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Bruder AL, Gururaja A, Narayani N, Kleinpell R, Schlesinger JJ. Patients' Perceptions of Virtual Live Music in the Intensive Care Unit. Am J Crit Care 2024; 33:54-59. [PMID: 38161170 DOI: 10.4037/ajcc2024140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Implementing music in the intensive care unit has increased in popularity because the environment can be stressful and anxiety inducing for many patients. In hospital settings, therapeutic music can be beneficial for patients' well-being and recovery. Although live music typically involves a face-to-face encounter between the musician and patient, the COVID-19 pandemic has prompted a change to virtual live therapeutic music, using technology to present music in real time (eg, with a tablet computer). OBJECTIVE To generate novel findings regarding patients' perceptions of virtual live therapeutic music, which has been little studied compared with live or recorded music.. METHODS Fifty patients in Vanderbilt University Medical Center intensive care units listened to virtual live music played by a volunteer musician via an online video communication platform. Patients' responses to 5 survey questions were transcribed and analyzed qualitatively and quantitatively using data analysis software. RESULTS Seven major themes describing the familiarity and significance of music for patients were identified. Forty-seven patients (94%) experienced positive emotions from the music, 46 (92%) indicated that music was a significant part of their lives, 28 (56%) accessed a cherished memory, and 45 (90%) indicated that they would not change anything. CONCLUSIONS Therapeutic virtual music was well received and provided tangible benefits to patients. Additional research would provide information on patients' outcomes and differences between live and virtual live music.
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Affiliation(s)
- Alexandra L Bruder
- Alexandra L. Bruder is a medical student at the Ohio State University College of Medicine, Columbus, and was a lead research assistant, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee during the study
| | - Akash Gururaja
- Akash Gururaja is a research associate, Department of Anesthesiology, Vanderbilt University Medical Center
| | - Nikita Narayani
- Nikita Narayani is a research associate, Department of Anesthesiology, Vanderbilt University Medical Center
| | - Ruth Kleinpell
- Ruth Kleinpell is an associate dean for clinical scholarship and a professor, Vanderbilt University School of Nursing, Nashville
| | - Joseph J Schlesinger
- Joseph J. Schlesinger is a professor of anesthesiology and critical care medicine, Department of Anesthesiology, Vanderbilt University Medical Center
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Part I: The Effects of Music for the Symptom Management of Anxiety, Pain, and Insomnia in Critically Ill Patients: An Integrative Review of Current Literature. Dimens Crit Care Nurs 2018; 36:234-243. [PMID: 28570377 DOI: 10.1097/dcc.0000000000000254] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Critical care environments are known for provoking anxiety, pain, and sleeplessness. Often, these symptoms are attributed to patients' underlying physiological conditions; life-sustaining or life-prolonging treatments such as ventilators, invasive procedures, tubes, and monitoring lines; and noise and the fast-paced technological nature of the critical care environment. This, in turn, possibly increases length of stay and morbidity and challenges the recovery and healing of critically ill patients. Complementary therapies can be used as adjunctive therapies alongside pharmacological interventions and modalities. One complementary therapy with promise in critical care for improving symptoms of anxiety, pain, and sleeplessness is music. A review of current literature from Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and PubMed was conducted to examine the evidence for the use of this complementary therapy in critical care settings. This review presents the evidence on effectiveness of music for the symptom management of anxiety, pain, and insomnia in critically ill adult patients. The evidence from this review supports music in symptom management of pain, insomnia, and anxiety in critically ill patients. This review provides practice recommendations, generates dialog, and promotes future research. This review is part I of a 2-part series that focuses on evidence for use of music, aromatherapy and guided imagery for improving anxiety, pain, and sleeplessness of patients in critically ill patients.
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Supnet C, Crow A, Stutzman S, Olson D. Music as Medicine: The Therapeutic Potential of Music for Acute Stroke Patients. Crit Care Nurse 2018; 36:e1-7. [PMID: 27037347 DOI: 10.4037/ccn2016413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Nurses caring for patients with acute stroke are likely to administer both music and medication with therapeutic intent. The administration of medication is based on accumulated scientific evidence and tailored to the needs of each patient. However, the therapeutic use of music is generally based on good intentions and anecdotal evidence. This review summarizes and examines the current literature regarding the effectiveness of music in the treatment of critically ill patients and the use of music in neurologically injured patients. The rationale for hypothesis-driven research to explore therapeutic music intervention in acute stroke is compelling.
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Affiliation(s)
- Charlene Supnet
- Charlene Supnet is an experienced basic/clinical neuroscience researcher and writer for the Department of Neurology and Neurotherapeutics and the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.April Crow is a nurse in the inpatient rehabilitation unit of Zale Lipshy University Hospital, Dallas, Texas.Sonja Stutzman is the clinical research manager for the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center. Additionally, she coordinates several acute studies in the neuroscience intensive care unit.DaiWai Olson is an associate professor and director of the Neuroscience Nursing Research Center at University of Texas Southwestern
| | - April Crow
- Charlene Supnet is an experienced basic/clinical neuroscience researcher and writer for the Department of Neurology and Neurotherapeutics and the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.April Crow is a nurse in the inpatient rehabilitation unit of Zale Lipshy University Hospital, Dallas, Texas.Sonja Stutzman is the clinical research manager for the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center. Additionally, she coordinates several acute studies in the neuroscience intensive care unit.DaiWai Olson is an associate professor and director of the Neuroscience Nursing Research Center at University of Texas Southwestern
| | - Sonja Stutzman
- Charlene Supnet is an experienced basic/clinical neuroscience researcher and writer for the Department of Neurology and Neurotherapeutics and the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.April Crow is a nurse in the inpatient rehabilitation unit of Zale Lipshy University Hospital, Dallas, Texas.Sonja Stutzman is the clinical research manager for the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center. Additionally, she coordinates several acute studies in the neuroscience intensive care unit.DaiWai Olson is an associate professor and director of the Neuroscience Nursing Research Center at University of Texas Southwestern
| | - DaiWai Olson
- Charlene Supnet is an experienced basic/clinical neuroscience researcher and writer for the Department of Neurology and Neurotherapeutics and the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center, Dallas, Texas.April Crow is a nurse in the inpatient rehabilitation unit of Zale Lipshy University Hospital, Dallas, Texas.Sonja Stutzman is the clinical research manager for the Neuroscience Nursing Research Center, University of Texas Southwestern Medical Center. Additionally, she coordinates several acute studies in the neuroscience intensive care unit.DaiWai Olson is an associate professor and director of the Neuroscience Nursing Research Center at University of Texas Southwestern.
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Abstract
Intensive care units are care centers where, in order to provide the maximum benefit to individuals whose life is in danger, many lifesaving technological tools and devices are present, and morbidity and mortality rates are high. In the intensive care unit, when classic treatments fail or become unbearable because of side effects, complementary methods have been suggested to be the best alternative. Complementary health approaches are methods that are used both for the continuation and the improvement of the well-being of an individual and as additions to medical treatments that are based on a holistic approach. These applications are especially helpful in the treatment of the stresses, anxieties, and other symptoms of unstable patients in the intensive care unit who do not tolerate traditional treatment methods well, increasing their psychological and physiological well-being, helping them sleep and rest. In intensive care patients, in order to decrease the incidence of postoperative atrial fibrillation, antiemetic and medicine needs, mechanical ventilation duration, and the intensity of the disease as well as to cope with symptoms such as pain, anxiety, physiological parameters, dyspnea, and sleep problems, body-mind interventions such as massage, reflexology, acupressure, aromatherapy, music therapy, energy therapies (healing touch, therapeutic touch, the Yakson method), and prayer are used as complementary health approaches.
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Evans SC, Garabedian C, Bray J. 'Now He Sings'. The My Musical Memories Reminiscence Programme: Personalised Interactive Reminiscence Sessions for People Living with Dementia. DEMENTIA 2017; 18:1181-1198. [PMID: 28554224 DOI: 10.1177/1471301217710531] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This paper explores the impact of the My Musical Memories Reminiscence Programme (MMMRP), an innovative intervention that adopts a music-based reminiscence approach. MMMRP builds on the format of the popular Singing for the Brain sessions with the aim of increasing opportunities for interaction and reminiscence amongst people living with dementia. Data were collected pre- and post-intervention and three months later using structured observation, interviews and focus groups. Results suggest that the programme had a positive impact on participants by promoting engagement, reminiscence and social interaction. For some individuals the impacts continued beyond their participation in the programme. A range of key facilitators for successful implementation of this approach were identified including the Session Leader role, the involvement of informal carers and the input of volunteers.
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Affiliation(s)
- Simon C Evans
- Association for Dementia Studies, University of Worcester, UK
| | | | - Jennifer Bray
- Association for Dementia Studies, University of Worcester, UK
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Mofredj A, Alaya S, Tassaioust K, Bahloul H, Mrabet A. Music therapy, a review of the potential therapeutic benefits for the critically ill. J Crit Care 2016; 35:195-9. [DOI: 10.1016/j.jcrc.2016.05.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 05/23/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
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Chlan LL. Engaging Critically Ill Patients in Symptom Management: Thinking Outside the Box! Am J Crit Care 2016; 25:293-300. [PMID: 27369026 DOI: 10.4037/ajcc2016932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Caring for critically ill patients receiving mechanical ventilation in the intensive care unit (ICU) is an immense challenge for clinicians. Interventions to maintain physiological stability and life itself can cause a number of adverse effects that have a marked impact on patients beyond the period of critical illness or injury. These ICU-acquired conditions include but are not limited to weakness, depression, and post-intensive care syndrome, all of which markedly affect patients' quality of life after they leave the unit. How best to manage the many symptoms experienced by patients undergoing mechanical ventilation without contributing to adverse ICU-acquired sequelae remains a daunting charge for clinicians and requires innovative "out of the box" approaches to address these complex issues. Systematic, cutting-edge research is needed to challenge the "usual" way of managing ICU patients in order to provide the best available evidence for practice integration that minimizes adverse, ICU-acquired sequelae and improves outcomes for the most vulnerable patients. This article highlights a program of research focused on interventions for managing symptoms in critically ill patients receiving mechanical ventilatory support, including the appropriate empowerment of symptom self-management by patients undergoing mechanical ventilation. Development and testing of innovative, nontraditional interventions specifically tailored for ICU patients receiving mechanical ventilatory support are presented. Music listening is highlighted as a nonpharmacological, adjunctive intervention to reduce anxiety associated with mechanical ventilation. Patient-controlled sedation is discussed as an alternative method to meet patients' highly individual needs for sedative therapy to promote comfort.
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Affiliation(s)
- Linda L. Chlan
- Linda L. Chlan is associate dean for nursing research, Mayo Clinic, Rochester, Minnesota
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Affiliation(s)
- Rebecca Shaw
- Rebecca Shaw is a clinical nurse on the orthopedics and trauma acute care unit at the University of North Carolina Medical Center in Chapel Hill, North Carolina
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9
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Tedore T, Weinberg R, Witkin L, Giambrone GP, Faggiani SL, Fleischut PM. Acute Pain Management/Regional Anesthesia. Anesthesiol Clin 2015; 33:739-751. [PMID: 26610627 DOI: 10.1016/j.anclin.2015.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Effective and efficient acute pain management strategies have the potential to improve medical outcomes, enhance patient satisfaction, and reduce costs. Pain management records are having an increasing influence on patient choice of health care providers and will affect future financial reimbursement. Dedicated acute pain and regional anesthesia services are invaluable in improving acute pain management. In addition, nonpharmacologic and alternative therapies, as well as information technology, should be viewed as complimentary to traditional pharmacologic treatments commonly used in the management of acute pain. The use of innovative technologies to improve acute pain management may be worthwhile for health care institutions.
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Affiliation(s)
- Tiffany Tedore
- Department of Anesthesiology, Weill Cornell Medical College, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Roniel Weinberg
- Department of Anesthesiology, Weill Cornell Medical College, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Lisa Witkin
- Department of Anesthesiology, Weill Cornell Medical College, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Gregory P Giambrone
- Department of Anesthesiology, Weill Cornell Medical College, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Susan L Faggiani
- Department of Anesthesiology, Weill Cornell Medical College, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Peter M Fleischut
- Department of Anesthesiology, Weill Cornell Medical College, 525 East 68th Street, Box 124, New York, NY 10065, USA.
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Tracy MF, Chlan L. Nonpharmacological interventions to manage common symptoms in patients receiving mechanical ventilation. Crit Care Nurse 2011; 31:19-28. [PMID: 21632591 DOI: 10.4037/ccn2011653] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Patients receiving mechanical ventilation can experience symptoms such as pain, anxiety, agitation, and lack of sleep while in the intensive care unit, all of which can affect healing. Nonpharmacological complementary therapies can be used as adjuncts to sedatives and analgesics. By incorporating appropriate use of complementary therapies in conjunction with mainstream medical therapies, nurses can decrease patients' anxiety, promote sleep, and promote a healing environment to improve outcomes. Minimizing noise and providing access to natural light help promote a healing environment. Methods to promote sleep include relaxation techniques such as progressive muscle relaxation and massage and communication with patients' and their families to determine the patients' normal sleep patterns. Complementary therapies to relieve anxiety and agitation include music intervention, imagery, presence, and animal-assisted therapy.
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Affiliation(s)
- Mary Fran Tracy
- University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota 55455, USA.
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Norton K. How music-inspired weeping can help terminally ill patients. THE JOURNAL OF MEDICAL HUMANITIES 2011; 32:231-243. [PMID: 21626088 DOI: 10.1007/s10912-011-9140-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Music's power to improve the 'human condition' has been acknowledged since ancient times. Something as counter-intuitive as weeping in response to music can ameliorate suffering for a time even for terminally ill patients. Several benefits-including catharsis, communication, and experiencing vitality-can be associated with grieving in response to "sad" music. In addressing the potential rewards of such an activity for terminally ill patients, this author combines concepts from philosopher Jerrold R. Levinson's article, entitled "Music and Negative Emotion," an illustration from a major motion picture, and supporting research from medical reports and aesthetic writings. Carefully offering this experience is recommended for patients who retain the capacity to express preference.
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Affiliation(s)
- Kay Norton
- School of Music, Arizona State University, Tempe, USA.
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12
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Lee YY, Chan MF, Mok E. Effectiveness of music intervention on the quality of life of older people. J Adv Nurs 2010; 66:2677-87. [PMID: 20831571 DOI: 10.1111/j.1365-2648.2010.05445.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This paper is a report of a study of the effect of music on the quality of life of community-dwelling older Chinese people in Hong Kong. BACKGROUND Older people's quality of life can be improved by preparing for the transition into old age. Listening to music, as a vehicle for feeling, can facilitate the non-verbal expression of emotion, reaching people's inner feelings without being threatening, and it can be a tool for emotional catharsis. METHOD A randomized controlled trial design was conducted from in 2007 in a community centre in Hong Kong. A total of 66 older people (31 in music group and 35 in control group), aged from 65 to 90 years were randomly assigned to undergo either a 30-minute music intervention or a rest period for 4 weeks; quality of life outcomes were then measured. RESULTS Quality of life improved weekly in the music group, indicating a cumulative dose effect, and a statistically significantly better quality of life was found over time in each sub-score for those in the music group compared with the controls. However, in the music group, there were no statistically significant improvements of quality of life in each sub-score over the 4 weeks. CONCLUSION Being engaged in music activities can help a person to connect with their life experiences and with other people, and to be more stimulated. Music is a non-invasive, simple and inexpensive therapeutic method of improving quality of life in community-dwelling elders.
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Affiliation(s)
- Yin Yi Lee
- Orthopaedic and Traumatology Department, United Christian Hospital, HKSAR, China
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Chlan L. A review of the evidence for music intervention to manage anxiety in critically ill patients receiving mechanical ventilatory support. Arch Psychiatr Nurs 2009; 23:177-9. [PMID: 19327560 DOI: 10.1016/j.apnu.2008.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 12/12/2008] [Indexed: 11/30/2022]
Abstract
Critically ill patients receiving mechanical ventilatory support experience profound anxiety with this common treatment modality. Music intervention is one adjunctive therapy that can be implemented to allay anxiety. This article reviews the evidence support music as an adjunctive intervention with mechanically ventilated patients.
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Affiliation(s)
- Linda Chlan
- University of Minnesota, School of Nursing, 5-160 Weaver-Densford Hall, 308 Harvard St. SE, Minneapolis, MN 55455, USA.
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Okada K, Kurita A, Takase B, Otsuka T, Kodani E, Kusama Y, Atarashi H, Mizuno K. Effects of Music Therapy on Autonomic Nervous System Activity, Incidence of Heart Failure Events, and Plasma Cytokine and Catecholamine Levels in Elderly Patients With Cerebrovascular Disease and Dementia. Int Heart J 2009; 50:95-110. [DOI: 10.1536/ihj.50.95] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Kaoru Okada
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital
| | | | - Bonpei Takase
- Division of Biomedical Engineering, National Defense Medical College Research Institute
| | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School
| | - Eitaro Kodani
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital
| | - Yoshiki Kusama
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital
| | - Hirotsugu Atarashi
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital
| | - Kyoichi Mizuno
- Department of Internal Medicine and Cardiology, Nippon Medical School
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Abstract
BACKGROUND Music has been used for therapeutic purposes since the beginning of cultural history. However, despite numerous descriptions of beneficial effects, the precise mechanisms by which music may improve human well-being remain unclear. METHODS We conducted a randomized study in ten critically ill patients to identify mechanisms of music-induced relaxation using a special selection of slow movements of Mozart's piano sonatas. These sonatas were analyzed for compositional elements of relaxation. We measured circulatory variables, brain electrical activity, serum levels of stress hormones and cytokines, requirements for sedative drugs, and level of sedation before and at the end of a 1-hr therapeutic session. RESULTS Compared with controls, we found that music application significantly reduced the amount of sedative drugs needed to achieve a comparable degree of sedation. Simultaneously, among those receiving the music intervention, plasma concentrations of growth hormone increased, whereas those of interleukin-6 and epinephrine decreased. The reduction in systemic stress hormone levels was associated with a significantly lower blood pressure and heart rate. CONCLUSION Based on the effects of slow movements of Mozart's piano sonatas, we propose a neurohumoral pathway by which music might exert its sedative action. This model includes an interaction of the hypothalamic-pituitary axis with the adrenal medulla via mediators of the unspecific immune system
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Effects of Music Therapy on Heart Rate Variability in Elderly Patients with Cerebral Vascular Disease and Dementia. J Arrhythm 2006. [DOI: 10.1016/s1880-4276(06)80014-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
A questionnaire was mailed to 300 randomly selected hospices in the United States, to gather preliminary data on the nature of complementary therapy services provided by hospices. Information included types of complementary therapies offered, utilization, staffing, obstacles, as well as suggestions for improving hospice complementary therapy services. Of a total of 169 responding hospices, 60% offered complementary therapies to patients. The most popular therapies were massage therapy and music therapy. Only a portion of patients in these hospices received complementary therapy. Many hospices were limited in the amount of complementary therapy services they could provide because of program constraints, such as funding problems, lack of qualified complementary staff, inadequate knowledge of complementary therapies and how to offer these services, and resistance to complementary therapies by some staff and patients. A crucial challenge for hospices interested in providing complementary therapies to patients is to find ways to overcome these obstacles.
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Affiliation(s)
- Craig Demmer
- Department of Health Services, Lehman College, City University of New York, Bronx, New York 10468, USA.
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Abstract
Creativity in meeting patients' needs is required daily by the staff in acute and critical care environments. For critical care patients, many alternative and complementary therapies including aromatherapy, hydrotherapy, humor, imagery, massage, music, and relaxation can be used successfully as adjunct therapies to help decrease stress.
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Affiliation(s)
- Lynn Keegan
- Holistic Nursing Consultants, 315 Shade Tree Lane, Port Angeles, WA 98362, USA
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Richards K, Nagel C, Markie M, Elwell J, Barone C. Use of complementary and alternative therapies to promote sleep in critically ill patients. Crit Care Nurs Clin North Am 2003; 15:329-40. [PMID: 12943139 DOI: 10.1016/s0899-5885(02)00051-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The efficacy of complementary and alternative therapies for sleep promotion in critically ill patients is largely unexamined. We found only seven studies (three on environmental interventions and one each on massage, music therapy, therapeutic touch, and, melatonin) that examined the effect of complementary and alternative therapies. A number of studies, however, have shown that massage, music therapy. and therapeutic touch promote relaxation and comfort in critically ill patients, which likely leads to improved sleep. Massage, music therapy, and therapeutic touch are safe for critically ill patients and should be routinely applied by ICU nurses who have received training on how to administer these specialized interventions. Environmental interventions, such as reducing noise, playing white noise such as ocean sounds, and decreasing interruptions to sleep for care, also are safe and logical interventions that ICU nurses should use to help patients sleep. Progressive muscle relaxation has been extensively studied and shown to be efficacious for improving sleep in persons with insomnia; however, progressive muscle relaxation requires that patients consciously attend to relaxing specific muscle groups and practice these techniques, which may be difficult for critically 11 patients. We do not currently recommend aromatherapy and alternative sedatives, such as valerian and melatonin, for sleep promotion in critically ill patients because the safety of these substances is unclear. In summary, we recommend that ICU nurses implement music therapy, environmental interventions, therapeutic touch, and relaxing massage to promote sleep in critically ill patients. These interventions are safe and may improve patient sleep, although randomized controlled trials are needed to test their efficacy. Aromatherapy and alternative sedatives require further investigation to determine their safety and efficacy.
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Affiliation(s)
- Kathy Richards
- Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, 3J/NLRVA, North Little Rock, AR 72114, USA.
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22
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Abstract
Consider implementing a Quiet Time for patient relaxation to enhance the healing process and increase patient satisfaction.
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Affiliation(s)
- Judith Ski Lower
- Neuroscience CCU and PCU, Johns Hopkins Hospital, Baltimore, MD, USA
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Nilsson U, Rawal N, Enqvist B, Unosson M. Analgesia following music and therapeutic suggestions in the PACU in ambulatory surgery; a randomized controlled trial. Acta Anaesthesiol Scand 2003; 47:278-83. [PMID: 12648193 DOI: 10.1034/j.1399-6576.2003.00064.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study was designed to determine whether music (M), or music in combination with therapeutic suggestions (M/TS) could improve the postoperative recovery in the immediate postoperative in daycare surgery. METHODS One-hundred and eighty-two unpremedicated patients who underwent varicose vein or open inguinal hernia repair surgery under general anaesthesia were randomly assigned to (a). listening to music (b). music in combination with therapeutic suggestions or (c). blank tape in the immediate postoperative period. The surgical technique, anaesthesia and postoperative analgesia were standardized. Analgesia, the total requirement of morphine, nausea, fatigue, well-being, anxiety, headache, urinary problems, heart rate and oxygen saturation were studied as outcome variables. RESULTS Pain intensity (VAS) was significantly lower (P = 0.002) in the M (2.1), and the M/TS (1.9) group compared with the control group (2.9) and a higher oxygen saturation in M (99.2%) and M/TS (99.2%) group compared with the control (98.0%), P < 0.001, were found. No differences were noted in the other outcome variables. CONCLUSION This controlled study has demonstrated that music with or without therapeutic suggestions in the early postoperative period has a beneficial effect on patients' experience of analgesia. Although statistically significant, the improvement in analgesia is modest in this group of patients with low overall pain levels.
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Affiliation(s)
- U Nilsson
- Department of Medicine and Care, Faculty of Health Science, Linköping, Sweden.
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Halstead MT, Roscoe ST. Restoring the spirit at the end of life: music as an intervention for oncology nurses. Clin J Oncol Nurs 2002; 6:332-6. [PMID: 12434464 DOI: 10.1188/02.cjon.332-336] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Music is a useful therapeutic intervention that can improve quality of life for dying patients. Physiologic mechanisms in response to carefully chosen musical selections help to alleviate pain, anxiety, and nausea and induce sleep. Expression of feelings enhances mood. Palliative care nurses increase the effectiveness of this intervention through careful assessment of patient needs, preferences, goals of intervention, and available resources. Music, a universal language, is an important clinical adjunct that addresses individual and family needs, thereby assisting patients to achieve a peaceful death. This article explores musical categories of preferences to assist nurses, patients, and families in choosing music that meets specific therapeutic objectives.
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Abstract
Increasing numbers of people have been supplementing their health care needs with complementary therapies. Complementary therapies have been used to promote health and treat patients with a variety of ailments. Types of complementary therapies used with terminally ill patients have included massage, therapeutic touch, Reiki, art and music therapy, aromatherapy, and hypnotherapy. The purpose of this study was to survey primary caregivers (PCGs) regarding their perceptions and satisfaction with a hospice complementary therapy program. Perhaps this study's most interesting finding is that patients who received complementary therapies were generally more satisfied with overall hospice services.
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Affiliation(s)
- Craig Demmer
- Lehman College, City University of New York, Bronx, USA
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Lewin RJP, Thompson DR, Elton RA. Trial of the effects of an advice and relaxation tape given within the first 24 h of admission to hospital with acute myocardial infarction. Int J Cardiol 2002; 82:107-14; discussion 115-6. [PMID: 11853894 DOI: 10.1016/s0167-5273(01)00620-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND The study was performed to examine the effects of giving patients with acute myocardial infarction an advice and relaxation audio tape within 24 h of admission to hospital. METHODS A prospective, two-group design was used with 243 subjects randomised to receive either the advice and relaxation tape or a music tape of their choice within 24 h of sustaining a myocardial infarction. Outcomes comprised anxiety, cardiac misconceptions, lifestyle change, attendance at a cardiac rehabilitation programme, and quality of life. RESULTS Although the advice and relaxation tape reduced the number of cardiac misconceptions this did not lead to any improvements in outcome, whilst in hospital or at 6 months. Both tapes were equally appreciated by the patients, 98% of whom said that they would recommend them to other patients. CONCLUSIONS An advice and relaxation tape reduces cardiac misconceptions but does not confer any other benefits over a music tape.
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Affiliation(s)
- Robert J P Lewin
- British Heart Foundation Rehabilitation Research Unit, Department of Health Sciences, University of York, Genesis 6, York Y010 5DQ, UK
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Wong HL, Lopez-Nahas V, Molassiotis A. Effects of music therapy on anxiety in ventilator-dependent patients. Heart Lung 2001; 30:376-87. [PMID: 11604980 DOI: 10.1067/mhl.2001.118302] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the effectiveness of music therapy in decreasing anxiety in ventilator-dependent patients. DESIGN A crossover repeated measures design with random assignment was used. SETTING The intensive care unit of a university hospital in Hong Kong was used as the setting for this study. PATIENTS Twenty patients who were ventilator-dependent were recruited for the study. They were all Chinese with a mean age of 58.25 years (range, 19-84 y). Most (75%) were men. OUTCOME MEASURES Physiologic measures of anxiety assessed in this study were mean blood pressure and respiratory rate. An additional measure was the Chinese version of the Spielberger State-Trait Anxiety Inventory. INTERVENTION Patients were randomized to receive either 30 minutes of uninterrupted rest and then 30 minutes of music therapy or the music therapy first and then the uninterrupted rest period. Patients listened to relaxing music by using audiocassette players and headphones. Subjects selected the music of their choice from a selection including both Chinese and Western music. Subjects had physiologic measures taken immediately before the intervention (or rest period) and at 5-minute intervals throughout the intervention. The Chinese version of Spielberger's State-Trait Anxiety Inventory was completed before the intervention and immediately after the intervention. RESULTS Findings indicated that music therapy was more effective in decreasing state anxiety than was an uninterrupted rest period (P <.01). As measured by analysis of variance with repeated measures, blood pressure and respiratory rate showed no significant differences in the 2 conditions over time. However, significant differences were observed at the end of the intervention (after 30 minutes) between the 2 conditions, with music therapy being superior to the rest period. CONCLUSION Music therapy is an effective nursing intervention in decreasing anxiety in ventilator-dependent patients and its use should be incorporated into the care of mechanically ventilated patients. For the Chinese patients, culture and language were the predominant factors in their choice of music.
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Affiliation(s)
- H L Wong
- Intensive Care Unit, Prince of Wales Hospital, Hong Kong, China
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Abstract
Music is a powerful tool for maintaining and restoring health and is particularly suited to elder care. Music can be used to induce relaxation, alter moods, and create distraction. Music's effect is attributed to its vibrational properties, which are processed through the senses and integrated within the central nervous system. Nurses have a major responsibility to understand, appreciate, and use music in their practice.
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Affiliation(s)
- M K Kramer
- University of Utah, College of Nursing, Salt Lake City, USA
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Cadigan ME, Caruso NA, Haldeman SM, McNamara ME, Noyes DA, Spadafora MA, Carroll DL. The effects of music on cardiac patients on bed rest. PROGRESS IN CARDIOVASCULAR NURSING 2001; 16:5-13. [PMID: 11252881 DOI: 10.1111/j.0889-7204.2001.00797.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hospitalizations that require invasive cardiac procedures or support with an intra-aortic balloon pump can be unsettling. This study was undertaken to measure the effect of a music intervention on physiologic and psychological responses of patients on bed rest due to procedural sheaths or an intra-aortic balloon pump. A randomized, two-group, pretest/post-test design was utilized to measure the effect of a 30-minute music intervention on heart rate, blood pressure, respiratory rate, skin temperature, pain perception, and mood states. One hundred forty subjects participated, 65 in the control group and 75 in the treatment group. There were no significant differences between the groups in demographic, clinical, or baseline variables, except for respiratory rate. After the music intervention, there were reductions in blood pressure, respiratory rate, and psychological distress, as measured by the Profile of Mood States (p < 0.05). Music appeared to affect selected physiologic responses and reduce psychological distress in patients on bed rest.
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Affiliation(s)
- M E Cadigan
- Department of Nursing, Patient Care Services, Massachusetts General Hospital, Boston, MA 02114, USA
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Happ MB. Using a best practice approach to prevent treatment interference in critical care. PROGRESS IN CARDIOVASCULAR NURSING 2000; 15:58-62. [PMID: 10804596 DOI: 10.1111/j.0889-7204.2000.080394.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Treatment interference, also known as therapy disruption, device disruption, or self extubation, is a common and especially difficult clinical problem in critical care. This paper presents creative and practical clinical innovations and relevant research findings as a "best practice approach" to prevent treatment interference in critical care settings. Key principles are presented to guide patient assessment and selection of nursing strategies. Nursing assessment parameters are described and a wide range of nonrestraint strategies are discussed.
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Affiliation(s)
- M B Happ
- Center for Advancing Care in Serious Illness, School of Nursing, University of Pennsylvania, Philadelphia 19104-6069, USA
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Chlan L, Evans D, Greenleaf M, Walker J. Effects of a single music therapy intervention on anxiety, discomfort, satisfaction, and compliance with screening guidelines in outpatients undergoing flexible sigmoidoscopy. Gastroenterol Nurs 2000; 23:148-56. [PMID: 11310081 DOI: 10.1097/00001610-200007000-00003] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Screening flexible sigmoidoscopy (FS) is an effective tool for the detection of colon cancer. Nonetheless, persons are reluctant to undergo FS for a variety of reasons such as anxiety, discomfort, and the possibility of abnormal findings. Nurses caring for FS patients can implement interventions to allay anxiety and promote comfort in an effort to enhance satisfaction and future compliance. Music therapy is one nonpharmacologic intervention that has been shown to be effective in allaying anxiety, reducing discomfort, and promoting satisfaction in other patient populations. A two-group pretest, posttest experimental design with repeated measures study recruited 64 subjects undergoing FS from one Midwestern tertiary care center. Subjects were randomly assigned to a control condition of usual procedural care or to an experimental condition of music therapy during the examination. State and trait anxieties were measured at pretest. State anxiety, discomfort, satisfaction, and perceived compliance with future screening were measured after the procedure. Subjects in the music group reported less anxiety and discomfort than subjects in the control group. There were no differences on satisfaction ratings or perceived compliance with screening guidelines. Nurses caring for patients undergoing screening FS can offer music therapy as one nonpharmacologic intervention to ameliorate anxiety and reduce discomfort.
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Affiliation(s)
- L Chlan
- University of Minnesota, School of Nursing, Minneapolis, MN, USA
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Deisch P, Soukup SM, Adams P, Wild MC. GUIDED IMAGERY. Nurs Clin North Am 2000. [DOI: 10.1016/s0029-6465(22)02479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Chlan LL. Music therapy as a nursing intervention for patients supported by mechanical ventilation. AACN CLINICAL ISSUES 2000; 11:128-38. [PMID: 11040559 DOI: 10.1097/00044067-200002000-00014] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Music therapy is a nonpharmacologic nursing intervention that can be used as a complementary adjunct in the care of patients supported by mechanical ventilation. This article details the theoretical basis of music therapy for relaxation and anxiety reduction, highlights the research testing the intervention in such patients, and discusses areas of needed research to extend further the implementation of music therapy in critical care nursing practice in an effort to promote a healing environment for patients.
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Affiliation(s)
- L L Chlan
- University of Minnesota School of Nursing, Minneapolis 55455, USA
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