Effect of music on ambulatory surgery patients' preoperative anxiety

AORN Journal, April, 1996 by Penny Augustin, Anthony A. Hains

STUDY DESCRIPTION

When we designed this study to evaluate the effectiveness of music in reducing ambulatory surgery patients preoperative anxiety, we included patient selection of preferred music as an important variable. We hypothesized that patients who received preoperative teaching and then listened to their choices of music while waiting for surgery would have significantly lower anxiety levels than patients who received only preoperative teaching. We measured patients, anxiety levels objectively by comparing their vital signs and subjectively by having patients complete the state portion of the StateTrait Anxiety Inventory (STAI).(16)

Study sample. The study took place in an ASC at a hospital located in a small midwestern city. The ASC cares for one to 12 patients per day, with an average of four to six patients per day. The study sample consisted of 42 Caucasian, middle-class patients who were scheduled for ambulatory surgery with local anesthesia, regional anesthesia, general anesthesia, or IV conscious sedation with local anesthesia. We included any ASC patient who was older than 15 years unless the patient

* had a cognitive disability or delay or a hearing impairment,

* received a preoperative sedative, which would alter the patient's vital signs or level of consciousness,

* received a colon preparation, which would necessitate frequent trips to the bathroom,

* was scheduled for cataract removal and would, therefore, be interrupted frequently for eyedrop instillation; or

* lacked sufficient time to participate in the study in an unhurried manner.

Patients in the sample ranged in age from 18 to 73 years, with the mean age being 47 years. Seventeen females and 25 males participated. They were scheduled for the following surgical procedures:

* arthroscopy (12 patients),

* herniorrhaphy (eight patients),

* minor orthopedic procedures (six patients),

* urologic procedures (five patients),

* nerve repairs (four patients),

* endoscopic procedures (three patients),

* laparoscopic procedures (two patients), and

* breast biopsies (two patients).

Forty-three patients initially agreed to participate. We ultimately excluded one patient who had unanticipated laboratory tests during the preoperative waiting period and was unable to complete the data collection activities.

Study design. We used a quantitative, experimental research design, comparing anxiety levels of two groups of patients before and after routine preoperative instruction (ie, control group) and preoperative instruction coupled with music listening tie, experimental group). We asked a convenience sample of ambulatory surgery patients if they would like to participate in a study to analyze how patients feel before surgery. When patients agreed to participate, we obtained their written informed consents and alternately assigned them to either the experimental or control group. Each group had 21 patients.

Instruments. We assessed the effectiveness of music as a relaxation modality through measurement of patients, vital signs and patients, self-reported anxiety at the time of admission to the ASC and 10 minutes before surgery. The ambulatory surgery nurses measured patients, respirations, heart rates, and blood pressure readings using standard, noninvasive technology, performing the measurements within minutes of each other.