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Ji C, Zhao J, Nie Q, Wang S. The role and outcomes of music therapy during pregnancy: a systematic review of randomized controlled trials. J Psychosom Obstet Gynaecol 2024; 45:2291635. [PMID: 38146963 DOI: 10.1080/0167482x.2023.2291635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/01/2023] [Indexed: 12/27/2023] Open
Abstract
INTRODUCTION The abundant functions of music and its effects on human's mental and physical health have been verified since ancient times, but rarely received attention as an alternative obstetric intervention. OBJECTIVE This study aims to investigate the benefits of music therapy on prenatal and delivery experiences of pregnant women. METHOD A systematic search for articles was conducted in electronic databases including CINAHL, Web of Science, PubMed/Medline, and CNKI. A total of 240 articles were identified, and 17 studies were selected for this review. The extracted data included author, year, location, sample size, intervention phase, type of music, music therapy strategy, measuring instruments, and results. The data were organized chronologically based on the publication year of each study. RESULT The articles indicated that music therapy has advantages in reducing pain during childbirth, lowering anxiety and stress levels in mothers, improving sleep quality, and increasing fetal movements, basal fetal heart rate, and accelerations. CONCLUSION Based on the findings, it can be concluded that music therapy is an effective approach to enhance the experience of pregnant women during pregnancy and delivery. Therefore, its implementation in obstetrical clinical practice is highly recommended.
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Affiliation(s)
- Chao Ji
- Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, China
| | - Jing Zhao
- Department of Obstetrics, Qingdao Municipal Hospital, Qingdao, China
| | - Qiaole Nie
- Musical anesthesia, Beijing Yuedi Music Analgesia Labor Institute, China
| | - Shuo Wang
- Labor Union, Qingdao Women and Children's Hospital, Qingdao, China
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Park S, Lee S, Howard S, Yi J. Technology-Based Music Interventions to Reduce Anxiety and Pain Among Patients Undergoing Surgery or Procedures: Systematic Review of the Literature. JMIR Mhealth Uhealth 2024; 12:e48802. [PMID: 38976863 PMCID: PMC11263896 DOI: 10.2196/48802] [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: 05/07/2023] [Revised: 12/19/2023] [Accepted: 06/03/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Hospitalized patients undergoing surgery or procedures may experience negative symptoms. Music is a nonpharmacological complementary approach and is used as an intervention to reduce anxiety, stress, and pain in these patients. Recently, music has been used conveniently in clinical situations with technology devices, and the mode of providing music is an important factor in technology-based music interventions. However, many reviews have focused only on the effectiveness of music interventions. OBJECTIVE We aimed to review randomized controlled trials (RCTs) of technology-based music interventions for reducing anxiety and pain among patients undergoing surgery or procedures. We examined the clinical situation, devices used, delivery methods, and effectiveness of technology-based music interventions in primary articles. METHODS The search was performed in the following 5 electronic databases: PubMed, MEDLINE (OvidSP), CINAHL complete, PSYCINFO, and Embase. This systematic review focused on technology-based music interventions. The following articles were included: (1) RCTs, (2) studies using interactive technology (eg, smartphones, mHealth, tablets, applications, and virtual reality), (3) empirical studies reporting pain and anxiety outcomes, and (4) English articles published from 2018 to 2023 (as of January 18, 2023). The risk of bias was assessed using the Cochrane Risk of Bias tool version 2. RESULTS Among 292 studies identified, 21 met the inclusion criteria and were included. Of these studies, 9 reported that anxiety scores decreased after music interventions and 7 reported that pain could be decreased before, during, and after procedures. The methodology of the music intervention was important to the results on anxiety and pain in the clinical trials. More than 50% (13/21, 62%) of the studies included in this review allowed participants to select themes themselves. However, it was difficult to distinguish differences in effects depending on the device or software used for the music interventions. CONCLUSIONS Technology-based music interventions could help reduce anxiety and pain among patients undergoing surgery or procedures. The findings of this review could help medical teams to choose a practical methodology for music interventions. Future studies should examine the effects of advanced technology-based music interventions using smart devices and software that promote interactions between medical staff and patients.
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Affiliation(s)
- Sunghee Park
- Nursing Department, Ajou University Hospital, Suwon, Republic of Korea
- College of Nursing, Ajou University, Suwon, Republic of Korea
| | - Sohye Lee
- Loewenberg College of Nursing, The University of Memphis, Memphis, TN, United States
| | - Sheri Howard
- Loewenberg College of Nursing, The University of Memphis, Memphis, TN, United States
| | - Jeeseon Yi
- College of Nursing & Sustainable Health Research Institute, Gyeongsang National University, Jinju, Republic of Korea
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Liu J, Liu M, Shi S, Jiang F, Zhang Y, Guo J, Gong X. Evaluation of the effect of intraoperative tropisetron on postoperative rebound pain after brachial plexus block: a randomized controlled trial. Pain Rep 2024; 9:e1163. [PMID: 38756786 PMCID: PMC11098252 DOI: 10.1097/pr9.0000000000001163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/07/2024] [Accepted: 03/24/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Postoperative rebound pain after peripheral nerve block increases patient suffering and delays recovery after surgery. Objectives We tested whether the 5HT-3 receptor antagonist and α7nAChR agonist tropisetron could prevent postoperative rebound pain. Methods A total of 115 patients were randomized to receive 5-mg/5-mL tropisetron or the same volume of normal saline. Pain intensity was measured with the numerical rating scale of pain (NRS). Rebound pain was defined as a change from mild pain (NRS ≤ 3) measured in the postanesthesia care unit to severe pain (NRS ≥ 7) within 24 hours after peripheral nerve blockade. Logistic regression was used to identify relevant factors associated with postoperative rebound pain. Results Tropisetron did not affect the NRS score or the incidence of rebound pain after peripheral nerve block. Logistic regression revealed that preoperative pain, bone surgery, and length of incision were risk factors for postoperative rebound pain, and patient-controlled analgesia was protective against postoperative rebound pain. Conclusion Tropisetron does not affect the incidence of rebound pain after peripheral nerve block. Patients at high risk of postoperative rebound pain should be identified for appropriate management. Registration site: www.chictr.org.cn (ChiCTR2300069994).
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Affiliation(s)
- Junli Liu
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Mingming Liu
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Shengnan Shi
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Fei Jiang
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Ye Zhang
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Jing Guo
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Xingrui Gong
- Department of Anesthesiology, Xiangyang Central Hospital, Institution of Neuroscience and Brain Disease, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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Pellicer LE, Rubio JLM, Casañas E, Villar AC. Immediate implant placement influenced by musical flow: a prospective randomized controlled clinical trial. BMC Oral Health 2024; 24:628. [PMID: 38807113 PMCID: PMC11134954 DOI: 10.1186/s12903-024-04366-8] [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: 06/30/2023] [Accepted: 05/13/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The purpose of this study was to test how musical flow using baroque (BM) and classical era music (CM) as a non-pharmacological therapy can control anxiety and pain levels among patients undergoing IPI (Immediate post-extraction implants). METHODS 78 patients who required an IPI were enrolled in this randomized clinical trial. Each patient was assigned to one of the three experimental groups with a simple randomization: Group I (n = 26) listened to BM; Group II (n = 27) listened to CM; and Group III (n = 25) did not listen to music and was the control group (C). The physiological dependent variables analyzed were systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SpO2). The psychological dependent variable analyzed was modified dental anxiety scale (MDAS) and visual analogue scale (VAS), measured before and after surgery. In all cases, the level of statistical significance was set at p < 0.01. RESULTS Statistically significant differences were found in the SBP decrease in the CM group (p = 0.001, CI = 1.9716-6.5840) and the BM group (p = 0.003, CI = 1.4450-6.4396). Anxiety levels during the intervention decreased in both groups that listened to music: BM group (p = 0.002, CI = 0.645-2.662) and CM group (p = 0.000, CI = 1.523-3.884). CONCLUSIONS Patients undergoing IPI placement surgery can register lower levels of SBP when listening to BM and CM than patients who were not exposed to the musical flow, improving their anxiety levels.
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Affiliation(s)
- Lorenzo Esteban Pellicer
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Plaza Francisco Morano s/n, Madrid, 28005, Spain.
- School for Doctoral Studies and Research, Universidad Europea de Madrid, Madrid, Spain.
| | - José Luis Martínez Rubio
- Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Elisabeth Casañas
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Plaza Francisco Morano s/n, Madrid, 28005, Spain
| | - Antonio Conde Villar
- Department of Clinical Dentistry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Plaza Francisco Morano s/n, Madrid, 28005, Spain
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T. Zaatar M, Alhakim K, Enayeh M, Tamer R. The transformative power of music: Insights into neuroplasticity, health, and disease. Brain Behav Immun Health 2024; 35:100716. [PMID: 38178844 PMCID: PMC10765015 DOI: 10.1016/j.bbih.2023.100716] [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: 10/07/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024] Open
Abstract
Music is a universal language that can elicit profound emotional and cognitive responses. In this literature review, we explore the intricate relationship between music and the brain, from how it is decoded by the nervous system to its therapeutic potential in various disorders. Music engages a diverse network of brain regions and circuits, including sensory-motor processing, cognitive, memory, and emotional components. Music-induced brain network oscillations occur in specific frequency bands, and listening to one's preferred music can grant easier access to these brain functions. Moreover, music training can bring about structural and functional changes in the brain, and studies have shown its positive effects on social bonding, cognitive abilities, and language processing. We also discuss how music therapy can be used to retrain impaired brain circuits in different disorders. Understanding how music affects the brain can open up new avenues for music-based interventions in healthcare, education, and wellbeing.
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Affiliation(s)
- Muriel T. Zaatar
- Department of Biological and Physical Sciences, American University in Dubai, Dubai, United Arab Emirates
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Ko SY, Wong EML, Ngan TL, Leung HK, Kwok KTY, Tam HF, Chan CC. Effects of virtual reality on anxiety and pain in adult patients undergoing wound-closure procedures: A pilot randomized controlled trial. Digit Health 2024; 10:20552076241250157. [PMID: 38846363 PMCID: PMC11155349 DOI: 10.1177/20552076241250157] [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] [Accepted: 04/11/2024] [Indexed: 06/09/2024] Open
Abstract
Background In emergency departments, suturing is a typical procedure for closing lacerated wounds but is invasive and often causes anxiety and pain. Virtual reality (VR) intervention has been reported as a relaxing measure. Objective The study aims to examine the effects of VR intervention on anxiety, pain, physiological parameters, local anesthesia requirements and satisfaction in Chinese adult patients undergoing wound closure in emergency departments in Hong Kong. Methods Adult patients who had lacerated wounds and were undergoing wound closure by suturing can communicate in Chinese and were hemodynamically stable were invited for this trial. Eighty patients were randomly assigned to the VR group, which received VR intervention and standard care, or to the control group, which received standard care only. The primary outcome was anxiety, and the secondary outcomes included pain, blood pressure, pulse rate, satisfactory with pain management, service satisfactory, and extra local analgesia requirement. Outcomes were conducted at baseline, during the procedure and 5 min after the procedure. Results The VR group had a significantly greater reduction in anxiety (p < 0.001), pain (p < 0.001), systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001), pulse rate (p = 0.003) and requested less amount of additional local anesthesia (p = 0.025). The satisfactory level with pain management (p = 0.019) and service (p = 0.002) were significantly higher in participants who received VR intervention. In addition, most participants preferred to have VR in the future, and no major adverse events associated with the use of VR were reported. Conclusion This pilot study provides insight into the use of VR and the direction of future studies. It may effectively improve psychological and physiological outcomes in adult patients during wound-closure procedures in emergency departments.
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Affiliation(s)
- SY Ko
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - Eliza ML Wong
- School of Nursing, Tung Wah College, Hong Kong, China
| | - TL Ngan
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - HK Leung
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - Kennis TY Kwok
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - HF Tam
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
| | - CC Chan
- Accident and Emergency Department, Tuen Mun Hospital, Hospital Authority, Hong Kong, China
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Hunter AR, Heiderscheit A, Galbally M, Gravina D, Mutwalli H, Himmerich H. The Effects of Music-Based Interventions for Pain and Anxiety Management during Vaginal Labour and Caesarean Delivery: A Systematic Review and Narrative Synthesis of Randomised Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7120. [PMID: 38063550 PMCID: PMC10706633 DOI: 10.3390/ijerph20237120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/04/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023]
Abstract
Music-based interventions are not physically invasive, they usually have minimal side effects, and they are increasingly being implemented during the birthing process for pain and anxiety relief. The aim of this systematic review is to summarise and evaluate published, randomised controlled trials (RCTs) assessing the effects of music-based interventions for pain and anxiety management during vaginal labour and caesarean delivery. Following the PRISMA guidelines, a systematic search of the literature was conducted using: PsychInfo (Ovid), PubMed, and Web of Science. Studies were included in the review if they were RCTs that assessed the effects of music on pain and anxiety during vaginal and caesarean delivery by human mothers. A narrative synthesis was conducted on 28 identified studies with a total of 2835 participants. Most, but not all, of the included studies assessing music-based interventions resulted in reduced anxiety and pain during vaginal and caesarean delivery. Music as part of a comprehensive treatment strategy, participant-selected music, music coupled with another therapy, and relaxing/instrumental music was specifically useful for reducing light to moderate pain and anxiety. Music-based interventions show promising effects in mitigating pain and anxiety in women during labour. However, the long-term effects of these interventions are unclear.
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Affiliation(s)
- Amy Rose Hunter
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Mental Health Studies Programme, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AB, UK
| | - Annie Heiderscheit
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 2LZ, UK
| | - Megan Galbally
- School of Clinical Sciences, Department of Psychiatry, Monash University, Clayton, VIC 3168, Australia
| | - Davide Gravina
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Clinical and Experimental Medicine, University of Pisa, 56127 Pisa, Italy
| | - Hiba Mutwalli
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK
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Le Lous M, Beridot C, Baxter JSH, Huaulme A, Vasconcelos F, Stoyanov D, Siassakos D, Jannin P. Physical environment of the operating room during cesarean section: A systematic review. Eur J Obstet Gynecol Reprod Biol 2023; 288:1-6. [PMID: 37406465 DOI: 10.1016/j.ejogrb.2023.06.029] [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: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Environmental factors in the operating room during cesarean sections are likely important for both women/birthing people and their babies but there is currently a lack of rigorous literature about their evaluation. The principal aim of this study was to systematically examine studies published on the physical environment in the obstetrical operating room during c-sections and its impact on mother and neonate outcomes. The secondary objective was to identify the sensors used to investigate the operating room environment during cesarean sections. METHODS In this literature review, we searched MEDLINE a database using the following keywords: Cesarean section AND (operating room environment OR Noise OR Music OR Video recording OR Light level OR Gentle OR Temperature OR Motion Data). Eligible studies had to be published in English or French within the past 10 years and had to investigate the operating room environment during cesarean sections in women. For each study we reported which aspects of the physical environment were investigated in the OR (i.e., noise, music, movement, light or temperature) and the involved sensors. RESULTS Of a total of 105 studies screened, we selected 8 articles from title and abstract in PubMed. This small number shows that the field is poorly investigated. The most evaluated environment factors to date are operating room noise and temperature, and the presence of music. Few studies used advanced sensors in the operating room to evaluate environmental factors in a more nuanced and complete way. Two studies concern the sound level, four concern music, one concerns temperature and one analyzed the number of entrances/exits into the OR. No study analyzed light level or more fine-grained movement data. CONCLUSIONS Main findings include increase of noise and motion at specific time-points, for example during delivery or anaesthesia; the positive impact of music on parents and staff alike; and that a warmer theatre is better for babies but more uncomfortable for surgeons.
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Affiliation(s)
- Maela Le Lous
- Department of Obstetrics and Gynecology, University Hospital of Rennes, France; LTSI - INSERM UMR 1099, University of Rennes 1, F35000 Rennes, France; Department of Computer Science, Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom.
| | - Caroline Beridot
- Department of Obstetrics and Gynecology, University Hospital of Rennes, France
| | - John S H Baxter
- LTSI - INSERM UMR 1099, University of Rennes 1, F35000 Rennes, France
| | - Arnaud Huaulme
- LTSI - INSERM UMR 1099, University of Rennes 1, F35000 Rennes, France
| | - Francisco Vasconcelos
- Department of Computer Science, Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
| | - Danail Stoyanov
- Department of Computer Science, Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom
| | - Dimitrios Siassakos
- Department of Computer Science, Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom; EGA Institute for Women's Health, University College London, London, United Kingdom
| | - Pierre Jannin
- LTSI - INSERM UMR 1099, University of Rennes 1, F35000 Rennes, France
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Xie W, Ye F, Yan X, Cao M, Ho MH, Kwok JYY, Lee JJ. Acupressure can reduce preoperative anxiety in adults with elective surgery: A systematic review and meta-analysis of randomised controlled trials. Int J Nurs Stud 2023; 145:104531. [PMID: 37321140 DOI: 10.1016/j.ijnurstu.2023.104531] [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: 10/10/2022] [Revised: 03/28/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Preoperative anxiety is prevalent amongst adults with elective surgery and is associated with multiple detrimental perioperative physiological effects. Increasing studies support the effectiveness of acupressure in managing preoperative anxiety. However, the magnitude of acupressure's positive association with preoperative anxiety is still unclear due to a lack of rigorous evidence synthesis. OBJECTIVE To estimate the efficacy of acupressure on preoperative anxiety and physiological parameters amongst adults scheduled for elective surgery. DESIGN Systematic review and meta-analysis. DATA SOURCES Search terms were combined for acupressure and preoperative anxiety in PubMed, Cochrane Library, EMBASE, CINAHL, China National Knowledge Infrastructure, and WanFang Data Knowledge Service Platform to search for eligible randomised controlled trials from the inception of each database through September 2022. METHODS Pairs of researchers independently screened and extracted data from included studies. The risk of bias was assessed using the Cochrane risk of bias tool Version 2.0. Meanwhile, random-effects meta-analysis of overall effects and prespecified subgroup (i.e., surgery types, intervention providers, and acupressure stimulation tools) was conducted using Review Manager Software 5.4.1. Meta-regression was performed to explore study-level variables that may contribute to heterogeneity using STATA 16. RESULTS Of 24 eligible randomised controlled trials, there were a total of 2537 participants from 5 countries contributed to this synthesis. When comparing acupressure with usual care or placebo, acupressure showed a large effect size for preoperative anxiety (SMD = -1.30; 95%CI = -1.54 to -1.06; p < 0.001; I2 = 86%). The significant mean reduction of heart rate, and systolic and diastolic blood pressure was -4.58 BPM (95%CI = -6.70 to -2.46; I2 = 89%), -6.05 mmHg (95%CI = -8.73 to -3.37; p < 0.001; I2 = 88%), and -3.18 mmHg (95%CI = -5.09 to -1.27; p = 0.001; I2 = 78%), respectively. Exploratory subgroup analyses showed significant differences in surgery types and acupressure stimulation tools, whilst the intervention providers (i.e., healthcare professionals and self-administered) showed no statistically significant difference for acupressure therapy. None of the predefined participants and study-level characteristics moderated preoperative anxiety through meta-regression. CONCLUSION Acupressure appears efficacious as a therapy for improving preoperative anxiety and physiological parameters amongst adults with elective surgery. Self-administered acupressure, which is effective with a large effect, may be considered as an evidence-based approach to managing preoperative anxiety. Hence, this review aids in the development of acupressure in different types of elective surgeries and the improvement of the rigour of acupressure therapy.
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Affiliation(s)
- Wenxuan Xie
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Fen Ye
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Xinyi Yan
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Mengyao Cao
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Jojo Yan Yan Kwok
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Jung Jae Lee
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China.
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Shukla A, Kaushik N, Hemlata H, Verma R, Gautam S, Singh GP. Improvement in Patient Satisfaction and Anxiety With Perioperative Music Therapy in Patients Undergoing Total Abdominal Hysterectomy: A Single-Blind Prospective Study. Cureus 2023; 15:e39519. [PMID: 37378174 PMCID: PMC10292085 DOI: 10.7759/cureus.39519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Listening to music is a safe and low-cost way to reduce preoperative anxiety among patients, but more research is needed to evaluate its effectiveness fully. Aims The aim of the study is to identify the effect of intraoperative music therapy on the visual analogue scale for anxiety (VASA) scores (VASA 1 and VASA 2) and patient satisfaction score (PSS) perioperatively. Methods In a study of 188 patients aged 40-70, those in group A (94 patients) listened to pre-approved music during their surgery for abdominal hysterectomy, while group B (94 patients) did not. Both groups wore noise-cancelling earphones. VASA was recorded before (VASA 1) and after (VASA 2) the surgery. PSS was recorded in the postoperative ward. Music preferences were kept confidential from the investigator recording the scores. Result The two groups of patients had similar demographic profiles and baseline characteristics. The VASA 1 of both groups was similar, with a mean value of 4.36 ± 1.13 for group A and 4.23 ± 1.05 for group B (p = 0.606). However, group A had lower VASA 2 (1.79 ± 0.83) than group B (3.77 ± 0.98). The difference was statistically significant (p < 0.001). The patient satisfaction score in group A was notably higher than those in group B. A total of 52 patients were highly satisfied in group A as compared to none in group B (p < 0.001), and a total of 42 patients were moderately satisfied as compared to eight patients in group B (p < 0.001). Eighty-six patients in group B were unsatisfied. Conclusion According to our research, playing specific music at the right volume can significantly lower anxiety levels and increase patients' satisfaction scores for those who have had abdominal hysterectomy surgeries.
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Affiliation(s)
- Aparna Shukla
- Department of Anaesthesiology, King George's Medical University (KGMU), Lucknow, IND
| | - Nishant Kaushik
- Department of Anaesthesiology, King George's Medical University (KGMU), Lucknow, IND
| | - Hemlata Hemlata
- Department of Anaesthesiology, King George's Medical University (KGMU), Lucknow, IND
| | - Reetu Verma
- Department of Anaesthesiology, King George's Medical University (KGMU), Lucknow, IND
| | - Shefali Gautam
- Department of Anaesthesiology, King George's Medical University (KGMU), Lucknow, IND
| | - Gyan Prakash Singh
- Department of Anaesthesiology, King George's Medical University (KGMU), Lucknow, IND
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Anolak H, Lau F, Davis D, Browne J, Watt B. Creative arts intervention in support of women experiencing a high-risk pregnancy: A qualitative descriptive thematic analysis. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100830. [PMID: 36898309 DOI: 10.1016/j.srhc.2023.100830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/09/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Mental illness can have negative effects on both the pregnant woman and her unborn child. Studies that use the creative arts as interventions have proven to be beneficial to women's antenatal mental health and wellbeing, however, these studies are limited and emergent. Music, drawing and narrative (MDN) is an established music therapy intervention, stemming from guided imagery and music (GIM), that has the potential to support positive mental health and wellbeing. Yet, to date, there have been limited studies on the use of this form of therapy with inpatient antenatal women. AIM To describe antenatal inpatient women's experiences of participating in a MDN session. METHODS Qualitative data were collected from a sample of 12 inpatient pregnant women who participated in MDN group sessions of drawing to music. Post intervention interviews explored the mental and emotional health of participants. A thematic analysis of the transcribed interview data was performed. FINDINGS Through reflection women were supported to acknowledge both the positives and difficulties of pregnancy as well as establish meaningful connections through shared experience. These thematic findings highlighted that MDN enabled this group of pregnant women to better communicate their feelings, validate emotions, engage in positive distractions, develop greater connections, improve optimism, experience calmness, and learn from others. CONCLUSION This project demonstrates that MDN may offer a viable method for supporting women experiencing high risk pregnancies.
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Affiliation(s)
- Helena Anolak
- Federation University, Mt Helen, PO Box 663, Ballarat, VIC 3353, Australia.
| | - Farrah Lau
- Flinders University, Sturt Rd, Bedford Park, S.A 5042, Australia.
| | - Deborah Davis
- University of Canberra, 11 Kirinari St, Bruce, ACT 2617, Australia.
| | - Jenny Browne
- University of Canberra, 11 Kirinari St, Bruce, ACT 2617, Australia.
| | - Bec Watt
- Flinders University, Sturt Rd, Bedford Park, S.A 5042, Australia.
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12
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Can Music Decrease Anxiety and Pain During Dental Implant Surgery? A Randomized Clinical Trial. J Oral Maxillofac Surg 2023; 81:194-200. [PMID: 36368427 DOI: 10.1016/j.joms.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Music has proven to be an effective tool in the management of anxiety during some surgical procedures. The aim of this study was to test the effect of baroque (BM) and classical era music (CM) as a nonpharmacological therapy on the control of anxiety and pain levels among patients undergoing dental implant placement surgery. METHODS A randomized controlled clinical trial of patients attending a dental clinic was conducted. Patients with psychiatric disorders were excluded. Twenty six patients of Spanish nationality requiring single-tooth dental implant were included. Each patient was assigned to 1 of the 3 experimental groups, which acted as an independent variable: Group I (n = 8) listened to BM; Group II (n = 10) listened to CM; and Group III (n = 8) did not listen to music and was the control group (C). The dependent variables were divided into physiological variables and psychological variables. The physiological dependent variables analysed were systolic and diastolic blood pressure, heart rate, and oxygen saturation, recorded at 4 different times during surgery. The Kruskal-Wallis test compared each of these variables between the 3 experimental groups. The psychological dependent variable analyzed was the degree of anxiety, measured by the self-completed Modified Dental Anxiety Scale and Visual Analog Scale (measured before and after surgery). The Wilcoxon statistical test compared degree of anxiety before and after surgery. In all cases, the level of statistical significance was set at P < .05. RESULTS The mean age of the sample was 46.5 ± 10.6 (range, 24-69 years), 50% male and 50% female. Statistically significant differences in degree of anxiety before and after surgery were found in the BM (P = .027, confidence interval [CI] = 0.146-6.104; BM before = 4.25 ± 3.91 and BM after = 1.13 ± 1.45) and CM groups (P = .044, CI = 0.161-3.039; CM before = 3.10 ± 2.88 and CM after = 1.50 ± 1.43) and were not found in group C (P = .180, CI = 1.104-3.604; C before = 2.63 ± 3.62 and C after = 1.38 ± 1.99). When comparing the perceived pain after the intervention among the 3 groups (C, BM, and CM), no significant differences were observed between them (P = .319; CI = -0.58-1.96; C = 0.75 ± 1.75, BM = 1.25 ± 1.75, and CM = 1.70 ± 1.70). CONCLUSION Listening to BM and CM reduces anxiety in patients undergoing dental implant placement surgery. Musical flow should be applied in this practice.
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Qian J, Sun S, Wang M, Sun X, Yu X. Art-based interventions for women's mental health in pregnancy and postpartum: A meta-analysis of randomised controlled trials. Front Psychiatry 2023; 14:1112951. [PMID: 36873226 PMCID: PMC9976780 DOI: 10.3389/fpsyt.2023.1112951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/26/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE Pregnant and postpartum women are vulnerable to psychological problems with a high estimated prevalence. To date, there is no meta-analysis that specifically assesses the effectiveness of art-based interventions to improve mental health in pregnant and postpartum women. The objective of this meta-analysis was to assess the efficacy of art-based interventions when delivered to pregnant and postpartum women. METHODS Systematic literature searches were conducted from the inception to 6 March 2022 in seven English databases, including PubMed, Embase, Cochrane Central Register, CINAHL, ProQuest, Scopus, and Web of Science. Randomised controlled trials (RCTs) reporting art-based interventions targeting the improvement of women's mental health in pregnancy and postpartum were included. Cochrane risk of bias tool was applied to assess evidence quality. RESULTS Twenty-one randomised controlled trials (RCTs) involving 2,815 participants were eligible for data analysis. A pooled analysis demonstrated that art-based interventions significantly reduced anxiety (SMD = -0.75, 95% CI = -1.10 to -0.40) and depression symptoms (MD = -0.79, 95% CI = -1.30 to -0.28). However, art-based interventions did not alleviate stress symptoms as expected in our findings. Subgroup analysis demonstrated that intervention implementation time, intervention duration and music selected by the participants vs. not could have influence on the efficacy of art-based intervention for anxiety. CONCLUSION In perinatal mental health, art-based interventions may be effective in alleviating anxiety and depression. In the future, we still need to conduct high-quality RCTs to validate our findings and enrich clinical application of art-based interventions.
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Affiliation(s)
- Jialu Qian
- Faculty of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Man Wang
- Faculty of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiangyu Sun
- Faculty of Nursing, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
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Halakou S, Khoddam H, Nikpeyma N, Modanloo M. Development and implementation of anxiety management program for women under gynecological surgery with spinal anesthesia: Protocol of action research study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:374. [PMID: 36618462 PMCID: PMC9818629 DOI: 10.4103/jehp.jehp_762_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 01/24/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Anxiety is the most common health problem and the second leading cause of disability worldwide. Patients undergoing surgery often experience anxiety. It is necessary to use appropriate interventions to achieve the best results. The aim of this study is to develop, implement, and evaluate of anxiety management program for gynecological surgery patients under spinal anesthesia. MATERIALS AND METHODS This participatory action research will be conducted through four phases; problem identification, planning, action, and evaluation phases in the Gonbad-e-Kavous Shahada, hospital in northeastern of Iran. These phases will be guided based on the Promoting Action on Research Implementation in Health Services framework. Participants will be included using purposive sampling method. We will use both of qualitative (semi-structured interview, observation) and quantitative (questionnaire) approaches for data collection through the study. CONCLUSION For anxiety management of patients, context-based interventions should be performed. Combination of multidimension approach based on health-care providers, patients, and environment will have an effect to solve the problem in the clinical setting.
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Affiliation(s)
- Solmaz Halakou
- Postgraduate Department, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
| | - Homeira Khoddam
- Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
| | - Nasrin Nikpeyma
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Modanloo
- Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
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15
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SELÇUK AKARAKUŞ, BAYSAL E. The effect of dark chocolate and music on pain and anxiety in young women with primary dysmenorrhea: Randomized controlled trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Thevi T, Abas AL, Vossmerbaeumer U. Effects of Music on Pain and Autonomic Functions of Heart Rate, Blood Pressure, Nausea and Vomiting After Major Surgery—Meta-analysis. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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17
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Miremberg H, Yirmiya K, Vinter D, Lauterbach R, Yefet E, Nassra R, Paz YG, Hagege R, Weiner E. An informative video before planned cesarean delivery and maternal anxiety-a multicenter randomized controlled trial. Am J Obstet Gynecol MFM 2022; 4:100604. [PMID: 35240345 DOI: 10.1016/j.ajogmf.2022.100604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cesarean delivery is one of the most common procedures performed in obstetrics, and although cesarean delivery is a blissful occasion, it is commonly associated with fear and anxiety for the new mother. OBJECTIVE We aimed to study the impact of watching a detailed, informative video on maternal anxiety levels, childbirth experience, and patient satisfaction in patients undergoing a primary cesarean delivery. STUDY DESIGN We performed a multicenter randomized control trial. Women scheduled to undergo a primary nonemergent cesarean delivery were recruited. All participants in the intervention group watched an informative video on recruitment. This 4-minute video described in detail the expected cesarean delivery process: preparations before entering the operation room, regional anesthesia administration, sterile covering, the surgical procedure itself, and recovery (including mobilization and lactation). Situation-specific anxiety was measured at recruitment, before exposure to the video (S1), at the day of the operation (S2), and at postpartum day 1 (S3) using the State-Trait Anxiety Inventory score. In addition, participants answered a 10-item Childbirth Experience Questionnaire. A sample size of 63 per group was planned to achieve 80% power to detect a difference of 5 points in the primary outcome (State-Trait Anxiety Inventory score on the day of the operation). RESULTS Overall, 154 participants from 4 medical centers were randomized, and 132 participants were analyzed after completing all questionnaires, 64 participants in the video group and 68 participants in the control group. The groups did not differ in demographics and delivery characteristics and had similar baseline anxiety levels (S1). On operation day (S2, the primary outcome), significantly lower anxiety levels were reported in the video group than in the control group (State-Trait Anxiety Inventory scores, 41.3±9.5 vs 49.3±10.3; P<.001). Moreover, anxiety levels in postpartum day 1 (S3) remained significantly lower in the video group (P<.001). No difference between the groups in childbirth experience score or patient satisfaction was demonstrated. CONCLUSION A detailed informative video shown to patients before primary cesarean delivery decreased maternal anxiety levels before and after the procedure.
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Affiliation(s)
- Hadas Miremberg
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel (Drs Miremberg, Ganor Paz, and Weiner); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Miremberg and Weiner).
| | - Karen Yirmiya
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel (Dr Yirmiya); Interdisciplinary Center, Herzliya, Israel (Dr Yirmiya)
| | - Dana Vinter
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel (Drs Vinter and Lauterbach); The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel (Drs Vinter and Lauterbach)
| | - Roy Lauterbach
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel (Drs Vinter and Lauterbach); The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel (Drs Vinter and Lauterbach)
| | - Enav Yefet
- Department of Obstetrics and Gynecology, Baruch Padeh Medical Center, Poriya, Tiberias, Israel (Drs Yefet and Nassra); Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel (Dr Yefet)
| | - Rima Nassra
- Department of Obstetrics and Gynecology, Baruch Padeh Medical Center, Poriya, Tiberias, Israel (Drs Yefet and Nassra)
| | - Yael Ganor Paz
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel (Drs Miremberg, Ganor Paz, and Weiner); Department of Obstetrics and Gynecology, Samson Assuta Ashdod University Hospital, Ashdod, Israel (Drs Ganor Paz and Hagege); Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel (Dr Ganor Paz)
| | - Rina Hagege
- Department of Obstetrics and Gynecology, Samson Assuta Ashdod University Hospital, Ashdod, Israel (Drs Ganor Paz and Hagege)
| | - Eran Weiner
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel (Drs Miremberg, Ganor Paz, and Weiner); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Miremberg and Weiner)
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18
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Almedhesh SA, Elgzar WT, Ibrahim HA, Osman HA. The effect of virtual reality on anxiety, stress, and hemodynamic parameters during cesarean section: A randomized controlled clinical trial. Saudi Med J 2022; 43:360-369. [PMID: 35414614 PMCID: PMC9998068 DOI: 10.15537/smj.2022.43.4.20210921] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the effect of virtual reality (VR) on anxiety, stress, and hemodynamic parameters during cesarean section (CS). METHODS This is a randomized controlled clinical trial conducted at the operating theatre / Maternal and Children Hospital, Najran, Saudi Arabia from February to October 2021. The study comprised a random sample of 351(176 study and 175 control) low-risk pregnant women undergoing elective CS with regional anesthesia. Data collection was carried out using 5 instruments. Basic and clinical data sheet, maternal hemodynamic parameters assessment sheet, brief measure of preoperative emotional stress, a novel visual facial anxiety scale, and maternal satisfaction scale. Virtual reality group exposed to 3D natural videos associated with calm Quran or music voices via phone using VR glasses immediately after anesthesia until completion of skin suture. The control group left for routine hospital care. RESULTS The VR group showed significantly lower stress and anxiety levels immediately after skin suture and 2h postoperative (p=0.000). Maternal satisfaction 2 hours after CS showed that 58% of the VR group were completely satisfied compared to 11.3% of the control group (FET=135.359 p=0.000). Virtual reality have an impact on hemodynamic parameters at some time points while peripheral oxygen saturation did not differ significantly (p>0.05). CONCLUSION Virtual reality significantly reduced anxiety and stress among women undergoing CS under regional anesthesia. Virtual reality may be added to the routine intraoperative techniques that help induce patient relaxation and increase satisfaction.
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Affiliation(s)
- Sultan A. Almedhesh
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Wafaa T. Elgzar
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Heba A. Ibrahim
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Hiba A. Osman
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
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Lim K, Jung S, Kim H. Integrative review of non-pharmacological intervention and multidimensional evaluation for intraoperative anxiety under spinal anaesthesia. J Clin Nurs 2022; 32:2114-2127. [PMID: 35352416 DOI: 10.1111/jocn.16309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/22/2021] [Accepted: 03/07/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patients under spinal anaesthesia experience high levels of anxiety during surgery. Clinical nurses tried to manage patient's anxiety under spinal anaesthesia using non-pharmacological interventions for its benefit. Thus, it is required to identify comprehensive evidences of various non-pharmacological interventions and of how to measure anxiety under spinal anaesthesia. AIMS This study aims to review current research on the non-pharmacological interventions to relieve intraoperative anxiety under spinal anaesthesia and to identify subjective and objective measures of intraoperative anxiety under spinal anaesthesia. METHODS Wittemore and Knafl's integrative review methodology was used. Researchers conducted five scientific rigor steps; problem identification, searching literature, evaluation of literature, analysis of literature and presentation of results. The PRISMA checklist was used. To evaluate the level of evidence, critical appraisal tools of Joanna Briggs Institute were used. RESULTS Eleven studies were included in this integrative review. Delivering music is the most frequently used as non-pharmacological intervention by researchers. They tried to manage intraoperative anxiety under spinal anaesthesia with using diverse genre and application of music. In addition, dry cupping method, progressive muscle relaxation (PMR) exercise and virtual reality (VR) goggles were used in included studies. Researchers measured intraoperative anxiety under spinal anaesthesia with objective or subjective way. The State-Trait Anxiety Inventory and visual analogue scale were used as subjective method to approach intraoperative anxiety. In contrary, researchers tried to obtain objective evidence of intraoperative anxiety with vital signs, cortisol, blood glucose, alpha-amylase and adrenocorticotropic hormone. CONCLUSION Various types of non-pharmacological interventions are effective to manage patient's intraoperative anxiety under spinal anaesthesia. It is recommended to measure intraoperative anxiety under spinal anaesthesia with using both objective and subjective methods. RELEVANCE TO CLINICAL PRACTICE Clinical nurses can use non-pharmacological interventions to manage intraoperative anxiety under spinal anaesthesia by comprehensive monitoring with diverse measures.
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Affiliation(s)
- Kyuhee Lim
- College of Nursing, Yonsei University, Seoul, Republic of Korea.,Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Sooah Jung
- Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.,Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Heejung Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea.,Brain Korea 21 FOUR Project, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, Seoul, Republic of Korea.,Yonsei Evidence Based Nursing Centre of Korea: a JBI Affiliated Group, Yonsei University, Seoul, Republic of Korea
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20
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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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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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Akard TF, Davis K, Hills T, Lense M, Kim D, Webber R, Dietrich MS, Gilmer MJ. Songwriting intervention for cognitively-impaired children with life-limiting conditions: Study protocol. Contemp Clin Trials Commun 2021; 22:100765. [PMID: 33981908 PMCID: PMC8085894 DOI: 10.1016/j.conctc.2021.100765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/11/2021] [Accepted: 03/29/2021] [Indexed: 11/15/2022] Open
Abstract
Investigations evaluating the effectiveness of music-based interventions as a complementary approach to symptom management and health promotion for cognitively-impaired children with life-limiting conditions and their families are needed to minimize the physical and psychological burdens on individuals and their caregivers. Songwriting is one music-based strategy for a remote family-centered complementary approach to improve outcomes for cognitively-impaired children with life-limiting conditions, their parents, and families. The overall purpose of this study is to test the feasibility and preliminary efficacy of a songwriting intervention for cognitively-impaired children (ages 5-17 years) who are receiving palliative or complex care and their parents. Specific aims are to: (1) determine the feasibility of songwriting for cognitively-impaired children with life-limiting conditions and their parents, and (2) examine preliminary efficacy of songwriting for child psychological distress and physical symptoms, parent psychological distress, and family environment. The protocol for this 1-group pre-and post-intervention clinical trial (N = 25) is described.
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Affiliation(s)
| | - Kelly Davis
- Vanderbilt University, Nashville, TN, USA
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Tracy Hills
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Miriam Lense
- Vanderbilt University, Nashville, TN, USA
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dana Kim
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Rylie Webber
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | | | - Mary Jo Gilmer
- Vanderbilt University, Nashville, TN, USA
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
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Ambler M, Springs S, Garcia D, Born C. Heterogeneity of outcomes for intraoperative music interventions: a scoping review and evidence map. BMJ Evid Based Med 2021; 26:116-117. [PMID: 32816900 DOI: 10.1136/bmjebm-2020-111382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Over the past 30 years, numerous studies have been performed that assess the efficacy of intraoperative music as an adjunctive means to regional and local anaesthesia to improve clinical outcomes. Despite an emerging body of evidence and growing adoption of music in surgical settings, the variety of interventions studied, and the heterogeneity of outcomes and outcome measurement tools applied makes difficult the task of aggregating evidence. OBJECTIVE This study assesses the state of the field of intraoperative musical interventions by documenting and visualising the breadth of outcomes measured in studies. DESIGN Scoping review and evidence map. METHODS Three electronic databases (PubMed, Embase and a music-focussed research database, RILM (International Music Literature Repository)) were searched for full-text articles published between January 1991 and July 2019. Results from these searches were screened and relevant data was extracted from full-text articles on type of music intervention and type of anaesthesia; outcomes measured were recorded in an evidence map in order to identify the current state of the field and assess for trends in outcome measurements. INTERVENTIONS Music administered to adult patients via headphones or speakers under regional or local sedation in during the intraoperative period. RESULTS Twenty-one studies with a total of 2283 patients were included. A total of 42 unique outcomes were measured across the 21 studies, with each measuring an average of 6.41±2.63 outcomes. Systolic blood pressure, diastolic blood pressure, heart rate, anxiety, pain, patient satisfaction, respiratory rate and sedation requirements were the most prevalent outcomes reported. Only 15 outcome measures (36%) were used in more than one study, while the remaining 27 outcome measures (64%) were identified in only one study in our review. CONCLUSIONS Our scoping review identifies that almost two-thirds of studies in this field used >1 outcome measure unique to that study (not also used in other studies), which hinders opportunities to aggregate data across studies and meta-analyse evidence. Future studies should provide clear documentation regarding the intervention and consider using valid and reliable outcome tools. Researchers should consider standardisation when appropriate and adopting the use of core outcome sets for conditions where these sets have been developed.
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Affiliation(s)
- Melanie Ambler
- Brown University Division of Biology and Medicine, Providence, Rhode Island, USA
- Diane Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Stacey Springs
- Center for Evidence Synthesis, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Dioscaris Garcia
- Diane Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Christopher Born
- Diane Weiss Center for Orthopaedic Trauma Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Orthopaedic Surgery, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
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Wong MM, Tahir T, Wong MM, Baron A, Finnerty R. Biomarkers of Stress in Music Interventions: A Systematic Review. J Music Ther 2021; 58:241-277. [PMID: 33822108 DOI: 10.1093/jmt/thab003] [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: 12/22/2022]
Abstract
Psychological stress is a significant public health concern as it is associated with various comorbidities and long-term health implications. Music interventions are emerging therapies for alleviating psychological stress and improving one's physical and mental well-being. We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines for reporting to identify all neuroendocrine biomarkers used to evaluate psychological stress in randomized control trials involving music interventions. We identified 18 unique biomarkers of stress from 14 full-text randomized controlled trials studies. Only one of the 14 music studies included a music therapy intervention. The most frequently used biomarkers across the studies were plasma cortisol, salivary cortisol, and salivary α-amylase. Of the 14 studies, 12 included in this review assessed at least one of these three biomarkers. Of these 12 studies, five papers reported p-values for changes in both stress biomarkers and psychological stress outcome measures. Four of the five studies found significant p-values for the reduction of both stress biomarkers and psychological stress in music intervention groups. The variety of stress biomarkers used and the variance in study protocols makes it difficult to assess the magnitude of effect of music interventions on psychological stress. However, our findings suggest that music interventions have the potential for reducing both stress biomarker levels and psychological stress in acute stress situations.
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Affiliation(s)
| | | | | | - Annilee Baron
- McMaster University, Hamilton, ON, Canada.,Music Therapy Academy, Hamilton, ON, Canada
| | - Rachael Finnerty
- McMaster University, Hamilton, ON, Canada.,Music Therapy Academy, Hamilton, ON, Canada
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Schaal NK, Brückner J, Wolf OT, Ruckhäberle E, Fehm T, Hepp P. The effects of a music intervention during port catheter placement on anxiety and stress. Sci Rep 2021; 11:5807. [PMID: 33707520 PMCID: PMC7970967 DOI: 10.1038/s41598-021-85139-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 02/25/2021] [Indexed: 11/09/2022] Open
Abstract
Studies have shown that perioperative music interventions can reduce patients' anxiety levels. However, in small operations like port catheter surgery evidence is sparse. The present single-blinded, randomised controlled two-armed study included 84 female patients undergoing port catheter placement who were randomly assigned to either listening to music during surgery vs. no music intervention. The medical staff was blind to group allocation. On the day of the surgery anxiety and stress levels were evaluated using subjective (STAI questionnaire, visual analogue scales) and objective (vital parameters, salivary cortisol) parameters at different time points (before the surgery, at the end of the surgery and 1 h post-surgery). The music group showed significant reductions of systolic blood pressure (from 136.5 mmHg ± 26.1 to 123.3 mmHg ± 22.0, p = .002) and heart rate (from 75.6 bpm ± 12.3 to 73.1 bpm ± 12.2, p = .035) from beginning of the surgery to skin suture, whereas the control group did not. No significant effects of the music intervention on subjective anxiety measures or salivary cortisol were revealed. In sum, the study demonstrates that a music intervention during port catheter placement positively influences physiological anxiety levels, whereas no effects were revealed for subjective anxiety and salivary cortisol. Thus, music can be considered as a low cost addition in clinical routine in order to reduce patients' heart rate and blood pressure. Future studies are encouraged to further explore the differential effects of intraoperative music interventions on physiological, endocrinological and subjective anxiety levels.
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Affiliation(s)
- Nora K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University, Universitätsstraße 1, 40225, Düsseldorf, Germany.
| | - Johanna Brückner
- Department of Experimental Psychology, Heinrich-Heine-University, Universitätsstraße 1, 40225, Düsseldorf, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-University, Bochum, Germany
| | - Eugen Ruckhäberle
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Tanja Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Philip Hepp
- Clinic for Gynecology and Obstetrics, University Clinic, Augsburg, Germany.,Clinic for Gynecology and Obstetrics, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
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Casarin J, Cromi A, Sgobbi B, Di Siena A, Serati M, Bolis ME, Ghezzi F. Music Therapy for Preoperative Anxiety Reduction in Women Undergoing Total Laparoscopic Hysterectomy: A Randomized Controlled Trial. J Minim Invasive Gynecol 2021; 28:1618-1624.e1. [PMID: 33549732 DOI: 10.1016/j.jmig.2021.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 12/23/2022]
Abstract
STUDY OBJECTIVE To assess the superiority of a music therapy intervention (Music) vs usual care (Control) in reducing the preoperative anxiety of patients undergoing total laparoscopic hysterectomy (TLH) with nononcologic indications. DESIGN This was a 1:2 (Music vs Control) randomized controlled study. SETTING A teaching hospital. PATIENTS One hundred patients were available for the analysis: 30 and 70 in the Music and Control arms, respectively. INTERVENTIONS Perioperative music therapy pathway in patients undergoing TLH for benign disease. MEASUREMENTS AND MAIN RESULTS Anxiety was evaluated with the State-Trait Anxiety Inventory Y Form (STAI-Y) at different time points: at baseline and during preoperative, early postoperative, and late postoperative periods. Pathologic anxiety was defined as STAI-Y state >45. Postoperative pain was registered using the visual analog scale. Women in the Music arm experienced lower anxiety levels (median STAI-Y scores 38.0 vs 41.0; p = .002) during the preoperative period. STAI-Y scores did not vary significantly by intervention at each subsequent time point. A significant difference between the groups (Music vs Control) was found in the proportion of women with pathologic anxiety during the preoperative (16.7% vs 37.2%; p = .04) and early postoperative periods (0% vs 12.9%; p = .04), whereas no significant difference between the groups was registered during the late postoperative period (6.6% vs 7.1%; p = .93). Postoperative pain intensity did not significantly differ between the groups at 1, 3, and 6 hours after surgery. CONCLUSIONS Music therapy might be a viable complementary modality to usual surgical care in the gynecologic setting for its ability to significantly decrease preoperative anxiety in women undergoing TLH for benign conditions.
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Affiliation(s)
- Jvan Casarin
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors).
| | - Antonella Cromi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Barbara Sgobbi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Anna Di Siena
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Maurizio Serati
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Maria Elena Bolis
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
| | - Fabio Ghezzi
- Department of Obstetrics and Gynecology, Women's and Children's Del Ponte Hospital, University of Insubria, Varese, Italy (all authors)
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Perinatal Anxiety Symptoms: Rates and Risk Factors in Mexican Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010082. [PMID: 33374261 PMCID: PMC7795471 DOI: 10.3390/ijerph18010082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 02/04/2023]
Abstract
Anxiety during pregnancy and after childbirth can have negative consequences for a woman and her baby. Despite growing interest in the perinatal mental health of Mexican women living in the U.S., perinatal anxiety symptom (PAS) rates and risk factors have yet to be established for women in Mexico. We sought to determine PAS rates and identify risk factors, including the traditional female role (TFR) in a sample of Mexican women. This secondary data analysis is based on 234 Mexican women who participated in a longitudinal study on perinatal depression in Mexico. Anxiety symptoms were assessed in pregnancy and at six weeks postpartum. Rates were determined through frequencies, and multiple logistics regressions were conducted to identify risk factors in the sample. The PAS rate was 21% in pregnancy and 18% postpartum. Stressful life events and depressive symptoms were associated with a higher probability of PAS. Adherence to TFR increased the probability of prenatal anxiety; lower educational attainment and low social support during pregnancy increased the probability of postpartum anxiety. The PAS rates were within the range reported in the literature. The TFR was only associated with anxiety in gestation, highlighting the role of this culturally relevant risk factor. Culturally responsive early interventions are therefore required.
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Santiváñez-Acosta R, Tapia-López EDLN, Santero M. Music Therapy in Pain and Anxiety Management during Labor: A Systematic Review and Meta-Analysis. ACTA ACUST UNITED AC 2020; 56:medicina56100526. [PMID: 33050409 PMCID: PMC7599829 DOI: 10.3390/medicina56100526] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 12/21/2022]
Abstract
Background and Objective: The study of music therapy in labor is unknown. The main objective of this research was to evaluate the effectiveness of music therapy to manage pain and anxiety during labor. Materials and Methods: A search strategy was used with PubMed/MEDLINE, LILACS, Cochrane, TRIPDATABASE, and Google Scholar. The selection criteria were based on randomized clinical trials; quasi-experimental research on pain intensity and anxiety during labor was evaluated. The primary outcomes were measured by the Visual Analogue Scale (VAS). A meta-analysis of the fixed effects was performed using mean differences (MD). Twelve studies were included for the final analysis, six (778 women) of which were meta-analyzed. Results: Decreased VAS scores for pain intensity associated with music therapy were found in the latent (MD: -0.73; 95% CI -0.99; -0.48) and active (MD: -0.68; 95% CI -0.92; -0.44) phases of labor. VAS scores for anxiety decreased both in the latent (MD: -0.74; 95% CI -1.00; -0.48) and active (MD: -0.76; 95% CI -0.88; -0.64) phases. Conclusion: Music therapy seems to have beneficial effects on pain intensity and anxiety during labor, especially for women giving birth for the first time. However, the evidence is qualified as low.
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Affiliation(s)
- Rocio Santiváñez-Acosta
- Centro Nacional de Salud Intercultural, Instituto Nacional de Salud, Av. Defensores del Morro 2268 (Ex Huaylas)—Chorrillos, Lima 9, Lima 15066, Peru
- Correspondence: ; Tel.: +51-96-5077-260
| | | | - Marilina Santero
- Instituto de Efectividad Clínica y Sanitaria (IECS), Escuela de Salud Pública de la Universidad de Buenos Aires, Marcelo T. de Alvear, Buenos Aires 2202, Argentina;
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Navaee M, Khayat S, Abed ZG. Effect of pre-cesarean foot reflexology massage on anxiety of primiparous women. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 17:jcim-2019-0229. [PMID: 32284448 DOI: 10.1515/jcim-2019-0229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/31/2019] [Indexed: 01/19/2023]
Abstract
Introduction Anxiety is a common feeling in cesarean section and lack of attention to it is associated with negative consequences for health of mother and child. Reflexology is a way to reduce anxiety. So far, the effect of reflexology on pre-cesarean anxiety has not been evaluated. Therefore, we aimed to evaluate the effect of pre-cesarean foot reflexology massage on the anxiety of women during their first pregnancy. Materials and Methods This study is a three-group clinical trial that was conducted in 2019. The study sample consisted of 90 pregnant women hospitalized for cesarean section in Zahedan who were randomly divided into three groups of 30 women. The subjects completed the state section of Spielberger anxiety questionnaire. The control group did not receive any intervention. For two groups, 1 h before surgery, a group received reflexive massage, and the another group simple massage. Duration of massage for each group was 30 min. After 30 min, the subjects completed the state section of Spielberger questionnaire again. Statistical analysis was performed by SPSS software program, version 21.0. ANOVA and ANCOVA tests were used to compare between groups and paired t-test was used for intra-group comparisons. Results The results showed that the level of anxiety was significantly reduced in the reflexology massage group (from 55 ± 8 to 40 ± 7) as well as simple massage group (from 51 ± 10 to 47 ± 7) (p<0.001). In the control group, anxiety was increased (from 49 ± 9 to 56 ± 9) (p<0.001). Comparison between the three groups by ANCOVA indicated that reflexology massage and simple massage significantly decreased anxiety scores (p>0.001 and p>0.001,respectively). Reflexive massage significantly reduced anxiety scores (p>0.001) as compared to simple massage. Conclusion The results of this study revealed the positive effect of reflexology massage on pre-cesarean anxiety. Because reflexology massage is an inexpensive, simple, and easy approach, the use of this non-pharmaceutical method is recommended to reduce pre-cesarean anxiety.
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Affiliation(s)
- Maryam Navaee
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Samira Khayat
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zahra Ghadiri Abed
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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30
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The effects of a music and singing intervention during pregnancy on maternal well-being and mother-infant bonding: a randomised, controlled study. Arch Gynecol Obstet 2020; 303:69-83. [PMID: 32776296 PMCID: PMC7854426 DOI: 10.1007/s00404-020-05727-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022]
Abstract
Purpose Stress and impaired mother–infant bonding during pregnancy can lead to adverse effects for the expectant mother and the unborn child. The present study investigates whether a prenatal music and singing intervention can improve maternal well-being as well as mother–infant bonding. Methods A total of 172 pregnant women took part in this prospective, randomised, three-armed (music, singing or control group) study. Depressive symptoms, self-efficacy, maternal well-being and mother–infant bonding were assessed with visual analogue scales and questionnaires before the intervention phase (30th week of gestation) and afterwards (36th week of gestation). Additionally, immediate changes regarding experienced stress and mood from before until after the music and singing interventions were explored with questionnaires as well as saliva samples (for cortisol, alpha-amylase and oxytocin determination). Results Regarding immediate effects, both interventions showed positive effects on the emotional state, stress (cortisol) and bonding (oxytocin). Additionally, the singing group showed a larger reduction in cortisol and a larger improvement in valence than the music group. Looking at more prolonged effects, significant effects on general self-efficacy and perceived closeness to the unborn child (measured with a visual analogue scale) were found. No significant effects were revealed for the mother–infant bonding questionnaire and for depressive symptoms. Conclusion In the present study, promising effects of music and in particular singing on maternal well-being and perceived closeness during pregnancy appeared. Prenatal music and singing interventions could be an easy to implement and effective addition to improve mood and well-being of the expectant mother and support mother-infant bonding. Trial registration number DRKS00012822, date of registration: 17.10.2017 Electronic supplementary material The online version of this article (10.1007/s00404-020-05727-8) contains supplementary material, which is available to authorized users.
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Schaal NK, Hepp P, Heil M, Wolf OT, Hagenbeck C, Fleisch M, Fehm T. Perioperative anxiety and length of hospital stay after caesarean section - A cohort study. Eur J Obstet Gynecol Reprod Biol 2020; 248:252-256. [PMID: 32283431 DOI: 10.1016/j.ejogrb.2020.03.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/19/2020] [Accepted: 03/25/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The caesarean section is one of the most frequently performed surgeries. Due to growing economic challenges, hospitals are encouraged to improve their cost-efficiency. One factor that influences hospital costs of caesarean sections is a prolonged hospital stay. STUDY DESIGN The aim of the current prospective study was to investigate psychosocial factors, with an emphasis on anxiety, and sociodemographic factors that are associated with longer hospital stay after caesarean sections with no medical complications. Data of 195 women who gave birth by caesarean section was analyzed. As possible predictors anxiety levels measured pre-, peri- and postoperative as well as age, parity (primiparous/multiparous), repeated caesarean (yes/no), BMI (<30/ ≥30), STAI-Trait scores, duration of surgery, PH arterial and Apgar 5 min. were entered into a backward linear regression with duration of hospital stay as the dependent factor. RESULTS The analysis revealed that higher age, primiparity as well as higher anxiety scores during the postoperative phase are significant factors associated with prolonged hospital stay. The significant model explains 22.1 % of the variance. CONCLUSION The results should sensitize the medical team to these risk factors in order to improve patients' recovery and shorten hospital stays.
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Affiliation(s)
- N K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany.
| | - P Hepp
- Clinic for Gynecology and Obstetrics, HELIOS University Clinic, Wuppertal, University Witten/Herdecke, Germany; Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany; Clinic for Gynecology and Obstetrics, University Clinic, Augsburg, Germany
| | - M Heil
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - O T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-University Bochum, Germany
| | - C Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - M Fleisch
- Clinic for Gynecology and Obstetrics, HELIOS University Clinic, Wuppertal, University Witten/Herdecke, Germany
| | - T Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
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Brillo E, Tosto V, Ceccagnoli A, Nikolova N, Pinzaglia V, Bordoni F, Spano F, Bini V, Giardina I, Renzo GCD. The effect of prenatal exposure to music on fetal movements and fetal heart rate: a pilot study. J Matern Fetal Neonatal Med 2019; 34:2274-2282. [PMID: 31554450 DOI: 10.1080/14767058.2019.1663817] [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] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess and compare fetal cardiac parameters of fetuses listening to music before and during nonstress test, only during the test or never. STUDY DESIGN Thirty healthy mother-fetus dyads were randomized in a 1:1:1 ratio to one of three groups: group A in which fetuses were submitted to prelistening phase (33rd + 0 to 36th + 3 week) and listening sessions during 4 nonstress tests, group B in which fetuses were submitted to listening sessions during 4 nonstress tests, and group C receiving 4 nonstress tests without any listening. We assessed mean fetal heart rate, fetal heart rate accelerations, fetal heart rate decelerations, fetal movements and uterine contractility. RESULTS Fetuses of the group A, who had already listened to a particular piece of music during previous sessions, had significantly increased their heart rate accelerations and movements during the music listening session of the last nonstress test. No significant changes were observed in the number of uterine contractions. CONCLUSIONS Our findings show that fetuses slightly respond to that music they know, but they do not significantly respond to unknown music.
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Affiliation(s)
- Eleonora Brillo
- Unit of Research Methods and Organisation, Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,PhD Program, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Tosto
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Andrea Ceccagnoli
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Natasha Nikolova
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, PhD program on "Translational Medicine", University of Perugia, Perugia, Italy
| | - Valentina Pinzaglia
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Francesca Bordoni
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Filippo Spano
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Vittorio Bini
- Internal Medicine, Endocrinal and Metabolic Science, University of Perugia, Perugia, Italy
| | - Irene Giardina
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Gian Carlo Di Renzo
- Department of Obstetrics and Gynaecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
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The Effect of Perioperative Music on the Stress Response to Surgery: A Meta-analysis. J Surg Res 2019; 244:444-455. [PMID: 31326711 DOI: 10.1016/j.jss.2019.06.052] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 04/15/2019] [Accepted: 06/14/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Current perioperative patient care aims to maintain homeostasis by attenuation of the stress response to surgery, as a more vigorous stress response can have detrimental effects on postoperative recovery. This systematic review and meta-analysis aims to assess the effect of perioperative music on the physiological stress response to surgery. METHODS The Embase, Medline Ovid, Cochrane Central, Web of Science, and Google Scholar databases were searched from inception date until February 5, 2019, using a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines for randomized controlled trials investigating the effect of music before, during, and/or after surgery in adult surgical patients on the stress response to surgery. Meta-analysis was performed using a random effects model and pooled standardized mean differences were calculated with 95% confidence intervals. This study was registered in the PROSPERO database (CRD42018097060). RESULTS The literature search identified 1076 articles. Eighteen studies (1301 patients) were included in the systematic review, of which eight were included in the meta-analysis. Perioperative music attenuated the neuroendocrine cortisol stress response to surgery (pooled standardized mean difference -0.30, [95% confidence interval -0.53 to -0.07], P = 0.01, I2 = 0). CONCLUSIONS Perioperative music can attenuate the neuroendocrine stress response to surgery.
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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: 5] [Impact Index Per Article: 1.0] [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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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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