Effects of music therapy on anxiety and physiologic parameters in angiography: a systematic review and meta-analysis

Prospective randomized study on the effect of music on anxiety and pain related to CT-guided percutaneous interventions

BACKGROUND

CT-guided percutaneous interventions may cause patients to experience high levels of stress and anxiety, negatively affecting post-interventional outcomes. Music played during medical interventions has been shown to reduce anxiety and pain, yet the effect of music on patients undergoing interventional radiology procedures has not been evaluated. The aim of this study was to assess whether music played during CT-guided percutaneous interventions may reduce anxiety and pain.

METHODS

This prospective randomized controlled trial included patients undergoing CT-guided transcutaneous procedures. The final analysis included a total of 209 patients, randomized into a music group (MG, n = 107) and a control group (CG, n = 102). Items of state and trait anxiety were analysed using the short form of the State Trait Anxiety Inventory (STAI-6) before and after the procedure. Post-procedural pain was assessed with the numeric rating scale (NRS) with faces.

RESULTS

Patients in the MG exhibited lower anxiety and a greater reduction in anxiety levels as compared to patients in the CG (p < 0.001, respectively). The median change of anxiety was 6.5 ± 3.8 (range: -3 to 14) in the MG versus 3.7 ± 3.5 (range: -6 to 13) in the CG. Post-procedural pain showed a value of 2 ± 2.1 (median, range: 0 to 9) in the MG, versus 6 ± 2.4, (median, range: 0 to 10) in the CG.

CONCLUSION

Exposure to music during CT-guided percutaneous interventions can aid in significantly lowering peri-interventional anxiety and pain and thus improve overall patient care without any negative side effects.

KEY POINTS

Question Does listening to music during CT-guided percutaneous interventions reduce peri-interventional anxiety and pain in patients? Findings This prospective randomized-controlled trial found that patients exposed to music during CT-guided interventions experienced significantly lower levels of anxiety and pain compared to those in a control group. Clinical relevance Incorporating music into CT-guided interventions provides an easy, non-invasive, and cost-effective method to reduce patient anxiety and pain in the clinical setting.

Research protocol for a systematic review and meta-analysis of the effects of music on anxiety and physiological outcomes in patients undergoing bronchoscopy

INTRODUCTION

Bronchoscopy is a routine clinical examination that can cause discomfort and anxiety in patients. This paper presents a protocol for a systematic review and meta-analysis aiming to assess the effect of music on anxiety and physiological outcomes in patients undergoing bronchoscopy.

METHODS

The protocol adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines and has been registered in PROSPERO (CRD42024567398). Our documentary research strategy will involve four databases: PubMed, Google Scholar, Scopus, and the Cochrane Library. In addition, manual searches will be conducted through related articles and references. We will include randomized controlled trials that evaluate the effect of music on patients undergoing bronchoscopy. The primary outcome will be the anxiety level and the secondary outcome will include physiological outcomes. Study selection, data extraction, and quality assessment will be carried out independently by two reviewers. Any discrepancies will be resolved through consultation with a third reviewer. The quality and the risk of bias in the studies will be evaluated using The Joanna Briggs Institute critical appraisal tool. The results of this systematic review will be synthesized to provide an overview on the effectiveness of music on anxiety and physiological parameters in patients during bronchoscopy. If the results are considered acceptable and sufficiently homogeneous, a meta-analysis will be performed to synthesize the findings.

CONCLUSION

The systematic review produced from this protocol will provide evidence on the effectiveness of music for patients undergoing bronchoscopy and will contribute to strengthening the existing body of knowledge on non-pharmacological interventions for anxiety management during medical procedures.

A meta-review of systematic reviews on the effectiveness of music therapy on depression, stress, anxiety and cognitive function in adult's with dementia or cognitive impairment

BACKGROUND

Subjective cognitive impairment has been reported to be associated with depressive symptoms, stress and anxiety in older people. This study examines the impact of music interventions on cognitive functioning, depression, anxiety, and stress for adults with dementia or cognitive impairment.

METHOD

We searched Academic Search Complete, CINAHL, Medline, and PsycINFO without restriction to date. Systematic reviews with or without meta-analysis of music interventions were included. Effect sizes were estimated using standardized mean difference (SMD), weighted mean difference (WMD), mean difference (MD), and Hedges g, as reported. Effect sizes were reported as 〈 0.1 = small effect to 〉 0.5 as large effect.

RESULTS

Twenty systematic reviews were included. There is evidence that music interventions can have effects on cognitive abilities compared to standard care, with a small to large decrease in anxiety.

CONCLUSION

Music interventions might have variable effects on improved cognitive functioning, depression, anxiety and stress.

Raga Bhairavi in virtual reality reduces stress-related psychophysiological markers

The effects of classical music on psychophysiological parameters are not well understood. This study aimed to investigate the impact of listening to raga Bhairavi, an Indian Classical Music for six days on anxiety, stress, depression, and heart rate variability (HRV) parameters. Forty-four individuals were randomly assigned to either the intervention group (VR-raga), where they listened to raga Bhairavi via 360° video in a virtual reality environment, or the control group, where there was no exposure to raga Bhairavi for six days. Before allocation, the HRV baselines (relax-baseline and stress-baseline) were recorded on the first day. On the first and sixth days of the intervention, HRV was monitored, and the Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was administered before and after the intervention. After six days, all DASS-21 subscales were significantly reduced in the VR-raga group. A similar trend was observed in the seven HRV parameters evaluated in this study, which demonstrated reduced physiological stress and enhanced autonomic balance following the six-day intervention. The findings collectively indicated the efficacy of the VR-based raga Bhairavi intervention in reducing psychological stress markers and highlighted the potential applications of utilizing the VR-based raga intervention for improving mental well-being in the real-world context.

Designing and evaluating a mobile app to assist patients undergoing coronary angiography and assessing its impact on anxiety, stress levels, and self-care

BACKGROUND

Coronary artery disease is one of the leading causes of death and disability worldwide. Coronary angiography is a diagnostic procedure used to detect atherosclerosis. Patients typically experience anxiety and stress before and during the angiography procedure. Furthermore, self-care ability is crucial following angiography.

AIM

This study aims to describe the design and evaluation of a mobile application focusing on stress, anxiety, and self-care abilities in patients undergoing coronary angiography.

METHOD

The researchers developed a mobile application for patients undergoing angiography. The application provides information about angiography and tips for enhancing self-care following the procedure. An interventional study was conducted on 70 patients admitted to the angiography ward in hospitals in Kerman, Iran, between 2022 and 2023. The participants were randomly divided into two groups: control and intervention. The interventional group received the intervention application the night before angiography. Two groups completed the Anxiety and Stress Questionnaire (DAS) and Kearney-Flescher Self-Care Survey before the intervention. The researchers used questionnaires that had been prepared and previously utilized in other studies. The two groups completed the anxiety and stress questionnaire within three to six hours and the self-care questionnaire one month after angiography. SPSS 15 software was used for data analysis, with a significance level set at 0.05.

RESULTS

The study found that the majority of participants were women. Before the study, there was no significant difference between the two groups in terms of anxiety, stress, and self-care scores. However, after the study, the intervention group showed a significant decrease in average anxiety and stress scores (p < 0.001). Additionally, compared to the control group, the intervention group demonstrated significant improvement in average self-care score (p < 0.001).

CONCLUSION

According to this study, AP can be effective in influencing the anxiety, stress levels, and self-care ability of patients who undergo coronary angiography. It can help to reduce stress and anxiety while increasing self-care. Instructive software is user-friendly, cost-effective, and can be recommended by nurses and doctors.

Effect of music-based interventions on anxiety and stress-related vital signs in patients undergoing cardiac catheterization: A systematic review and meta-analysis

OBJECTIVES

This work aimed to evaluate the effect of music-based intervention (MBI) on anxiety and stress-related vital signs (heart rate, respiratory rate and blood pressure) in patients undergoing cardiac catheterization.

DESIGN

A systematic review and meta-analysis.

METHODS

This systematic review and meta-analysis was conducted according to PRISMA guidelines. PubMed, Cochrane Library, Embase and CINAHL were systematically searched from inception to October 31, 2023. Two authors independently searched electronic databases, selected literature, extracted data and assessed the risk of bias according to the eligibility criteria. The Review Manager software (RevMan version 5.4.1) was used to perform meta-analysis.

RESULTS

Eleven randomized controlled trials (RCTs) with adult patients (n = 1204) (passive music therapy, 8 studies; passive music listening, 3 studies) were enrolled and brought into qualitative assessment. Nine of these RCTs (n = 868) were taken into quantitative analysis. Meta-analysis using the random-effects model revealed that the difference in the pre-post anxiety level in the music group was significantly greater than that in the control group. However, meta-analysis results for heart rate, respiratory rate, systolic blood pressure and diastolic blood pressure did not show significant differences.

CONCLUSION

The findings suggested that MBI had a significant effect on reducing anxiety in patients undergoing cardiac catheterization. However, the limited quantity and quality of included studies highlight the need for additional research to comprehensively analyze the influence of MBI on anxiety reduction in this patient population.

Music to relieve pain and anxiety in cardiac catheterization: A systematic review and meta-analysis

Objectiveto evaluate the effectiveness of using music to relieve pain, anxiety, and change in vital signs in adult and older adult patients undergoing cardiac catheterization.Methodsthis is a systematic review with meta-analysis carried out in October 2022, using 12 data sources, without time or language restrictions. The study followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The "Risk-of-bias tool" was used to assess the risk of bias, the "R CORE Team program: A language and environment for statistical computing" was used to perform the meta-analysis, and the "Grading of Recommendations Assessment, Development and Evaluation" was used to assess the quality of evidence in the studies.

Results

a total of nine studies were included, totaling 1456 participants. The most used tools for measuring anxiety were the State-Trait Anxiety Inventory and Numerical Rating Scale. This was also used to measure pain, in addition to the Visual Analogue Scale. The use of instrumental, classical and relaxing music prevailed, applied using headphones during the painful procedure, at a frequency of 60 to 100bpm and sound intensity of 60-70 dB. There was statistical significance in the use of music in reducing pain, anxiety and systolic blood pressure.

Conclusion

music interventions are effective in relieving pain, reducing systolic pressure and anxiety, but indifferent in terms of heart rate, respiratory rate and diastolic pressure. They provide humanization of care, can reduce hospital costs and length of hospital stay.

The MULAN Trial - RCT on the use of MUsic in Cath-Lab to reduce ANxiety during peripheral vascular interventions

Background: The purpose was to analyze the use of classical music to reduce procedure-related anxiety while conducting percutaneous transluminal angioplasty in patients with peripheral artery disease. Patients and methods: A total of 155 patients were analyzed in this single center randomized controlled trial. Procedure-related anxiety was assessed by a numerical rating scale (NRS, 0-10) and by recording of physiological parameters at three different points in time. A survey was conducted after the intervention. Results: This study showed that the patients listened to music overcame their procedure-related anxiety more quickly than the patients in the control group. The NRS at second timepoint was significantly reduced in intervention group compared to control group (p<0.01; r=0.2). Most participants stated that they would like to listen to music during possible future interventions. Conclusions: Classical music during endovascular interventions reduced procedure-related anxiety measured as greater reduction in NRS values in intervention group as well as in results of questionnaire performed post procedurally in PAD patients.

Impact of background music listening on anxiety in cancer patients undergoing initial radiation therapy: a randomized clinical trial

BACKGROUND

Patients undergoing radiation therapy (RT) often experience anxiety, which may jeopardize the treatment success. The efficacy of music interventions in reducing anxiety remains contentious. This randomized trial aimed to evaluate the impact of music listening on anxiety symptoms in patients undergoing initial RT.

METHODS

First-time RT patients were randomly allocated to experimental and control groups. The Brief Symptom Rating Scale (BSRS-5), Distress Thermometer (DT), and Beck Anxiety Inventory (BAI-C) were administered pre- and post-RT. Changes in physiological anxiety symptoms were monitored over 10 consecutive days starting from the first day of RT. The experimental group received music during RT; the control group did not. The generalized linear mixed model was used to estimate the pre-post difference in the BSRS-5, DT, and BAI-C scores between the music intervention and control group.

RESULTS

This study included 50 patients each in the experimental and control groups. BSRS-5 and DT scores were significantly reduced in the experimental group post-RT (p = 0.0114 and p = 0.0023, respectively). When music listening was discontinued, these scores rebounded. While the posttest BAI-C score was significantly lower in the experimental group (p < 0.0001), the pre-post difference between the two groups was not significant (p = 0.0619). On cessation of music listening, the BAI-C score also rebounded.

CONCLUSIONS

For cancer patients undergoing initial RT, music listening intervention significantly reduced anxiety symptoms measured using the BSRS-5, DT, and BAI-C scores after two weeks. Our results demonstrate the effectiveness of music listening intervention in reducing anxiety symptoms, thereby potentially improving the quality of life of cancer patients undergoing RT.

Visual art- and music-based interventions as adjuvants in the treatment of eating disorders: a systematic review and a theoretical model

AIM

To assess the effect of visual art- and music-based interventions in the treatment of eating disorders.

METHODS

This study was registered in PROSPERO (CRD42020161503). Six databases (CINAHL, EMBASE, Lilacs, PsycINFO, PubMed and The Cochrane Library) were consulted. The searches were performed on 19 June 2019, and updated on 18 March 2022. No restriction on language, date, or publication status was applied. Methodological quality was assessed using Joanna Briggs Institute's instruments. All steps were performed by two independent reviewers and a third participated in the event of disagreement.

RESULTS

Eight studies were included. Few statistically significant results were found. Overall, both interventions might help to reduce negative emotional states.

CONCLUSION

Visual art- and music-based interventions present limited and inconclusive scientific evidence in patients with eating disorders and therefore their effectiveness is currently unknown. A theoretical model is proposed to guide future research. Further studies are needed to clarify their clinical relevance.

The influence of classical music on learning and memory in rats: a systematic review and meta-analysis

During the learning process, music can activate important neural areas in the brain, promoting the retention of information and memory formation. However, studies testing music effects on memory had found different improvements, which could be due to the methodological differences across studies. Thus, the purpose of this article was to systematically review the literature and meta-analyze the effects of music on Rattus norvegicus' explicit memory (Maze tests) only in controlled investigations. The seven studies included led to a very homogeneous analysis (I2 = 0%), confirming the consistency of the significant standardized mean difference (SMD) between the memory of animals exposed and not exposed to music (SMD 0.60 (95% CI 0.38; 0.83, p < 0.001)). Exploratory analysis suggests music benefits on memory can be acquired when begun at any age, when tested with the three types of mazes evaluated, with exposure lasting from 8 to 83 days and when the age on test day was either under 30 days or over 30 days. To expand the actual understanding of music effects on memory, future studies should investigate different types of music and animal species, with different sex and health conditions, at different time points.

The effects of music intervention on anxiety and stress responses in adults with CHD undergoing cardiac catheterisation

INTRODUCTION

This study evaluated the effect of music intervention on the anxiety and stress responses of patients who underwent an interventional cardiac catheterisation.

METHODS

The study design was a pre- and post-test randomised controlled trial that included 94 patients who underwent a transcatheter atrial septal defect closure. Patients were allocated to receive either music intervention (n = 47) or usual care (n = 47) during the interventional cardiac catheterisation. Music intervention effectiveness was examined in terms of anxiety, salivary cortisol level, and heart rate variability.

RESULTS

The average age of participants was 45.40 years (±16.04) in the experimental group and 47.26 years (±13.83) in the control group. Two-thirds (66.0%) of the participants in each group were women. State anxiety (F = 31.42, p < 0.001), anxiety-numerical rating scale (F = 20.08, p < 0.001), salivary cortisol levels (F = 4.98, p = 0.021), and low-frequency component/high-frequency component ratio (F = 17.31, p < 0.001) in the experimental group were significantly reduced compared with those in the control group at the end of the music intervention.

CONCLUSION

This study provides practical evidence of a reduction in anxiety and stress response from music intervention preceding an interventional cardiac catheterisation, indicating that this intervention should be considered in clinical management.

Cananga odorata Aromatherapy Reduces Anxiety in Unexperienced Patients Hospitalized for Interventional Neuroradiology Procedures: A Randomized Control Trial

The hospitalization and the unfamiliar experiences of patients in interventional radiology procedures cause a moderate to high levels of anxiety. This study was aimed to evaluate the anxiolytic effect of Cananga odorata essential oil (COE) aromatherapy in unexperienced patients hospitalized for interventional neuroradiology (INR) procedures. Forty-four patients admitted for their first INR procedure were randomly divided into COE and placebo control groups. COE or distilled water was dropped onto 2 pieces of mulberry paper and attached to the participant's gown at the shoulder level overnight. The main outcomes were observed from the morning salivary cortisol levels and salivary alpha-amylase activity after intervention. The Thai version of Spielberger State-Trait Anxiety Inventory (STAI) and the vital signs (blood pressure and heart rate) were also assessed before and after COE intervention as the secondary outcome. The demographic and baseline data of both groups did not show any significant difference. After intervention, COE group had a significantly lower salivary alpha-amylase activity than placebo control group. The post-intervention scores of Trait (STAI-T) and State (STAI-S) anxiety were significantly less than those of baseline in both groups. Interestingly, the COE group had a greater percentage reduction on STAI-T after intervention than placebo control group. No significant difference was observed in other outcomes. In addition, the salivary alpha-amylase activity was weak but showed significant correlation with STAI anxiety scores. This study indicates that COE aromatherapy reduces the saliva alpha amylase activity and STAI-T anxiety in unexperienced patients hospitalized for INR procedures.

Characteristics of music intervention to reduce anxiety in patients undergoing cardiac catheterization: scoping review

The characteristics of music interventions for reducing anxiety in patients undergoing cardiac catheterization were mapped. A scoping review was conducted according to the Joanna Briggs Institute methodology. Searches were performed in electronic portals and databases PubMed, CINAHL, PsycINFO, Cochrane, EMBASE, Scopus, LILACS, CAPES Thesis Portal (Brazil), DART-Europe E-theses Portal, Theses Canada Portal, Pro-Quest, and Google Scholar databases, gray literature, with no limitation on the year of publication. Eighteen articles were included in the search. The characteristics of the interventions were heterogeneous and not comprehensively described in the primary studies. The songs were predominantly of a single genre, instrumental, and selected by the interventionist, with a rhythm between 60 and 80 beats per minute. The interventions were delivered in a single session, mostly in the catheterization laboratory, before or during the procedure, by means of digital audio and earphones for over 20 min. The heterogeneity of interventions and incompleteness of information in the studies compromises the advancement of knowledge on the effects of music on health outcomes.

Effect of Indian Music as an Auditory Stimulus on Physiological Measures of Stress, Anxiety, Cardiovascular and Autonomic Responses in Humans-A Randomized Controlled Trial

Among the different anthropogenic stimuli humans are exposed to, the psychological and cardiovascular effects of auditory stimuli are less understood. This study aims to explore the possible range of change after a single session of auditory stimulation with three different ‘Modes’ of musical stimuli (MS) on anxiety, biomarkers of stress, and cardiovascular parameters among healthy young individuals. In this randomized control trial, 140 healthy young adults, aged 18−30 years, were randomly assigned to three MS groups (Mode/Raga Miyan ki Todi, Malkauns, and Puriya) and one control group (natural sounds). The outcome measurements of the State-Trait Anxiety Inventory, salivary alpha-amylase (sAA), salivary cortisol (sCort), blood pressure, and heart rate variability (HRV) were collected at three time points: before (M1), during (M2), and after the intervention (M3). State anxiety was reduced significantly with raga Puriya (p = 0.018), followed by raga Malkauns and raga Miyan Ki Todi. All the groups showed a significant reduction in sAA. Raga Miyan ki Todi and Puriya caused an arousal effect (as evidenced by HRV) during the intervention and significant relaxation after the intervention (both p < 0.005). Raga Malkauns and the control group had a sustained rise in parasympathetic activity over 30 min. Future studies should try to use other modes and features to develop a better scientific foundation for the use of Indian music in medicine.

Effectiveness of music during cardiac catheterization on children's pain, fear, anxiety and vital signs: A randomized, blind controlled trial

PURPOSE

This study aims to examine the effectiveness of music during pediatric cardiac catheterization procedure on children's pain, fear, anxiety and vital signs.

DESIGN AND METHODS

This randomized, blind controlled study was conducted with the guidelines of Consolidated Standards of Reporting Trials (CONSORT). The sample of children was allocated to the Control Group, the Classic Music Group, and the Self-Selected Group. Pain, fear, and anxiety levels were measured before and after the pediatric cardiac catheterization procedure. Vital signs were measured before, during, and after the pediatric cardiac catheterization procedure.

RESULTS

There was no significant difference between the groups in terms of demographic status, pain, fear, or anxiety levels and vital signs before the procedure. In post pediatric cardiac catheterization measurement in the recovery phase, pain, fear levels, anxiety levels, heart rate, systolic and diastolic blood pressure of children in the musical intervention groups were lower than the control group. No statistical difference was found in terms of pain, fear and anxiety levels of the children in groups Classic and Self-Selected.

CONCLUSION AND PRACTICE IMPLICATIONS

The result of this research reveals that musical intervention applied during the pediatric cardiac catheterization procedure in children affects the reduction of pain, fear and anxiety levels and stabilization of vital signs. This intervention could be an effective nonpharmacological method to improve outcomes.Nurses can improve children's comfort by using musical interventions.

CLINICAL REGISTRATION

This study was registered at the U.S. National Library of Medicine Clinical Trials (code: NCT04316754).

A prospective randomized controlled trial assessing the effect of music on patients' anxiety in venous catheter placement procedures

The aim of the study was to assess the influence of music on anxiety levels compared to standard patient care in patients undergoing venous catheter placement procedures. This prospective randomized controlled trial included patients undergoing placement procedures for peripherally inserted central venous catheters (PICC), ports and central venous catheters (CVC). Patients were randomly assigned to a music intervention group (MIG) and a control group (CTRL). State and trait anxiety levels were assessed as primary outcome using the state-trait anxiety inventory (STAI) before and after the procedures. Secondary outcomes comprised averaged heart rate for all participants and time of radiological surveillance for port placement procedures exclusively. 72 participants were included into the final analysis (MIG n = 40; CTRL n = 32). All procedures were successful and no major complications were reported. Mean levels for post-interventional anxieties were significantly lower in the MIG compared to the CTRL (34.9 ± 8.9 vs. 44 ± 12.1; p < 0.001). Mean heart rate in the MIG was significantly lower than in the CTRL (76.1 ± 13.7 vs. 93 ± 8.9; p < 0.001). Procedure time for port implantation was significantly longer in the MIG by 3 min 45 s (p = 0.031). Music exposure during central venous catheter placement procedures highly significantly reduces anxiety and stress levels and can be used to improve patients’ overall experience in the angio suite.

A Proposal for a Data-Driven Approach to the Influence of Music on Heart Dynamics

Electrocardiographic signals (ECG) and heart rate viability measurements (HRV) provide information in a range of specialist fields, extending to musical perception. The ECG signal records heart electrical activity, while HRV reflects the state or condition of the autonomic nervous system. HRV has been studied as a marker of diverse psychological and physical diseases including coronary heart disease, myocardial infarction, and stroke. HRV has also been used to observe the effects of medicines, the impact of exercise and the analysis of emotional responses and evaluation of effects of various quantifiable elements of sound and music on the human body. Variations in blood pressure, levels of stress or anxiety, subjective sensations and even changes in emotions constitute multiple aspects that may well-react or respond to musical stimuli. Although both ECG and HRV continue to feature extensively in research in health and perception, methodologies vary substantially. This makes it difficult to compare studies, with researchers making recommendations to improve experiment planning and the analysis and reporting of data. The present work provides a methodological framework to examine the effect of sound on ECG and HRV with the aim of associating musical structures and noise to the signals by means of artificial intelligence (AI); it first presents a way to select experimental study subjects in light of the research aims and then offers possibilities for selecting and producing suitable sound stimuli; once sounds have been selected, a guide is proposed for optimal experimental design. Finally, a framework is introduced for analysis of data and signals, based on both conventional as well as data-driven AI tools. AI is able to study big data at a single stroke, can be applied to different types of data, and is capable of generalisation and so is considered the main tool in the analysis.

The Effects of Clinical Music Therapy on Resiliency in Adults Undergoing Infusion: A Randomized, Controlled Trial

CONTEXT

Eighty-seven patients newly diagnosed with lung, breast, or gastrointestinal cancer and undergoing chemotherapy in the infusion suite of a large urban hospital in New York City.

OBJECTIVE

Patients were enrolled in this study of music therapy's impact on resilience in coping with the impact of symptoms inclusive of symptom clustering.

METHODS

Patients were randomly assigned to three arms: clinical instrumental improvisation or clinical vocal improvisation 43 subjects to instrumental improvisation or vocal improvisation and 44 subjects to control. All subjects received a Medical Music Psychotherapy Assessment including psychosocial information and music preferences, pre-/post-Resilience Scale, Hospital Anxiety and Depression Scale, Visual Analogue Scale/Faces Scale, and a pain-Color Analysis Scale. Interventions included 20-minute music therapy (MT) and two additional sessions.

RESULTS

Significant increases in Resilience Scale in MT groups after treatment with instrumental and vocal MT interventions equally potent-reflect average changes of 3.4 and 4.83 (P = 0.625), respectively. Although Hospital Anxiety and Depression Scale scores showed little impact of MT on perceived anxiety/depression, a strong correlation is seen between vocal intervention and lower depression scores through Visual Analogue Scale-rendered postsessions. This yielded a significant decrease in pain levels immediately after MT, with the final session showing the most significant change in pain level. Resilience in enduring procedures is a necessary component of combating potential negative illness perception.

CONCLUSION

Our study shows MT's facility to propel resilience in patients newly diagnosed with cancer, particularly when promoting and pairing adaptation toward coping through the expression of perceived negative effects of emotional and physiological symptoms.

Meditation Monologue can Reduce Clinical Injection-Related Anxiety: Randomized Controlled Trial

Background.

Strategies to reduce anxiety prior to injection procedures are not well understood. The purpose is to determine the effect of a meditation monologue intervention delivered via phone/mobile application on pre-injection anxiety levels among patients undergoing a clinical injection. The following hypothesis was tested: patients who listened to a meditation monologue via phone/mobile application prior to clinical injection would experience less anxiety compared to those who did not.

Methods.

A prospective, randomized controlled trial was performed at an orthopedics and sports medicine clinic of a tertiary level medical center in the New England region, USA. Thirty patients scheduled for intra- or peri-articular injections were randomly allocated to intervention (meditation monologue) or placebo (nature sounds) group. Main outcome variables were state and trait anxiety inventory (STAI) scores and blood pressure (BP), heart rate, and respiratory rate.

Results.

There were 16 participants who were allocated to intervention (meditation monologue) while 14 participants were assigned to placebo (nature sounds). There was no interaction effect. However, a main time effect was found. Both state anxiety (STAI-S) and trait anxiety (STAI-T) scores were significantly reduced post-intervention compared to pre-intervention (STAI-S: p = 0.04, STAI-T: p = 0.04). Also, a statistically significant main group effect was detected. The pre- and post- STAI-S score reduction was greater in the intervention group (p = 0.028). Also, a significant diastolic BP increase between pre- and post-intervention was recorded in the intervention group (p = 0.028), but not in the placebo group (p = 0.999).

Conclusion.

Listening to a meditation monologue via phone/mobile application prior to clinical injection can reduce anxiety in adult patients receiving intra- and peri-articular injections. Registration:ClinicalTrials.gov NCT02690194

Music Interventions in Percutaneous Coronary Procedures: A Meta-Analysis

To clarify the effectiveness of music intervention for improving the well-being of patients undergoing coronary procedures for coronary heart disease, we conducted full-text searches of various databases (MEDLINE, Cochrane Library, CINAHL, ProQuest, and Airiti Library; 1966-2019) to identify randomized controlled trials and quasi-experimental studies of music intervention in recipients of angiography or percutaneous coronary intervention. Outcome measures included anxiety, discomfort, pain, heart rate, and blood pressure. The Cochrane methodology, Jadad Quality Score, and ROBINS-I were employed to evaluate evidence from 10 studies. Music intervention reduced anxiety (effect size: Z = 2.15, p = .03; six studies) and discomfort of lying (Z = 2.40, p = .02; two studies), but did not affect pain (Z = 0.94; two studies), heart rate (Z = 0.94; five studies), or blood pressure (systolic, Z = 1.27; diastolic, Z = 1.32; four studies) (all p > .05). The heterogeneity among studies was high. Large-scale, transcultural, high-quality trials are warranted to confirm the benefit of music intervention in patients undergoing coronary procedures.