Exploring the effect of sound and music on health in hospital settings: A narrative review

Restoring Well-Being for Physicians Through Lifestyle Medicine

In the wake of the COVID-19 pandemic, physician burnout is a more relevant concern than ever. Pre-existing stressors in health care, such as poor work-life balance, perfectionism, and inadequate social support, have been exacerbated by uncertainty, increased risk exposure, and general anxiety. Burnout places not only physicians, but also patients, systems, and communities at risk. The promotion of physician well-being is critical to sustaining the health care system. Actions to reduce burnout and increase well-being can and should occur on multiple levels. Organizations and leaders must take steps to create a culture of support and respect for health care providers. Such steps may include improved time-off policies, destigmatizing the use of mental health services, and reducing administrative burden. Physician well-being may benefit from action on an individual level as well. The pillars of Lifestyle Medicine provide a framework for engaging in behaviors compatible with overall well-being, such as physical activity, social connection, and sleep. Lifestyle Medicine plays a key role in mitigating the impact of physician burnout, and will be essential to the success of the health care system moving forward.

[Effects of classical or heavy metal music in humans and animals: implications for intensive care medicine]

BACKGROUND

The importance of music in intensive care medicine is still controversial and the mechanisms of music are unclear. It is important whether different music styles (classical music [CM], Heavy Metal [HM] show measurable effects on blood pressure (BP) or heart rate (HR) in humans or not. It is also unclear whether behavioral patterns are influenced by music (CM, HM) in animals.

METHODS

We studied the influence of CM (Bach, Orchestral Suite No. 3, BWV 1068) and HM (Band Disturbed: Indestructible) compared to a control group (CO) without music exposure in 120 healthy subjects (60 study subjects, 60 control subjects) and 36 young pigs (18 Pietrains, 18 Wiesenauer Minipigs) according to an identical study protocol (21 minutes of music exposure (CM, HM) or 21 minutes of no music (C0).

RESULTS

We were able to clearly demonstrate in 36 pigs that CM led to significantly more activity behavior than HM or CO (p<0,01). HM caused significantly more stress behavior than CM or CO (p<0,01). In humans, there was a decrease in BPsyst, BPdiast or HR (beats per minute [bpm]) among CM: decrease BPsyst -7,5±9,1 mm Hg, BPdiast -4,9±7,5 mm Hg, HR -7,2±10,2 bpm. This was observed less frequently in HM: BPsyst -3,6±7,1 mm Hg, BPdiast -2,7±6,9 mm Hg, HR -5,9±9,0 bpm. The influence of BP and HR was significantly lower in CO compared to music: BPsyst -2,3±7,2 mm Hg, BPdiast -2,0±7,3 mm Hg, HR -5,8±12,3 bpm.

CONCLUSIONS

BP and HR in humans and behavioral patterns in animals are clearly influenced by music. CM leads more frequently to activity behavior in animals and to lower BP and HR in humans compared to HM or CO. In both animal breeds, stress behavior was observed more frequently in HM compared to CM or CO. Therefore, music may play a role in intensive care medicine.

Effect of Audio-Visual-Based Art and Music Therapy in Reducing Adolescents Post Traumatic Stress Disorder

PURPOSE

Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that can develop due to exposure to any event that may result in psychological trauma. This study compared the effect of interactive audio-visual-based art and music therapy in reducing post-traumatic stress disorder in adolescents who survived abduction in Nigeria.

METHODS

A quasiexperiment was carried out in two selected secondary schools in Northern Nigeria. The study sample comprised 470 students randomly divided into a control group of 235 and an experiment group of 235. The treatment group was further divided into art 118 and music 117 therapy groups, respectively.

RESULTS

Results suggest that interactive audio-visual art therapy and music therapy is an effective intervention strategy for reducing the PTSD of school adolescents that have experienced kidnapping in Nigeria. However, art therapy is more effective in reducing PTSD than music therapy.

DISCUSSION

We recommend the introduction of audio-visual-based music and art therapy to reduce the PTSD of adolescents that survived kidnapping in Nigeria. More focus should be made on art therapy, which is more effective in curtailing adolescents PTSD.

Exploring the Synergy of Music and Medicine in Healthcare: Expert Insights into the Curative and Societal Role of the Relationship between Music and Medicine

Our study aimed to investigate the correlation between medicine, health perception, and music as well as the role of music in the healthcare setting. To gain insights into the dynamics between these two fields, we gathered opinions from attendees and presenters at an international conference on music medicine, musicians' health, and music therapy. A team of six interviewers conducted a total of 26 semi-structured interviews. The interview guide focused on four predetermined themes: (1) "music in medicine", (2) "performing arts medicine", (3) "music for the individual", and (4) "music for society". The responses were analyzed using grounded theory methods as well as thematic and content analysis. To enhance the analytical strength, investigator triangulation was employed. Within the predefined themes, we identified several subthemes. Theme 1 encompassed topics such as "listening and performing music for treating diseases and establishing non-verbal relationships", "the value of music in specific disorders, end-of-life care, and pain management", and "the design of sound spaces". Theme 2 explored aspects including the "denial and taboo surrounding physical and mental health issues among musicians", "the importance of prevention", and an antithesis: "pain and suffering driving creativity". Theme 3 addressed the "mental role of music in ordinary and extraordinary life" as well as "music's ability to enable self-conditioning". Lastly, Theme 4 examined the role of music in "cultural self-identification" and "development and education for children". Throughout the interviews, participants expressed a lack of knowledge and awareness regarding interdisciplinary research and the fields of music and medicine. Our findings affirm the significance of music therapy and performing arts medicine as well as the broader relationship between music and medicine. They highlight the potential benefits of perception and experiential pathways for individuals and, consequently, for human society.

Background Music's Impact on Patients Waiting in Surgery and Radiology Clinics

OBJECTIVES

To assess the impact of different types of background music on patients' anxiety and perceptions in a healthcare setting.

BACKGROUND

An overwhelming number of studies in the West have been conducted on the use of background music in reducing patients' anxiety and their perception of hospitals. Despite the optimism for Western classical music in such settings, evidence documenting the successful use of this genre of music in waiting rooms across other people groups has, thus far, been inconclusive.

METHOD

A single-blind randomized study in which a total of 303 participants were recruited from both surgery and radiology clinics using a between-groups experimental design. Patients were seated in the waiting room for at least 20 min while music (Western classical, lo-fi) or no music was playing in the background. Participants were then required to complete a questionnaire that consisted of a shortened 6-item State Trait Anxiety Inventory (STAI-6), and eight questions relating to overall perceptions of the hospital.

RESULTS

The results from both clinics revealed that patients in the no music condition rated themselves as feeling significantly less anxious than those in either of the two music conditions. Patients' perceptions of the hospital's overall service and expectations were higher in the no music condition.

CONCLUSIONS

Firstly, the choice of background music should match the differing pace of the day; for example, a more upbeat song would better fit the mood of a busy clinic, leading to a more "congruent" atmosphere. Secondly, playing background music in a "task-oriented" and highly charged/anxious environment may increase arousal levels, which in turn could result in negative perceptions of the hospital and an increase in anxiety among patients. Finally, music is a cultural product and music that primes certain beliefs in one culture may not have similar effects among other people groups. Hence, specific curated playlists are necessary to convey "intentions" to different people groups.

Evaluation of Multisensory Interactions Between the Healing Built Environment and Nurses in Healthcare Nursing Stations: Case Study of Tehran Hospitals

BACKGROUND

Nursing stations are important features of medical centers that are constantly in use. As nursing is an inherently stressful occupation, nursing stations should be designed to minimize stress on those who must spend time there.

AIM

This study evaluated the effect of environmental design factors on mitigating the stress levels on nurses in nursing stations by determining the environmental factors that most influence the perceptual senses that affect physical and psychological comfort.

METHODS

A quantitative approach was used to evaluate the parameters that affect the sensory perceptions of nurses in nursing stations at four hospitals in Tehran. A survey was conducted to identify environmental design parameters that affect the visual, auditory, tactile, kinesthetic, and olfactory senses.

RESULTS

The results revealed that the olfactory category scored highest, followed by the auditory, visual and tactile categories, which had similar scores, and kinesthetic was ranked last.

CONCLUSION

A connection was revealed between the educational level of the nurses and environmental factors affecting their sensory perception in terms of materials, aesthetics and the appropriate number of windows as a visual sense, and ergonomics as a kinesthetic sense. Significantly, the gender variable differed in the Furniture variable based on comfort of seating with respect structure. Based on the results of this study, a combination of olfactory, visual, and auditory factors should be required at the nursing stations to decrease the stress level of nurses.

Music in the acute preoperative nursing care - A mixed-method pilot study

AIM

The aim was to (1) examine the feasibility aspect of a music intervention, (2) examine the association between music and pain, relaxation and well-being and (3) explore patients' experience of listening to music while waiting for acute surgery.

DESIGN

The design was a mixed-method study.

METHODS

Participants were offered a music pillow for 30 min. Before and after the intervention, participants reported their pain, relaxation and well-being using a visual analogue scale ranging from 0 to10. The qualitative part was based on field observation followed by a semi-structured interview.

RESULTS

The quantitative part included 30 participants. The Wilcoxon signed-rank test showed a positive significant association between music and pain, relaxation and well-being (p < 0.001). The qualitative part included 15 participants. Two themes derived from the analysis: (1) feelings of physical and mental well-being and (2) a break from the acute preoperative context.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Live music in hospital oncology settings: environmental, interpersonal, and personal outcomes for staff, patients, and carers

BACKGROUND

This paper explores the environmental, interpersonal, and personal outcomes of music performance in a hospital oncology setting. An original, qualitative research study examined the impact of live music for staff, patients, and carers.

METHODS

Data were collected using a multi-method approach of observations and semi-structured interviews and were analysed using inductive and theory-driven theming that was shaped by a determinants of health framework.

RESULTS

The research found that live music promoted stronger relationships and calmer environments, among other environmental, social and individual outcomes. Improved communication between staff through the creation of a more supportive environment was a pertinent finding of the research. No negative effects were reported.

CONCLUSIONS

We discuss research findings in the context of relevant literature and suggest recommendations for future hospital-based live music programs. Results of this study indicate that live music interventions impacted individual, interpersonal, social and environment factors that led to health and wellbeing outcomes for participants.

Meaning in Music Is Intentional, but in Soundscape It Is Not-A Naturalistic Approach to the Qualia of Sounds

The sound environment and music intersect in several ways and the same holds true for the soundscape and our internal response to listening to music. Music may be part of a sound environment or take on some aspects of environmental sound, and therefore some of the soundscape response may be experienced alongside the response to the music. At a deeper level, coping with music, spoken language, and the sound environment may all have influenced our evolution, and the cognitive-emotional structures and responses evoked by all three sources of acoustic information may be, to some extent, the same. This paper distinguishes and defines the extent of our understanding about the interplay of external sound and our internal response to it in both musical and real-world environments. It takes a naturalistic approach to music/sound and music-listening/soundscapes to describe in objective terms some mechanisms of sense-making and interactions with the sounds. It starts from a definition of sound as vibrational and transferable energy that impinges on our body and our senses, with a dynamic tension between lower-level coping mechanisms and higher-level affective and cognitive functioning. In this way, we establish both commonalities and differences between musical responses and soundscapes. Future research will allow this understanding to grow and be refined further.

Impact of the Soundscape on the Physical Health and the Perception of Senior Adults in Senior Care Facilities

Purpose:

To explore the impact of different acoustic stimuli of varying sound pressure levels on physical responses and the perception of senior adults.

Background:

Noise-related health problems have been gaining increased attention as studies have shown an association with negative impacts on physiological parameters resulting in cardiovascular morbidity and mortality. However, a gap in knowledge exists in exploring the impact of exposure to sound recordings in the actual environment on physiological measurements.

Methods:

Five acoustic stimuli were recorded in real life and 120 senior adults listened to them in a sound treated room to analyze the impacts of low-, middle-, and high-decibel sounds on their heart rate, blood pressure, and perception. The physical responses, heart rate, and blood pressure were measured during the sound exposure, and questionnaires were administered afterward.

Results:

Exposure to different sounds resulted in fluctuations and an inconsistent trend in heart rate, systolic pressure, and diastolic pressure. According to the physical measures and subjective evaluations, sport sounds and traffic noise were given the lowest rating for preference, while music was perceived as the most comfortable.

Conclusions:

A sound pressure level below 55–65 dB(A) correlates with increased comfort and less increase in heart rate and blood pressure. Senior adults with normal hearing preferred and were most comfortable with music, while those with severe hearing impairment preferred entertainment sounds the most.

Music Literacy and Soundscape Perception: A Study Based on the Soundwalk Method of Soundscapes

To explore a method of promoting college aesthetic education through campus environments, the Aesthetic Education Center of the Beijing Institute of Technology Zhuhai (BITZH-AEC) used the soundwalk method of soundscapes to carry out an experiment on students’ soundscape perceptions on campus. Half of the students who participated in the experiment (n = 42) had musical instrument learning experience and musical literacy. The research work used conventional statistical analysis methods and “Soundscapy”, newly developed by the British soundscape research team, to process the experimental data. It was found that the soundscape perception evaluation of students with musical literacy was different from that of ordinary students. This included a difference in the overall evaluation of the three experimental areas and a difference in the degree of dispersion of the soundscape evaluation of all six experimental areas. The study also found that there was no correlation between the acoustic noise level and the students’ evaluations of soundscape perception. BITZH-AEC proposes that aesthetic educators should pay attention to the idea of inspiring students to stimulate cultural imagination through soundscape perception.

Nighttime Walking with Music: Does Music Mediate the Influence of Personal Distress on Perceived Safety?

There is growing interest in identifying the environmental factors that contribute to individuals’ perceptions of safety and sense of well-being in public spaces. As such, this study examined how music listening during nighttime walking influenced female university students’ psychological state and perceptions of their campus. A total of 178 female university students with a mean age of 23.0 years participated in this study. One group of 78 students listened to prerecorded music while walking across their campus at night, while the other 100 students did not listen to music during nighttime walking. Immediately following their nighttime walking, participants were asked to rate their psychological state, perceptions on the safety of their campus, and the music (only for the music-listening group). For the non-music-listening group, significant correlations were found between the perceived safety of the campus and psychological states (both anxiety and psychological distress); the correlations were not significant in the music-listening group. The results indicate that music can mediate psychological states, supporting the proactive use of music as a psychological resource for coping with their perceptions of adverse environments. Given the limitations of this preliminary study, further studies with controlled music listening conditions, type of music, and environmental issues are suggested.

Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature

The health and well-being impacts of art and aesthetic experiences have been rigorously studied by a range of disciplines, including cognitive neuroscience, psychiatry, public health, and translational clinical research. These experiences, encompassed in the concepts of set and setting, have long been claimed to be pivotal in determining the acute and enduring effects of psychedelic experiences. Responding to the field's longstanding emphasis on the role and value of setting, a rapid scoping review was undertaken to identify the extent to which effects of setting and aesthetics on psychedelic experiences and therapies have been explicitly studied. It offers an analysis of the strengths and limitations of the extant literature and discusses evidentiary gaps as well as evidentiary opportunities for the field. The 43 included studies indicate apparent consensus regarding the importance of setting in psychedelic therapies, as well as consistent interest in theorizing about these effects. However, this consensus has yet to generate consistent, prospective, rigorous tests of setting and its complexities. As a result, the field continues to lack understanding or agreement regarding the effects of various specific elements of setting, the mechanisms by which they affect outcomes, for whom these effects occur, under what circumstances, given what conditions, and other critical factors. Further studies of setting and aesthetics in the context of psychedelic therapies are likely to not only improve these therapies and their delivery, but also inform considerations of setting and aesthetics for non-psychedelic interventions.

Combining Music and Indoor Spatial Factors Helps to Improve College Students' Emotion During Communication

Against the background of weakening face-to-face social interaction, the mental health of college students deserves attention. There are few existing studies on the impact of audiovisual interaction on interactive behavior, especially emotional perception in specific spaces. This study aims to indicate whether the perception of one's music environment has influence on college students' emotion during communication in different indoor conditions including spatial function, visual and sound atmospheres, and interior furnishings. The three-dimensional pleasure-arousal-dominance (PAD) emotional model was used to evaluate the changes of emotions before and after communication. An acoustic environmental measurement was performed and the evaluations of emotion during communication was investigated by a questionnaire survey with 331 participants at six experimental sites [including a classroom (CR), a learning corridor (LC), a coffee shop (CS), a fast food restaurant (FFR), a dormitory (DT), and a living room(LR)], the following results were found: Firstly, the results in different functional spaces showed no significant effect of music on communication or emotional states during communication. Secondly, the average score of the musical evaluation was 1.09 higher in the warm-toned space compared to the cold-toned space. Thirdly, the differences in the effects of music on emotion during communication in different sound environments were significant and pleasure, arousal, and dominance could be efficiently enhanced by music in the quiet space. Fourthly, dominance was 0.63 higher in the minimally furnished space. Finally, we also investigated influence of social characteristics on the effect of music on communication in different indoor spaces, in terms of the intimacy level, the gender combination, and the group size. For instance, when there are more than two communicators in the dining space, pleasure and arousal can be efficiently enhanced by music. This study shows that combining the sound environment with spatial factors (for example, the visual and sound atmosphere) and the interior furnishings can be an effective design strategy for promoting social interaction in indoor spaces.

Sounds in nursing homes and their effect on health in dementia: a systematic review

OBJECTIVES

Nursing home residents with dementia are sensitive to detrimental auditory environments. This paper presents the first literature review of empirical research investigating (1) the (perceived) intensity and sources of sounds in nursing homes, and (2) the influence of sounds on health of residents with dementia and staff.

DESIGN

A systematic review was conducted in PubMed, Web of Science and Scopus. Study quality was assessed with the Mixed Methods Appraisal Tool. We used a narrative approach to present the results.

RESULTS

We included 35 studies. Nine studies investigated sound intensity and reported high noise intensity with an average of 55-68 dB(A) (during daytime). In four studies about sound sources, human voices and electronic devices were the most dominant sources. Five cross-sectional studies focused on music interventions and reported positives effects on agitated behaviors. Four randomized controlled trials tested noise reduction as part of an intervention. In two studies, high-intensity sounds were associated with decreased nighttime sleep and increased agitation. The third study found an association between music and less agitation compared to other stimuli. The fourth study did not find an effect of noise on agitation. Two studies reported that a noisy environment had negative effects on staff.

CONCLUSIONS

The need for appropriate auditory environments that are responsive to residents' cognitive abilities and functioning is not yet recognized widely. Future research needs to place greater emphasis on intervention-based and longitudinal study design.

Sound and Soundscape in Restorative Natural Environments: A Narrative Literature Review

Acoustic experiences of nature represent a growing area in restorative environments research and are explored in this narrative literature review. First, the work surveyed indicates that nature is broadly characterized by the sounds of birdsong, wind, and water, and these sounds can enhance positive perceptions of natural environments presented through visual means. Second, isolated from other sensory modalities these sounds are often, although not always, positively affectively appraised and perceived as restorative. Third, after stress and/or fatigue nature sounds and soundscapes can lead to subjectively and objectively improved mood and cognitive performance, as well as reductions in arousal, although some inconsistencies in findings are observed. Fourth, theoretical frameworks of restorative environments would benefit from inclusion of acoustic environmental properties such as sound intensity or frequency. Fifth, findings regarding positive, learned semantic associations with nature have arisen as a result of recent work on sounds and restoration. This represents another important area of potential theoretical development for broader restorative environments research.

The Cognitive-Emotional Design and Study of Architectural Space: A Scoping Review of Neuroarchitecture and Its Precursor Approaches

Humans respond cognitively and emotionally to the built environment. The modern possibility of recording the neural activity of subjects during exposure to environmental situations, using neuroscientific techniques and virtual reality, provides a promising framework for future design and studies of the built environment. The discipline derived is termed "neuroarchitecture". Given neuroarchitecture's transdisciplinary nature, it progresses needs to be reviewed in a contextualised way, together with its precursor approaches. The present article presents a scoping review, which maps out the broad areas on which the new discipline is based. The limitations, controversies, benefits, impact on the professional sectors involved, and potential of neuroarchitecture and its precursors' approaches are critically addressed.

Binaural beats or 432 Hz music? which method is more effective for reducing preoperative dental anxiety?

Background

The aim of this prospective clinical study was to investigate the effectiveness of binaural beats and music at a frequency of 432 Hz and compare which method is more effective for reducing preoperative dental anxiety in impacted third molar surgery.

Material and Methods

Ninety patients were randomly selected to the binaural beats group, music group and control group. Visual analog scale used to evaluate dental anxiety before the local anesthesia in the first measurement. Local anesthesia was applied to the all patients. Patients in the music group listened to 432 Hz tuned music using earphones for 10 minutes. Patients in the binaural beats group listened to binaural beats using earphones (for the right ear, 220 Hz and for the left ear 210 Hz) for 10 minutes. No special treatment was applied to the patients in control group. In the second measurement, dental anxiety was measured again in all three groups. For analysis of differences between three groups was used One way Anova and Kruskal Wallis test.

Results

Twenty seven male and 53 female patients included the study. In the first measurement, the same level of anxiety was recorded in all three groups. (p=0.811) There was a significant decrease in anxiety in both the binaural beats and music group in the second measurement. (p<0.001).

Conclusions

Binaural beats and 432 Hz tuned music are a valid non pharmacological adjuvant to reduce dental anxiety in impacted third molar surgery. They have a positive effect to reduce the dental anxiety.

Key words:Binaural beats, 432 Hz music, dental anxiety.

Methods to improve quality of life, beyond medicines. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes

The pharmaceutical approach to skin disease has been hugely successful, but despite effective drugs being available and used, there are still vast numbers of people who continue to have some level of persisting skin disease and continue to experience quality of life (QoL) impairment. So the question that needs to be answered, while we await further advances in our drug-based armamentarium, is how can we improve patients' QoL, beyond drugs? A working group was formed from members of the EADV Task Force on QoL and Patient Oriented Outcomes. Participants were asked to suggest all the ways in which they considered patients' QoL may be improved beyond medicines. Four groups of management approaches that may improve QoL in dermatology were identified: interventions within the dermatology service (hospitalization, multidisciplinary teams, patch testing and establishing relevant allergens and education), external services (corrective make-up, climatotherapy and balneotherapy), psychological (psychological intervention, cognitive therapy, hypnosis), lifestyle (lifestyle behavioural changes, religion and spirituality and music). The ultimate aim of therapy is to eradicate a disease in an individual and return the person's life to normal. But until the day comes when this has been achieved for every skin disease and for every patient there will be a need to support and assist many patients in additional non-pharmaceutical ways. These 'adjuvant' approaches receive too little attention while dermatologists and researchers strive for better pharmacological therapy. The different ways in which patients may benefit have been reviewed in our paper, but the reality is that most have a very poor evidence base. The research challenges that we have to meet are to identify those approaches that might be of value and to provide evidence for their optimal use. In the meantime, clinicians should consider the use of these approaches where QoL remains impaired despite optimal use of standard therapy.

"My Friends are at the Bottom of My Schedule": A Qualitative Study on Social Health among Nursing Students during Clinical Placement

Clinical placement is an essential component for nursing students, allowing them to transfer professional knowledge into practice. The quality of life among nursing students and nurses was reviewed to examine its impact on the quality of provided care. However, it is unclear how social health among nursing students is affected during clinical placement. Final-year students who had finished clinical placement were invited to participate in this qualitative study. Twenty-one in-depth interviews were conducted and transcribed verbatim for thematic analysis. Two main themes, i.e., contributors to lack of social health, and manifestations of lack of social health, emerged from seven sub-themes. Students experienced different challenges during the clinical placement, but some of these did contribute to effects on their social health. Lack of social health might further influence career development after graduation. Supportive strategies from colleagues, nursing colleges and hospitals might potentially improve students' social health during the clinical placement.

A critical scoping review about the impact of music in the lives of young adults who use drugs

ISSUES

Music is among the most frequently used medium to promote young adults' well-being. To that aim, the efficiency of music is explained by its capacity to modulate emotions through its effect on the brain's reward pathways. Hence, music could help individuals suffering from dysregulations in these pathways, whose experience of positive emotions is often inhibited. Such dysregulations are particularly present in individuals with problematic psychoactive substance (PAS) use, who are overrepresented in the context of homelessness. While few of them initiate treatment, they successfully rely on their own resources to promote their well-being, including music, though its impact in this context remains under-studied.

APPROACH

This scoping review describes the impact of music on the well-being, PAS use and addictive trajectory of young housed and homeless individuals with problematic PAS use. Eleven French and English databases were screened for peer-reviewed articles using concepts and keywords related to music, PAS and well-being. From the 3697 results, 39 were reviewed. Results were organised according to the observed impact of music and analysed critically.

KEY FINDINGS

Literature shows that PAS users value the impact of music in meeting emotional, psychological and social needs, especially when they experience homelessness. Yet, research has been highly limited to the harmful consequences of music, limiting our knowledge of its potential benefits.

IMPLICATIONS AND CONCLUSION

To deepen our understanding about the impact of music, future research should endorse a broader perspective and consider the personal and contextual experiences accompanying the involvement in music, factors that were traditionally overlooked.

Effects of the Musical Sound Environment on Communicating Emotion

The acoustic environment is one of the factors influencing emotion, however, existing research has mainly focused on the effects of noise on emotion, and on music therapy, while the acoustic and psychological effects of music on interactive behaviour have been neglected. Therefore, this study aimed to investigate the effects of music on communicating emotion including evaluation of music, and d-values of pleasure, arousal, and dominance (PAD), in terms of sound pressure level (SPL), musical emotion, and tempo. Based on acoustic environment measurement and a questionnaire survey with 52 participants in a normal classroom in Harbin city, China, the following results were found. First, SPL was significantly correlated with musical evaluation of communication: average scores of musical evaluation decreased sharply from 1.31 to -2.13 when SPL rose from 50 dBA to 60 dBA, while they floated from 0.88 to 1.31 between 40 dBA and 50 dBA. Arousal increased with increases in musical SPL in the negative evaluation group. Second, musical emotions had significant effects on musical evaluation of communication, among which the effect of joyful-sounding music was the highest; and in general, joyful- and stirring-sounding music could enhance pleasure and arousal efficiently. Third, musical tempo had significant effect on musical evaluation and communicating emotion, faster music could enhance arousal and pleasure efficiently. Finally, in terms of social characteristics, familiarity, gender combination, and number of participants affected communicating emotion. For instance, in the positive evaluation group, dominance was much higher in the single-gender groups. This study shows that some music factors, such as SPL, musical emotion, and tempo, can be used to enhance communicating emotion.

Designing Supportive Soundscapes for Nursing Home Residents with Dementia

Sound and its resulting soundscape is a major appraisal component of the living environment. Where environmental sounds (e.g., outdoor traffic sounds) are often perceived as negative, a soundscape (e.g., containing natural sounds) can also have a positive effect on health and well-being. This supportive effect of a soundscape is getting increasing attention for use in practice. This paper addresses the design of a supportive sonic environment for persons with dementia in nursing homes. Starting from a review of key mechanisms related to sonic perception, cognitive deficits and related behavior, a framework is derived for the composition of a sonic environment for persons with dementia. The proposed framework is centered around using acoustic stimuli for influencing mood, stimulating the feeling of safety and triggering a response in a person. These stimuli are intended to be deployed as added sounds in a nursing home to improve the well-being and behavior of the residents.

Therapeutic gardens as a design approach for optimising the healing environment of patients with Alzheimer's disease and other dementias: A narrative review

PURPOSE

The first half of this paper documents the role of nature in healthcare environments and its impact on wellness, with a particular focus on gardens. The second half presents a scientific evaluation of the role of gardens as a therapeutic intervention to optimise the clinical outcomes in patients with Alzheimer's disease (AD) and dementia, including a review of the innovative application of technologies alongside nature to promote cognitive rehabilitation in this particular patient population.

METHODS

Using search engines such as the Institute for Scientific Information (ISI) Web of Science, PubMed, ProQuest Central, MEDLINE, Scopus and Google Scholar, a relevant literature search on the positive health implications of therapeutic gardens (TG) on AD and dementia patients in the healthcare milieu was conducted.

RESULTS

The health implications of TG for AD and dementia patients span physical, social, psychological and cognitive effects. Virtual reality (VR) technologies that display natural environments also offer positive cognitive outcomes for AD and dementia patients.

CONCLUSION

TG should be used to improve the health and wellbeing of AD and dementia patients, and its application should be extended to other patient populations to promote quicker recovery. Future directions in the design of TG, with a focus on patients with AD and other dementias, is also discussed.

Quantitative Evaluations of the Effects of Noise on Mental Workloads Based on Pupil Dilation during Laparoscopic Surgery

Noise can exert undeniable pressure on human minds, especially during tasks that require high precision and attention, such as those performed during surgery. To investigate whether auditory stimuli increases mental loads during laparoscopic surgery, we examined the effects of operating room (OR) noises and music by measuring mean changes in pupil sizes and subjectively assessing performances during surgery. We recruited 24 subjects with varying laparoscopic surgery experience levels to perform complete appendectomy using a laparoscopic simulator. Wearable eye trackers were worn by all subjects to monitor pupil sizes during surgery, and surgical tasks were performed under conditions of silence, background OR noise, and music. National Aeronautics and Space Administration-Task Load Index scores and performance parameters were also recorded during surgical tasks. Noise distractions were associated with significant increases in pupil sizes compared with those observed in silence, and the related increases in mental loads may have affected surgical performance. However, more experienced operators had smaller changes in pupil sizes because of auditory disturbances than moderately experienced surgeons. Noise stimulation in the OR increases surgeon's mental workload and performance. Auditory regulation of the OR may be better standardized using data from studies of the effects of acoustic stimulation in the OR, and mental stresses during surgery could be considered in a more humane manner. Further investigations are necessary to determine the cognitive consequences of various auditory stimuli.

Playing Music for Hospitalized Patients Enhances Mood and Reduces Perceptions of Pain

OBJECTIVES

For most people, music serves as a calming influence or as a pleasurable stimulus that lifts their spirits. In an attempt to both distract and cheer up hospitalized patients, we designed a brief intervention that would bring music to their hospital rooms in attempt to enhance their mood and minimize their awareness of pain.

METHODS

In this prospective study of adult patients on the general medicine ward at Johns Hopkins Hospital, we assessed the impact of self-selected music delivery on patients' mood and their perception of pain. Patients' mood and pain were assessed using the modified Hospital Anxiety and Depression Scale and the Verbal Numerical Rating Scale, a validated 10-point Likert pain scale.

RESULTS

Of the 151 patients studied, their mean age was 57 years, 57% were women, and 65% were white. Ninety-seven percent of patients described listening to music regularly at home, but only 28% of patients reported that they had listened to any music since being in the hospital (P < 0.0001). The patients' modified Hospital Anxiety and Depression Scale score and pain score were decreased significantly (-4.99, standard error 0.45, P < 0.0001, and -0.72, standard error 1.51, P < 0.0001, respectively) after listening to a couple of their favorite songs.

CONCLUSIONS

This study demonstrates that bringing music to hospitalized patients and encouraging them to listen to their favorite songs are genuinely appreciated. If this intervention can enhance moods and reduce pain for patients in the hospital, then directing resources to make it sustainable may be justified.

Effect of a Quality Improvement Project to Reduce Noise in a Pediatric Unit

PURPOSE

Noise levels remain high in clinical settings, which may result in stress and sleep disruption, and can lead to immunosuppression, delayed healing, confusion, disorientation, delusions, and increased length of hospital stay. The purpose of this quality improvement project was to assess effects of a multidisciplinary noise reduction program on a pediatric unit in an acute care hospital in a developing country.

METHODS

A quality improvement project was carried out over 15 months in a pediatric unit. A three-phase study was conducted where the first phase included obtaining patient satisfaction ratings and recording sound levels, the second phase included implementing a noise reduction program and designing a noise detector machine, and the third phase included obtaining patient satisfaction data and recording noise levels over a 1-year period.

RESULTS

There was a significant decrease in noise of 8 A-weighted decibels when comparing the values before and after implementing the quality improvement project at t = 6.44, p < 0.000. There was no significant difference in patient satisfaction ratings.

CLINICAL IMPLICATIONS

Noise in the pediatric unit exceeded recommended guidelines; however, decreasing the levels was possible and sustainable, which can improve the psychological and physiological wellbeing of hospitalized children.

Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain

Placebo and nocebo effects are embodied psycho-neurobiological responses capable of modulating pain and producing changes at different neurobiological, body at perceptual and cognitive levels. These modifications are triggered by different contextual factors (CFs) presented in the therapeutic encounter between patient and healthcare providers, such as healing rituals and signs. The CFs directly impact on the quality of the therapeutic outcome: a positive context, that is a context characterized by the presence of positive CFs, can reduce pain by producing placebo effects, while a negative context, characterized by the presence of negative CFs, can aggravate pain by creating nocebo effects. Despite the increasing interest about this topic; the detailed study of CFs as triggers of placebo and nocebo effects is still lacked in the management of musculoskeletal pain.

Increasing evidence suggest a relevant role of CFs in musculoskeletal pain management. CFs are a complex sets of internal, external or relational elements encompassing: patient’s expectation, history, baseline characteristics; clinician’s behavior, belief, verbal suggestions and therapeutic touch; positive therapeutic encounter, patient-centered approach and social learning; overt therapy, posology of intervention, modality of treatment administration; marketing features of treatment and health care setting. Different explanatory models such as classical conditioning and expectancy can explain how CFs trigger placebo and nocebo effects. CFs act through specific neural networks and neurotransmitters that were described as mediators of placebo and nocebo effects.

Available findings suggest a relevant clinical role and impact of CFs. They should be integrated in the clinical reasoning to increase the number of treatment solutions, boosts their efficacy and improve the quality of the decision-making. From a clinical perspective, the mindful manipulation of CFs represents a useful opportunity to enrich a well-established therapy in therapeutic setting within the ethical border. From a translational perspective, there is a strong need of research studies on CFs close to routine and real-world clinical practice in order to underline the uncertainty of therapy action and help clinicians to implement knowledge in daily practice.

Effects of music during daytime rest in the intensive care unit

BACKGROUND

Sleep is essential to the recovery of patients in the intensive care unit. Patients in the intensive care unit frequently experience poor sleep, characterized by sleep deprivation, sleep fragmentation and abnormal sleep architecture. Factors affecting sleep are multifactorial.

AIM

To investigate the effects of music on self-reported quality of sleep during daytime rest among patients in the intensive care unit.

STUDY DESIGN

A randomized controlled trial.

METHODS

The study was conducted between February and April 2016 in two Danish multidisciplinary intensive care units. The study sample consisted of 37 patients (19 in the control group and 18 in the intervention group) who complied with the criteria of inclusion for the study. Patients were randomly assigned to either an intervention group or a control group. The intervention group listened to music for 30 min during daytime rest while the control group rested without music. The Richards-Campbell Sleep Questionnaire was used to measure the subjective quality of sleep.

RESULTS

Significant differences in the mean scores of the subjective quality of sleep were found between the intervention group and the control group (p < 0·02). Significant differences were also found between groups in three items of sleep scores: sleep depth (p < 0·02), awakenings (p < 0·00) and the overall perceived quality of sleep (p < 0·01). The perceived noise level score was higher in the intervention group compared with the control group, although not statistically significant (p < 0·67).

CONCLUSION

Listening to music during daytime rest improves subjective sleep in patients in the intensive care unit. Furthermore, there are indications that listening to music reduces the subjective experience of noise in some patients.

RELEVANCE TO CLINICAL PRACTICE

The result of this study implies that music can be an effective practice for nurses to improve sleep among patients in the intensive care unit.

The effect of nature sounds on physiological indicators among patients in the cardiac care unit

BACKGROUND AND OBJECTIVES

Environmental noises may create physiological and psychological disorders in patients hospitalized in the CCU. Therefore, this study was conducted to investigate the effects of nature sounds on physiological indicators among patients in the CCU.

MATERIALS & METHODS

This randomized clinical trial was conducted on 93 patients hospitalized in the cardiac care units of three teaching hospitals in 2016. The patients were selected using the convenient method with three randomized blocks. The patients were assigned into three groups as nature sounds, silence that received a set of headphones without playing sounds, and control groups. In addition to routine care, the patients in the intervention group listened to nature sounds for 30 min using a set of headphones for two days. The patients in the control group only received routine care. In addition to routine care, the patients in the silence group used a set of headphones for 30 min to block noises and no sound was played for them. Physiological indicators such as heartbeat rate, systolic and diastolic blood pressures, respiration rate, and arterial O₂ saturation were assessed using monitoring devices. Descriptive and inferential statistics were used for data analysis via the SPSS software.

FINDINGS

Nature sounds and silence had no statistically significant effects on physiological indicators. However, a statistically significant difference was reported in the heart rate in the nature sound group before and after the intervention in the first day of the intervention (P = 0.046). In the second day of the intervention, there were statistically significant differences in the diastolic blood pressure in the nature sounds group (P = 0.028), heart rate (P = 0.001) and diastolic blood pressure (P = 0.013) in the silence group, and heart rate (P = 0.014) in the control group before and after the intervention.

CONCLUSION

Listening to nature sounds or the use of headphones blocked environmental noises and could influence mean arterial pressure. Future studies can examine the effects of this intervention implemented for a longer term using nature sounds by patients.

Sound as a supportive design intervention for improving health care experience in the clinical ecosystem: A qualitative study

PURPOSE

Most prior hospital noise research usually deals with sound in its noise facet and is based merely on sound level abatement, rather than as an informative or orientational element. This paper stimulates scientific research into the effect of sound interventions on physical and mental health care in the clinical environment.

METHODS

Data sources comprised relevant World Health Organization guidelines and the results of a literature search of ISI Web of Science, ProQuest Central, MEDLINE, PubMed, Scopus, JSTOR and Google Scholar.

RESULTS

Noise induces stress and impedes the recovery process. Pleasant natural sound intervention which includes singing birds, gentle wind and ocean waves, revealed benefits that contribute to perceived restoration of attention and stress recovery in patients and staff.

CONCLUSIONS

Clinicians should consider pleasant natural sounds perception as a low-risk non-pharmacological and unobtrusive intervention that should be implemented in their routine care for speedier recovery of patients undergoing medical procedures.