or otherwise, for a related primary research agenda. OBJECTIVE The objective of this review was to determine the best available evidence on the effectiveness of music listening in reducing adult hospital patients' pre-procedural state anxiety. INCLUSION CRITERIA Types of studies This review included randomised controlled trials and quasi-experimental research designs that examined the efficacy of music listening in reducing state anxiety among pre-procedural hospital patients published between January 1985 and February 2006. The search was limited to publications after 1985 to coincide with the increasing interest and use of complementary therapies within health care during the 1980s and 1990s. Types of participants Participants of interest to the review were adult day patients, ambulatory patients and inpatients who were about to undergo any type of clinical procedure. Types of intervention The review focused on studies that investigated pre-procedural music listening employed and prescribed as a potentially therapeutic activity. It excluded any other form of music therapy. Types of outcome measures The primary outcome measures examined were alterations in state anxiety and a variety of physiological variables such as blood pressure and respiration and heart rates. SEARCH STRATEGY A search for published and unpublished literature between January 1985 and February 2006 was conducted using all major electronic databases. A three-step search strategy was devised which consisted of using high-precision MeSH terminology and keywords to ensure that all material relevant to the review was captured. CRITICAL APPRAISAL: The methodological quality of included studies was assessed by two reviewers, who appraised each study independently, using the standard Joanna Briggs Institute (JBI) critical appraisal tools. DATA EXTRACTION AND SYNTHESIS Data were extracted from the studies that were identified as meeting the criteria for methodological quality using a data-extraction tool developed for the review. Studies were grouped by outcome measure and summarised using tabular and narrative formats. RESULTS The review demonstrated that state anxiety is defined and measured using both psychological and physiological parameters. Music listening had a consistently positive and statistically significant effect on reducing psychological parameters of pre-procedural state anxiety. However, the results from the measurement of various pre-procedural physiological parameters failed to reveal any consistent positive changes in patients who had listened to music. This calls into question the adequacy of the theories in this area which link anxiety and the automated and central nervous systems and the effect that music listening may have on these processes and physiological responses. CONCLUSIONS/IMPLICATIONS FOR PRACTICE 1 In order to reduce anxiety, it is likely that patients will benefit psychologically from having the opportunity to listen to music in the immediate pre-procedural period. 2 Patients do not appear to experience any alteration in physiological status as a result of listening to music. 3 Further research is indicated in order to replicate existing studies, to strengthen the evidence to support such interventions and to establish intervention parameters. 4 Further research is needed analysing the physiological mechanisms by which music listening is believed to reduce state anxiety and the contribution of the automated and other nervous systems to this reduction.
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Affiliation(s)
- Elizabeth Gillen
- Wales Centre for Evidence Based Care (a Collaborating Centre of the Joanna Briggs Institute) Cardiff School of Nursing and Midwifery, Cardiff University, Cardiff, Wales
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Luo YY. Effects of written plus oral information vs. oral information alone on precolonoscopy anxiety. J Clin Nurs 2012; 22:817-27. [PMID: 22845184 DOI: 10.1111/j.1365-2702.2011.04053.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS AND OBJECTIVES To determine the effect of written plus oral information vs. oral information alone on precolonoscopy anxiety. BACKGROUND Information provision has been considered to reduce precolonoscopy anxiety. However, the best means to provide information before colonoscopy has not yet been determined as there is inconsistency in the outcomes of the clinical trials. DESIGN A two-group, pretest, post-test, prospective, quasi-experimental design with non-random assignment. METHODS Participants were assigned to group 1 or 2 in the study. In the enrolment all the participants completed the questionnaires to collect personal characteristics data and assessed subjects' anxiety level by the Chinese version of the State Scale of State-Trait Anxiety Inventory as baseline data. After that, subjects in group 1 received written plus oral information before colonoscopy, while those in group 2 received oral information before colonoscopy. On the day for colonoscopy all subjects completed the Chinese version of the State Scale of State-Trait Anxiety Inventory again. RESULTS There was no difference in state anxiety and personal characteristic between the two groups at enrolment. After the intervention, although the state anxiety scores were dropped, there were no statistical significant differences between two groups or within groups 1 and 2. CONCLUSIONS Information provision before colonoscopy did not reduce the anxiety level in patients directly before colonoscopy. RELEVANCE TO CLINICAL PRACTICE There was a trend that information had a positive effect on patients' state anxiety. Future information provision studies may need to add more interactive methods appropriately and take patients' gender, educational level and coping style into consideration.
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Affiliation(s)
- Yuan-Yuan Luo
- School of Medicine, Jianghan University, Wuhan, Hubei, China.
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Zolfaghari M, Eybpoosh S, Hazrati M. Effects of Therapeutic Touch on Anxiety, Vital Signs, and Cardiac Dysrhythmia in a Sample of Iranian Women Undergoing Cardiac Catheterization. J Holist Nurs 2012; 30:225-34. [DOI: 10.1177/0898010112453325] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose of the study: To investigate the effects of Therapeutic Touch (TT) on anxiety, vital signs, and cardiac dysrhythmia in women undergoing cardiac catheterization. Design: It was a quasi-experimental study. The participants had no history of hallucination, anxiety, or other psychological problems. Participants had to be conscious and have attained at least sixth-grade literacy level. Participants were randomly assigned into an intervention group ( n = 23; received 10-15 minutes TT), a placebo group ( n = 23; received 10-15 minutes simulated touch), and a control group ( n = 23; did not receive any therapy). Data were collected using Spielberger’s anxiety test, cardiac dysrhythmia checklist, and vital signs recording sheet. Statistical analyses were considered to be significant at α = .05 levels. Findings: Sixty-nine women ranging in age from 35 to 65 years participated. TT significantly decreased state anxiety p < 0.0001 but not trait anxiety ( p = .88), decreased the incidence of all cardiac dysrhythmias p < 0.0001 except premature ventricular contraction ( p = .01), and regulated vital signs p < 0.0001 in the intervention group versus placebo and control group. Conclusions: TT is an effective approach for managing state anxiety, regulating vital signs, and decreasing the incidence of cardiac dysrhythmia during stressful situations, such as cardiac catheterization, in Iranian cardiac patients.
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Affiliation(s)
- Mitra Zolfaghari
- Nursing & Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sana Eybpoosh
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Hazrati
- Fatemeh (P.B.U.H) School of Nursing & Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Sharif F, Shoul A, Janati M, Kojuri J, Zare N. The effect of cardiac rehabilitation on anxiety and depression in patients undergoing cardiac bypass graft surgery in Iran. BMC Cardiovasc Disord 2012; 12:40. [PMID: 22682391 PMCID: PMC3420238 DOI: 10.1186/1471-2261-12-40] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 06/08/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Many patients experience anxiety and depression after cardiac bypass surgery.The aim of this study was to examine the effect of cardiac rehabilitation on anxiety and depression in patients undergoing coronary artery bypass grafting in hospitals affiliated to Shiraz University of Medical Sciences in southern Iran. METHODS For this randomized controlled trial, 80 patients who met the inclusion criteria were recruited and randomly assigned to case and control groups. Anxiety was measured with the Spielberger Anxiety Scale and depression was measured using Beck's Depression Inventory at three points in time: on discharge from the hospital, immediately after the intervention, and 2 months after cardiac rehabilitation. After measuring anxiety and depression in both groups upon discharge, the experimental group participated in 8 cardiac rehabilitation sessions over a 4-week period. The control group received only the routine follow-up care. RESULTS There was a statistically significant difference in depression scores between groups at all three time-points (Mean score from 19.6 to 10 in the intervention group and from 19.5 to 14 in the control group, P = 0.0014). However, no significant difference was seen in anxiety scores between the groups (Mean score from 37 to 28 in the intervention group and from 38 to 32 in the control group, P = 0.079). CONCLUSIONS Cardiac rehabilitation was effective in reducing depression 2 months after surgery in patients undergoing coronary artery bypass grafting. TRIAL REGISTRATION IRCTN201203262812N8.
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Affiliation(s)
- Farkhondeh Sharif
- Mental Health Nursing Department, Community Based Nursing & Midwifery Research Center, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Psychiatric& Mental Health Nursing, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Shoul
- Faghihi Hospital, Cardiac Surgery Unit, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansour Janati
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Kojuri
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najaf Zare
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
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Drahota A, Ward D, Mackenzie H, Stores R, Higgins B, Gal D, Dean TP. Sensory environment on health-related outcomes of hospital patients. Cochrane Database Syst Rev 2012; 2012:CD005315. [PMID: 22419308 PMCID: PMC6464891 DOI: 10.1002/14651858.cd005315.pub2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Hospital environments have recently received renewed interest, with considerable investments into building and renovating healthcare estates. Understanding the effectiveness of environmental interventions is important for resource utilisation and providing quality care. OBJECTIVES To assess the effect of hospital environments on adult patient health-related outcomes. SEARCH METHODS We searched: the Cochrane Central Register of Controlled Trials (last searched January 2006); MEDLINE (1902 to December 2006); EMBASE (January 1980 to February 2006); 14 other databases covering health, psychology, and the built environment; reference lists; and organisation websites. This review is currently being updated (MEDLINE last search October 2010), see Studies awaiting classification. SELECTION CRITERIA Randomised and non-randomised controlled trials, controlled before-and-after studies, and interrupted times series of environmental interventions in adult hospital patients reporting health-related outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently undertook data extraction and 'Risk of bias' assessment. We contacted authors to obtain missing information. For continuous variables, we calculated a mean difference (MD) or standardized mean difference (SMD), and 95% confidence intervals (CI) for each study. For dichotomous variables, we calculated a risk ratio (RR) with 95% confidence intervals (95% CI). When appropriate, we used a random-effects model of meta-analysis. Heterogeneity was explored qualitatively and quantitatively based on risk of bias, case mix, hospital visit characteristics, and country of study. MAIN RESULTS Overall, 102 studies have been included in this review. Interventions explored were: 'positive distracters', to include aromas (two studies), audiovisual distractions (five studies), decoration (one study), and music (85 studies); interventions to reduce environmental stressors through physical changes, to include air quality (three studies), bedroom type (one study), flooring (two studies), furniture and furnishings (one study), lighting (one study), and temperature (one study); and multifaceted interventions (two studies). We did not find any studies meeting the inclusion criteria to evaluate: art, access to nature for example, through hospital gardens, atriums, flowers, and plants, ceilings, interventions to reduce hospital noise, patient controls, technologies, way-finding aids, or the provision of windows. Overall, it appears that music may improve patient-reported outcomes such as anxiety; however, the benefit for physiological outcomes, and medication consumption has less support. There are few studies to support or refute the implementation of physical changes, and except for air quality, the included studies demonstrated that physical changes to the hospital environment at least did no harm. AUTHORS' CONCLUSIONS Music may improve patient-reported outcomes in certain circumstances, so support for this relatively inexpensive intervention may be justified. For some environmental interventions, well designed research studies have yet to take place.
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Affiliation(s)
- Amy Drahota
- UK Cochrane Centre, National Institute for Health Research, Oxford, UK.
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Li XM, Zhou KN, Yan H, Wang DL, Zhang YP. Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: a randomized clinical trial. J Adv Nurs 2011; 68:1145-55. [PMID: 21978087 DOI: 10.1111/j.1365-2648.2011.05824.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This paper is a report of a clinical trial of the effects of music therapy on anxiety of female breast cancer patients following radical mastectomy. BACKGROUND There is insufficient evidence on the effects of music therapy on state anxiety of breast cancer patients following radical mastectomy. METHODS A Hall's Core, Care, and Cure Model-based clinical trial was conducted in 120 female breast cancer patients from March to November 2009. A randomized controlled design was utilized. The patients were randomly allocated to the experimental group (n = 60) received music therapy in addition to routine nursing care, and the control group (n = 60) only received routine nursing care. A standardized questionnaire and the State Anxiety Inventory were applied. The primary endpoint was the state anxiety score measured at pretest (on the day before radical mastectomy) and at three post-tests (on the day before patients were discharged from hospital, the second and third time of admission to hospital for chemotherapy respectively). RESULTS The pretest score revealed that the majority of the patients had a moderate level (77·5%) and 15% had severe level of state anxiety. The repeated-measure ancova model analysis indicated that the mean state anxiety score was significantly lower in the experimental group than those in the control group at each of the three post-test measurements. The mean difference between the experimental and control group together with 95% confidence intervals were -4·57 (-6·33, -2·82), -8·91 (-10·75, -7·08) and -9·69 (-11·52, -7·85) at the 1st post-test, 2nd post-test and 3rd post-test respectively. CONCLUSION Music therapy is found to have positive effects on decreasing state anxiety score.
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Affiliation(s)
- Xiao-Mei Li
- Department of Nursing, College of Medicine, Xi'an Jiaotong University, China
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Weeks BP, Nilsson U. Music Interventions in Patients During Coronary Angiographic Procedures: A Randomized Controlled Study of the Effect on Patients' Anxiety and Well-Being. Eur J Cardiovasc Nurs 2011; 10:88-93. [DOI: 10.1016/j.ejcnurse.2010.07.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 06/30/2010] [Accepted: 07/02/2010] [Indexed: 02/08/2023]
Affiliation(s)
- Birgit P. Weeks
- Northwest Hospital & Medical Center, Seattle, Washington, USA
| | - Ulrica Nilsson
- Department of Anaesthesia and Intensive Care and Centre for Health Care Sciences, Örebro University Hospital, School of Health and Medical Sciences, Örebro University, Sweden
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Ni CH, Tsai WH, Lee LM, Kao CC, Chen YC. Minimising preoperative anxiety with music for day surgery patients - a randomised clinical trial. J Clin Nurs 2011; 21:620-5. [DOI: 10.1111/j.1365-2702.2010.03466.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lee KC, Chao YH, Yiin JJ, Hsieh HY, Dai WJ, Chao YF. Evidence That Music Listening Reduces Preoperative Patients’ Anxiety. Biol Res Nurs 2011; 14:78-84. [DOI: 10.1177/1099800410396704] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Patients often exhibit preoperative fear and anxiety that may influence the process of induction and recovery from anesthesia. Music is thought to be an alternative to medication for relief of fear and anxiety. Objectives: The purpose of the present study was to explore the feasibility of using heart rate (HR) variability (HRV) for evaluating the efficacy of music listening to relieve the patients’ anxiety during their stay in the operation room waiting area and to compare the HRV measures with subjective Visual Analogue Scale (VAS) scores. Methods: In total, 140 patients were randomly assigned to the experimental ( n = 64) or control group ( n = 76). The intervention consisted of a 10-min period of exposure to relaxing music delivered through headphones. Anxiety levels were measured by VAS (a 10-point scale) and 5 min of HRV monitoring before and after the music intervention. Results: The music group demonstrated significant reductions in VAS scores, mean HR, low-frequency HRV, and low- to high-frequency ratio and an increase in high-frequency HRV, while patients in the control group showed no changes. The subjective results of patients’ VAS anxiety scores were consistent with the objective results of HRV parameters. Conclusions: Listening to music can significantly lower the anxiety levels of patients before surgery. The frequency-domain parameters of HRV can be indicators for monitoring the change in anxiety level of preoperative patients.
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Affiliation(s)
- Kwo-Chen Lee
- School of Nursing, National Yang-Ming University
- Nursing Department, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Huei Chao
- Department of Anesthesiology, Lotung Poh-Ai Hospital, Yi-lan, Taiwan
| | - Jia-Jean Yiin
- Department of Neurosurgery, Taichung Veteran General Hospital, Taichung, Taiwan
| | - Hsin-Yi Hsieh
- Nursing Department, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wen-Jan Dai
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yann-Fen Chao
- School of Nursing, Mackay Medical College, Taipei, Taiwan
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Mikosch P, Hadrawa T, Laubreiter K, Brandl J, Pilz J, Stettner H, Grimm G. Effectiveness of respiratory-sinus-arrhythmia biofeedback on state-anxiety in patients undergoing coronary angiography. J Adv Nurs 2010; 66:1101-10. [DOI: 10.1111/j.1365-2648.2010.05277.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nilsson U, Lindell L, Eriksson A, Kellerth T. The Effect of Music Intervention in Relation to Gender During Coronary Angiographic Procedures: A Randomized Clinical Trial. Eur J Cardiovasc Nurs 2009; 8:200-6. [DOI: 10.1016/j.ejcnurse.2009.01.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Revised: 01/06/2009] [Accepted: 01/07/2009] [Indexed: 12/31/2022]
Abstract
Several studies have evaluated music interventions prior and after coronary angiography and percutaneous coronary intervention (PCI), but there is no clear evidence showing that music has an effect on patients during these procedures. The purpose was to investigate the effects of music on anxiety, angina, pain, relaxation, and comfort in patients during angiographic procedures and to evaluate gender differences. The study was a four-armed, prospective randomized controlled trial included 240 patients undergoing coronary angiography and/or PCI. Patients were allocated to receive relaxing music, MusiCure® or standard care during the procedure. Outcome measures were; puncture pain and the discomfort related to it, angina and the discomfort related to it, anxiety, experience of the sound environment, discomfort of lying still, and the doses of anxiolytics and analgesics during the procedure. No differences were found between the music and control groups regarding any of the trial endpoints or gender-related differences. The overall rating of the sound environment and feeling of relaxation was high. In conclusion, music intervention in patients undergoing angiographic procedures was highly feasible, but not effective in this study though the delivery of music went smoothly and did not disturb the examination and patients and staff alike looked favorably on it.
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Affiliation(s)
- Ulrica Nilsson
- Department of Cardiothoracic Surgery, Örebro University Hospital, Sweden
- Centre for Health Care Sciences, P.O. Box 1324, SE-70113, Örebro University Hospital, Sweden
| | - Lena Lindell
- Department of Cardiology, Örebro University Hospital, Sweden
| | - Annika Eriksson
- Department of Cardiology, Örebro University Hospital, Sweden
| | - Thomas Kellerth
- Department of Cardiology, Örebro University Hospital, Sweden
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Nilsson U. The effect of music intervention in stress response to cardiac surgery in a randomized clinical trial. Heart Lung 2009; 38:201-7. [DOI: 10.1016/j.hrtlng.2008.07.008] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 06/09/2008] [Accepted: 07/30/2008] [Indexed: 11/26/2022]
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Jaber S, Bahloul H, Guétin S, Chanques G, Sebbane M, Eledjam JJ. Effets de la musicothérapie en réanimation hors sédation chez des patients en cours de sevrage ventilatoire versus des patients non ventilés. ACTA ACUST UNITED AC 2007; 26:30-8. [DOI: 10.1016/j.annfar.2006.09.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2005] [Accepted: 09/11/2006] [Indexed: 11/30/2022]
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Taylor-Piliae RE, Haskell WL, Waters CM, Froelicher ES. Change in perceived psychosocial status following a 12-week Tai Chi exercise programme. J Adv Nurs 2006; 54:313-29. [PMID: 16629916 DOI: 10.1111/j.1365-2648.2006.03809.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This paper reports a study to examine change in psychosocial status following a 12-week Tai Chi exercise intervention among ethnic Chinese people with cardiovascular disease risk factors living in the United States of America. BACKGROUND Regular participation in physical activity is associated with protection against cardioavascular disease, and improvements in physical and psychological health. Increasing amounts of scientific evidence suggests that mind-body exercise, such as Tai Chi, are related to improvements in mental health, emotional well-being, and stress reduction. No prior study has examined the effect of a Tai Chi exercise intervention on psychosocial status among people with cardiovascular disease risk factors. METHODS This was a quasi-experimental study. Participants attended a 60-minute Tai Chi exercise class three times per week for 12 weeks. Data were collected at baseline, 6 and 12 weeks following the intervention. Psychosocial status was assessed using Chinese versions of Cohen's Perceived Stress Scale, Profile of Mood States, Multidimensional Scale of Perceived Social Support, and Tai Chi exercise self-efficacy. RESULTS A total of 39 participants, on average 66-year-old (+/-8.3), married (85%), Cantonese-speaking (97%), immigrants participated. The majority were women (69%), with < or =12 years education (87%). Statistically significant improvements in all measures of psychosocial status were found (P < or = 0.05) following the intervention. Improvement in mood state (eta2 = 0.12), and reduction in perceived stress (eta2 = 0.13) were found. In addition, Tai Chi exercise statistically significantly increased self-efficacy to overcome barriers to Tai Chi (eta2 = 0.19), confidence to perform Tai Chi (eta2 = 0.27), and perceived social support (eta2 = 0.12). CONCLUSIONS Tai Chi was a culturally appropriate mind-body exercise for these older adults, with statistically significant psychosocial benefits observed over 12-weeks. Further research examining Tai Chi exercise using a randomized clinical trial design with an attention-control group may reduce potential confounding effects, while exploring potential mechanisms underlying the relaxation response associated with mind-body exercise. In addition, future studies with people with other chronic illnesses in all ethnic groups are recommended to determine if similar benefits can be achieved.
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Affiliation(s)
- Ruth E Taylor-Piliae
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, California 94305-5705, USA.
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Argstatter H, Haberbosch W, Bolay HV. Untersuchung der Wirksamkeit von musikalischer Stimulation bei Herzkatheteruntersuchungen. ACTA ACUST UNITED AC 2006. [DOI: 10.1026/0933-6885.17.1.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Hintergrund: Herzkatheteruntersuchungen sind mittlerweile Routineverfahren. Da viele Patienten die Untersuchung als belastend empfinden, wurden begleitende psychosoziale Interventionen vorgeschlagen. Ziel der vorliegenden Studie war die Überprüfung der Wirksamkeit von Musiktherapie bei Herzkatheteruntersuchungen auf das subjektive und objektive Angsterleben sowie eine daraus folgende Reduktion von Sedativa. Methoden: Eine dreiarmige (Musikexposition während der HKU; Musikexposition + ergänzendes musiktherapeutisches Coaching; Kontrollgruppe mit Standardbehandlung) randomisierte Studie mit N = 83 Patienten (48 männlich, 35 weiblich, Alter 66 ± 11 Jahre). Zielvariablen waren subjektiv empfundene Angst (STAI-S) sowie physiologische Variablen (Blutdruck, Puls, Cortisol, IgA). Ergebnisse: In der Expositionsgruppe konnte die subjektive Angst (STAI-S) gegenüber den beiden anderen Gruppen prä-post signifikant gesenkt werden (Exposition 11 P, Coaching 4 P, Kontrolle 6 P; p = .033). Die physiologischen Werte unterschieden sich jedoch nicht, ebenso wenig die Medikation. Diskussion: Durch musikalische Stimulation kann das subjektive Angsterleben beeinflusst werden. Auf physiologische Parameter nimmt die Musikintervention nicht so gezielt Einfluss. In der klinischen Anwendung lässt sich der Einsatz adjuvanter Musiktherapie in Form der Exposition rechtfertigen und empfehlen.
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Henderson A, Shum D, Lee D. To Lopez V (2005) Commentary on Lee et al. (2004). J Clin Nurs 2005; 14:1013-4. [PMID: 16102153 DOI: 10.1111/j.1365-2702.2005.00989.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Amanda Henderson
- Princess Alexandra Hospital, Woolloongabba, 4101, Queensland, Australia
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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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Affiliation(s)
- Kathi J Kemper
- Department of Pediatrics, Section of Hematology and Oncology, Wake Forest University School of Medicine, Medical Center Blvd., WinstonSalem, NC 27157, USA.
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Guétin S, Ginies P, Blayac JP, Eledjam JJ. Une nouvelle technique contrôlée de musicothérapie dans la prise en charge des douleurs viscérales aiguës et chroniques. ACTA ACUST UNITED AC 2005. [DOI: 10.1007/bf03014561] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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