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Schmitz-Hübsch A, Gruber ME, Diaz Y, Wirzberger M, Hancock PA. Towards enhanced performance: an integrated framework of emotional valence, arousal, and task demand. ERGONOMICS 2024:1-14. [PMID: 39004835 DOI: 10.1080/00140139.2024.2370440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 06/16/2024] [Indexed: 07/16/2024]
Abstract
Extensive evaluations exist concerning the linkage between objective task demands and subsequent effects on user performance. However, the human user also experiences a range of emotions related to external task demands. Problematically, little is known about the associations between emotional valence, and arousal associated with the task demand-performance axis. In this paper, we advance a theoretical model concerning such interactive influences using three dimensions: (1) emotional valence, (2) arousal, and (3) task demand. The model evaluates the impact of these dimensions on user performance. It also identifies critical emotional user states, particularly those resulting in negative performance effects, as well as non-critical emotional states that can positively impact performance. Finally, we discuss the implications for affect-adaptive systems that can mitigate the impact of critical emotional states while leveraging the benefits of non-critical ones.
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Affiliation(s)
- Alina Schmitz-Hübsch
- University of Stuttgart, Stuttgart, Germany
- Fraunhofer Institute for Communication, Information Processing and Ergonomics FKIE, Wachtberg, Germany
| | - M E Gruber
- University of Central Florida, Orlando, FL, USA
| | - Yazmin Diaz
- University of Central Florida, Orlando, FL, USA
| | | | - P A Hancock
- University of Central Florida, Orlando, FL, USA
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Mackeen AD, Sullivan MV, Berghella V. Evidence-based cesarean delivery: preoperative management (part 7). Am J Obstet Gynecol MFM 2024; 6:101362. [PMID: 38574855 DOI: 10.1016/j.ajogmf.2024.101362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/18/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
Preoperative preparation for cesarean delivery is a multistep approach for which protocols should exist at each hospital system. These protocols should be guided by the findings of this review. The interventions reviewed and recommendations made for this review have a common goal of decreasing maternal and neonatal morbidity and mortality related to cesarean delivery. The preoperative period starts before the patient's arrival to the hospital and ends immediately before skin incision. The Centers for Disease Control and Prevention recommends showering with either soap or an antiseptic solution at least the night before a procedure. Skin cleansing in addition to this has not been shown to further decrease rates of infection. Hair removal at the cesarean skin incision site is not necessary, but if preferred by the surgical team then clipping or depilatory creams should be used rather than shaving. Preoperative enema is not recommended. A clear liquid diet may be ingested up to 2 hours before and a light meal up to 6 hours before cesarean delivery. Consider giving a preoperative carbohydrate drink to nondiabetic patients up to 2 hours before planned cesarean delivery. Weight-based intravenous cefazolin is recommended 60 minutes before skin incision: 1-2 g intravenous for patients without obesity and 2 g for patients with obesity or weight ≥80 kg. Adjunctive azithromycin 500 mg intravenous is recommended for patients with labor or rupture of membranes. Preoperative gabapentin can be considered as a way to decrease pain scores with movement in the postoperative period. Tranexamic acid (1 g in 10-20 mL of saline or 10 mg/kg intravenous) is recommended prophylactically for patients at high risk of postpartum hemorrhage and can be considered in all patients. Routine use of mechanical venous thromboembolism prophylaxis is recommended preoperatively and is to be continued until the patient is ambulatory. Music and active warming of the patient, and adequate operating room temperature improves outcomes for the patient and neonate, respectively. Noise levels should allow clear communication between teams; however, a specific decibel level has not been defined in the data. Patient positioning with left lateral tilt decreases hypotensive episodes compared with right lateral tilt, which is not recommended. Manual displacers result in fewer hypotensive episodes than left lateral tilt. Both vaginal and skin preparation should be performed with either chlorhexidine (preferred) or povidone iodine. Placement of an indwelling urinary catheter is not necessary. Nonadhesive drapes are recommended. Cell salvage, although effective for high-risk patients, is not recommended for routine use. Maternal supplemental oxygen does not improve outcomes. A surgical safety checklist (including a timeout) is recommended for all cesarean deliveries.
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Affiliation(s)
- A Dhanya Mackeen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger, Danville, PA (Drs Mackeen and Sullivan).
| | - Maranda V Sullivan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger, Danville, PA (Drs Mackeen and Sullivan)
| | - Vincenzo Berghella
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA (Dr Berghella)
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Nuri A, Abute L, Tesfaye Elilo L, Dejene Y, Ali S, Mezgebu T, Hailu M, Beyene T, Erjino E. Assessment of Preoperative Anxiety Levels Among Patients Admitted for Surgery in Public Hospitals, Southern Ethiopia. SAGE Open Nurs 2024; 10:23779608241274191. [PMID: 39185502 PMCID: PMC11342311 DOI: 10.1177/23779608241274191] [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: 10/05/2023] [Revised: 07/09/2024] [Accepted: 07/12/2024] [Indexed: 08/27/2024] Open
Abstract
Background Anxiety before surgery is one of the most challenging aspects of preoperative care. Preoperative anxiety has a number of postoperative complications. There are only a few studies that report on preoperative anxiety in surgical patients in Ethiopia, and their prevalence differs from one study to the next. Objective The aim of this study was to assess the level of preoperative anxiety and associated factors among surgical patients admitted at public hospitals in southern Ethiopia. Methods From July to August 2022, a facility-based cross-sectional study was conducted among patients admitted to surgical wards at public hospitals. Data collection was conducted using a pretested, structured questionnaire administered by an interviewer. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory scale. The data were coded and entered in Epi Data Version 4.6, then exported to Statistical Package for Social Sciences version 25 for analysis. To describe the study variables, descriptive statistics were used. The associated factors were then identified using bivariate and multivariate logistic regression analyses. Results were declared at a p-value of less than 0.05 based on an adjusted odds ratio with a 95% confidence interval. Result A total of 220 patients were enrolled, with a 99.5% response rate. The observed preoperative anxiety level was 57.5% (95%CI: 54.63-62.35). High preoperative anxiety was associated with no formal educational status (AOR: 3.75; 95%CI = 1.36, 10.39), fear of death (AOR =2.01; 95%CI = 1.09, 3.73), fear of waking up in middle of surgery (AOR =3.42; 95%CI =1.19, 9.77), fear of postoperative pain (AOR = 2.56; 95%CI = 1.15, 5.74). Conclusion This study found that five out of ten patients scheduled for surgery in public hospitals had high levels of preoperative anxiety. Anxiety levels were associated with factors such as the educational status of respondents, fear of death, fear of waking up in the middle of surgery, and fear of postoperative pain. Preoperative anxiety assessments should be conducted regularly in each hospital, and appropriate anxiety-reducing methods must be implemented.
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Affiliation(s)
- Ashenafi Nuri
- Department of Public Health, Lemo Woreda Health Office, Hossana, Ethiopia
| | - Lonsako Abute
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Legesse Tesfaye Elilo
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Yesuneh Dejene
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Samrawit Ali
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Taye Mezgebu
- Department of Emergency Medicine and Critical Care Nursing, School of Nursing, College of Health Science and Medicine, Wachemo University, Hosanna, Ethiopia
| | - Mickiale Hailu
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tilahun Beyene
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Eshetu Erjino
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
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Kefelegn R, Tolera A, Ali T, Assebe T. Preoperative anxiety and associated factors among adult surgical patients in public hospitals, eastern Ethiopia. SAGE Open Med 2023; 11:20503121231211648. [PMID: 38020793 PMCID: PMC10655790 DOI: 10.1177/20503121231211648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Objective This study aimed to assess the prevalence of preoperative anxiety and associated factors among adult surgical patients in public hospitals of eastern Ethiopia from 25 April to 26 May 2022. Methods An institutional-based cross-sectional study was undertaken using a systematic sampling technique among 423 participants from patients eligible for elective surgery. The prevalence of preoperative anxiety was assessed using the state and trait anxiety inventory measurement scale. Data were analyzed using SPSS version 26. Descriptive and summary statistics were computed. Binary and multivariable logistic regression were computed. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval and statistical significance was declared at a p-value < 0.05. Results The prevalence of preoperative anxiety among patients scheduled for elective surgery was 51.2%. Being 31-45 aged adult (AOR = 0.36; 95% CI = 0.17, 0.78), having moderate (AOR = 0.46; 95% CI = 0.22, 0.96) and strong social support (AOR = 0.04; 95% CI = 0.02, 0.08), being single (AOR = 0.19; 95% CI = 0.04, 0.89), listening to music (AOR = 0.37; 95% CI = 0.18, 0.74) and finding social and religious support (AOR = 0.15; 95% CI = 0.07, 0.33), and orthopedic surgery (AOR = 0.21; 95% CI = 0.10, 0.43) were significantly associated with lower odds of preoperative anxiety, whereas having fear of death (AOR = 1.16; 95% CI = 0.64, 2.09) was significantly associated with increased odds of preoperative anxiety. Conclusion In the current study, the magnitude of preoperative anxiety was high. Being an older adult and having social and treatment support was associated with lower odds of preoperative anxiety. In contrast, lower psychological readiness (fear of death) was associated with increased odds of preoperative anxiety. Patients should be routinely assessed for anxiety during the preoperative appointment, and the proper coping mechanisms and anxiety-reduction approaches should be used. It is also advisable that appropriate policies and procedures for reducing preoperative anxiety should be devised.
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Affiliation(s)
- Reta Kefelegn
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abebe Tolera
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Ali
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Assebe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Lee HY, Nam ES, Chai GJ, Kim DM. Benefits of Music Intervention on Anxiety, Pain, and Physiologic Response in Adults Undergoing Surgery: A Systematic Review and Meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:138-149. [PMID: 37276961 DOI: 10.1016/j.anr.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/07/2023] Open
Abstract
PURPOSE Evidence on factors influencing the variations of music's effect on anxiety and pain in surgical patients is unclear. We aimed to elucidate the effects of music intervention on anxiety and pain throughstudy characteristics. METHODS We conducted a search on the PubMed, CINAHL, Embase, Cochrane, and Web of Science databases from March 7 to April 21, 2022, for randomized controlled trials (RCTs) for the effect of music intervention on anxiety, pain, and physiological responses in surgical patients. We included studies published within the last 10 years. We assessed the risk of bias in the study using the Cochrane risk of bias tool for randomized trials and performed meta-analyses using a random-effects model for all outcomes. We used change-from-baseline scores as summary statistics and computed bias-corrected standardized mean differences (Hedges'g) for anxiety and pain outcomes and mean differences (MD) for blood pressure and heart rate. RESULTS Of the 454 records retrieved, 30 RCTs involving 2280 participants were found to be eligible. Music intervention was found to be superior to standard care in reducing anxiety (Hedges' g = -1.48, 95% confidence interval: -1.97 to -0.98), pain (Hedges's g = -0.67, -1.11 to -0.23), systolic blood pressure (MD = -4.62, -7.38 to -1.86), and heart rate (MD = -3.37, -6.65 to -0.10) in surgical patients. The impact of music on anxiety and pain relief varied significantly depending on the duration of the intervention. The largest effect was observed in interventions lasting between 30 and 60 minutes, with a decrease in anxiety and pain. CONCLUSIONS Music intervention is an effective way to reduce anxiety, pain, and physiological responses in surgical patients. Future reviews examining the influence of different types of surgery on the effects of music would add to the body of knowledge in this field. This study has been registered on the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42022340203, with a registration date of July 4, 2022.
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Affiliation(s)
- Ho Yeon Lee
- Doowon Technical University, Department of Nursing, Anseong, Republic of Korea
| | - Eun Sook Nam
- Kangwon National University, College of Nursing, Chuncheon, Republic of Korea.
| | - Gong Ju Chai
- Hallym Polytechnic University, Department of Nursing, Chuncheon, Republic of Korea
| | - Doo Myung Kim
- Andong Science College, Department of Nursing, Andong, Republic of Korea
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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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Anxiety Disorder and Smoking Behavior: The Moderating Effects of Entertainment and Informational Television Viewing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159160. [PMID: 35954515 PMCID: PMC9368348 DOI: 10.3390/ijerph19159160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023]
Abstract
Smoking is more common among individuals with mental health issues than those who do not have mental illnesses. In particular, among individuals with an anxiety disorder, a high prevalence of smoking has been found. Mood adjustment theory suggests that individuals with negative moods could adjust their moods depending on the type of television they watched. To understand this relationship better, we aim to examine how different television viewing can moderate the tendency of smoking behavior for individuals with an anxiety disorder. We used national U.S. survey data and concepts from the mood adjustment theory to answer our research questions. Our main contributions were to: (1) extend the mood adjustment theory by focusing on the association between a diagnosed mental disorder (i.e., anxiety) and risky behavior (i.e., smoking), and (2) examine the nuances of television genres by dividing entertainment television into excitement-valenced and ambiguously-valenced entertainment programs, along with information programs. The primary findings show that individuals with an anxiety disorder were more likely to smoke and this association was significantly attenuated when they watched cartoons, sports, and health information programs, but the positive association between an anxiety disorder and the extent of smoking was intensified when they watched drama, music, sci-fi, and television news. Patients with an anxiety disorder may take advantage of excitement-valenced entertainment programs and health-related information but need to be cautious in choosing ambiguously-valenced entertainment programs and news.
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Arfasa N, Nega Kassa R, Girma Legesse T. Preoperative anxiety and its associated factors among patients undergoing cardiac catheterization at saint peter Specialized Hospital and Addis Cardiac Center, Addis Ababa, Ethiopia. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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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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Brosh K, Roditi E, Wasser LM, Aryan A, Hanhart J, Potter MJ. Effect of Music Selection on Anxiety Level during Intravitreal Injections for Individuals of Varying Cultures. Ophthalmic Epidemiol 2021; 29:582-587. [PMID: 34293998 DOI: 10.1080/09286586.2021.1955390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: To investigate music selection as a treatment for anxiety during Intravitreal injections (IVI) for individuals of varying cultures.Methods: 106 individuals were enrolled in this randomized controlled study. Individuals were randomized into one to three categories: (1) a control group in which the IVI procedure was performed without music (n = 35), (2) an experimental group in which the music was selected by the physician (n = 36), (3) an experimental group in which the music was selected by the patient (n = 35). After the procedure, all patients responded to a questionnaire regarding their level of experienced anxiety, pain and discomfort (grade 0-10). The primary outcome was anxiety level during the procedure.Results: The experimental group in which patients selected music had higher number of patients with low anxiety score compared to the other groups (anxiety score <4 in 19,18 and 27 patients, respectively, p = .04). Interestingly, patients who answered the questionnaire in Arabic were less likely to desire music on subsequent injections compared to Hebrew and English speakers (52% Vs 78% Vs 100%, p = .02). Music was deemed by both experimental groups as an effective method to induce relaxation (average score of 6.6 and 7.2 in group 2 and 3, respectively). Preference for music on subsequent injections was increased in both experimental groups compared to the control group (P < .01). Patients in the third group preferred music selection on future injections more than the other groups (P < .01).Conclusion: Music selection may be an effective way to reduce anxiety levels during IVI. Preference for music during future injections is higher in patients who were exposed to music during IVI and may be influenced by culture.
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Affiliation(s)
- Koby Brosh
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Eduardo Roditi
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Lauren M Wasser
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Ahmad Aryan
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Joel Hanhart
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
| | - Michael J Potter
- Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel
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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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Shimada BMO, Santos MDSOMD, Cabral MA, Silva VO, Vagetti GC. Interventions among Pregnant Women in the Field of Music Therapy: A Systematic Review. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:403-413. [PMID: 34182584 PMCID: PMC10304802 DOI: 10.1055/s-0041-1731924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 12/08/2020] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To investigate in the literature the studies on the benefits of music therapy interventions among pregnant women in the prenatal, delivery and postpartum periods. DATA SOURCES The search for articles was carried out in the following electronic databases: VHL, LILACS, SciELO, Portal CAPES, PsycINFO, ERIC, PubMed/Medline, and journals specialized in this field: Revista Brasileira de Musicoterapia ("Brazilian Journal of Music Therapy") and Voices. STUDY SELECTION Descriptors in Portuguese (musicoterapia, gravidez, gestantes, revisão), English (music therapy, pregnancy, pregnant women, review) and Spanish (musicoterapia, embarazo, mujeres embarazadas, revisión) were used. The search was delimited between January 2009 and June 2019. The process of selection and evaluation of the articles was performed through peer review. DATA COLLECTION The following data were extracted: article title, year of publication, journal, author(s), database, country and date of collection, purpose of the study, sample size, type of care, intervention, instruments used, results, and conclusion. The data were organized in chronological order based on the year of publication of the study. SUMMARY OF THE DATA In total, 146 articles were identified, and only 23 studies were included in this systematic review. The articles found indicate among their results relaxation, decreased levels of anxiety, psychosocial stress and depression, decreased pain, increase in the maternal bond, improvement in the quality of sleep, control of the fetal heart rate and maternal blood pressure, and decreased intake of drugs in the postoperative period. CONCLUSION Music therapy during the prenatal, delivery and postpartum periods can provide benefits to pregnant women and newborns, thus justifying its importance in this field.
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Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis. Harv Rev Psychiatry 2021; 29:196-215. [PMID: 33979106 DOI: 10.1097/hrp.0000000000000294] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention). METHODS We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number. RESULTS 295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features. CONCLUSION Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.
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Granot R, Spitz DH, Cherki BR, Loui P, Timmers R, Schaefer RS, Vuoskoski JK, Cárdenas-Soler RN, Soares-Quadros JF, Li S, Lega C, La Rocca S, Martínez IC, Tanco M, Marchiano M, Martínez-Castilla P, Pérez-Acosta G, Martínez-Ezquerro JD, Gutiérrez-Blasco IM, Jiménez-Dabdoub L, Coers M, Treider JM, Greenberg DM, Israel S. "Help! I Need Somebody": Music as a Global Resource for Obtaining Wellbeing Goals in Times of Crisis. Front Psychol 2021; 12:648013. [PMID: 33935907 PMCID: PMC8079817 DOI: 10.3389/fpsyg.2021.648013] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/10/2021] [Indexed: 12/28/2022] Open
Abstract
Music can reduce stress and anxiety, enhance positive mood, and facilitate social bonding. However, little is known about the role of music and related personal or cultural (individualistic vs. collectivistic) variables in maintaining wellbeing during times of stress and social isolation as imposed by the COVID-19 crisis. In an online questionnaire, administered in 11 countries (Argentina, Brazil, China, Colombia, Italy, Mexico, the Netherlands, Norway, Spain, the UK, and USA, N = 5,619), participants rated the relevance of wellbeing goals during the pandemic, and the effectiveness of different activities in obtaining these goals. Music was found to be the most effective activity for three out of five wellbeing goals: enjoyment, venting negative emotions, and self-connection. For diversion, music was equally good as entertainment, while it was second best to create a sense of togetherness, after socialization. This result was evident across different countries and gender, with minor effects of age on specific goals, and a clear effect of the importance of music in people's lives. Cultural effects were generally small and surfaced mainly in the use of music to obtain a sense of togetherness. Interestingly, culture moderated the use of negatively valenced and nostalgic music for those higher in distress.
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Affiliation(s)
- Roni Granot
- Department of Musicology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniel H. Spitz
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Jerusalem School of Business Administration, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Boaz R. Cherki
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Federmann Center for the Study of Rationality, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Psyche Loui
- Department of Music, College of Arts, Media and Design, Northeastern University, Boston, MA, United States
| | - Renee Timmers
- Department of Music, The University of Sheffield, Sheffield, United Kingdom
| | - Rebecca S. Schaefer
- Health, Medical & Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
- Academy for Creative and Performing Arts, Leiden University, Leiden, Netherlands
| | - Jonna K. Vuoskoski
- Centre for Interdisciplinary Studies in Rhythm, Time and Motion (RITMO), University of Oslo, Oslo, Norway
| | - Ruth-Nayibe Cárdenas-Soler
- Escuela de Música, Facultad de Ciencias de la Educación, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia
| | | | - Shen Li
- Department of Psychology, Central China Normal University, Wuhan, China
| | - Carlotta Lega
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Stefania La Rocca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Isabel Cecilia Martínez
- Laboratory for the Study of Musical Experience, Facultad de Artes, Universidad Nacional de La Plata, La Plata, Argentina
| | - Matías Tanco
- Laboratory for the Study of Musical Experience, Facultad de Artes, Universidad Nacional de La Plata, La Plata, Argentina
| | - María Marchiano
- Laboratory for the Study of Musical Experience, Facultad de Artes, Universidad Nacional de La Plata, La Plata, Argentina
| | - Pastora Martínez-Castilla
- Department of Developmental and Educational Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Gabriela Pérez-Acosta
- Facultad de Música, Universidad Nacional Autónoma de México, UNAM, Mexico City, Mexico
| | - José Darío Martínez-Ezquerro
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento (UIESSAE), Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS) & Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | | | - Lily Jiménez-Dabdoub
- Laboratory of Psychology and Musical Arts, Faculty of Psychology and Faculty of Music, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Marijn Coers
- Health, Medical & Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
| | - John Melvin Treider
- Centre for Interdisciplinary Studies in Rhythm, Time and Motion (RITMO), University of Oslo, Oslo, Norway
| | - David M. Greenberg
- Interdisciplinary Department of Social Sciences and Department of Music, Bar-Ilan University, Ramat Gan, Israel
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, United Kingdom
| | - Salomon Israel
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
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Salazar de Pablo G, De Micheli A, Nieman DH, Correll CU, Kessing LV, Pfennig A, Bechdolf A, Borgwardt S, Arango C, van Amelsvoort T, Vieta E, Solmi M, Oliver D, Catalan A, Verdino V, Di Maggio L, Bonoldi I, Vaquerizo-Serrano J, Baccaredda Boy O, Provenzani U, Ruzzi F, Calorio F, Nosari G, Di Marco B, Famularo I, Molteni S, Filosi E, Mensi M, Balottin U, Politi P, Shin JI, Fusar-Poli P. Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis. Eur Neuropsychopharmacol 2020; 41:28-39. [PMID: 33162291 DOI: 10.1016/j.euroneuro.2020.10.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/24/2020] [Accepted: 10/16/2020] [Indexed: 12/31/2022]
Abstract
Promotion of good mental health in young people is important. Our aim was to evaluate the consistency and magnitude of the efficacy of universal/selective interventions to promote good mental health. A systematic PRISMA/RIGHT-compliant meta-analysis (PROSPERO: CRD42018088708) search of Web of Science until 04/31/2019 identified original studies comparing the efficacy of universal/selective interventions for good mental health vs a control group, in samples with a mean age <35 years. Meta-analytical random-effects model, heterogeneity statistics, assessment of publication bias, study quality and sensitivity analyses investigated the efficacy (Hedges' g=effect size, ES) of universal/selective interventions to promote 14 good mental health outcomes defined a-priori. 276 studies were included (total participants: 159,508, 79,142 interventions and 80,366 controls), mean age=15.0 (SD=7.4); female=56.0%. There was a significant overall improvement in 10/13 good mental health outcome categories that could be meta-analysed: compared to controls, interventions significantly improved (in descending order of magnitude) mental health literacy (ES=0.685, p<0.001), emotions (ES=0.541, p<0.001), self-perceptions and values (ES=0.49, p<0.001), quality of life (ES=0.457, p=0.001), cognitive skills (ES=0.428, p<0.001), social skills (ES=0.371, p<0.001), physical health (ES=0.285, p<0.001), sexual health (ES=0.257, p=0.017), academic/occupational performance (ES=0.211, p<0.001) and attitude towards mental disorders (ES=0.177, p=0.006). Psychoeducation was the most effective intervention for promoting mental health literacy (ES=0.774, p<0.001) and cognitive skills (ES=1.153, p=0.03). Physical therapy, exercise and relaxation were more effective than psychoeducation and psychotherapy for promoting physical health (ES=0.498, p<0.001). In conclusion, several universal/selective interventions can be effective to promote good mental health in young people. Future research should consolidate and extend these findings.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Andrea De Micheli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, the Netherlands
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience; The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Centre (FRITZ), Vivantes Klinikum Am Urban, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Klinikum im Friedrichshain, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; ORYGEN, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Neurosciences Department, University of Padova, Italy
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Spain
| | - Valeria Verdino
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Molecular and Developmental Medicine, Division on Psychiatry, University of Siena, Italy
| | - Lucia Di Maggio
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ilaria Bonoldi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Julio Vaquerizo-Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ottone Baccaredda Boy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Umberto Provenzani
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesca Ruzzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Federica Calorio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Benedetto Di Marco
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Irene Famularo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Silvia Molteni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Eleonora Filosi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Martina Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Child and Adolescent Neuropsychiatric Unit
| | - Umberto Balottin
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK.
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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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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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What is good mental health? A scoping review. Eur Neuropsychopharmacol 2020; 31:33-46. [PMID: 31901337 DOI: 10.1016/j.euroneuro.2019.12.105] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/24/2019] [Accepted: 12/08/2019] [Indexed: 12/20/2022]
Abstract
Promotion of good mental health in young people with and without mental disorders has received little empirical research attention and interventions for improving mental health in young people are not well established. This situation could be explained among other reasons due to the difficulties to define and operationalise what good mental health is. The current manuscript, produced by the European College of Neuropsychopharmacology Thematic Working Group on the Prevention of Mental Disorders and Mental Health Promotion (ECNP TWG PMD-MHP), presents a critical review of the available operationalizations for good mental health. A pragmatic conceptual operationalisation of good mental health is a much-needed step towards more standardised research in this field. Good mental health can be defined as a state of well-being that allows individuals to cope with the normal stresses of life and function productively. Universal and selective interventions are suitable to promote mental health. Core domains that define good mental health encompass: (i) mental health literacy, (ii) attitude towards mental disorders, (iii) self-perceptions and values, (iv) cognitive skills, (v) academic/ occupational performance, (vi) emotions, (vii) behaviours, (viii) self-management strategies, (ix) social skills, (x) family and significant relationships (xi) physical health, (xii) sexual health, (xiii) meaning of life, (xiv) and quality of life. These domains should be widely traceable in the literature and can be used to conduct further empirical research in the field of good mental health. Such data can lead to more robust evidence to identify and establish the pathways to follow in order to improve mental health.
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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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Moon EJ, Go Y, Woo G, Seo H, Lee BJ. Preoperative anxiety can cause convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery: a case report. J Int Med Res 2019; 47:5323-5327. [PMID: 31516074 PMCID: PMC6833385 DOI: 10.1177/0300060519873473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Preoperative anxiety in patients under spinal anaesthesia may cause serious complications. We report a case of combined transient convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery in a patient who presented with severe preoperative anxiety. Our patient’s consciousness and blood pressure recovered normally without any sequelae. However, preoperative anxiety can induce such complications, particularly in patients under regional anaesthesia. Therefore, early detection and deliberate management for preoperative anxiety are required for the patient’s safety and satisfaction.
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Affiliation(s)
- Eun-Jin Moon
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Yoonju Go
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.,Department of Anesthesiology and Pain Medicine, Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Gil Woo
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyungseok Seo
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Bong-Jae Lee
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
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21
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Kizilkaya T, Gul A. Parameters that Affect the Comfort Level of Pregnant Women Before Cesarean Section: Fasting and Anxiety. J Perianesth Nurs 2019; 34:1265-1273. [PMID: 31474518 DOI: 10.1016/j.jopan.2019.05.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to investigate whether fasting time and anxiety parameters affect pregnant women's preoperative comfort levels. DESIGN Cross-sectional descriptive study. METHODS Data were collected from pregnant women using the State-Trait Anxiety Inventory (STAI), General Comfort Questionnaire (GCQ), and Numerical Rating Scale. FINDINGS The mean age of the participants was 29.15 ± 4.54 years, and the spinal anesthesia rate was 65.5%. The mean fasting time was 13.16 ± 2.38 hours for solid food and 10.57 ± 2.91 hours for liquid food. The mean GCQ score was 129.82 ± 12.66, while the mean STAI subscale scores were 46.72 ± 9.37 and 43.65 ± 7.95. Moderately negative correlation was found between the total GCQ and STAI scores, while weak positive correlation was observed between the STAI score and the thirst sensation and mouth dryness. CONCLUSIONS The preoperative process negatively affects comfort levels of pregnant women. Interventions that reduce the fasting time and anxiety level of pregnant women will increase comfort.
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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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23
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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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Drzymalski DM, Lumbreras-Marquez MI, Tsen LC, Camann WR, Farber MK. The effect of patient-selected or preselected music on anxiety during cesarean delivery: a randomized controlled trial. J Matern Fetal Neonatal Med 2019; 33:4062-4068. [PMID: 30880522 DOI: 10.1080/14767058.2019.1594766] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Women undergoing cesarean delivery may have significant anxiety prior to surgery. Nonpharmacological approaches to anxiety reduction are favored in this patient population.Objective: The aim of this study was to determine the effects of patient-selected or preselected music on anxiety in parturients undergoing scheduled cesarean delivery.Materials and methods: This is a prospective, randomized controlled trial (IRB protocol #2015P002043; ClinicalTrials.gov, NCT02732964), of 150 parturients undergoing elective cesarean delivery. Parturients were randomized to patient-selected music (Pandora®), preselected music (Mozart), or no music (control). The primary outcome was anxiety after music exposure (versus no music) in the preoperative holding room. Secondary outcomes included postoperative anxiety, postoperative pain, and patient satisfaction.Results: Baseline anxiety and anxiety following preoperative exposure did not differ in the Pandora versus control group (3.8 ± 2.4 versus 4.6 ± 2.6, mean difference -0.8 [95% CI -1.8 to 0.2], p = .12), but was lower in the Mozart group versus control group (3.5 ± 2.5 versus 4.6 ± 2.5, mean difference -1.1 [95% CI -2.2 to -0.1], p = .03). Postoperative anxiety did not differ in the Pandora versus control group (1.0 ± 1.4 versus 1.3 ± 2.0, mean difference -0.3 [95% CI -1.0 to 0.4], p = .43), or in the Mozart versus control group (0.8 ± 1.3 versus 1.3 ± 2.0, mean difference -0.5 [95% CI -1.2 to 0.2], p = .15). Postoperative pain was not different in the Pandora group versus control group (0.8 ± 1.5 versus 1.4 ± 1.9, mean difference -0.6 [95% CI -1.3 to 0.1], p = .10), but was lower in the Mozart versus control group (0.6 ± 1.3 versus 1.4 ± 1.9, mean difference -0.8 [95% CI -1.4 to -0.1], p = .03). Total patient satisfaction scores were not different among the control, Pandora, and Mozart groups.Conclusion: While preselected Mozart music results in lower anxiety prior to cesarean delivery, patient-selected Pandora music does not. Further investigation to determine how music affects patients, clinicians, and the operating room environment during cesarean delivery is warranted.Clinical trial registration: NCT02732964.
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Affiliation(s)
- Dan Michael Drzymalski
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Mario Isaac Lumbreras-Marquez
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lawrence Ching Tsen
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - William Reid Camann
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michaela Kristina Farber
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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25
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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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Caumo W, Nazare Furtado da Cunha M, Camey S, Maris de Jezus Castro S, Torres ILS, Cadore Stefani L. Development, psychometric evaluation and validation of a brief measure of emotional preoperative stress (B-MEPS) to predict moderate to intense postoperative acute pain. Br J Anaesth 2018; 117:642-649. [PMID: 27799179 DOI: 10.1093/bja/aew310] [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] [Accepted: 07/15/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Preoperative stress might influence postoperative pain, thereby, it is desirable to assess it more precisely. Thus, we developed and evaluated the psychometric properties of a brief measure of emotional preoperative stress (B-MEPS) index using Item Response Category Characteristic Curves. We validated and assessed whether the B-MEPS can predict moderate to intense acute postoperative pain (MIAPP). METHODS We included 863 adult patients who underwent elective surgeries (ASA I-III physical status). The B-MEPS was constructed based on items selected from instruments to assess anxiety, depression, future self-perception and minor psychiatric disorders. We identified 24 items with greatest discriminant power to identify patients who should undergo surgery to treat cancer with MIAPP. The reliability was maximized using the Cronbach's alpha indices. Fifteen items remained, which were adjusted by the Generalized Partial Credit Model. The convergent validity was assessed correlating the B-MEPS index with the pain catastrophizing (n = 100). Finally, the B-MEPS was applied in a prospective cohort of patients who underwent an abdominal hysterectomy (n = 150). RESULTS The Cronbach's alpha for selected items was 0.83. The correlation coefficient between B-MEPS index and catastrophizing was r = 0.37 (P < 0.01). A hierarchical regression model evidenced that the B-MEPS index was a factor independent to predict MIAPP after an abdominal hysterectomy [odds ratio (OR)=1.20, confidence interval (CI) 95% 1.05-1.43). CONCLUSIONS The B-MEPS index presents satisfactory psychometric evaluations based on its internal consistency, convergent, and discriminant validity. The B-MEPS is a propensity index to MIAPP, which might help the clinician to decide on the best therapeutic approaches for acute postoperative pain.
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Affiliation(s)
- W Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS) .,Surgery Department, School of Medicine.,Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation at HCPA, Porto Alegre, Brazil
| | - M Nazare Furtado da Cunha
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS)
| | - S Camey
- Pharmacology Department, Instituto de Ciências Básicas da Saúde, UFRGS
| | | | - I L S Torres
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS).,Pharmacology Department, Instituto de Ciências Básicas da Saúde, UFRGS
| | - L Cadore Stefani
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS).,Surgery Department, School of Medicine.,Anesthesia and Perioperative Pain Medicine at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Statistics Department at UFRGS, Porto Alegre, Brazil
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27
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A smartphone-based music intervention to reduce pain and anxiety in women before or during labor. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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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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Effects of Tibetan Music on Neuroendocrine and Autonomic Functions in Patients Waiting for Surgery: A Randomized, Controlled Study. Anesthesiol Res Pract 2018; 2018:9683780. [PMID: 29692808 PMCID: PMC5859866 DOI: 10.1155/2018/9683780] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/10/2018] [Accepted: 01/21/2018] [Indexed: 02/05/2023] Open
Abstract
Background The aim of this study was to investigate the effects of listening to Tibetan music on anxiety and endocrine, autonomic, cognitive responses in patients waiting for urologic surgery. Methods Sixty patients waiting for surgery were enrolled to the study. They were randomized in music (M) and control (C) groups. The M group listened to a low-frequency Tibetan music for 30 min (T0-T30) through headphones, and the C group wore headphones with no sound. The State Trait Anxiety Inventory Questionnaire (STAI) Y-1 was administered at T0 and T30. Normalized low (LFnu) and high frequencies (HFnu) of heart rate variability, LF/HF ratio, and galvanic skin response (GRS) data were analyzed at T0, T10, T20, T30, and T35. The salivary α-amylase (sAA) samples were collected at T0, T35, and T45. Results In the M group, the STAI Y-1 score decreased at T30 versus baseline (p < 0.001), sAA levels decreased at T35 versus T0(p=0.004), and GSR remained unchanged. In the C group, the STAI Y-1 score remained unchanged, sAA level increased at T35 versus T0(p < 0.001), and GSR slightly increased at T35 versus baseline (p=0.359). LFnu was lower, and HFnu was significantly higher (T10-T30) in M versus C group. Mean LF/HF ratio slightly reduced in the M group. Conclusions Our results suggest that preoperative listening to relaxing Tibetan music might be a useful strategy to manage preoperative anxiety.
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30
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What promotes and hinders success in breastfeeding in hospital care? – the role of social support and anxiety. HEALTH PSYCHOLOGY REPORT 2018. [DOI: 10.5114/hpr.2018.73051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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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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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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Chang HC, Yu CH, Chen SY, Chen CH. The effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy. Complement Ther Med 2015; 23:509-15. [PMID: 26275644 DOI: 10.1016/j.ctim.2015.05.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 05/13/2015] [Accepted: 05/24/2015] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE While music listening has been studied as an intervention to help reduce anxiety in pregnant women, few studies have explored the effect of music listening on pregnancy-specific stress relief. This study examines the effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy. DESIGN A randomized controlled trial was implemented. A valid sample of 296 pregnant women in their second or third trimester was randomly distributed into an experimental group (n=145) and a control group (n=151). INTERVENTIONS The experimental group received routine prenatal care and music listening. The control group received routine prenatal care only. MAIN OUTCOME MEASURES Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Perceived Stress Scale (PSS), and Maternal-Fetal Attachment Scale (MFAS). RESULTS The post-test results identified a significantly lower level of psychosocial stress in the experimental group than in the control group, particularly in terms of the stresses related to baby care and changing family relationships and to maternal role identification. However, no statistically significant differences in terms of perceived stress and maternal-fetal attachment were found between the post-test results of the two groups. CONCLUSION This study provides evidence in support of using of music in interventions designed to relieve psychosocial stress in prenatal women. IRB approval number: ER98223.
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Affiliation(s)
- Hsing-Chi Chang
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 701, Taiwan.
| | - Chen-Hsiang Yu
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical Center, No. 138, Sheng Li Road, Tainan 701, Taiwan.
| | - Shu-Yueh Chen
- Department of Nursing, HungKuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung 403, Taiwan.
| | - Chung-Hey Chen
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 701, Taiwan.
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Biddiss E, Knibbe TJ, McPherson A. The Effectiveness of Interventions Aimed at Reducing Anxiety in Health Care Waiting Spaces. Anesth Analg 2014; 119:433-448. [DOI: 10.1213/ane.0000000000000294] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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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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Escribano B, Quero I, Feijóo M, Tasset I, Montilla P, Túnez I. Role of noise and music as anxiety modulators: Relationship with ovarian hormones in the rat. Appl Anim Behav Sci 2014. [DOI: 10.1016/j.applanim.2013.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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Abstract
BACKGROUND Patients awaiting surgical procedures often experience significant anxiety. Such anxiety may result in negative physiological manifestations, slower wound healing, increased risk of infection, and may complicate the induction of anaesthesia and impede postoperative recovery. To reduce patient anxiety, sedatives and anti-anxiety drugs are regularly administered before surgery. However, these often have negative side effects and may prolong patient recovery. Therefore, increasing attention is being paid to a variety of non-pharmacological interventions for reduction of preoperative anxiety such as music therapy and music medicine interventions. Interventions are categorized as 'music medicine' when passive listening to pre-recorded music is offered by medical personnel. In contrast, music therapy requires the implementation of a music intervention by a trained music therapist, the presence of a therapeutic process, and the use of personally tailored music experiences. A systematic review was needed to gauge the efficacy of both music therapy and music medicine interventions for reduction of preoperative anxiety. OBJECTIVES To examine the effects of music interventions with standard care versus standard care alone on preoperative anxiety in surgical patients. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7), MEDLINE (1950 to August 2012), CINAHL (1980 to August 2012), AMED (1985 to April 2011; we no longer had access to AMED after this date), EMBASE (1980 to August 2012), PsycINFO (1967 to August 2012), LILACS (1982 to August 2012), Science Citation Index (1980 to August 2012), the specialist music therapy research database (March 1 2008; database is no longer functional), CAIRSS for Music (to August 2012), Proquest Digital Dissertations (1980 to August 2012), ClinicalTrials.gov (2000 to August 2012), Current Controlled Trials (1998 to August 2012), and the National Research Register (2000 to September 2007). We handsearched music therapy journals and reference lists, and contacted relevant experts to identify unpublished manuscripts. There was no language restriction. SELECTION CRITERIA We included all randomized and quasi-randomized trials that compared music interventions and standard care with standard care alone for reducing preoperative anxiety in surgical patients. DATA COLLECTION AND ANALYSIS Two review authors independently extracted the data and assessed the risk of bias. We contacted authors to obtain missing data where needed. Where possible, results were presented in meta analyses using mean differences and standardized mean differences. Post-test scores were used. In cases of significant baseline differences, we used change scores. MAIN RESULTS We included 26 trials (2051 participants). All studies used listening to pre-recorded music. The results suggested that music listening may have a beneficial effect on preoperative anxiety. Specifically, music listening resulted, on average, in an anxiety reduction that was 5.72 units greater (95% CI -7.27 to -4.17, P < 0.00001) than that in the standard care group as measured by the Stait-Trait Anxiety Inventory (STAI-S), and -0.60 standardized units (95% CI -0.90 to -0.31, P < 0.0001) on other anxiety scales. The results also suggested a small effect on heart rate and diastolic blood pressure, but no support was found for reductions in systolic blood pressure, respiratory rate, and skin temperature. Most trials were assessed to be at high risk of bias because of lack of blinding. Blinding of outcome assessors is often impossible in music therapy and music medicine studies that use subjective outcomes, unless in studies in which the music intervention is compared to another treatment intervention. Because of the high risk of bias, these results need to be interpreted with caution.None of the studies included wound healing, infection rate, time to discharge, or patient satisfaction as outcome variables. One large study found that music listening was more effective than the sedative midazolam in reducing preoperative anxiety and equally effective in reducing physiological responses. No adverse effects were identified. AUTHORS' CONCLUSIONS This systematic review indicates that music listening may have a beneficial effect on preoperative anxiety. These findings are consistent with the findings of three other Cochrane systematic reviews on the use of music interventions for anxiety reduction in medical patients. Therefore, we conclude that music interventions may provide a viable alternative to sedatives and anti-anxiety drugs for reducing preoperative anxiety.
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Affiliation(s)
- Joke Bradt
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA.
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