Effects of music on patient anxiety - Research

AORN Journal, Feb, 2003 by Esther Mok, Kwai-Yiu Wong

Patients were assigned to the experimental group or the control group via an alternate week arrangement. For example, patients who came in one week were assigned to the experimental group, and patients who came in the next week were assigned to the control group. This assigning process was repeated until each group had 40 patients.

To ensure consistency in data collection, only one researcher collected the data. Demographic data were collected from patients in the control group and the experimental group, including data on age, sex, marital status, education level, type of surgery, and previous surgical experiences. This information was analyzed with chi-square tests, and the two groups were not found to be significantly different Table 1.

Music and songs selected Patients in the experimental group were given a choice of taped music to listen to through headphones. Classical music, contemporary popular music, and Chinese popular music were selected as categories because these types of music are the most popular in Hong Kong and people are familiar with them. Songs with relatively slow rhythms were selected based on recommendations from three music teachers. Before the study was implemented, a panel of three secondary school (ie, students range in age from 12 to 18) music teachers listened to the selected music. They concurred that the music selected should have a slow or moderate rhythm and be something with which most people are familiar. The running time of each tape lasted for about 45 minutes, which is long enough to last throughout a minor surgical procedure so the patient is not interrupted.

Instruments. The researchers assessed the effectiveness of music as a relaxation modality by measuring patients' vital signs and through patients' self-report of anxiety before and after the procedure. The research nurse measured patients' blood pressure and heart rate using an automated portable blood pressure and heart rate monitor. Before the study began, this machine was calibrated according to the manufacturer's set tolerance level.

Patients reported their anxiety levels by completing the state portion of the C STAI. Only the state anxiety portion of the C-STAI version was used to measure patients' intraoperative anxiety because it is a transitory emotional state and only can provide a measure of an individual's anxiety level in the current situation. The reliability and validity of the C-STAI have been well documented, and alpha reliability coefficients range from 0.83 to 0.92 for state anxiety scores. The C-STAI was tested in Hong Kong and found to be highly reliable. (21) The reliabilities of the inventory were not calculated in the present study.

Evaluation questionnaire. The structured interview schedule was based on the questionnaire developed by K. Stevens, MA, AMusA. It included both closed-ended and open-ended questions related to patients' perception of music during minor surgery. A question related to ranking of attitudes was used to measure the patient's perception of degree of helpfulness of the music.