A physician's perspective on allaying patients' fears

A controlled trial of music and pre-operative anxiety in Chinese men undergoing transurethral resection of the prostate

AIM OF THE STUDY

To test the effects of music intervention on pre-operative anxiety in Chinese males undergoing transurethral resection of the prostate.

RATIONALE

No studies have measured the effects of music intervention in reducing pre-operative anxiety for patients with transurethral resection of the prostate (TURP). Previous studies have examined the effects of music on pre-operative anxiety but have not examined the possible effects of the presence of a carer as an independent variable in pre-operative anxiety levels of patients in addition to the music intervention. The cultural validity of applying a music intervention to the reduction of pre-operative anxiety was also investigated.

DESIGN

A quasi-experimental design with three groups: music intervention, nurse presence and control group.

METHOD

Thirty patients having TURP were randomly assigned (n = 10 each group) to one of the three groups. Pre- and post-test measures of systolic and diastolic blood pressure, heart rate and state anxiety using the Chinese State-Trait Anxiety Inventory (C-STAI) were obtained for the three groups.

RESULTS

The findings showed that the music intervention significantly reduced all blood pressure levels for the patients. A reduction in state anxiety level was also found for the music intervention group. No significant reductions in blood pressure, heart rate and state anxiety level were found in the nurse presence and control groups.

CONCLUSION

The results support the cross-cultural validity of using a music intervention in pre-operative anxiety reduction, in this case for TURP patients waiting in the theatre holding area.

Patients' perceptions of music during surgery

Music, as an aesthetic and symbolic medium, has the ability to dispel much of the fear and anxiety associated with facing the unknown alone. As such it is an ideal support for patients undergoing surgery where a non-general anaesthetic is administered. However, it is important to consider whether, from the patient's perspective, the inclusion of music in such a situation is considered to be helpful. A pilot study conducted at an acute hospital involved interviewing 25 patients who, through an attitudinal scale and their interview responses, revealed positive support for the music that they listened to during their operation. Their remarks focused on the ability of the music, as a familiar personal and cultural medium, to ease their anxiety, to act as a distractor and to increase their threshold of pain. From a nursing perspective, such an application of music as therapy to reduce fear and anxiety may be viewed as being highly relevant to the work of the anaesthetic nurse, with regard to a more individualized and holistic approach to patient care.