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Sensory-based interventions in the NICU: systematic review of effects on preterm brain development. Pediatr Res 2022; 92:47-60. [PMID: 34508227 DOI: 10.1038/s41390-021-01718-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Infants born preterm are known to be at risk for abnormal brain development and adverse neurobehavioral outcomes. To improve early neurodevelopment, several non-pharmacological interventions have been developed and implemented in the neonatal intensive care unit (NICU). Sensory-based interventions seem to improve short-term neurodevelopmental outcomes in the inherently stressful NICU environment. However, how this type of intervention affects brain development in the preterm population remains unclear. METHODS A systematic review of the literature was conducted for published studies in the past 20 years reporting the effects of early, non-pharmacological, sensory-based interventions on the neonatal brain after preterm birth. RESULTS Twelve randomized controlled trials (RCT) reporting short-term effects of auditory, tactile, and multisensory interventions were included after the screening of 1202 articles. Large heterogeneity was identified among studies in relation to both types of intervention and outcomes. Three areas of focus for sensory interventions were identified: auditory-based, tactile-based, and multisensory interventions. CONCLUSIONS Diversity in interventions and outcome measures challenges the possibility to perform an integrative synthesis of results and to translate these for evidence-based clinical practice. This review identifies gaps in the literature and methodological challenges for the implementation of RCTs of sensory interventions in the NICU. IMPACT This paper represents the first systematic review to investigate the effect of non-pharmacological, sensory-based interventions in the NICU on neonatal brain development. Although reviewed RCTs present evidence on the impact of such interventions on the neonatal brain following preterm birth, it is not yet possible to formulate clear guidelines for clinical practice. This review integrates existing literature on the effect of sensory-based interventions on the brain after preterm birth and identifies methodological challenges for the conduction of high-quality RCTs.
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Costa VS, Bündchen DC, Sousa H, Pires LB, Felipetti FA. Clinical benefits of music-based interventions on preterm infants' health: A systematic review of randomised trials. Acta Paediatr 2022; 111:478-489. [PMID: 34919292 DOI: 10.1111/apa.16222] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/26/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
AIM This systematic review aimed to differentiate and isolate the results of different music-based interventions used with preterm infants in the neonatal intensive care unit and explore their clinical benefits. METHODS The last search was performed on 5 July 2021 on Web of Science, Scopus, EMBASE, PsycINFO, CINAHL, LILACS and CENTRAL. Only randomised clinical trials that explored the health benefits of music-based interventions were considered. RESULTS A total of 39 studies were included. All music-based interventions were divided into music medicine and music therapy. The overall results suggested that music medicine interventions were associated with a significant improvement in pain relief; in turn, improvements in cardiac and respiratory function, weight gain, eating behaviour, and quiet alert and sleep states were more consistent in studies that followed a music therapy approach with the presence of a music therapist. CONCLUSION This review supports the beneficial effects of music-based interventions on the health of preterm infants in a neonatal intensive care unit; however, it also offers suggestions for future studies in order to increase the number of interventions with music therapists, since the results of music therapy approaches were more consistent for physiological and behavioural outcomes.
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Affiliation(s)
- Victor Seabra Costa
- Department of Health Sciences Federal University of Santa Catarina (UFSC) Araranguá Brazil
| | | | - Helena Sousa
- Department of Education and Psychology Center for Health Technology and Services Research (CINTESIS.UA) University of Aveiro Aveiro Portugal
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Mohan A, Gokulakrishnan G, El‐Saie A, Brickley A, Hagan J, Pammi M. Music therapy for preterm neonates in the neonatal intensive care unit: An overview of systematic reviews. Acta Paediatr 2021; 110:3180-3200. [PMID: 34346112 DOI: 10.1111/apa.16055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023]
Abstract
AIM To summarise the quantity and quality of evidence for using music therapy for preterm infants in the neonatal intensive care unit (NICU). METHODS We performed an overview of evidence for the effectiveness and safety of MT for preterm infants in the NICU. We performed a random-effects meta-analysis of data from studies that fit the definition of MT. RESULTS We identified 12 eligible systematic reviews and the methodological quality by AMSTAR-2 ranged from moderate to critically low. We identified 14 eligible randomised trials and 7 observational studies where the intervention fits the definition of MT. Meta-analysis of the RCTs showed that MT significantly decreases heart rate, mean difference (MD) (95% CI), -3.21 [-5.22, -1.19], respiratory rate, MD -2.93 [-5.65, -0.22], and maternal anxiety, MD -17.50 [-20.10, -14.90], and increases feeding volume, MD 29.59 [12.79, 46.38]. Long-term neurodevelopmental or safety outcomes were not reported. GRADE assessment of outcomes ranged from low to very low, downgraded for high risk of bias in the included studies, inconsistency and imprecision. CONCLUSION Low to very low certainty evidence suggests that MT in preterm infants improves short-term physiological parameters, feeding and maternal anxiety but safety and long-term outcomes were not reported.
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Affiliation(s)
| | - Ganga Gokulakrishnan
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Ahmed El‐Saie
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Alix Brickley
- Children’s Hospital Colorado in the Ponzio Creative Arts Therapy Program Denver CO USA
| | - Joseph Hagan
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Mohan Pammi
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
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Mikulis N, Inder TE, Erdei C. Utilising recorded music to reduce stress and enhance infant neurodevelopment in neonatal intensive care units. Acta Paediatr 2021; 110:2921-2936. [PMID: 34107110 DOI: 10.1111/apa.15977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/02/2021] [Accepted: 06/08/2021] [Indexed: 12/01/2022]
Abstract
AIM This paper summarises published evidence on the use of recorded music in high-risk infants to reduce stress and improve neurodevelopment, forming recommendations for proposed clinical applications in neonatal intensive care units. METHODS We searched two comprehensive library catalogues and two databases for articles evaluating the impact of recorded music interventions on hospitalised preterm infants. Original and review papers published in English in the 10 years prior to this search were selected if the study included a component of recorded music interventions. RESULTS Most original studies (80.95%) and all literature reviews (100%) reported positive effects of recorded music interventions for preterm infants, primarily in the short term. No negative effects were reported. Evidence is emerging regarding the neurobiological mechanisms of recorded music on longer-term effects on preterm infant neurodevelopment. Clinical applications were suggested drawing upon available evidence. Due to generally small sample sizes and variability in study design, unanswered questions remain. CONCLUSION Carefully designed recorded music interventions appear to be safe, feasible and effective in reducing stress and improving neurodevelopment of hospitalised infants. Additional rigorous, well-powered trials with relevant outcomes are needed to further refine specific elements for recorded music interventions to better inform practice.
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Affiliation(s)
- Nicole Mikulis
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
| | - Terrie E. Inder
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
- Harvard Medical School Boston Massachusetts USA
| | - Carmina Erdei
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
- Harvard Medical School Boston Massachusetts USA
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Hasegawa Y, Hoshiyama M. Effect of environmental music on autonomic function in infants in intensive and growing care units. J Neonatal Perinatal Med 2021; 13:395-401. [PMID: 31771074 DOI: 10.3233/npm-180174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of this study is (1) to observe the effect of the background music (BGM) in the incubator on heart rate variability (HRV) during the first few weeks of life in preterm infants in the neonatal intensive (NICU) and growing care units (GCU) and (2) to investigate the effect of environmental music on autonomic function in the infants. METHODS Thirty infants, including premature (26 3/7 - 38 4/7 weeks) and low-birth weight (LBW) (946-2,440 g) infants, admitted to the NICU or GCU were involved. The heart rate, low- (LF, 0.05-0.15 Hz) and high- (HF, 0.15-0.4 Hz) frequency HRV components, and LF/HF ratio were measured. The BGM, lullabies for a baby, was delivered through a speaker in the incubator, and the HRV components were compared among before, during, and after intervention with BGM. RESULTS The mean HR did not change among the experimental conditions. The LF and HF values decreased during the BGM condition, but not LF/HF, compared with the condition before BGM. CONCLUSIONS The present results showed that an auditory environment affected the autonomic function of infants with a range of BGM in the NICU/GCU. The present study also suggested that BGM, a non-invasive and non-pharmacological intervention, could be an evaluation tool for autonomic function in infants in NICU/GCU.
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Affiliation(s)
- Y Hasegawa
- Department of Rehabilitation Sciences, Graduate School of Health Sciences, Nagoya University, Nagoya, Japan
| | - M Hoshiyama
- Brain and Mind Research Center, Nagoya University, Higashi-ku, Nagoya, Japan
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Giordano V, Goeral K, Schrage-Leitner L, Berger A, Olischar M. The Effect of Music on aEEG Cyclicity in Preterm Neonates. CHILDREN-BASEL 2021; 8:children8030208. [PMID: 33803493 PMCID: PMC8000223 DOI: 10.3390/children8030208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 12/25/2022]
Abstract
Several methods can be used in the neonatal intensive care unit (NICU) to reduce stress and optimize the quality of life during this period of hospitalization. Among these, music could play an important role. We investigated the effect of different kinds of music therapies on the brain activity of very preterm infants using amplitude-integrated EEG. Sixty-four patients were included and randomly assigned to three different groups: live music group, recorded music group, and control group. In both intervention groups, music was started after the appearance of the first quiet-sleep phase, with a subsequent duration of 20 min. Changes between the first and second quiet-sleep epochs were analyzed using the amplitude-integrated EEG. When looking at single parameters of the amplitude-integrated EEG trace, no differences could be found between the groups when comparing their first and second quiet-sleep phase regarding the parameters of change from baseline, quality of the quiet-sleep epoch, and duration. However, when looking at the total cyclicity score of the second quiet-sleep phase, a difference between both intervention groups and the control group could be found (live music therapy vs. control, p = 0.003; recorded music therapy vs. control, p = 0.006). Improvement within the first and second quiet-sleep epochs were detected in both music groups, but not in the control group. We concluded that our study added evidence of the beneficial effect of music on the amplitude-integrated EEG activity in preterm infants.
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Affiliation(s)
- Vito Giordano
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria; (K.G.); (A.B.); (M.O.)
- Correspondence: ; Tel.: +43-40400-3232 or +43-69918-186496; Fax: +43-40400-2929
| | - Katharina Goeral
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria; (K.G.); (A.B.); (M.O.)
| | - Leslie Schrage-Leitner
- Department of Music Therapy, University of Music and Performing Arts, Seilerstätte 26, 1010 Vienna, Austria;
| | - Angelika Berger
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria; (K.G.); (A.B.); (M.O.)
| | - Monika Olischar
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria; (K.G.); (A.B.); (M.O.)
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Sleep Promotion for Preterm Infants in the NICU. Nurs Womens Health 2020; 24:24-35. [PMID: 32083554 DOI: 10.1016/j.nwh.2019.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/09/2019] [Accepted: 11/01/2019] [Indexed: 12/19/2022]
Abstract
Sleep is a crucial human physiologic need. Preterm infants in the NICU are exposed to noxious stimuli that often disrupt and shorten their sleep periods. Sleep disruption may have a negative effect on clinical outcomes, growth, and development and may also delay hospital discharge. Increasing evidence suggests that sleep quality is critical for brain development and synaptic plasticity and is associated with long-term neurodevelopmental outcomes. The purpose of this article is to discuss the importance of sleep in preterm infants, describe tools commonly used to assess infant sleep and identify different sleep-wake states, and identify interventions that promote sleep in preterm infants in the NICU. Nurses play a vital role in implementing appropriate interventions that promote preterm infants' sleep.
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Chorna O, Filippa M, De Almeida JS, Lordier L, Monaci MG, Hüppi P, Grandjean D, Guzzetta A. Neuroprocessing Mechanisms of Music during Fetal and Neonatal Development: A Role in Neuroplasticity and Neurodevelopment. Neural Plast 2019; 2019:3972918. [PMID: 31015828 PMCID: PMC6446122 DOI: 10.1155/2019/3972918] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/06/2019] [Accepted: 02/24/2019] [Indexed: 01/17/2023] Open
Abstract
The primary aim of this viewpoint article is to examine recent literature on fetal and neonatal processing of music. In particular, we examine the behavioral, neurophysiological, and neuroimaging literature describing fetal and neonatal music perception and processing to the first days of term equivalent life. Secondly, in light of the recent systematic reviews published on this topic, we discuss the impact of music interventions on the potential neuroplasticity pathways through which the early exposure to music, live or recorded, may impact the fetal, preterm, and full-term infant brain. We conclude with recommendations for music stimuli selection and its role within the framework of early socioemotional development and environmental enrichment.
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Affiliation(s)
- O. Chorna
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - M. Filippa
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Social Science Department, University of Valle d'Aosta, Aosta, Italy
| | - J. Sa De Almeida
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - L. Lordier
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - M. G. Monaci
- Social Science Department, University of Valle d'Aosta, Aosta, Italy
| | - P. Hüppi
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - D. Grandjean
- Swiss Center for Affective Sciences and Department of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - A. Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Music Therapy Self-Care Group for Parents of Preterm Infants in the Neonatal Intensive Care Unit: A Clinical Pilot Intervention. MEDICINES 2018; 5:medicines5040134. [PMID: 30558347 PMCID: PMC6313327 DOI: 10.3390/medicines5040134] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/07/2018] [Accepted: 12/13/2018] [Indexed: 11/17/2022]
Abstract
Background: The parents of preterm infants face major mental health challenges in the Neonatal Intensive Care Unit (NICU). Family-centered music therapy actively integrates and empowers parents in their infants' care. With the aim to better understand and address parental needs separately from their babies' needs, a music therapy (MT) self-care group was implemented as part of clinical practice at the hospital Clínica de la Mujer, in Bogotá, Colombia. Methods: The group was provided for both parents, twice a week, in the NICU. Music guided relaxations, breathing techniques, and self-expression were at the center of the MT group sessions. The parents completed a pre/post self-administered Numeric Rating Scale (NRS), including anxiety levels, stress levels, mood and motivation. Results: The parents highly valued the MT self-care group in the NICU. On average, there was a 37% improvement in anxiety levels, 28% improvement in stress levels, and 12% improvement in mood, restfulness and motivation. Being able to relax, to distract themselves from their worries and having time for themselves are amongst the most frequently mentioned benefits. Conclusions: Addressing parents' needs separately from their babies' treatment, with culturally sensitive interventions aimed at improving parental mental health, is essential for continuing the development of family-centered music therapy interventions in the NICU.
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A Review of Non-Pharmacological Treatments for Pain Management in Newborn Infants. CHILDREN-BASEL 2018; 5:children5100130. [PMID: 30241352 PMCID: PMC6210323 DOI: 10.3390/children5100130] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/05/2018] [Accepted: 09/17/2018] [Indexed: 11/17/2022]
Abstract
Pain is a major problem in sick newborn infants, especially for those needing intensive care. Pharmacological pain relief is the most commonly used, but might be ineffective and has side effects, including long-term neurodevelopmental sequelae. The effectiveness and safety of alternative analgesic methods are ambiguous. The objective was to review the effectiveness and safety of non-pharmacological methods of pain relief in newborn infants and to identify those that are the most effective. PubMed and Google Scholar were searched using the terms: “infant”, “premature”, “pain”, “acupuncture”, “skin-to-skin contact”, “sucrose”, “massage”, “musical therapy” and ‘breastfeeding’. We included 24 studies assessing different methods of non-pharmacological analgesic techniques. Most resulted in some degree of analgesia but many were ineffective and some were even detrimental. Sucrose, for example, was often ineffective but was more effective than music therapy, massage, breast milk (for extremely premature infants) or non-invasive electrical stimulation acupuncture. There were also conflicting results for acupuncture, skin-to-skin care and musical therapy. Most non-pharmacological methods of analgesia provide a modicum of relief for preterm infants, but none are completely effective and there is no clearly superior method. Study is also required to assess potential long-term consequences of any of these methods.
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Liao J, Hu R, Su L, Wang S, Xu Q, Qian X, He H. Nonpharmacological Interventions for Sleep Promotion on Preterm Infants in Neonatal Intensive Care Unit: A Systematic Review. Worldviews Evid Based Nurs 2018; 15:386-393. [DOI: 10.1111/wvn.12315] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Jin‐Hua Liao
- School of NursingFujian Medical University Fujian China
| | - Rong‐Fang Hu
- School of NursingFujian Medical University Fujian China
| | - Li‐Jing Su
- School of NursingFujian Medical University Fujian China
| | - Shuo Wang
- School of NursingFujian Medical University Fujian China
| | - Qin Xu
- School of NursingFujian Medical University Fujian China
| | - Xiao‐Fang Qian
- Division of NursingFujian Women's and Children's Hospital Fujian China
| | - Hong‐Gu He
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of MedicineNational University of Singapore Singapore
- National University Health System Singapore
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Boyce M, Bungay H, Munn-Giddings C, Wilson C. The impact of the arts in healthcare on patients and service users: A critical review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:458-473. [PMID: 28940775 DOI: 10.1111/hsc.12502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 05/06/2023]
Abstract
This review provides an updated evaluation of the emerging body of literature on the value of the arts in healthcare settings. Internationally, there is growing interest in the use of the arts in the healthcare context supported by the number of research studies reported in the nursing and medical literature. There is evidence that arts interventions have positive effects on psychological and physiological outcomes on patients in a hospital environment. A critical review of the literature between 2011 and 2016 was undertaken. The following databases were searched: MedLine, CINAHL, AMED, Web of Science and ASSIA. Searches included words from three categories: cultural activities, outcomes and healthcare settings. Initial searches identified 131 potentially relevant articles. Following screening and review by the research team, a total of 69 studies were included in the final review. The majority of studies examined the effect of music listening on patients/service users (76.8%). These studies were primarily quantitative focusing on the measurable effects of music listening in a surgical context. Overall, the studies in the review support the growing evidence base on the value of the arts in a variety of healthcare settings for patients/service users. The review findings suggest that now is the time for different voices and art forms to be considered and represented in the research on arts in healthcare. Further research is also required to strengthen the existing evidence base.
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Affiliation(s)
- Melanie Boyce
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Hilary Bungay
- Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK
| | - Carol Munn-Giddings
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Ceri Wilson
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
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Robb SL, Hanson-Abromeit D, May L, Hernandez-Ruiz E, Allison M, Beloat A, Daugherty S, Kurtz R, Ott A, Oyedele OO, Polasik S, Rager A, Rifkin J, Wolf E. Reporting quality of music intervention research in healthcare: A systematic review. Complement Ther Med 2018; 38:24-41. [PMID: 29857877 PMCID: PMC5988263 DOI: 10.1016/j.ctim.2018.02.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Concomitant with the growth of music intervention research, are concerns about inadequate intervention reporting and inconsistent terminology, which limits validity, replicability, and clinical application of findings. OBJECTIVE Examine reporting quality of music intervention research, in chronic and acute medical settings, using the Checklist for Reporting Music-based Interventions. In addition, describe patient populations and primary outcomes, intervention content and corresponding interventionist qualifications, and terminology. METHODS Searching MEDLINE, PubMed, CINAHL, HealthSTAR, and PsycINFO we identified articles meeting inclusion/exclusion criteria for a five-year period (2010-2015) and extracted relevant data. Coded material included reporting quality across seven areas (theory, content, delivery schedule, interventionist qualifications, treatment fidelity, setting, unit of delivery), author/journal information, patient population/outcomes, and terminology. RESULTS Of 860 articles, 187 met review criteria (128 experimental; 59 quasi-experimental), with 121 publishing journals, and authors from 31 countries. Overall reporting quality was poor with <50% providing information for four of the seven checklist components (theory, interventionist qualifications, treatment fidelity, setting). Intervention content reporting was also poor with <50% providing information about the music used, decibel levels/volume controls, or materials. Credentialed music therapists and registered nurses delivered most interventions, with clear differences in content and delivery. Terminology was varied and inconsistent. CONCLUSIONS Problems with reporting quality impedes meaningful interpretation and cross-study comparisons. Inconsistent and misapplied terminology also create barriers to interprofessional communication and translation of findings to patient care. Improved reporting quality and creation of shared language will advance scientific rigor and clinical relevance of music intervention research.
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Affiliation(s)
- Sheri L. Robb
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Deanna Hanson-Abromeit
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Lindsey May
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Eugenia Hernandez-Ruiz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Megan Allison
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Beloat
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Sarah Daugherty
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Rebecca Kurtz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Ott
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | | | - Shelbi Polasik
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Allison Rager
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Jamie Rifkin
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Emily Wolf
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
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Stokes A, Agthe AG, El Metwally D. Music exposure and maturation of late preterm sleep-wake cycles: a randomised crossover trial. Acta Paediatr 2018; 107:582-586. [PMID: 28929527 DOI: 10.1111/apa.14079] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 08/01/2017] [Accepted: 09/08/2017] [Indexed: 12/19/2022]
Abstract
AIM To determine the effect of music on sleep-wake cycle (SWC) patterns in late preterm neonates. METHODS In a masked crossover study, infants between 32 and 36 6/7 weeks gestation were randomised to music exposure either during the first six or last six hours of a 12-hour observation period. SWC characteristics were determined by continuous amplitude-integrated electroencephalography (aEEG) read by two coders masked to exposure sequence. Analysis was performed in paired comparisons. ANOVA was used to assess the effects of music exposure, period and crossover on SWC outcomes: (i) Burdjalov Scores (BS) during active sleep (AS) (ii) per cent and duration of quiet sleep (QS). RESULTS Thirty infants were studied. A total of 222 QS cycles (median seven per patient; range five to 12) were analysed. Music exposure was associated with higher BS (F = 10.60, p = 0.0019) in AS and decreased interruptions during QS. The advanced postconceptual age (PCA) SWC pattern during AS was equivalent to a one-week mean. Number, duration and ratio of QS cycles did not change with music exposure. CONCLUSION Music exposure elicits an increasing PCA pattern in AS and fewer interruptions in QS. Music may benefit sleep in late preterm infants.
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Affiliation(s)
- Adia Stokes
- Department of Pediatrics; Division of Neonatology; University of Maryland School of Medicine; Baltimore MD USA
- Neonatology Associates Ltd; Pediatrix Medical Group; Phoenix Children's Hospital; St Joseph Hospital and Medical Center; Phoenix AZ USA
| | - Alexander G. Agthe
- Department of Pediatrics; Division of Neonatology; University of Maryland School of Medicine; Baltimore MD USA
- Department of Pediatrics; Division of Neonatology; Vanderbilt University School of Medicine; Nashville TN USA
| | - Dina El Metwally
- Department of Pediatrics; Division of Neonatology; University of Maryland School of Medicine; Baltimore MD USA
- Department of Pediatrics; Faculty of Medicine; Suez Canal University; Ismailia Egypt
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15
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Palazzi A, Nunes CC, Piccinini CA. Music therapy and musical stimulation in the context of prematurity: A narrative literature review from 2010-2015. J Clin Nurs 2017; 27:e1-e20. [DOI: 10.1111/jocn.13893] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Ambra Palazzi
- Federal University of Rio Grande do Sul - Psychology Institute; Porto Alegre Brazil
| | - Camila Canani Nunes
- Federal University of Rio Grande do Sul - Psychology Institute; Porto Alegre Brazil
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16
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van den Hoogen A, Teunis CJ, Shellhaas RA, Pillen S, Benders M, Dudink J. How to improve sleep in a neonatal intensive care unit: A systematic review. Early Hum Dev 2017; 113:78-86. [PMID: 28720290 DOI: 10.1016/j.earlhumdev.2017.07.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
UNLABELLED There is increasing evidence that sleep plays a major role in the development of neural pathways in the neonatal brain. Several studies have suggested evidence-based approaches to improve sleep for infants admitted to the neonatal intensive care unit (NICU); however, in many neonatal centers very few of these strategies seem to be implemented in routine care. OBJECTIVE To systematically review the literature to determine interventions promoting neonatal sleep on the NICU, in order to develop key guidelines to improve neonatal sleep. METHODS A systematic search was conducted according to the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for conducting and reporting systematic reviews. The search was performed in Pubmed, CINAHL and the Cochrane Library on 19 September 2016 and again on 28 January 2017. RESULTS In total, fourteen studies were included (10 RCT's and three quasi-experimental study designs): four studies were of high quality, eight of moderate quality and two of low quality. Two studies investigating kangaroo care reported significant effect on infant sleep behavior, two studies comparing Yakson and Gentle Human Touch (GHT) found significant effect on behavioral states and one study reported an increase in sleep behavior using different sleep surfaces. One study showed a significant effect on sleep patterns using music as an intervention and one study showed no significant effect using music. Two studies showed no significant effect on infant sleep using cycled light and different types of LED-light and one study showed significant effect of cycled lightning. There were no effects of Neonatal Individualized Developmental Care Program (NIDCAP) or massage therapy. CONCLUSION Although many different interventions have been reported to promote sleep in infants who require intensive care, there is great heterogeneity across studies: the methods of sleep assessment, the targeted sleep behaviors, and the study populations vary significantly across published reports. Based on the results there seems to be insufficient evidence to recommend any new intervention to promote neonatal sleep on the NICU. However because of the importance of sleep for the development of the neonatal brain we do suggest some key guidelines based on moderate evidence, expert opinion and parental values to improve sleep on the NICU and to direct future neonatal sleep studies.
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Affiliation(s)
- Agnes van den Hoogen
- University of Utrecht, Medical and Clinical Health Science, The Netherlands; Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands
| | - Charlotte J Teunis
- University of Utrecht, Medical and Clinical Health Science, The Netherlands
| | - Renée A Shellhaas
- Department of Pediatrics & Communicable Diseases (Division of Pediatric Neurology), University of Michigan, Ann Arbor, MI, USA
| | - Sigrid Pillen
- Sleep Medicine Center, Kempenhaeghe, Heeze, The Netherlands
| | - Manon Benders
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands.
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17
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van der Heijden MJE, Oliai Araghi S, Jeekel J, Reiss IKM, Hunink MGM, van Dijk M. Do Hospitalized Premature Infants Benefit from Music Interventions? A Systematic Review of Randomized Controlled Trials. PLoS One 2016; 11:e0161848. [PMID: 27606900 PMCID: PMC5015899 DOI: 10.1371/journal.pone.0161848] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 08/12/2016] [Indexed: 11/18/2022] Open
Abstract
Objective Neonatal intensive care units (NICU) around the world increasingly use music interventions. The most recent systematic review of randomized controlled trials (RCT) dates from 2009. Since then, 15 new RCTs have been published. We provide an updated systematic review on the possible benefits of music interventions on premature infants’ well-being. Methods We searched 13 electronic databases and 12 journals from their first available date until August 2016. Included were all RCTs published in English with at least 10 participants per group, including infants born prematurely and admitted to the NICU. Interventions were either recorded music interventions or live music therapy interventions. All control conditions were accepted as long as the effects of the music intervention could be analysed separately. A meta-analysis was not possible due to incompleteness and heterogeneity of the data. Results After removal of duplicates the searches retrieved 4893 citations, 20 of which fulfilled the inclusion/exclusion criteria. The 20 included studies encompassed 1128 participants receiving recorded or live music interventions in the NICU between 24 and 40 weeks gestational age. Twenty-six different outcomes were reported which we classified into three categories: physiological parameters; growth and feeding; behavioural state, relaxation outcomes and pain. Live music interventions were shown to improve sleep in three out of the four studies and heart rate in two out of the four studies. Recorded music improved heart rate in two out of six studies. Better feeding and sucking outcomes were reported in one study using live music and in two studies using recorded music. Conclusions Although music interventions show promising results in some studies, the variation in quality of the studies, age groups, outcome measures and timing of the interventions across the studies makes it difficult to draw strong conclusions on the effects of music in premature infants.
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Affiliation(s)
| | | | - Johannes Jeekel
- Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Irwin K. M Reiss
- Department of Neonatology, Erasmus MC, Rotterdam, The Netherlands
| | - M. G. Myriam Hunink
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Monique van Dijk
- Department of Paediatrics, division of Neonatology and Department of Pediatric Surgery, Intensive care Erasmus MC, Rotterdam, the Netherlands
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18
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Wang Q, Chair SY, Wong EML, Li X. The Effects of Music Intervention on Sleep Quality in Community-Dwelling Elderly. J Altern Complement Med 2016; 22:576-84. [DOI: 10.1089/acm.2015.0304] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Qun Wang
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Mi Ling Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaomei Li
- Faculty of Nursing, College of Medicine, Xian Jiaotong University, Xian, Shaanxi Province, China
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19
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Shoemark H, Hanson-Abromeit D, Stewart L. Constructing optimal experience for the hospitalized newborn through neuro-based music therapy. Front Hum Neurosci 2015; 9:487. [PMID: 26388762 PMCID: PMC4558927 DOI: 10.3389/fnhum.2015.00487] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/21/2015] [Indexed: 11/13/2022] Open
Abstract
Music-based intervention for hospitalized newborn infants has traditionally been based in a biomedical model, with physiological stability as the prime objective. More recent applications are grounded in other theories, including attachment, trauma and neurological models in which infant, parent and the dyadic interaction may be viewed as a dynamic system bound by the common context of the neonatal intensive care unit (NICU). The immature state of the preterm infant’s auditory processing system requires a careful and individualized approach for the introduction of purposeful auditory experience intended to support development. The infant’s experience of an unpredictable auditory environment is further compromised by a potential lack of meaningful auditory stimulation. Parents often feel disconnected from their own capacities to nurture their infant with potentially life-long implications for the infant’s neurobehavioral and psychological well-being. This perspectives paper will outline some neurological considerations for auditory processing in the premature infant to frame a premise for music-based interventions. A hypothetical clinical case will illustrate the application of music by a music therapist with an infant and family in NICU.
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Affiliation(s)
- Helen Shoemark
- Music Therapy, Temple University Philadelphia, PA, USA ; Sensory Experience in Early Development, Murdoch Childrens Research Institute Melbourne, VIC, Australia
| | | | - Lauren Stewart
- Department of Psychology, Goldsmiths, University of London New Cross London, UK ; Center for Music in the Brain, Department of Clinical Medicine, Aarhus University and The Royal Academy of Music Aarhus/Aalborg Aarhus, Denmark
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20
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Loewy J. NICU music therapy: song of kin as critical lullaby in research and practice. Ann N Y Acad Sci 2015; 1337:178-85. [PMID: 25773633 DOI: 10.1111/nyas.12648] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Music therapy can improve neonatal function and reduce anxiety in parents during neonatal intensive care unit (NICU) stays. Live music entrained to an infant's observed vital signs, provided by a certified music therapist with First Sounds RBL (rhythm, breath, and lullaby) training, enhanced bonding for infant-parent dyads and triads. The author's song of kin intervention, which employs parent-selected songs, is compared to the presentation of a well-known folk theme ("Twinkle") in 272 neonates. Culturally based, parent-selected, personalized musical tunes provided in song, as a noninvasive intervention, foster optimal, continuous quality of care. Music psychotherapy sessions for parents before working with their infants can instill a potent means of nonconfrontational support, allowing for expression of fear or anxiety related to the premature birth. Although most attention is typically directed to their infant, using music can support the parents' grief and assist in the expression of hope that can instill a sense of security and containment. From the NICU to home, a familiar thread-line theme can be resourced directly from the family and/or parent and applied effortlessly throughout the growing baby's transitional moments.
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Affiliation(s)
- Joanne Loewy
- The Louis Armstrong Center for Music and Medicine, Mount Sinai Beth Israel, New York, New York; Icahn School of Medicine at Mount Sinai, New York, New York
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21
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Amplitudenintegriertes Elektroenzephalogramm. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-014-3106-9] [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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22
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Dearn T, Shoemark H. The Effect of Maternal Presence on Premature Infant Response to Recorded Music. J Obstet Gynecol Neonatal Nurs 2014; 43:341-50. [DOI: 10.1111/1552-6909.12303] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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23
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Pölkki T, Korhonen A. The effectiveness of music on pain among preterm infants in the NICU: a systematic review. ACTA ACUST UNITED AC 2014. [DOI: 10.11124/jbisrir-2014-1412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Loewy J, Stewart K, Dassler AM, Telsey A, Homel P. The effects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics 2013; 131:902-18. [PMID: 23589814 DOI: 10.1542/peds.2012-1367] [Citation(s) in RCA: 202] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Recorded music risks overstimulation in NICUs. The live elements of music such as rhythm, breath, and parent-preferred lullabies may affect physiologic function (eg, heart and respiratory rates, O2 saturation levels, and activity levels) and developmental function (eg, sleep, feeding behavior, and weight gain) in premature infants. METHODS A randomized clinical multisite trial of 272 premature infants aged ≥32 weeks with respiratory distress syndrome, clinical sepsis, and/or SGA (small for gestational age) served as their own controls in 11 NICUs. Infants received 3 interventions per week within a 2-week period, when data of physiologic and developmental domains were collected before, during, and after the interventions or no interventions and daily during a 2-week period. RESULTS Three live music interventions showed changes in heart rate interactive with time. Lower heart rates occurred during the lullaby (P < .001) and rhythm intervention (P = .04). Sucking behavior showed differences with rhythm sound interventions (P = .03). Entrained breath sounds rendered lower heart rates after the intervention (P = .04) and differences in sleep patterns (P < .001). Caloric intake (P = .01) and sucking behavior (P = .02) were higher with parent-preferred lullabies. Music decreased parental stress perception (P < .001). CONCLUSIONS The informed, intentional therapeutic use of live sound and parent-preferred lullabies applied by a certified music therapist can influence cardiac and respiratory function. Entrained with a premature infant's observed vital signs, sound and lullaby may improve feeding behaviors and sucking patterns and may increase prolonged periods of quiet-alert states. Parent-preferred lullabies, sung live, can enhance bonding, thus decreasing the stress parents associate with premature infant care.
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Affiliation(s)
- Joanne Loewy
- The Louis Armstrong Center for Music and Medicine, Beth Israel Medical Center, New York, NY 10003, USA.
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Pölkki T, Korhonen A, Laukkala H. Expectations associated with the use of music in neonatal intensive care: a survey from the viewpoint of parents. J SPEC PEDIATR NURS 2012; 17:321-8. [PMID: 23009044 DOI: 10.1111/j.1744-6155.2012.00343.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to describe parents' expectations concerning the use of music in a neonatal intensive care unit (NICU) and to reveal any related background factors. DESIGN AND METHODS A cross-sectional, descriptive, and correlational design guided a survey of 197 parents from five NICUs in Finland. RESULTS Most parents agreed that the preferred music could have positive effects on the infants, staff, and parents in the NICU. PRACTICE IMPLICATIONS When nurses consider making use of music in the NICU, it is also important to take into account the parents' viewpoints.
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Affiliation(s)
- Tarja Pölkki
- Institute of Health Sciences, University of Oulu, Oulu, Finland.
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