The effectiveness of music as an intervention for hospital patients: a systematic review.

INTRODUCTION Over the past few decades there has been a growing interest in the use of music, which has seen it used to achieve a diverse range of outcomes. While music as an intervention for hospital patients has subject to considerable evaluation, many of these studies are small and findings are therefore often contradictory. This systematic review was conducted to investigate the effectiveness of music as an intervention for hospital patients. METHOD A comprehensive search was undertaken involving all major health care databases. For studies to be included in the review they must have investigated the effect of music, involved adult hospital patients and used a randomized controlled trial design. These studies must also have used outcome measures such as anxiety, satisfaction, pain, mood and vital signs. Identified studies were critically appraised, and then categorized according to whether music was evaluated during normal care delivery or during invasive and unpleasant procedures. When appropriate, studies were combined in a meta-analysis. RESULTS A total of 29 studies were identified that fulfilled the inclusion criteria, of which 10 were subsequently excluded following critical appraisal. Music played via headphones reduces anxiety of patients during normal care deliver, but it has no impact on the anxiety of patients undergoing procedures such as bronchoscopy, sigmoidoscopy or surgery with a spinal anaesthetic. Music produces a small reduction in respiratory rate during normal care delivery, but appears to have little effect on other vital sign parameters. It has no impact on the vital signs of patients undergoing procedures. Although the evidence is limited, music also appears improve the mood and tolerance of patients. CONCLUSION This review demonstrates the effectiveness of music for the reduction of anxiety during normal care deliver. Given the inexpensive nature of this intervention, and the lack of adverse events, it is recommended as an adjunct to normal care practices. This review also highlights the need for further research into many aspect of this intervention.

[1]  H. Colt,et al.  Effect of music on state anxiety scores in patients undergoing fiberoptic bronchoscopy. , 1999, Chest.

[2]  L. Zimmerman,et al.  The effects of music interventions on anxiety in the patient after coronary artery bypass grafting. , 1995, Heart & lung : the journal of critical care.

[3]  F. Chung,et al.  Music increases satisfaction in elderly outpatients undergoing cataract surgery , 1998, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[4]  L. Janelli,et al.  Music intervention with physically restrained patients. , 1997, Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses.

[5]  A. Miller,et al.  A distraction technique for control of burn pain. , 1992, The Journal of burn care & rehabilitation.

[6]  D. S. Cowan Music Therapy in the Surgical Arena , 1991 .

[7]  C. A. Bolwerk Effects of relaxing music on state anxiety in myocardial infarction patients. , 1990, Critical care nursing quarterly.

[8]  P. Yung,et al.  Introducing a music programme to reduce preoperative anxiety , 1999, The British journal of theatre nursing : NATNews : the official journal of the National Association of Theatre Nurses.

[9]  L. Chlan,et al.  Psychophysiologic responses of mechanically ventilated patients to music: a pilot study. , 1995, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[10]  D. Milton,et al.  The effect of music in the postanesthesia care unit on pain levels in women who have had abdominal hysterectomies. , 1998, Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses.

[11]  Sally Beattie,et al.  Effects of Music and Imagery On Physiologic and Self‐Report Of Analogued Labor Pain , 1989, Nursing research.

[12]  G. Colditz,et al.  How to review the evidence: systematic identification and review of the scientific literature , 2000 .

[13]  C. E. Sabo,et al.  The influence of personal message with music on anxiety and side effects associated with chemotherapy. , 1996, Cancer nursing.

[14]  Allan O. Diefendorf,et al.  Effect of Stimulative and Sedative Music on Systolic Blood Pressure, Heart Rate, and Respiratory Rate in Premature Infants , 1994 .

[15]  K. Dickersin,et al.  Systematic Reviews: Identifying relevant studies for systematic reviews , 1994 .

[16]  A. Mathews,et al.  Reduction of anxiety during MR imaging: a controlled trial. , 2000, Magnetic resonance imaging.

[17]  P. Bampton,et al.  Effect of relaxation music on patient tolerance of gastrointestinal endoscopic procedures. , 1997, Journal of clinical gastroenterology.

[18]  J. Standley,et al.  Music Therapy Research and Applications in Pediatric Oncology Treatment , 1995, Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses.

[19]  S. Broscious,et al.  Music: an intervention for pain during chest tube removal after open heart surgery. , 1999, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[20]  M. Good A Comparison of the Effects Of Jaw Relaxation and Music On Postoperative Pain , 1995, Nursing research.

[21]  A. Denney Quiet music. An intervention for mealtime agitation? , 1997, Journal of gerontological nursing.

[22]  The Sedative and Analgesic Sparing Effect of Music , 1998, Anesthesiology.

[23]  J. Denobile,et al.  Effect of music therapy on state anxiety in patients undergoing flexible sigmoidoscopy , 1994, Diseases of the colon and rectum.

[24]  M. Pratter,et al.  Music Improves Patient Comfort Level During Outpatient Bronchoscopy , 1995 .

[25]  M. Bookbinder,et al.  Introducing a music program in the perioperative area. , 1997, AORN journal.

[26]  K. Johnston,et al.  An introduction to music therapy: Helping the oncology patient in the ICU , 1996, Critical care nursing quarterly.

[27]  Barbara Miluk-Kolasa,et al.  The Effects of Music Listening on Changes in Selected Physiological Parameters in Adult Pre-Surgical Patients , 1996 .

[28]  K. Gaberson The effect of humorous and musical distraction on preoperative anxiety. , 1995, AORN journal.

[29]  J. Caine,et al.  The effects of music on the selected stress behaviors, weight, caloric and formula intake, and length of hospital stay of premature and low birth weight neonates in a newborn intensive care unit. , 1991, Journal of music therapy.

[30]  R. Heiser,et al.  The use of music during the immediate postoperative recovery period. , 1997, AORN journal.

[31]  J. M. White,et al.  Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction. , 1999, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[32]  J. M. White,et al.  Music therapy: an intervention to reduce anxiety in the myocardial infarction patient. , 1992, Clinical nurse specialist CNS.

[33]  A. Malone The Effects of Live Music on the Distress of Pediatric Patients Receiving Intravenous Starts, Venipunctures, Injections, and Heel Sticks , 1996 .

[34]  S. Robb,et al.  The Effects of Music Assisted Relaxation on Preoperative Anxiety , 1995 .

[35]  A. Hains,et al.  Effect of music on ambulatory surgery patients' preoperative anxiety. , 1996, AORN journal.

[36]  L. Chlan,et al.  Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. , 1998, Heart & lung : the journal of critical care.

[37]  C. O’Callaghan Pain, music creativity and music therapy in palliative care , 1996, The American journal of hospice & palliative care.

[38]  S. Flocke,et al.  Taped therapeutic suggestions and taped music as adjuncts in the care of coronary-artery-bypass patients. , 1995, The American journal of clinical hypnosis.