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

AORN Journal,  April, 2008  by Ulrica Nilsson

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* music intervention is easy to implement,

* patients enjoy it, (1-4,2,14) and

* patients can use music as a self-management technique for distraction or escapism. (69)

In the review presented here, the quality assessment was adapted from Rubin and Hotopf (15) with the addition of the criterion "sample size calculation." Calculating the sample size helps maximize the chances of detecting a statistically and clinically significant difference between interventions when a difference really exists. (16,66) The Consolidated Standard of Reporting Trials (CONSORT), which documents a set of recommendations for the reporting of clinical trials, also identifies that the method for determining sample size should be detailed in publications. (70)

It is notable that there was no relationship between the year of publication and the determined quality level of the studies. Future RCTs on music must maintain high quality standards. This can be ensured by following the CONSORT statement, which includes a flow diagram that can be used to identify the appropriate number of participants

* eligible for the study;

* excluded from the study,

* randomized;

* analyzed;

* assigned, but who did not actually receive the intervention; and

* lost to follow-up.

This statement also recommends providing specific details about blinding. (70)

IMPLICATIONS FOR NURSING

The effect of music on pain and stress for surgical patients is not well understood. A number of methodological limitations are evident in the reviewed research. Further research and research of higher quality is needed on the ability of music to affect patients' perioperative pain, anxiety, and stress. It is recommended that elements of the CONSORT statement be included in any future research in this area.

It is important to provide information on evidence-based interventions to perioperative nurses and managers. In clinical practice, it also is important to meet the needs of patients by incorporating effective methods to reduce patients' anxiety and discomfort. Music intervention may be a useful method to reduce patients' experiences of unpleasant symptoms and discomfort. During perioperative care, soothing and relaxing music can be used as audioanalgesia, audioanxiolytic, or audio-relaxation as an integral part of the multimodal regimen administered to patients. Providing music to patients is an inexpensive technique that does not require extra staff members or expensive equipment. Music intervention can help maximize efforts to promote patient comfort and relaxation as well as reduce or control perioperative patient distress.

Editor's notes: AMED is a registered trademark of the British Library, London, England. CINAHL, Cumulative Index to Nursing and Allied Health Literature, is a registered trademark of EBSCO Industries, Birmingham, AL. MEDLINE is a registered trademark of the US National Library of Medicine's Medical Literature Analysis and Retrieval System, Bethesda, MD.

Acknowledgement: This study was supported by the Research Committee of Orebro County Council, Orebro, Sweden. The author thanks Per Thorgaard, MD, chief physician, Department of Anaesthesia and Intensive Care, Aalborg Sygehus, Aarhus University Hospital, Northern Jutland, Denmark, for his assistance with the review of the manuscript.