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Ding S, Wang Q, Fu X, Huang X, Liao L, Zhang Y. Effects of acoustic stimulation on painful procedures in preterm and full-term infants: A systematic review and network meta-analysis. Int J Nurs Stud 2025; 165:105031. [PMID: 40048939 DOI: 10.1016/j.ijnurstu.2025.105031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 02/10/2025] [Accepted: 02/13/2025] [Indexed: 03/30/2025]
Abstract
AIM This study aims to compare and rank the effects of acoustic stimulation on painful procedures in both preterm and full-term infants. METHODS Six databases including Medline, Web of Science, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Embase, and SinoMed, were searched from inception to July, 2023. A Bayesian network meta-analysis with random effects models was performed using R software and Stata 15.0. The quality of included studies was assessed using the Cochrane Collaboration's tool. The study protocol was registered at PROSPERO (Registration number: CRD42023451102). RESULTS A total of 28 studies involving 2624 preterm and full-term infants were included and 8 acoustic stimulation interventions were identified. Regarding pain levels during procedures, maternal voice, maternal voice plus, music therapy and maternal voice plus, music therapy plus, other pharmaceutical interventions, vocal music therapy, white noise, and white noise plus were significantly more effective than control group [standardized mean differences (SMD) ranged from -2.6 to -0.87]. White noise plus was the most effective intervention for reducing pain levels during procedures (90.6 %). Regarding pain levels after procedures (no specific time mentioned), maternal voice, maternal voice plus, music therapy and maternal voice plus, music therapy plus, other pharmaceutical interventions, other non-pharmaceutical interventions, routine care, vocal music therapy, and white noise plus were significantly more effective than control group (SMD ranged from -4.7 to -1.6). Music therapy and maternal voice plus was the most effective intervention for reducing pain levels after procedures, without specific time mentioned (95.29 %). Regarding pain levels 1 min after procedures, only music therapy plus and other pharmaceutical interventions were effective (SMD ranged from -4.5 to -4.9) and music therapy plus was the most effective intervention (93.41 %). No interventions had significant effects on pain levels 3, 5, and 10 min after procedures. Regarding heart rate, only white noise plus could provide a lower increase during procedures. For oxygen saturation, only vocal music therapy could provide a lower decrease after painful procedures (no specific time mentioned). No interventions had significant effects on stabilizing respiratory rate. CONCLUSION This review suggests that multiple acoustic stimulation interventions are effective for pain relief in both preterm and full-term infants undergoing painful procedures. More high quality studies with larger sample size are required to generate evidence regarding the short- and long-term effectiveness and safety of acoustic stimulation interventions on painful procedures.
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Affiliation(s)
- Shenglan Ding
- Birth Room, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and technology of, China
| | - Qingxia Wang
- Birth Room, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and technology of, China
| | - Xiujuan Fu
- Birth Room, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and technology of, China
| | - Xiuhua Huang
- Surgery Intensive Care Unit, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and technology of, China
| | - Luxi Liao
- Birth Room, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and technology of, China
| | - Yilan Zhang
- Birth Room, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and technology of, China.
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Shahbazi F, Fattahi-Darghlou M, Moslehi S, Dabiri-Golchin M, Shahbazi M. Effect of music therapy on behavioral and physiological neonatal outcomes: A systematic review and dose-response meta-analysis. PLoS One 2025; 20:e0316674. [PMID: 39775364 PMCID: PMC11709260 DOI: 10.1371/journal.pone.0316674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 12/14/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Previous studies have documented the effectiveness of music therapy in improving adverse neonatal outcomes in premature infants. However, this review aims to address the question of how long listening to music can enhance these neonatal outcomes. METHODS To conduct this dose-response meta-analysis, we searched the PubMed, Scopus, Web of Science, and Cochrane Library databases. The inclusion criteria comprised randomized clinical trials that investigated the effects of music therapy on improving adverse neonatal outcomes. Preterm infants were defined as those born between 27 and 37 weeks of gestation, as fetuses are known to respond to auditory stimuli starting at the 27th week of pregnancy. The initial search was performed on January 28, 2024, and there were no restrictions on the time frame for the search. Ultimately, we employed a two-stage random effects model using the "drmeta" package in Stata software to perform this dose-response meta-analysis. RESULTS In total, 30 articles (1855 participants) were identified for inclusion in our meta-analysis. According to pooled analysis with each minute increase in music therapy, the means of respiratory rate, pain score, SBP, DBP, behavioral score, and body temperature decrease by 35.3 beats per minutes, 15.3 VAS, 30.7 mmHg, 8.9 mmHg, 2.7, and 0.27°C. On the other hand, with each minute increase in listening to the music, the mean of O2 saturation, heart rate and sleep duration increase 1.7%, 89.2 beats per minutes and 5.081 minutes per day, respectively. CONCLUSION Music therapy improves the neonatal outcomes of O2 saturation, heart rate, respiratory rate, sleep duration, body temperature and systolic and diastolic blood pressures. Therefore, the existence of a dose-response relationship can indicate a causal relationship between music therapy and the improvement of neonatal outcomes.
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Affiliation(s)
- Fatemeh Shahbazi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marzieh Fattahi-Darghlou
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Samad Moslehi
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Minoo Dabiri-Golchin
- Department of Occupational Therapy, University of Manitoba, Winnipeg, MB, Canada
| | - Marjan Shahbazi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Xiang Q, Chen JJ, Feng NN, Li XH. Research progress of music intervention in nursing of premature infants in neonatal intensive care unit. Technol Health Care 2025; 33:555-566. [PMID: 39302405 DOI: 10.3233/thc-241263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
BACKGROUND With the continuous advancement of medical technology, the survival rate of preterm infants is gradually improving, However, due to the underdeveloped function of various organs and systems, preterm infants are often exposed to light, noise, medical as well as nursing operations and other stimuli during their hospitalization in neonatal intensive care unit (NICU); it is highly susceptible to a number of problems, such as pain, unstable vital signs, growth retardation, and sleep disruption. OBJECTIVE This article reviews the research progress of music intervention in nursing of premature infants in NICU with both traditional and conventional care. METHODS This article reviews the research background, methodology/design, and measurement/application effects of music interventions, including Chinese and Western traditional music, in the care of preterm infants in NICU. All scholarly literature retrieved from MEDLINE\PubMed, Science Citation Index Expanded, Google scholar, CNKI scholar, Scopus and PubsHub. RESULTS As a simple and effective non-pharmacological intervention, music intervention can effectively alleviate neonatal surgical pain, increase heart rate and oxygen saturation, promote sleep, growth and development, and improve neurological development. CONCLUSIONS This review provide theoretical references for clinical practice.
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Affiliation(s)
- Qiong Xiang
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
- Institute of Medicine, Medical Research Center, Jishou University, Hunan, China
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Jia-Jia Chen
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Ni-Na Feng
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Xian-Hui Li
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
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Çuhacı AB, Efe YS, Güneş T. The effect of music on pain, comfort, and physiological parameters during premature retinopathy examination. J Pediatr Nurs 2024; 78:149-157. [PMID: 38943838 DOI: 10.1016/j.pedn.2024.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/29/2024] [Accepted: 06/16/2024] [Indexed: 07/01/2024]
Abstract
AIM To determine the effect of music applied during the ROP examination on pain, comfort, and physiological parameters in preterm infants. METHODS The sample of this prospective randomized controlled double-blind experimental study consisted of 28 preterm infants who were examined for ROP of a tertiary hospital in the Neonatal Unit. Data were collected with a Questionnaire, Physiological Parameters Observation Form (PPOF), Revised-Premature Infant Pain Profile (PIPP-R), and Premature Infant Comfort Scale (PICS). RESULTS The results revealed that the crying times of the infants in the experimental group were shorter than the infants in the control group. The preterm infants in the experimental group had statistically lower PIPP-R scores during and after the procedure than the PIPP-R scores of the infants in the control group (p < 0.001) and the music applied to the preterm infants resulted in a mean decrease of 3.857 in the post-procedure and pre-procedure PIPP-R scores (p < 0.05). While there was no statistical difference between the pre-procedure and pre-procedural PICS scores of the preterm infants in the experimental and control groups (p = 0.599; p = 117), the post-procedure PICS values of the preterm infants in the experimental group were found to be lower than those of the control group (p < 0.001). It was found that the music applied to preterm infants during the ROP examination resulted in a mean decrease of 1.286 in PICS scores after the procedure and before the procedure (p < 0.05). CONCLUSION It was determined that the music listened to during the ROP examination decreased the PIPP-R pain scores of preterm infants, had a positive effect on the PICS scores after the procedure, but did not affect the physiological parameters positively. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05263973.
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Affiliation(s)
| | - Yağmur Sezer Efe
- Department of Pediatric Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Türkiye.
| | - Tamer Güneş
- Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Türkiye.
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Ting B, Su CH, Chen DTL, Hsu WT, Tsai CL, Lin PY, Jingling L. The Sound of Memory: Investigating Music Therapy's Cognitive Benefits in Patients with Dementia-A Network Meta-Analysis of Randomized Controlled Trials. J Pers Med 2024; 14:497. [PMID: 38793079 PMCID: PMC11122286 DOI: 10.3390/jpm14050497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Numerous previous studies have shown the effectiveness of music therapy in enhancing cognitive functions in patients with dementia. Despite this, robust evidence in this field, especially concerning the comparison of different music therapy types, is lacking. Therefore, randomized controlled trials (RCTs) focusing on music therapy and cognitive functions in dementia patients, termed by "music" AND "dementia" OR "Alzheimer's disease" AND "cognitive", were identified from primary electronic databases to conduct this network meta-analysis (NMA). The primary outcome focused on the impact on cognitive functions, and the secondary outcome was the comparison of dropout rates between the intervention groups and the usual care control groups. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed for effect evaluation. This study protocol has been registered in IPLASY (INPLASY202430082). A total of 14 RCTs with 1056 participants were enrolled, examining interventions including Active Music Therapy (AMT), Active Music Therapy with Singing (AMT + Sing), Rhythmic Music Therapy (RMT), Listening to Music (LtM), and Singing (Sing). The results indicated that RMT, AMT + Sing, and AMT all significantly improve cognitive functions in dementia patients, of which the SMD were 0.76 (95% CI = 0.32-1.21), 0.79 (95% CI = 0.03-1.49), and 0.57 (0.18-0.96), respectively. Compared with the control group (usual care), no music therapy type was associated with an increased dropout risk. In conclusion, music therapy can improve cognitive functions in patients with dementia without increasing the risk of dropout, particularly RMT, AMT + Sing, and AMT.
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Affiliation(s)
- Berne Ting
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung 404328, Taiwan;
| | - Chen-Hsin Su
- Department of Psychiatry, Chiayi Christian Hospital, Chia-Yi 600566, Taiwan;
| | - Daniel Tzu-Li Chen
- M.D.-Ph.D. Program, College of Medicine, China Medical University, Taichung 404328, Taiwan;
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404328, Taiwan; (W.-T.H.); (C.-L.T.)
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 404327, Taiwan
| | - Wei-Ti Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404328, Taiwan; (W.-T.H.); (C.-L.T.)
- Department of Anesthesiology, China Medical University Hospital, Taichung 404327, Taiwan
| | - Chia-Lin Tsai
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404328, Taiwan; (W.-T.H.); (C.-L.T.)
| | - Pan-Yen Lin
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 404327, Taiwan
- Department of Psychiatry, Wei Gong Memorial Hospital, Miaoli 351498, Taiwan
| | - Li Jingling
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404328, Taiwan; (W.-T.H.); (C.-L.T.)
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Ou Y, Chen L, Zhu X, Zhang T, Zhou Y, Zou L, Gao Y, Wang Z, Zheng X. The effect of music on pain management in preterm infants during daily painful procedures: a systematic review and meta-analysis. Front Pediatr 2024; 12:1351401. [PMID: 38384661 PMCID: PMC10880729 DOI: 10.3389/fped.2024.1351401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Background The present systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to investigate the effects of music on pain management in preterm neonates during painful procedures. Methods The PubMed, Embase, Web of Science, EBSCO and Cochrane Library databases were searched to identify relevant articles published from their inception to September 2023. The study search strategy and all other processes were implemented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results Four RCTs that satisfied the inclusion criteria were included in this meta-analysis. The music group had significantly lower Premature Infant Pain Profile (PIPP) scores during (RR = -1.21; 95% CI = -2.02--0.40, p = 0.0032) and after painful procedures (RR = -0.65; 95% CI = -1.06--0.23, p = 0.002). The music group showed fewer changes in PIPP scores after invasive operations than did the control group (RR = -2.06; 95% CI -3.16--0.96; p = 0.0002). Moreover, our results showed that music improved oxygen saturation during (RR = 3.04, 95% CI = 1.64-4.44, p < 0.0001) and after painful procedures (RR = 3.50, 95% CI = 2.11-4.90, p < 0.00001). However, the change in peak heart rate during and after painful procedures was not statistically significant (RR = -12.14; 95% CI = -29.70-5.41 p = 0.18; RR = -10.41; 95% CI = -22.72-1.90 p = 0.10). Conclusion In conclusion, this systematic review demonstrated that music interventions are effective for relieving procedural pain in preterm infants. Our results indicate that music can reduce stress levels and improve blood oxygen saturation. Due to the current limitations, large-scale, prospective RCTs should be performed to validate the present results.
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Affiliation(s)
- Yiran Ou
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Chen
- Institute of Taoism and Religious Culture, Sichuan University, Chengdu, China
| | - Xinyue Zhu
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China
| | - Tianci Zhang
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China
| | - Ye Zhou
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China
| | - Lu Zou
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Gao
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenghao Wang
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaofeng Zheng
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, China
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Haslbeck FB, Mueller K, Karen T, Loewy J, Meerpohl JJ, Bassler D. Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants. Cochrane Database Syst Rev 2023; 9:CD013472. [PMID: 37675934 PMCID: PMC10483930 DOI: 10.1002/14651858.cd013472.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND Preterm birth interferes with brain maturation, and subsequent clinical events and interventions may have additional deleterious effects. Music as therapy is offered increasingly in neonatal intensive care units aiming to improve health outcomes and quality of life for both preterm infants and the well-being of their parents. Systematic reviews of mixed methodological quality have demonstrated ambiguous results for the efficacy of various types of auditory stimulation of preterm infants. A more comprehensive and rigorous systematic review is needed to address controversies arising from apparently conflicting studies and reviews. OBJECTIVES We assessed the overall efficacy of music and vocal interventions for physiological and neurodevelopmental outcomes in preterm infants (< 37 weeks' gestation) compared to standard care. In addition, we aimed to determine specific effects of various interventions for physiological, anthropometric, social-emotional, neurodevelopmental short- and long-term outcomes in the infants, parental well-being, and bonding. SEARCH METHODS We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, RILM Abstracts, and ERIC in November 2021; and Proquest Dissertations in February 2019. We searched the reference lists of related systematic reviews, and of studies selected for inclusion and clinical trial registries. SELECTION CRITERIA We included parallel, and cluster-randomised controlled trials with preterm infants < 37 weeks` gestation during hospitalisation, and parents when they were involved in the intervention. Interventions were any music or vocal stimulation provided live or via a recording by a music therapist, a parent, or a healthcare professional compared to standard care. The intervention duration was greater than five minutes and needed to occur more than three times. DATA COLLECTION AND ANALYSIS Three review authors independently extracted data. We analysed the treatment effects of the individual trials using RevMan Web using a fixed-effects model to combine the data. Where possible, we presented results in meta-analyses using mean differences with 95% CI. We performed heterogeneity tests. When the I2 statistic was higher than 50%, we assessed the source of the heterogeneity by sensitivity and subgroup analyses. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included 25 trials recruiting 1532 infants and 691 parents (21 parallel-group RCTs, four cross-over RCTs). The infants gestational age at birth varied from 23 to 36 weeks, taking place in NICUs (level 1 to 3) around the world. Within the trials, the intervention varied widely in type, delivery, frequency, and duration. Music and voice were mainly characterised by calm, soft, musical parameters in lullaby style, often integrating the sung mother's voice live or recorded, defined as music therapy or music medicine. The general risk of bias in the included studies varied from low to high risk of bias. Music and vocal interventions compared to standard care Music/vocal interventions do not increase oxygen saturation in the infants during the intervention (mean difference (MD) 0.13, 95% CI -0.33 to 0.59; P = 0.59; 958 infants, 10 studies; high-certainty evidence). Music and voice probably do not increase oxygen saturation post-intervention either (MD 0.63, 95% CI -0.01 to 1.26; P = 0.05; 800 infants, 7 studies; moderate-certainty evidence). The intervention may not increase infant development (Bayley Scales of Infant and Toddler Development (BSID)) with the cognitive composition score (MD 0.35, 95% CI -4.85 to 5.55; P = 0.90; 69 infants, 2 studies; low-certainty evidence); the motor composition score (MD -0.17, 95% CI -5.45 to 5.11; P = 0.95; 69 infants, 2 studies; low-certainty evidence); and the language composition score (MD 0.38, 95% CI -5.45 to 6.21; P = 0.90; 69 infants, 2 studies; low-certainty evidence). Music therapy may not reduce parental state-trait anxiety (MD -1.12, 95% CI -3.20 to 0.96; P = 0.29; 97 parents, 4 studies; low-certainty evidence). The intervention probably does not reduce respiratory rate during the intervention (MD 0.42, 95% CI -1.05 to 1.90; P = 0.57; 750 infants; 7 studies; moderate-certainty evidence) and post-intervention (MD 0.51, 95% CI -1.57 to 2.58; P = 0.63; 636 infants, 5 studies; moderate-certainty evidence). However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention (MD -1.38, 95% CI -2.63 to -0.12; P = 0.03; 1014 infants; 11 studies; moderate-certainty evidence). This beneficial effect was even stronger after the intervention. Music/vocal interventions reduce heart rate post-intervention (MD -3.80, 95% CI -5.05 to -2.55; P < 0.00001; 903 infants, 9 studies; high-certainty evidence) with wide CIs ranging from medium to large beneficial effects. Music therapy may not reduce postnatal depression (MD 0.50, 95% CI -1.80 to 2.81; P = 0.67; 67 participants; 2 studies; low-certainty evidence). The evidence is very uncertain about the effect of music therapy on parental state anxiety (MD -0.15, 95% CI -2.72 to 2.41; P = 0.91; 87 parents, 3 studies; very low-certainty evidence). We are uncertain about any further effects regarding all other secondary short- and long-term outcomes on the infants, parental well-being, and bonding/attachment. Two studies evaluated adverse effects as an explicit outcome of interest and reported no adverse effects from music and voice. AUTHORS' CONCLUSIONS Music/vocal interventions do not increase oxygen saturation during and probably not after the intervention compared to standard care. The evidence suggests that music and voice do not increase infant development (BSID) or reduce parental state-trait anxiety. The intervention probably does not reduce respiratory rate in preterm infants. However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention, and this beneficial effect is even stronger after the intervention, demonstrating that music/vocal interventions reduce heart rates in preterm infants post-intervention. We found no reports of adverse effects from music and voice. Due to low-certainty evidence for all other outcomes, we could not draw any further conclusions regarding overall efficacy nor the possible impact of different intervention types, frequencies, or durations. Further research with more power, fewer risks of bias, and more sensitive and clinically relevant outcomes are needed.
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Affiliation(s)
| | - Katharina Mueller
- Zentrum für Kinder und Jugendmedizin, University Freiburg, Freiburg, Germany
| | - Tanja Karen
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Joanne Loewy
- Mount Sinai Health System, The Louis Armstrong Center for Music & Medicine, New York City, USA
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
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Belpınar A, Yayan EH. Effect of Yakson touch and mother's voice on pain and comfort level during nasal CPAP application in Turkey: A randomized controlled study. Explore (NY) 2023; 19:743-748. [PMID: 36872192 DOI: 10.1016/j.explore.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/31/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023]
Abstract
PURPOSE This study was conducted to evaluate the effects of Yakson touch and mother's voice on pain and comfort levels of preterm infants during nasal CPAP application. DESIGN AND METHODS The study was conducted as a randomized experimental study with a control group. It included 124 premature infants (mother's voice group = 31, Yakson touch group = 31, mother's voice+ Yakson touch group= 31, control group = 31) of 28-37 weeks of age who had nasal CPAP application in the NICU of a state hospital in souteastern Turkey between April 2019 and August 2020. While the infants in the experimental group received mother's voice, Yakson touch, and mother's voice+ Yakson touch procedures before, during and after nasal CPAP application, the infants in the control group received nasal CPAP application without extra intervention. "Newborn Infant Pain Scale (NIPS)" and "Premature Infant Comfort Scale (PICS)" were used to collect data. RESULTS Further analysis revealed that the Yakson Touch was the most beneficial intervention for reducing NIPS scores and PICS scores during and after nasal CPAP application in the experimental groups, followed by mother's voice + Yakson touch and lastly mother's voice. CONCLUSION Yakson touch and mother's voice+Yakson touch methods, are effective in neonatal pain and comfort management during and after the nasal CPAP application.
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Affiliation(s)
- Ayşe Belpınar
- Department of Medical Services and Techniques, Vocational School of Health Services, Yozgat Bozok University, Yozgat, Turkey
| | - Emriye Hilal Yayan
- Pediatric Nursing Department, Faculty of Nursing, İnönü University, Malatya, Turkey
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Pillai Riddell RR, Bucsea O, Shiff I, Chow C, Gennis HG, Badovinac S, DiLorenzo-Klas M, Racine NM, Ahola Kohut S, Lisi D, Turcotte K, Stevens B, Uman LS. Non-pharmacological management of infant and young child procedural pain. Cochrane Database Syst Rev 2023; 6:CD006275. [PMID: 37314064 PMCID: PMC10265939 DOI: 10.1002/14651858.cd006275.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite evidence of the long-term implications of unrelieved pain during infancy, it is evident that infant pain is still under-managed and unmanaged. Inadequately managed pain in infancy, a period of exponential development, can have implications across the lifespan. Therefore, a comprehensive and systematic review of pain management strategies is integral to appropriate infant pain management. This is an update of a previously published review update in the Cochrane Database of Systematic Reviews (2015, Issue 12) of the same title. OBJECTIVES To assess the efficacy and adverse events of non-pharmacological interventions for infant and child (aged up to three years) acute pain, excluding kangaroo care, sucrose, breastfeeding/breast milk, and music. SEARCH METHODS For this update, we searched CENTRAL, MEDLINE-Ovid platform, EMBASE-OVID platform, PsycINFO-OVID platform, CINAHL-EBSCO platform and trial registration websites (ClinicalTrials.gov; International Clinical Trials Registry Platform) (March 2015 to October 2020). An update search was completed in July 2022, but studies identified at this point were added to 'Awaiting classification' for a future update. We also searched reference lists and contacted researchers via electronic list-serves. We incorporated 76 new studies into the review. SELECTION CRITERIA: Participants included infants from birth to three years in randomised controlled trials (RCTs) or cross-over RCTs that had a no-treatment control comparison. Studies were eligible for inclusion in the analysis if they compared a non-pharmacological pain management strategy to a no-treatment control group (15 different strategies). In addition, we also analysed studies when the unique effect of adding a non-pharmacological pain management strategy onto another pain management strategy could be assessed (i.e. additive effects on a sweet solution, non-nutritive sucking, or swaddling) (three strategies). The eligible control groups for these additive studies were sweet solution only, non-nutritive sucking only, or swaddling only, respectively. Finally, we qualitatively described six interventions that met the eligibility criteria for inclusion in the review, but not in the analysis. DATA COLLECTION AND ANALYSIS: The outcomes assessed in the review were pain response (reactivity and regulation) and adverse events. The level of certainty in the evidence and risk of bias were based on the Cochrane risk of bias tool and the GRADE approach. We analysed the standardised mean difference (SMD) using the generic inverse variance method to determine effect sizes. MAIN RESULTS: We included total of 138 studies (11,058 participants), which includes an additional 76 new studies for this update. Of these 138 studies, we analysed 115 (9048 participants) and described 23 (2010 participants) qualitatively. We described qualitatively studies that could not be meta-analysed due to being the only studies in their category or statistical reporting issues. We report the results of the 138 included studies here. An SMD effect size of 0.2 represents a small effect, 0.5 a moderate effect, and 0.8 a large effect. The thresholds for the I2 interpretation were established as follows: not important (0% to 40%); moderate heterogeneity (30% to 60%); substantial heterogeneity (50% to 90%); considerable heterogeneity (75% to 100%). The most commonly studied acute procedures were heel sticks (63 studies) and needlestick procedures for the purposes of vaccines/vitamins (35 studies). We judged most studies to have high risk of bias (103 out of 138), with the most common methodological concerns relating to blinding of personnel and outcome assessors. Pain responses were examined during two separate pain phases: pain reactivity (within the first 30 seconds after the acutely painful stimulus) and immediate pain regulation (after the first 30 seconds following the acutely painful stimulus). We report below the strategies with the strongest evidence base for each age group. In preterm born neonates, non-nutritive sucking may reduce pain reactivity (SMD -0.57, 95% confidence interval (CI) -1.03 to -0.11, moderate effect; I2 = 93%, considerable heterogeneity) and improve immediate pain regulation (SMD -0.61, 95% CI -0.95 to -0.27, moderate effect; I2 = 81%, considerable heterogeneity), based on very low-certainty evidence. Facilitated tucking may also reduce pain reactivity (SMD -1.01, 95% CI -1.44 to -0.58, large effect; I2 = 93%, considerable heterogeneity) and improve immediate pain regulation (SMD -0.59, 95% CI -0.92 to -0.26, moderate effect; I2 = 87%, considerable heterogeneity); however, this is also based on very low-certainty evidence. While swaddling likely does not reduce pain reactivity in preterm neonates (SMD -0.60, 95% CI -1.23 to 0.04, no effect; I2 = 91%, considerable heterogeneity), it has been shown to possibly improve immediate pain regulation (SMD -1.21, 95% CI -2.05 to -0.38, large effect; I2 = 89%, considerable heterogeneity), based on very low-certainty evidence. In full-term born neonates, non-nutritive sucking may reduce pain reactivity (SMD -1.13, 95% CI -1.57 to -0.68, large effect; I2 = 82%, considerable heterogeneity) and improve immediate pain regulation (SMD -1.49, 95% CI -2.20 to -0.78, large effect; I2 = 92%, considerable heterogeneity), based on very low-certainty evidence. In full-term born older infants, structured parent involvement was the intervention most studied. Results showed that this intervention has little to no effect in reducing pain reactivity (SMD -0.18, 95% CI -0.40 to 0.03, no effect; I2 = 46%, moderate heterogeneity) or improving immediate pain regulation (SMD -0.09, 95% CI -0.40 to 0.21, no effect; I2 = 74%, substantial heterogeneity), based on low- to moderate-certainty evidence. Of these five interventions most studied, only two studies observed adverse events, specifically vomiting (one preterm neonate) and desaturation (one full-term neonate hospitalised in the NICU) following the non-nutritive sucking intervention. The presence of considerable heterogeneity limited our confidence in the findings for certain analyses, as did the preponderance of evidence of very low to low certainty based on GRADE judgements. AUTHORS' CONCLUSIONS Overall, non-nutritive sucking, facilitated tucking, and swaddling may reduce pain behaviours in preterm born neonates. Non-nutritive sucking may also reduce pain behaviours in full-term neonates. No interventions based on a substantial body of evidence showed promise in reducing pain behaviours in older infants. Most analyses were based on very low- or low-certainty grades of evidence and none were based on high-certainty evidence. Therefore, the lack of confidence in the evidence would require further research before we could draw a definitive conclusion.
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Affiliation(s)
| | - Oana Bucsea
- Department of Psychology, York University, Toronto, Canada
| | - Ilana Shiff
- Department of Psychology, York University, Toronto, Canada
| | - Cheryl Chow
- Department of Psychology, York University, Toronto, Canada
| | | | | | | | - Nicole M Racine
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Sara Ahola Kohut
- Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Canada
| | - Diana Lisi
- Department of Psychology, University of British Columbia Okanagan, Kelowna, Canada
| | - Kara Turcotte
- Department of Psychology, University of British Columbia Okanagan, Kelowna, Canada
| | - Bonnie Stevens
- Nursing Research, The Hospital for Sick Children, Toronto, Canada
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10
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Bekar P, Efe E. Effects of mother-sung lullabies on vaccination-induced infant pain and maternal anxiety: A randomized controlled trial. J Pediatr Nurs 2022; 65:e80-e86. [PMID: 35341657 DOI: 10.1016/j.pedn.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to investigate the effects of mother-sung lullabies during vaccination on vaccine-induced pain in infants and anxiety in mothers. DESIGN AND METHODS Our team conducted a randomized controlled trial with two parallel groups between March 4, 2020 and August 28, 2020, at two family health centers in Turkey. This study included 60 healthy-term infants (lullaby group: 30, control group: 30) aged two months, who received the Bacillus Calmette-Guérin (BCG) vaccine, and their mothers. We used the Information Form, the Neonatal Infant Pain Scale, the Intervention Follow-Up Form (including heart rate, oxygen saturation, and crying duration), and the State Anxiety Inventory as data collection tools. RESULTS Infants in the lullaby group had significantly decreased pain responses than those in the control group (p < .05). Further, singing a lullaby resulted in significantly reduced maternal anxiety in the lullaby group compared to the control group (p < .05). CONCLUSIONS The lullaby singing method was effective for reducing infants' pain response and mothers' anxiety during vaccination. PRACTICE IMPLICATIONS The lullaby method can be used to reduce pain during potentially painful procedures performed in infants and reduce anxiety in mothers. The study is registered under the ClinicalTrials.gov identifier NCT04692584.
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Affiliation(s)
- Pınar Bekar
- Burdur Mehmet Akif Ersoy University, Bucak School of Health, Department of Child Development, Bucak/Burdur, Turkey.
| | - Emine Efe
- Akdeniz University, Nursing Faculty, Department of Child Health and Diseases Nursing, 07058, Campus, Antalya, Turkey.
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11
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Zhang TT, Fan Z, Xu SZ, Guo ZY, Cai M, Li Q, Tang YL, Wang LW, Chen X, Tang LJ, Li ZY, Wen Y. The effects of music therapy on peripherally inserted central catheter in hospitalized children with leukemia. J Psychosoc Oncol 2022; 41:76-86. [PMID: 35695058 DOI: 10.1080/07347332.2022.2044967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
To explore the effect of music therapy on children with leukemia who have peripherally inserted central catheters (PICC). In this study, we divided 107 patients undergoing PICC into music group (47 cases) and control group (60 cases). The music group received music therapy during PICC, while the control group was given no complementary treatment. The total length of catheterization, the use of sedatives and the changes of pain level and emotion level before and after PICC placement were compared between two groups. Compared with the control group, the total PICC placement time of the music group was significantly shorter (35(30-40) vs. 60(60-60); Z = -8.307; p < 0.001), and the use of sedative medications was also significantly reduced (4.35% (n = 2) vs. 91.84% (n = 45); p < 0.001). Moreover, the pain of catheterization was significantly alleviated. The median difference of pain scores of the music group was significantly less (2(1-3) vs. 5(5-5); p < 0.001). The mood of patients was also improved. The median difference of emotional scores of the music group was significantly more (5(4.75-6) vs. 3(3-3); p < 0.001) than the control group. Music therapy is effective to use in PICC. It can shorten the treatment time, reduce the use of sedative medications, and improve the children's emotion and pain response significantly, which is worth clinical application.
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Affiliation(s)
- Ting-Ting Zhang
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhong Fan
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shu-Zhen Xu
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | | | - Min Cai
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiong Li
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan-Lai Tang
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li-Wei Wang
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xi Chen
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li-Jun Tang
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi-Ying Li
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yun Wen
- Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Music and Reflection, Inc, Guangzhou, China.,Children's Palace of Guangzhou, Guangzhou, China
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12
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Costa VS, Bündchen DC, Sousa H, Pires LB, Felipetti FA. Clinical benefits of music-based interventions on preterm infants' health: A systematic review of randomised trials. Acta Paediatr 2022; 111:478-489. [PMID: 34919292 DOI: 10.1111/apa.16222] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/26/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
AIM This systematic review aimed to differentiate and isolate the results of different music-based interventions used with preterm infants in the neonatal intensive care unit and explore their clinical benefits. METHODS The last search was performed on 5 July 2021 on Web of Science, Scopus, EMBASE, PsycINFO, CINAHL, LILACS and CENTRAL. Only randomised clinical trials that explored the health benefits of music-based interventions were considered. RESULTS A total of 39 studies were included. All music-based interventions were divided into music medicine and music therapy. The overall results suggested that music medicine interventions were associated with a significant improvement in pain relief; in turn, improvements in cardiac and respiratory function, weight gain, eating behaviour, and quiet alert and sleep states were more consistent in studies that followed a music therapy approach with the presence of a music therapist. CONCLUSION This review supports the beneficial effects of music-based interventions on the health of preterm infants in a neonatal intensive care unit; however, it also offers suggestions for future studies in order to increase the number of interventions with music therapists, since the results of music therapy approaches were more consistent for physiological and behavioural outcomes.
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Affiliation(s)
- Victor Seabra Costa
- Department of Health Sciences Federal University of Santa Catarina (UFSC) Araranguá Brazil
| | | | - Helena Sousa
- Department of Education and Psychology Center for Health Technology and Services Research (CINTESIS.UA) University of Aveiro Aveiro Portugal
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13
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Ting B, Tsai CL, Hsu WT, Shen ML, Tseng PT, Chen DTL, Su KP, Jingling L. Music Intervention for Pain Control in the Pediatric Population: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:991. [PMID: 35207263 PMCID: PMC8877634 DOI: 10.3390/jcm11040991] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023] Open
Abstract
Music intervention (MI) has been applied as an effective adjunctive treatment for pain control in various clinical settings. However, no meta-analysis has yet been published on the analgesic effects of MI in infants and children. We performed a systematic review of PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify randomized controlled trials (RCTs) with the keywords "pain" AND "music therapy" from inception to January 2022. Primary outcomes were pain intensity and vital signs. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed using a random effect model. Subgroup analyses with age groups, types of pain, and music styles were conducted. A total of 38 RCTs involving 5601 participants met the selection criteria. MI significantly decreased the pain levels (SMD = -0.57, p < 0.001), both in the newborn group (p = 0.007) and in the infant/children group (p < 0.001). MI significantly reduced heart rate (SMD = -0.50, p < 0.001) and respiratory rate (SMD = -0.60, p = 0.002) and increased peripheral capillary oxygen saturation (SMD = 0.44, p < 0.001). In subgroup analyses of types of pain, MI had significant effects on prick pain (p = 0.003), chronic and procedural pain (p < 0.001), and postoperative pain (p = 0.018). As for music styles, significant analgesic effects were observed for classical music (p < 0.001), kids' music (p < 0.001), and pop music (p = 0.001), but not for world music (p = 0.196), special composition (p = 0.092), and multiple music combinations (p = 0.420). In conclusion, our analysis provides supportive evidence about the efficacy of MI, especially classical, kids', and pop music, in controlling prick, procedural, and postoperative pain in the pediatric population.
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Affiliation(s)
- Berne Ting
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung 404, Taiwan;
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan; (C.-L.T.); (D.T.-L.C.)
| | - Chia-Lin Tsai
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan; (C.-L.T.); (D.T.-L.C.)
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404, Taiwan;
| | - Wei-Ti Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404, Taiwan;
- Department of Anesthesiology, China Medical University Hospital, Taichung 404, Taiwan
| | | | - Ping-Tao Tseng
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan;
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan
| | - Daniel Tzu-Li Chen
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan; (C.-L.T.); (D.T.-L.C.)
- M.D.-Ph.D. Program, College of Medicine, China Medical University, Taichung 404, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Kuan-Pin Su
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 404, Taiwan; (C.-L.T.); (D.T.-L.C.)
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404, Taiwan;
- M.D.-Ph.D. Program, College of Medicine, China Medical University, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan
| | - Li Jingling
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404, Taiwan;
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Corrigan MJ, Keeler JR, Miller HD, Ben Khallouq BA, Fowler SB. Music therapy and retinopathy of prematurity screening: using recorded maternal singing and heartbeat for post exam recovery. J Perinatol 2020; 40:1780-1788. [PMID: 32681063 DOI: 10.1038/s41372-020-0719-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/27/2020] [Accepted: 07/07/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Explore a music therapy (MT) intervention to support infant recovery post retinopathy of prematurity (ROP) exam. STUDY DESIGN Prospective, double-masked, randomized, parallel group study of 100 preterm infants exposed to MT (recorded maternal singing/heartbeat) or standard care (SC). Premature Infant Pain Profile (PIPP) measured at: baseline, during the exam, and 1 and 5 min post exam. RESULTS Recovery PIPP scores were less with MT vs. SC, but statistical significance not achieved (Mean ± sd: MT 1 min [5.81 ± 2.93] and 5 min [3.91 ± 1.73] vs. SC 1 min [6.40 ± 2.78] and 5 min [4.76 ± 2.07], p = 0.07). Recovery PIPP sores were significantly higher with SC compared to MT when eye exams were longer (p = 0.049) or when exams were more painful (p = 0.04). CONCLUSION Recorded maternal singing and heartbeat can support recovery post ROP exam. For longer/more painful ROP exams, MT may be more effective than SC promoting recovery post exam.
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Affiliation(s)
- Maxwell J Corrigan
- Orlando Health Winnie Palmer Hospital for Women & Babies, Alexander Center for Neonatology, Orlando, FL, USA.
| | - Jason R Keeler
- Orlando Health Winnie Palmer Hospital for Women & Babies, Alexander Center for Neonatology, Orlando, FL, USA
| | - Harriet D Miller
- Orlando Health Winnie Palmer Hospital for Women & Babies, Alexander Center for Neonatology, Orlando, FL, USA.,Orlando Health Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Bertha A Ben Khallouq
- Orlando Health Arnold Palmer Hospital for Children, Orlando, FL, USA.,University of Central Florida, College of Sciences, Orlando, FL, USA
| | - Susan B Fowler
- Orlando Health, Center for Nursing Research, Orlando, FL, USA.,Walden University, Baltimore, MD, USA.,Thomas Edison State University, Trenton, NJ, USA
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Barandouzi ZA, Keshavarz M, Montazeri A, Ashayeri H, Rajaei Z. Comparison of the analgesic effect of oral sucrose and/or music in preterm neonates: A double-blind randomized clinical trial. Complement Ther Med 2019; 48:102271. [PMID: 31987233 DOI: 10.1016/j.ctim.2019.102271] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 10/19/2019] [Accepted: 11/26/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To compare the analgesic effects of sucrose, music, and their combination on venipuncture's pain in preterm neonates. METHODOLOGY A double-blinded randomized control trial conducted at a Neonatal Intensive Care Unit (NICU) affiliated to Tehran University of Medical Sciences (TUMS) in Tehran, Iran. One hundred and twenty preterm neonates were randomly allocated into three experimental (sucrose, music and combination of sucrose and music) and one control groups (n = 30 for each group). Two minutes before the venipuncture, 0.5 ml of oral 24% sucrose was provided for the sucrose and combination groups. The combination group additionally received lullaby music as same as the music group. The control group had headphones without playing music and received sterile water. Blinded assessment of the Premature Infant Pain Profile (PIPP) was performed before and during venipuncture, as well as 30 s and 10 min and 10 min after its completion. RESULTS The pain scores during venipuncture in the sucrose and combination groups were significantly lower than the control group (p = .003, p < .001, respectively) but not in the music group. Thirty seconds after the end of the venipuncture, the pain score in the three intervention groups was significantly lower than the control group (sucrose, music and, combination group, p < .001, p = .009, p < .001, respectively). Ten min after the venipuncture, there was no significant difference in pain scores among the four groups. CONCLUSION Music could relief pain 30 s after the venipuncture completion but not during the venipuncture. A more prolonged period of playing music is recommended to evaluate the analgesic effects of music in preterm neonates in future studies.
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Affiliation(s)
| | - Maryam Keshavarz
- Midwifery and Reproductive Health Department, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
| | - Hassan Ashayeri
- Rehabilitation Department, Iran University of Medical Sciences, Tehran, Iran.
| | - Zahra Rajaei
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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