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Giordano F, Mitrotti A, Losurdo A, Esposito F, Granata A, Pesino A, Rossini M, Natale P, Dileo V, Fiorentino M, Gesualdo L. Effect of music therapy intervention on anxiety and pain during percutaneous renal biopsy: a randomized controlled trial. Clin Kidney J 2023; 16:2721-2727. [PMID: 38046004 PMCID: PMC10689136 DOI: 10.1093/ckj/sfad246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Indexed: 12/05/2023] Open
Abstract
Background Percutaneous renal biopsy (PRB) may subject patients to emotional distress and pain before and during the biopsy. The aim of this study was to evaluate the effects of complementary/non-pharmacological interventions such as music therapy (MT) on anxiety, pain and satisfaction in renal patients undergoing PRB. Methods A prospective, single-centre, single-blind, randomized controlled two-arm trial was conducted. Patients ≥18 years of age, hospitalized at the Nephrology, Dialysis and Transplantation Unit (Bari, Italy) and scheduled for PRB were screened. Participants were assigned to standard treatment (CG) or to the music therapy (MT) intervention group. Participants in the MT group received standard care and an MT intervention by a certified music therapist qualified in guided imagery and music. The CG patients received the standard of care. MT and CG patients were subjected to identical measurements (pre/post) of the parameters in the State Trait Anxiety Inventory Y1 (STAI-Y1), visual analogue scale for pain (VAS-P) and satisfaction (VAS-S) and heart rate variability. Results A statistically significant difference in the anxiety scores after PRB between MT and CG patients (STAI-Y1 35.4 ± 6.2 versus 42.9 ± 9.0) was observed. MT also had strong and significant effects on VAS-P compared with CG (5.0 ± 1.4 versus 6.3 ± 1.3, respectively; P < .001) and VAS-S (7.8 ± 1.0 versus 6.0 ± 0.9, respectively; P < .001). Decreased activity of the sympathetic nervous system and increased activity of the parasympathetic nervous system was observed after PRB in the MT group. Conclusion Our study supports the use of MT to mitigate the psychological anxiety, pain and sympathetic activation associated with PRB.
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Affiliation(s)
- Filippo Giordano
- Nephrology, Dialysis and Transplantation, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Adele Mitrotti
- Nephrology, Dialysis and Transplantation, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Antonia Losurdo
- Nephrology, Dialysis and Transplantation, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | | | - Antonio Granata
- Nephrology and Dialysis Unit, “Cannizzaro” Emergency Hospital, Catania, Italy
| | - Alessandra Pesino
- Nephrology, Dialysis and Transplantation, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Michele Rossini
- Nephrology, Dialysis and Transplantation, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Patrizia Natale
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vincenzo Dileo
- Nephrology, Dialysis and Transplantation, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Marco Fiorentino
- Nephrology, Dialysis and Transplantation, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
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Giordano F, Giglio M, Sorrentino I, Dell'Olio F, Lorusso P, Massaro M, Tempesta A, Limongelli L, Selicato L, Favia G, Varrassi G, Puntillo F. Effect of Preoperative Music Therapy Versus Intravenous Midazolam on Anxiety, Sedation and Stress in Stomatology Surgery: A Randomized Controlled Study. J Clin Med 2023; 12:jcm12093215. [PMID: 37176656 PMCID: PMC10179016 DOI: 10.3390/jcm12093215] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Patients undergoing surgery and general anesthesia often experience anxiety, fear and stress, with negative bodily responses. These may be managed by the pre-procedural application of anxiolytic, analgesic, and anesthetic drugs that have, however, potential risks or side effects. Music therapy (MT) can be used as a complementary no-drug intervention alongside standard surgical care before, during and after medical procedures. The aim of this study was to evaluate the effects of preoperative MT intervention compared to premedication with midazolam on levels of anxiety, sedation and stress during general anesthesia for elective stomatology surgery. METHODS A two-arm randomized and controlled single-center, parallel-group, pre-post event study was conducted. In total, 70 patients affected by stage I or II (both clinically and instrumentally N0) micro-invasive oral cancer and undergoing elective surgery under general anesthesia were assigned to the control group (CG) or to the music therapy group (MTG). MTG patients received preoperative music therapy intervention (MT) from a certified music therapist before surgery, while the CG patients did not receive MT but instead received premedication with intravenous midazolam, 0.02 mg/kg. Anesthesia was the same in both groups. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded at the entrance to the operating room, just before the induction of anesthesia and every 5 min until the end of surgery. An anxiety visual analogues scale (A-VAS) was used to evaluate the level of anxiety. The bispectral index (BIS) monitor was used to measure the depth of sedation just before and 10 min after both music intervention and midazolam administration. Stress response was assessed 5 min before and 20 min after surgery via the control of plasma prolactin (PRL), growth hormone (GH), and cortisol levels. The patient global impression of satisfaction (PGIS) was tested 1 h after surgery. Participants in the MTG were asked to answer 3 questions concerning their experience with MT. RESULTS No statistical differences among the PRL, GH and cortisol levels between the two groups were registered before and after the treatment, as well as for PAS, PAD and HR. Significant differences in the A-VAS scores between the MTG and CG (p < 0.01) was observed. Compared to the CG, MTG patients had a statistically significantly lower BIS score (p = 0.02) before induction. A PGIS score of 86.7% revealed that patients in the MTG were very satisfied, versus 80% in the CG (p < 0.05). CONCLUSION Preoperative music therapy could be an alternative to intravenous midazolam when aiming to promote a preoperative and post-operative state of anxiolysis and sedation in stomatology surgery, even if no differences were found in terms of the surgery-related stress response according to physiological and hormonal determinations.
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Affiliation(s)
- Filippo Giordano
- Department of Precision and Regenerative Medicine and Ionian Area, Aldo Moro University, 70124 Bari, Italy
| | - Mariateresa Giglio
- Department of Interdisciplinary Medicine, Aldo Moro University, 70124 Bari, Italy
| | - Irene Sorrentino
- Department of Precision and Regenerative Medicine and Ionian Area, Aldo Moro University, 70124 Bari, Italy
| | - Fabio Dell'Olio
- Department of Mathematic, Aldo Moro University, 70124 Bari, Italy
| | - Pantaleo Lorusso
- Department of Precision and Regenerative Medicine and Ionian Area, Aldo Moro University, 70124 Bari, Italy
| | - Maria Massaro
- Department of Precision and Regenerative Medicine and Ionian Area, Aldo Moro University, 70124 Bari, Italy
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, Aldo Moro University, 70124 Bari, Italy
| | - Luisa Limongelli
- Department of Interdisciplinary Medicine, Aldo Moro University, 70124 Bari, Italy
| | - Laura Selicato
- Department of Mathematic, Aldo Moro University, 70124 Bari, Italy
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, Aldo Moro University, 70124 Bari, Italy
| | - Giustino Varrassi
- Department of Research, Paolo Procacci Foundation, 00193 Roma, Italy
| | - Filomena Puntillo
- Department of Interdisciplinary Medicine, Aldo Moro University, 70124 Bari, Italy
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AUDIO ANALYSIS REVEALS MUTUAL ASSOCIATIONS BETWEEN CLIENTS’ AND THERAPISTS’ VOCAL TIMBRES IN GUIDED IMAGERY AND MUSIC SESSIONS. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Blichfeldt-Ærø SC, Knutsen TM, Hagen HM, Diep LM, Trondalen G, Halvorsen S. Music therapy as an adjunct in cardiac device lead extraction procedures: A randomized controlled trial. Appl Nurs Res 2020; 56:151376. [DOI: 10.1016/j.apnr.2020.151376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/24/2020] [Accepted: 10/21/2020] [Indexed: 11/26/2022]
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Story KM, Beck BD. Guided Imagery and Music with female military veterans: An intervention development study. ARTS IN PSYCHOTHERAPY 2017. [DOI: 10.1016/j.aip.2017.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Effectiveness of guided imagery relaxation on levels of pain and depression in patients diagnosed with fibromyalgia. Holist Nurs Pract 2015; 29:13-21. [PMID: 25470476 DOI: 10.1097/hnp.0000000000000062] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIM The aim of this study was to evaluate the effects of guided imagery as a nursing intervention for pain management and depression in patients diagnosed with fibromyalgia. BACKGROUND Many studies support the use of guided imagery to improve patient outcomes. Guided imagery has been used for different purposes and it is thought to be an effective intervention for people suffering from nonmalignant pain. DESIGN A 2-group quasi-experimental study was conducted during 8 weeks by the University of Nursing in Almeria (Spain). METHODS Patients diagnosed with fibromyalgia aged 18 to 70 years (n = 60) were randomly assigned to a guided imagery group (n = 30) or a control group (n = 30). The outcomes measures were scores for pain with the McGill Pain Questionnaire long form (MPQ-LF) and the Visual Analogue Scale (VAS) and depression with the Beck Depression Inventory and the VAS for depression. The effects were examined at baseline, postintervention (4th week), and at the end of the study (8th week). RESULTS Treatment efficacy was analyzed by using a t test for paired samples. Temporal changes in the scores were examined by using a 2-way repeated-measures analysis of variance. The treatment group reported statistically significantly lower levels of pain (P < .046) and depression (P < .010) than the control group at the week 4 evaluation. A statistically significant effect on pain as measured by the daily VAS diary was also found in the experimental group. At week 8, no significant differences were found for pain. CONCLUSION Patients diagnosed with fibromyalgia may benefit from this nursing intervention in terms of relieving pain and depression. Guided imagery relaxation therapy could be incorporated as part of fibromyalgia treatment to promote health among people with fibromyalgia. RELEVANCE TO CLINICAL PRACTICE Guided imagery as a nursing intervention can alleviate pain and depression in patients diagnosed with fibromyalgia.
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Strange J. Text Watch. BRITISH JOURNAL OF MUSIC THERAPY 2014. [DOI: 10.1177/135945751402800211] [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]
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Abstract
Music therapy is a service that has become more prevalent as an adjunct to medical practice-as its evidence base expands and music therapists begin to join the cardiology team in every phase of care, from the most serious cases to those maintaining good heart health. Although applications of music medicine, primarily listening to short segments of music, are capable of stabilizing vital signs and managing symptoms in the short-term, music therapy interventions by a qualified practitioner are showing promise in establishing deeper and more lasting impact. On the basis of mind-body approaches, stress/coping models, the neuromatrix theory of pain, and entrainment, music therapy capitalizes on the ability of music to affect the autonomic nervous system. Although only a limited number of randomized controlled trials pinpoint the efficacy of specific music therapy interventions, qualitative research reveals some profound outcomes in certain individuals. A depth of understanding related to the experience of living with a cardiovascular disease can be gained through music therapy approaches such as nonverbal music psychotherapy and guided imagery and music. The multifaceted nature of musical responsiveness contributes to strong individual variability and must be taken into account in the development of research protocols for future music therapy and music medicine interventions. The extant research provides a foundation for exploring the many potential psychosocial, physiological, and spiritual outcomes of a music therapy service for cardiology patients.
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Mirbagher Ajorpaz N, Mohammadi A, Najaran H, Khazaei S. Effect of music on postoperative pain in patients under open heart surgery. Nurs Midwifery Stud 2014; 3:e20213. [PMID: 25699280 PMCID: PMC4332992 DOI: 10.17795/nmsjournal20213] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/09/2014] [Accepted: 07/13/2014] [Indexed: 12/16/2022] Open
Abstract
Background: Music, as a non-pharmacological and inexpensive nursing intervention, can be used easily as a complementary technique in reducing pain along with other methods. While some studies have demonstrated pain to decrease after music, others found music to be ineffective on pain. Objectives: The aim of this study was to investigate the effect of music on postoperative pain in patients under open heart surgery. Patients and Methods: A quasi-experimental study was performed on 60 patients under open heart surgery referred to ICU of Shahid Beheshti hospital in Kashan city. Patients were randomly divided into two groups including experimental and control groups. Patients in music group listened to nonverbal music for 30 minutes after surgery by headphones. The control group did not receive any intervention other than routine care. Before and after intervention, pain intensity was measured and recorded by visual analog scale in two groups. Data was analyzed using Chi-Square and t-tests. Results: Before intervention, the mean of pain intensity was 6.32 ± 0.21 and 6.10 ± 0.21 for experimental and control groups, respectively; and the difference was not significant (P = 0.21). After intervention, the mean of pain intensity was 3.11 ± 0.12 and 5.81 ± 0.38 for experimental and control groups, respectively; and the difference was significant (P = 0.04). Conclusions: Listening to the relaxant music can reduce postoperative pain. It is suggested that relaxant music be used as a complementary method in patients in order to reduce prospective pain.
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Affiliation(s)
| | - Abouzar Mohammadi
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Hamed Najaran
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Shala Khazaei
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
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