Music imagery for adults with acute leukemia in protective environments: a feasibility study. A non-randomized [corrected] controlled trial of the active music engagement (AME) intervention on children with cancer. Effects of a single music therapy intervention on anxiety, discomfort, satisfaction, and compliance with screening guidelines in outpatients undergoing flexible sigmoidoscopy. Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation: a randomized controlled trial. Use of preferred music to reduce emotional distress and symptom activity during radiation therapy. Effects of music therapy on health-related outcomes in cardiac rehabilitation: a randomized controlled trial. Music as an adjunct to antiemetic therapy. The impact of music therapy on language functioning in dementia. Effects of a music therapy intervention on quality of life and distress in women with metastatic breast cancer. The effects of music on cardiac patients on bed rest. Short-term effects of exercise and music on cognitive performance among participants in a cardiac rehabilitation program. Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia. The effect of music on preoperative anxiety in day surgery. Evidence that music listening reduces preoperative patients' anxiety. Stress reduction through music in patients undergoing cerebral angiography. Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. The therapeutic use of music for cancer-related pain. Music as a therapeutic intervention for anxiety in patients receiving radiation therapy. The sedative and analgesic sparing effect of music. Minimising preoperative anxiety with music for day surgery patients - a randomised clinical trial. Music reduces stress and anxiety of patients in the surgical holding area. Effect of music therapy in the postanesthesia care unit: a nursing intervention. Psychophysiologic responses of mechanically ventilated patients to music: a pilot study. Effect of music on ambulatory surgery patients' preoperative anxiety. [Role of interactive music in oncological pediatric patients undergoing painful procedures]. Music therapy for in-patients with schizophrenia: exploratory randomised controlled trial. The effects of music on the rate of perceived exertion and general mood among coronary artery bypass graft patients enrolled in cardiac rehabilitation phase II. Effectiveness of music therapy for anxiety reduction in women with breast cancer in chemotherapy treatment. Music increases satisfaction in elderly outpatients undergoing cataract surgery. Music therapy to relieve anxiety in pregnant women on bedrest: a randomized, controlled trial. Influence of music on the stress response in patients receiving mechanical ventilatory support: a pilot study. [Active music therapy for senile depression]. Music: a diversionary therapy. The effect of two nursing interventions on the postoperative outcomes of gynecologic laparoscopic patients. Effects of music on Alzheimer patients. The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. The effect of music therapy on anxiety in patients who are terminally ill. A music intervention to reduce anxiety prior to gastrointestinal procedures. Effects of music therapy on anxiety in ventilator-dependent patients. Effect of music therapy on anxiety and depression in patients with Alzheimer's type dementia: randomised, controlled study. Overture for growth hormone: requiem for interleukin-6? The additional therapeutic effect of group music therapy for schizophrenic patients: a randomized study. Effect of music on vital signs and postoperative pain. Music versus distraction for procedural pain and anxiety in patients with cancer. Use of music to decrease aggressive behaviors in people with dementia. Benefits of music therapy as an adjunct to chest physiotherapy in infants and toddlers with cystic fibrosis. Stress reduction through listening to Indian classical music during gastroscopy. [Effect of music on children with cancer]. Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial. Calming music and hand massage with agitated elderly. [The effect of music therapy on anxiety level in hospitalized asthmatic patients]. A controlled trial of music and pre-operative anxiety in Chinese men undergoing transurethral resection of the prostate. Music therapy in moderate and severe dementia of Alzheimer's type: a case-control study. Effect of music therapy on state anxiety in patients undergoing flexible sigmoidoscopy. Music therapy: an intervention to reduce anxiety in the myocardial infarction patient. Effects of music on patients undergoing a C-clamp procedure after percutaneous coronary interventions. Effects of music therapy on physiological and psychological outcomes for patients undergoing cardiac surgery. Effects of music therapy on women's physiologic measures, anxiety, and satisfaction during cesarean delivery. A music intervention to reduce anxiety before vascular angiography procedures. Recreational music-making: a cost-effective group interdisciplinary strategy for reducing burnout and improving mood states in long-term care workers. The effect of music as a conditioning aid in prepared childbirth education. The effects of Western music on postoperative pain in Taiwan. Study of the effectiveness of musical stimulation during intracardiac catheterization. The effect of music on the neurohormonal stress response to surgery under general anesthesia. Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial. Effectiveness of different music-playing devices for reducing preoperative anxiety: a clinical control study. The effect of nursing interventions utilizing music therapy or sensory information on Chinese patients' anxiety prior to cardiac catheterization: a pilot study. Coping with preoperative anxiety in cesarean section: physiological, cognitive, and emotional effects of listening to favorite music. Listening to music decreases need for sedative medication during colonoscopy: a randomized, controlled trial. [Effects of music therapy in intensive care unit without sedation in weaning patients versus non-ventilated patients]. Effect of music on chronic osteoarthritis pain in older people. The effect of music in the postanesthesia care unit on pain levels in women who have had abdominal hysterectomies. Music: an intervention for pain during chest tube removal after open heart surgery. Music therapy for patients receiving spine surgery. Using massage and music therapy to improve postoperative outcomes. Does routine assessment and real-time feedback improve cancer patients' psychosocial well-being? Taped therapeutic suggestions and taped music as adjuncts in the care of coronary-artery-bypass patients. Music does not reduce alfentanil requirement during patient-controlled analgesia (PCA) use in extracorporeal shock wave lithotripsy for renal stones. The effect of music listening on older adults undergoing cardiovascular surgery. The effect of self-selected music during colonoscopy on anxiety, heart rate, and blood pressure. Relief of postoperative pain with jaw relaxation, music and their combination. The effects of music interventions on postoperative pain and sleep in coronary artery bypass graft (CABG) patients.
Patients receiving intensive chemotherapy can experience increased distressed related to both the cancer diagnosis and treatment isolation. If not addressed, distress can lead to anxiety, depression, and post-traumatic stress disorder. The purpose of this study was to determine the feasibility and possible benefits of a music imagery intervention for patients hospitalized in a protective environment for the treatment of acute leukemia or high-grade non-Hodgkin's lymphoma.
                Adults receiving intensive myelosuppressive chemotherapy in a protective environment were randomized to standard care or standard care plus music imagery. The music imagery sessions occurred twice weekly for up to eight sessions. Patients were encouraged to use the music imagery daily.
                The principal criteria of feasibility were rate of consent, rate of completion of scheduled sessions, and rate of questionnaire completion. Forty-nine out of 78 patients consented, a 63% consent rate. Seventy-two percent of all scheduled music imagery sessions were completed. The rate of questionnaire completion was 60% with missing data because of illness severity and early discharge. The principal outcomes of benefit (e.g., efficacy) were positive and negative affects, fatigue, and anxiety. Both groups improved over time on all outcomes (all p < 0.001). However, a subgroup of individuals with low baseline negative affect who received the intervention reported significantly less anxiety at discharge than individuals with low baseline negative affect who did not receive the intervention.
                Music imagery is feasible for adults with acute leukemia in protected environments. Patients with lower initial distress may benefit from a music imagery program in terms of reduced anxiety at discharge. Coping theorists argue that environmental factors affect how children perceive and respond to stressful events such as cancer. However, few studies have investigated how particular interventions can change coping behaviors. The active music engagement (AME) intervention was designed to counter stressful qualities of the in-patient hospital environment by introducing three forms of environmental support.
                The purpose of this multi-site randomized controlled trial was to determine the efficacy of the AME intervention on three coping-related behaviors (i.e. positive facial affect, active engagement, and initiation). Eighty-three participants, ages 4-7, were randomly assigned to one of three conditions: AME (n = 27), music listening (ML; n = 28), or audio storybooks (ASB; n = 28). Conditions were videotaped to facilitate behavioral data collection using time-sampling procedures.
                After adjusting for baseline differences, repeated measure analyses indicated that AME participants had a significantly higher frequency of coping-related behaviors compared with ML or ASB. Positive facial affect and active engagement were significantly higher during AME compared with ML and ASB (p<0.0001). Initiation was significantly higher during AME than ASB (p<0.05).
                This study supports the use of the AME intervention to encourage coping-related behaviors in hospitalized children aged 4-7 receiving cancer treatment.
                (c) 2007 John Wiley & Sons, Ltd. Screening flexible sigmoidoscopy (FS) is an effective tool for the detection of colon cancer. Nonetheless, persons are reluctant to undergo FS for a variety of reasons such as anxiety, discomfort, and the possibility of abnormal findings. Nurses caring for FS patients can implement interventions to allay anxiety and promote comfort in an effort to enhance satisfaction and future compliance. Music therapy is one nonpharmacologic intervention that has been shown to be effective in allaying anxiety, reducing discomfort, and promoting satisfaction in other patient populations. A two-group pretest, posttest experimental design with repeated measures study recruited 64 subjects undergoing FS from one Midwestern tertiary care center. Subjects were randomly assigned to a control condition of usual procedural care or to an experimental condition of music therapy during the examination. State and trait anxieties were measured at pretest. State anxiety, discomfort, satisfaction, and perceived compliance with future screening were measured after the procedure. Subjects in the music group reported less anxiety and discomfort than subjects in the control group. There were no differences on satisfaction ratings or perceived compliance with screening guidelines. Nurses caring for patients undergoing screening FS can offer music therapy as one nonpharmacologic intervention to ameliorate anxiety and reduce discomfort. High-dose therapy with autologous stem cell transplantation (HDT/ASCT) is a commonly used treatment for hematologic malignancies. The procedure causes significant psychological distress and no interventions have been demonstrated to improve mood in these patients. Music therapy has been shown to improve anxiety in a variety of acute medical settings. In the current study, the authors determined the effects of music therapy compared with standard care on mood during inpatient stays for HDT/ASCT.
                Patients with hematologic malignancy admitted for HDT/ASCT at two sites (Memorial Sloan-Kettering Cancer Center and Ireland Cancer Center in Cleveland, Ohio) were randomized to receive music therapy given by trained music therapists or standard care. Outcome was assessed at baseline and every 3 days after randomization using the Profile of Mood States.
                Of 69 patients registered in the study, follow-up data were available for 62 (90%). During their inpatient stay, patients in the music therapy group scored 28% lower on the combined Anxiety/Depression scale (P = 0.065) and 37% lower (P = 0.01) on the total mood disturbance score compared with controls.
                Music therapy is a noninvasive and inexpensive intervention that appears to reduce mood disturbance in patients undergoing HDT/ASCT.
                Copyright 2003 American Cancer Society. Music therapy has decreased anxiety levels in many medical settings. This randomized clinical trial examined the effectiveness of a music listening intervention, delivered by a board-certified music therapist, in patients undergoing curative radiation therapy (RT). Emotional distress (anxiety, depression, and treatment-related distress) and symptoms (fatigue and pain) were measured at baseline, mid-treatment, and end of treatment in 63 patients undergoing RT. Although patients who listened to self-selected music reported lower anxiety and treatment-related distress, there was a decline in these outcomes for patients in both groups over the course of RT. Depression, fatigue, and pain were not appreciably affected by music therapy. Within the music group, there was a significant correlation between number of times music was used/week and the change in treatment-related distress, suggesting that higher doses of music produced greater declines in distress. While these findings provided some support for the use of music in reducing distress during RT, further research demonstrating clear differences between intervention and control conditions is needed. Physical symptoms were not affected by the use of music over the course of RT. This study tested effectiveness of music therapy in improving health-related outcomes of cardiac rehabilitation patients. Using a randomized, controlled trial with follow-up, the study was conducted in an outpatient cardiac rehabilitation program in Ohio. Sixty-eight of 103 recruited patients, 30 to 80 years of age, completed the protocol through posttreatment. Physiological and psychological outcomes were measured. Cardiac rehabilitation patients were randomly assigned to cardiac rehabilitation only or to music therapy plus cardiac rehabilitation. Music therapy included musical experiences, counseling, and Music-Assisted Relaxation and Imagery. The null hypothesis of no differences in health-related outcomes between cardiac rehabilitation patients who experienced cardiac rehabilitation with and without music therapy was rejected due to changes in systolic blood pressure pre to post-treatment. Interpretation of changes at 4 months posttreatment in anxiety, general health, and social functioning are limited, due to small sample sizes at follow-up. Pre to post-music therapy session improvements were also reported. Findings suggest that some health-related outcomes may be affected positively by participation in music therapy in addition to cardiac rehabilitation. Attrition contributed to limitations in statistical power. To test whether use of music as a diversional intervention during high-dose chemotherapy administration would affect perception of nausea and episodes of vomiting.
                39 patients undergoing bone marrow transplant. A total of 33 patients were included in the data analysis, with 17 in the control group and 16 in the music intervention group.
                Patients were assigned randomly to a control group (usual antiemetic protocol) or the experimental group (usual antiemetic group plus music intervention during the 48 hours of high-dose cyclophosphamide administered as part of the preparative regimen).
                Use of a music intervention, perception of nausea, and instances of vomiting.
                Significant differences were found between group scores on a visual analog scale for nausea and number of episodes of vomiting, demonstrating that the experimental group experienced less nausea and fewer instances of vomiting.
                This study found that music is an effective adjunct to a pharmacologic antiemetic regimen for lessening nausea and vomiting, and this study merits further investigation through a larger multi-institutional effort.
                Using music as a diversional adjunct intervention to antiemetic therapy is helpful in decreasing nausea and vomiting. The intervention can be initiated independently by nurses and individualized for each patient, leading to greater patient comfort and compliance with high-dose chemotherapy. Dementias, such as Alzheimer's disease, include a progressive deterioration of language functioning. While some researchers have reported an increase in patients' self-expression following music therapy, it is not clear whether these changes specifically reflect improved language skills or whether simple interpersonal interaction with a therapist could account for the improvement. In this study, the effects of music therapy were compared to conversational sessions on language functioning in dementia patients. Participants were selected according to the following criteria: (a) residing in a facility specializing in Alzheimer's and related disorders; (b) possessing sufficient verbal ability to answer simple questions and to comply with requests to speak, participate, or sit down; and (c) attaining the written consent of the patient's guardian or representative. All participants had been in music therapy twice per week for at least 3 months prior to the study onset. One week prior to the beginning of the study, subjects were assessed for cognitive functioning using the Mini-Mental State Examination (MMSE), and language ability via the Western Aphasia Battery (WAB). A within-subjects design was used, with order of condition (music or group conversation first) counter-balanced between participants. Subjects participated in groups of 2 to 4, twice per week for 20-30 minutes for a total of 8 sessions (4 music therapy and 4 conversation sessions or vice-versa), and were re-tested on the WAB at the end of each 2 week (4 session) interval. Results from 20 participants revealed that music therapy significantly improved performance on both speech content and fluency dimensions of the spontaneous speech subscale of the WAB (p =.01). While the difference in overall Aphasia Quotient (AQ) for music and conversation sessions (mean AQ = 76 vs. 70, respectively) did not reach statistical significance, data were only available for 10 participants (5 per condition). Hopefully, these findings will stimulate additional research on the use of music therapy interventions with demented patients, as it may offer a noninvasive mechanism to enhance communication between victims and their caregivers. This study examined the effects of music therapy (MT), immediate and over time, on patients' psychological functioning, quality of life, and physiologic stress arousal. This intervention, whereby patients use music strategies to cope with cancer-related stressors, is based on a transactional stress-coping framework. Using a longitudinal, randomized controlled design, 70 women with metastatic breast cancer received either MT or usual care. The MT consisted of three individual sessions led by a music therapist. Psychological symptoms were measured with the Hospital Anxiety and Depression Scale and quality of life with the Functional Assessment of Cancer Therapy-General plus a a Spirituality subscale at baseline approximately 6 weeks and 3 months later. Visual analog scales, heart rate, and blood pressure were assessed in the MT group immediately before and after individual session. Significant immediate effects of MT were observed: relaxation, p = < .00001; comfort, p = < . 00001; happiness, p = < .00001; heart rate, p = .0003; although no significant differences between conditions were found over time. A high attrition rate underscored the complexities inherent in conducting intervention research with advanced cancer patients. Hospitalizations that require invasive cardiac procedures or support with an intra-aortic balloon pump can be unsettling. This study was undertaken to measure the effect of a music intervention on physiologic and psychological responses of patients on bed rest due to procedural sheaths or an intra-aortic balloon pump. A randomized, two-group, pretest/post-test design was utilized to measure the effect of a 30-minute music intervention on heart rate, blood pressure, respiratory rate, skin temperature, pain perception, and mood states. One hundred forty subjects participated, 65 in the control group and 75 in the treatment group. There were no significant differences between the groups in demographic, clinical, or baseline variables, except for respiratory rate. After the music intervention, there were reductions in blood pressure, respiratory rate, and psychological distress, as measured by the Profile of Mood States (p < 0.05). Music appeared to affect selected physiologic responses and reduce psychological distress in patients on bed rest. Exercise has been associated with improved cognitive performance among patients with coronary artery disease. Music listening has been associated with enhanced cognitive functioning among healthy adults. This study evaluated the combined influence of exercise and music listening on cognitive performance among patients in cardiac rehabilitation (CR).
                Using a within-subjects repeated measures design, this study was conducted in an outpatient University-based CR facility.
                Thirty-three men and women (mean age = 62.6 +/- 10.5 years) participated in this study.
                Participants completed 1 exercise session accompanied by music and a second exercise session without music. Order of conditions was assigned randomly. Before and after each exercise session, participants completed a brief assessment of depression and anxiety, and a cognitive test of verbal fluency.
                The music condition was associated with significant improvements in verbal fluency, but the no-music control condition was not associated with cognitive change.
                The study provides preliminary evidence of the combined benefit of exercise and music listening for cognitive performance among patients in CR. Music therapy (MT) has been proposed as valid approach for behavioral and psychologic symptoms (BPSD) of dementia. However, studies demonstrating the effectiveness of this approach are lacking.
                To assess MT effectiveness in reducing BPSD in subjects with dementia.
                Fifty-nine persons with dementia were enrolled in this study. All of them underwent a multidimensional assessment including Mini Mental State Examination, Barthel Index and Neuropsychiatry Inventory at enrollment and after 8, 16, and 20 weeks. Subjects were randomly assigned to experimental (n=30) or control (n=29) group. The MT sessions were evaluated with standardized criteria. The experimental group received 30 MT sessions (16 wk of treatment), whereas the control group received educational support or entertainment activities.
                NPI total score significantly decreased in the experimental group at 8th, 16th, and 20th weeks (interaction time x group: F3,165=5.06, P=0.002). Specific BPSD (ie, delusions, agitation, anxiety, apathy, irritability, aberrant motor activity, and night-time disturbances) significantly improved. The empathetic relationship and the patients' active participation in the MT approach, also improved in the experimental group.
                The study shows that MT is effective to reduce BPSD in patients with moderate-severe dementia. This paper reports a study to test the hypothesis that day surgery patients who listen to music during their preoperative wait will have statistically significantly lower levels of anxiety than patients who receive routine care.
                Although previous day surgery research suggests that music effectively reduces preoperative anxiety, methodological issues limit the generalizability of results.
                In early 2004, a randomized controlled trial design was conducted to assess anxiety before and after listening to patient preferred music. Participants were allocated to an intervention (n=60), placebo (n=60) or control group (n=60). Pre- and post-test measures of anxiety were carried out using the State-Trait Anxiety Inventory.
                Music statistically significantly reduced the state anxiety level of the music (intervention) group. No relationships were found between socio-demographic or clinical variables such as gender or type of surgery.
                The findings support the use of music as an independent nursing intervention for preoperative anxiety in patients having day surgery. 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.
                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.
                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.
                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. We studied the influence of music on stress reaction of patients during cerebral angiography. We randomised 30 patients to a music or a control group. We measured stress hormones, blood pressure, heart rate and psychological parameters. Patients examined without music showed rising levels of cortisol in plasma, indicating high stress levels, while cortisol in patients examined with music remained stable. Systolic blood pressure was significantly lower listening to music. Patients with a high level of fear did appear to benefit particularly from the music. The aim of this study was to investigate the effects of music on the anxiety of patients on mechanical ventilation, as assessed by objective parameters and a subjective validated anxiety scale.
                Mechanical ventilation, although sometimes lifesaving, is often associated with levels of anxiety requiring sedatives, which has inevitable implications on costs and complications.
                A randomized controlled trial design.
                A total of 64 subjects was randomly assigned to undergo either 30 minutes of music intervention or a rest period. The subjects were asked to answer the Chinese State Trait Anxiety Inventory scale before and after the study period and physiological indices and resting behaviours were recorded before and after the study period in both groups. The subjects' satisfaction with music was also obtained after music intervention.
                The findings indicate that patients on mechanical ventilation that listened to a single 30-minute session of music appeared to show greater relaxation as manifested by a decrease in physiological indices and an increase in comfortable resting behaviours.
                Music can provide an effective method of reducing potentially harmful physiological responses arising from anxiety in mechanically ventilated patients.
                As indicated by the results of this study, music therapy can act as a simple and safe nursing intervention to allay anxiety and promote patient comfort. Interest and comments on music therapy provided as a relaxation technique should be elicited from both nurses and patients. The purpose of this experimental crossover study was to evaluate to what extent the therapeutic use of music would decrease pain in patients with cancer who were receiving scheduled analgesics. Baseline data were collected for three days. Subjects then were assigned randomly to listen to their preference of seven types of relaxing music or a control (a 60-cycle hum) twice daily for three days. Then they crossed over into the alternate group for the next three days. Finally, each subject returned to a follow-up baseline period. Pain, the dependent variable, and mood, which was proposed as an intervening variable, were measured by visual analogue scales. The convenience sample included 15 outpatients with cancer, 12 female and 3 male, ages 20 through 87. Results of the McGill Pain Questionnaire (MPQ), a reliable and valid multidimensional instrument administered upon entry into the study, indicated that the study sample was comparable to other samples of patients with cancer who were in pain. There was an inconsistent relation between pain and mood. The effect of the music on pain varied by individual; 75% had at least some response and 47% had a moderate or great response. Multivariate Analysis of Variance (MANOVA) indicated a statistically significant decrease in pain from using either the music or sound, but there was no effect on mood. Although the mean percentage of change in pain for music was twice that for sound, the results did not differ statistically. The findings support the use of music as an independent nursing intervention to relieve pain. To determine whether music moderates the level of anxiety that patients experience during radiation therapy.
                Experimental, longitudinal, random assignment to music or no music therapy.
                Urban radiation oncology center in a Department of Veterans Affairs hospital in the southeastern United States.
                Forty-two men (19 in the experimental group, 23 in the control group) aged 39-80 years (74% white, 12% African American, 12% Hispanic, and 2% other) receiving definitive external beam radiation therapy for pelvic or abdominal malignancies.
                Patients in the experimental group listened to music of their choice provided via audiotapes and headphones before and during their simulation and daily treatments for the duration of the planned course of therapy. The control group received standard care. The State-Trait Anxiety Inventory was administered initially to participants in both groups at the time of evaluation (time 1), post-simulation (time 2), at the end of the first week (time 3), at the end of the third week (time 4), and at the end of the fifth week or end of radiation therapy (time 5).
                State anxiety.
                No significant difference existed between the two groups to suggest that music moderated the level of anxiety during radiotherapy. However, post-hoc analyses identified changes and trends in state anxiety scores, suggesting a possible benefit of music therapy during radiotherapy.
                Despite a lack of group differences, early intervention with music therapy for patients with high levels of anxiety may be beneficial.
                Nurses and other clinicians may administer state anxiety scales at the initial visit or prior to pretreatment radiation planning (simulation). Individuals who have high state anxiety scores may receive nursing interventions tailored to reduce anxiety during simulation and the early part of radiotherapy. To determine whether music influences intraoperative sedative and analgesic requirements, two randomized controlled trials were performed.
                In phase 1, 35 adults undergoing urologic procedures with spinal anesthesia and patient-controlled intravenous propofol sedation were randomly assigned to hear favorable intraoperative music via headset or to have no music. In phase 2, 43 adults undergoing lithotripsy treatment of renal or ureteral calculi and receiving patient-controlled intravenous opioid analgesia were randomly assigned to either a music or no-music group. The effect of music on sedatives and analgesics requirements, recovery room duration, and adverse outcomes was assessed.
                In phase 1, patients in the music group required significantly less propofol for sedation than patients in the control group (0 [0-150] mg vs. 90 [0-240] mg, median[range]; P < 0.001). These findings persisted after adjusting for duration of surgery (0.3+/-0.1 mg/min vs. 1.6+/-0.4 mg/min; P < 0.001). Similarly, in phase 2, patients who listened to music had a significant reduction in alfentanil requirements (1,600 [0-4,250] microg vs. 3,900 [0-7,200] microg; P = 0.005). This persisted after adjusting for duration of surgery (52+/-9 microg/min vs. 119 +/-16 microg/min, mean +/- SD, P < 0.001). Duration of stay in the postanesthesia care unit and the rate of adverse events was similar in both groups (P = NS).
                Use of intraoperative music in awake patients decreases patient-controlled sedative and analgesic requirements. It should be noted, however, that patients in the no-music group did not use a headset during operation. Thus, the decrease in sedative and analgesic requirements could be caused by elimination of ambient operating room noise and not by the effects of music. The objective of this study was to evaluate the effects of musical intervention on preoperative anxiety and vital signs in patients undergoing day surgery.
                Studies and systematic meta-analyses have shown inconclusive results of the efficacy of music in reducing preoperative anxiety. We designed a study to provide additional evidence for its use in preoperative nursing care.
                Randomised, controlled study.
                Patients (n = 183) aged 18-65 admitted to our outpatient surgery department were randomly assigned to either the experimental group (music delivered by earphones) or control group (no music) for 20 minutes before surgery. Anxiety, measured by the State-Trait Anxiety Inventory, and vital signs were measured before and after the experimental protocol.
                A total of 172 patients (60 men and 112 women) with a mean age of 40·90 (SD 11·80) completed the study. The largest number (35·7%) was undergoing elective plastic surgery and 76·7% of the total reported previous experience with surgery. Even though there was only a low-moderate level of anxiety at the beginning of the study, both groups showed reduced anxiety and improved vital signs compared with baseline values; however, the intervention group reported significantly lower anxiety [mean change: -5·83 (SD 0·75) vs. -1·72 (SD 0·65), p < 0·001] on the State-Trait Anxiety Inventory compared with the control group.
                Patients undergoing day surgery may benefit significantly from musical intervention to reduce preoperative anxiety and improve physiological parameters.
                Finding multimodal approaches to ease discomfort and anxiety from unfamiliar unit surroundings and perceived risks of morbidity (e.g. disfigurement and long-term sequelae) is necessary to reduce preoperative anxiety and subsequent physiological complications. This is especially true in the day surgery setting, where surgical admission times are often subject to change and patients may have to accommodate on short notice or too long a wait that may provoke anxiety. Our results provide additional evidence that musical intervention may be incorporated into routine nursing care for patients undergoing minor surgery.
                © 2011 Blackwell Publishing Ltd. Many patients in the Surgical Holding Area become stressed and anxious. In a hospital setting music reduces patients' anxiety. This study determined that music can reduce the anxiety and stress of patients in the Surgical Holding Area. In this study, one group of subjects listed to music while a second group did not. Subjects who listened to music while in the Surgical Holding Area had significantly less stress and anxiety than did those who did not listen to music. Both groups spent similar lengths of time in the Surgical Holding Area. The results strongly suggest that if music were available to all patients in the Surgical Holding Area, most would select this option, and they would experience less anxiety. This study examined the effect of music on pain, hemodynamic variables, and respiration in the PACU, and the impact of music on patients' recall of their PACU experience. Sixty patients scheduled for thyroid, parathyroid, or breast surgery under general anesthesia were studied. Patients were randomly assigned into three groups: group 1, control, not wearing headphones; group 2, wearing headphones but hearing no music; and group 3, wearing headphones and listening to music. A visual analogue pain scale was used to rate patients' perception of pain. There was no difference in pain level, morphine requirement, hemodynamics, respiration, or length of stay in the PACU among the 3 groups, yet the music group was able to wait significantly longer before requiring analgesia on the nursing unit. Patients who listened to music perceived their PACU experience as significantly more pleasant than the patients in the other two groups as recalled both 1 day and 1 month later. Although mechanically ventilated patients experience numerous stressors, they have not been included in music therapy stress reduction and relaxation studies.
                To examine selected psychophysiologic responses of mechanically ventilated patients to music.
                A two-group experimental design with pretest, posttest, and repeated measures was used. Twenty mechanically ventilated patients were randomized to a music-listening group or a nonmusic (headphones only) group. Physiologic dependent measures--heart rate and rhythm, respiratory rate, systolic and diastolic blood pressure, oxygen saturation, and airway pressure--were collected at timed intervals. Psychologic data were collected before and after intervention using the Profile of Mood States.
                Using repeated measures analysis of variance, results for heart rate and respiratory rate over time and over time between groups were significant. Between-group differences were significant for respiratory rate. Significant differences were found via t test for the music group's Profile of Mood States scores. No adverse cardiovascular responses were noted for either group.
                Data indicated that music listening decreased heart rate, respiratory rate, and Profile of Mood States scores, indicating relaxation and mood improvement. The authors investigated music as a method to reduce ambulatory surgery patients' preoperative anxiety. They assigned 42 patients to either an experimental or a control group and compared the patients' vital signs and self-reports of anxiety, which were measured using the state portion of the State-Trait Anxiety Inventory. The study results indicate that music can be more beneficial than preoperative instruction alone in reducing ambulatory surgery patients' anxiety. Patients who listened to their choice of music before surgery in addition to receiving preoperative instruction had significantly lower heart rates than patients in the control group who received only preoperative instruction. Differences in experimental and control group patients' blood pressure measurements and respiratory rates approached significance. The authors suggest that perioperative nurses offer music as a viable option to reduce anxiety in ambulatory surgery patients who believe music is a method of relaxation. The present study has examined whether interactive music may be considered an effective treatment for the attenuation of anxiety in oncological paediatric patients undergoing painful procedures (lumbar injection, bone marrow aspiration, osteomedullary biopsy and arterial catheter).
                Thirty-nine tumour patients aged between 2 and 12 were randomised into 2 groups: Music (M) (N. 20) and Controls (N. 19) and were treated by M: conscious sedation and intervention of interactive music and C: sedation. The following factors were assessed: temperament on the Emotivity, Activity, Sociability scale, anxiety on the Yale preoperative anxiety scale (mYPAS), the induction compliance checklist (ICC), parent anxiety by cataloguing the trait-state anxiety inventory, and the degree of satisfaction of children, parents and staff using the Barrera questionnaires. Data significance was accepted with values of P<0.05.
                There was a fall in mYPAS values in M compared to C in the four phases of the process: Phase 1 (P<0.05); Phase 2, 3 and 4 (P<0.01). For the ICC children with a score of <or=1, ''collaborated'', those with a score of >1 were ''non collaborators''; in the music group the trend was for an increase in the number of collaborating children (P<0.07).
                The M group presents a significant effect of attenuation of anticipatory anxiety and a tendency to great induction compliance compared to group C. The parents do not show any significant anxiety attenuation effect. The degree of satisfaction of children, parents and staff point to a positive role and a beneficial effect of interactive music on the occasion of painful procedures. Music therapy may provide a means of improving mental health among people with schizophrenia, but its effects in acute psychoses have not been explored.
                To examine the feasibility of a randomised trial of music therapy for inpatients with schizophrenia, and explore its effects on mental health.
                Up to 12 weeks of individual music therapy plus standard care were compared with standard care alone. Masked assessments of mental health, global functioning and satisfaction with care were conducted at 3 months.
                Of 115 eligible patients 81 (70%) were randomised. Two-thirds of those randomised to music therapy attended at least four sessions (median attendance, eight sessions). Multivariate analysis demonstrated a trend towards improved symptom scores among those randomised to music therapy, especially in general symptoms of schizophrenia.
                A randomised trial of music therapy for in-patients with schizophrenia is feasible. The effects and cost-effectiveness of music therapy for acute psychosis should be further explored in an explanatory randomised trial. The purpose of the study was to identify the effect of music on perceived exertion and mood in 30 coronary artery bypass graft patients during cardiac rehabilitation. The modified Borg Scale of Perceived Exertion (RPE) and the Rejeski Feeling Scale (FS) were the dependent variables. Group A subjects exercised with music and Group B subjects exercised without music as they rated their perceived exertion and mood. The use of music to reduce perceived exertion was not supported (p = 0.16). However, Group A members reported significantly enhanced mood while exercising to music and Group B members reported a significantly decreased mood without music (p = 0.0006). Enhancement of mood might lead to increased compliance with a regular exercise routine. In the last decade, the public use of complementary and alternative therapies for the solution of various health problems has increased dramatically. Listening to music can be considered a support to the traditional medical practice for the reduction of anxiety and stress related to chemotherapy. Music has long been known to reduce anxiety, minimize the need for sedatives, and make patients feel more at ease. The purpose of the study was to evaluate the effect of music in elderly outpatients undergoing elective cataract surgery with retrobulbar block and monitored anaesthetic care using fentanyl or alfentanil and midazolam.
                One hundred and twenty one patients were prospectively and randomly assigned to hear: relaxing suggestions, white noise, operating room noise or relaxing music via audio-cassette headphones. Vital signs were documented before and after retrobulbar block and every 15 min thereafter. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) before and after surgery. Visual analogue scales (VAS) were used to assess anxiety and patient satisfaction postoperatively with a standardized questionnaire. Between group comparisons were made using Chi-Square, or ANOVA, where appropriate.
                There were no differences between groups in STAI or anxiety VAS scores at any time. Differences were noted in systolic blood pressure, but not in other vital signs. Patients' ratings of the whole operative experience, satisfaction with the tape played, general level of relaxation and preference for the chosen tape for subsequent surgery were different (music > relaxing suggestions > white noise and OR noise, P < 0.05).
                Elderly patients undergoing cataract surgery under retrobulbar block were more satisfied with their experience if they heard relaxing music, rather than relaxing suggestions or white noise or OR noise. The type of auditory stimuli to which the patients were exposed did not influence the level of anxiety. To explore the effect of music therapy on anxiety alleviation for antepartal women on bedrest in China.
                One hundred and twenty patients recruited from one tertiary hospital in Changsha city, China were enrolled in a randomized controlled trial. Women in the experimental group received music therapy for 30 minutes on 3 consecutive days. Usual care participants had a 30-minute rest on 3 consecutive days. Variables included anxiety (State-Trait Anxiety Inventory), and physiological responses (vital signs, fetal heart rate). Descriptive statistics, t tests, chi tests, Wilcoxon rank sum tests, and Pearson correlation analyses were used to analyze the data.
                Anxiety levels decreased and physiological responses improved significantly in the intervention group, which was provided with music therapy while on bedrest.
                Carefully selected music that incorporates a patient's own preferences may offer an inexpensive and effective method to reduce anxiety for antepartal women with high risk pregnancies who are on bedrest. Music is considered an ideal therapy for reducing stress in patients receiving mechanical ventilation. Previous studies of the effect of music on stress in such patients have focused solely on indirect markers of the stress response rather than on serum biomarkers.
                To explore the influence of music on serum biomarkers of the stress response in patients receiving ventilatory support.
                A convenience sample of 10 patients receiving mechanical ventilation was recruited from an 11-bed medical intensive care unit. Patients were randomly assigned to listen to music or to rest quietly for 60 minutes. Levels of corticotropin, cortisol, epinephrine, and norepinephrine were measured 4 times during the 60 minutes.
                The levels of the 4 biomarkers of the stress response did not differ significantly between patients who listened to music and patients who rested quietly, though the levels of corticotropin and cortisol showed interesting trends.
                Additional research is needed with a larger sample size to evaluate further the influence of music on biochemical markers of the stress response in patients receiving mechanical ventilatory support. In future studies, confounding factors such as endotracheal suctioning and administration of medications that influence the stress response should be controlled for. 68 cases with senile depression were divided randomly into two groups--test group and control group. Patients of both groups received same antidepressive drugs while for the patients in the test group active music therapy was provided everyday in addition and the course of music therapy was 8 weeks. Patients in the test group showed improvement of their symptoms at the end of first week while most patients in the control group were getting somewhat better at the 3rd-4th week. The effectiveness of combined treatment in the test group is better than that in the control group. Patients in the test group became calm and active and the atmosphere on the ward appeared to be somewhat harmonized so that it was beneficial to the nursing care. 1. Music is a simple, inexpensive, aesthetically pleasing means of alleviating the anxiety of surgical candidates during the immediate preoperative period. 2. When allowed to participate in decision-making regarding their care, patients can regain a partial sense of control. Preoperatively, this goal can be achieved by permitting them to choose their own music and to experience music's diversionary effect. 3. As patient advocates, nurses should take advantage of the therapeutic effect of music by incorporating it into the perioperative setting. Anecdotal reports support research findings in documenting the high incidence of negative postoperative outcomes after gynecologic (GYN) laparoscopic surgery. Three outcome measures, postoperative pain, postoperative nausea and vomiting (PONV), and length of stay, have received considerable attention. Two nursing interventions frequently suggested for their positive effects are guided imagery and music therapy. An experimental pilot study was conducted to determine the effects of these nursing inventions on postoperative pain, PONV, and length of stay for GYN laparoscopic patients (n = 84). During the perioperative period, patients were randomly assigned to one of 3 interventions: guided imagery audiotapes (GI), music audiotapes (MU), or standard care (C), and outcome measures were evaluated. Results indicated that patients in both the guided imagery and music groups had significantly less pain on PACU discharge to home than the patients in the control group. These findings suggest that both guided imagery and music are effective strategies in improving pain, a difference that becomes apparent when the patient is ready to be discharged. It is possible that these interventions act as distractions in reducing the report of negative postoperative outcomes. From a large nursing care facility, 60 elderly patients diagnosed as having Alzheimer disease were randomly separated into three groups of equal size and given tests to measure their mood and mental state. For music Group 1, "Big Band" music from the 1920s and 1930s was played during their daily recreation period while Group 2 were given puzzle exercises during their activity sessions. Members of Group 3 participated in the standard recreational activities of drawing and painting. After six months, the questionnaire was again given to all participants. Analysis of variance showed the individuals in Group 1 were more alert, happier, and had higher recall of past personal history than patients in the other two groups. This suggests that music can be of therapeutic value to Alzheimer patients. The purpose of this study was to evaluate the effects of music therapy on quality of life, length of life in care, physical status, and relationship of death occurrence to the final music therapy interventions of hospice patients diagnosed with terminal cancer. Subjects were adults who were living in their homes, receiving hospice care, and were diagnosed with terminal cancer. A total of 80 subjects participated in the study and were randomly assigned to one of two groups: experimental (routine hospice services and clinical music therapy) and control (routine hospice services only). Groups were matched on the basis of gender and age. Quality of life was measured by the Hospice Quality of Life Index-Revised (HQOLI-R), a self-report measure given every visit. Functional status of the subjects was assessed by the hospice nurse during every visit using the Palliative Performance Scale. All subjects received at least two visits and quality of life and physical status assessments. A repeated measures ANOVA revealed a significant difference between groups on self-report quality of life scores for visits one and two. Quality of life was higher for those subjects receiving music therapy, and their quality of life increased over time as they received more music therapy sessions. Subjects in the control group, however, experienced a lower quality of life than those in the experimental group, and without music, their quality of life decreased over time. There were no significant differences in results by age or gender of subjects in either condition. Furthermore, there were no significant differences between groups on physical functioning, length of life, or time of death in relation to the last scheduled visit by the music therapist or counselor. This study provides an overview of hospice/palliative care, explains the role of music therapy in providing care, and establishes clinical guidelines grounded in research for the use of music therapy in improving the quality of life among the terminally ill. The literature supporting the use of music therapy in palliative care is growing. However, the number of quantitative research studies investigating the use of music therapy in palliative care, and specifically anxiety, is limited.
                The aim of this research project was to examine the effectiveness of a single music therapy session in reducing anxiety for terminally ill patients.
                A randomized-controlled design was implemented and the following hypotheses tested. There will be a significant difference between the experimental and control groups on anxiety levels as demonstrated by the anxiety measurement of the Edmonton Symptom Assessment System (ESAS), and heart rate. The experimental group received a single music therapy intervention and the control group received a volunteer visit.
                Twenty-five participants with end-stage terminal disease receiving inpatient hospice services were recruited.
                The first hypothesis was supported. Results demonstrated a significant reduction in anxiety for the experimental group on the anxiety measurement of the ESAS (p = 0.005). A post hoc analysis found significant reductions in other measurements on the ESAS in the experimental group, specifically pain (p = 0.019), tiredness (p = 0.024) and drowsiness (p = 0.018). The second hypothesis was not supported.
                The study supports the use of music therapy to manage anxiety in terminally ill patients. Further studies are required to examine the effect of music therapy over a longer time period, as well as addressing other symptom issues. Patients scheduled for gastrointestinal procedures such as colonoscopy or esophagogastroduodenoscopy are often anxious and frightened. High levels of anxiety may result in more difficult and painful procedures. Past research has reported education, coping skills, relaxation techniques, and combinations of these including music, have decreased anxiety in patients across many settings. Self-selected music therapy for preprocedural anxiety has not been studied. A randomized controlled trial of 198 patients was undertaken to determine whether 15 minutes of self-selected music reduced preprocedure anxiety. The State Trait Anxiety Inventory was used to measure patients' anxiety. One-hundred ninety-three men and 5 women comprised the sample with an average age of 61 (SD 10.5). Patients who listened to music (n = 100) reduced their anxiety score from 36.7 (SD 9.1) to 32.3 (SD 10.4), while those who did not listen to music (n = 98) reduced their anxiety score from 36.1 (SD 8.3) to 34.6 (SD 11.5). These differences were statistically significant (F = 7.5, p =.007) after controlling for trait anxiety. There were no significant vital sign changes premusic and postmusic. Music is a noninvasive nursing intervention that can significantly reduce patients' anxiety prior to gastrointestinal procedures. Further research should address using music to reduce anxiety in other procedure areas and testing effectiveness of self-selected versus investigator-selected music in reducing anxiety. The purpose of this study was to assess the effectiveness of music therapy in decreasing anxiety in ventilator-dependent patients.
                A crossover repeated measures design with random assignment was used.
                The intensive care unit of a university hospital in Hong Kong was used as the setting for this study.
                Twenty patients who were ventilator-dependent were recruited for the study. They were all Chinese with a mean age of 58.25 years (range, 19-84 y). Most (75%) were men. Outcome Measures: Physiologic measures of anxiety assessed in this study were mean blood pressure and respiratory rate. An additional measure was the Chinese version of the Spielberger State-Trait Anxiety Inventory.
                Patients were randomized to receive either 30 minutes of uninterrupted rest and then 30 minutes of music therapy or the music therapy first and then the uninterrupted rest period. Patients listened to relaxing music by using audiocassette players and headphones. Subjects selected the music of their choice from a selection including both Chinese and Western music. Subjects had physiologic measures taken immediately before the intervention (or rest period) and at 5-minute intervals throughout the intervention. The Chinese version of Spielberger's State-Trait Anxiety Inventory was completed before the intervention and immediately after the intervention.
                Findings indicated that music therapy was more effective in decreasing state anxiety than was an uninterrupted rest period (P <.01). As measured by analysis of variance with repeated measures, blood pressure and respiratory rate showed no significant differences in the 2 conditions over time. However, significant differences were observed at the end of the intervention (after 30 minutes) between the 2 conditions, with music therapy being superior to the rest period.
                Music therapy is an effective nursing intervention in decreasing anxiety in ventilator-dependent patients and its use should be incorporated into the care of mechanically ventilated patients. For the Chinese patients, culture and language were the predominant factors in their choice of music. Numerous studies have indicated the value of music therapy in the management of patients with Alzheimer's disease. A recent pilot study demonstrated the feasibility and usefulness of a new music therapy technique. The aim of this controlled, randomised study was to assess the effects of this new music therapy technique on anxiety and depression in patients with mild to moderate Alzheimer-type dementia.
                This was a single-centre, comparative, controlled, randomised study, with blinded assessment of its results. The duration of follow-up was 24 weeks. The treated group (n = 15) participated in weekly sessions of individual, receptive music therapy. The musical style of the session was chosen by the patient. The validated 'U' technique was employed. The control group (n = 15) participated under the same conditions in reading sessions. The principal endpoint, measured at weeks 1, 4, 8, 16 and 24, was the level of anxiety (Hamilton Scale). Changes in the depression score (Geriatric Depression Scale) were also analyzed as a secondary endpoint.
                Significant improvements in anxiety (p < 0.01) and depression (p < 0.01) were observed in the music therapy group as from week 4 and until week 16. The effect of music therapy was sustained for up to 8 weeks after the discontinuation of sessions between weeks 16 and 24 (p < 0.01).
                These results confirm the valuable effect of music therapy on anxiety and depression in patients with mild to moderate Alzheimer's disease. This new music therapy technique is simple to implement and can easily be integrated in a multidisciplinary programme for the management of Alzheimer's disease.
                Copyright 2009 S. Karger AG, Basel. Music has been used for therapeutic purposes since the beginning of cultural history. However, despite numerous descriptions of beneficial effects, the precise mechanisms by which music may improve human well-being remain unclear.
                We conducted a randomized study in ten critically ill patients to identify mechanisms of music-induced relaxation using a special selection of slow movements of Mozart's piano sonatas. These sonatas were analyzed for compositional elements of relaxation. We measured circulatory variables, brain electrical activity, serum levels of stress hormones and cytokines, requirements for sedative drugs, and level of sedation before and at the end of a 1-hr therapeutic session.
                Compared with controls, we found that music application significantly reduced the amount of sedative drugs needed to achieve a comparable degree of sedation. Simultaneously, among those receiving the music intervention, plasma concentrations of growth hormone increased, whereas those of interleukin-6 and epinephrine decreased. The reduction in systemic stress hormone levels was associated with a significantly lower blood pressure and heart rate.
                Based on the effects of slow movements of Mozart's piano sonatas, we propose a neurohumoral pathway by which music might exert its sedative action. This model includes an interaction of the hypothalamic-pituitary axis with the adrenal medulla via mediators of the unspecific immune system Schizophrenia is one of the most serious mental disorders. Music therapy has only recently been introduced as a form of treatment. The aim of this study was to examine the effect of music therapy for schizophrenic in-patients needing acute care.
                Thirty-seven patients with psychotic disorders were randomly assigned to an experimental group and a control group. Both groups received medication and treatment indicated for their disorder. Additionally, the experimental group (n = 21) underwent group music therapy.
                Significant effects of music therapy are found in patients' self-evaluation of their psychosocial orientation and for negative symptoms. No differences were found in the quality of life.
                Musical activity diminishes negative symptoms and improves interpersonal contact. These positive effects of music therapy could increase the patient's abilities to adapt to the social environment in the community after discharge from the hospital. Pharmacological methods to improve postoperative pain are well documented, but an increasing interest in nonpharmacological methods has stimulated research in this field. Traditional and pharmacological interventions to relieve perioperative anxiety and pain are being challenged by an increasing demand for more holistic approaches. This study tested the hypothesis that listening to music preoperatively and postoperatively would affect patients' experience of pain, nausea, and well-being and have an impact on their vital signs. The authors conclude that a period of peaceful rest before and after surgery reduces patient anxiety. To test the hypotheses that the effects of a music intervention are greater than those of simple distraction and that either intervention is better at controlling procedural pain and anxiety than treatment as usual.
                Randomized, controlled experiment.
                A midwestern comprehensive cancer center.
                60 people with cancer having noxious medical procedures such as tissue biopsy or port placement or removal; 58 provided usable data.
                Participants completed measures of pain and anxiety before and after their medical procedures and provided a rating of perceived control over pain and anxiety after the procedure.
                Procedural pain, state anxiety, and perceived control over pain and anxiety.
                Contrary to hypotheses, outcomes achieved with music did not differ from those achieved with simple distraction. Moreover, outcomes achieved under treatment as usual were not significantly different from those obtained with music or distraction interventions. Some patients found that the interventions were bothersome and reported that they wanted to attend to the activities of the surgeon and the medical procedure itself.
                The effects of music, distraction, and treatment as usual are equivocal. In addition, patients have individual preferences for use of distraction during painful or anxiety-provoking procedures.
                Patients having noxious medical procedures should be asked about their desire to be distracted before and during the procedure and offered a strategy that is consistent with their preferences. The purpose of this study was to examine the effects of recorded, preferred music in decreasing occurrences of aggressive behavior among individuals with Alzheimer's type dementia during bathing episodes. Eighteen older adults, age 55 to 95, with severe levels of cognitive impairment, participated in the study. They were randomly scheduled for observation during bath time under either a control (no music) condition or an experimental condition in which recorded selections of preferred music were played via audiotape recorder during the bathing episode. Following a 2-week (10 episode) observation period, conditions were reversed. A total of 20 observations were recorded for each individual. Results indicated that during the music condition, decreases occurred in 12 of 15 identified aggressive behaviors. Decreases were significant (p < 0.05) for the total number of observed behaviors and for hitting behaviors. During the music condition, caregivers frequently reported improved affect and a general increase in cooperation with the bathing task. The implications of these findings for improving the overall quality of care for severely cognitively impaired older adults are discussed. Routine chest physiotherapy (CPT) is an important component of prophylactic therapy in children with cystic fibrosis (CF) and requires a significant commitment of time and energy. It is important, therefore, to establish CPT as a positive experience. In this study, we evaluated the effect of recorded music as an adjunct to CPT. Specifically, we compared the use of newly composed music, familiar music, and the family's usual routine on children's and parents' enjoyment of CPT and the parents' perception of time taken to complete CPT. Enjoyment and perception of time were evaluated via questionnaires designed specifically for this study. Participants were caregivers of one or more children with CF who were aged between 4(1/2) months and 24 months at the commencement of the clinical trial and required CPT on a daily basis. Participants were randomly allocated into control and treatment groups. Control group participants experienced two conditions consecutively: no audiotape (NT; control) and familiar music tape (FT; placebo control). Treatment group participants were given the treatment music tape (TT), which was composed and compiled by a music therapist. After baseline assessment, evaluation occurred at two 6-weekly intervals. Children's enjoyment increased significantly after use of the TT (+1. 25 units) compared to NT (-0.5 units; P = 0.03), as did parents' enjoyment (+1.0 vs. 0.0 units, P = 0.02). Children's enjoyment did not change significantly after use of the FT (+0.75 units) compared to NT (n.s.). Likewise, parents' enjoyment did not change significantly after use of the FT (+1.0 units, n.s.). There was no change in perception of time after use of the TT (-4.5 vs. +0.2 min, n.s.) or the FT (+3.3 min, n.s.). These results indicate that children's and parents' enjoyment of CPT significantly increased after the use of specifically composed and recorded music as an adjunct. We therefore recommend that recorded music, such as that provided in this study, be given to parents to use as an adjunct to CPT when their young children are diagnosed with CF, in order to assist the establishment of a positive routine.
                Copyright 2000 Wiley-Liss, Inc. The purpose of this study was to examine the effects of music on elevated state of anxiety as many patients become stressed and anxious during diagnostic procedures. The study was conducted on 104 consecutive patients undergoing GI endoscopy for various reasons. Patients were randomly assigned to two groups regardless of sex, age and underlying disease. One group of 54 patients were made to listen to a recorded Indian classical instrumental music before and during the procedure, while the other group of 50 patients did not. Blood pressure, heart rate and respiratory rate were recorded at the beginning of consultation and end of procedure. Perception of procedure using a three point attitude scale was assessed. Our results indicate that the background Indian classical music is efficacious in reducing psychological distress during a gastroscopic examination. We suggest that music could be applied to other medical situations as well, which tend to generate undue psychological stress and anxiety. Music, as a familiar personal and culture medium, can be used to ease anxiety, to act as distractor, to increase discomfort and pain threshold. This study looked for a relationship between immunity and one's spirits while investigating the effect musical therapy produces on Immunoglobulina A (IgA) found in saliva and a Patient's Opinion on the Likert Scale (OPEL). There were 30 children as patients, 15 in a control group and 15 in an experimental group. They were 5 or 16 years of age and checked into the Sant Joan de Deu Hospital in Barcelona due to neoplastic illness. A nonpharmacological method can be an alternative or complement to analgesics.The aim of this study was to evaluate if music medicine influences pain and anxiety in children undergoing lumbar punctures. A randomized clinical trial was used in 40 children (aged 7-12 years) with leukemia, followed by interviews in 20 of these participants. The participants were randomly assigned to a music group (n = 20) or control group (n = 20). The primary outcome was pain scores and the secondary was heart rate, blood pressure, respiratory rate, and oxygen saturation measured before, during, and after the procedure. Anxiety scores were measured before and after the procedure. Interviews with open-ended questions were conducted in conjunction with the completed procedures. The results showed lower pain scores and heart and respiratory rates in the music group during and after the lumbar puncture. The anxiety scores were lower in the music group both before and after the procedure. The findings from the interviews confirmed the quantity results through descriptions of a positive experience by the children, including less pain and fear. Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care.
                To examine whether modifying environmental stimuli by the use of calming music and hand massage affects agitated behavior in persons with dementia.
                A four group, repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music, hand massage, or calming music and hand massage simultaneously, or no intervention (control) on the frequency and type of agitated behaviors in nursing home residents with dementia (N = 68). A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors.
                Each of the experimental interventions reduced agitation more than no intervention. The benefit was sustained and increased up to one hour following the intervention (F = 6.47, p<.01). The increase in benefit over time was similar for each intervention group. When types of agitated behaviors were examined separately, none of the interventions significantly reduced physically aggressive behaviors (F = 1.93, p=.09), while physically nonaggressive behaviors decreased during each of the interventions (F = 3.78, p< 01). No additive benefit resulted from simultaneous exposure to calming music and hand massage. At one hour following any intervention, verbally agitated behavior decreased more than no intervention.
                Calming music and hand massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding, offsetting disturbing stimuli, but no additive benefit was found by combining interventions simultaneously. The role of music therapy as a supportive treatment is not well defined. The music therapy cannot be estimated as the isolated method it is often only the part of the complex therapy. The aim of this study was to evaluate the influence of music therapy on anxiety level in hospitalized asthmatic patients. The patient group was consisted of 36 patients with bronchial asthma (23 women and 13 men). In all patients we evaluated the level of anxiety (attribute and state) according to Spielberger and intensity of dyspnoe according to Borg scale at the first day of examination and after 10 days of rehabilitation program. Moreover we performed spirometry. The respiratory rehabilitation program included: exercise of breath control, correction of respiratory pattern, training of diaphragm and additional respiratory muscles. The duration of music therapy lasted 15 min. After 10 days rehabilitation with or without music therapy we found the reduction of anxiety (state) (p<0.0001). However we did not observe the difference between two studied groups with or without music therapy in diminishing of anxiety (p = 0.55). In conclusion, we believe that the music therapy can play important role in treatment of somatic disease but our study did not confirm its additive positive meaning in patients with bronchial asthma. To test the effects of music intervention on pre-operative anxiety in Chinese males undergoing transurethral resection of the prostate.
                No studies have measured the effects of music intervention in reducing pre-operative anxiety for patients with transurethral resection of the prostate (TURP). Previous studies have examined the effects of music on pre-operative anxiety but have not examined the possible effects of the presence of a carer as an independent variable in pre-operative anxiety levels of patients in addition to the music intervention. The cultural validity of applying a music intervention to the reduction of pre-operative anxiety was also investigated.
                A quasi-experimental design with three groups: music intervention, nurse presence and control group.
                Thirty patients having TURP were randomly assigned (n = 10 each group) to one of the three groups. Pre- and post-test measures of systolic and diastolic blood pressure, heart rate and state anxiety using the Chinese State-Trait Anxiety Inventory (C-STAI) were obtained for the three groups.
                The findings showed that the music intervention significantly reduced all blood pressure levels for the patients. A reduction in state anxiety level was also found for the music intervention group. No significant reductions in blood pressure, heart rate and state anxiety level were found in the nurse presence and control groups.
                The results support the cross-cultural validity of using a music intervention in pre-operative anxiety reduction, in this case for TURP patients waiting in the theatre holding area. Music therapy is a potential non-pharmacological treatment for the behavioral and psychological symptoms of dementia, but although some studies have found it to be helpful, most are small and uncontrolled.
                This case-control study was carried out by qualified music therapists in two nursing homes and two psychogeriatric wards. The participants were 38 patients with moderate or severe Alzheimer's disease (AD) assigned randomly to a music therapy group and a control group.
                The study showed a significant reduction in activity disturbances in the music therapy group during a 6-week period measured with the Behavior Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). There was also a significant reduction in the sum of scores of activity disturbances, aggressiveness and anxiety. Other symptoms rated by subscales of the BEHAVE-AD did not decrease significantly. Four weeks later the effects had mostly disappeared.
                Music therapy is a safe and effective method for treating agitation and anxiety in moderately severe and severe AD. This is in line with the results of some non-controlled studies on music therapy in dementia. Patient anxiety related to flexible sigmoidoscopy can negatively affect acceptability and compliance with screening protocol, complicate and prolong procedure time, and potentially result in prematurely aborted procedures. Music has been recognized through research as a safe, inexpensive, and effective nonpharmaceutical anxiolitic agent.
                An experimental study was performed on 50 adults scheduled for outpatient sigmoidoscopy. The control group received standard sigmoidoscopy protocol. Subjects in the experimental group received the standard protocol with the addition of listening to music throughout the procedure. State-Trait Anxiety Inventory (STAI) measurements were performed on all subjects before and postsigmoidoscopy. Physiologic recordings of heart rate and mean arterial pressure were recorded before and during the procedure.
                Patients who listened to self-selected music tapes during the procedure had significantly decreased STAI scores (P < 0.002), heart rates (P < 0.03), and mean arterial pressures (P < 0.001) in comparison to the control subjects.
                The results of the study indicate that music is an effective anxiolitic adjunct to flexible sigmoidoscopy. The purpose of this study was to examine the effects of relaxing music on elevated state anxiety in patients with a confirmed medical diagnosis of acute myocardial infarction. In addition, the relationship between trait anxiety and state anxiety was analyzed. A purposive sample of 40 myocardial infarction patients was randomly assigned to an experimental or control group. Statistically significant reduction in heart rate, respiratory rate, and state anxiety scores were found in the group that listened to relaxing music. A statistically significant positive correlation was found between trait anxiety scores and baseline state anxiety scores. Statistically significant negative correlations were found between trait anxiety scores and the degree of change in posttreatment state anxiety scores when examined as a net change, as well as a percent change. Results suggested that music therapy may be an effective intervention to reduce state anxiety levels in the acute myocardial infarction patient. This paper reports a study to determine the effect of music on physiological parameters and level of pain in patients undergoing application of a C-clamp after percutaneous coronary interventions.
                Most percutaneous coronary interventions are performed through the femoral artery. In order to stop bleeding and achieve homeostasis, a C-clamp is used after percutaneous coronary interventions. However, the experience is painful for patients and they inevitably suffer discomfort. Pain may lead to stress responses and may affect the physical and mental health of patients. One potential beneficial practice is having the patient listen to relaxing music, which might have the effect of reducing situational discomfort and pain.
                A randomized controlled study was conducted during the period September 2004 to March 2005. Forty-three people (20 experimental and 23 control) were recruited from the intensive care units of two acute care hospitals in Hong Kong. Physiological and psychological variables were collected at baseline and at 15, 30 and 45 minutes.
                In the music group, there were statistically significant reductions (P=0.001) in heart rate, respiratory rate, and oxygen saturation than the control participants at 45 minutes. In the music group, statistically significant reductions (P=0.001) in systolic blood pressure, heart rate, respiratory rate and oxygen saturation were found at the four time points, but not in the control group. No statistically significant differences were found at baseline comparison of the two groups, but statistically significant differences in pain scores were found at 45 minutes for participants in the music group compared with the control group (P=0.003). Participants in the control group showed statistically significant increases in pain at 45 minutes compared with baseline (P<0.001).
                The benefits of preventing physiological reactions to pain were demonstrated. Music is a simple, safe and effective method of reducing potentially harmful physiological and psychological responses arising from pain. Cardiac surgery is a common interventional procedure for ischemic and valvular heart disease. Cardiac surgery is accompanied by postoperative pain and anxiety. The use of music therapy has been shown to reduce pain, anxiety, and physiological parameters in patients having surgical procedures.
                To compare the effects of music therapy versus a quiet, uninterrupted rest period on pain intensity, anxiety, physiological parameters, and opioid consumption after cardiac surgery.
                An experimental design was used. A total sample of 86 patients (69.8% males) were randomized to 1 of 2 groups; 50 patients received 20 minutes of music (intervention), whereas 36 patients had 20 minutes of rest in bed (control). Anxiety, pain, physiologic parameters, and opioid consumption were measured before and after the 20-minute period.
                A significant reduction in anxiety (P < or = .001) and pain (P = .009) was demonstrated in the group that received music compared with the control group, but no difference was observed in systolic blood pressure (P = .17), diastolic blood pressure (P = .11), or heart rate (P = .76). There was no reduction in opioid usage in the 2 groups.
                Patients recovering from cardiac surgery may benefit from music therapy. The purpose of the study was to investigate the effects of music therapy on women's physiologic measures, level of anxiety, and satisfaction during cesarean delivery. Sixty-four women who were planning to have a cesarean delivery were randomly divided into an experimental and a control group. The experimental group received routine care and music therapy, whereas the control group received routine care only. Our results indicated that compared to the control group the experimental group had significantly lower anxiety and a higher level of satisfaction regarding the cesarean experience. No significant differences were found between the two groups in any of the physiological indexes. This controlled study provides evidence that music therapy can reduce anxiety and create a more satisfying experience for women undergoing cesarean delivery. Patients scheduled for vascular angiography are often anxious and frightened. High levels of anxiety may result in more difficult and painful procedures. Past research has reported mixed results for anxiety reduction techniques in other procedures settings, such as education, cognitive-behavioral skills, coping and relaxation skills, combinations of techniques, and music. Music as an intervention for pre-procedural anxiety prior to vascular angiography has not been studied. A randomized controlled trial of 170 patients was undertaken to determine whether 15 minutes of self-selected music reduced pre-procedure anxiety. The State Trait Anxiety Inventory was used to measure patients' anxiety. One-hundred sixty-six men and 4 women comprised the sample with an average age of 66.8 years (SD 9.95, range 37 to 85 years). Patients who listened to music (n=89) reduced their anxiety score from 38.57 (SD 10.46) to 35.2 (SD 9.7), while those who did not listen to music (n=81) reduced their anxiety score from 36.23 (SD 10.54) to 35.1 (SD 10.59); the difference between the groups was statistically significant (t=1.95, df 161, p=0.05). Pulse achieved a statistically significant reduction in the music group (t=2.45, df 167, p=0.02). Music is a noninvasive nursing intervention that patients enjoy and reduces their anxiety and their pulse rate. Further research should address using music to reduce anxiety in other interventional vascular angiography settings with equal numbers of men and women and comparing self-selected versus investigator-selected music. This controlled, prospective, randomized study examined the clinical and potential economic impact of a 6-session Recreational Music-making (RMM) protocol on burnout and mood dimensions, as well as on Total Mood Disturbance (TMD) in an interdisciplinary group of long-term care workers.
                A total of 112 employees participated in a 6-session RMM protocol focusing on building support, communication, and interdisciplinary respect utilizing group drumming and keyboard accompaniment. Changes in burnout and mood dimensions were assessed with the Maslach Burnout Inventory and the Profile of Mood States respectively. Cost savings were projected by an independent consulting firm, which developed an economic impact model.
                Statistically-significant reductions of multiple burnout and mood dimensions, as well as TMD scores, were noted. Economic-impact analysis projected cost savings of $89,100 for a single typical 100-bed facility, with total annual potential savings to the long-term care industry of $1.46 billion.
                A cost-effective, 6-session RMM protocol reduces burnout and mood dimensions, as well as TMD, in long-term care workers. The addition of self-selected music as a conditioning aid during prepared childbirth education and subsequent family performance in labor within a musical environment were examined. Thirty primigravida couples received the same psychoprophylactic instruction, with 15 randomly selected couples receiving the added musical conditioning aid. Medication use remained minimal, without significant difference, for couples who did and couples who did not use music. However, the value of music to both the family and the health care staff is felt to be of enough subjective significance to warrant its use as a normal component of prepared childbirth education. Music is a method nurses can use to help relieve pain, however little is known about its effectiveness across cultures. In this study, Western music was tested for its effectiveness in reducing postoperative pain in 38 Taiwanese patients, and its acceptability was explored. A pretest and post-test experimental design was used with visual analogue scales to measure sensation and distress of pain. Before surgery, subjects were randomly assigned to receive tape recorded music or the usual care. Those who were assigned to the music group chose among 5 types of sedative music. On postoperative Day 1 and Day 2, the effectiveness of the tape-recorded music was investigated during 15 minutes of rest in bed. Patients were interviewed on Day 3 to determine their liking for the music, its calming effects, and the helpfulness of the music. Repeated measures analysis of variance showed a significant interaction between time and group in the distress of pain on Day 1, but not on Day 2, and in pain sensation on Day 2, but not Day 1. Subjects from Taiwan were similar to subjects in a previous study in the United States in their liking for the music, and in reports of the helpfulness of the music for pain sensation and distress, but fewer Taiwanese found the music calming, and they had different choices: more chose harp music and fewer chose jazz than subjects in the U.S. study, and some would prefer Buddhist hymns or popular songs heard in Taiwan. Findings support the use of culturally acceptable music in addition to analgesic medication for the sensation and distress of postoperative pain. Intracardiac catheterization is a routine physical examination. Due to psychological strains, several psychosocial interventions, including music therapy, have been proposed. The aim of the present study was to examine whether the preventive or adjuvant use of music therapy results in a reduction in both subjective and objective anxiety and thus leads to a reduction in sedative medication. METHODS OF ASSESSMENT: N=83 patients (48 male, 35 female, 66+/-11 yrs) waiting for scheduled cardiac catheterization were randomly allocated to one of three groups: control group (standard care), exposure group (music stimulation during the procedure), or coaching group (additional music therapeutic coaching). Target variables were subjective anxiety and physiological parameters.
                Music intervention did effectively reduce subjective anxiety (STAI-S reduction pre-post: exposure 11 pt, coaching: 4 pt, control: 6 pt; p=0.033). Physiological values and medication did not differ between groups.
                The use of music stimulation during the catheterization has a relaxing and calming effect on patients. It seems to be especially beneficial in a subgroup of patients with higher-than-average psychological strains. Several pharmacological interventions reduce perioperative stress hormone release during surgery under general anesthesia. Listening to music and therapeutic suggestions were also studied, but mostly in awake patients, and these have a positive effect on postoperative recovery and the need for analgesia. In this study, we evaluated the effect of listening to music under general anesthesia on the neurohormonal response to surgical stress as measured by epinephrine, norepinephrine, cortisol, and adrenocorticotropic hormone (ACTH) blood levels. Thirty female patients scheduled for abdominal gynecological procedures were enrolled and randomly divided into two groups: group NM (no music) and group M (music). In group M, music was played from after the induction of anesthesia until the end of surgery. In the NM group, the patients wore the headphones but no music was played. We established three sample times for hormonal dosage during the procedure and one in the recovery room. Hemodynamic data were recorded at all times, and postoperative consumption of morphine in the first 24 h was noted. There was no group difference at any sample time or in the postoperative period in terms of mean arterial blood pressure, heart rate, isoflurane end-tidal concentration, time of the day at which the surgery was performed, bispectral index (BIS) value, doses of fentanyl, or consumption of postoperative morphine. There was no difference between the two groups with regard to plasmatic levels of norepinephrine, epinephrine, cortisol, or ACTH at any sample time, although the blood level of these hormones significantly increased in each group with surgical stimulation. In conclusion, we could not demonstrate a significant effect of intraoperative music on surgical stress when used under general anesthesia.
                Listening to music under general anesthesia did not reduce perioperative stress hormone release or opioid consumption in patients undergoing gynecological surgery. This study was designed to determine whether music or music in combination with therapeutic suggestions in the intra-operative period under general anaesthesia could improve the recovery of hysterectomy patients.
                In a double-blind randomised clinical investigation, 90 patients who underwent hysterectomy under general anaesthesia were intra-operatively exposed to music, music in combination with therapeutic suggestion or operation room sounds. The anaesthesia was standardised. Postoperative analgesia was provided by a patient-controlled analgesia (PCA). The pain scores were recorded by means of a visual analogue scale. Nausea, emesis, bowel function, fatigue, well-being and duration of hospital stay were studied as outcome variables.
                On the day of surgery, patients exposed to music in combination with therapeutic suggestions required less rescue analgesic compared with the controls. Patients in the music group experienced more effective analgesia the first day after surgery and could be mobilised earlier after the operation. At discharge from the hospital patients in the music and music combined with therapeutic suggestion group were less fatigued compared to the controls. No differences were noted in nausea, emesis, bowel function, well-being or length of hospital stay between the groups.
                This double-blind study has demonstrated that intra-operative music and music in combination with therapeutic suggestions may have some beneficial effects on postoperative recovery after hysterectomy. Further controlled studies are necessary to confirm our results. While waiting for surgery, patients often exhibit fear and anxiety. Music is thought to be an alternative to medication to relieve anxiety. However, due to concerns about infection control, devices other than headphones may be considered for this purpose.
                The purpose of this study was to determine the anxiety-relieving effect of broadcast versus headphone music playing for patients awaiting surgery.
                A randomized controlled clinical study.
                The waiting area of an operating theater of a metropolitan teach hospital in Taiwan.
                Alert adult with age between 20 and 65 years old waiting for surgery without premedications.
                A total of 167 patients were randomly assigned to the headphone, broadcast and control groups. Both the headphone and the broadcast groups were provided with the same instrumental music, while the control group did not listen to any music. The tools for measuring anxiety were visual analogue scale (VAS) ranging from "not anxious at all" to "extremely anxious" and heart rate variability (HRV).
                The VAS score exhibited a significant decrease for both the headphone and broadcast groups. The low frequency and low-to-high frequency LF/HF ratio of the broadcast and headphone groups were significantly lower than those of the control group. None of the heart rate variables showed significant differences between the broadcast group and the headphone group.
                Both headphone and broadcast music are effective for reducing the preoperative patient's anxiety in the waiting room.
                In order to take infection control into account, broadcast speakers can substitute for headphones for playing music to lower the anxiety level of patients waiting for surgery.
                Copyright © 2011 Elsevier Ltd. All rights reserved. Unrelieved anxiety can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. Nursing interventions using music therapy or sensory information among patients with coronary artery disease has resulted in anxiety reduction, though results in Chinese subjects has not previously been published.
                To determine the effects of using nursing interventions of music therapy or sensory information, on reducing anxiety and uncertainty, and improving negative mood among Chinese subjects immediately prior to cardiac catheterization.
                An experimental three-group repeated measures design for this pilot study was used. Forty-five hospitalized adults (15/group) undergoing cardiac catheterization were randomly assigned to either (1) a music therapy intervention, (2) a sensory information intervention or (3) treatment as usual (control). Anxiety, uncertainty and mood state were measured using self-reported questionnaires and physiological measures were made at baseline, post-intervention to determine their effect and post-cardiac catheterization to determine whether these interventions had any long-lasting effect.
                The control group was found to be significantly older (P=0.001) than the two experimental groups. Older age was associated with lower anxiety scores (r=-0.31, P=0.04 at baseline; r=-0.30, P=0.04 post-intervention; r=-0.22, P=0.15 post-cardiac catheterization). After controlling for age, the use of music therapy or sensory information did not significantly reduce anxiety, improve mood state, reduce uncertainty, decrease heart or respiratory rate among subjects undergoing cardiac catheterization.
                The non-significant result may have been affected by the small sample, and the social and cultural expectations regarding the public display of emotions among Chinese populations. Listening to music has a stress-reducing effect in surgical procedures. The effects of listening to music immediately before a cesarean section have not been studied. The objective of this study was to assess the effects of listening to selected music while waiting for a cesarean section on emotional reactions, on cognitive appraisal of the threat of surgery, and on stress-related physiological reactions.
                A total of 60 healthy women waiting alone to undergo an elective cesarean section for medical reasons only were randomly assigned either to an experimental or a control group. An hour before surgery they reported mood, and threat perception. Vital signs were assessed by a nurse. The experimental group listened to preselected favorite music for 40 minutes, and the control group waited for the operation without music. At the end of this period, all participants responded to a questionnaire assessing mood and threat perception, and the nurse measured vital signs.
                Women who listened to music before a cesarean section had a significant increase in positive emotions and a significant decline in negative emotions and perceived threat of the situation when compared with women in the control group, who exhibited a decline in positive emotions, an increase in the perceived threat of the situation, and had no change in negative emotions. Women who listened to music also exhibited a significant reduction in systolic blood pressure compared with a significant increase in diastolic blood pressure and respiratory rate in the control group.
                Listening to favorite music immediately before a cesarean section may be a cost-effective, emotion-focused coping strategy. (BIRTH 39:2 June 2012).
                © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc. Music played during endoscopic procedures may alleviate anxiety and improve patient acceptance of the procedure. A prospective randomized, controlled trial was undertaken to determine whether music decreases the requirement for midazolam during colonoscopy and makes the procedure more comfortable and acceptable.
                Patients undergoing elective colonoscopy between October 2003 and February 2004 were randomized to either not listen to music (Group 1; n=40) or listen to music of their choice (Group 2; n=38) during the procedure. All patients received intravenous midazolam on demand in aliquots of 2 mg each. The dose of midazolam, duration of procedure, recovery time, pain and discomfort scores and willingness to undergo a repeat procedure using the same sedation protocol were compared.
                Patients in Group 2 received significantly less midazolam than those in Group 1 (p=0.007). The pain score was similar in the two groups, whereas discomfort score was lower in Group 2 (p=0.001). Patients in the two groups were equally likely to be willing for a repeat procedure.
                Listening to music during colonoscopy helps reduce the dose of sedative medications and decreases discomfort experienced during the procedure. Music has been found to be an effective nonpharmacologic adjunct for managing anxiety and promoting relaxation in limited trials of critically ill patients. However, its effects have not been compared in intubated patients during weaning from mechanical ventilation with non-intubated patients spontaneously breathing.
                A cross-over randomized experimental design.
                Thirty patients were studied (intubated group n = 15, non-intubated group n = 15). Patients were randomized to receive either 20 minutes of uninterrupted rest or then 20 minutes of music therapy or the music therapy first and then the uninterrupted rest period. Patients selected a relaxing music of their choice from a selection including different types of music. Heart rate (HR), systolic blood pressure (SAP), respiratory rate (RR) and bispectral index (BIS score) were recorded each 5-min intervals throughout both periods (rest and music). Agitation/sedation state and pain were evaluated by the Richmond-Agitation-Sedation-Scale (RASS) and the Numerical-Rating-Scale (NRS) respectively, before and after each studied periods. Music have not been performed in five patients (5/35 = 14%).
                Music significantly decreased HR (88+/-15 vs 82+/-15, P<0.05), SAP (137+/-17 vs 128+/-14, P<0.05), RR (25+/-3 vs 22+/-4, P<0.05), BIS (94+/-5 vs 81+/-10, P<0.01), RASS (+0.1+/-0.7 vs -0.7+/-0.9, P<0.05) and NRS (4.4+/-1.7 vs 1.9+/-1.3, P<0.01) in both intubated and non-intubated groups whereas no significant change was observed during the rest period. The variations level studied parameters induced by music were comparable for the two groups.
                A single music therapy session was found to be effective for decreasing anxiety and promoting relaxation, as indicated by decreases in heart rate, blood pressure, BIS and respiratory rate over the intervention period in intubated patients during weaning phase. Osteoarthritis is the most common degenerative disease in humans. It usually begins in middle age and is progressive. Chronic pain in older people presents a significant obstacle in maintaining function and independence. Previous studies have shown that music can improve motivation, elevate mood, and increase feelings of control in older people.
                The purpose of this randomized clinical trial was to examine the influence of music as a nursing intervention on osteoarthritis pain in elders.
                Data were collected using the short form of the McGill Pain Questionnaire with 66 elders suffering from chronic osteoarthritis pain. Differences in perceptions of pain were measured over 14 days in an experimental group who listened to music for 20 minutes daily and a control group who sat quietly for 20 minutes daily. All participants completed the Short Form McGill Pain Questionnaire (SF-MPQ) on day 1, 7, and 14 of the study.
                Results of t-tests indicated that those who listened to music had less pain on both the Pain Rating Index on day 1 (P = 0.001), day 7 (P = 0.001) and day 14 (P = 0.001) and on the Visual Analogue Scale on day 1 (P = 0.001), day 7 (P = 0.001) and day 14 (P = 0.001), when compared with those who sat quietly and did not listen to music. A repeated measure analysis of variance controlling for pretest measures demonstrated a significant decrease in pain among experimental group participants when compared with the control group on the pain descriptor section of the SF-MPQ (P = 0.001) and the visual analogue portion of the SF-MPQ (P = 0.001).
                Listening to music was an effective nursing intervention for the reduction of chronic osteoarthritis pain in the community-dwelling elders in this study. Management of pain in the immediate postoperative period is a major concern of postanesthesia nurses. Music is a nursing intervention with the potential to decrease patient perception of pain in the PACU. The purpose of this study was to examine the effect of the use of music on the level of patient pain in the immediate postoperative period. A quasi-experimental study design was used with three study groups. All patients scheduled for elective abdominal hysterectomies using a general anesthesia technique were eligible for participation in the study. The setting is a PACU in a community hospital in a suburban area. Subjects were asked to rate their pain level every 15 minutes while in the PACU using two valid and reliable measures, a verbal pain rating scale and a graphic numeric pain intensity scale. Repeated measures of analysis of variance showed no differences in level of pain between groups or over time. Pain associated with chest tube removal is a major problem for patients who undergo open heart surgery. Because this pain is short-lived, timing the administration of pharmacological agents for pain relief is difficult and is therefore done inconsistently.
                To examine the effect of music as an intervention for pain relief during chest tube removal after open heart surgery.
                In an experimental design, 156 subjects (mean age, 66 years; 69% men) were randomly assigned to 1 of 3 groups: control, white noise, or music. All subjects preselected the type of music they preferred hearing. Ten minutes before the chest tube was removed, the patient's heart rate and blood pressure were measured, the patient rated pain intensity by using a numeric rating scale, and the prerecorded audiotape of music was begun. The patients rated their pain again immediately after chest tube removal and 15 minutes later. Physiological variables were assessed every 5 minutes until 15 minutes after the chest tubes were removed.
                Self-reported pain intensity, physiological responses, and narcotic intake after chest tube removal did not differ significantly among the 3 groups.
                Although the findings were not statistically significant, most subjects enjoyed listening to the music, and therefore the use of music as an adjuvant to other therapies may be an appropriate nursing intervention. The aim of this study was to evaluate the effects of music therapy on anxiety, postoperative pain and physiological reactions to emotional and physical distress in patients undergoing spinal surgery.
                Surgery-related anxiety and pain are the greatest concern of surgical patients, especially for those undergoing major procedures.
                A quasi-experimental study design was conducted in a medical centre in Taiwan from April-July 2006.
                Sixty patients were recruited. The study group listened to selected music from the evening before surgery to the second day after surgery. The control group did not listen to music. Patients' levels of anxiety and pain were measured with visual analogue scales (VAS). Physiological measures, including heart rate, blood pressure and 24-hour urinalysis, were performed. Results: The average age of the 60 patients was 62·18 (SD 18·76) years. The mean VAS score for degree of anxiety in the study group was 0·8-2·0, compared with 2·1-5·1 in the control group. The mean VAS score for degree of pain in the study group was 1·7-3·0, compared with 4·4-6·0 in the control group. The differences between the two groups in VAS scores for both anxiety (p = 0·018-0·001) and pain (p = 0·001) were statistically significant. One hour after surgery, the mean blood pressure was significantly lower in the study group than in the control group (p = 0·014), but no significant differences were found between the two groups in urine cortisol (p = 0·145-0·495), norepinephrine (p = 0·228-0·626) or epinephrine values (p = 0·074-0·619).
                Music therapy has some positive effects on levels of anxiety and pain in patients undergoing spinal surgery.
                Complementary music therapy can alleviate pain and anxiety in patients before and after spinal surgery.
                © 2011 Blackwell Publishing Ltd. An experimental pilot study was conducted to investigate the effects of preoperative massage and music therapy on patients' preoperative, intraoperative, and postoperative experiences. Participants were assigned randomly to one of four groups--a group that received massage with music therapy, a group that received massage only, a group that received music therapy only, or a control group. Hemodynamics, serum cortisol and prolactin levels, and anxiety were measured preoperatively and postoperatively. Postoperative anxiety levels were significantly lower and postoperative prolactin levels were significantly higher for all groups. This study examined the effectiveness of giving medical oncologists immediate feedback about cancer patients' self-reported psychosocial well-being in reducing those patients' levels of anxiety, depression, perceived needs and physical symptoms. Cancer patients attending one cancer centre for their first visit were allocated to intervention (n = 42) or control (n = 38) groups. All patients completed a computerized survey assessing their psychosocial well-being while waiting to see the oncologist. Intervention patients' responses were immediately scored and summary reports were placed in each patient's file for follow-up. A total of 48 participants (25 intervention and 23 control) completed the survey four times. Intervention patients who reported a debilitating physical symptom at visit 2 were significantly less likely to report a debilitating physical symptom at visit 3 compared with control patients (OR = 2.8, P = 0.04). Reductions in levels of anxiety, depression and perceived needs among intervention patients were not significantly different to control patients. Repeated collection and immediate feedback of patient-reported health information to oncologists has potential to improve patients' symptom control, but has little impact upon emotional well-being, including those at high risk. Future research should consider providing the feedback to other health professionals and patients, and monitor the impact on the process of individual patient care. A randomized, single-blinded, placebo-controlled trial examined the benefits of taped therapeutic suggestions and taped music in coronary-artery-bypass patients. Sixty-six patients listened to either suggestion tapes or music tapes, intraoperatively and postoperatively; 29 patients listened to blank tapes intraoperatively and listened to no tapes postoperatively. Half the patients who listened to a tape found it helpful. There were no significant differences between groups in length of SICU or postoperative hospital stay, narcotic usage, nurse ratings of anxiety and progress, depression, activities of daily living, or cardiac symptoms. There were no significant differences in these same outcomes between the patients who were helped by the tapes and the patients not helped. These results suggest that if taped therapeutic suggestions have a measurable effect upon cardiac surgery patients, demonstrating this effect will require more detailed patient evaluations to identify subgroups of patients responsive to this type of intervention. To evaluate the impact of music on opioid requirements and pain levels during renal lithotripsy using alfentanil patient-controlled analgesia (PCA), we conducted a prospective, blinded, randomized controlled trial. Patients undergoing lithotripsy were instructed in PCA use and asked to rate their anxiety and select their preferred type of music. They were then premedicated with morphine and ketorolac and randomly allocated into two groups. Group 1 (n = 97) had music started 10 min before the procedure and maintained until 10 min after its conclusion. Group 2 (n = 96) had music begun at the conclusion of lithotripsy and continued for 10 min. Pain intensity, alfentanil requirement, side effects, quality of analgesia, patient satisfaction, and acceptance of the technique were evaluated. Demographics, alfentanil requirement, pain levels, side effects, quality of analgesia, and patient satisfaction were similar in both groups. The addition of music did not provide any benefit. This result raises the possibility that some nonpharmacologic therapies have minimal impact in settings where the painful stimulus is moderate to severe and adequate pharmacotherapy is available. The purpose of this study was to determine the effect of music listening on postoperative anxiety and intubation time in patients undergoing cardiovascular surgery. Coronary artery disease and valvular heart disease affect approximately 15 million Americans and 5 million persons in the U.K. annually, with the majority of these patients being older adults. The anxiety experienced before, during and after surgery increases cardiovascular workload, thereby prolonging recovery time. Music listening as a nursing intervention has shown an ability to reduce anxiety. The study used a randomized control trial design. Sixty adults older than 65 years were randomly assigned to the control and the experimental groups. The experimental group listened to music during and after surgery, while the control group received standard postoperative care. The Spielberger State Trait Anxiety Inventory was administered to both groups before surgery and 3 days postoperatively. The mean of the differences between scores was compared using analysis of variance. Differences in mean intubation time were measured in both groups. Older adults who listened to music had lower scores on the state anxiety test (F = 5.57, p = .022) and had significantly fewer minutes of postoperative intubation (F = 5.45, p = .031) after cardiovascular surgery. Older adults undergoing cardiovascular surgery who listen to music had less anxiety and reduced intubation time than those who did not. The purpose of this study was to examine the effects of music therapy on self-reported and physiological signs of anxiety among ambulatory patients undergoing colonoscopy. Thirty-two patients were randomly assigned to either an experimental group who listened to music during the colonoscopy or a standard procedure no music control group. Before and after the procedure, subjects completed the State Anxiety Inventory. Physiological signs of anxiety, including heart rate and blood pressure, were monitored at four time points during the procedure. Repeated measures analysis of variance indicated a significant group by time interaction on the physiological signs of anxiety. Post hoc analysis indicated that heart rate and systolic and diastolic blood pressure significantly decreased among the music intervention group during the procedure while remaining unchanged in the control group. No significant effect of the treatment was observed on the State Anxiety Inventory, although a trend indicated that the music intervention decreased state anxiety. Finally, the group who received the music intervention required less physician-administered sedation during the procedure than did the control group. These findings indicate that music therapy has the potential to reduce physiological indicators of anxiety and the need for sedation among individuals undergoing a colonoscopy.
                Copyright 2002, Elsevier Science (USA). All rights reserved. The aim of this randomized controlled trial was to determine the effect of jaw relaxation, music and the combination of relaxation and music on postoperative pain after major abdominal surgery during ambulation and rest on postoperative days 1 and 2. Opioid medication provided for pain, following abdominal surgery, does not always give sufficient relief and can cause undesired side effects. Thus, additional interventions such as music and relaxation may provide more complete relief. Previous studies have found mixed results due to small sample sizes and other methodological problems. In a rigorous experimental design, 500 subjects aged 18-70 in five Midwestern hospitals were randomly assigned by minimization to a relaxation, music, relaxation plus music, or control group. Interventions were taught preoperatively and tested postoperatively. The same amount of time was spent with subjects in the control group. Pain was measured with the visual analogue sensation and distress of pain scales. Demographic and surgical variables, and milligrams of parenteral or oral opioids in effect at the time of testing were not significantly different between the groups, nor did they correlate with pain scores. Controlling for pretest sensation and distress, orthogonal a priori contrasts and multivariate analysis of covariance indicated that the three treatment groups had significantly less pain than the controls, (P = 0.028-0.000) which was confirmed by the univariate analysis of covariance (P = 0.018-0.000). Post hoc multivariate analysis revealed that the combination group had significantly less sensation and distress of pain than the control group on all post-tests (P = 0.035-0.000), and the relaxation and music groups had significantly less on all tests (P = 0.022-0.000) except after ambulation. At post ambulation those using relaxation did not have significantly less pain than the controls on both days and those using music did not on day 1, although there were some univariate effects. A corresponding significant decrease in mastery of the interventions from pre to post ambulation suggests the need for reminders to focus on the intervention during this increased activity. Physicians and nurses preparing patients for surgery and caring for them afterward, should encourage patients to use relaxation and music as adjuvants to medication for postoperative pain. The purpose of this experimental study was to determine the effects of second and third day postoperative music interventions (music, music video) on pain and sleep in 96 postoperative patients having CABG surgery. The Verbal Rating Scale scores obtained before and after each 30-minute session showed that pain decreased over time for all three groups with no difference across groups. The McGill Pain Questionnaire (MPQ) was administered before session 1 and after session 2, and results indicated that Sensory, Affective, and Present Pain Intensity subscales showed no group difference for pain; however, pain decreased from Day 2 to Day 3 for all three groups. For the evaluative component of pain, those in the music group had significantly (F[2,93] = 4.74, p < .05) lower scores on postoperative Day 2 than the rest period control group. Effects of the intervention on sleep as measured by the Richard Sleep Questionnaire indicated that the video group had significantly (F[2, 92] = 3.18, p < .05) better sleep scores than the control group on the third morning. These findings lend some support for selected music interventions.
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.