Music listening alleviates anxiety and physiological responses in patients receiving spinal anesthesia

Efficacy of Music Therapy on Quality of Life in Cancer Patients: A Systematic Review and Meta-Analysis

OBJECTIVE

This meta-analysis aims to evaluate the efficacy of music therapy on quality of life (QoL), anxiety, and depression in cancer patients.

METHODS

Nine electronic databases, encompassing six English and three Chinese databases were systematically searched for randomized controlled trials (RCTs) from the date of database inception to September 1, 2024. All RCTs that involved participants aged at least 18 years with any type of cancer, who received music therapy and had QoL as an outcome measure, were screened. The revised Cochrane's risk of bias tool was applied to evaluate the risk of bias. The Review Manager software was applied to execute this meta-analysis. Subgroup analyses were performed based on the type and duration of the music therapy.

RESULTS

Fourteen RCTs involving 1104 patients were included in this meta-analysis. The results showed that compared with usual care, wait list or health education, music therapy could significantly improve the QoL of cancer patients (standardized mean difference (SMD = 1.36); 95% confidence interval (CI: 0.77-1.96); p < 0.01; Grading of Recommendations Assessment, Development, and Evaluation assessment [GRADE]: moderate), with passive music therapy being superior to active-passive music therapy, can be protective against anxiety (SMD = -1.37; 95% CI:-2.29 to -0.45; p < 0.01; GRADE: moderate) and depression (SMD = -1.86; 95% CI:-3.65 to -0.08; p = 0.04; GRADE: low).

CONCLUSION

Music therapy was effective in improving the QoL of patients with cancer, with passive music therapy being superior to active-passive music therapy. Meanwhile, anxiety and depression were relieved as well. Further studies with rigorous study designs are needed to verify our conclusions.

Using music to reduce anxiety and stress in patients undergoing coronary angioplasty: A randomized clinical trial protocol

In the current health context, there is a widespread increase in chronic non-communicable diseases that predominantly affect the cardiovascular system. Recent epidemiological data in Brazil indicate a rise in these diseases, which can result in severe harm to patients, including death. This study aims to present a study protocol to evaluate the effect of music in reducing anxiety and stress in patients undergoing coronary angioplasty. A randomized, controlled, double-blind clinical trial will be conducted with 52 patients undergoing coronary angioplasty. The patients will be randomly assigned to one of two groups: a Control Group or an Experimental Group, to assess the effect of music on anxiety and stress. Two key points will be considered to evaluate the intervention's impact: data on patients' anxiety and stress, collected through structured forms, will be gathered both before and after the intervention, along with an assessment of vital signs. The primary expected outcome is a reduction in anxiety and stress, while the secondary expected outcome is stability in vital signs.

Watching a movie or listening to music is effective in managing perioperative anxiety and pain: a randomised controlled trial

PURPOSE

Despite the use of perioperative anxiolytics and pain medication, surgery can be a stressful and painful experience. Providing patients with distractions using video and/or audio tools in addition to medication may be helpful. To date, no studies have compared different distraction modalities in a same-day surgical setting in adults. This study aims to determine whether audio-visual distraction with video glasses (AVD) is more effective in reducing anxiety and pain compared to audio distraction (AD) in conscious patients undergoing orthopaedic surgery. It was hypothesised that AVD, being the more immersive modality, would be more effective than AD on the outcome parameters.

METHODS

Fifty patients undergoing orthopaedic surgery with local and/or regional anaesthesia in a clinical day-care setting were randomly assigned to receive either fixed-scenery AVD or patient-choice AD with music. Primary outcome was anxiety, as measured by the Dutch version of the Spielberger State-Trait Anxiety Inventory-6 (STAI-6) prior to and 15 min after the intervention. Secondary outcomes were pain (Numeric Rating Scale Pain [NRS-P]), systolic and diastolic blood pressure, heart rate and patient satisfaction.

RESULTS

Within each group, there was a significant reduction in anxiety (p = 0.028 for AVD, p < 0.001 for AD). In contrast to our hypothesis, listening to music without watching a video (AD group) reduced anxiety significantly more than experiencing full AVD (p = 0.018). The mean pain score did not change significantly within either user group, nor did pain scores differ between user groups.

CONCLUSION

In conscious patients undergoing surgery, watching a movie (using video glasses and a headphone set) and listening to music (using only a headphone set) are able to significantly reduce anxiety. AVD, although believed to provide higher levels of distraction, did not prove to be superior to AD. The clinical relevance of this study highlights the potential benefits of AVD or AD modalities in improving the surgical experience for conscious patients. Further research is required to examine the influence of freedom of choice in content on the aforementioned outcomes. To estimate the true value of higher immersion levels, different distraction modalities (e.g. AVD versus virtual reality) featuring the exact same scenery or content need to be compared.

LEVEL OF EVIDENCE

Level I.

Inhalation of Origanum majorana L. essential oil while working reduces perceived stress and anxiety levels of nurses in a COVID-19 intensive care unit: a randomized controlled trial

Background

Nurses caring for patients with coronavirus disease 2019 (COVID-19) experience higher psychosocial distress than other healthcare workers, and this can adversely affect the quality of patient care. There is evidence that inhalation of essential oil from marjoram (Origanum majorana L.) has calming effects, suggesting this intervention may help to reduce the stress and anxiety of nurses working in a COVID-19 intensive care unit (ICU). This study aimed to investigate the effect of inhalation of marjoram essential oil at work on the stress and anxiety levels of nurses in a COVID-19 ICU.

Methods

Nurses (n = 57) working in a single COVID-19 ICU were randomly assigned to inhale 3% marjoram essential oil (marjoram group, n = 29) or almond oil (control group, n = 28) for 2 h while at work. Mean arterial pressure (MAP), heart rate, state anxiety score, and score on a visual analog scale for anxiety (VAS-anxiety) and stress (VAS-stress) were measured before and after the intervention.

Results

The two groups had similar baseline variables. MAP did not have within-group or between-group differences. Heart rate increased significantly in the marjoram group after the intervention (p = 0.031), but it remained within the normal range and the increase was not clinically meaningful. There was no significant between-group difference in the state-anxiety or VAS-anxiety score after the intervention, but the marjoram group had a significantly lower state-anxiety (p = 0.001) and VAS-anxiety (p = 0.037) score at posttest vs. pretest. The VAS-stress score was significantly lower in the marjoram group at the posttest vs. the pretest (p = 0.026).

Conclusion

Nurses caring for patients in a COVID-19 ICU experience significant stress, and strategies are needed to address this important issue. Inhalation of 3% marjoram essential oil while caring for patients in a COVID-19 ICU may be a simple and effective intervention that reduces perceived stress and anxiety in nurses.Clinical Trial Registration: https://cris.nih.go.kr/, KCT0007543.

The Effect of Music Therapy on Adult Patients’ Heart Rate: A Meta-Analysis

Background: Music can be used as a complementary intervention to bring about a positive effect on the quality of life. It has been widely employed in clinical practice as one of the earliest forms of treatment. Despite the fact that music therapy is widely utilized and practiced in clinical and educational contexts, it has received little attention in formal medical settings. In addition, contradictory findings about the effect of music deserve further investigation.Purpose: This meta-analysis is conducted to examine the effect of music therapy on heart rates among adult patients.Methods: The MEDLINE, CINAHL, PsycInfo, Cochrane Library, and PubMed databases were used for searching the literature. The literature review was conducted by two independent researchers using the following Medical Subject Headings terms: musicotherapy OR music therapy, AND heart rate OR vital signs AND clinical trials as the topic. Standard mean difference (SMD) with 95% confidence interval (CI) values was used to evaluate the effect of music therapy on heart rates.Results: Out of 194 studies, 12 studies were included with 1,118 patients. According to the results of the meta-analysis, the heart rates in the experimental groups in which music therapy was used with various diagnoses of adult patients were found to be significantly different in comparison with the control group (SMD=-0.450, 95% CI=-8.86 to -0.31, p=0.04).Conclusion:The results established that using music therapy for adult patients reduced their heart rates. However, the heterogeneity among the studies was high. Therefore, it is recommended that high-quality trials are warranted to confirm the benefits of music therapy interventions among adult patients. 

THE EFFECT OF LAVENDER AROMATHERAPY ON THE LEVEL OF INTRAOPERATIVE ANXIETY IN CAESAREAN CASE UNDER SPINAL ANESTHESIA: A RANDOMIZED CONTROLLED TRIAL

BACKGROUND

Preoperative anxiety can be reduced by aromatherapy. This study aimed to evaluate the effect of lavender aromatherapy in reducing intraoperative anxiety in patients undergoing caesarean section (CS) under spinal anesthesia.

METHODS

This study was two-armed and randomized controlled trial. A total of 96 patients who were scheduled for CS were randomly divided into two groups: the aromatherapy (A) group (n=48), comprising patients who were randomized to receive lavender aromatherapy with mask oxygen after the birth of the baby, and the control (C) group (n=48), comprising patients who inhaled carrier oil. During the preoperative period, baseline anxiety levels and Visual Analog Scale (VAS) pain scores were recorded using the State-Trait Anxiety Inventory (STAI-I) scale. After birth, two drops of oil were inhaled in an oxygen mask for 5 min. After 5 min, the Ramsey Sedation Scale was evaluated, and patients with a score of 1 received 2 mg of intravenous midazolam for sedation. The STAI-I and VAS pain scores were re-evaluated at the third postoperative hour.

RESULTS

The primary outcome was the significant reduction in the need for midazolam brought about by lavender aromatherapy, and the secondary outcomes included postoperative third-hour STAI-I scores, intraoperative complications and patient satisfaction.

CONCLUSION

The effectiveness of lavender aromatherapy, which reduced the need for intraoperative anxiolytics, can be offered as an alternative for pregnant women who undergo CS under spinal anesthesia.

Development and implementation of anxiety management program for women under gynecological surgery with spinal anesthesia: Protocol of action research study

BACKGROUND

Anxiety is the most common health problem and the second leading cause of disability worldwide. Patients undergoing surgery often experience anxiety. It is necessary to use appropriate interventions to achieve the best results. The aim of this study is to develop, implement, and evaluate of anxiety management program for gynecological surgery patients under spinal anesthesia.

MATERIALS AND METHODS

This participatory action research will be conducted through four phases; problem identification, planning, action, and evaluation phases in the Gonbad-e-Kavous Shahada, hospital in northeastern of Iran. These phases will be guided based on the Promoting Action on Research Implementation in Health Services framework. Participants will be included using purposive sampling method. We will use both of qualitative (semi-structured interview, observation) and quantitative (questionnaire) approaches for data collection through the study.

CONCLUSION

For anxiety management of patients, context-based interventions should be performed. Combination of multidimension approach based on health-care providers, patients, and environment will have an effect to solve the problem in the clinical setting.

Nociceptive pain and anxiety in equines: Physiological and behavioral alterations

Pain and anxiety are two of the most important concerns in clinical veterinary medicine because they arise as consequences of multiple factors that can severely affect animal welfare. The aim of the present review was to provide a description and interpretation of the physiological and behavioral alterations associated with pain and anxiety in equines. To this end, we conducted an extensive review of diverse sources on the topic. The article begins by describing the neurophysiological pathway of pain, followed by a discussion of the importance of the limbic system in responses to pain and anxiety, since prolonged exposure to situations that cause stress and pain generates such physiological changes as tachycardia, tachypnea, hypertension, hyperthermia, and heart rate variability (HRV), often accompanied by altered emotional states, deficient rest, and even aggressiveness. In the long term, animals may show deficiencies in their ability to deal with changes in the environment due to alterations in the functioning of their immune, nervous, and endocrinologic systems. In conclusion, pain and anxiety directly impact the homeostasis of organisms, so it is necessary to conduct objective evaluations of both sensations using behavioral scales, like the horse grimace scale, complemented by assessments of blood biomarkers to analyze their correlation with physiological parameters: Heart rate, respiratory rate, HRV, theparasympathetic tone activity index, lactate and glucose levels, and temperature. Additional tools - infrared thermography, for example - can also be used in these efforts to improve the quality of life and welfare of horses.

Use of music to enhance sleep and psychological outcomes in critically ill patients: a protocol for a systematic review and meta-analysis

INTRODUCTION

Music listening is used as a non-pharmacological intervention in various populations with positive results; however, evidence for its effect on sleep and psychological outcomes in critically ill patients remains unclear. It is essential to understand the impact of music listening for critically ill patients to optimise care and minimise the risk for harm. We will assess whether music listening improves sleep and psychological outcomes in critically ill patients.

METHODS AND ANALYSIS

We will systematically search scientific databases for relevant studies, including PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, ProQuest, the Cochrane Central Register of Controlled Trials, China Biological Medicine Database, China National Knowledge Infrastructure Library, Wan fang databases, VIP Database for Chinese Technical Periodicals and the Chinese Clinical Trial Registry. Databases will be searched for articles published from inception to 10 June 2020. Music therapy journals and reference lists in some articles will be hand-searched. Grey literature will also be searched. We will include randomised and quasi-randomised controlled trials that used music listening to improve sleep and psychological outcomes in critically ill patients. The primary outcomes will be sleep-related outcomes, and secondary outcomes will be anxiety and depression scores and physiological outcomes. Two reviewers will independently verify study eligibility and methodological quality; disagreements will be resolved by a third reviewer or through discussion. The risk of bias will be independently determined using the Cochrane Risk of Bias Tool. The Consolidated Standards of Reporting Trials checklist will be used to examine the quality of included papers. Data will be extracted from eligible studies by two researchers. RevMan V.5.3 will be used for meta-analysis.

ETHICS AND DISSEMINATION

This work will review existing trial data and will not introduce new patient data or interventions; therefore, ethics committee approval is not required. We will disseminate this protocol in a related peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42019147202.

Physiological and Psychological Effects of Forest and Urban Sounds Using High-Resolution Sound Sources

Exposure to natural sounds is known to induce feelings of relaxation; however, only few studies have provided scientific evidence on its physiological effects. This study examined prefrontal cortex and autonomic nervous activities in response to forest sound. A total of 29 female university students (mean age 22.3 ± 2.1 years) were exposed to high-resolution sounds of a forest or city for 60 s, using headphones. Oxyhemoglobin (oxy-Hb) concentrations in the prefrontal cortex were determined by near-infrared spectroscopy. Heart rate, the high-frequency component of heart rate variability (which reflects parasympathetic nervous activity), and the ratio of low-frequency to high-frequency (LF/HF) components (which reflects sympathetic nervous activity) were measured. Subjective evaluation was performed using the modified semantic differential method and profiles of mood states. Exposure to the forest sound resulted in the following significant differences compared with exposure to city sound: decreased oxy-Hb concentrations in the right prefrontal cortex; decreased ln(LF/HF); decreased heart rate; improved feelings described as "comfortable,'' "relaxed," and "natural"; and improved mood states. The findings of this study demonstrated that forest-derived auditory stimulation induced physiological and psychological relaxation effects.