The anxiety- and pain-reducing effects of music interventions: a systematic review

AORN Journal,  April, 2008  by Ulrica Nilsson

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For a meta-analysis, the intervention and the dose of the intervention must be constant. For the studies included in this review, the types of music used differed; the duration of listening time differed (ie, the dose); and the patients' care differed. A meta-analysis, therefore, was not performed. Thus, the studies were assessed for the quality of their methodology, and they were analyzed according to outcome measures.

RESULTS

A total of 42 RCTs were assessed. They varied in patient demographics and procedural type, the timing and type of musical intervention used, and the quality measurement assigned to the RCT by the researcher conducting this review.

BASELINE CHARACTERISTICS. The 42 RCTs that were reviewed included 3,936 patients. The number of patients in these studies ranged from nine to 500. The mean age of the participants ranged from 34 to 76 years. In 33 of the studies, both men and women were included. In one study, only men were included, and in five studies only women were included. Three studies did not report the gender of the participants.

Patients in all the studies underwent elective surgery. The types of surgery included gynecological; abdominal; ear, nose, and throat; cardiac; urologic; ophthalmologic; orthopedic; and breast biopsy. Some studies included combinations of different types of surgery (eg, major abdominal, outpatient). Other studies were more precise in their inclusion criteria, with all included patients having the same type of surgery (eg, hysterectomy, septorhinoplasty, inguinal hernia repair, open-heart surgery, transurethral resection of the prostate, varicectomy, lithotripsy, cataract surgery, lumbar disk surgery).

INTERVENTION. The majority of the music interventions (n = 15) were performed postoperatively. (17-31) In 10 of the studies, interventions were performed preoperatively, (32-41) and in nine of the studies, interventions were performed intraoperatively. (42-49) Two studies compared intraoperative and postoperative interventions. (50,51) The remaining five studies were performed with a combination of interventions:

* preoperative, intraoperative, and postoperative; (52-54)

* preoperative and intraoperative; (55)

* preoperative and postoperative; (56) and

* intraoperative and postoperative, (57,58)

The type of music was soothing (ie, 60 to 80 beats per minute), and in the majority of the studies (n = 29), self-selected music was used. This included the patient's own favorite music or music chosen from a selected list of musical genres (eg, classical, New Age, jazz). In the other 15 studies, one specific genre of music was provided by the researchers. This included New Age, (48-51, 58) classical, (24, 26, 43, 44) slow instrumental, (34) piano, (37,54) and pan flute. (56)

The duration of preoperative or postoperative listening time lasted from five minutes to four hours. In the majority of the studies, the listening time lasted from 15 to 30 minutes. (17, 20- 22, 27, 29-35, 37, 39-41, 56) Intraoperatively, music was used during the entire period, beginning at the start of the procedure. (42-51, 58) Four of the studies did not report the duration of the listening time. (28, 53, 54, 57) In only one study was the music played using loud speakers. (26) Two of the studies did not report whether headphones or loudspeakers were used. (23, 39) All of the remaining studies (n = 39) used headphones to provide music to the patients.