The effect of music on preoperative anxiety in day surgery

AIM: 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. BACKGROUND: Although previous day surgery research suggests that music effectively reduces preoperative anxiety, methodological issues limit the generalizability of results. METHODS: 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. RESULTS: 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. CONCLUSION: The findings support the use of music as an independent nursing intervention for preoperative anxiety in patients having day surgery.     

The effect of music on discomfort experienced by intensive care unit patients during turning: A randomized cross‐over study

Cooke M, Chaboyer W, Schluter P, Foster M, Harris D, Teakle R. International Journal of Nursing Practice 2010; 16 : 125–131
The effect of music on discomfort experienced by intensive care unit patients during turning: A randomized cross‐over study Research consistently demonstrates that intensive care unit (ICU) patients experience pain, discomfort and anxiety despite analgesic and sedative use. The most painful procedure reported by critically ill patients is being turned. Music diminishes anxiety and discomfort in some populations; however, its effect on critically ill patients remains unknown. This research aimed to identify the effect of music on discomfort experienced by ICU patients during turning using a single blind randomized cross‐over design. Seventeen post‐operative ICU patients were recruited and treatment order randomized. Discomfort and anxiety were measured 15 min before and immediately after two turning procedures. Findings indicated that listening to music 15 min before and during turning did not significantly reduce discomfort or anxiety. Pain management might effectively be addressing discomfort and anxiety experienced during turning. Given previous studies have identified turning as painful, current results are promising and it might be useful to determine if this is widespread.     

A controlled trial of music and pre-operative anxiety in Chinese men undergoing transurethral resection of the prostate

AIM OF THE STUDY: To test the effects of music intervention on pre-operative anxiety in Chinese males undergoing transurethral resection of the prostate. RATIONALE: 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. DESIGN: A quasi-experimental design with three groups: music intervention, nurse presence and control group. METHOD: 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. RESULTS: 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. CONCLUSION: 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 and its effect on anxiety in short waiting periods: a critical appraisal

Aims and objectives. This paper undertakes a critical appraisal of the methodological issues associated with studies that have investigated the extent to which music decreased the anxiety experienced by patients in short‐term waiting periods such as day surgery. Background. Investigations and surgery undertaken on a day basis have significantly increased in number over the last decade. Music has been evaluated as an appropriate nursing intervention in relation to pain, discomfort and anxiety in a number of clinical settings but its usefulness for decreasing anxiety in short‐term waiting periods such as day surgery is only beginning to be understood. Conclusion. A number of methodological limitations are identified by this critical review, particularly in relation to the design of research studies. Recommendations to strengthen research in this area are suggested and include (i) describing methods clearly and with detail to allow assessment of the validity and rigour of study results; (ii) using permuted block randomization; (iii) recruiting from a variety of surgical procedures and cultural groups; and (iv) standardizing the health care provided during waiting period. Relevance to clinical practice. Music as a simple and cost‐effective intervention to reduce the anxiety experienced in limited time periods will have enormous impact on clinical practice where patients wait and undergo invasive investigations, procedures or surgery. However, the evidence of its utility in these unique environments is only beginning to emerge and this critical review provides a basis for considerations for future research.     

Effectiveness of relaxation for postoperative pain and anxiety: randomized controlled trial

Title.  Effectiveness of relaxation for postoperative pain and anxiety: randomizedcontrolled trial
Aim.  This paper is a report of a study to determine the effectiveness of jaw and total body relaxation for postoperative pain, anxiety and level of relaxation, and to determine any patient expectancy effects.
Background.  Relaxation is increasingly suggested as a pain control technique that can be used by nurses in daily practice. A systematic review of the effectiveness of relaxation for postoperative pain relief revealed many poorly designed studies and only some weak evidence supporting the use of relaxation for postoperative pain.
Method.  A randomized controlled trial ( n  =   118) was conducted between 2002 and 2003 to compare total body relaxation, jaw relaxation, attention control and usual care. Consenting patients admitted for elective orthopaedic surgery aged 18 or over, able to speak English and able to tense and relax more than two muscle groups were included. Pain at rest and on movement, anxiety and relaxation were assessed at pre-admission clinic, pre-intervention, immediately post-intervention and 1, 2, 3 and 4 hours later. However, the trial was under-powered.
Findings.  There were statistically significant reductions in pain at rest from pre- to post-intervention for both the relaxation groups and the attention control group. The usual care group had a small increase in pain, whilst the other three groups had similar small decreases in pain. There was no statistically significant difference in anxiety or relaxation scores pre- to post-intervention between groups.
Conclusion.  Jaw relaxation could give these orthopaedic patients a small, very short-lasting additional amount of pain relief, and it may be that staff and patients feel this small benefit to be worthwhile.