Elsevier

Heart & Lung

Volume 30, Issue 5, September–October 2001, Pages 376-387
Heart & Lung

Issues in Pulmonary Care
Effects of music therapy on anxiety in ventilator-dependent patients*

https://doi.org/10.1067/mhl.2001.118302Get rights and content

Abstract

Objective: The purpose of this study was to assess the effectiveness of music therapy in decreasing anxiety in ventilator-dependent patients. Design: A crossover repeated measures design with random assignment was used. Setting: The intensive care unit of a university hospital in Hong Kong was used as the setting for this study. Patients: 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. Intervention: 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. Results: 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. Conclusion: 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. (Heart Lung® 2001;30:376-87.)

Section snippets

Methodology

This study used a pretest/post-test crossover experimental repeated measures design. A nonprobability convenience sampling was used to recruit subjects. Subjects were recruited in the intensive care unit (22 beds) of a hospital in Hong Kong. Patients were identified daily in the unit, and eligibility was decided in consultation with the staff nurses. Inclusion criteria were that the persons be Chinese and meet the following requirements: (a) understood Cantonese or English, (b) aged 18 to 85

Data analysis

Data were analyzed by using SPSS-PC software (version 9.0 for Windows). Descriptive analyses were used to summarize the data. Paired-samples t tests were used to detect any significant differences in the baseline data of each intervention (ie, state anxiety score, mean blood pressure value, respiratory rate). To examine the effects of the interventions on subjects' state anxiety immediately after interventions, paired t tests were also used to test for any significant differences between

Demographic characteristics

As shown in Table I, the sample consisted of 20 Chinese subjects—15 men and 5 women.Their ages ranged from 19 to 84 years (mean, 58.25 years; SD, 15.53). Of the 20 subjects who participated in this study, 18 were married and 2 were single. More than half of the subjects (n = 12) had no religious beliefs, 5 were Buddhists, and 3 were Christians. Most of them were primary school graduates (n = 12), 5 were secondary school graduates, and 3 were illiterate with no formal school education. Nearly

Discussion

Music therapy, a noninvasive nursing intervention, reduced state anxiety among mechanically ventilated subjects in this study. Although both music therapy and rest conditions indicated reduced post-test anxiety scores, subjects in the experimental condition (music therapy) experienced significantly greater reduction in state anxiety score compared with subjects who undertook the control condition (rest). These results are consistent with previous literature.18, 20, 23

On the other hand, the

References (50)

  • R. Wolman

    Introduction, recognition, assessment and treatment of anxiety in the critical care patient

    Crit Care Nurs

    (1994)
  • CD Spielberger

    Anxiety as an emotional state

  • CD Spielberger

    Understanding stress and anxiety

    (1979)
  • C Guzzetta et al.

    Nursing diagnostic pilot study: psychophysiologic stress

    Adv Nurs Sci

    (1979)
  • A Freedman et al.

    Diagnosing mental illness: evaluation in psychiatry and psychology

    (1972)
  • LL Henry

    Music therapy, a nursing intervention for the control of pain and anxiety in the ICU: a review of the research literature

    Dimens Crit Care Nurs

    (1995)
  • JS D'Agostino

    Psychological stressors of the mechanically ventilated patient [master's thesis]

    (1979)
  • I. Grossbach-Landis

    Weaning from mechanical ventilation

    Crit Care Update

    (1983)
  • L. Chlan

    Psychophysiologic responses of mechanically ventilated patients to music: a pilot study

    Am J Crit Care

    (1995)
  • S Munro et al.

    Music therapy in palliative care

    Can Med Assoc J

    (1978)
  • CA Bolwerk

    Effects of relaxing music on state anxiety in myocardial infarction patients

    Crit Care Nurs Q

    (1990)
  • CE Guzzetta

    Effects of relaxation and music therapy on patients in a coronary care unit with presumptive myocardial infarction

    Heart Lung

    (1989)
  • P. Updike

    Music therapy results for ICU patients

    Dimens Crit Care Nurs

    (1990)
  • JM White

    Music therapy: an intervention to reduce anxiety in the myocardial infarction patient

    Clin Nurs Spec

    (1992)
  • M MaCaffery et al.

    Pain: clinical manual for nursing practice

    (1989)
  • Cited by (138)

    • Palliative and End-of-Life Care

      2018, Integrative Medicine: Fourth Edition
    View all citing articles on Scopus
    *

    Reprint requests: Violeta Lopez-Nahas, RN, PhD, Assistant Professor, Department of Nursing, Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China.

    View full text