The effect of music therapy during colonoscopy on pain, anxiety and patient comfort: A randomized controlled trial

Effects of non-pharmacological interventions on anxiety in patients undergoing colonoscopy: A network meta-analysis of randomized controlled trials

BACKGROUND

Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered.

OBJECTIVES

To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies.

METHODS

We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the "gemtc" package based on R4.3.0.

RESULTS

The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (-0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(-0.96,-0.12)), video information (SMD = -1.47, 95 %CI(-2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(-2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(-2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low.

CONCLUSION

This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.

What is the current state of anxiety and its related factors in Chinese patients undergoing colonoscopy? A cross-sectional study

BACKGROUND

Anxiety in patients undergoing colonoscopy may also result in adverse effects, including altered vital signs such as elevated heart rate and blood pressure, exacerbation of symptoms like bloating and gastrointestinal discomfort, a decline in cooperation and satisfaction, and even colonoscopy failure. However, limited studies have explored the level of anxiety, factors that influence it, and its specific causes.

METHODS

A cross-sectional study was conducted, recruiting 825 patients undergoing colonoscopy in Hunan Province between January and July 2023 using stratified sampling. The Spielberger State-Trait Anxiety Inventory (STAI), a self-designed demographic characteristics questionnaire, and a colonoscopy patient anxiety influencing factor questionnaire were used. The data were analyzed in SPSS (version 26) using Mann-Whitney U, Kruskal-Wallis, and multiple regression analysis tests.

RESULTS

The final study included 825 participants, of whom 19.8% exhibited mild anxiety, 37.0% exhibited moderate anxiety, and 43.2% exhibited severe anxiety. The results indicated that insomnia (β=-0.080, p = 0.013), no comorbidities (β=-0.147, p < 0.001), not smoking or drinking (β=-0.158, p < 0.001), and poor health (moderate: β=-0.183, p < 0.001; poor: β=-0.164, p < 0.001) were negatively associated with anxiety levels. In contrast, marital status (β = 0.177, p < 0.001), education level (β = 0.204, p < 0.001), age (β = 0.114, p = 0.007), medical insurance (Basic Medical Insurance for Urban Residents β = 0.204, p < 0.001; Commercial medical insurance: β = 0.112, p < 0.001), care provided by relatives (β = 0.102, p = 0.002), diarrhoea (β = 0.089, p = 0.005), occupation (farmers: β = 0.099, p = 0.009; self-employed: β = 0.082, p = 0.014), and paternal upbringing (β = 0.067, p = 0.034) were positively correlated with anxiety. Several factors had a greater impact on the anxiety level of the patients: education level (β = 0.204), health status (moderate: β=-0.183; not good: β=-0.164), and marital status (β = 0.177). It probably because higher education levels may increase awareness of potential risks associated with colonoscopy, contributing to greater anxiety. The five common reasons for anxiety included the presence of bloody faeces, enemas, need for further treatment, lack of timely feedback from the physician, lack of an accurate diagnosis.

CONCLUSION

The level of anxiety experienced by patients during the colonoscopy phase was more severe and should be alleviated with targeted interventions based on the cause of anxiety, such as pre-procedural counseling, patient education materials, and enhanced communication with healthcare providers.

Implementing Music Medicine to Improve Pain Outcomes After Abdominal or Pelvic Surgery: A Quality Improvement Project

PURPOSE

Define the impact of the implementation of evidence-based music medicine (MM) on pain management outcomes after abdominal and pelvic surgery when combined with usual care.

DESIGN

This quality improvement project implemented MM in a hospital postanesthesia care unit using a pretest-posttest design. The Roy Adaptation Model and Kotter's Change theory guided all project phases.

METHODS

Nursing staff were educated in-person, via electronic formats and paper handouts. A convenience sample of adults who underwent abdominal or pelvic surgery was offered a preselected MM playlist (via earphones and MP3 players) in addition to usual care during the Phase I recovery period. The outcomes included administered opioids (oral morphine milligram equivalents), pain levels (numerical rating scale), heart rate, respiratory rate, and systolic blood pressure. The outcomes for those who accepted MM (music group) were compared to those for patients admitted to the postanesthesia care unit 1 month before project implementation (baseline group).

FINDINGS

The music group data revealed highly significant reductions in heart rate (P = .008, Cohen's d = 0.57) and systolic blood pressure (P < .001, Cohen's d = 0.78) at 30 minutes compared with pretest data. In contrast, the baseline group data showed no effect on systolic blood pressure levels (P = .274). The music group showed higher clinical significance (1.8 to >2-fold higher effect size) on reducing numerical rating scale scores at 30 minutes (music group: P < .001, Cohen's d = 1.19; baseline group: P = .008, Cohen's d = 0.55) and the final period in phase I (music group: P < .001, Cohen's d = 1.71; baseline group: P < .001, Cohen's d = 0.93). The mean morphine milligram equivalents dose for the music group (29.5 ± SD 19.8) compared with the baseline group (33.0 ± SD 26.6) was not significantly different (P = .376, Cohen's d = 0.18).

CONCLUSIONS

Adding MM with usual care leads to statistically and clinically significant reductions in pain indicators in adults who had abdominal or pelvic surgeries versus usual care alone.

Effects of Using Virtual Reality Technology on Pain and Hemodynamic Variables in Patients Receiving Hand Laceration Repair in an Emergency Department: A Randomized Controlled Trial

BACKGROUND

Pain and altered hemodynamic variables are among the most common complications in patients undergoing hand laceration repair in an Emergency Department.

AIM

This study aimed to evaluate the effects of using virtual reality (VR) technology on pain and hemodynamic variables in patients receiving hand laceration repair in an Emergency Department.

METHOD

This nonblinded randomized clinical trial included 160 patients undergoing laceration repair to their hands under local anesthetics from November 2020 to May 2021. The participants were randomly allocated to the experimental and control groups. Patients in the control group received routine care (such as ambient noise reduction, providing explanations about the surgery, and Lidocaine injection before the surgery). In the experimental group, a video containing natural landscapes and sounds was played using a semi-immersive VR headset during the surgery. Pain level and hemodynamic variables were measured immediately before and after the intervention. The pain was measured using the Critical Care Pain Observation Tool and Visual Analog Scale.

RESULTS

Immediately after the intervention, systolic blood pressure (BP), respiration rate, and pain intensity were significantly lower in the intervention group compared with the control group (p < .05). There were no significant differences between the intervention and control groups regarding diastolic BP, mean BP, SPO2, heart rate, and muscular tension (p > .05).

CONCLUSIONS

Semi-immersive VR is effective in managing pain and hemodynamic variables during hand laceration repair. The nurses could use the semi-immersive VR to better control of pain and hemodynamic variables during hand laceration repair.

A Prospective Study on Activities of Daily Living, Comfort, Body Image, and Cardiac Symptoms in Coronary Artery Bypass Patients

BACKGROUND

A coronary artery bypass graft procedure reduces mortality for cardiovascular patients, but those undergoing it often face negative body perception, loss of daily activities, and lingering symptoms, hindering full functional recovery and comfort.

AIM

To compare the comfort level, activities of daily living, and body image based on certain characteristics of patients at baseline, (ii) Evaluate changes over time in levels of discomfort, activities of daily living, body image, and cardiac symptoms before and after CABG surgery within three months.

METHOD

This descriptive prospective cohort study comprised 50 patients scheduled for coronary artery bypass surgery. The study examined cardiac symptoms, comfort levels, daily activities, and multidimensional body-self relationships as its outcomes.

RESULTS

A Friedman test revealed that patients' body image, comfort levels, activities of daily living, and each heart symptom were significantly influenced by the time of day. According to this study, patients most frequently reported experiencing exhaustion, depression, and worry as cardiac symptoms. Only the comfort level exhibited a high correlation with each heart symptom, as indicated by Spearman's rho analysis.

CONCLUSION

The body image, comfort level, activities of daily living, and cardiac symptoms of patients changed over time. Therefore, regular assessments of these symptoms during the pre- and post-operative periods could offer valuable insights into patients' needs. This information can be instrumental in developing interventions that address patients' well-being and may positively impact patient outcomes.

Effects of Music on Pain and Anxiety During Otolaryngology Surgery: A Systematic Review and Meta-analysis

Objective

Patients undergoing surgery commonly experience anxiety during their procedure which can negatively affect surgical outcomes. Music therapy has emerged as a promising noninvasive approach to reducing anxiety particularly in patients undergoing otolaryngology procedures.The objective of this study is to evaluate the effectiveness of music therapy on anxiety and pain during these procedures.

Data Sources

PubMed and Embase.

Review Methods

A systematic search was conducted using the PRISMA approach to retrieve articles published between 1980 and March 2024. The search terms were applied to PubMed and Embase databases. The search term yielded a total of 669 articles on PubMed and 1027 articles on Embase, 5 of which met the inclusion criteria.

Results

Five studies consisting of 4 randomized controlled trials and one case-control studies were included in our study, resulting in a total of 381 patients undergoing various otolaryngology procedures. Music therapy was found to reduce preoperative, perioperative, and postoperative anxiety and pain levels compared to control groups. Furthermore, patients who received music therapy experienced improvements in physiological parameters such as heart rate and blood pressure, indicating a positive impact on stress.

Conclusion

Music therapy offers a potentially cost-effective and noninvasive method of reducing anxiety and pain in otolaryngological surgery patients. Our study indicates that music therapy can serve as a valuable addition to traditional pharmacological approaches in managing surgery-related anxiety and pain. However, more research is needed to standardize music therapy protocols and compare its effect in comparison to other nonpharmacologic and pharmacologic modalities to optimize care for patients.

The effect of music on comfort, pain, and anxiety in patients with bone marrow aspiration and biopsy in Turkey: a mixed-methods study

AIM

This study was conducted to determine the effect of music on the pain, anxiety, and comfort levels of patients who underwent bone marrow aspiration and biopsy.

METHODS

This study was conducted on patients with hematological malignancies. Music was used with the intervention group. Patients' pain, anxiety, and comfort levels were measured. In addition, qualitative data were obtained through in-depth interviews with patients.

RESULTS

A significant difference (p < 0.05) was found between the experimental and control groups regarding pain, comfort and anxiety levels following the application of music. It was found that there was a negative correlation between comfort and pain (r=-0.442 p < 0.001) and between comfort and anxiety (r=-0.544 p < 0.001). As a result of qualitative interviews, patients mentioned the relaxing effect of music and the reduction of anxiety and pain levels. They also stated that music can be utilized as an alternative method.

CONCLUSION

According to the results of the present study, music reduced the pain and anxiety levels of the patients in bone marrow aspiration and biopsy and increased their comfort levels. We can say that music can be used in the clinic as a non-pharmacological method for pain, anxiety and comfort.

CLINICAL TRIALS NUMBER

NCT05895357 (Date:08/06/2023).

The Effect of Listening to Music Presurgery on the Anxiety Level of Individuals who are Planned for Urological Surgery: Randomized Controlled Study

PURPOSE

This study aims to evaluate the effects of listening to music on preoperative anxiety levels in individuals planned for urological surgery.

DESIGN

The study was a pretest-post-test randomized controlled study.

METHODS

This research was conducted with 80 (intervention=40, control=40) individuals who applied to the urology clinic of a university hospital between September 2021 and February 2022 with surgery planned. The data were collected via the information form, state-trait anxiety inventory (STAI= STAI-S: state anxiety, STAI-T: trait anxiety), anxiety specific to surgery questionnaire (ASSQ).

FINDINGS

The mean STAI-S scores for the pretest and post-test intervention group were 37.15 ± 8.04 and 34.67 ± 9.09; while scores for the control group were 36.23 ± 9.44 and 37.23 ± 9.78. While the difference in the intervention group was statistically significant (P = .006), there was no difference observed in the control group (P = .256). The pretest and post-test STAI-T mean scores for the intervention group were 39.73 ± 7.71 and 39.88 ± 8.22; the control group scores were 40.68 ± 4.91 and 41.25 ± 5.87; the difference between the intervention (P = .840) and control (P = .346) groups was not statistically significant. The pretest and post-test surgery-specific anxiety scale mean scores of the intervention group were 18.08 ± 4.52 and 16.55 ± 4.79; the control group were 20.50 ± 7.31 and 20.95 ± 7.69. While the difference in the intervention group was statistically significant (P = .011), no difference (P = .498) was determined in the control group.

CONCLUSIONS

Individuals planned for urological surgery who listened to music for 30 minutes had reduced state and surgery-specific anxiety for 15 minutes after listening, however, this did not affect trait anxiety. The practice of listening to music before surgery may be recommended for individuals who are scheduled for urological surgery to reduce patient anxiety.

The Effect of Virtual Reality Practice and Music on Patients' Pain, Comfort, and Vital Signs After Laparoscopic Abdominal Surgery

AIM

This research was conducted to identify the effect of virtual reality and music on patients' pain, comfort, and vital signs after laparoscopic abdominal surgery.

METHODS

This study was designed as a prospective randomized controlled single-blind clinical trial. The research population consisted of adult patients who underwent laparoscopic abdominal surgery in surgery clinics. The research sample comprised 225 patients who had laparoscopic abdominal surgery. Experimental groups watched virtual reality videos and listened to music, whereas no intervention was administered to the control group. The research data were evaluated with descriptive statistics, the χ 2 test, the Friedman test, the one-way analysis of variance, the Kruskal-Wallis test, and Tukey's and Dunn's post hoc tests.

FINDINGS

In the post-test phase after the 2 interventions, the virtual reality and music groups had lower pain and comfort levels than the control group, and this intergroup difference was statistically significant ( P <0.05). Results for vital signs in successively repeated post-test measurements after interventions were in general different, and these differences were statistically significant. Patients in the virtual reality group generally had higher pulse rate, diastolic blood pressure, respiratory rate, and body temperature values in successively repeated post-test measurements than patients in other groups ( P <0.05). Patients in the control group generally had higher systolic blood pressure and saturation values in successively repeated post-test measurements than patients in other groups ( P <0.05).

CONCLUSION

It was discerned that music and the virtual reality practice reduced patients' pain and comfort levels and had positive effects on their vital signs after laparoscopic abdominal surgery.

Improving the Patient Experience During Care in the Orthopedic Cast Room

Patients regularly have casts, splints, and wounds that require attention in the clinic. Patients commonly experience anxiety and pain during such visits. We hypothesized that aromatherapy and music would improve these patients' pain and anxiety when compared with no exposure. Patients in the orthopedic cast room were randomly exposed to no experience, music, or aromatherapy. Postprocedural surveys using an abbreviated form of the Spielberger State-Trait Anxiety Inventory (5 items; 4-point Likert scale) and a visual analog scale (0 to 10) were used to collect patient perceptions that were then compared using Spearman rank correlation calculations, t tests, and ordinal regression. Correlation results for the anxiety inventory were not different for patients with music or aromatherapy exposure vs no exposure; however, lower anxiety inventory scores were correlated with lower pain scores for upset, frightened, nervous, and confused measures. Mean reported pain scores were statistically lower for patients exposed to music (3.0) or aromatherapy (3.9) compared with patients who had no exposure (5.1; P=.004). These results support our hypothesis that exposure to music or aromatherapy improves pain. Although neither music nor aromatherapy resulted in significantly lower scores on the anxiety inventory items, the attention to patients' pain could have an indirect effect on their anxiety. [Orthopedics. 2024;47(2):e90-e92.].

The effects of ergonomic sleep mask use on sleep quality and comfort in intensive care patients

This study was conducted to determine the effects of the use of ergonomic sleep mask on sleep quality and comfort in intensive care patients. This randomised controlled experimental study was completed with 128 surgical intensive care patients (control = 64, experimental = 64). During the second night of their stay in the unit, ergonomic sleep masks were given to the patients in the experimental group, and earplugs and eye masks were given to the patients in the control group. A Patient information form, Visual analogue scale for discomfort, and the Richard-Campbell sleep questionnaire were used to collect data. While 51.6% of the patients were female, the mean age of the patients was 63.87 ± 14.94 years. The highest rates of patients had undergone cardiovascular surgery (28.9%) and general anaesthesia (57.8%). It was determined that the sleep quality of the patients in the experimental group was statistically and clinically significantly higher after the intervention (50.86 ± 21.46 vs 37.64 ± 14.97, t = -5.355, Cohen's d = 0.450, p < 0.001). Likewise, the patients who used ergonomic sleep masks had a statistically significantly lower mean VAS for Discomfort score, and their comfort level was higher (p < 0.001), but the difference was not clinically significant (Cohen's d = 0.208). The results of this study showed that the use of ergonomic sleep masks in surgical intensive care patients had a more positive effect on both the sleep quality and comfort levels of patients compared with earplugs and eye masks. The use of an ergonomic sleep mask is recommended in the early period to facilitate sleep and rest in surgical intensive care patients.

A Comparison of the Effects of Acupressure and Music on Venipuncture Pain Intensity in Children: A Randomized Controlled Clinical Trial

Pain from injections is common in children of all ages, and more than 90% of hospitalized children experience invasive and painful procedures such as venipuncture. In light of the complications associated with pain relief medications, nonpharmacological and complementary medicine approaches have gained attention. This study aims to compare the effects of acupressure and music on venipuncture pain intensity in children. This randomized controlled clinical trial involved 180 children aged 3-6 years who sought treatment at the Children's Medical Center Hospital Emergency Department at Tehran University of Medical Sciences, Iran. The children were randomly assigned to one of three groups: acupressure, music, or control. The interventions were given within 5 minutes, starting 3 minutes before the venipuncture and continuing until completion. The interventions included playing music through headphones and applying acupressure to the Hugo point. Venipuncture was carried out under identical conditions using an Angiocath 24G needle. Pain intensity was assessed using the Oucher scale. Data were analyzed using SPSS 24, employing the Kruskal-Wallis, chi-square, and Bonferroni pairwise comparison tests, with a significance level of 0.05. The mean pain intensity was 3.32 ± 1.44 in the music group, 4.82 ± 1.51 in the acupressure group, and 8.32 ± 1.10 in the control group. Pain intensity significantly differed among the three groups (p < 0.001). Specifically, pain intensity was lower in the music group compared to both the acupressure (p < 0.001) and control (p < 0.001) groups. Furthermore, pain intensity was lower in the acupressure group than in the control group (p < 0.001). Based on the results, music and acupressure methods effectively reduce pain intensity during venipuncture in children. Considering that music demonstrated a more pronounced effect in alleviating venipuncture pain than acupressure, the recommendation is to utilize music as a method of pain management during venipuncture in children. Iranian Registry of Clinical Trials, Trial No. IRCT20120109008665N15, was registered on 6 December 2021.

The effect of position change and abdominal massage on anxiety, pain and distension after colonoscopy: A randomized clinical trial

CONTEXT

Pain, abdominal distention, and anxiety are major risk factors encountered after colonoscopy. Complementary and alternative treatments, such as abdominal massage and position change, are used to reduce the associated risk factors.

OBJECTIVE

To determine the effect of position change and abdominal massage on anxiety, pain, and distension after colonoscopy.

DESIGN

A randomized three-group experimental trial.

SETTING AND PARTICIPANTS

This study was conducted with 123 patients who underwent colonoscopy at the endoscopy unit of a hospital located in western Turkey.

METHODS

Three groups were formed: two interventional (abdominal massage and position change) and one control, each including 41 patients. Data were gathered using a personal information form, pre- and post-colonoscopy measurement form, the Visual Analog Scale (VAS), and the Spielberger State-Trait Anxiety Inventory. Pain and comfort levels, abdominal circumference values, and vital signs of the patients were measured at four evaluation times.

RESULTS

In the abdominal massage group, the VAS pain scores and abdominal circumference measurements decreased the most and the VAS comfort scores increased the most 15 min after the patients were taken to the recovery room (p<0.05). Furthermore, bowel sounds were heard, and bloating was relieved in all patients in both intervention groups 15 min after they were taken to the recovery room.

CONCLUSIONS

Abdominal massage and position change can be considered effective interventions for relieving bloating and facilitating flatulence after colonoscopy. Moreover, abdominal massage can be a powerful method for reducing pain and abdominal circumference and increasing patient comfort.

The Effect of Video Streaming With Virtual Reality on Anxiety and Pain During Bone Marrow Aspiration and Biopsy Procedure

BACKGROUND

Pain and anxiety are among the most common symptoms in patients undergoing invasive procedures. Increased pain levels tend to worsen anxiety, and anxiety often leads to more frequent or severe pain.

AIMS

The study was conducted to determine the efficacy of virtual reality goggles (VRG) on pain and anxiety during bone marrow aspiration and biopsy (BMAB) procedure.

DESIGN

A randomized controlled experimental study.

SETTINGS

The outpatient unit of an adult hematology clinic of a tertiary care university hospital.

PARTICIPANTS/SUBJECTS

The study was conducted in patients aged 18 years and older who underwent a BMAB procedure. Thirty-five patients in the experimental (VRG) group and 40 patients in the control group.

METHODS

Patient identification form, visual analogue scale (VAS), state and trait anxiety inventory (STAI), and VRG were used to collect the data.

RESULTS

Postprocedural state anxiety mean scores were found to be statistically significantly higher in the control group than in the VRG group (p = .022). A statistically significant difference was found between groups in terms of procedure-related pain (p = .002). The postprocedural mean pain scores were found to be statistically significantly higher in the control group than in the VRG group (p < .001). A statistically significant but moderate positive correlation was found between the postprocedural pain and preprocedural state anxiety variable (r = 0.477). A statistically significant and strong positive correlation was found between the postprocedural pain and the postprocedural state anxiety variable (r = 0.657). A statistically significant but moderate positive relationship was found between preprocedural and postprocedural state anxiety variables (r = 0.519).

CONCLUSIONS

We determined that video streaming with VRG reduces pain and anxiety felt by adult patients during the BMAB procedure. VRG can be recommended to use in controlling pain and anxiety in patients undergoing a BMAB procedure.

Effects of Music on Anxiety, Pain, and Comfort in Patients Undergoing Upper Endoscopy: A Randomized Clinical Trial

Although upper gastrointestinal endoscopy is an important diagnostic procedure in the detection of diseases, it can cause discomfort and anxiety in patients. This study is a randomized controlled trial conducted to determine the effects of listening to music on the anxiety, pain, and comfort levels of patients undergoing upper gastrointestinal endoscopy. The patients were randomly divided into the intervention group ( n = 40), who listened to music for 45 minutes before upper gastrointestinal endoscopy, and the control group ( n = 40), which did not receive any intervention other than routine nursing care. It was observed that the pain and anxiety levels of the patients who listened to music before the procedure decreased, and their comfort levels and ease of the procedure increased. In order to reduce the pain and anxiety of patients who will undergo upper gastrointestinal endoscopy, increase the success of the procedure, and facilitate patient-doctor cooperation, encouraging patients to listen to music while awaiting the procedure can be effective.

Three Distraction Methods for Pain Reduction During Colonoscopy: A Randomized Controlled Trial Evaluating the Effects on Pain and Anxiety

PURPOSE

The aim of this study was to compare the effects of distraction methods on pain, anxiety, and satisfaction during a colonoscopy.

DESIGN

This experimental research was conducted as a single-center, randomized, parallel-group trial.

METHODS

A total of 120 patients were recruited and randomized into 4 groups (music, stress ball, audiovisual distraction, and control). The data were collected using individual an identification form, observation form, the Visual Analog Scale, and the State-Trait Anxiety Inventory.

FINDINGS

Pain severity during colonoscopy was found to be lower in the intervention (music and audiovisual distraction) groups compared to the stress ball and control groups (P < .001).There was no statistically significant difference between the pre- and postanxiety levels in the intervention groups compared to the control group. After the colonoscopy, satisfaction levels were significantly higher in the music group compared to the audiovisual, control, and stress ball groups (P < .001).

CONCLUSIONS

Distraction methods used during colonoscopy were found to reduce pain. Although sedation is widely used during a colonoscopy procedure and is accepted as a general standard, music and VR can be used as effective alternative strategies in reducing pain for colonoscopy patients.

The effect of music intervention on sedation in elderly patients undergoing transurethral resection of prostate under spinal anesthesia: a prospective randomized controlled clinical trial

PURPOSE

Music intervention is commonly used as a non-pharmacologic therapeutic modality to alleviate anxiety in perioperative patients. This study aimed to assess the sedative and anxiolytic effects of music on elderly patients receiving transurethral resection of prostate (TURP) under spinal anesthesia.

METHODS

This was a prospective randomized controlled trial on patients who aged over 60 and received TURP under spinal anesthesia. Participants were randomized to the music group or the control group (no music). The primary outcome was perioperative BIS values, and the secondary outcomes were patient's perioperative anxiety levels, heart rate (HR), blood pressure, and patient satisfaction score.

RESULTS

A total of 82 patients were analyzed. The perioperative BIS values in the music group were significantly lower than those of the control group at almost all time points (P < 0.001), as well as showed a significant reduction compared with baseline (P < 0.001), whereas the control group did not. In comparison with the control group, systolic blood pressure (SBP) significantly decreased in the music group at the beginning (mean difference, - 8.0 mmHg; 95% CI - 15.70 to 0.35; P = 0.041) and the 60th minute (mean difference, - 7.9 mmHg; 95% CI - 15.30 to 0.51; P = 0.037) of TURP. Furthermore, compared with baseline within the music group, diastolic blood pressure (DBP) and HR significant reduced at whole time points (P < 0.05), yet the control group not.

CONCLUSION

Music intervention effectively provided slight sedation for elderly patients when undergoing TURP under spinal anesthesia without sedatives.

Effect of Virtual Reality Distraction on Satisfaction and Tolerability in Patients Undergoing In-Office KTP Laser Procedure

OBJECTIVES

To study the effect of virtual reality (VR) on satisfaction, discomfort, stress, and cooperation in patients undergoing in-office potassium titanyl phosphate (KTP) laser procedure.

STUDY DESIGN

Prospective study.

METHODS

Thirty-seven patients were enrolled in this prospective study. The State Anxiety Scale of Spielberg's State-Trait Anxiety Inventory was used to measure the level of state anxiety. Satisfaction, discomfort, pain, stress, acceptance of VR, relaxation with VR, and willingness to wear VR were evaluated using a 100-mm visual analog scale (VAS). A 5-point Likert-like scale was used to rate the patient cooperation.

RESULTS

All procedures were completed successfully with cooperation of patients. Satisfaction score in VR group was 88.3 ± 9.0, and in control group was 81.6 ± 9.7 (P = 0.040). There were significant differences in both nasal cavity and laryngopharynx discomfort between two groups (P = 0.030 and P = 0.016, respectively). The pain score of control group was higher than that of VR group but it was not statistically significant (P = 0.140). The stress of control group during procedure was more obvious than that of VR group (30.5 ± 24.0 versus 17.0 ± 9.2, P = 0.021). The mean VAS scores of acceptance of VR were all more than 75. The results of regression analysis showed that VR had significant effects on satisfaction with the procedure (P = 0.004), discomfort of nasal cavity (P = 0.030) and laryngopharynx (P = 0.016), and feeling of stress (P = 0.021) during the procedure.

CONCLUSION

Distraction of VR can enhance satisfaction in both procedure and stress management for patients undergoing in-office KTP laser procedure. Acceptance of VR in VR group was relatively good.

Effect of music on colonoscopy performance: A propensity score-matched analysis

BACKGROUND

Music has been used to reduce stress and improve task performance during medical therapy.

AIM

To assess the effects of music on colonoscopy performance outcomes.

METHODS

We retrospectively reviewed patients who underwent colonoscopy performed by four endoscopists with popular music. Colonoscopy performance outcomes, such as insertion time, adenoma detection rate (ADR), and polyp detection rate (PDR), were compared between the music and non-music groups. To reduce selection bias, propensity score matching was used.

RESULTS

After one-to-one propensity score matching, 169 colonoscopies were selected from each group. No significant differences in insertion time (4.97 vs 5.17 min, P = 0.795) and ADR (39.1% vs 46.2%, P = 0.226) were found between the two groups. Subgroup analysis showed that the insertion time (3.6 vs 3.8 min, P = 0.852) and ADR (51.1% vs 44.7%, P = 0.488) did not significantly differ between the two groups in experts. However, in trainees, PDR (46.9% vs 66.7%, P = 0.016) and ADR (25.9% vs 47.6%, P = 0.006) were significantly lower in the music than in the non-music group.

CONCLUSION

The current study found that listening to music during colonoscopy did not affect procedure performance. Moreover, it suggested that music may distract trainees from appropriately detecting adenomas and polyps.

"This Won't Hurt a Bit": Is There a Role for Music in Bedside Procedures?

Music has played a long and storied role in clinical healing. However, the integration of music into clinical practice has been slow to gain traction, despite a recent meta-analysis demonstrating association of music interventions with clinically meaningful improvements in health-related quality of life. There is growing evidence that music has an active role in reducing patient pain and anxiety as well as affecting physiologic parameters, such as heart rate and blood pressure, in an ICU setting. Past studies have shown that incorporation of music into procedures in the operating room, radiology suites, and catheterization labs has reduced concurrent pharmacologic sedation requirements. In the age of patient-centered personalized medicine, we propose a call to action to implement an easily accessible, attainable checklist item offering a personal choice of music for patients during standardized bedside procedural training, to reduce anxiety, pain, and pharmacologic sedation and potentially improve clinical outcomes.

Effects of light music played by piano intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: A randomized controlled trial

BACKGROUND

Colonoscopy is the main kind of way to detect and treat diseases about large intestine, but during the examination and preparation, these 2 processes are able to lead abdominal pain, abdominal distention and other discomfort feel, which will cause patients to refuse the examination and become anxious. Painless and sedative endoscopy may reduce discomfort of patients, but there is a risk of adverse effects. Many studies have shown that playing music during colonoscopy can reduce discomfort and increase acceptance of colonoscopy, but the conclusion remains controversial. The 3 approaches of random, single-blind, controlled method were used to investigate the interventions effects of piano light music on satisfaction, anxiety and pain in patients undergoing colonoscopy.

METHODS

A total of 216 patients were randomly divided into piano music group (n = 112, piano music played during colonoscopy) and control group (n = 104, no music during colonoscopy) to compare patients satisfaction, anxiety score, pain score, vital signs, endoscopic difficulty score, and willingness to undergo colonoscopy again.

RESULTS

There were no significant differences in vital signs, pre-colonoscopic state anxiety score, and trait anxiety score before and after colonoscopy, and willingness to undergo colonoscopy again between the 2 groups (P > .05). The difficulty of colonoscopy operation and the score of state anxiety after colonoscopy in the piano group were lower than those in the control group (P < .05), and the satisfaction of colonoscopy process, pain management and overall service satisfaction were better than those of the control group (P < .05), and they were more likely to listen to music in the next examination (P < .001).

CONCLUSION

The light music played by piano can relieve patients' anxiety, improve the satisfaction of colonoscopy process, pain management and service satisfaction, reduce the difficulty of colonoscopy, which have no obvious adverse reactions. Therefore, it is worthy of promotion.

Effect of visual distraction on pain in adults undergoing colonoscopy: a meta-analysis

BACKGROUND

Pain is a contributing factor to the low compliance rate for performing a colonoscopy on screening for colorectal cancer.

PURPOSE

This meta-analysis aimed to evaluate the effect of visual distraction on adults undergoing colonoscopy.

METHODS

We searched PubMed, EMBASE, Web of Science, and Cochrane Library Database from their inception to February 2022. Randomized controlled trials comparing visual distraction with non-visual distraction were considered for inclusion. The fixed-effects and random-effects models were used to pool the data from individual studies and the Cochrane risk of bias assessment tool was used to determine the methodology quality.

RESULTS

This meta-analysis included four studies (N = 301) for pain level and total procedure time, three studies (N = 181) for satisfaction score, three studies (N = 196) for anxiety level, and four studie (N = 402) for willingness to repeat the procedure. The pooled analysis shown that significantly lower pain levels (SMD, - 0.25; 95% CI - 0.47 to - 0.02; P = 0.03), higher satisfaction score with the procedure (SMD, 0.63; 95% CI, 0.33 to 0.93; P < 0.0001), and higher willingness to repeat the procedure (OR, 2.66; 95% CI 1.70 to 4.17; P < 0.0001) in the visual distraction group than those in the non-visual distraction group, with no significant differences in total procedure time (SMD,- 0.07; 95% CI - 0.30 to 0.15; P = 0.53) or anxiety level (SMD,- 0.27; 95% CI - 0.55 to 0.01; P = 0.06).

CONCLUSIONS

Visual distraction improved the patient's pain, satisfaction, and willingness to repeat the procedure. Thus, visual stimulation is an effective way to reduce pain during colonoscopy and should be recommended.

Music therapy and psychological-clinical impact in surgery: a systematic review

BACKGROUND

Music therapy is a discipline that makes use of music, active or passive, to produce beneficial effects on the psyche of subjects. The field of use of music therapy has recently been broadened with the introduction of music therapy interventions to treat various problems, such as anxiety and stress, arising from pre- and post-operative psychophysical conditions. This review aims to examine the use of music therapy and its outcomes in the context of surgery in recent years.

METHODS

The main procedure was to search for studies on various scientific platforms such as PubMed, Medline, PsycINFO and CINAHL.Many studies pertaining to the topic in question were examined and from the variety of articles available, thirty-four were selected that fully reflected the focus of this review.

CONCLUSIONS

The use of music therapy is still little exploited in hospital conditions such as the one reported in this review, but despite its reduced use compared to other treatments, it has proved to be an effective technique for reducing anxiety and stress prior to surgery and for improving psychophysical conditions following surgery. Above all, the absence of side effects is emphasised since it is a nonpharmacological treatment. Further research is needed for additional confirmation of the effectiveness of music therapy mainly because this method is still being explored worldwide.

Effect of music intervention in colonoscopy-naïve adults: a randomised controlled trial

BACKGROUND

Previous studies have evaluated music interventions before and during a colonoscopy, but the results are contradictory and inconclusive.

AIMS

The aims of the present study were to evaluate the effect of a music intervention with MusiCure music, both before and during colonoscopy.

METHODS

The study was a two-armed, prospective, randomised, controlled trial and 337 patients undergoing colonoscopy were included. Patients were allocated to receive relaxing music (MusiCure) before and during the colonoscopy or standard care (no music). Outcome measures included pain intensity, duration of the colonoscopy, consumption of alfentanil and midazolam, vital signs, patient satisfaction and caecal intubation rates (CIR).

FINDINGS

Men in the music group had a lower middle arterial blood pressure compared with men in the no music group. The majority of patients in the music group would prefer to listen to music if they need a colonoscopy in the future. No differences were found between groups regarding pain intensity, duration of the colonoscopy, consumption of alfentanil and midazolam, vital signs, patient satisfaction and CIR.

CONCLUSION

The researchers were unable to show an effect on the primary endpoints. However, a high patient satisfaction was found in the music group and a decrease in the blood pressure during the colonoscopy, indicating a reduced stress level. Music before and during a colonoscopy may improve the patient experience.

Effect of New Nursing on Patients with Acute Cerebral Infarction

Objective. To explore the effect of the comfortable intervention-based nursing mode under the quality nursing intervention combined with Internet mobile health on the quality of life (QOL) and psychological status of patients with acute cerebral infarction (ACI). Methods. 90 ACI patients treated in our hospital (June 2019-June 2020) were chosen and equally split into the experimental group (EG) and control group (CG) according to the order of admission. CG received routine nursing, while EG received the comfortable intervention-based nursing mode under the quality nursing intervention combined with Internet mobile health to compare the clinical indexes between the two groups. Results. Compared with CG, EG after intervention achieved obviously higher SS-QOL, ESCA, and GCQ scores ( $P<0.001$ ), and lower MSSNS and NIHSS scores ( $P<0.001$ ). Conclusion. The application of the comfortable intervention-based nursing mode under the quality nursing intervention combined with Internet mobile health effectively improves QOL and alleviates the negative emotions of patients. Compared with routine nursing, this model has higher application value, and further research of the joint intervention will help build better a solution for patients.

Effect of Music on Fatigue, Comfort, and Vital Signs in Patients After Liver Transplant Surgery: A Randomized Controlled Trial

This randomized controlled clinical trial was conducted to determine the effect of music therapy on fatigue, comfort and vital signs of the liver transplant patients. The study sample comprised 120 adult patients (60 in the experimental and 60 in the control group) who met the inclusion criteria and agreed to participate in the study. In the experimental group, the researcher performed music therapy. After applying music therapy once to patients for 30 minutes, their fatigue, comfort, and vital signs were evaluated. No treatment was performed in the control group. According to music therapy follow-ups after liver transplantation, mean scores of fatigue levels were lower, comfort levels were higher, and vital signs were normal, with a statistical significance in the experimental group compared with the control group in all measurements before and after music therapy (P < .001). The study should be repeated using different parameters.

Effect of Music Selection on Anxiety Level during Intravitreal Injections for Individuals of Varying Cultures

Purpose: To investigate music selection as a treatment for anxiety during Intravitreal injections (IVI) for individuals of varying cultures.Methods: 106 individuals were enrolled in this randomized controlled study. Individuals were randomized into one to three categories: (1) a control group in which the IVI procedure was performed without music (n = 35), (2) an experimental group in which the music was selected by the physician (n = 36), (3) an experimental group in which the music was selected by the patient (n = 35). After the procedure, all patients responded to a questionnaire regarding their level of experienced anxiety, pain and discomfort (grade 0-10). The primary outcome was anxiety level during the procedure.Results: The experimental group in which patients selected music had higher number of patients with low anxiety score compared to the other groups (anxiety score <4 in 19,18 and 27 patients, respectively, p = .04). Interestingly, patients who answered the questionnaire in Arabic were less likely to desire music on subsequent injections compared to Hebrew and English speakers (52% Vs 78% Vs 100%, p = .02). Music was deemed by both experimental groups as an effective method to induce relaxation (average score of 6.6 and 7.2 in group 2 and 3, respectively). Preference for music on subsequent injections was increased in both experimental groups compared to the control group (P < .01). Patients in the third group preferred music selection on future injections more than the other groups (P < .01).Conclusion: Music selection may be an effective way to reduce anxiety levels during IVI. Preference for music during future injections is higher in patients who were exposed to music during IVI and may be influenced by culture.

A randomised study of comfort during bronchoscopy comparing conscious sedation and anaesthetist-controlled general anaesthesia, including the utility of bispectral index monitoring

Background

The difference in patient comfort with conscious sedation versus general anaesthesia for bronchoscopy has not been adequately assessed in a randomised trial. This study aimed to assess if patient comfort during bronchoscopy with conscious sedation is noninferior to general anaesthesia.

Methods

96 subjects were randomised to receive conscious sedation or general anaesthesia for bronchoscopy. The primary outcome was subject comfort. Secondary outcomes included willingness to undergo a repeat procedure if necessary and level of sedation assessed clinically and by bispectral index (BIS) monitoring.

Results

There was no significant difference between subject comfort scores (difference -0.01, 95% CI -0.63-0.61 on a 10-point scale; p=0.97) or willingness to undergo a repeat procedure (97.7% versus 91.8%, 95% CI -4.8-15.5%; p=0.37). Deeper levels of sedation in the general anaesthesia cohort was confirmed with both clinical and BIS monitoring. There was no significant difference in diagnostic accuracy (conscious sedation 93.9%, 95% CI 80.4-98.3% versus general anaesthesia 86.5%, 95% CI 72.0-94.1%; p=0.43). There were more complications (29.6%, 95% CI 18.2-44.2% versus 6.1%, 95% CI 2.1-16.5%; p<0.01) in the general anaesthesia group. There was no relationship between high BIS scores and subject discomfort. BIS levels <40 during a procedure were associated with increased complications.

Conclusion

Conscious sedation is not inferior to general anaesthesia in providing patient comfort during bronchoscopy, despite lighter sedation, and is associated with fewer complications and comparable diagnostic accuracy. BIS monitoring may have a role in preventing complications associated with deeper sedation.

The Effect of Music Listening on Pain in Adults Undergoing Colonoscopy: A Systematic Review and Meta-Analysis

PURPOSE

To investigate the role of music listening in reducing pain in adults undergoing colonoscopy.

DESIGN

This is a systematic review and meta-analysis of randomized control trials (RCTs) that evaluated the effect of music in reducing pain in adults undergoing colonoscopy.

METHODS

We searched CINAHL, Embase, MEDLINE, PsycINFO, and PubMed for RCTs that reported on the effects of music listening in reducing pain in adult patients undergoing colonoscopy from database inception to March 15, 2020, when the search was completed. Studies published in English with adult participants testing the efficacy of music during colonoscopy were eligible for inclusion. Studies reporting the results of combined nonpharmacological interventions were excluded. The methodological quality of each included RCT was assessed using the Cochrane Collaboration tool for assessing the risk of bias. Two authors independently abstracted data and assessed risks of bias.

FINDINGS

Seven RCTs with a total of 622 adult participants fulfilled our inclusion criteria and were, therefore, included. A random-effects model estimated the summary effect of the 7 included studies as -1.83 ± 0.98, P = 0.06.

CONCLUSIONS

Although our meta-analysis demonstrated a small treatment effect, this effect was clinically not statistically significant. Substantial heterogeneity among the included trials limits the certainty of our findings. Additional trials investigating the effects of listening to music on pain in adults undergoing colonoscopy are needed to generate further evidence to establish the analgesic effect of music in adults undergoing colonoscopy.

The effects of a music intervention during port catheter placement on anxiety and stress

Studies have shown that perioperative music interventions can reduce patients' anxiety levels. However, in small operations like port catheter surgery evidence is sparse. The present single-blinded, randomised controlled two-armed study included 84 female patients undergoing port catheter placement who were randomly assigned to either listening to music during surgery vs. no music intervention. The medical staff was blind to group allocation. On the day of the surgery anxiety and stress levels were evaluated using subjective (STAI questionnaire, visual analogue scales) and objective (vital parameters, salivary cortisol) parameters at different time points (before the surgery, at the end of the surgery and 1 h post-surgery). The music group showed significant reductions of systolic blood pressure (from 136.5 mmHg ± 26.1 to 123.3 mmHg ± 22.0, p = .002) and heart rate (from 75.6 bpm ± 12.3 to 73.1 bpm ± 12.2, p = .035) from beginning of the surgery to skin suture, whereas the control group did not. No significant effects of the music intervention on subjective anxiety measures or salivary cortisol were revealed. In sum, the study demonstrates that a music intervention during port catheter placement positively influences physiological anxiety levels, whereas no effects were revealed for subjective anxiety and salivary cortisol. Thus, music can be considered as a low cost addition in clinical routine in order to reduce patients' heart rate and blood pressure. Future studies are encouraged to further explore the differential effects of intraoperative music interventions on physiological, endocrinological and subjective anxiety levels.