Music Therapy Reduces Anxiety in Mechanically Ventilated Patients
Abstract & Commentary
Synopsis: Music represents a practical, nonpharmacologic alternative that could be used instead of sedative medications.
Source: Chlan L. Heart Lung 1998;27:169-176.
To test the effects of music on relaxation and anxiety in patients on mechanical ventilation, Chlan randomized patients to a 30-minute music session or 30-minute rest period. For the music session, subjects using headphones listened to a cassette tape with their choice of program. Options included classical, new age, country-western, religious, and easy listening. In each category, the tempo of the music was 60-80 beats/min, a rate shown to promote relaxation. For both groups, the immediate environment was set to enhance rest by closing blinds, dimming lights, and posting a "do not disturb" sign. The subjects (n = 54) were recruited from four ICUs in three university-affiliated teaching hospitals. Mean age was 57.1 years, 49% were women, and the mean duration of mechanical ventilation (SIMV) was 7.4 days (median, 3.5 days). Anxiety was measured using the Speilberger State-Trait Inventory. Significant differences between groups were found, with subjects in the music group experiencing less anxiety (P < 0.001), a lower respiratory rate (P < 0.001), and heart rate (P < 0.001), which persisted up to five minutes after the intervention.
Comment by Leslie A. Hoffman, PhD, RN
Results indicated that a single, 30-minute music session was effective in reducing anxiety and promoting relaxation in patients who had received mechanical ventilation for an average of seven days (range, 1-62 days). The attraction of findings from this study relates to the simplicity of the intervention. Patients in an ICU are exposed to many stressors, especially those who are alert, as patients were in this study, and those who require long-term mechanical ventilation. The intervention included a variety of musical choices, which were considered important by the investigator. Most patients chose classical (56%), followed by country-western (28%), easy-listening (12%), and new-age music (4%).
Commonly, stress and anxiety are managed by administering sedatives. Although they can be effective, these medications have untoward effects. Music represents a practical, nonpharmacologic alternative that could be used instead of sedative medications. Radios can also be used, but the advantage of this intervention is that other noises were blocked by the headphones, potentially promoting greater relaxation. (Dr. Hoffman is Professor, Medical-Surgical Nursing; Chair, Department of Acute/Tertiary Care, University of Pittsburgh School of Nursing.)
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