Use of music in therapeutic care

Efficacy and safety of music therapy for the treatment of anxiety and delirium in ICU patients: a meta-analysis and systematic review of randomized controlled trials

INTRODUCTION

The medical application of music therapy (MT) has received widespread attention in recent years and some researchers have attempted to apply MT to the treatment of patients with anxiety and delirium in ICU.

EVIDENCE ACQUISITION

Relevant randomized controlled trials (randomized controlled trials s) were searched in databases, such as Web of Science, PubMed, Embase, Cochrane Library, Medline, Scopus, and CINAHL. Researchers performed literature screening, data extraction, literature quality assessment, and heterogeneity analysis among RCTs.

EVIDENCE SYNTHESIS

Fourteen studies met the inclusion criteria. In general, we included RCTs with low risk of bias, and the primary outcome indicators, including the Chinese version of the State-Trait Anxiety Inventory (C-STAI), Visual Analogue Scale for Anxiety Measurement (VAS-A), and Facial Anxiety Scale (FAS), with a recommended level of evidence of "strong". The pooled results indicated that MT was effective in alleviating the anxiety state of ICU patients (95% CI, SMD=-1.09 [-1.52, -0.67], P<0.05) and could reduce mental and physical fatigue in patients with anxious delirium in ICU (95% CI, WMD=-2.35 [-3.37, -1.33], P <0.05). There were significant differences in the therapeutic effects of MT with different intervention durations. Both 15-minute and 30-minute MT were effective in reducing anxiety levels in patients with anxiety disorders in the ICU (15min: 95%CI, SMD=-1.70[-2.15, -1.24], P<0.05; 30min: 95%CI, SMD=-0.73[-1.16, - 0.29], P<0.05). However, when the duration of MT exceeded 45 min, the overtreatment of MT instead interfered with patient rest and failed to produce a positive therapeutic effect (95% CI, SMD=-1.04 [-3.06, 0.97], P=0.31). In addition, a meta-analysis of physiological outcomes found that MT was effective in maintaining the stabilization of heart rate (HR), respiratory rate (RR), and systolic blood pressure (SBP) in ICU patients with anxiety (P<0.05), but did not affect patients' oxygen saturation, mean arterial pressure and diastolic blood pressure (P>0.05). No adverse events occurred during MT treatment in the reports of included 14 studies.

CONCLUSIONS

MT can safely and effectively reduce the anxiety level of patients with anxiety and delirium in ICU and relieve their psychological and physical fatigue. And MT was able to maintain the stability of HR, RR, and SBP in ICU patients.

The effects of music on clients with learning disabilities: a literature review

The aim of this paper was to promote the use of musical interventions with clients with learning disabilities. Musical interventions with this group of clients were found to be effective in reducing self-injurious behaviour, aggression and other behaviour, which challenge the service providers. Music was also found to have the potential to improve the communication skills of clients and to maintain their psychological well being. A review of the literature shows that music, though not widely used in the field of learning disabilities, can be an effective medium through which the quality of life of clients can be enhanced.

Reducing patient stress in theatre. Alison Bell Memorial Award

For most patients, admission to hospital for surgery can be very stressful. It is well recognised that stress, created by prolonged anxiety, can produce harmful effects and may even delay a patient's recovery following surgery. This article, submitted for the 1999 Alison Bell award (sponsored by NATN and Regent Medical), looks at key ways to reduce the effects of such stress.

Enhancing pediatric health care with music

The pediatric nurse practitioner can use music therapeutically in a variety of clinical situations. Literature supports the effectiveness of music in reducing anxiety based on psychologic and physiological outcomes. Music also enhances standard therapeutic modalities and increases patient satisfaction. Specific interventions should be based on the child's stage be based on the child's stage of development.