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Yang HF, Chang WW, Chou YH, Huang JY, Liao YS, Liao TE, Tseng HC, Chang ST, Chen HL, Ke YF, Tsai PF, Chan HM, Chang BJ, Hwang YT, Tsai HY, Lee YC. Impact of background music listening on anxiety in cancer patients undergoing initial radiation therapy: a randomized clinical trial. Radiat Oncol 2024; 19:73. [PMID: 38862982 PMCID: PMC11167881 DOI: 10.1186/s13014-024-02460-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/24/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Patients undergoing radiation therapy (RT) often experience anxiety, which may jeopardize the treatment success. The efficacy of music interventions in reducing anxiety remains contentious. This randomized trial aimed to evaluate the impact of music listening on anxiety symptoms in patients undergoing initial RT. METHODS First-time RT patients were randomly allocated to experimental and control groups. The Brief Symptom Rating Scale (BSRS-5), Distress Thermometer (DT), and Beck Anxiety Inventory (BAI-C) were administered pre- and post-RT. Changes in physiological anxiety symptoms were monitored over 10 consecutive days starting from the first day of RT. The experimental group received music during RT; the control group did not. The generalized linear mixed model was used to estimate the pre-post difference in the BSRS-5, DT, and BAI-C scores between the music intervention and control group. RESULTS This study included 50 patients each in the experimental and control groups. BSRS-5 and DT scores were significantly reduced in the experimental group post-RT (p = 0.0114 and p = 0.0023, respectively). When music listening was discontinued, these scores rebounded. While the posttest BAI-C score was significantly lower in the experimental group (p < 0.0001), the pre-post difference between the two groups was not significant (p = 0.0619). On cessation of music listening, the BAI-C score also rebounded. CONCLUSIONS For cancer patients undergoing initial RT, music listening intervention significantly reduced anxiety symptoms measured using the BSRS-5, DT, and BAI-C scores after two weeks. Our results demonstrate the effectiveness of music listening intervention in reducing anxiety symptoms, thereby potentially improving the quality of life of cancer patients undergoing RT.
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Affiliation(s)
- Huei-Fan Yang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan
| | - Wen-Wei Chang
- Department of Biomedical Sciences, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Ying-Hsiang Chou
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan
| | - Yu-Shiun Liao
- Taichung Municipal Chu-Jen Junior High School, Taichung, 403002, Taiwan
| | - Ting-En Liao
- Taichung Municipal Chu-Jen Junior High School, Taichung, 403002, Taiwan
| | - Hsien-Chun Tseng
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Shih-Tsung Chang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Hsin Lin Chen
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Ya-Fang Ke
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan
| | - Pei-Fang Tsai
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan
| | - Hsiu-Man Chan
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan
| | - Bo-Jiun Chang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Yi-Ting Hwang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Hsueh-Ya Tsai
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan
| | - Yueh-Chun Lee
- Department of Radiation Oncology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd, Taichung, 40201, Taiwan.
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan.
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Yang L, Yuan B, Ju Y, Liu W, Wang Y. Effect of quality nursing care on wound pain and anxiety in burn patients: A meta-analysis. Int Wound J 2024; 21:e14798. [PMID: 38572761 PMCID: PMC10993347 DOI: 10.1111/iwj.14798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/04/2024] [Indexed: 04/05/2024] Open
Abstract
To systematically evaluate the effects of quality nursing care on wound pain and anxiety in burn patients. Computerised searches of PubMed, Google Scholar, Cochrane Library, Embase, Wanfang, China Biomedical Literature Database and China National Knowledge Infrastructure databases randomised controlled trials (RCTs) on the application of quality nursing care to burn patients were carried out from database inception to October 2023. Literature was screened and evaluated by two researchers based on inclusion and exclusion criteria, and data were extracted from the final included literature. Stata 17.0 software was employed for data analysis. Overall, 15 RCTs and 1115 burn patients were included, including 563 and 552 in the quality care and routine care groups. It was found that, compared with routine care, burn patients who implemented quality care had significantly less wound pain (SMD: -1.79, 95% CI: -2.22 to -1.36, p < 0.001), anxiety (SMD: -2.71. 95% CI: -3.49 to -1.92, p < 0.001) and depression (SMD: -1.74, 95% CI: -2.35 to -1.14, p < 0.001) levels were significantly reduced post-trauma.
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Affiliation(s)
- Ling Yang
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
| | - Bo‐Qin Yuan
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
| | - Yang‐Yang Ju
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
| | - Wei Liu
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
| | - Yang‐Ping Wang
- Department of BurnThe Southwest Hospital of Army Medical UniversityChongqingChina
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Zhang WM, Sun Y, Zhang XH. How does Music Therapy survive in challenging times? Burns 2024; 50:774-775. [PMID: 38097438 DOI: 10.1016/j.burns.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 04/08/2024]
Affiliation(s)
- Wu-Ming Zhang
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun 130021, China
| | - Yue Sun
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun 130021, China
| | - Xiu-Hang Zhang
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun 130021, China.
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Vieira L, Carvalho C, Grilo A, Reis J, Pires AF, Pereira E, Carolino E, Almeida-Silva M. Effects of a music-based intervention on psychophysiological outcomes of patients undergoing medical imaging procedures: A systematic review and meta-analysis. Radiography (Lond) 2024; 30:589-604. [PMID: 38330892 DOI: 10.1016/j.radi.2024.01.014] [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: 08/25/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Musical intervention (MI) is a valuable strategy for addressing the psychological and emotional challenges faced by patients undergoing imaging procedures. This study explores MI's impact on psychophysiological outcomes during imaging procedures, detailing the sound repertoire and technical characteristics employed in MI. METHODS A systematic review (SR) and meta-analysis (MA) were conducted. Electronic database searches of PubMed, Web-of-Science, and Scopus were performed encompassing original randomised research and quasi-experimental articles published until June 2023. RESULTS Thirteen articles were included in this SR, scoring between 23 and 68 on the Joanna Briggs Institute (JBI) Checklist. Four articles were included to perform a MA concerning anxiety and heart rate (HR) outcomes. Most studies utilised digital playlists as the medium for MI. Headphones were commonly used, with an average volume of 50-60 dB and a musical frequency of 60-80 beats/min. While authors generally preferred selecting musical genres for the repertoire, two articles specifically chose Johann Pachelbel's "Canon in D major" as their musical theme. In terms of psychological parameters, the experimental groups exhibited lower anxiety values than the control groups, with further reductions after MI. However, MA shows that this trend is only marginally significant. Patient comfort and overall examination experience showed improvement with MI. Regarding physiological parameters, HR, especially in the final phase of the examination, was significantly lower in the experimental group compared to the control group. CONCLUSION Across multiple studies, MI demonstrated the ability to reduce anxiety and HR. However, no specific music repertoire emerged as the most effective. IMPLICATIONS FOR PRACTICE MI arises as a painless, reliable, low-cost, and side-effect-free strategy, presenting imaging departments with a practical means to enhance patient comfort and mitigate anxiety and stress during medical procedures.
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Affiliation(s)
- L Vieira
- H&TRC, Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal.
| | - C Carvalho
- H&TRC, Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal.
| | - A Grilo
- H&TRC, Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal; Centro de Investigação em Ciência Psicológica, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal.
| | - J Reis
- Escola Superior de Música de Lisboa, Instituto Politécnico de Lisboa, Campus de Benfica do IPL, Lisbon 1500-651, Portugal; Instituto de Etnomusicologia - Centro de Estudos de Música e Dança, Faculdade de Ciências Sociais e Humanas, Universidade Nova de Lisboa, Lisboa, Av. De Berna, 26 C 1069-061, Lisboa, Portugal.
| | - A F Pires
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal.
| | - E Pereira
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal; Nuclearmed - Instituto de Medicina Nuclear, R. Manuel Febrero 85, 2805-192, Almada, Portugal.
| | - E Carolino
- H&TRC, Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal.
| | - M Almeida-Silva
- H&TRC, Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal; OSEAN-Outermost Regions Sustainable Ecosystem for Entrepreneurship and Innovation, 9000-082 Funchal, Portugal.
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Troian-Michel CH, Tietz L, Mendes AT, Duarte PHM, Weissheimer T, da Rosa RA, Só MVR. Effect of music during endodontic treatment on patients' anxiety: a systematic review of randomized clinical trials. Clin Oral Investig 2023; 27:6321-6332. [PMID: 37728616 DOI: 10.1007/s00784-023-05247-0] [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: 06/14/2022] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES Endodontic treatment is one of the most fearful procedures among dentistry, and the use of music during the procedure has been evaluated to control patients' anxiety. This systematic review has been conducted to provide a synthesis of the state of knowledge in this field and aimed to answer the following question: "Can music therapy reduce patient's state anxiety during endodontic treatment?". METHODS A search was performed in six electronic databases (PubMed, Cochrane Library, Scopus, Web of Science, EMBASE, and Open Gray) for articles published until April 2022. The eligibility criteria, based on the PICOS strategy, were as follows: (P) patients undergoing endodontic treatment; (I) exposure to music; (C) no music; (O) patients' anxiety; (S) only randomized clinical trials. The risk of bias was analyzed according to the Cochrane Risk of Bias tool for randomized controlled trials (RoB 2). The strength of evidence from the included studies was assessed using the Grading of Assessment, Development, and Assessment Recommendations (GRADE) tool. RESULTS Five eligible studies were retrieved. A low to high risk of bias was verified. Descriptive analysis showed an effect in favor of music intervention, with differences among state anxiety, heart rate and blood pressure. CONCLUSIONS With a very low quality of evidence, dental care professionals may consider playing background music during endodontic treatment since it is a cost-effective and easy alternative to trying to reduce dental anxiety. CLINICAL RELEVANCE Five studies were included in this systematic review and showed, with a very low quality of evidence, that music may reduce state anxiety levels on patients during root canal treatment.
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Affiliation(s)
- Carolina Horn Troian-Michel
- Department of Endodontics, School of Dentistry, Rio Grande Do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil.
| | - Lilian Tietz
- Department of Endodontics, School of Dentistry, Rio Grande Do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Aline Teixeira Mendes
- Department of Endodontics, School of Dentistry, Rio Grande Do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Pedro Henrique Marks Duarte
- Department of Endodontics, School of Dentistry, Rio Grande Do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Theodoro Weissheimer
- Department of Endodontics, School of Dentistry, Rio Grande Do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Department of Endodontics, School of Dentistry, Rio Grande Do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Marcus Vinicius Reis Só
- Department of Endodontics, School of Dentistry, Rio Grande Do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
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Gergin ÖÖ, Pehlivan SS, Erkan İ, Bayram A, Aksu R, Görkem SB, Biçer C, Yıldız K. The effect of playing music and mother's voice to children on sedation level and requirement during pediatric magnetic resonance imaging. Explore (NY) 2023; 19:600-606. [PMID: 36628804 DOI: 10.1016/j.explore.2023.01.001] [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: 07/20/2022] [Revised: 12/22/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Magnetic resonance imaging examinations frequently cause anxiety and fear in children. The objective of this study was to investigate the effects of listening to music sound, the mother's voice, and sound isolation on the depth of sedation and need for sedatives in pediatric patients who would undergo MRI. METHODS Ninety pediatric patients aged 3 to 12 years who were planned for imaging in the MRI unit were randomly assigned to isolation group (Group I), musical sound group (Group II), and mother's voice group (Group III). We evaluated patients' anxiety and sedation levels via the Observer's Assessment of Alertness/Sedation (OAA/S) RESULTS: Heart rate, oxygen saturation, OAA/S, and Ramsey scores during the procedure were not significantly different among the groups (p>0.05). The mean amount of propofol and total propofol consumption was statistically lower in the mother's voice group than in the isolation and music sound groups (p<0.001). Mean propofol amount and total propofol consumption were not significantly different in isolation and music sound groups (p>0.05). No difference was found between the groups regarding the time it took for the patients' Modified Aldrete score to reach 9 (p>0.05). CONCLUSIONS In pediatric patients, listening to the mother's voice during MRI decreased the total sedative requirement consumed without increasing the depth of sedation.
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Affiliation(s)
- Özlem Öz Gergin
- Department of Anaesthesiology and Reanimation, Medical Faculty, Erciyes University, Kayseri 38039, Turkey.
| | - Sibel Seckin Pehlivan
- Department of Anaesthesiology and Reanimation, Medical Faculty, Erciyes University, Kayseri 38039, Turkey
| | - İbrahim Erkan
- Department of Anaesthesiology and Reanimation, Medical Faculty, Erciyes University, Kayseri 38039, Turkey
| | - Adnan Bayram
- Department of Anaesthesiology and Reanimation, Medical Faculty, Erciyes University, Kayseri 38039, Turkey
| | - Recep Aksu
- Department of Anaesthesiology and Reanimation, Medical Faculty, Erciyes University, Kayseri 38039, Turkey
| | - Süreyya Burcu Görkem
- Department of Radiology, Division of Pediatric Radiology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Cihangir Biçer
- Department of Anaesthesiology and Reanimation, Medical Faculty, Erciyes University, Kayseri 38039, Turkey
| | - Karamehmet Yıldız
- Department of Anaesthesiology and Reanimation, Medical Faculty, Erciyes University, Kayseri 38039, Turkey
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Liechty KL, Shields K, Ogden E, Eshraghi N, Dedeo M, Bishop P. A Multimodal Pain Management Strategy for Burn Patients. Pain Manag Nurs 2023; 24:44-51. [PMID: 36319550 DOI: 10.1016/j.pmn.2022.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 08/02/2022] [Accepted: 09/24/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Acute burn pain is difficult to manage, and poorly managed pain can lead to deleterious consequences such as post-traumatic stress disorder, prolonged recovery, chronic pain and long-term dependence on opioids. Understanding the role of nursing in promoting self-efficacy and minimizing opioid use is valuable. It is unknown whether strategic efforts aimed at enhancing patient self-efficacy will improve pain managment and lessen opioid requirements in the adult burn population. AIM The aim of this study was to examine the effect of a multi-modal, interdisciplinary pain management strategy on coping self-efficacy, pain scores, and opioid use in adult burn patients in the acute care setting. METHOD A quasi-experimental pre-test/post-test design was employed in an American Burn Association (ABA) verified burn center in the Pacific Northwestern United States. Data were collected prospectively for a 6-month period on 44 burn patients. The comparison group received usual care (n = 28), and the intervention received a pain management protocol (n = 16). Coping self-efficacy was measured on admission and at discharge in both groups using the Coping Self-Efficacy Scale. Numeric pain scores and opioid use in morphine milligram equivalents were averaged for each participant. Burn nurse perceptions were gathered via an anonymous electronic survey post data collection in February 2021. RESULTS There were no significant differences in measured coping self-efficacy, pain scores, or opioid use between the intervention and comparison groups. A significant positive correlation was found between length of stay, size of burn, and coping self-efficacy and problem focused self-efficacy. Burn nurses reported increased use of nonpharmacologic adjuncts since protocol implementation. CONCLUSION Nonpharmacologic adjuncts are more likely to be used consistently when protocolized. There is also evidence to support that certain aspects of self-efficacy may be enhanced during acute phase of burn care.
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Affiliation(s)
- Kara L Liechty
- Legacy Good Samaritan Pain Management Center, Portland, Oregon; Legacy Emanuel Oregon Burn Center, Portland, Oregon.
| | - Kelly Shields
- Legacy Health, Portland, Oregon; Legacy Emanuel Oregon Burn Center, Portland, Oregon
| | - Emily Ogden
- Legacy Emanuel Oregon Burn Center, Portland, Oregon
| | - Niknam Eshraghi
- Legacy Emanuel Oregon Burn Center, Portland, Oregon; General Surgery & Burn Specialists, Portland, OR
| | - Michelle Dedeo
- Providence Swedish, Seattle, Washington; Old Dominion University, Virginia Beach, Virginia
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Ettenberger M, Calderón Cifuentes NP. Intersections of the arts and art therapies in the humanization of care in hospitals: Experiences from the music therapy service of the University Hospital Fundación Santa Fe de Bogotá, Colombia. Front Public Health 2022; 10:1020116. [PMID: 36530717 PMCID: PMC9757166 DOI: 10.3389/fpubh.2022.1020116] [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: 08/15/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
Humanization of care is becoming an increasingly important aspect in providing high-quality health services and the arts are more and more implemented to support and foster humanization and person-centered care efforts. Musical experiences are one of the most frequently encountered art forms in medical settings. Music therapy as a healthcare profession has a decades-long tradition in hospitals, both in inpatient and outpatient areas. However, while studies regarding the effectiveness of music therapy are on the forefront of clinical research, little attention has been paid to the profession's inherent opportunities to assist the hospitals' strategies in terms of humanization of care. Yet, the musical experiences in music therapy are especially versatile in supporting healthcare users from a holistic perspective, contributing to a more compassionate, personalized, and humanized environment. In this article, the basic pillars of humanized and person-centered care will be outlined, followed by examples of seven intersections in which the music therapy service of the University Hospital Fundación Santa Fe de Bogotá aligns with its Humanized and Compassionate Care Model. The aim of this article is to stimulate the discussion on music therapy not only as a profession that provides safe and effective treatment, but also as a therapeutic art experience that can add value for hospitals on their path toward a more humanized care culture.
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Affiliation(s)
- Mark Ettenberger
- Music Therapy Service, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia,SONO – Centro de Musicoterapia, Bogotá, Colombia,*Correspondence: Mark Ettenberger
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Malhotra B, Haith LR, Stair-Buchmann M, Kaimal G. "Through the fire and flames, we carry on:" Art Therapy Small N Feasibility Study with Adult Burn Patients in an Acute Care Setting. J Burn Care Res 2022; 44:631-640. [PMID: 35939378 DOI: 10.1093/jbcr/irac113] [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: 04/26/2022] [Indexed: 11/13/2022]
Abstract
This study aimed to investigate the feasibility of facilitating four sessions of art therapy intervention with a primary focus on implementation and acceptability. The exploratory aim was on assessing the impact of art therapy on self-reported outcomes on anxiety and mood among 5 individuals (aged 18+ years) hospitalized for burn injuries and to understand their perceptions of engagement with art therapy. A convergent mixed methods small N design was adopted wherein both quantitative and qualitative data are gathered and then integrated, and an individual served as his/her own control when assessed before and after art therapy. Anxiety was assessed using Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety short-form of the emotional distress bank, and mood was assessed using the Positive and Negative Affect Schedule (PANAS). There was a statistically significant decrease in anxiety scores and negative mood scale. Positive mood scale scores tended to improve after art therapy though were not statistically significant. Thematic analysis of qualitative data indicates that art therapy improves a) symptom management, b) facilitates emotional expression and c) insight, d) brings out symbolic and metaphorical representations, and e) allows tactile and sensory exploration of art media. This study demonstrated that art therapy can be successfully implemented with acute burn patients and can have promising psychosocial benefits. More research in needed to determine the impact and effectiveness of art therapy with burn patients, in ways that is meaningful to the patients.
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Affiliation(s)
- Bani Malhotra
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, USA
| | - Linwood R Haith
- The Nathan Speare Regional Burn Treatment Center, Crozer-Chester Medical Center, Upland, PA, USA
| | - Megan Stair-Buchmann
- The Nathan Speare Regional Burn Treatment Center, Crozer-Chester Medical Center, Upland, PA, USA
| | - Girija Kaimal
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, USA
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Mohammadi F, Oshvandi K, Borzou SR, Khodaveisi M, Khazaei S, Shokouhi MR, Nouri F, Taheri M, Kalbasi M. Suicide resilience, identity crisis and quality of life in burned adolescents. Nurs Open 2022; 10:287-296. [PMID: 35941757 PMCID: PMC9748065 DOI: 10.1002/nop2.1303] [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: 02/02/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 01/04/2023] Open
Abstract
AIM The aim of this study was to investigate the relationship between identity crisis and suicide resilience and quality of life in adolescents with burns in Iranian society. DESIGN A cross-sectional study. METHODS Four hundred thirty adolescents with burn in three hospitals were selected via convenience sampling. They completed questionnaires online. Data were analysed by SPSS software version 22. RESULTS Findings showed a strong and inverse correlation between identity crisis with suicide resilience (r = -.92, p < .001) and quality of life (r = -.87, p < .001). Variables of suicide resilience, being a child of a divorced family, cause of burns, extent of burn, financial situation, gender and age can predict 68.74% of the variance in identity crisis in these patients. PATIENT OR PUBLIC CONTRIBUTION Adolescents with burns suffer from an identity crisis, and although they report high resilience to suicide, they have a mediocre quality of life. Therefore, it is suggested that basic planning and extensive support be taken to improve physical and mental health, promote the quality of life and consequently reduce the identity crisis in these adolescents.
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Affiliation(s)
- Fateme Mohammadi
- Department of Pediatric Nursing, School of Nursing and Midwifery,Chronic Diseases(Home Care) Research Center and Autism Spectrum Disorders Research CenterHamadan University of Medical SciencesHamadanIran
| | - Khodayar Oshvandi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Chronic Diseases (Homecare) Research CenterHamadan University of Medical SciencesHamadanIran
| | - Seyed Reza Borzou
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research CenterHamadan University of Medical SciencesHamadanIran
| | - Masood Khodaveisi
- Department of community Health Nursing, School of Nursing and Midwifery, Mother and Child Care Research CenterHamadan University of Medical SciencesHamadanIran
| | - Salman Khazaei
- Research Center for Health SciencesHamadan University of Medical SciencesHamadanIran
| | - Mohammad Reza Shokouhi
- Department of Medical Emergencies, School of Nursing and MidwiferyHamadan University of Medical SciencesHamadanIran
| | - Fatemeh Nouri
- Department of Pharmaceutical Biotechnology, School of PharmacyHamadan University of Medical SciencesHamadanIran
| | - Mohammad Taheri
- Department of Microbiology, School of MedicineHamadan University of Medical SciencesHamadanIran
| | - Majid Kalbasi
- Plastic, Reconstructive and Aesthetic surgery fellowshipIsfahan University of Medical SciencesIsfahanIran
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Optimal timing and effect of music therapy in patients with burn injuries: Systematic review and meta-analysis of randomized controlled trials. Burns 2022; 48:1069-1078. [PMID: 34426015 DOI: 10.1016/j.burns.2021.07.016] [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: 02/03/2021] [Revised: 07/06/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Burn injuries may have both physiological and psychological consequences. Numerous studies have reported the use of music therapy during burn injury treatment, but the optimal timing for music therapy remains unclear. Therefore, we performed a systematic review and meta-analysis of randomized controlled trials on patients with burn injuries to analyze the effects of music intervention on them at different timings: background (T0) and time before (T1), during (T2), and after (T3) change dressing (CD). METHOD The PubMed and EMBASE databases were searched for articles published before Novenber 2020 based on predetermined criteria. Our search focused on two keywords: music and burn. Reviewers extracted data from all eligible studies independently. The I2 statistic was used to determine statistical heterogeneity. The endpoints included standardized mean differences (SMDs) and 95% confidence intervals (CIs). Relevant Forest plots were also created. RESULT This study finally included seven trials recruiting a total of 524 patients. The results indicated that compared with non-music intervention, music intervention significantly reduced anxiety at T0 (SMD = -1.32, 95% CI [-2.61, -0.02], T1 (SMD = -2.15, 95% CI [-4.30, -0.00]) and T2 (SMD = -0.39, 95% CI [-0.74, -0.04]). Moreover, they also significantly reduced the pain levels at T0 (SMD = -1.59, 95% CI [-2.00, -1.17]) and T2 (SMD = -0.47, 95% CI [-0.82, -0.12]), improved the mental condition, and reduced the amount of opioid analgesics used at T0. CONCLUSION Music therapy seems to have some effects at T0 and T1 in patients with burn injuries. Music therapy was more effective in improving psychological outcomes than physiological outcomes. However, additional high-quality studies related to music therapy for patients with burn injuries are warranted.
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12
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Aghakhani N, Faraji N, Parizad N, Goli R, Alinejad V, Kazemzadeh J. Guided Imagery: An Effective and Practical Complementary Medicine Method to Alleviate Pain Severity and Pain-Related Anxiety During Dressing Change in Burn Victims. J Burn Care Res 2022; 43:756. [PMID: 35213722 DOI: 10.1093/jbcr/irac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Nader Aghakhani
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of Medical Surgical Nursing, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical Surgical Nursing, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Vahid Alinejad
- Department of Biostatistics, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Jafar Kazemzadeh
- Reconstructive and Burn Surgery Department, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
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13
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Monsalve-Duarte S, Betancourt-Zapata W, Suarez-Cañon N, Maya R, Salgado-Vasco A, Prieto-Garces S, Marín-Sánchez J, Gómez-Ortega V, Valderrama M, Ettenberger M. Music therapy and music medicine interventions with adult burn patients: A systematic review and meta-analysis. Burns 2022; 48:510-521. [PMID: 34906387 DOI: 10.1016/j.burns.2021.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/08/2021] [Accepted: 11/04/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pain is one of the most common and most difficult symptoms to manage in adult burn patients in the Intensive Care Unit (ICU). Insufficient or unsuccessful pain management can negatively affect physiological, psychological, and social health in burn patients, both during and after hospitalization. Music therapy and music medicine interventions have been shown to positively affect pain and mental health in this population. This systematic review and meta-analysis provide an update of Randomized Controlled Trials (RCTs) using music therapy or music medicine interventions in adult burn patients. METHODS A variety of databases were searched from their beginning to June 2020, including PsycINFO and PsycArticles (via APAsycNET), PubMed and MEDLINE (via OvidSP), Scopus, Web of Science, and the Cochrane Library. Data of all articles meeting the inclusion criteria were extracted, organized, and processed according to the PRISMA guidelines. Statistical analysis was performed using Q-test and I2 statistics. RESULTS 10 RCTs with a total of 1061 participants were included. The results of the meta-analysis showed a statistically significant reduction of pain (I2 = 96.03%, P < 0.001), anxiety (I2 = 98.85%, P < 0.002), and improved relaxation (I2 = 87.19%, P < 0.001) favoring music interventions compared to control groups. CONCLUSIONS This review provides preliminary evidence for the effectiveness of music interventions for adult burn patients. However, more high-quality RCTs are needed to safely establish guidelines for music therapists and other health care professionals in using music for health purposes with this population.
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Affiliation(s)
| | | | - Nicolas Suarez-Cañon
- Department of Critical Care, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Rafael Maya
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrés Salgado-Vasco
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sergio Prieto-Garces
- Department of Critical Care, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | - Mario Valderrama
- Department of Biomedical Engineering, University Los Andes, Bogotá, Colombia
| | - Mark Ettenberger
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia..
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14
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Krieger Y, Pachevsky M, Shoham Y, Biederko R, Novack L, Sarid O. Relieving pain and distress symptoms in the outpatient burn clinic: The contribution of a medical clown. Burns 2022; 48:654-661. [PMID: 34670712 DOI: 10.1016/j.burns.2021.06.008] [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: 01/14/2021] [Revised: 05/20/2021] [Accepted: 06/24/2021] [Indexed: 12/15/2022]
Abstract
CONTEXT High levels of pain and emotional distress characterize the experience of patients, at burn outpatient clinic and reflect on their accompanying persons and the medical personal. OBJECTIVES To examine the effect of a medical clown presence on: the patients' pain and distress levels as perceived by the patient and by their accompanying persons, and the emotional response of healthcare personnel. METHODS A yearlong prospective observational comparative study in the burn outpatient clinic, operating twice a week, with a medical clown's presence once a week [Exposure Group - EG] versus clinic without clown presence [Non exposure Group- NEG]. Patients and accompanying persons filled pain [WBS, VAS] and emotional distress [SUDS] questionnaires regarding the patient's experience: before (T1) and after treatment (T2). The clinic personnel filled SUDS at the beginning and the end of the clinic working hours. RESULTS Significantly lower WBS, VAS, and SUDS scores were reported at T2 in the EG as compared to the NEG both in patients and in the accompanying persons' evaluations. Personnel SUDS were affected in a similar manner. CONCLUSION Presence of a medical clown induced a positive atmosphere in the clinic. It is possible that the effect of humor through stress reduction mechanism lessened agony. Furthermore, the distraction the clown evoked played a role in the decrease of pain and emotional distress. We recommend implementing psychosocial oriented interventions such as those performed by a medical clown to improve the emotional atmosphere in the ambulatory clinic of patients, accompanying persons and healthcare personnel.
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Affiliation(s)
- Yuval Krieger
- Department of Plastic Surgery, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Michelle Pachevsky
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yaron Shoham
- Department of Plastic Surgery, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ron Biederko
- Biostatistics and Epidemiology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lena Novack
- Biostatistics and Epidemiology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Orly Sarid
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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15
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Moradipoor Y, Rejeh N, Heravi Karimooi M, Tadrisi SD, Dahmardehei M, Bahrami T, Vaismoradi M. Comparing Auditory and Visual Distractions for Reducing Pain Severity and Pain Anxiety in Older Outpatients with Burn: A Randomized Controlled Trial. Geriatrics (Basel) 2022; 7:54. [PMID: 35645277 PMCID: PMC9149902 DOI: 10.3390/geriatrics7030054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023] Open
Abstract
Pain and anxiety are major issues among older patients with burn injuries. Complementary medicine and non-pharmacological methods can relieve pain and anxiety in older people, but comparison of the effects of these methods needs further research. This study aimed to compare the effects of auditory and visual distractions on pain severity and pain anxiety in older outpatients referred to a burn clinic for dressing change. In this randomized controlled clinical trial, older men were randomly assigned to three groups as auditory distraction, visual distraction, and control (n = 45 in each group). The Visual Analogue Scale (VAS) and the Burn Specific Pain Anxiety Scale (BSPAS) were used to asses pain severity and pain anxiety before and immediately after the interventions, and after wound dressing. Reduction in pain severity and pain anxiety after visual distraction was reported. Auditory distraction only reduced pain anxiety. Therefore, visual distraction had a better effect on alleviating pain anxiety compared with auditory distraction. Visual distraction is suggested to be used during dressing changes for older outpatients with burn injuries in outpatient clinics in order to reduce their burn-related suffering and improve their collaboration with the therapeutic regimen.
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Affiliation(s)
- Yaghob Moradipoor
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Nahid Rejeh
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Majideh Heravi Karimooi
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Seyed Davood Tadrisi
- Trauma Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran;
| | - Mostafa Dahmardehei
- Burn Research Center, Iran University of Medical Sciences, Tehran 1449614535, Iran;
| | - Tahereh Bahrami
- Faculty of Nursing and Midwifery, Shahed University, Tehran 1865133191, Iran; (Y.M.); (M.H.K.); (T.B.)
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway;
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16
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Wang L, Zhuang S, Zhou X, Liu J. Effects of Music Therapy Combined with Progressive Muscle Relaxation on Anxiety and Depression Symptoms in Adult Women with Methamphetamine Dependence: Study Protocol for a Randomized Controlled Trail. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00786-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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17
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Oliver JA, Oliver LA, Aggarwal N, Baldev K, Wood M, Makusha L, Vadivelu N, Lichtor L. Ambulatory Pain Management in the Pediatric Patient Population. Curr Pain Headache Rep 2022; 26:15-23. [PMID: 35129824 DOI: 10.1007/s11916-022-00999-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW Outpatient surgery in the pediatric population has become increasingly common. However, many patients still experience moderate to severe postoperative pain. A poor understanding of the extent of pain after pediatric ambulatory surgery and the lack of randomized control studies of pain management of the outpatient necessitate this review of scientific evidence and multimodal analgesia. RECENT FINDINGS A multimodal approach to pain management should be applied to the ambulatory setting to decrease postoperative pain. These include non-pharmacological techniques, multimodal pharmacologics, and neuraxial and peripheral nerve blocks. Postoperative pain management in pediatric ambulatory surgical patients remains suboptimal at most centers due to limited evidence-based approach to postoperative pain control. Pediatric ambulatory pain management requires a multipronged approach to address this inadequacy.
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Affiliation(s)
- Jodi-Ann Oliver
- Department of Anesthesiology, Yale University, New Haven, CT, 06520, USA
| | - Lori-Ann Oliver
- Department of Anesthesiology, Yale University, New Haven, CT, 06520, USA
| | - Nitish Aggarwal
- Department of Anesthesiology, Yale University, New Haven, CT, 06520, USA.
| | - Khushboo Baldev
- Department of Anesthesiology, Yale University, New Haven, CT, 06520, USA
| | - Melanie Wood
- Department of Anesthesiology, Yale University, New Haven, CT, 06520, USA
| | - Lovemore Makusha
- Department of Anesthesiology, Stanford University, Pao Alto, CA, USA
| | - Nalini Vadivelu
- Department of Anesthesiology, Yale University, New Haven, CT, 06520, USA
| | - Lance Lichtor
- Department of Anesthesiology, Yale University, New Haven, CT, 06520, USA
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18
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de Jesus Catalã CA, Pan R, Kron-Rodrigues MR, de Oliveira Freitas N. Virtual reality therapy to control burn pain: systematic review of randomized controlled trials. J Burn Care Res 2021; 43:880-888. [PMID: 34757408 DOI: 10.1093/jbcr/irab213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Virtual reality therapy has been shown to be an excellent alternative to non-pharmacological treatment for the control of burn pain. OBJECTIVE To evaluate the effects of virtual reality therapy on pain control in people who have suffered burns published in the scientific literature. METHOD Systematic review carried out as recommended by Cochrane®. The search was carried out in the Embase, PubMed, Lilacs and Cochrane Library databases, in the period from March 2021. Randomized clinical trials were included without language restriction and year of publication. The risk of bias was assessed using the Cochrane® tool. RESULTS Of the 3755 articles found, only 17 articles were selected for reading in full. Of these, only four articles met the inclusion criteria. The results of the studies showed that the use of virtual reality therapy reduced the intensity of pain in children and adolescents with burns, despite the fact that most results are not statistically significant. No selected study had a high risk of bias. CONCLUSIONS Virtual reality therapy has been shown to be effective in controlling pain, reducing the time spent thinking about it and greater distraction during the procedures. However, most randomized clinical trials results were not statistically significant in at least one of the moments when pain was assessed. It is noteworthy that randomized clinical trials are still necessary to administer virtual reality therapy, especially in adults.
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Affiliation(s)
| | - Raquel Pan
- RN, PhD, Professor of Pediatric Nursing at the Federal University of Triângulo Mineiro. Uberaba, Minas Gerais, Brazil
| | | | - Noélle de Oliveira Freitas
- RN, PhD, Professor of Pediatric Nursing at the Federal University of Triângulo Mineiro. Uberaba, Minas Gerais, Brazil
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19
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Kabuk A, Şendir M, Filinte G. The effect of reflexology massage and passive music therapy intervention before burn dressing on pain, anxiety level and sleep quality. Burns 2021; 48:1743-1752. [PMID: 34955298 DOI: 10.1016/j.burns.2021.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/09/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The pain, anxiety, and sleep disorders that burn patients experience due to burn dressing negatively affect their treatment process. The aim of this study was to determine the effect of reflexology massage and passive music therapy intervention before burn dressing on pain, anxiety level and sleep quality. METHODS This study was a randomized controlled trial. The study sample consisted of 36 patients who were hospitalized in the Burn Center of a University Hospital. After obtaining written consent, patients were enrolled to study according to inclusion criteria and then, divided into Reflexology Massage (n = 12), Reflexology Massage with Passive Music Therapy (n = 12) and Control (n = 12) groups using simple random allocation. In the experimental groups, in addition to standard care, interventions were performed for consecutive three days. Interventions were done before dressing for 40 min in the patient's room. The control group received only standard care during this time. Severity of pain in three groups was measured using "Visual Analog Scale" twice a day (before dressing change and 2 h after dressing change). Severity of state anxiety and sleep quality in three groups was measured using "State Anxiety Scale" and "Richards-Campbell Sleep Questionnaire" once a day (before dressing change). Severity of trait anxiety in three groups was measured using "Trait Anxiety Scale" for two times (before and after study). The drugs used by the patients for 3 days were recorded in the "Opioid and Analgesic Drug Form." Data were analyzed using Pearson Chi-square, Independent Samples T-test, One-Way ANOVA, Bonferroni, Paired Sample T-Test, Repeated Measures ANOVA tests were used. RESULTS The results showed no significant difference in severity of pain, anxiety, and sleep quality (p > 0,05) between the three groups on the first day. However, the mean pain scores showed a significant difference between the experimental and control groups in the third (p < 0,05) and fourth (p < 0001) days after intervention. Anxiety scores also showed a significant difference between the experimental and control groups on the fourth (p < 0001) day. Sleep quality of the experimental groups was higher than the control group on the fourth day (p < 00001). No significant difference using of opioid and analgesic drugs between the three groups (p > 0,05). CONCLUSIONS Our results showed reflexology massage and passive music therapy before burn dressing reduced pain and anxiety level, and increased sleep quality.
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Affiliation(s)
- A Kabuk
- Department of Fundamentals of Nursing, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey.
| | - M Şendir
- Department of Fundamentals of Nursing, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey
| | - G Filinte
- Department of Plastic, Reconstructive and Aesthetic Surgery, University of Health Sciences, Istanbul, Turkey
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20
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Ettenberger M, Maya R, Salgado-Vasco A, Monsalve-Duarte S, Betancourt-Zapata W, Suarez-Cañon N, Prieto-Garces S, Marín-Sánchez J, Gómez-Ortega V, Valderrama M. The Effect of Music Therapy on Perceived Pain, Mental Health, Vital Signs, and Medication Usage of Burn Patients Hospitalized in the Intensive Care Unit: A Randomized Controlled Feasibility Study Protocol. Front Psychiatry 2021; 12:714209. [PMID: 34733185 PMCID: PMC8558489 DOI: 10.3389/fpsyt.2021.714209] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Burn patients experience major physiological and psychological stressors during treatment and rehabilitation, including elevated levels of pain, anxiety, stress, or depression. Music interventions inclusive of music therapy (MT) have been shown to improve such symptoms, but rigorous clinical trials investigating specific music therapy methods in adult burn patients are scarce. Methods: This is a single center Randomized Controlled Trial (RCT) protocol with two parallel arms. Participants are 81 adult burn patients admitted to the Intensive Care Unit (ICU) of the University Hospital Fundación Santa Fe de Bogotá in Colombia. The intervention consists of a Music Assisted Relaxation (MAR) protocol, a music therapy technique composed of entrained live music combined with a guided relaxation and/or the use of imagery. The effects of the MAR will be compared to a control group (treatment as usual) over a period of maximum 2 weeks or six interventions. The primary outcome measure is perceived background pain, as measured with a Visual Analog Scale (VAS) before and after each intervention. Secondary outcomes are anxiety and depression levels; vital signs; and the use of pain medication. Additionally, some patients in the intervention group will be invited to participate in electroencephalography, electromyography, and electrocardiography recordings during the MAR. Discussion: This study protocol follows the SPIRIT guidelines for defining items of clinical trials and is the first study in Colombia to evaluate the effects of music therapy for adult burn patients. With this RCT it is hoped to gather new knowledge about the potential of music therapy to help critical care patients cope and recover from their injuries during the hospitalization in the ICU. Trial registration: www.clinicaltrials.gov, Identifier: NCT04571255. Protocol version: V1.0, May 24th 2021.
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Affiliation(s)
- Mark Ettenberger
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Rafael Maya
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrés Salgado-Vasco
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | - Nicolas Suarez-Cañon
- Department of Critical Care, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sergio Prieto-Garces
- Department of Critical Care, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | - Mario Valderrama
- Department of Biomedical Engineering, University Los Andes, Bogotá, Colombia
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21
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Vinolo-Gil MJ, Casado-Fernández E, Perez-Cabezas V, Gonzalez-Medina G, Martín-Vega FJ, Martín-Valero R. Effects of the Combination of Music Therapy and Physiotherapy in the Improvement of Motor Function in Cerebral Palsy: A Challenge for Research. CHILDREN (BASEL, SWITZERLAND) 2021; 8:868. [PMID: 34682132 PMCID: PMC8534581 DOI: 10.3390/children8100868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND There are different therapeutic strategies such as physiotherapy and music therapy for the treatment of cerebral palsy. Intervention protocols using both therapies to unify the measurement of motor function have not been investigated. Aims and scope: To summarize the effects of the treatment of cerebral palsy through the use of both for the improvement of motor function, analyse the challenges encountered, and submit proposals for improving them. METHODS The systematic review was conducted following PRISMA guidelines and registered in the PROSPERO database (CRD42020162493). Clinical trials that described the results obtained in terms of motor function through physiotherapy and music therapy were included. RESULTS Eight clinical trials with 234 participants were considered with a significant improvement in motor function. Results of meta-analysis suggested improvements in gait velocity in favour of the control group for cerebral palsy (mean differences = 0.03; 95% confidence interval = 0.01, 0.04, p = 0.001; I2 = 97%). However, high heterogeneity was identified in the meta-analysis due to the small number of studies included. CONCLUSIONS The combination can be effective in subjects with cerebral palsy to improve motor function, although due to the diversity of studies analysed, it is complex to extrapolate results.
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Affiliation(s)
- Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Esteban Casado-Fernández
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Veronica Perez-Cabezas
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Gloria Gonzalez-Medina
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Francisco Javier Martín-Vega
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
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22
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Gillum M, Huang S, Kuromaru Y, Dang J, Yenikomshian HA, Gillenwater TJ. Nonpharmacologic Management of Procedural Pain in Pediatric Burn Patients: A Systematic Review of Randomized Controlled Trials. J Burn Care Res 2021; 43:368-373. [PMID: 34534314 DOI: 10.1093/jbcr/irab167] [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] [Indexed: 11/13/2022]
Abstract
Pain following burn injury is associated with long-term health consequences in the pediatric population. Literature suggests nonpharmacologic treatment may provide improved pain control as an effective adjunct for these patients. This study aims to summarize randomized controlled trials on nonpharmacologic procedural pain management in pediatric burn patients. A systematic review was conducted on nonpharmacologic procedural pain management techniques used in the pediatric burn population. Fifteen studies were included and involved virtual reality, distraction devices, child life therapy, directed play, digital tablet games, cartoons, hypnosis, and music therapy. Treatment was effective in 8 out of 15 studies. Compared to controls, nonpharmacologic treatments reduced mid procedure pain by 19.7% and post procedure pain by 20.1%. This study demonstrates nonpharmacologic therapy can be an effective adjunct in pediatric procedural burn pain management, however further studies are needed to develop standardized algorithms to integrate nonpharmacologic treatments with pharmacologic therapies.
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Affiliation(s)
- Matthew Gillum
- Keck School of Medicine, University of Southern California, Los Angeles CA.,Los Angeles County Regional Burn Center, Los Angeles County + University of Southern California Medical Center
| | - Samantha Huang
- Keck School of Medicine, University of Southern California, Los Angeles CA.,Los Angeles County Regional Burn Center, Los Angeles County + University of Southern California Medical Center
| | - Yuki Kuromaru
- Keck School of Medicine, University of Southern California, Los Angeles CA.,Los Angeles County Regional Burn Center, Los Angeles County + University of Southern California Medical Center
| | - Justin Dang
- Los Angeles County Regional Burn Center, Los Angeles County + University of Southern California Medical Center
| | - Haig A Yenikomshian
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles CA.,Los Angeles County Regional Burn Center, Los Angeles County + University of Southern California Medical Center
| | - T Justin Gillenwater
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles CA.,Los Angeles County Regional Burn Center, Los Angeles County + University of Southern California Medical Center
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23
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Polychronopoulou E, Raji MA, Wolf SE, Kuo YF. US national trends in prescription opioid use after burn injury, 2007 to 2017. Surgery 2021; 170:952-961. [PMID: 33472746 PMCID: PMC8285464 DOI: 10.1016/j.surg.2020.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/30/2020] [Accepted: 12/09/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Opioid misuse and overdose in the United States remain a public health emergency. Overprescribing has been recognized as a significant contributor to the epidemic. Opioids are the mainstay for pain management after burn; however, to date, no large-scale nationally representative study has evaluated outpatient opioid prescribing practices in this population. METHODS A retrospective study was conducted of patients up to 65 years old with burn injuries between 2007 and 2017 using national commercial insurance data. The primary outcome was initial opioid prescribing after burn injury. Secondary outcomes were total days' supply, oral daily morphine milligram equivalents, and number of refills. RESULTS Of the 140,753 patients with burns, 34,685 (24.6%) received an opioid prescription. The odds of prescription opioid use were lower in 2015, 2016, and 2017 compared with 2007. Interactions with age, severity (P < .0001), and region (P = .003) showed significant variation in rates of decline from 2007 to 2017, with the steepest decline in those aged <20 and in residents of Northeast United States. Prescribing rates remained stable over time among those with more severe burn injuries. The significant decline in daily opioid morphine milligram equivalents after 2013 was paralleled by an increase in days of supply (P values <.005). The odds of refill declined in 2016 and 2017. CONCLUSION While opioid prescribing after burn has declined in the past decade, significant variation remains among regions and age groups, suggesting a need to develop uniform guidelines to improve the quality of opioid prescribing and pain management protocols in burn patients.
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Affiliation(s)
- Efstathia Polychronopoulou
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX; Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX
| | - Mukaila A Raji
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX; Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, University of Texas Medical Branch, Galveston, TX; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX
| | - Steven E Wolf
- Division of Burn and Trauma Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Yong-Fang Kuo
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX; Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, University of Texas Medical Branch, Galveston, TX; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX; Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX.
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Environmental Enrichment in Postoperative Pain and Surgical Care: Potential Synergism With the Enhanced Recovery After Surgery Pathway. Ann Surg 2021; 273:86-95. [PMID: 32209895 DOI: 10.1097/sla.0000000000003878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Holistic biopsychosocial care has been underemphasized in perioperative pathway designs. The importance and a cost-effective way of implementing biopsychosocial care to improve postoperative pain and facilitate surgical convalescence are not well established, despite the recent popularization of Enhanced Recovery After Surgery (ERAS) programs. OBJECTIVE We have explored the evidence and rationale of environmental enrichment (EE) as a complementary multimodal psychosocial care pathway to reduce postoperative pain, optimize patient recovery and improve existing weaknesses in surgical care. METHODS We conducted a database search to identify and grade potential EE techniques for their evidence quality and consistency in the management of acute postoperative pain, perioperative anxiety and the etiologically comparable acute procedural or experimental pain. FINDINGS AND CONCLUSIONS The introduction of music, virtual reality, educational information, mobile apps, or elements of nature into the healthcare environment can likely improve patients' experience of surgery. Compared with traditional psychological interventions, EE modalities are voluntary, therapist-sparing and more economically sustainable. We have also discussed practical strategies to integrate EE within the perioperative workflow. Through a combination of sensory, motor, social and cognitive modalities, EE is an easily implementable patient-centered approach to alleviate pain and anxiety in surgical patients, create a more homelike recovery environment and improve quality of life.
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Chu H, Brailey R, Clarke E, Sen SK. Reducing pain through distraction therapy in small acute paediatric burns. Burns 2021; 47:1635-1638. [PMID: 33972148 DOI: 10.1016/j.burns.2021.01.012] [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] [Received: 02/10/2020] [Revised: 01/17/2021] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The majority of patients who sustained small (low % total body surface area [TBSA]) burns are assessed in an outpatient setting. This can be a traumatic experience, particularly, for paediatric patients. During the initial assessment pharmacological and non-pharmacological adjuncts, such as distraction therapy, can be employed to provide an environment that may reduce and minimise distress. In this study, we investigated whether distraction therapy reduces objective pain scores during the outpatient assessment of small acute burns in children. METHODS Two cohorts of patients were formed. In the first group (group A), the children received analgesia and routine nursing care. In the second group (group B), the children received specialist distraction therapy in addition to the same analgesia and nursing care. We recorded patient demographics, TBSA, anatomical sites and mechanism of burn. The Wong Baker™ visual analogue scale (VAS) was used to convert perceived pain, as reported by the patient or parent, into a numerical value at three set intervals during the consultation. RESULTS 50 patients were recruited with 32 patients in group A and 18 in group B. A larger TBSA positively correlated with higher pain scores (p < 0.05). At the start of the consultation the mean pain score without distraction therapy was 1.55 and with specialist distraction therapy was 0.33 (p < 0.05). The mean peak pain score during dressing change without distraction therapy was 6.80 and with specialist distraction was 4.47 (p < 0.05). At the end of the procedure, the mean pain score was 2.12 without distraction therapy and with specialist distraction 1.75. CONCLUSION This study of pain scores in small acute paediatric burns has shown that distraction therapy provided by a qualified play specialist can reduce maximal pain by over 2 points on the Wong-Baker™ VAS. Consideration should be given to ensure that distraction therapy is available at all times during initial consultations for children who have sustained small burns.
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Affiliation(s)
- H Chu
- Department of Burns, Plastic and Reconstructive Surgery, Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom.
| | - R Brailey
- Department of Burns, Plastic and Reconstructive Surgery, Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom
| | - E Clarke
- Department of Burns, Plastic and Reconstructive Surgery, Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom
| | - S K Sen
- Department of Burns, Plastic and Reconstructive Surgery, Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom
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Eid MM, Abdelbasset WK, Abdelaty FM, Ali ZA. Effect of physical therapy rehabilitation program combined with music on children with lower limb burns: A twelve-week randomized controlled study. Burns 2020; 47:1146-1152. [PMID: 33288333 DOI: 10.1016/j.burns.2020.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/26/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Burn injuries cause significant physical impairments that need comprehensive rehabilitation and coordination with the acute burn care team. Music had been shown to increase positive mood during exercise, which may result in motivation for participation in exercise programs. The current study aimed to evaluate the effect of physical therapy rehabilitation program combined with music therapy on children with lower limb burns. METHODS A twelve-week randomized controlled study including thirty pediatrics with lower limb burns. They were randomly assigned into two equal groups, 15 children per each. Group A received a physical therapy rehabilitation program combined with music therapy in addition to routine medical care. However, Group B received a physical therapy rehabilitation program without music therapy. Assessment of pain was by visual analogue scale (VAS), assessment of the range of motion (ROM) by goniometer, and gait assessed by GAIT Rite. The evaluation was carried before and after the interventions. RESULTS Before starting the study, no significant differences were detected between the two study groups (p < 0.05). The study results reported statistically significant improvement in VAS, ROM, and GAIT Rite in both groups after the intervention (p < 0.05). Group A showed greater improvement than group B in all outcome measures (p < 0.05). CONCLUSION Physical therapy program combined with music therapy is an effective and safe modality for improving pain, range of motion, and gait parameters in pediatrics with lower limb burn. Also, physical therapy combined with music therapy is more effective than physical therapy alone in the treatment of pediatrics with lower limb burns.
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Affiliation(s)
- Marwa M Eid
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia; Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt.
| | - Fatma Moustafa Abdelaty
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Zeinab A Ali
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Physical Therapy, College of Applied Medical Sciences, Jouf University, Saudi Arabia
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Gochenour KS, Ellis RS, Meredith SL, Vesely KC, Kang P, Haefner S. Music and Medicine Come Together Over Pain in the Air Medical Transport Environment. Air Med J 2020; 39:484-488. [PMID: 33228899 DOI: 10.1016/j.amj.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/02/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to determine if noise-canceling headphones (NCHs) with music supersedes pain reduction of other hearing protection for patients transported by Guardian Air Transport via rotor or fixed wing aircraft from 2017 to 2019. METHODS We designed a randomized pilot study in which patients who received NCHs with or without music were compared with controls who received non-NCH hearing protection alone. Four hundred fifty-four adults 19 to 64 years of age and 36 pediatric patients 4 to 18 years old who received ≥ 1 dose of opioids were included. RESULTS In the aggregate population, opioid use was reduced by 31% from 14.3 to 10.0 morphine milligram equivalent/h transport (P = .131) with music compared with controls. The mean total pain reduction in the aggregate population from -2.5 (standard deviation [SD] = 3.2) to -4.0 (SD = 2.9) was 1.6-fold more than controls compared with NCH and music (P = .008). This effect was most profound in the pediatric population where the mean total pain reduction with NCHs and music (-5.4, SD = 3.1) was 3.4-fold more than controls (-1.6, SD = 2.7, P = .021). CONCLUSIONS Music may provide greater subjective pain relief when combined with NCHs in the air transport environment; further research is required.
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Affiliation(s)
| | | | | | | | - Paul Kang
- University of Arizona College of Medicine, Phoenix, Arizona
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Sandvik RK, Olsen BF, Rygh L, Moi AL. Pain relief from nonpharmacological interventions in the intensive care unit: A scoping review. J Clin Nurs 2020; 29:1488-1498. [DOI: 10.1111/jocn.15194] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 12/19/2019] [Accepted: 01/10/2020] [Indexed: 01/29/2023]
Affiliation(s)
- Reidun K. Sandvik
- Departement of Health and Caring Sciences Faculty of Health and Social Sciences Western Norway University of Applied Sciences Bergen Norway
- Department of Global Public Health and Primary Care Centre for Elderly and Nursing Home Medicine University of Bergen Bergen Norway
| | - Brita F. Olsen
- Intensive and Post‐operative Unit Østfold Hospital Trust Sarpsborg Norway
- Faculty of Health and Welfare Østfold University College Fredrikstad Norway
| | - Lars‐Jørgen Rygh
- Department of Anaesthesia and Intensive Care Haukeland University Hospital Bergen Norway
| | - Asgjerd Litlere Moi
- Departement of Health and Caring Sciences Faculty of Health and Social Sciences Western Norway University of Applied Sciences Bergen Norway
- Department of Plastic, Hand and Reconstructive Surgery National Burn Centre Haukeland University Hospital Bergen Norway
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Cimen SG, Oğuz E, Gundogmus AG, Cimen S, Sandikci F, Ayli MD. Listening to music during arteriovenous fistula surgery alleviates anxiety: A randomized single-blind clinical trial. World J Transplant 2020; 10:79-89. [PMID: 32405474 PMCID: PMC7205904 DOI: 10.5500/wjt.v10.i4.79] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/09/2020] [Accepted: 03/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Both end-stage renal disease and being wait-listed for a kidney transplant are anxiety-causing situations. Wait-listed patients usually require arteriovenous fistula surgery for dialysis access. This procedure is performed under local anesthesia. We investigated the effects of music on the anxiety, perceived pain and satisfaction levels of patients who underwent fistula surgery.
AIM To investigate the effect of music therapy on anxiety levels and perceived pain of patients undergoing fistula surgery.
METHODS Patients who were on a waiting list for kidney transplants and scheduled for fistula surgery were randomized to control and music groups. The music group patients listened to music throughout the fistula surgery. The State-Trait Anxiety Inventory was performed to assess anxiety, additionally visual analog scale was used to evaluate perceived pain, willingness to repeat the procedure and patient satisfaction. Demographic features, comorbidities, surgical history, basic surgical data (location of fistula creation, duration of surgery, incision length) and intra-operative hemodynamic parameters were recorded by an investigator blinded to the study group. An additional trait anxiety assessment was performed following the surgery.
RESULTS There was a total of 55 patients included in the study. However, 14 patients did not fulfill the criteria due to requirement of sedation during surgery or uncompleted questionnaires. The remaining 41 patients were included in the analysis. There were 26 males and 15 females. The control and music groups consisted of 20 and 21 patients, respectively. With regard to basic surgical and demographic data, there was no difference between the groups. Overall patient satisfaction was significantly higher and intra-operative heart rate and blood pressure were significantly lower in the music group (P < 0.05). Postoperative state anxiety levels were significantly lower in the music group.
CONCLUSION Music therapy can be a complimentary treatment for patients undergoing fistula surgery. It can reduce anxiety and perceived pain, improve intraoperative hemodynamic parameters and enhance treatment satisfaction, thus may contribute to better compliance of the patients.
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Affiliation(s)
- Sanem Guler Cimen
- Department of General Surgery, Diskapi Research and Training Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Ebru Oğuz
- Division of Nephrology, Department of Internal Medicine, Diskapi Research and Training Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Ayse Gokcen Gundogmus
- Department of Psychiatry, Diskapi Research and Traning Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Sertac Cimen
- Department of Urology, Diskapi Research and Traning Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Fatih Sandikci
- Department of Urology, Diskapi Research and Traning Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Mehmet Deniz Ayli
- Division of Nephrology, Department of Internal Medicine, Diskapi Research and Training Hospital, Health Sciences University, Ankara 06110, Turkey
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Lin C, Hwang S, Jiang P, Hsiung N. Effect of Music Therapy on Pain After Orthopedic Surgery—A Systematic Review and Meta‐Analysis. Pain Pract 2020; 20:422-436. [PMID: 31785131 DOI: 10.1111/papr.12864] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/18/2019] [Accepted: 11/25/2019] [Indexed: 12/31/2022]
Affiliation(s)
| | - Shiow‐Li Hwang
- Department of Nursing Asia University Taichung Taiwan
- Department of Medical Research China Medical University Hospital China Medical University Taichung Taiwan
| | - Ping Jiang
- The First People's Hospital of Yunnan Province Kunming Yunnan China
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Fardin A, Rezaei SA, Maslakpak MH. Non-pharmacological interventions for anxiety in burn patients: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2020; 49:102341. [PMID: 32147030 DOI: 10.1016/j.ctim.2020.102341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 10/25/2022] Open
Abstract
AIM Present review aimed to conduct a comprehensive review of the effectiveness of non-pharmacological interventions (NPIs) on reducing anxiety in adult burn patients. METHOD We searched PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases through September 2019 for randomized clinical trials comparing NPIs to a control group. The primary outcomes were general anxiety and pain anxiety. The Cochrane Risk of Bias Tool was used to assess the risk of bias. All data was pooled with Revman 5.3. RESULTS 20 studies were eligible for quantitative synthesis. Compared to routine care, Music (4 Randomized Clinical Trials (RCTs), Standardized Mean Difference (SMD) = -2.00, 95 % Confidence Interval (CI) = -3.21 to -0.79), massage (4 RCTs, SMD= -1.84, 95 % CI= -2.77 to -0.91), hypnosis (2 RCTs, SMD= -1.06, 95 % CI= -2.90 to 0.78), relaxation (2 RCTs, SMD= -0.77, 95 %CI= -1.52 to -0.02), transcranial direct current stimulation (1 RCT, SMD= -1.92, 95 %CI= -2.54 to -1.30), and therapeutic touch practices (1 RCT, SMD=-0.45 95 %CI= -0.86 to -0.04), were associated with a significant effect on the anxiety of burn patients. Aromatherapy interventions and virtual reality showed no evidence of a reduction in the anxiety. A large amount of heterogeneity exist among trials. Risk of bias varied across studies. Only one study reported on safety issues. CONCLUSION Due to weak evidence, we are unable to make strong recommendations in favor of NPIs for burn anxiety. Further well-designed large sample size randomized clinical trials are warranted.
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Affiliation(s)
- Ajoudani Fardin
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Zhang XH, Gao XX, Wu WW, Yu JA. Impact of orally administered tramadol combined with self-selected music on adult outpatients with burns undergoing dressing change: A randomized controlled trial. Burns 2019; 46:850-859. [PMID: 31672469 DOI: 10.1016/j.burns.2019.10.010] [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: 07/17/2019] [Revised: 10/01/2019] [Accepted: 10/04/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the effects of music and/or tramadol on pain and anxiety in burn outpatients undergoing dressing changes. DESIGN Randomized controlled trial. SETTING Burns and Plastic Reconstruction Unit. PARTICIPANTS Patients (N=180) with burns on up to 10%-30% of the total body surface area (TBSA). INTERVENTIONS The patients were randomly allocated to 4 equal-sized groups as follows: (1) tramadol group (TG), patients received 100mg of tramadol orally 20min before the dressing change; (2) music group (MG), patients listened to self-selected music during the dressing change; (3) music-plus-tramadol group (MTG), patients received tramadol and listened to self-selected music; and (4) control group (CG), patients received a routine dressing change only. All patients underwent the interventions once per day for 2days. MAIN OUTCOME MEASURES McGill Pain Questionnaire Short Form (MPQ-SF) (primary outcome), McGill Pain Persian version of Burn Specific Pain Anxiety Scale (BSPAS) (primary outcome), and heart rate (HR) and overall patient satisfaction (secondary outcomes). RESULTS The results showed that music-plus-tramadol group (MTG) had better outcomes with respect to pain and anxiety management during dressing changes. CONCLUSIONS In comparison with music or tramadol alone, the integration of music and tramadol offers a secure and favorable treatment choice to relieve pain and anxiety, ultimately improving the satisfaction levels of burn outpatients during dressing changes.
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Affiliation(s)
- Xiu-Hang Zhang
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun 130021, China.
| | - Xin-Xin Gao
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun 130021, China.
| | - Wei-Wei Wu
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun 130021, China.
| | - Jia-Ao Yu
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun 130021, China.
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Nandhra S, Wallace T, El-Sheikha J, Carradice D, Chetter I. A randomised controlled trial of perivenous tumescent anaesthesia in addition to general anaesthesia for surgical ligation and stripping of the great saphenous vein. Phlebology 2019; 35:305-315. [PMID: 31660788 DOI: 10.1177/0268355519885221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Open surgical ligation and stripping of the great saphenous vein is a highly cost-effective treatment when compared with conservative management and foam sclerotherapy but has limitations including post-operative morbidity and pain. This study aims to identify if the addition of tumescent anaesthesia could improve patient outcomes following treatment. METHODS Patients with primary superficial venous incompetence undergoing open surgical ligation and stripping of the great saphenous vein were randomised to either General Anaesthesia (GA) alone (GA) procedure or the addition of tumescent (G + T). The primary outcome was bodily pain (within SF-36) at one week. Additional outcomes included post-procedural pain score (100 mm visual analogue scale), complications and quality of life. RESULTS A total of 90 patients were randomised for inclusion. There was no significant difference in primary outcome; bodily pain at one week. Secondary outcome of 4-h post-procedural scores were significantly lower in the G + T group (32 (20-54) mm vs. (GA alone) 56 (24-70) mm (P = 0.016)). Complications were minor and equivalent. Both groups saw a significant increase (worsening) in Aberdeen Varicose Vein Questionnaire scores at week 1 with the G + T group faring worse at six weeks (10.0 (Interquartile Range [IQR] 5.6-17.9) vs. 4.3 (IQR 2.7-7.9) P = 0.004). CONCLUSION The G + T group did not demonstrate a significant difference in the one-week bodily pain domain. The addition of tumescent anaesthesia does improve immediate post-operative pain but appears to negatively impact on six-week quality of life. EudraCT Number: 2011-005574-39.
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Affiliation(s)
- Sandip Nandhra
- Academic Vascular Surgery, Hull Royal Infirmary, Hull, UK
| | - Tom Wallace
- Academic Vascular Surgery, Hull Royal Infirmary, Hull, UK
| | | | | | - Ian Chetter
- Academic Vascular Surgery, Hull Royal Infirmary, Hull, UK
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Mohammadhossini S, Ahmadi F, Gheibizadeh M, Saki Malehi A, Zarea K. Comprehensive physical domain care needs of burn patients: a qualitative study. Clin Cosmet Investig Dermatol 2019; 12:573-581. [PMID: 31686885 PMCID: PMC6709513 DOI: 10.2147/ccid.s215517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/29/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Burn patients have various physical needs. To provide full care for such patients, we need a broad range of services. The current study aims at showing the physical needs of burn patients. METHODS The current qualitative study has been done through content analysis. The data were collected from 20 in-depth, unstructured individual interviews with hospitalized patients with burns on more than 25% of their body, nurses, physiotherapists, and psychologists. The participants were selected by purposive sampling. The data were analyzed with a conventional content analysis approach using the Elo and Kyngas method. RESULTS By analyzing the data, 7 main categories were obtained from 932 primary codes: the necessity to provide optimal physiotherapy, the necessity of the patient's overall physical assessment, the necessity of monitoring and coordination in care, healthy nutrition for burn patients, the need for pharmacotherapy, the need for pain reliefs, and finally the theme for comprehensive physical care needs in burn patients. CONCLUSION According to the findings, by applying the extracted categories, it is possible to provide quality care based on the patient's individual needs. This can help speed up the treatment and shorten the length of hospitalization significantly.
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Affiliation(s)
- Sima Mohammadhossini
- Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahin Gheibizadeh
- Nursing Care Research Center in Chronic Diseases, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki Malehi
- Biostatistics and Epidemiology Department, Public Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Kim DE, Pruskowski KA, Ainsworth CR, Linsenbardt HR, Rizzo JA, Cancio LC. A Review of Adjunctive Therapies for Burn Injury Pain During the Opioid Crisis. J Burn Care Res 2019; 40:983-995. [DOI: 10.1093/jbcr/irz111] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abstract
Opioids are the mainstay of pain management after burn injury. The United States currently faces an epidemic of opioid overuse and abuse, while simultaneously experiencing a nationwide shortage of intravenous narcotics. Adjunctive pain management therapies must be sought and utilized to reduce the use of opioids in burn care to prevent the long-term negative effects of these medications and to minimize the dependence on opioids for analgesia. The purpose of this review was to identify literature on adjunctive pain management therapies that have been demonstrated to reduce pain severity or opioid consumption in adult burn patients. Three databases were searched for prospective studies, randomized controlled trials, and systematic reviews that evaluated adjunctive pain management strategies published between 2008 and 2019 in adult burn patients. Forty-six studies were analyzed, including 24 randomized controlled trials, six crossover trials, and 10 systematic reviews. Various adjunctive pain management therapies showed statistically significant reduction in pain severity. Only one randomized controlled trial on music therapy for acute background pain showed a reduction in opioid use. One cohort study on hypnosis demonstrated reduced opioid use compared with historical controls. We recommend the development of individualized analgesic regimens with the incorporation of adjunctive therapies in order to improve burn pain management in the midst of an abuse crisis and concomitant national opioid shortage.
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Affiliation(s)
- Daniel E Kim
- U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Kaitlin A Pruskowski
- U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Craig R Ainsworth
- U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Julie A Rizzo
- U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Leopoldo C Cancio
- U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
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Zapata-Copete JA, Cordoba-Wagner MJ, García-Perdomo HA. Role of Music in a Plastic Surgery Setting: A Systematic Review and Meta-analysis. Indian J Plast Surg 2019; 52:160-165. [PMID: 31602130 PMCID: PMC6785311 DOI: 10.1055/s-0039-1696792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective To assess the effectiveness and harm of music to reduce anxiety and pain in a plastic surgery setting. Materials and Methods A search strategy was conducted in the MEDLINE, CENTRAL, EMBASE, and LILACS databases. Searches were also conducted in other databases and unpublished literature. Clinical trials were included without language restrictions. The risk of bias was evaluated with the Cochrane Collaboration's tool. An analysis of random effects was conducted. The primary outcomes were anxiety and pain. The secondary outcomes were length of stay, physiological parameters, and adverse effects. The measure of the effect was the mean difference (MD) and standardized MD (SMD) with a 95% confidence interval (CI). The planned interventions were music versus no music. Results Four articles were included in the qualitative and quantitative analysis. A total of 306 patients were found among the four studies. A low risk of bias was shown for most of the study items. The overall standardized mean difference (SMD) for anxiety -3.64 [95%CI -5.71 to -1.56 (p-value = 0.0006)] favoring music compared with no intervention, and for pain the mean difference (MD) was -12.06 [95%CI -33.47 to 9.35 (p-value = 0.2696)] showing no statistical differences. Conclusion Playing music is a safe and free intervention that diminishes anxiety in patients who undergo plastic surgery procedures.
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Affiliation(s)
- James A. Zapata-Copete
- UROGIV Research Group at Universidad del Valle, Cali, Colombia
- Department of Epidemiology, Universidad Libre, Cali, Colombia
- Department of Plastic Surgery, Universidad del Valle, Cali, Colombia
| | | | - Herney Andrés García-Perdomo
- UROGIV Research Group at Universidad del Valle, Cali, Colombia
- Department of Epidemiology, Universidad Libre, Cali, Colombia
- School of Medicine at Universidad del Valle, Cali, Colombia
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Pathania S, Slater LZ, Vose C, Navarra AM. Music Therapy and Pain Management in Patients with End-Stage Liver Disease: An Evidence-Based Practice Quality Improvement Project. Pain Manag Nurs 2018; 20:10-16. [PMID: 30448441 DOI: 10.1016/j.pmn.2018.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 02/23/2018] [Accepted: 07/16/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Pain can negatively affect the inpatient hospitalization experience; however, in patients with compromised metabolic pathways who are more vulnerable to medication side effects, pain control becomes even more challenging. AIMS This evidence-based practice quality improvement project explored the feasibility of implementing a music therapy intervention for improved pain management (pain intensity, analgesic volume) and patient satisfaction among patients with a diagnosis of cirrhotic end-stage liver disease in the acute care setting. DESIGN The plan-do-check-act cycle served as the implementation framework. Four nurse champions were trained to implement a 30-minute music intervention. Self-selected musical selections were delivered via unit-based iPads with earbud headphones during 3 consecutive days. METHODS Data collection was performed using unit-based measures for pain and patient satisfaction and an investigator-developed audit tool. Bivariate analyses and descriptive statistics were used to assess the effect of the intervention on the three outcomes of interest. RESULTS Overall results from data collected with eight participants during a 6-week period indicated a 10% reduction in pain intensity and a 30% improvement in patient satisfaction with pain management care. CONCLUSIONS Findings from this evidence-based practice quality improvement project provide support for the effectiveness of music therapy as an adjunct to traditional pharmacologic modalities for pain management of the end-stage liver disease patient population.
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Affiliation(s)
- Sonia Pathania
- New York University Rory Meyers College of Nursing, New York, New York.
| | - Larry Z Slater
- New York University Rory Meyers College of Nursing, New York, New York
| | - Courtney Vose
- New York University Rory Meyers College of Nursing, New York, New York
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Psychosocial Issues and Lifestyle Changes for the Renal Patient. Nurs Clin North Am 2018; 53:589-600. [PMID: 30388984 DOI: 10.1016/j.cnur.2018.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This article provides an overview of the psychosocial issues faced by those with renal disease. The article discusses the physiologic connection between anxiety, depression, and pain-symptoms commonly seen in renal disease and other chronic illnesses. The application of integrative medicine or nonallopathic medicine and its role in the management of anxiety, depression, and pain are presented. Also presented is evidence surrounding several frequently used nonallopathic modalities appropriate for incorporation into a comprehensive management regimen for renal patients to reduce symptom burden. The article concludes with a discussion on the role of palliative care in treatment decisions for renal patients.
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Melo GAA, Rodrigues AB, Firmeza MA, Grangeiro ASDM, Oliveira PPD, Caetano JÁ. Musical intervention on anxiety and vital parameters of chronic renal patients: a randomized clinical trial. Rev Lat Am Enfermagem 2018. [PMID: 29538579 PMCID: PMC5863277 DOI: 10.1590/1518-8345.2123.2978] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to evaluate the therapeutic effect of music on anxiety and vital parameters in patients with chronic kidney disease when compared to patients receiving conventional care in hemodialysis clinics. METHOD randomized clinical trial conducted in three renal replacement therapy clinics. Sixty people with chronic kidney disease undergoing hemodialysis were randomly allocated to an experimental group and a control group, 30 persons per group). State anxiety was evaluated in both groups by the State-Trait Anxiety Inventory. A t-test was used to verify the effect of the experimental manipulation on the variables. RESULTS we found a statistically significant difference between the groups regarding the degree of anxiety experienced during hemodialysis sessions. The experimental group presented a statistically significant reduction of anxiety scores (p = 0.03), systolic blood pressure (p < 0.002), diastolic blood pressure (p < 0.002), heart rate (p < 0.01) and respiratory rate (p < 0.006) after listening to music. CONCLUSION music represents a potential resource for nursing intervention to reduce state anxiety during hemodialysis sessions. Brazilian Registry of Clinical Trials: RBR-64b7x7.
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Affiliation(s)
| | - Andrea Bezerra Rodrigues
- PhD, Adjunct Professor, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | | | | | - Patrícia Peres de Oliveira
- PhD, Adjunct Professor, Departamento de Enfermagem, Universidade Federal de São João del Rei, São João del Rei, MG, Brazil
| | - Joselany Áfio Caetano
- PhD, Associate Professor, Departamento de Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brazil
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Tick H, Nielsen A, Pelletier KR, Bonakdar R, Simmons S, Glick R, Ratner E, Lemmon RL, Wayne P, Zador V. Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: The Consortium Pain Task Force White Paper. Explore (NY) 2018; 14:177-211. [PMID: 29735382 DOI: 10.1016/j.explore.2018.02.001] [Citation(s) in RCA: 191] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 02/08/2018] [Indexed: 02/06/2023]
Abstract
Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices.
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Affiliation(s)
- Heather Tick
- Departments of Family Medicine, Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA.
| | - Arya Nielsen
- Department of Family Medicine & Community Health, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Kenneth R Pelletier
- Department of Medicine, University of California School of Medicine, San Francisco, CA
| | - Robert Bonakdar
- Department of Pain Management, Scripps Center for Integrative Medicine, La Jolla, CA
| | | | - Ronald Glick
- Departments of Psychiatry and Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Emily Ratner
- MedStar Health, Institute for Innovation, Integrative Medicine Initiatives, MedStar Montgomery Medical Center, Washington, DC
| | - Russell L Lemmon
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Peter Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Veronica Zador
- Beaumont Hospital Integrative Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI
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Can live music therapy reduce distress and pain in children with burns after wound care procedures? A randomized controlled trial. Burns 2018; 44:823-833. [PMID: 29395407 DOI: 10.1016/j.burns.2017.12.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Burn wound care procedures are very painful and lead to distress. Live music therapy has shown beneficial effects on distress and pain in specific pediatric patient populations. In this study we measured whether live music therapy has beneficial effects in terms of less distress and pain in children with burns after wound care procedures. METHODS This randomized assessor-blinded controlled trial (RCT) took place at the burns unit of the Red Cross War Memorial Children's Hospital, Cape Town, South Africa. It included newly admitted inpatients between the ages of 0 and 13 years undergoing their first or second wound care procedures. Excluded were children with a hearing impairment or low level of consciousness. The intervention group received one live music therapy session directly after wound care in addition to standard care. The control group received standard care only. The primary outcome was distress measured with the Observational Scale of Behavioral Distress-revised (OSBD-r). The secondary outcome was pain measured with the COMFORT-behavioral scale (COMFORT-B). In addition, in children older than 5 years self-reported distress with the validated Wong-Baker scale (FACES) and pain with the Faces Pain Scale-Revised (FPS-R) were measured. Patients in both groups were videotaped for three minutes before wound care; during the music therapy or the control condition; and for two minutes thereafter. Two researchers, blinded to the study condition, independently scored the OSBD-r and the COMFORT-B from the video footage before and after music therapy. RESULTS We included 135 patients, median age 22.6 months (IQR 15.4-40.7 months). Change scores did not significantly differ between the intervention and the control groups for either distress (p=0.53; d=0.11; 95% CI -0.23 to 0.45) or pain (p=0.99; d=0.04; 95% CI -0.30 to 0.38). Self-reported distress in a small group of children (n=18) older than 5 years indicated a significant reduction in distress after live music therapy (p=0.05). CONCLUSIONS Live music therapy was not found effective in reducing distress and pain in young children after burn wound care. Older children might be more responsive to this intervention.
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Green E, Cadogan J, Harcourt D. A qualitative study of health professionals' views on using iPads to facilitate distraction during paediatric burn dressing changes. Scars Burn Heal 2018; 4:2059513118764878. [PMID: 30627440 PMCID: PMC6305946 DOI: 10.1177/2059513118764878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Distraction is a non-pharmacologic pain management technique commonly used to avert a person's attention from procedural pain and distress during stressful procedures such as treatment after a burn injury. In recent years, computer tablets (such as iPads) have been used within paediatric burns services to facilitate distraction by way of apps, games, cartoons and videos during dressing changes. However, we know very little about health professionals' experiences of using them in this context. METHODS The current study explored health professionals' experiences of using iPads to facilitate distraction during paediatric burn dressing changes. Fifteen health professionals from a single paediatric burns unit were interviewed. Thematic analysis revealed two key themes: (1) the iPad is a universal panacea for distraction; and (2) trials and tribulations. DISCUSSION Participants considered iPads to be potentially useful and effective distraction tools, suitable for use with a wide range of patients with burn injuries including young children, adolescents and young adults. However, issues including health professionals' understandings of one another's roles, the challenge of working in a busy burns service, and lack of experience and confidence were identified as possible barriers to their use within routine burn care. Training for staff on the use of iPads as a means of facilitating distraction, development of guidelines and a review of how they are incorporated into routine burn care are recommended.
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Affiliation(s)
- Elizabeth Green
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Julia Cadogan
- Bristol Royal Hospital for Children, Bristol, UK
- The Scar Free Foundation Centre for Children’s Burns Research, Bristol, UK
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, Bristol, UK
- The Scar Free Foundation Centre for Children’s Burns Research, Bristol, UK
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Scheffler M, Koranyi S, Meissner W, Strauß B, Rosendahl J. Efficacy of non-pharmacological interventions for procedural pain relief in adults undergoing burn wound care: A systematic review and meta-analysis of randomized controlled trials. Burns 2017; 44:1709-1720. [PMID: 29287729 DOI: 10.1016/j.burns.2017.11.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/10/2017] [Accepted: 11/30/2017] [Indexed: 11/17/2022]
Abstract
The aim of the present meta-analysis was to investigate the efficacy of non-pharmacological interventions for procedural pain relief in adults undergoing burn wound care compared to standard care alone or an attention control. Through a comprehensive literature search in various electronic databases 21 eligible randomized controlled trials (RCTs) were included, comprising a total of 660 patients. Random effects meta-analyses revealed significant positive treatment effects on pain outcomes, Hedges' g=0.58, 95% CI [0.33; 0.84]. Heterogeneity of study effects was substantial, I2=72%. Effects were significantly larger for comparisons against treatment as usual (TAU), g=0.69, CI 95% [0.40; 0.98] than for comparisons against attention control groups, g=0.21 [-0.11; 0.54], p<0.001. Distraction interventions, particularly those using virtual reality, and hypnosis revealed the largest effects on pain relief. Non-pharmacological interventions further resulted in a significant small, homogeneous effect on anxiety reduction, g=0.36 [0.20; 0.52]. In summary, benefits of non-pharmacological interventions on procedural pain relief and reduction of mental distress were demonstrated. Results have been proven to be free of publication bias. However, further high quality trials are needed to strengthen the promising evidence.
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Affiliation(s)
- Michael Scheffler
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Jena, Germany
| | - Susan Koranyi
- University Hospital Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany
| | - Winfried Meissner
- Jena University Hospital, Department of Anesthesiology and Intensive Care Medicine, Jena, Germany
| | - Bernhard Strauß
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Jena, Germany
| | - Jenny Rosendahl
- Jena University Hospital, Institute of Psychosocial Medicine and Psychotherapy, Jena, Germany.
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Song M, Li N, Zhang X, Shang Y, Yan L, Chu J, Sun R, Xu Y. Music for reducing the anxiety and pain of patients undergoing a biopsy: A meta-analysis. J Adv Nurs 2017; 74:1016-1029. [PMID: 29171070 DOI: 10.1111/jan.13509] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Mingzhi Song
- Department of Orthopaedics; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
- Department of Orthopaedics; The Third Affiliated Hospital of Dalian Medical University; Jinpu New Area Liaoning China
| | - Nanyang Li
- Emergency Department; Huashan Hospital; Shanghai Medical College; Fudan University; Shanghai China
| | - Xianbin Zhang
- Department of Hepatobiliary Surgery; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
| | - Yuru Shang
- Department of Hepatobiliary Surgery; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
| | - Litao Yan
- Department of Orthopaedics; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
| | - Jin Chu
- Department of Orthopaedics; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
| | - Ran Sun
- Department of Nursing; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
- Operation Room; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
| | - Yun Xu
- Department of Nursing; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
- Operation Room; The First Affiliated Hospital of Dalian Medical University; Dalian Liaoning China
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