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Shafqat N, Agrawal A, Pushpalatha K, Singh B, Verma R, Podder L, Das S, Sutar RF. Effect of Music Therapy on Anxiety in Pregnancy: A Systematic Review of Randomized Controlled Trials. Cureus 2024; 16:e69066. [PMID: 39391386 PMCID: PMC11465781 DOI: 10.7759/cureus.69066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2024] [Indexed: 10/12/2024] Open
Abstract
Pregnancy can heighten anxiety levels, impacting both maternal and fetal well-being. This systematic review synthesizes evidence from 33 randomized controlled trials exploring the effects of music therapy on anxiety in pregnant women. The studies included diverse populations, ranging from women undergoing in vitro fertilization (IVF) to those facing high-risk pregnancies. Music therapy interventions varied widely, including virtual reality experiences, classical music, lullabies, and patient-selected music, administered at different pregnancy stages such as IVF treatments, elective cesarean sections, and high-risk hospitalizations. The findings consistently demonstrated that music therapy significantly reduces anxiety levels in pregnant women. Positive outcomes included reductions in both state and trait anxiety, improved pregnancy rates, and enhanced maternal-fetal parameters. Additionally, music therapy showed promise in reducing anxiety during labor, cesarean deliveries, and high-risk hospital stays. These varied interventions and their positive outcomes highlight the potential of music therapy as an effective, non-pharmacological approach to managing pregnancy-related anxiety. This review provides a comprehensive overview of the existing evidence on music therapy's efficacy in alleviating anxiety during pregnancy. It underscores the need for further research to standardize interventions and incorporate music therapy into routine prenatal care. By enhancing the overall well-being of expectant mothers, music therapy could become a valuable adjunct to conventional prenatal care practices.
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Affiliation(s)
- Naseema Shafqat
- Obstetrics and Gynecology Nursing, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Amit Agrawal
- Neurosurgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - K Pushpalatha
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Bharti Singh
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Ranjana Verma
- Medical Surgical Nursing, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Lily Podder
- Obstetrics and Gynecology Nursing, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Saikat Das
- Radiotherapy, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Roshan F Sutar
- Psychiatry, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
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Uto A, Yamashita K, Yoshimine S, Uchino M, Kibe T, Sugimura M. Analysis of perioperative autonomic nervous system activity to visualize stress in pediatric patients undergoing alveolar bone graft surgery. J Clin Monit Comput 2024:10.1007/s10877-024-01210-w. [PMID: 39172322 DOI: 10.1007/s10877-024-01210-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Abstract
Perioperative stress in pediatric patients is often difficult to assess via interviews; thus, an objective measure to assess perioperative stress is needed. To visualize perioperative stress, we observed autonomic nervous system (ANS) activity, circulatory dynamics, and psychological status in pediatric patients undergoing alveolar bone grafting under general anesthesia. This prospective observational study included 40 patients aged 8-12 years who were scheduled for alveolar bone grafting in our hospital. ANS activity was analyzed using heart rate variability the day before surgery, during general anesthesia, 2 h postoperatively, 24 h postoperatively, and the day before discharge. ANS assessment included LF/HF (sympathetic nervous system activity) and HF (parasympathetic nervous system activity). Additionally, heart rate (HR), systolic blood pressure (SBP), face scale (FS) score were recorded. Data from 31 patients, excluding dropouts, were analyzed. The ratio of change to the preoperative value was compared. After surgery, the LF/HF, HR, SBP, and FS score significantly increased (P < 0.01) and HF significantly decreased (2 h postoperatively: P < 0.05, 24 h postoperatively, before discharge: P < 0.01). SBP recovered to preoperative values 24 h postoperatively, and HR and FS scores recovered to preoperative values before discharge. However, even before discharge, LF/HF remained significantly higher than preoperative values, and HF remained significantly lower than preoperative values (P < 0.01). Conclusion We observed perioperative stress from multiple perspectives. Circulatory dynamics and psychological status recovered by the day before discharge; however, ANS activity did not. Therefore, evaluating ANS activity may be useful in visualizing potential perioperative stress in pediatric patients.
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Affiliation(s)
- Akari Uto
- Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kaoru Yamashita
- Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - Shusei Yoshimine
- Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Minako Uchino
- Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Toshiro Kibe
- Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mitsutaka Sugimura
- Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Hunter AR, Heiderscheit A, Galbally M, Gravina D, Mutwalli H, Himmerich H. The Effects of Music-Based Interventions for Pain and Anxiety Management during Vaginal Labour and Caesarean Delivery: A Systematic Review and Narrative Synthesis of Randomised Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7120. [PMID: 38063550 PMCID: PMC10706633 DOI: 10.3390/ijerph20237120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/04/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023]
Abstract
Music-based interventions are not physically invasive, they usually have minimal side effects, and they are increasingly being implemented during the birthing process for pain and anxiety relief. The aim of this systematic review is to summarise and evaluate published, randomised controlled trials (RCTs) assessing the effects of music-based interventions for pain and anxiety management during vaginal labour and caesarean delivery. Following the PRISMA guidelines, a systematic search of the literature was conducted using: PsychInfo (Ovid), PubMed, and Web of Science. Studies were included in the review if they were RCTs that assessed the effects of music on pain and anxiety during vaginal and caesarean delivery by human mothers. A narrative synthesis was conducted on 28 identified studies with a total of 2835 participants. Most, but not all, of the included studies assessing music-based interventions resulted in reduced anxiety and pain during vaginal and caesarean delivery. Music as part of a comprehensive treatment strategy, participant-selected music, music coupled with another therapy, and relaxing/instrumental music was specifically useful for reducing light to moderate pain and anxiety. Music-based interventions show promising effects in mitigating pain and anxiety in women during labour. However, the long-term effects of these interventions are unclear.
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Affiliation(s)
- Amy Rose Hunter
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Mental Health Studies Programme, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AB, UK
| | - Annie Heiderscheit
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 2LZ, UK
| | - Megan Galbally
- School of Clinical Sciences, Department of Psychiatry, Monash University, Clayton, VIC 3168, Australia
| | - Davide Gravina
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Clinical and Experimental Medicine, University of Pisa, 56127 Pisa, Italy
| | - Hiba Mutwalli
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK
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Okyay EK, Uçar T. The effect of emotional freedom technique and music applied to pregnant women who experienced prenatal loss on psychological growth, well-being, and cortisol level: A randomized controlled trial. Arch Psychiatr Nurs 2023; 45:101-112. [PMID: 37544684 DOI: 10.1016/j.apnu.2023.04.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/10/2023] [Accepted: 04/30/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Research has shown that application of emotional freedom technique and music ensures psychological growth, increases well-being, and decreases cortisol level. PURPOSE In the study, it was aimed to determine the effect of EFT and music applied to pregnant women who had experienced prenatal loss on their psychological growth, well-being, and cortisol level. METHODS The study was conducted as a randomized controlled trial in a city hospital in eastern Türkiye with 159 pregnant women, 53 of whom were in the EFT, 53 in the music group, and 53 in the control group. The study data were collected through Subjective Units of Disturbance Scale (SUDS), Subjective Units of Experience (SUE) Scale, Post Traumatic Growth Inventory (PTGI), and WHO-5 Well-Being Index, and saliva samples were taken for cortisol evaluation. EFT was applied to the women two times every other week; the women in the music group listened to music two times every other week. Throughout the week following the first intervention, the women continued the interventions at home. RESULTS It was determined that EFT and music significantly decreased the participants' subjective anxiety and salivary cortisol median scores, the lowest anxiety was in the EFT group, and PTGI and WHO-5 Well-Being Index mean scores increased (p < 0.005). Further analyses showed that EFT was more effective in terms of increasing well-being than music (p < 0.001; a > b > c). It was determined that the anxiety levels and salivary cortisol median values of the control group were statistically significantly higher compared to the EFT and music groups (p < 0.001). CONCLUSION It was found that EFT and music applied to the women who had experienced prenatal loss decreased anxiety, ensured psychological growth, improved well-being, and decreased salivary cortisol level.
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Affiliation(s)
- Esra Karataş Okyay
- Kahramanmaras Sutcu Imam University, Department of Midwifery, 46050 Kahramanmaras, Türkiye.
| | - Tuba Uçar
- Inonu University, Department of Midwifery, 44280 Malatya, Türkiye.
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Qian J, Sun S, Wang M, Sun X, Yu X. Art-based interventions for women's mental health in pregnancy and postpartum: A meta-analysis of randomised controlled trials. Front Psychiatry 2023; 14:1112951. [PMID: 36873226 PMCID: PMC9976780 DOI: 10.3389/fpsyt.2023.1112951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/26/2023] [Indexed: 02/17/2023] Open
Abstract
Objective Pregnant and postpartum women are vulnerable to psychological problems with a high estimated prevalence. To date, there is no meta-analysis that specifically assesses the effectiveness of art-based interventions to improve mental health in pregnant and postpartum women. The objective of this meta-analysis was to assess the efficacy of art-based interventions when delivered to pregnant and postpartum women. Methods Systematic literature searches were conducted from the inception to 6 March 2022 in seven English databases, including PubMed, Embase, Cochrane Central Register, CINAHL, ProQuest, Scopus, and Web of Science. Randomised controlled trials (RCTs) reporting art-based interventions targeting the improvement of women's mental health in pregnancy and postpartum were included. Cochrane risk of bias tool was applied to assess evidence quality. Results Twenty-one randomised controlled trials (RCTs) involving 2,815 participants were eligible for data analysis. A pooled analysis demonstrated that art-based interventions significantly reduced anxiety (SMD = -0.75, 95% CI = -1.10 to -0.40) and depression symptoms (MD = -0.79, 95% CI = -1.30 to -0.28). However, art-based interventions did not alleviate stress symptoms as expected in our findings. Subgroup analysis demonstrated that intervention implementation time, intervention duration and music selected by the participants vs. not could have influence on the efficacy of art-based intervention for anxiety. Conclusion In perinatal mental health, art-based interventions may be effective in alleviating anxiety and depression. In the future, we still need to conduct high-quality RCTs to validate our findings and enrich clinical application of art-based interventions.
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Affiliation(s)
- Jialu Qian
- Faculty of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Man Wang
- Faculty of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiangyu Sun
- Faculty of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
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Effects of Benson Relaxation Technique and Music Therapy on the Anxiety of Primiparous Women Prior to Cesarean Section: A Randomized Controlled Trial. Anesthesiol Res Pract 2022; 2022:9986587. [PMID: 36589598 PMCID: PMC9803568 DOI: 10.1155/2022/9986587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 12/25/2022] Open
Abstract
Background and Aims Primiparous women experience high levels of anxiety before cesarean section. Therefore, this research aimed to investigate the effects of the Benson Relaxation Technique (BRT) and Music Therapy (MT) on the anxiety of primiparous women prior to cesarean section. Methods A randomized controlled trial was carried out on 105 women scheduled for cesarean section. They were randomly assigned into three groups: BRT, MT, and control (n = 35 per group). The women in the BRT and MT groups performed exercises and listened to music, respectively, for 20 minutes prior to cesarean section. The State Anxiety Inventory was used to measure the women's anxiety in the groups before and after the intervention. Results Within-group comparisons showed that the women in the BRT (t = 5.61, p < 0.001, effect size (Cohen's d) = 0.94) and MT (t = 3.83, p = 0.001, d = 0.64) groups had significantly lower anxiety after the interventions compared to before the interventions. Also, between-group comparisons revealed that anxiety after the intervention was significantly lower in the BRT and MT groups compared to the control group (p = 0.007). Conclusions Although both of the BRT and MT helped with the reduction of anxiety among primiparous women before cesarean section, the BRT was shown more effective. These nonpharmacologic methods are safe and cost-effective and can improve well-being among women undergoing this invasive procedure. They can be used along with pharmacologic methods for reducing overreliance on medications.
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Liao Z, Feng S, Song H, Huang H. Continuous transthoracic echocardiographic monitoring for changes in maternal cardiac hemodynamics during cesarean section under combined epidural-spinal anesthesia: a prospective, observational study. J Clin Monit Comput 2021; 36:1387-1396. [PMID: 34743260 DOI: 10.1007/s10877-021-00777-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/01/2021] [Indexed: 02/05/2023]
Abstract
The change in maternal hemodynamics during cesarean section has not been well studied. Continuous transthoracic echocardiography can monitor cardiac function continuously. This study aimed to evaluate the effectiveness of maternal hemodynamic parameters monitoring during cesarean section using continuous transthoracic echocardiography. In this prospective, observational study, women with an uncomplicated singleton pregnancy scheduled for elective cesarean section at term under combined spinal-epidural anesthesia were enrolled. Maternal hemodynamic parameters were assessed by continuous transthoracic echocardiography at 11 pre-set time points. The image quality of continuous transthoracic echocardiography was evaluated before measurement was performed. Totally, one hundred parturients were recruited, and transthoracic echocardiography images with sufficient quality for further analysis were obtained in 72 women. Following anesthesia, maternal heart rate decreased by 11.18% and cardiac output decreased by 7.82%, but stroke volume remained stable. After delivery of the neonate and placenta, stroke volume and cardiac output increased by 21.09% and 22.33%, respectively. End-diastolic volume also increased significantly after delivery of the neonate, but end-systolic volume was unchanged. Following delivery of the neonate, fractional shortening increased till the end of the cesarean section while total peripheral resistance decreased significantly. In conclusion, continuous transthoracic echocardiographic monitoring revealed that there were significant changes in hemodynamic parameters during cesarean section after delivery of the newborn and placenta, which warranted further investigation.
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Affiliation(s)
- Zhimin Liao
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, 20#, 3rd Segment, Ren Min Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Shimiao Feng
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, 20#, 3rd Segment, Ren Min Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China
| | - Haibo Song
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Han Huang
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, 20#, 3rd Segment, Ren Min Nan Lu, Chengdu, 610041, Sichuan, People's Republic of China.
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Scoping review of the association between postsurgical pain and heart rate variability parameters. Pain Rep 2021; 6:e977. [PMID: 35155967 PMCID: PMC8824397 DOI: 10.1097/pr9.0000000000000977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. This scoping review provides some evidence of a possible association between heart rate variability and postsurgical pain, although significant variability exists among included studies. Surgical interventions can elicit neuroendocrine and sympathovagal responses, leading to cardiac autonomic imbalance. Cardiac complications account for approximately 30% of postoperative complications. Altered heart rate variability (HRV) was initially described in the 1970s as a predictor of acute coronary syndromes and has more recently been shown to be an independent predictor of postoperative morbidity and mortality after noncardiac surgery. In general, HRV reflects autonomic balance, and altered HRV measures have been associated with anesthetic use, chronic pain conditions, and experimental pain. Despite the well-documented relationship between altered HRV and postsurgical outcomes and various pain conditions, there has not been a review of available evidence describing the association between postsurgical pain and HRV. We examined the relationship between postsurgical pain and HRV. MEDLINE and EMBASE databases were searched until December 2020 and included all studies with primary data. Two reviewers independently assessed risk of bias for each study using the criteria outlined in the Cochrane Handbook for Systematic Review of Interventions. A total of 8 studies and 1002 participants were included. Studies examined the association of postsurgical pain and HRV or analgesia nociception index derived from HRV. There was a statistically significant association between HRV measures and postsurgical pain in 6 of 8 studies. Heterogeneity of studies precluded meta-analyses. No studies reported cardiovascular outcomes. There is a potential association between postsurgical pain and HRV or analgesia nociception index, although results are likely impacted by confounding variables. Future studies are required to better delineate the relationship between postsurgical pain and HRV and impacts on cardiovascular outcomes.
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Hepp P, Fleisch M, Hasselbach K, Fehm T, Schaal NK. Use of music during vaginal birth and caesarean section: an interprofessional survey. Arch Gynecol Obstet 2021; 304:355-363. [PMID: 33486579 PMCID: PMC8277630 DOI: 10.1007/s00404-020-05958-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/26/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Evidence abounds about the beneficial effects of music on patients and healthcare professionals for many medical indications. This study aimed to evaluate the dissemination and use of music in the obstetrical setting. METHODS Invitations to an online survey were sent to physicians and midwives of all obstetrics departments in Germany. The survey gathered descriptive data as well as information about the personal relation to music and the use of it during vaginal birth (VB) and caesarean section (CS) and whether data about positive or negative effects of music were known to the participant. RESULTS In total, there were 293 respondents. The 47% that had the means to play music during CS stated that music was played in 15% of the cases. Most respondents have the means to play music during VB (97%). Music is played in 38% of VB. Regardless of the mode of delivery, music was estimated to be positive for team communication and patient communication. It was also deemed calming and mood lifting on the respondents. Regarding the patient, music during CS and VB was rated as being positive on all scales. Listening to music was recommended more often during VB (66%) than CS (38%). CONCLUSIONS Although healthcare professionals are mostly aware of the beneficial effects of music in obstetrics, our study shows that music plays a more important role during VB than during CS in Germanys obstetrical wards. There is a lack of equipment to play music in operation theatres where CS take place.
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Affiliation(s)
- Philip Hepp
- University Witten/Herdecke, Landesfrauenklinik, Wuppertal, Germany.
- University Hospital Augsburg, Frauenklinik, Stenglinstr. 2, 86156, Augsburg, Germany.
| | - Markus Fleisch
- University Witten/Herdecke, Landesfrauenklinik, Wuppertal, Germany
| | - Kathrin Hasselbach
- Department for Cognitive Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Tanja Fehm
- University Hospital Düsseldorf, Frauenklinik, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nora K Schaal
- Department for Cognitive Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Weingarten SJ, Levy AT, Berghella V. The effect of music on anxiety in women undergoing cesarean delivery: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2021; 3:100435. [PMID: 34214717 DOI: 10.1016/j.ajogmf.2021.100435] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of music on anxiety in patients undergoing cesarean delivery. DATA SOURCES An electronic search of PubMed, CINAHL, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials was performed from inception to November 2020. STUDY ELIGIBILITY CRITERIA Eligibility criteria included all randomized controlled trials of pregnant women undergoing cesarean delivery who were randomized to either the music intervention or control. Studies needed to measure preoperative, intraoperative, or postoperative anxiety via a visual analog scale, State-Trait Anxiety Inventory, or Zung Self-Rating Anxiety Scale, for inclusion. The primary outcome was intraoperative anxiety during cesarean delivery. Secondary outcomes included preoperative and postoperative anxiety, postoperative pain, postoperative opioid requirements, blood pressure, and heart rate. STUDY APPRAISAL AND SYNTHESIS METHODS The methodologic quality of the included studies was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce a summary of treatment effects in terms of mean difference with 95% confidence intervals. A prespecified subgroup analysis of patients undergoing a scheduled or an unscheduled cesarean delivery was carried out for the main outcomes. RESULTS Of the 1296 studies screened, 15 met the inclusion criteria (n=613 music group vs n=748 controls). Three trials (n=217 music group vs n=215 controls) reported on intraoperative anxiety specifically. Among studies using a visual analog scale for anxiety assessment, women in the intervention group had lower intraoperative anxiety levels than the controls (mean difference, -0.54; 95% confidence interval, -0.87 to -0.20; I2=0%; n=2 studies). One trial used the State-Trait Anxiety Inventory and 1 trial used the Zung Self-Rating Anxiety Scale for intraoperative anxiety assessment. In both of these studies, music exposure was associated with lower anxiety levels when compared with the controls (State-Trait Anxiety Inventory: mean difference, -2.80; 95% confidence interval, -4.57 to -1.03; Zung Self-Rating Anxiety Scale: mean difference, -4.80; 95% confidence interval, -7.08 to -2.52). In the subgroup analyses, the same relationship persisted when the cesarean delivery was unscheduled and when the music was selected by the patient or by the study team. The effect of music on preoperative and postoperative anxiety varied depending on which anxiety assessment tool was used. Music was also associated with decreased opioid use (mean difference, -0.87; 95% confidence interval, -1.55 to -0.19; I2=0%). CONCLUSION In patients undergoing a cesarean delivery, music is associated with decreased intraoperative anxiety.
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Affiliation(s)
- Sarah J Weingarten
- Department of Obstetrics and Gynecology, New York Medical College, New York, NY (Dr Weingarten)
| | - Ariel T Levy
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY (Dr Levy)
| | - Vincenzo Berghella
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, PA (Dr Berghella)..
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Patient and procedural risk factors for increased postoperative pain after cesarean delivery under neuraxial anesthesia: a retrospective study. Int J Obstet Anesth 2020; 44:60-67. [DOI: 10.1016/j.ijoa.2020.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 07/07/2020] [Accepted: 07/15/2020] [Indexed: 12/17/2022]
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Santiváñez-Acosta R, Tapia-López EDLN, Santero M. Music Therapy in Pain and Anxiety Management during Labor: A Systematic Review and Meta-Analysis. ACTA ACUST UNITED AC 2020; 56:medicina56100526. [PMID: 33050409 PMCID: PMC7599829 DOI: 10.3390/medicina56100526] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 12/21/2022]
Abstract
Background and Objective: The study of music therapy in labor is unknown. The main objective of this research was to evaluate the effectiveness of music therapy to manage pain and anxiety during labor. Materials and Methods: A search strategy was used with PubMed/MEDLINE, LILACS, Cochrane, TRIPDATABASE, and Google Scholar. The selection criteria were based on randomized clinical trials; quasi-experimental research on pain intensity and anxiety during labor was evaluated. The primary outcomes were measured by the Visual Analogue Scale (VAS). A meta-analysis of the fixed effects was performed using mean differences (MD). Twelve studies were included for the final analysis, six (778 women) of which were meta-analyzed. Results: Decreased VAS scores for pain intensity associated with music therapy were found in the latent (MD: -0.73; 95% CI -0.99; -0.48) and active (MD: -0.68; 95% CI -0.92; -0.44) phases of labor. VAS scores for anxiety decreased both in the latent (MD: -0.74; 95% CI -1.00; -0.48) and active (MD: -0.76; 95% CI -0.88; -0.64) phases. Conclusion: Music therapy seems to have beneficial effects on pain intensity and anxiety during labor, especially for women giving birth for the first time. However, the evidence is qualified as low.
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Affiliation(s)
- Rocio Santiváñez-Acosta
- Centro Nacional de Salud Intercultural, Instituto Nacional de Salud, Av. Defensores del Morro 2268 (Ex Huaylas)—Chorrillos, Lima 9, Lima 15066, Peru
- Correspondence: ; Tel.: +51-96-5077-260
| | | | - Marilina Santero
- Instituto de Efectividad Clínica y Sanitaria (IECS), Escuela de Salud Pública de la Universidad de Buenos Aires, Marcelo T. de Alvear, Buenos Aires 2202, Argentina;
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Zimpel SA, Torloni MR, Porfírio GJ, Flumignan RL, da Silva EM. Complementary and alternative therapies for post-caesarean pain. Cochrane Database Syst Rev 2020; 9:CD011216. [PMID: 32871021 PMCID: PMC9701535 DOI: 10.1002/14651858.cd011216.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pain after caesarean sections (CS) can affect the well-being of the mother and her ability with her newborn. Conventional pain-relieving strategies are often underused because of concerns about the adverse maternal and neonatal effects. Complementary alternative therapies (CAM) may offer an alternative for post-CS pain. OBJECTIVES To assess the effects of CAM for post-caesarean pain. SEARCH METHODS We searched Cochrane Pregnancy and Childbirth's Trials Register, LILACS, PEDro, CAMbase, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (6 September 2019), and checked the reference lists of retrieved articles. SELECTION CRITERIA Randomised controlled trials (RCTs), including quasi-RCTs and cluster-RCTs, comparing CAM, alone or associated with other forms of pain relief, versus other treatments or placebo or no treatment, for the treatment of post-CS pain. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, extracted data, assessed risk of bias and assessed the certainty of evidence using GRADE. MAIN RESULTS We included 37 studies (3076 women) which investigated eight different CAM therapies for post-CS pain relief. There is substantial heterogeneity among the trials. We downgraded the certainty of evidence due to small numbers of women participating in the trials and to risk of bias related to lack of blinding and inadequate reporting of randomisation processes. None of the trials reported pain at six weeks after discharge. Primary outcomes were pain and adverse effects, reported per intervention below. Secondary outcomes included vital signs, rescue analgesic requirement at six weeks after discharge; all of which were poorly reported, not reported, or we are uncertain as to the effect Acupuncture or acupressure We are very uncertain if acupuncture or acupressure (versus no treatment) or acupuncture or acupressure plus analgesia (versus placebo plus analgesia) has any effect on pain because the quality of evidence is very low. Acupuncture or acupressure plus analgesia (versus analgesia) may reduce pain at 12 hours (standardised mean difference (SMD) -0.28, 95% confidence interval (CI) -0.64 to 0.07; 130 women; 2 studies; low-certainty evidence) and 24 hours (SMD -0.63, 95% CI -0.99 to -0.26; 2 studies; 130 women; low-certainty evidence). It is uncertain whether acupuncture or acupressure (versus no treatment) or acupuncture or acupressure plus analgesia (versus analgesia) has any effect on the risk of adverse effects because the quality of evidence is very low. Aromatherapy Aromatherapy plus analgesia may reduce pain when compared with placebo plus analgesia at 12 hours (mean difference (MD) -2.63 visual analogue scale (VAS), 95% CI -3.48 to -1.77; 3 studies; 360 women; low-certainty evidence) and 24 hours (MD -3.38 VAS, 95% CI -3.85 to -2.91; 1 study; 200 women; low-certainty evidence). We are uncertain if aromatherapy plus analgesia has any effect on adverse effects (anxiety) compared with placebo plus analgesia. Electromagnetic therapy Electromagnetic therapy may reduce pain compared with placebo plus analgesia at 12 hours (MD -8.00, 95% CI -11.65 to -4.35; 1 study; 72 women; low-certainty evidence) and 24 hours (MD -13.00 VAS, 95% CI -17.13 to -8.87; 1 study; 72 women; low-certainty evidence). Massage We identified six studies (651 women), five of which were quasi-RCTs, comparing massage (foot and hand) plus analgesia versus analgesia. All the evidence relating to pain, adverse effects (anxiety), vital signs and rescue analgesic requirement was very low-certainty. Music Music plus analgesia may reduce pain when compared with placebo plus analgesia at one hour (SMD -0.84, 95% CI -1.23 to -0.46; participants = 115; studies = 2; I2 = 0%; low-certainty evidence), 24 hours (MD -1.79, 95% CI -2.67 to -0.91; 1 study; 38 women; low-certainty evidence), and also when compared with analgesia at one hour (MD -2.11, 95% CI -3.11 to -1.10; 1 study; 38 women; low-certainty evidence) and at 24 hours (MD -2.69, 95% CI -3.67 to -1.70; 1 study; 38 women; low-certainty evidence). It is uncertain whether music plus analgesia has any effect on adverse effects (anxiety), when compared with placebo plus analgesia because the quality of evidence is very low. Reiki We are uncertain if Reiki plus analgesia compared with analgesia alone has any effect on pain, adverse effects, vital signs or rescue analgesic requirement because the quality of evidence is very low (one study, 90 women). Relaxation Relaxation may reduce pain compared with standard care at 24 hours (MD -0.53 VAS, 95% CI -1.05 to -0.01; 1 study; 60 women; low-certainty evidence). Transcutaneous electrical nerve stimulation TENS (versus no treatment) may reduce pain at one hour (MD -2.26, 95% CI -3.35 to -1.17; 1 study; 40 women; low-certainty evidence). TENS plus analgesia (versus placebo plus analgesia) may reduce pain compared with placebo plus analgesia at one hour (SMD -1.10 VAS, 95% CI -1.37 to -0.82; 3 studies; 238 women; low-certainty evidence) and at 24 hours (MD -0.70 VAS, 95% CI -0.87 to -0.53; 108 women; 1 study; low-certainty evidence). TENS plus analgesia (versus placebo plus analgesia) may reduce heart rate (MD -7.00 bpm, 95% CI -7.63 to -6.37; 108 women; 1 study; low-certainty evidence) and respiratory rate (MD -1.10 brpm, 95% CI -1.26 to -0.94; 108 women; 1 study; low-certainty evidence). We are uncertain if TENS plus analgesia (versus analgesia) has any effect on pain at six hours or 24 hours, or vital signs because the quality of evidence is very low (two studies, 92 women). AUTHORS' CONCLUSIONS Some CAM therapies may help reduce post-CS pain for up to 24 hours. The evidence on adverse events is too uncertain to make any judgements on safety and we have no evidence about the longer-term effects on pain. Since pain control is the most relevant outcome for post-CS women and their clinicians, it is important that future studies of CAM for post-CS pain measure pain as a primary outcome, preferably as the proportion of participants with at least moderate (30%) or substantial (50%) pain relief. Measuring pain as a dichotomous variable would improve the certainty of evidence and it is easy to understand for non-specialists. Future trials also need to be large enough to detect effects on clinical outcomes; measure other important outcomes as listed lin this review, and use validated scales.
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Affiliation(s)
| | - Maria Regina Torloni
- Cochrane Brazil, Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde, São Paulo, Brazil
| | - Gustavo Jm Porfírio
- Cochrane Brazil, Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde, São Paulo, Brazil
| | - Ronald Lg Flumignan
- Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Edina Mk da Silva
- Emergency Medicine and Evidence Based Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
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Arroyo-Fernández FJ, Calderón Seoane JE, Torres Morera LM. Strategies of analgesic treatment after cesarean delivery. Current state and new alternatives. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2020; 67:167-175. [PMID: 32085919 DOI: 10.1016/j.redar.2019.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
The number of caesarean sections performed worldwide is increasing, and with it, the need for the optimal analgesia strategies. Deficient postoperative analgesia increases the need for opioids, delays recovery, and is associated with chronic pain and postpartum depression. It is essential to find good postoperative pain control strategies that facilitate early mobility, early recovery, and early hospital discharge with minimal side effects on the mother and infant. Multimodal analgesia based on neuroaxial anaesthesia with morphine in combination with non-opioids such as non-steroidal anti-inflammatory drugs and paracetamol, gives the best post-caesarean analgesia outcome, and allows anaesthesiologists to reserve opioids, corticoids, gabapentin, magnesium or ketamine for situations where neuroaxial anaesthesia cannot be performed, for high-risk patients, or when pain is difficult to control. Peripheral nerve block techniques can also be added, such as transverse abdominis plane block, erector spinae block, or continuous wound infiltration.
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Belloeil V, Tessier Cazeneuve C, Leclercq A, Mercier MB, Legendre G, Corroenne R. Impact of music therapy before first-trimester instrumental termination of pregnancy: a randomised controlled trial. BJOG 2020; 127:738-745. [PMID: 31957130 DOI: 10.1111/1471-0528.16102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To evaluate the impact of preoperative Music Therapy (MT) on pain in first-trimester termination of pregnancy (TOP) under local anaesthesia. DESIGN Randomised controlled trial comparing women undergoing a first-trimester TOP under local anaesthesia with or without a preoperative MT session. SETTING University Hospital of Angers from November 2016 to August 2017. POPULATION Women who underwent first-trimester TOP under local anaesthesia. METHODS Women allocated to the MT group underwent a preoperative 20-minute session of MT. MAIN OUTCOME MEASURES Pain was assessed using a visual analogue scale (VAS) just before the procedure, during the procedure, at the end of the procedure and upon returning to the ward. RESULTS A total of 159 women were randomised (80 in the MT group, and 79 in the control group). Two women were excluded from the control group and six from the MT group. Therefore, 77 women were analysed in the control group and 74 in the MT group. The intensity of pain was similar in the two groups just before the procedure (VAS 4.0 ± 2.9 versus 3.6 ± 2.5; P = 0.78), during the procedure (VAS 5.3 ± 2.5 versus 4.9 ± 2.9; P = 0.78), at the end of the procedure (VAS 2.7 ± 2.4 versus 2.6 ± 2.4; P = 0.43) and upon returning to the ward (VAS 1.8 ± 2.0 versus 1.5 ± 2.0; P = 0.84). The difference in pain between entering the department and returning to the room after the procedure was similar between the MT and control groups (difference in VAS 0.3 ± 2.5 versus 0.3 ± 2.4; P = 0.92). CONCLUSION An MT session before a TOP under local anaesthesia procedure resulted in no improvement in patient perception of pain during a first-trimester TOP. TWEETABLE ABSTRACT Music therapy before first-trimester termination of pregnancy under local anaesthesia did not improve the perception of pain.
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Affiliation(s)
- V Belloeil
- Department of Obstetrics and Gynaecology, University Hospital of Angers, Angers, France
| | - C Tessier Cazeneuve
- Department of Obstetrics and Gynaecology, University Hospital of Angers, Angers, France
| | - A Leclercq
- Department of Obstetrics and Gynaecology, University Hospital of Angers, Angers, France
| | - M B Mercier
- Department of Obstetrics and Gynaecology, University Hospital of Angers, Angers, France
| | - G Legendre
- Department of Obstetrics and Gynaecology, University Hospital of Angers, Angers, France
| | - R Corroenne
- Department of Obstetrics and Gynaecology, University Hospital of Angers, Angers, France
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Yamashita K, Kibe T, Aoyama K, Ohno S, Kohjitani A, Sugimura M. The State Anxiety Inventory Is Useful for Predicting the Autonomic Nervous System State of Patients Before the Extraction of an Impacted Mandibular Third Molar. J Oral Maxillofac Surg 2019; 78:538-544. [PMID: 31884076 DOI: 10.1016/j.joms.2019.11.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Dental anxiety about extraction of impacted mandibular third molars changes the activity of the autonomic nervous system. Thus, to provide safe dental treatment, it is important that a surgeon be aware of a patient's pretreatment anxiety and autonomic nervous system state. Therefore, we analyzed how a scheduled treatment to extract mandibular third molars affects the pretreatment electroencephalogram (EEG), autonomic nervous system, and psychological state of patients. We compared their findings with those of volunteers not scheduled to undergo dental treatment. PATIENTS AND METHODS The study enrolled 30 patients who were scheduled to undergo impacted mandibular third molar extraction (ie, pretreatment group) and 30 volunteers who were not (ie, control group). Heart rate variability and an EEG were recorded during the experiment. The State Anxiety Inventory-State Anxiety scale (STAI-S) scores were recorded before the procedure. For the statistical analysis, P < .05 was deemed statistically significant. RESULTS High-frequency (HF) variability was significantly decreased and the STAI-S score was significantly increased in the pretreatment group compared with the control group (P < .01 for both). The low frequency (LF)/HF ratio and alpha-wave activity showed a significant negative correlation on both sides in the control group (P < .01); however, no correlation existed in the pretreatment group. The LF/HF ratio and STAI-S score showed a significant positive correlation in the pretreatment group (P < .05); however, no correlation existed in the control group. CONCLUSIONS Predicting a patient's autonomic nervous system state before dental treatment based on the EEG was difficult. The STAI-S psychological test was a useful method.
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Affiliation(s)
- Kaoru Yamashita
- Assistant Professor, Department of Dental Anesthesiology, Field of Oral Maxillofacial Rehabilitation, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Toshiro Kibe
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Surgery, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - Kanae Aoyama
- PhD Student, Department of Dental Anesthesiology, Field of Oral Maxillofacial Rehabilitation, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Sachi Ohno
- Assistant Professor, Department of Dental Anesthesiology, Field of Oral Maxillofacial Rehabilitation, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Atsushi Kohjitani
- Associate Professor, Department of Dental Anesthesiology, Field of Oral Maxillofacial Rehabilitation, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mitsutaka Sugimura
- Professor, Department of Dental Anesthesiology, Field of Oral Maxillofacial Rehabilitation, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Brillo E, Tosto V, Ceccagnoli A, Nikolova N, Pinzaglia V, Bordoni F, Spano F, Bini V, Giardina I, Renzo GCD. The effect of prenatal exposure to music on fetal movements and fetal heart rate: a pilot study. J Matern Fetal Neonatal Med 2019; 34:2274-2282. [PMID: 31554450 DOI: 10.1080/14767058.2019.1663817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess and compare fetal cardiac parameters of fetuses listening to music before and during nonstress test, only during the test or never. STUDY DESIGN Thirty healthy mother-fetus dyads were randomized in a 1:1:1 ratio to one of three groups: group A in which fetuses were submitted to prelistening phase (33rd + 0 to 36th + 3 week) and listening sessions during 4 nonstress tests, group B in which fetuses were submitted to listening sessions during 4 nonstress tests, and group C receiving 4 nonstress tests without any listening. We assessed mean fetal heart rate, fetal heart rate accelerations, fetal heart rate decelerations, fetal movements and uterine contractility. RESULTS Fetuses of the group A, who had already listened to a particular piece of music during previous sessions, had significantly increased their heart rate accelerations and movements during the music listening session of the last nonstress test. No significant changes were observed in the number of uterine contractions. CONCLUSIONS Our findings show that fetuses slightly respond to that music they know, but they do not significantly respond to unknown music.
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Affiliation(s)
- Eleonora Brillo
- Unit of Research Methods and Organisation, Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,PhD Program, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Tosto
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Andrea Ceccagnoli
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Natasha Nikolova
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, PhD program on "Translational Medicine", University of Perugia, Perugia, Italy
| | - Valentina Pinzaglia
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Francesca Bordoni
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Filippo Spano
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Vittorio Bini
- Internal Medicine, Endocrinal and Metabolic Science, University of Perugia, Perugia, Italy
| | - Irene Giardina
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Gian Carlo Di Renzo
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
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Pasternak Y, Miller N, Asali A, Yagur Y, Weitzner O, Nimrodi M, Pasternak Y, Berkovitz A, Biron-Shental T. Does music during labor affect mode of delivery in first labor after epidural anesthesia? A prospective study. Arch Gynecol Obstet 2019; 300:1239-1244. [PMID: 31549222 DOI: 10.1007/s00404-019-05310-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/14/2019] [Indexed: 11/28/2022]
Abstract
KEY MESSAGE Listening to music during labor increases the likelihood that primiparas will have a spontaneous vaginal delivery. PURPOSE To examine the effects of exposure to music during labor on the mode of delivery and parturients' stress levels. METHODS This prospective, interventional study included 124 low-risk women who were recruited during latent phase of their first labor after epidural anesthesia. Patients were grouped according to their preference to receive music intervention or not. The music intervention included two subgroups: soft classical music and rhythmic music. We evaluated cortisol levels in saliva as a surrogate for stress level and State-Trait Personality Inventory at enrollment and 1-3 h later in all women who were still in labor. Delivery and perinatal outcomes were collected from electronic medical records. Correlations between the music intervention and maternal and perinatal outcomes were evaluated. RESULTS Spontaneous vaginal delivery was significantly more frequent among women listening to music compared to the non-music group (P = 0.035). A trend towards lower rates of cesarean delivery was noted in the music group (P = 0.08), with no difference in instrumental vaginal delivery rates. Stress levels, as measured by questionnaires and by cortisol levels, blood pressure and pulse rate, remained similar throughout the study. No differences were noted between the different genres of music when examining obstetric and perinatal outcomes and stress levels. CONCLUSION Listening to music during labor, improves the likelihood of primiparas to have a vaginal delivery regardless of stress level. As this treatment is simple, easy, and harmless to administer, we suggest it may be offered to all patients during labor.
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Affiliation(s)
- Yael Pasternak
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Netanella Miller
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aula Asali
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Yagur
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer Weitzner
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Nimrodi
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel
| | - Yehonatan Pasternak
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pediatrics A, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Arie Berkovitz
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Ernsten L, Hepp P, Fehm T, Schaal NK. [Perioperative music-induced analgesia : Comparison of the effect of music on pain between preoperative, intraoperative and postoperative application]. Schmerz 2019; 33:100-105. [PMID: 30411138 DOI: 10.1007/s00482-018-0338-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Despite suitable analgesia procedures and interventions only approximately 24% of inpatients with strong to very strong pain receive adequate treatment. Besides opioids, which are associated with numerous side effects and risks, non-pharmacological approaches are increasingly being used. In this context, one of the oldest known methods are music interventions; however, the state of evidence is heterogeneous and there are no explicit manuals and recommendations for the effective implementation of music interventions. OBJECTIVE This review aimed to determine the optimal time point at which perioperative music interventions can most effectively relieve pain. MATERIAL AND METHODS A PubMed search was conducted and publications investigating the effect of music during the preoperative, intraoperative and postoperative stages of various interventions were identified. RESULTS During the preoperative phase, only positive effects of music on pain relief have been reported but availability of data is sparse. During the intraoperative stage of a medical intervention the effect of music seems to be mediated by the type of anesthesia procedure and sedation depth. Only patients who can consciously perceive the music seem to profit from it. Positive alleviating effects on subjective pain perception and analgesia needs were shown in the postoperative stage. CONCLUSION Music is a non-pharmacological method to alleviate pain, which is free of side effects. Important considerations for the use of music interventions for relief of acute pain associated with surgery are discussed taking into account numerous mediating factors, which influence the efficacy of the treatment.
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Affiliation(s)
- L Ernsten
- Institut für Experimentelle Psychologie, Heinrich-Heine-Universität, Universitätsstraße 1, 40225, Düsseldorf, Deutschland
| | - P Hepp
- Landesfrauenklinik, Helios Universitätsklinikum Wuppertal, Universität Witten-Herdecke, Wuppertal, Deutschland
| | - T Fehm
- Universitätsfrauenklinik, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - N K Schaal
- Institut für Experimentelle Psychologie, Heinrich-Heine-Universität, Universitätsstraße 1, 40225, Düsseldorf, Deutschland.
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Schaal NK, Fehm T, Wolf OT, Gielen P, Hagenbeck C, Heil M, Fleisch M, Hepp P. Comparing the course of anxiety in women receiving their first or repeated caesarean section: A prospective cohort study. Women Birth 2019; 33:280-285. [PMID: 31176587 DOI: 10.1016/j.wombi.2019.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/15/2019] [Accepted: 05/22/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Around 30% of births are through caesarean section and repetition rates for receiving a caesarean section are high. AIM The aim of the prospective study was to compare the course of anxiety in women undergoing their first caesarean section and women experiencing a repeated caesarean section. PARTICIPANTS 304 women with an indication for an elective caesarean section took part. 155 received their first caesarean section and 149 received a repeated caesarean section. METHODS In order to measure the course of anxiety on the day of the caesarean section subjective anxiety levels were measured and saliva samples for cortisol determination were taken at admission, during skin closure and two hours after the surgery. Blood pressure and heart rate were documented at skin incision and skin closure. RESULTS Women experiencing their first caesarean section displayed significantly higher anxiety levels compared to women with a repeated caesarean section. Scores of the STAI-State and visual analogue scale for anxiety differed significantly at admission (p=.006 and p<.001) and heart rate and alpha amylase levels were significantly higher at skin closure (p=.027 and p=.029). CONCLUSION The results show that previous experience with a caesarean section has a soothing effect. The study aims to sensitize surgeons, anesthetists, nurses and midwives when treating women receiving a caesarean section and encourage them to incorporate soothing interventions, especially for women receiving their first caesarean section to reduce anxiety levels and consequently improve postoperative recovery and patients' satisfaction.
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Affiliation(s)
- N K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany.
| | - T Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - O T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-University Bochum, Germany
| | - P Gielen
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - C Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - M Heil
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - M Fleisch
- Clinic for Gynecology and Obstetrics, HELIOS University Clinic, Wuppertal, University Witten/Herdecke, Germany
| | - P Hepp
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany; Clinic for Gynecology and Obstetrics, HELIOS University Clinic, Wuppertal, University Witten/Herdecke, Germany
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Yamashita K, Kibe T, Ohno S, Kohjitani A, Sugimura M. The Effects of Music Listening During Extraction of the Impacted Mandibular Third Molar on the Autonomic Nervous System and Psychological State. J Oral Maxillofac Surg 2019; 77:1153.e1-1153.e8. [DOI: 10.1016/j.joms.2019.02.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/21/2019] [Accepted: 02/14/2019] [Indexed: 12/28/2022]
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Lin HH, Chang YC, Chou HH, Chang CP, Huang MY, Liu SJ, Tsai CH, Lei WT, Yeh TL. Effect of music interventions on anxiety during labor: a systematic review and meta-analysis of randomized controlled trials. PeerJ 2019; 7:e6945. [PMID: 31143552 PMCID: PMC6525590 DOI: 10.7717/peerj.6945] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/11/2019] [Indexed: 12/26/2022] Open
Abstract
Background Anxiety is commonly experienced during the delivery process and has shown to have adverse effects on maternal and infant health outcomes. Music interventions tend to reduce the effects of anxiety in diverse populations, are low cost, are easily accessible, and have high acceptability. The aim of this review and meta-analysis was to assess the effectiveness of music interventions in reducing anxiety levels among women during labor. Methods Seven databases from inception to the end of December, 2018, without any language or time restriction including Embase, PubMed, the Cochrane Library, the Cumulative Index to Nursing and Allied Health, PsycINFO, Airiti Library, and PerioPath: Index to Taiwan Periodical Literature were searched using key terms related to pregnancy, anxiety, and music. Randomized controlled trials that assessed the effect of music during labor and measured anxiety levels as an outcome were included. Meta-analyses were conducted to assess anxiety reduction following a music intervention compared to that after placebo treatment. Results A total of 14 studies that investigated a total of 1,310 participants were included in this review. The meta-analyses indicated that those in the intervention group had a significant decrease in anxiety scores (standardized mean difference = −2.40, 95% confidence interval (CI) [−3.29 to −1.52], p < 0.001; I2 = 97.66%), heart rate (HR) (difference in means = −3.04 beats/min, 95% CI [−4.79 to −1.29] beats/min, p = 0.001; I2 = 0.00%), systolic blood pressure (SBP) (difference in means = −3.71 mmHg, 95% CI [−7.07 to −0.35] mmHg, p = 0.031; I2 = 58.47%), and diastolic blood pressure (DBP) (difference in means = −3.54 mmHg, 95% CI [−5.27 to −1.81] mmHg, p < 0.001; I2 = 0.00%) as compared to the women in the control group. Conclusions Music interventions may decrease anxiety scores and physiological indexes related to anxiety (HR, SBP, and DBP). Music interventions may be a good non-pharmacological approach for decreasing anxiety levels during labor.
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Affiliation(s)
- Hsin-Hui Lin
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yu-Chen Chang
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hsiao-Hui Chou
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chih-Po Chang
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Yuan Huang
- Department of Hospice and Palliative Care, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan
| | - Shu-Jung Liu
- Department of Medical Library, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan
| | - Chin-Han Tsai
- Department of Gynecology and Obstetrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Wei-Te Lei
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tzu-Lin Yeh
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.,Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
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Farzaneh M, Abbasijahromi A, Saadatmand V, Parandavar N, Dowlatkhah HR, Bahmanjahromi A. Comparative Effect of Nature-Based Sounds Intervention and Headphones Intervention on Pain Severity After Cesarean Section: A Prospective Double-Blind Randomized Trial. Anesth Pain Med 2019; 9:e67835. [PMID: 31341820 PMCID: PMC6614917 DOI: 10.5812/aapm.67835] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 02/24/2018] [Accepted: 03/18/2019] [Indexed: 11/16/2022] Open
Abstract
Background Non-pharmacological treatment methods are being increasingly investigated for pain prevention and relief either alone or in combination with pharmacological treatment. Methods The present randomized placebo-controlled trial was conducted on 57 mothers undergoing elective cesarean section over 10 months from April 2015 to February 2016. The participants were randomly assigned to three groups: control, headphone, and nature-based sounds (N-BS). The investigator recorded pain severity every eight hours after the surgery. Mothers in the headphone group used headphones for 20 minutes (without playing sounds) and mothers in the N-BS group used headphones and listened to N-BS for 20 minutes. We played pleasant nature sounds for the N-BS group using media players and headphones. Mothers' pain severity was measured immediately before the intervention and 15 and 60 minutes after the end of the intervention. Results The N-BS group had a significantly lower pain severity than the headphone and control groups. Statistically insignificant differences were observed between the control and headphone groups indicating that headphone only did not reduce the pain in the intervention group. These reductions were more evident progressively in 15 and 60 minutes after the end of the intervention. Conclusions The application of N-BS for mothers undergoing elective cesarean section promotes nursing autonomy and the notion that nurses can influence the patient's environment.
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Affiliation(s)
- Mehran Farzaneh
- Student Research Committee, Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ali Abbasijahromi
- Anesthesiology and Intensive Care Department, Research Center for Social Determinants of Health, School of Nursing and Paramedical Sciences, Jahrom University of Medical Sciences, Jahrom, Iran
- Corresponding Author: M.Sc. in Critical Care Nursing, Anesthesiology and Intensive Care Department, Ostad Motahari Blvd., School of Nursing and Paramedical Sciences, Jahrom University of Medical Sciences, Jahrom, Iran. Tel: +98-9173914974,
| | - Vahid Saadatmand
- Department of Medical Emergency, School of Nursing and Paramedical Sciences, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Nehleh Parandavar
- Department of Nursing and Midwifery, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Ayda Bahmanjahromi
- Student Research Committee, Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
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Hepp P, Hagenbeck C, Gilles J, Wolf OT, Goertz W, Janni W, Balan P, Fleisch M, Fehm T, Schaal NK. Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study. BMC Pregnancy Childbirth 2018; 18:435. [PMID: 30390639 PMCID: PMC6215648 DOI: 10.1186/s12884-018-2069-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/19/2018] [Indexed: 12/20/2022] Open
Abstract
Background Stress and anxiety during pregnancy and childbirth have negative consequences for both mother and child. There are indications that music has a positive effect in this situation. The present study investigates the influence of music during the caesarean on anxiety and stress of the expectant mother. Methods The SAMBA study is a single-centre, controlled, randomized study including 304 patients. Women in the intervention group heard music via loudspeakers from one of four self-selected genres. The control group had standard treatment without music. The caesarean was performed in regional Anesthesia. At admission, at skin incision, during skin suture and two hours after completion of surgery, different subjective (State-Trait Anxiety Inventory, visual analogue scale for anxiety) and objective parameters (salivary cortisol/amylase, heart rate, blood pressure) were collected. Mixed-factorial Analysis of variances as well as independent sample t-tests were applied for data analysis. Results At skin suture, significantly lower anxiety levels were reported in the intervention group regarding State anxiety (31.56 vs. 34.41; p = .004) and visual analogue scale for anxiety (1.27 vs. 1.76; p = .018). Two hours after surgery, the measured visual analogue scale for anxiety score in the intervention group was still significantly lower (0.69 vs. 1.04; p = .018). The objective parameters showed significant differences between the groups in salivary cortisol increase from admission to skin suture (12.29 vs. 16.61 nmol/L; p = .043), as well as systolic blood pressure (130.11 vs. 136.19 mmHg; p = .002) and heart rate (88.40 vs. 92.57/min; p = .049) at skin incision. Conclusions Music during caesarean is an easy implementable and effective way of reducing stress and anxiety of the expectant mother. Trial registration German registry for clinical trials (DRKS00007840). Registered 16/06/2015. Retrospectively registered.
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Affiliation(s)
- Philip Hepp
- Clinic for Gynecology and Obstetrics, Helios University Hospital Wuppertal, University Witten/Herdecke, Heusnerstr 40, 42283, Wuppertal, Germany. .,Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany.
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Julius Gilles
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Wolfram Goertz
- Musikerambulanz, Heinrich-Heine-University, Düsseldorf, Germany
| | - Wolfgang Janni
- Clinic for Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Percy Balan
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Markus Fleisch
- Clinic for Gynecology and Obstetrics, Helios University Hospital Wuppertal, University Witten/Herdecke, Heusnerstr 40, 42283, Wuppertal, Germany
| | - Tanja Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Nora K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
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Boyce M, Bungay H, Munn-Giddings C, Wilson C. The impact of the arts in healthcare on patients and service users: A critical review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:458-473. [PMID: 28940775 DOI: 10.1111/hsc.12502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 05/06/2023]
Abstract
This review provides an updated evaluation of the emerging body of literature on the value of the arts in healthcare settings. Internationally, there is growing interest in the use of the arts in the healthcare context supported by the number of research studies reported in the nursing and medical literature. There is evidence that arts interventions have positive effects on psychological and physiological outcomes on patients in a hospital environment. A critical review of the literature between 2011 and 2016 was undertaken. The following databases were searched: MedLine, CINAHL, AMED, Web of Science and ASSIA. Searches included words from three categories: cultural activities, outcomes and healthcare settings. Initial searches identified 131 potentially relevant articles. Following screening and review by the research team, a total of 69 studies were included in the final review. The majority of studies examined the effect of music listening on patients/service users (76.8%). These studies were primarily quantitative focusing on the measurable effects of music listening in a surgical context. Overall, the studies in the review support the growing evidence base on the value of the arts in a variety of healthcare settings for patients/service users. The review findings suggest that now is the time for different voices and art forms to be considered and represented in the research on arts in healthcare. Further research is also required to strengthen the existing evidence base.
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Affiliation(s)
- Melanie Boyce
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Hilary Bungay
- Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK
| | - Carol Munn-Giddings
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Ceri Wilson
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
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Robb SL, Hanson-Abromeit D, May L, Hernandez-Ruiz E, Allison M, Beloat A, Daugherty S, Kurtz R, Ott A, Oyedele OO, Polasik S, Rager A, Rifkin J, Wolf E. Reporting quality of music intervention research in healthcare: A systematic review. Complement Ther Med 2018; 38:24-41. [PMID: 29857877 PMCID: PMC5988263 DOI: 10.1016/j.ctim.2018.02.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Concomitant with the growth of music intervention research, are concerns about inadequate intervention reporting and inconsistent terminology, which limits validity, replicability, and clinical application of findings. OBJECTIVE Examine reporting quality of music intervention research, in chronic and acute medical settings, using the Checklist for Reporting Music-based Interventions. In addition, describe patient populations and primary outcomes, intervention content and corresponding interventionist qualifications, and terminology. METHODS Searching MEDLINE, PubMed, CINAHL, HealthSTAR, and PsycINFO we identified articles meeting inclusion/exclusion criteria for a five-year period (2010-2015) and extracted relevant data. Coded material included reporting quality across seven areas (theory, content, delivery schedule, interventionist qualifications, treatment fidelity, setting, unit of delivery), author/journal information, patient population/outcomes, and terminology. RESULTS Of 860 articles, 187 met review criteria (128 experimental; 59 quasi-experimental), with 121 publishing journals, and authors from 31 countries. Overall reporting quality was poor with <50% providing information for four of the seven checklist components (theory, interventionist qualifications, treatment fidelity, setting). Intervention content reporting was also poor with <50% providing information about the music used, decibel levels/volume controls, or materials. Credentialed music therapists and registered nurses delivered most interventions, with clear differences in content and delivery. Terminology was varied and inconsistent. CONCLUSIONS Problems with reporting quality impedes meaningful interpretation and cross-study comparisons. Inconsistent and misapplied terminology also create barriers to interprofessional communication and translation of findings to patient care. Improved reporting quality and creation of shared language will advance scientific rigor and clinical relevance of music intervention research.
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Affiliation(s)
- Sheri L. Robb
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Deanna Hanson-Abromeit
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Lindsey May
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Eugenia Hernandez-Ruiz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Megan Allison
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Beloat
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Sarah Daugherty
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Rebecca Kurtz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Ott
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | | | - Shelbi Polasik
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Allison Rager
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Jamie Rifkin
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Emily Wolf
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
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Kühlmann AYR, de Rooij A, Kroese LF, van Dijk M, Hunink MGM, Jeekel J. Meta-analysis evaluating music interventions for anxiety and pain in surgery. Br J Surg 2018; 105:773-783. [PMID: 29665028 PMCID: PMC6175460 DOI: 10.1002/bjs.10853] [Citation(s) in RCA: 162] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/08/2017] [Accepted: 02/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. METHODS Eleven electronic databases were searched for full-text publications of RCTs investigating the effect of music interventions on anxiety and pain during invasive surgery published between 1 January 1980 and 20 October 2016. Results and data were double-screened and extracted independently. Random-effects meta-analysis was used to calculate effect sizes as standardized mean differences (MDs). Heterogeneity was investigated in subgroup analyses and metaregression analyses. The review was registered in the PROSPERO database as CRD42016024921. RESULTS Ninety-two RCTs (7385 patients) were included in the systematic review, of which 81 were included in the meta-analysis. Music interventions significantly decreased anxiety (MD -0·69, 95 per cent c.i. -0·88 to -0·50; P < 0·001) and pain (MD -0·50, -0·66 to -0·34; P < 0·001) compared with controls, equivalent to a decrease of 21 mm for anxiety and 10 mm for pain on a 100-mm visual analogue scale. Changes in outcome corrected for baseline were even larger: MD -1·41 (-1·89 to -0·94; P < 0·001) for anxiety and -0·54 (-0·93 to -0·15; P = 0·006) for pain. Music interventions provided during general anaesthesia significantly decreased pain compared with that in controls (MD -0·41, -0·64 to -0·18; P < 0·001). Metaregression analysis found no significant association between the effect of music interventions and age, sex, choice and timing of music, and type of anaesthesia. Risk of bias in the studies was moderate to high. CONCLUSION Music interventions significantly reduce anxiety and pain in adult surgical patients.
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Affiliation(s)
- A Y R Kühlmann
- Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A de Rooij
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - L F Kroese
- Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M van Dijk
- Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M G M Hunink
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - J Jeekel
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands
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Williams C, Hine T. An investigation into the use of recorded music as a surgical intervention: A systematic, critical review of methodologies used in recent adult controlled trials. Complement Ther Med 2018; 37:110-126. [PMID: 29609922 DOI: 10.1016/j.ctim.2018.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 02/01/2018] [Accepted: 02/12/2018] [Indexed: 01/20/2023] Open
Abstract
CONTEXT While music is being increasingly used as a surgical intervention, the types of music used and the reasons underlying their selection remain inconsistent. Empirical research into the efficacy of such musical interventions is therefore problematic. OBJECTIVE To provide clear guidelines for musical selection and employment in surgical interventions, created through a synthesis of the literature. The aim is to examine how music is implemented in surgical situations, and to provide guidance for the selection and composition of music for future interventions. METHODS English language quantitative surgical intervention studies from Science Direct, ProQuest, and Sage Journals Online, all published within the last 10 years and featuring recorded music, were systematically reviewed. Variables investigated included: the time the intervention was performed, the intervention length, the outcomes targeted, music description (general and specific), theoretical frameworks underlying the selection of the music, whether or not a musical expert was involved, participant music history, and the participants' feedback on the chosen music. RESULTS Several aspects contribute to the lack of scientific rigour regarding music selection in this field, including the lack of a theoretical framework or frameworks, no involvement of musical experts, failure to list the music tracks used, and the use of vague and subjective terms in general music descriptions. Patients are frequently allowed to select music (risking both choosing music that has an adverse effect and making study replication difficult), and patient music history and listening habits are rarely considered. Crucially, five primary theoretical frameworks underlying the effectiveness of music arose in the literature (distraction, relaxation, emotional shift, entrainment, and endogenous analgesia), however music was rarely selected to enhance any of these mechanisms. CONCLUSIONS Further research needs to be conducted to ensure that music is selected according to a theoretical framework and more rigorous and replicable methodology. Music interventions can be made more effective at improving psychological states and reducing physiological arousal by selecting music conducive to specific mechanisms, and also by considering at what point during the surgical experience the music would be most effective. Greater involvement of music experts in interventions would help to ensure that the most appropriate music was chosen, and that it is clearly and precisely described.
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Affiliation(s)
- Courtney Williams
- Queensland Conservatorium Research Centre, Griffith University, South Brisbane, QLD, Australia.
| | - Trevor Hine
- Menzies Health Institute Queensland, Australia; School of Applied Psychology, Griffith University, Mt Gravatt, QLD, Australia.
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The joy of heartfelt music: An examination of emotional and physiological responses. Int J Psychophysiol 2017; 120:118-125. [DOI: 10.1016/j.ijpsycho.2017.07.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 11/24/2022]
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Wulff V, Hepp P, Fehm T, Schaal NK. Music in Obstetrics: An Intervention Option to Reduce Tension, Pain and Stress. Geburtshilfe Frauenheilkd 2017; 77:967-975. [PMID: 28959060 DOI: 10.1055/s-0043-118414] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/15/2017] [Accepted: 08/15/2017] [Indexed: 01/18/2023] Open
Abstract
In recent years, the effect of music interventions and music therapy has experienced increased attention in the literature. It has been shown that music has positive effects on cognitive and physical performance, such as concentration and endurance, as well as on psychological parameters, such as anxiety and relaxation. Studies within the context of medicine in particular are increasingly indicating that music may be used as an intervention for relief against anxiety, stress and pain. Music is therefore seen in actual practice as a supplement to conventional pharmacological and non-pharmacological forms of treatment - and the trend is rising. Studies involving music interventions in the field of obstetrics have shown, amongst other things, that music improves the ability to relax during pregnancy and can reduce anxiety. It was also discovered that during childbirth music interventions resulted in a reduction of pain and stress. Music also has the effect of reducing stress, pain and anxiety in expectant mothers during deliveries by caesarean section. This review intends to provide an overview of the literature on music interventions in the field of obstetrics and to give a resume on the current state of research around the topic of music in relation to pregnancy, spontaneous deliveries and caesarean sections. Furthermore, the relevance of music for everyday obstetrics will be illustrated.
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Affiliation(s)
- Verena Wulff
- Institut für Experimentelle Psychologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Philip Hepp
- Landesfrauenklinik, HELIOS Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Wuppertal, Germany
| | - Tanja Fehm
- Universitätsfrauenklinik, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Nora K Schaal
- Institut für Experimentelle Psychologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
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Abstract
Cesarean delivery rates are increasing worldwide, and effective postoperative pain management is a key priority of women undergoing cesarean delivery. Inadequate pain management in the acute postoperative period is associated with persistent pain, greater opioid use, delayed functional recovery, and increased postpartum depression. In addition to pain relief, optimal management of patients after cesarean delivery should address the goals of unrestricted maternal mobility, minimal maternal and neonatal side effects, rapid recovery to baseline functionality, and early discharge home. Multimodal analgesia should include neuraxial morphine in conjunction with nonopioid adjuncts, with additional oral or intravenous opioids reserved for severe breakthrough pain.
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Affiliation(s)
- Caitlin Dooley Sutton
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Brendan Carvalho
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA.
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Mirghafourvand M, Sehhati Shafaie F, Mohammad-Alizadeh-Charandabi S, Jabbari B. Effect of Vocalization of the Holy Quran With and Without Translation on Pregnancy Outcomes: A Randomized Clinical Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017; 18:e35421. [PMID: 28144462 PMCID: PMC5253461 DOI: 10.5812/ircmj.35421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 04/02/2016] [Accepted: 04/17/2016] [Indexed: 11/23/2022]
Abstract
Background During recent decades, research in Iran in the area of the Quran and medical science has been seriously engaged in. With respect to the tendency toward spirituality and alternative medicine, we tried to find other aspects of the influence of the Quran. Objectives This study aimed to determine the effect of vocalizations of the Holy Quran with and without translation on the consequences of pregnancy (the prevalence of preterm delivery, caesarean delivery, and neonatal anthropometric indices) in women admitted to health care centers in Urmia, Iran. Materials and Methods This was a three-armed parallel-group randomized clinical trial in which 168 pregnant women (25-28 weeks) in their first and second pregnancies were divided into three groups of 56 (Holy Quran with translation, Holy Quran without translation, and control group) by randomized blocking. The intervention was implemented once a week for three weeks in the health center, and on other days of the week, the participants listened at home to a CD they were given. The intervention and the control groups all received routine pregnancy care once a week. These mothers were tracked during their labor. Outcomes including gestational age at delivery, delivery type, and neonatal anthropometric indices were recorded based on the mother’s records. Results There was no statistically significant difference between the groups in terms of demographic and obstetric characteristics before the intervention. In comparison with the control group, the probability of preterm delivery was lower in the Holy Quran with translation group (odds ratio: 0.3, CI 95%: 0.1-1.2) and in the Holy Quran without translation group (0.6, 0.2-1.9) as compared to the control group. However, this difference was not statistically significant. Similarly, the probability of caesarean delivery was lower in the Holy Quran with translation group (0.6, 0.3-1.4) and the Holy Quran without translation group (0.5, 0.2-1.2) as compared to the control group. Based on one-way ANOVA, there was no statistically significant difference between the study groups regarding the infants’ anthropometric indices. Conclusions Based on the results of this study, despite the lower prevalence of preterm labor and caesarean section in the intervention groups as compared to the control group, no statistically significant effect was seen. This was apparently due to the small sample size.
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Affiliation(s)
| | | | - Sakineh Mohammad-Alizadeh-Charandabi
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Batoul Jabbari
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding Author: Batoul Jabbari, MSc of Midwifery, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-9143478379, E-mail:
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35
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Hepp P, Hagenbeck C, Burghardt B, Jaeger B, Wolf OT, Fehm T, Schaal NK. Measuring the course of anxiety in women giving birth by caesarean section: a prospective study. BMC Pregnancy Childbirth 2016; 16:113. [PMID: 27188222 PMCID: PMC4870728 DOI: 10.1186/s12884-016-0906-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/13/2016] [Indexed: 11/11/2022] Open
Abstract
Background Women undergoing elective caesarean section experience anxiety. However, course, extent and duration of anxiety have not been investigated yet. This study aimed to explore anxiety levels during the course of the day of surgery by employing and comparing subjective as well as objective measures. By examining their correlation it is intended to give methodological support for interventional studies. Methods This is a monocentric, prospectively planned study in which 47 women with an indication for primary caesarean section took part. Anxiety levels were evaluated using the State-Trait Anxiety Inventory (STAI-trait and STAI-state), the visual analogue scale for anxiety (VASA) as well as saliva cortisol at three time points on the day of the caesarean section (at admission, at skin closure and 2 h post surgery). Results Peak anxiety levels for the STAI-state and VASA were highest at admission and showed significant decreases to skin closure (p < .001). The subjective measures correlated significantly at all time points (p-values < .001). For cortisol levels the peak level of anxiety was shown at skin closure with a significant increase from admission to skin closure and a significant decrease from skin closure to 2 h post operation (p-values < .001). Additionally women with STAI-trait scores above the median showed significantly higher levels at the peaks of anxiety. Conclusion The study reveals the course of anxiety on the day of the caesarean section. A strong correlation of STAI-state and VASA was demonstrated. Cortisol showed a different course, which fits into its known biological kinetics. Taking into account all measures, anxiety seems to be most bothersome before surgery until skin closure. In a differentiated approach using STAI-trait scores as a discriminator we showed that the group with STAI-trait levels above the median is particularly prone to develop anxiety in the setting of the caesarean section and might therefore mostly be in need of an intervention against anxiety.
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Affiliation(s)
- Philip Hepp
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany. .,Clinic for Gynecology and Obstetrics, HELIOS Universitätsklinikum Wuppertal, University Witten/Herdecke, Vogelsangstr. 109, 42109, Wuppertal, Germany.
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Bettina Burghardt
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Bernadette Jaeger
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Tanja Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Nora K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
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Mastnak W. Perinatal Music Therapy and Antenatal Music Classes: Principles, Mechanisms, and Benefits. J Perinat Educ 2016; 25:184-192. [PMID: 30538415 DOI: 10.1891/1058-1243.25.3.184] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Antenatal music activities are in the ascendant. Regarding evidence-based research, the article advocates 5 main aims: music therapeutic control of pre- and perinatal stress, anxiety, and depression; music-related mental and physical birth preparation comprising cognitive adjustment, emotional regulation, physical activity, relaxation and pain management, and social inclusion; music-associated bonding and self-efficacy; prenatal sound stimulation to trigger learning processes, pedagogical priming and brain maturation; music activities to facilitate the child's acculturation and adaptive self-regulation. Underlying mechanisms such as neuroplasticity help to understand the multifaceted effects of music in pre- and perinatal care. Individual conditions and features of the mother and her child have to be taken into account and music interventions to be harmonized with complementary perinatal programs.
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Camann W. The gentle family-centered cesarean. HYPERTENSION RESEARCH IN PREGNANCY 2016. [DOI: 10.14390/jsshp.hrp2016-004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- William Camann
- Associate Professor of Anesthesia, Harvard Medical School, Director of Obstetric Anesthesia, Brigham & Women’s Hospital
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38
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Chen HJ, Chen TY, Huang CY, Hsieh YM, Lai HL. Effects of music on psychophysiological responses and opioid dosage in patients undergoing total knee replacement surgery. Jpn J Nurs Sci 2015; 12:309-19. [DOI: 10.1111/jjns.12070] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 10/20/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Hsin-Ji Chen
- Department of Nursing; Buddhist Tzu Chi General Hospital; Hualien Taiwan
| | - Tsung-Ying Chen
- Department of Anesthesiology; Buddhist Tzu Chi General Hospital; Hualien Taiwan
- Department of Medicine; Tzu Chi University; Hualien Taiwan
| | | | - Yuan-Mei Hsieh
- Department of Music; National University of Tainan; Tainan Taiwan
| | - Hui-Ling Lai
- Department of Nursing; Buddhist Tzu Chi General Hospital; Hualien Taiwan
- Department of Nursing; Tzu Chi University; Hualien Taiwan
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Requena G, Sánchez C, Corzo-Higueras JL, Reyes-Alvarado S, Rivas-Ruiz F, Vico F, Raglio A. Melomics music medicine (M3) to lessen pain perception during pediatric prick test procedure. Pediatr Allergy Immunol 2014; 25:721-4. [PMID: 25115240 DOI: 10.1111/pai.12263] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Gloria Requena
- Pediatric Allergy Unit, Hospital Materno Infantil Carlos Haya, Málaga, Spain
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40
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Kovac M. Music Interventions for the Treatment of Preoperative Anxiety. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2014. [DOI: 10.1080/15398285.2014.902282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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41
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Tan F, Tengah A, Nee LY, Fredericks S. A study of the effect of relaxing music on heart rate recovery after exercise among healthy students. Complement Ther Clin Pract 2014; 20:114-7. [PMID: 24767956 DOI: 10.1016/j.ctcp.2014.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 12/02/2013] [Accepted: 01/03/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Music has been employed in various clinical settings to reduce anxiety. However, meta-analysis has shown music to have little influence on haemodynamic parameters. This study aimed at investigating the effect of relaxing music on heart rate recovery after exercise. METHOD Twenty-three student volunteers underwent treadmill exercise and were assessed for heart rate recovery and saliva analysis; comparing exposure to sedative music with exposure to silence during the recovery period immediately following exercise. RESULTS No differences were found between music and non-music exposure regarding: heart rate recovery, resting pulse rate, and salivary cortisol. Music was no different to silence in affecting these physiological measures, which are all associated with anxiety. CONCLUSIONS Relaxing music unaccompanied by meditation techniques or other such interventions may not have a major role in reducing anxiety in certain experimental settings.
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Affiliation(s)
- Fuitze Tan
- PAPRSB Institute of Health Science, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong BE1410, Brunei Darussalam
| | - Asrin Tengah
- PAPRSB Institute of Health Science, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong BE1410, Brunei Darussalam
| | - Lo Yah Nee
- PAPRSB Institute of Health Science, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong BE1410, Brunei Darussalam
| | - Salim Fredericks
- PAPRSB Institute of Health Science, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong BE1410, Brunei Darussalam.
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Abstract
Cesarean deliveries can be associated with moderate to severe postoperative pain. Appropriate management of pain is important because it results in better patient satisfaction, earlier mobilization, and improved maternal-infant bonding. There are many individual options for treatment of pain; however, multimodal analgesic therapy has become the mainstay of treatment. In this article, the epidemiology of postcesarean delivery pain, pain mechanisms, and the multiple options available to providers for treatment of postoperative pain are discussed.
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