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Ettenberger M, Casanova-Libreros R, Chávez-Chávez J, Cordoba-Silva JG, Betancourt-Zapata W, Maya R, Fandiño-Vergara LA, Valderrama M, Silva-Fajardo I, Hernández-Zambrano SM. Effect of music therapy on short-term psychological and physiological outcomes in mechanically ventilated patients: A randomized clinical pilot study. JOURNAL OF INTENSIVE MEDICINE 2024; 4:515-525. [PMID: 39310061 PMCID: PMC11411563 DOI: 10.1016/j.jointm.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 09/25/2024]
Abstract
Background Elevated anxiety levels are common in patients on mechanical ventilation (MV) and may challenge recovery. Research suggests music-based interventions may reduce anxiety during MV. However, studies investigating specific music therapy techniques, addressing psychological and physiological well-being in patients on MV, are scarce. Methods This three-arm randomized clinical pilot study was conducted with MV patients admitted to the intensive care unit (ICU) of Hospital San José in Bogotá, Colombia between March 7, 2022, and July 11, 2022. Patients were divided into three groups: intervention group 1 (IG1), music-assisted relaxation; intervention group 2 (IG2), patient-preferred therapeutic music listening; and control group (CG), standard care. The main outcome measure was the 6-item State-Anxiety Inventory. Secondary outcomes were: pain (measured with a visual analog scale), resilience (measured with the Brief Resilience Scale), agitation/sedation (measured with the Richmond Agitation-Sedation Scale), vital signs (including heart rate, blood pressure, oxygen saturation, and respiratory rate), days of MV, extubation success, and days in the ICU. Additionally, three patients underwent electroencephalography during the interventions. Results Data from 23 patients were analyzed in this study. The age range of the patients was 24.0-84.0 years, with a median age of 66.0 years (interquartile range: 57.0-74.0). Of the 23 patients, 19 were female (82.6%). No statistically significant differences between the groups were observed for anxiety (P=0.330), pain (P=0.624), resilience (P=0.916), agitation/sedation (P=0.273), length of ICU stay (P=0.785), or vital signs. A statistically significant difference between the groups was found for days of MV (P=0.019). Electroencephalography measurements showed a trend toward delta and theta band power decrease for two patients and a power increase on both beta frequencies (slow and fast) in the frontal areas of the brain for one patient. Conclusions In this pilot study, music therapy did not significantly affect the anxiety levels in patients on MV. However, the interventions were widely accepted by the staff, patients, and caregivers and were safe, considering the critical medical status of the participants. Further large-scale randomized controlled trials are needed to investigate the potential benefits of music therapeutic interventions in this population.Trial Registration ISRCTN trial registry identifier: ISRCTN16964680.
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Affiliation(s)
| | | | - Josefina Chávez-Chávez
- Vice-Rectorate for Research, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
| | | | | | - Rafael Maya
- SONO - Centro de Musicoterapia, Bogotá, Colombia
| | | | - Mario Valderrama
- Department of Biomedical Engineering, University of Los Andes, Bogotá, Colombia
| | - Ingrid Silva-Fajardo
- Faculty of Nursing, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
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Meghani S, Frishkopf M, Park T, Montgomery CL, Norris C, Papathanassoglou E. Music-based interventions and theoretical mechanisms in post-ICU survivors: A critical narrative synthesis. Intensive Crit Care Nurs 2024; 86:103777. [PMID: 39182325 DOI: 10.1016/j.iccn.2024.103777] [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: 05/09/2024] [Revised: 07/08/2024] [Accepted: 07/17/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Hospitalization in the ICU can have long-term physiological and psychological impacts, affecting functional recovery and quality of life of post-ICU patients. Despite systematic reviews showing the impact of music interventions on physiological and psychological outcomes in ICU patients, their applicability and effectiveness in the post-ICU context remain unclear. AIM This review aimed to summarize: a) the types and characteristics of music/sound of interventions used in the rehabilitation of ICU patients, b) evidence on the feasibility, safety and acceptability of sound and music interventions for post ICU survivors, c) the types of post-ICU outcomes explored and the effects of sound and music interventions on any type of outcome in post-ICU survivors, and d) potential mechanisms or theoretical frameworks underlying the effects of sound and music interventions. METHOD We combined current systematic review search methods with a critical narrative approach to synthesize a diverse body of evidence. RESULTS Results showed that music interventions positively affect the psychological well-being and health outcomes of post-ICU patients. Outcomes included improvements in stress, anxiety, mood, movement, sleep, and pain, despite differences in patient populations and intervention design. No safety concerns were reported. The identified theoretical frameworks described physiological, neurobiological and/or psycho-social pathways as key mediators, however, these mechanisms are not completely understood. CONCLUSION Research evidence supports the positive effects of music interventions in post-ICU patients. Further experimental studies are required, especially in adult post-ICU populations to elucidate the characteristics, components, feasibility, and long-term effects of sound/music interventions. IMPLICATION TO PRACTICE 1. Music interventions help in post-ICU patients' recovery benefitting stress, anxiety, PTSD, mood, movement, sleep, and pain. 2. Integrating theoretical frameworks into music interventions can expand outcome measures to include physiological markers alongside psychological ones, improving quality of life. 3. Further rigorous interventional studies are required to identify the effectiveness of sound and music interventions in post-ICU patients.
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Affiliation(s)
- Shaista Meghani
- Faculty of Nursing, University of Alberta Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9, Canada.
| | - Michael Frishkopf
- Canadian Centre for Ethnomusicology (CCE), Faculty of Medicine and Dentistry, Department of Music, Faculty of Arts, University of Alberta, 3-98 Fine Arts Building, Edmonton, AB T6G 2C9, Canada.
| | - Tanya Park
- College of Healthcare Sciences, James Cook University, Nguma-bada Campus, Cairns, Queensland, Australia.
| | - Carmel L Montgomery
- Faculty of Nursing, University of Alberta, 3-141 ECHA, 11405 87 Avenue NW, Edmonton, AB T6G 1C9, Canada.
| | - Colleen Norris
- Faculty of Nursing, University of Alberta, 5-246 ECHA, 11405 87 Avenue NW, Edmonton, AB T6G 1C9, Canada.
| | - Elizabeth Papathanassoglou
- Faculty of Nursing, University of Alberta, Scientific Director, Neurosciences Rehabilitation & Vision Strategic Clinical Network TM Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9, Canada.
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Pérez-Pacheco A, Rodríguez Morales FY, Misaghian K, Faubert J, Lugo Arce JE. Auditory Noise Facilitates Lower Visual Reaction Times in Humans. BIOLOGY 2024; 13:631. [PMID: 39194569 DOI: 10.3390/biology13080631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/14/2024] [Accepted: 08/17/2024] [Indexed: 08/29/2024]
Abstract
Noise is commonly seen as a disturbance but can influence any system it interacts with. This influence may not always be desirable, but sometimes it can improve the system's performance. For example, stochastic resonance is a phenomenon where adding the right amount of noise to a weak signal makes it easier to detect. This is known as sub-threshold detection. This sub-threshold detection's natural fingerprint is the fact that the threshold values follow an inverse U-shaped curve as the noise intensity increases. The minimum threshold value is the point of maximum sensitivity and represents the optimal point that divides the dynamics in two. Below that point, we can find the beneficial noise branch, where the noise can facilitate better detection. Above that point, the common detrimental noise concept can be found: adding noise hinders signal detection. The nervous system controls the movements and bodily functions in the human body. By reducing the sensory thresholds, we can improve the balance of these functions. Additionally, researchers have wondered if noise could be applied to different senses or motor mechanisms to enhance our abilities. In this work, noise is used to improve human reaction times. We tested the hypothesis that visual reaction times decrease significantly when the subject's perception is in the beneficial noise branch and closer to the optimal point than outside of this condition. Auditory noise was introduced in 101 human subjects using an interface capable of searching for the right amount of noise to place the subject in the beneficial noise branch close to the optimal point. When comparing the results, the reaction times decreased when the subjects were at the optimal point compared to when the subjects were outside of such conditions. These results reveal the possibility of using this approach to enhance human performance in tasks requiring faster reaction times, such as sports.
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Affiliation(s)
- Argelia Pérez-Pacheco
- Directorate of Research, Hospital General de México "Dr. Eduardo Liceaga", Mexico City 06720, Mexico
- Research and Technological Development Unit (UIDT), Hospital General de México "Dr. Eduardo Liceaga", Mexico City 06720, Mexico
| | | | - Khashayar Misaghian
- Faubert Laboratory, Université de Montréal, Montreal, QC H3T 1P1, Canada
- Sage-Sentinel Smart Solutions, Onna, Okinawa 904-0495, Japan
| | - Jocelyn Faubert
- Faubert Laboratory, Université de Montréal, Montreal, QC H3T 1P1, Canada
- Sage-Sentinel Smart Solutions, Onna, Okinawa 904-0495, Japan
| | - Jesus Eduardo Lugo Arce
- Faubert Laboratory, Université de Montréal, Montreal, QC H3T 1P1, Canada
- Sage-Sentinel Smart Solutions, Onna, Okinawa 904-0495, Japan
- Facultad de Ciencias Físico-Matematicas, Ciudad Universitaria, Puebla 72570, Mexico
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Zhang B, Xiao Q, Gu J, Ma Q, Han L. A qualitative study on the disease coping experiences of pancreatic cancer patients and their spouses. Sci Rep 2024; 14:18626. [PMID: 39128911 PMCID: PMC11317503 DOI: 10.1038/s41598-024-69599-7] [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: 02/17/2024] [Accepted: 08/07/2024] [Indexed: 08/13/2024] Open
Abstract
Cancer affects patients as well as their spouses. Patients and their spouses use different strategies to cope with cancer and the associated burden. This study aimed to gain a deeper and more differentiated understanding of support systems for patients and their spouses. This was an exploratory qualitative study conducted in China. The study was based on 20 semistructured face-to-face interviews. Ten pancreatic cancer patients and their spouses were interviewed. The interviews took place at a tertiary hospital from June 2023 to December 2023. The data were analysed using thematic analysis according to Braun and Clarke's methodology. This study was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Twenty participants of different ages (patients: range = 49-75 years; spouses: range = 47-73 years) participated. Patients with different cancer stages (e.g., potentially resectable, borderline resectable, locally advanced) and cancer types (initial diagnosis or relapse) participated in the study. Five themes emerged from the data, namely, denial and silence, fear and worry, struggle, coping strategies and cherishing the present. Active dyadic coping is conducive to promoting disease adaptation, and spouses seem to need more psychological support to improve their own well-being. Health care providers should pay attention to pancreatic cancer patients and their spouses in terms of five themes: denial and silence, fear and worry, struggle, coping strategies and cherishing the present. Future studies should use a combination of qualitative and quantitative methods to explore dyadic coping in greater depth.
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Affiliation(s)
- Bo Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Qigui Xiao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Jingtao Gu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Qingyong Ma
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710061, China.
| | - Liang Han
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710061, China.
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Menza R, Bongiovanni T, Leutwyler H, Tang J, Johnson JK, Howie-Esquivel J. Music-Based Interventions for Symptom Management in Critically Ill, Mechanically Ventilated Adults: A Scoping Review of the Literature. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 39046944 DOI: 10.1089/jicm.2023.0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Background: Patients in intensive care units experience high symptom burden during mechanical ventilation (MV). Pharmacologic symptom management is associated with side effects and increased morbidity. Music-based interventions (MBIs) have been associated with reductions in both anxiety in MV adults and pain for critically ill adults, yet their use for the management of other burdensome symptoms has not been evaluated. The purpose of this scoping review is to map the state of evidence for the use of prerecorded music listening MBIs for symptom management in MV adults. Methods: A systematic search of the literature was conducted across four electronic databases (PubMed, EMBASE, CINAHL, and Web of Science) for experimental designed studies that measured the efficacy of MBIs for the management of physical and psychological symptoms including anxiety, sedation/agitation, dyspnea, distress, delirium, sleep, stress, fear, loneliness, or depression in critically ill, MV adults between January 1, 1998, and April 18, 2023. Results: A total of 643 abstracts and 29 clinical trials were included. Overall, the risk of bias, assessed using the Evidence Project tool, was moderate. MBIs were mostly delivered with headphones using music selected either by investigators or from a limited selection. MBIs were associated with reduced pain, agitation, dyspnea, distress and anxiety, and improved tolerance of MV and sedative weaning. Outcomes of delirium were mixed. No studies explored sleep disturbances, fear, or loneliness. Conclusions: Use of MBIs improved symptom experience for critically ill adults during MV. Future studies employing unrestricted patient-preferred music selections and exploring outcomes of sleep quality, psychological distress, and delirium are needed in this highly symptomatic patient population.
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Affiliation(s)
- Rebecca Menza
- Trauma Surgery Department, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Tasce Bongiovanni
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Heather Leutwyler
- School of Physiological Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Julin Tang
- Department of Anesthesia, University of California San Francisco, San Francisco, California, USA
| | - Julene K Johnson
- University of California San Francisco Institute for Health & Aging, San Francisco, California, USA
| | - Jill Howie-Esquivel
- School of Physiological Nursing, University of California San Francisco, San Francisco, CA, USA
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Han J, Lee H, Kim T, Lee S. Exploring the Impact of Positive Psychology-Based Virtual Music Therapy on Mental Health in Stressed College Students during COVID-19: A Pilot Investigation. Healthcare (Basel) 2024; 12:1467. [PMID: 39120171 PMCID: PMC11311473 DOI: 10.3390/healthcare12151467] [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: 06/25/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024] Open
Abstract
This study explored the effectiveness of a virtual music therapy program, based on positive psychotherapy principles, in college students during the COVID-19 pandemic. Twenty-four undergraduate students with partial PTSD were initially assigned to either an experimental group or a control group, with 11 participants in each group by the study's end. The experimental group underwent 15 video sessions of the therapy program, completing one session per weekday over 3 weeks. The program involved worksheets targeting goals aligned with positive psychology, such as positive affect, life meaning, personal strengths, gratitude, hope, and happiness. The activities included writing music autobiographies, creating and analyzing song lyrics, and exploring various music pieces. The effectiveness of the intervention was measured using the 21-item Depression Anxiety Stress Scale and the Korean Version of Positive Psychological Capital (K-PPC) before, immediately after, and 3 weeks post-program. The experimental group showed significant improvements in stress (F = 5.759, p < 0.05), anxiety (F = 4.790, p < 0.01), depression (F = 5.740, p < 0.01), self-efficacy (F = 3.723, p < 0.05), resilience (F = 4.739, p < 0.05), and the K-PPC total score (F = 3.740, p < 0.05) compared with the control group. These improvements were maintained at the 3-week follow-up. The findings suggest that positive psychology-based virtual music therapy can significantly enhance the mental health of highly stressed college students, especially during challenging times such as the COVID-19 pandemic.
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Affiliation(s)
- Jinwoo Han
- Department of Public Health, Graduate School, Wonkwang University, Iksan 54538, Republic of Korea; (J.H.); (H.L.)
- Department of Arts Therapy, Daegu Catholic University, Gyeongsan 38430, Republic of Korea
| | - Hyejin Lee
- Department of Public Health, Graduate School, Wonkwang University, Iksan 54538, Republic of Korea; (J.H.); (H.L.)
| | - Teri Kim
- Division of Health and Sport Science, Dongguk University-WISE, Gyeongju 38066, Republic of Korea;
| | - Sangyeol Lee
- Department of Public Health, Graduate School, Wonkwang University, Iksan 54538, Republic of Korea; (J.H.); (H.L.)
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea
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Levy CE, Uomoto JM, Betts DJ, Hoenig H. Creative Arts Therapies in Rehabilitation. Arch Phys Med Rehabil 2024:S0003-9993(24)01127-4. [PMID: 39043332 DOI: 10.1016/j.apmr.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024]
Abstract
Appreciation for the utility of creative arts therapy in rehabilitation is on the rise. The limitations of conventional approaches to address posttraumatic stress disorder and co-occurring traumatic brain injury is spurring the development and increased use of creative arts therapies, especially in US military health care systems. However, emerging applications of creative arts therapies in rehabilitation extend well beyond posttraumatic stress disorder/traumatic brain injury and military populations to span the continuum of care, from the intensive care unit, postoperative recovery unit, acute inpatient medical and surgical wards, outpatient clinics, and home health, as well as in traditional long-term care and psychiatric settings. Critical steps to more fully integrating creative arts therapies in rehabilitation include the following: (1) incorporation of education about creative arts therapies into the curricula across rehabilitation disciplines; (2) alteration of national and state policies to promote greater inclusion of creative arts therapies as reimbursable treatments for a wide array of clinical diagnoses and conditions; and (3) significant expansion of creative arts therapies' evidence base. This can be achieved by increasing funding levels to encourage rigorously designed and controlled studies to determine the efficacy, populations, diagnoses and conditions, cofactors, and the mechanisms of action of creative arts therapies. The time has come for a concentrated effort from the community of rehabilitation professional associations, advocacy organizations, and practitioners to promote the advancement and inclusion of creative arts therapies into appropriate clinical settings to optimize outcomes for patients.
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Affiliation(s)
- Charles E Levy
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Creative Forces: National Endowment for the Arts Military Healing Arts Network, Bethesda, MD; Center for Arts in Medicine and Department of Occupational Therapy, University of Florida, Gainesville, FL.
| | - Jay M Uomoto
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Creative Forces: National Endowment for the Arts Military Healing Arts Network, Bethesda, MD
| | | | - Helen Hoenig
- Durham VA Health Care System, Durham, NC; Duke University, Durham, NC
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Pampel J, McCarthy C, Krankenberg H, Dannberg G, Schulze PC, Thieme M. The MULAN Trial - RCT on the use of MUsic in Cath-Lab to reduce ANxiety during peripheral vascular interventions. VASA 2024; 53:237-245. [PMID: 38738469 DOI: 10.1024/0301-1526/a001126] [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] [Indexed: 05/14/2024]
Abstract
Background: The purpose was to analyze the use of classical music to reduce procedure-related anxiety while conducting percutaneous transluminal angioplasty in patients with peripheral artery disease. Patients and methods: A total of 155 patients were analyzed in this single center randomized controlled trial. Procedure-related anxiety was assessed by a numerical rating scale (NRS, 0-10) and by recording of physiological parameters at three different points in time. A survey was conducted after the intervention. Results: This study showed that the patients listened to music overcame their procedure-related anxiety more quickly than the patients in the control group. The NRS at second timepoint was significantly reduced in intervention group compared to control group (p<0.01; r=0.2). Most participants stated that they would like to listen to music during possible future interventions. Conclusions: Classical music during endovascular interventions reduced procedure-related anxiety measured as greater reduction in NRS values in intervention group as well as in results of questionnaire performed post procedurally in PAD patients.
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Affiliation(s)
- Johannes Pampel
- REGIOMED Vascular-Center, Sonneberg, Germany
- Department of Internal Medicine I, University Hospital Jena, Jena, Germany
| | | | | | - Gudrun Dannberg
- Department of Internal Medicine I, University Hospital Jena, Jena, Germany
| | | | - Marcus Thieme
- REGIOMED Vascular-Center, Sonneberg, Germany
- Department of Internal Medicine I, University Hospital Jena, Jena, Germany
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Gu J, Wang H, Pei J, Meng J, Song Y. The dyadic coping experience of ICU transfer patients and their spouses: A qualitative study. Nurs Crit Care 2024; 29:672-681. [PMID: 37922250 DOI: 10.1111/nicc.12993] [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: 03/29/2023] [Revised: 09/04/2023] [Accepted: 10/09/2023] [Indexed: 11/05/2023]
Abstract
BACKGROUND The patient's spouse, in their role as the primary caregiver, assumes responsibility for the patient's care during the recovery process and provides the most robust social support. Previous research has primarily focused on the coping experiences and thoughts of individual intensive care unit (ICU) patients or caregivers, with limited attention afforded to the relationship between patients and their spouses. AIMS This study aims to explore the dyadic coping experiences of ICU transfer patients and their spouses, with the goal of providing evidence to support the subsequent development of an individualized intervention program. STUDY DESIGN A qualitative study using a phenomenological research approach was undertaken. Purposive sampling was employed to select participants for face-to-face semi-structured in-depth interviews. The interviews took place at a tertiary general hospital in Nanjing from January 2023 to February 2023.Twelve ICU transfer patients and their twelve spouses were interviewed. The data were then summarized, and themes were derived using the Colaizzi 7-step analysis method. FINDINGS A total of four themes and eleven sub-themes emerged from the analysis. The identified themes include positive coping (actively seeking solutions, and facing challenges together), negative coping (avoiding problems, displaying overprotective behaviour, and bearing the burden alone), difficulties and challenges (a lack of information, high physical and psychological stress, and significant financial burden), and needs and suggestions (strengthening transition care, fostering increased intimacy, and reducing negative emotions). CONCLUSION Both patients and spouses experience physical and psychological stress during the transfer from the ICU to the ward. Therefore, any intervention developed for caregivers should be designed in a dyadic manner. Increasing dyadic coping skills may represent an important area for future research and intervention. RELEVANCE TO CLINICAL PRACTICE This study provides valuable evidence to inform the formulation of a comprehensive dual disease management plan for ICU transfer patients and their spouses.
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Affiliation(s)
- Jiayi Gu
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - He Wang
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Jiaqin Pei
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Jingyu Meng
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Yan Song
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, China
- Depatment of Nursing, The Second Hospital of Nanjing, Nanjing University of Chinese Medcine, Nanjing, China
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Mao Y, Tao X, Zhang G, Chen H. Effect of Music Therapy on Negative Psychology, Sleep, and Quality of Life in Elderly Patients Recovering from Cerebral Infarction with Depression and Anxiety: A Retrospective Analysis. Noise Health 2024; 26:430-435. [PMID: 39345088 DOI: 10.4103/nah.nah_84_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 06/05/2024] [Indexed: 10/01/2024] Open
Abstract
OBJECTIVE To observe the effects of music therapy on negative psychology, sleep, and quality of life in elderly patients recovering from cerebral infarction accompanied by depression and anxiety. METHODS We performed a retrospective analysis of 160 patients with convalescent cerebral infarction diagnosed between December 2022 and December 2023 in the Affiliated Brain Hospital of Nanjing Medical University. Cases from the control group (n = 76) were treated with conventional rehabilitation training. Meanwhile, the music therapy group (n = 84) cases were managed with standard and music therapy. Various measures, including polysomnography, the general quality of life questionnaire-74 (GQOL-74), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) were collected at baseline (admission) and 4 weeks post-admission. RESULTS After 4 weeks, the music therapy group exhibited higher GQOL-74 scores, lower SAS scores, and lower SDS scores (P < 0.001). Furthermore, compared with the control group, the music therapy group had shorter sleep latency, longer sleep duration, higher sleep efficiency, lower wake time, fewer wake times, shorter S1 stage, longer S3 + S4 stage, and longer REM period (P < 0.001). CONCLUSIONS Music therapy appears to be effective in improving negative psychology, sleep quality, and quality of life in elderly patients with comorbid depression and anxiety during recovery from cerebral infarction.
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Affiliation(s)
- Ying Mao
- Intensive Care Medicine Department, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Xumei Tao
- Department of Geriatrics (Geriatric Neurology), The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Ge Zhang
- Department of Geriatrics (Geriatric Neurology), The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Hounan Chen
- Department of Geriatrics (Geriatric Neurology), The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
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Sagun E, Akyol A, Kaymak C. Chrononutrition in Critical Illness. Nutr Rev 2024:nuae078. [PMID: 38904422 DOI: 10.1093/nutrit/nuae078] [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: 06/22/2024] Open
Abstract
Circadian rhythms in humans are biological rhythms that regulate various physiological processes within a 24-hour time frame. Critical illness can disrupt the circadian rhythm, as can environmental and clinical factors, including altered light exposure, organ replacement therapies, disrupted sleep-wake cycles, noise, continuous enteral feeding, immobility, and therapeutic interventions. Nonpharmacological interventions, controlling the ICU environment, and pharmacological treatments are among the treatment strategies for circadian disruption. Nutrition establishes biological rhythms in metabolically active peripheral tissues and organs through appropriate synchronization with endocrine signals. Therefore, adhering to a feeding schedule based on the biological clock, a concept known as "chrononutrition," appears to be vitally important for regulating peripheral clocks. Chrononutritional approaches, such as intermittent enteral feeding that includes overnight fasting and consideration of macronutrient composition in enteral solutions, could potentially restore circadian health by resetting peripheral clocks. However, due to the lack of evidence, further studies on the effect of chrononutrition on clinical outcomes in critical illness are needed. The purpose of this review was to discuss the role of chrononutrition in regulating biological rhythms in critical illness, and its impact on clinical outcomes.
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Affiliation(s)
- Eylul Sagun
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, Ankara, 06100, Turkey
| | - Asli Akyol
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, Ankara, 06100, Turkey
| | - Cetin Kaymak
- Gülhane Faculty of Medicine, Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Training and Research Hospital, Intensive Care Unit, Ankara, 06230, Turkey
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Mistraletti G, Solinas A, Del Negro S, Moreschi C, Terzoni S, Ferrara P, Negri K, Calabretta D, Formenti P, Formenti A, Umbrello M. Generalized music therapy to reduce neuroactive drug needs in critically ill patients. Study protocol for a randomized trial. Trials 2024; 25:379. [PMID: 38867317 PMCID: PMC11170779 DOI: 10.1186/s13063-024-08220-8] [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: 02/13/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Critically ill patients are exposed to several physical and emotional stressors, needing analgesic and sedative drugs to tolerate invasive procedures and the harsh intensive care unit (ICU) environment. However, this pharmacological therapy presents several side effects: guidelines suggest using a light sedation target, keeping critically ill patients calm, conscious, and cooperative. Personalized music therapy (MT) can reduce stress and anxiety, decreasing the need for drugs. The aim of the current investigation is to compare different approaches for MT in the ICU: a personalized approach, with music selected by patients/families and listened through headphones, or a generalized approach, with ambient music chosen by a music therapist and transmitted through speakers. PRIMARY OUTCOME number of days "free from neuroactive drugs" in the first 28 days after ICU admission. SECONDARY OUTCOMES total amount of neuroactive drugs (midazolam, propofol, morphine, fentanyl, haloperidol), stress during ICU stay (sleep at night, anxiety and agitation, use of physical restraints, stressors evaluated at discharge), the feasibility of generalized MT (interruptions requested by staff members and patients/families). METHODS Randomized, controlled trial with three groups of critically ill adults: a control group, without MT; a personalized MT group, with music for at least 2 h per day; a generalized MT group, with music for 12.5 h/day, subdivided into fifteen 50-min periods. DISCUSSION One hundred fifty-three patients are expected to be enrolled. This publication presents the rationale and the study methods, particularly the strategies used to build the generalized MT playlist. From a preliminary analysis, generalized MT seems feasible in the ICU and is positively received by staff members, critically ill patients, and families. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03280329. September 12, 2017.
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Affiliation(s)
- Giovanni Mistraletti
- Dipartimento Di Fisiopatologia Medico-Chirurgica E Dei Trapianti, Università Degli Studi Di Milano, Milan, Italy.
- SC Rianimazione e Anestesia, Ospedale Civile di Legnano, ASST Ovest Milanese, Milan, Italy.
| | - Anna Solinas
- Dipartimento Di Salute Mentale, AUSL Piacenza, Piacenza, Italy
| | - Silvia Del Negro
- Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Milan, Italy
- Servizio Di Psicologia Clinica, Ospedale San Paolo - Polo Universitario, ASST Santi Paolo E Carlo, Milan, Italy
| | - Carlotta Moreschi
- Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Milan, Italy
| | - Stefano Terzoni
- Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Milan, Italy
| | - Paolo Ferrara
- Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Milan, Italy
| | - Katerina Negri
- Dipartimento Di Fisiopatologia Medico-Chirurgica E Dei Trapianti, Università Degli Studi Di Milano, Milan, Italy
| | - Davide Calabretta
- Dipartimento Di Fisiopatologia Medico-Chirurgica E Dei Trapianti, Università Degli Studi Di Milano, Milan, Italy
| | - Paolo Formenti
- SC Anestesia, Rianimazione e Terapia Intensiva; ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo, Italy
| | - Angelo Formenti
- Centro Sperimentale Regionale Della Voce E Della Deglutizione "E. De Amicis", Milan, Italy
| | - Michele Umbrello
- SC Rianimazione e Anestesia, Ospedale Civile di Legnano, ASST Ovest Milanese, Milan, Italy
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Becker AS, van der Valk Bouman ES, Schaap J, de Vos CC, van Eijck K, Jeekel H, Klimek M. A multidisciplinary approach on music induced-analgesia differentiated by socio-cultural background in healthy volunteers (MOSART): A cross-over randomized controlled trial protocol. Contemp Clin Trials Commun 2024; 39:101313. [PMID: 38881543 PMCID: PMC11179059 DOI: 10.1016/j.conctc.2024.101313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/08/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
Background Integrating music into pain treatment demonstrates significant benefits, effectively reducing subjective pain levels and perioperative opioid requirements. Currently, the relationship between the impact of specific types of music and listeners' socio-cultural background is still unclear. This is especially relevant given that sociological research indicates that these factors can have a notable influence on music preference and perception. Current evidence suggests that individuals who choose their own music may experience greater benefits. However, additional research is needed to comprehensively grasp whether the effect of (preferred) music on pain endurance remains consistent across different socio-cultural backgrounds. Methods In this study, a collaborative effort between medical and sociological researchers aims to investigate music-induced analgesia differentiated by socio-cultural background in healthy volunteers. Participants (n = 84) will listen to self-, and researcher-chosen music and a podcast as a control condition in a cross-over study design. The primary outcome of this study is pain endurance measured by electric stimuli of increasing intensity. Detailed sociological validated questionnaires will be utilized. Considering the notable influence of educational level on music taste formation found in previous research and its crucial role as a source of socio-cultural differentiation, participants will be stratified based on their level of education. Discussion This experimental study represents one of the first efforts to gain a socio-culturally differentiated understanding of the therapeutic potential of music. Consequently, this could pave the way to purposefully and inclusively implement personalized music in healthcare settings.
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Affiliation(s)
- Antonia S Becker
- Department of Neuroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Julian Schaap
- Department of Arts and Culture Studies, Erasmus University, Rotterdam, the Netherlands
| | - Cecile C de Vos
- Centre for Pain Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Koen van Eijck
- Department of Arts and Culture Studies, Erasmus University, Rotterdam, the Netherlands
| | - Hans Jeekel
- Department of Neuroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Markus Klimek
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands
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Misrani A, Tabassum S, Wang T, Huang H, Jiang J, Diao H, Zhao Y, Huang Z, Tan S, Long C, Yang L. Vibration-reduced anxiety-like behavior relies on ameliorating abnormalities of the somatosensory cortex and medial prefrontal cortex. Neural Regen Res 2024; 19:1351-1359. [PMID: 37905885 DOI: 10.4103/1673-5374.385840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/19/2023] [Indexed: 11/02/2023] Open
Abstract
Abstract
JOURNAL/nrgr/04.03/01300535-202406000-00040/inline-graphic1/v/2023-10-30T152229Z/r/image-tiff
Tibetan singing bowls emit low-frequency sounds and produce perceptible harmonic tones and vibrations through manual tapping. The sounds the singing bowls produce have been shown to enhance relaxation and reduce anxiety. However, the underlying mechanism remains unclear. In this study, we used chronic restraint stress or sleep deprivation to establish mouse models of anxiety that exhibit anxiety-like behaviors. We then supplied treatment with singing bowls in a bottomless cage placed on the top of a cushion. We found that unlike in humans, the combination of harmonic tones and vibrations did not improve anxiety-like behaviors in mice, while individual vibration components did. Additionally, the vibration of singing bowls increased the level of N-methyl-D-aspartate receptor 1 in the somatosensory cortex and prefrontal cortex of the mice, decreased the level of γ-aminobutyric acid A (GABA) receptor α 1 subtype, reduced the level of CaMKII in the prefrontal cortex, and increased the number of GABAergic interneurons. At the same time, electrophysiological tests showed that the vibration of singing bowls significantly reduced the abnormal low-frequency gamma oscillation peak frequency in the medial prefrontal cortex caused by stress restraint pressure and sleep deprivation. Results from this study indicate that the vibration of singing bowls can alleviate anxiety-like behaviors by reducing abnormal molecular and electrophysiological events in somatosensory and medial prefrontal cortex.
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Affiliation(s)
- Afzal Misrani
- South China Normal University-Panyu Central Hospital Joint Laboratory of Translational Medical Research, Panyu Central Hospital, Guangzhou, Guangdong Province, China
- School of Life Sciences, Guangzhou University, Guangzhou, Guangdong Province, China
- School of Life Sciences, South China Normal University, Guangzhou, Guangdong Province, China
| | - Sidra Tabassum
- South China Normal University-Panyu Central Hospital Joint Laboratory of Translational Medical Research, Panyu Central Hospital, Guangzhou, Guangdong Province, China
- School of Life Sciences, Guangzhou University, Guangzhou, Guangdong Province, China
- School of Life Sciences, South China Normal University, Guangzhou, Guangdong Province, China
| | - Tintin Wang
- Guangzhou Hongai Cultural Development, Inc., Guangzhou, Guangdong Province, China
- Yinguo Health Management Team, Guangzhou, Guangdong Province, China
| | - Huixian Huang
- South China Normal University-Panyu Central Hospital Joint Laboratory of Translational Medical Research, Panyu Central Hospital, Guangzhou, Guangdong Province, China
- School of Life Sciences, South China Normal University, Guangzhou, Guangdong Province, China
| | - Jinxiang Jiang
- School of Life Sciences, Guangzhou University, Guangzhou, Guangdong Province, China
- School of Life Sciences, South China Normal University, Guangzhou, Guangdong Province, China
| | - Hongjun Diao
- Guangzhou Hongai Cultural Development, Inc., Guangzhou, Guangdong Province, China
- Yinguo Health Management Team, Guangzhou, Guangdong Province, China
| | - Yanping Zhao
- College of Biophotonics, South China Normal University, Guangzhou, Guangdong Province, China
| | - Zhen Huang
- South China Normal University-Panyu Central Hospital Joint Laboratory of Translational Medical Research, Panyu Central Hospital, Guangzhou, Guangdong Province, China
| | - Shaohua Tan
- South China Normal University-Panyu Central Hospital Joint Laboratory of Translational Medical Research, Panyu Central Hospital, Guangzhou, Guangdong Province, China
| | - Cheng Long
- South China Normal University-Panyu Central Hospital Joint Laboratory of Translational Medical Research, Panyu Central Hospital, Guangzhou, Guangdong Province, China
- School of Life Sciences, South China Normal University, Guangzhou, Guangdong Province, China
| | - Li Yang
- School of Life Sciences, Guangzhou University, Guangzhou, Guangdong Province, China
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Han S, Cai Z, Cao L, Li J, Huang L. Effects of Chinese traditional five-element music intervention on postoperative delirium and sleep quality in elderly patients after non-cardiac surgery: a randomized controlled trial. Perioper Med (Lond) 2024; 13:47. [PMID: 38807220 PMCID: PMC11134639 DOI: 10.1186/s13741-024-00408-5] [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: 01/14/2024] [Accepted: 05/23/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Postoperative delirium (POD) is a common neurologic disorder among elderly patients after non-cardiac surgery, which leads to various negative outcomes. Sleep disorder is considered an important cause of POD. The objective of this study was to investigate whether the Chinese traditional five-element music intervention could reduce POD by improving sleep quality in elderly patients undergoing non-cardiac surgery. METHODS A total of 132 patients aged 65 to 90 years who underwent non-cardiac surgery were randomized to two groups: the intervention (n = 60) and the control group (n = 63). Patients in the intervention group were subjected to the Chinese traditional five-element music intervention during the perioperative, while patients in the control group had no music intervention. POD was evaluated using the Confusion Assessment Method (CAM) in the first 5 days after surgery. The Richards‒Campbell Sleep Questionnaire (RCSQ) was used to assess subjective sleep quality. The levels of nocturnal melatonin and cortisol in saliva were measured on the preoperative and the first 2 postoperative days. RESULTS The incidence of POD within 5 days was 27.0% in the control group and 11.7% in the intervention group. Preoperative PSQI and MMSE scores were associated with POD. The RCSQ scores on the first postoperative day were significantly decreased in the two groups compared to the preoperative day. Compared to the control group, the RCSQ scores showed a significant improvement in the intervention group on the first postoperative day. Compared to the control group, the level of saliva melatonin in the intervention group showed a significant increase on the first postoperative day. However, there was no statistical difference in cortisol levels between the two groups. CONCLUSIONS Chinese traditional five-element music intervention decreased the incidence of POD in elderly patients who underwent noncardiac surgery via improving sleep quality, which may be associated with increased levels of melatonin.
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Affiliation(s)
- Shuang Han
- Department of Anesthesiology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050061, Hebei, China
- Department of Anesthesiology, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Zenghua Cai
- Department of Anesthesiology, Bethune International Peace Hospital, Shijiazhuang, 050082, Hebei, China
| | - Longlu Cao
- Department of Anesthesiology, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Jianli Li
- Department of Anesthesiology, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China.
| | - Lining Huang
- Department of Anesthesiology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050061, Hebei, China.
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Xiao M, Gong C, Mai M, Huang M, Xiong A, Liu H, Jiang R. 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. Minerva Anestesiol 2024; 90:439-451. [PMID: 38619185 DOI: 10.23736/s0375-9393.24.17900-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
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.
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Affiliation(s)
- Meixia Xiao
- First Affiliated Hospital of Nanchang University, Nanchang City, China
| | - Cheng Gong
- Gannan Medical University, Ganzhou City, China
| | - Miao Mai
- Gannan Medical University, Ganzhou City, China
| | - Miao Huang
- Gannan Medical University, Ganzhou City, China
| | - Anyu Xiong
- Gannan Medical University, Ganzhou City, China
| | - Hongsuo Liu
- First Affiliated Hospital of Nanchang University, Nanchang City, China
| | - Rong Jiang
- First Affiliated Hospital of Nanchang University, Nanchang City, China -
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Bilgili S, Balci Akpinar R. The effect of listening to music during continuous positive airway pressure on agitation levels and compliance of intensive care patients with COVID-19: A randomized controlled trial. Nurs Crit Care 2024; 29:357-365. [PMID: 37537508 DOI: 10.1111/nicc.12952] [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: 01/29/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Agitation and incompliance with the treatment may be observed in patients undergoing continuous positive airway pressure (CPAP), which may cause inadequate oxygenation, sedation, termination of CPAP or intubation of the patient. AIM This study was conducted to determine the effect of listening to music during CPAP on the agitation levels of intensive care patients who underwent CPAP as a result of COVID-19 and their compliance with the treatment. STUDY DESIGN This study was a prospective, randomized, controlled clinical trial. Seventy-six intensive care patients with COVID-19 were included in this study and assigned to the music and control groups via the block randomization method. The study was completed with 70 patients. The patients and outcome assessors were not blinded in this study. The Richmond Agitation and Sedation Scale (RASS) level, respiratory rate, oxygen saturation (SpO2 ) and mask air leakage amount were the outcome measures. RESULTS The mean RASS score of the patients in the intervention group was 2.14 ± 0.69 before CPAP, 1.63 ± 064 at the 1st minute, 0.89 ± 0.58 at the 15th minute and 0.74 ± 0.61 at the 30th minute. The mean RASS score of the patients in the control group was 2.06 ± 0.53 before CPAP, 1.80 ± 0.58 at the 1st minute, 1.43 ± 0.60 at the 15th minute and 1.46 ± 0.61 at the 30th minute of CPAP. There was a statistically significant difference between the groups at the 15th and 30th minutes (t = -3.81, p < .001; t = -4.89, p < .001 respectively). The mean respiratory rate, SpO2 and mask air leakage amount were compared between the groups. There was a statistically significant difference in favour of the intervention group at the 15th minute (t = -2.47, p < .001; t = 2.57, p < .001; t = 2.93, p < .001 respectively) and 30th minute (t = -3.17, p < .001; t = 3.46, p < .001; t = -3.93, p < .001 respectively). CONCLUSIONS The study results show that listening to music during CPAP reduces the agitation levels of patients and helps them comply with the treatment. RELEVANCE TO CLINICAL PRACTICE Music may be a beneficial application for patients who are agitated and unable to comply with CPAP therapy. This is an easy and applicable method, which can protect patients from the adverse effects of failed CPAP.
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Affiliation(s)
| | - Reva Balci Akpinar
- Faculty of Nursing, Department of Nursing Fundamentals, Ataturk University, Erzurum, Turkey
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Bates A, Golding H, Rushbrook S, Highfield J, Pattison N, Baldwin D, Grocott MPW, Cusack R. Mixed-methods randomised study exploring the feasibility and acceptability of eye-movement desensitisation and reprocessing for improving the mental health of traumatised survivors of intensive care following hospital discharge: protocol. BMJ Open 2024; 14:e081969. [PMID: 38286705 PMCID: PMC10826543 DOI: 10.1136/bmjopen-2023-081969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Post-traumatic symptoms are common among patients discharged from intensive care units (ICUs), adversely affecting well-being, increasing healthcare utilisation and delaying return to work. Non-pharmacological approaches (eg, music, therapeutic touch and patient diaries) have been suggested as candidate interventions and trauma-focused psychological interventions have been endorsed by international bodies. Neither category of intervention is supported by definitive evidence of long-term clinical effectiveness in patients who have been critically ill. This study assesses the feasibility and acceptability of using eye-movement desensitisation and reprocessing (EMDR) to improve the mental health of ICU survivors. METHODS AND ANALYSIS EMERALD is a multicentre, two-part consent, pilot feasibility study, recruiting discharged ICU survivors from three hospitals in the UK. We are gathering demographics and measuring post-traumatic symptoms, anxiety, depression and quality of life at baseline. Two months after discharge, participants are screened for symptoms of post-traumatic stress disorder (PTSD) using the Impact of Events Scale-Revised (IES-R). Patients with IES-R scores<22 continue in an observation arm for 12 month follow-up. IES-R scores≥22 indicate above-threshold PTSD symptoms and trigger invitation to consent for part B: a randomised controlled trial (RCT) of EMDR versus usual care, with 1:1 randomisation. The study assesses feasibility (recruitment, retention and intervention fidelity) and acceptability (through semistructured interviews), using a theoretical acceptability framework. Clinical outcomes (PTSD, anxiety, depression and quality of life) are collected at baseline, 2 and 12 months, informing power calculations for a definitive RCT, with quantitative and qualitative data convergence guiding RCT refinements. ETHICS AND DISSEMINATION This study has undergone external expert peer review and is funded by the National Institute for Health and Care Research (grant number: NIHR302160). Ethical approval has been granted by South Central-Hampshire A Research Ethics Committee (IRAS number: 317291). Results will be disseminated through the lay media, social media, peer-reviewed publication and conference presentation. TRIAL REGISTRATION NUMBER NCT05591625.
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Affiliation(s)
- Andrew Bates
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hannah Golding
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | | | - Natalie Pattison
- University of Hertfordshire, Hatfield, UK
- East and North Hertfordshire NHS Trust, Stevenage, UK
| | - David Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Michael P W Grocott
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rebecca Cusack
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- University of Southampton Faculty of Medicine, Southampton, UK
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Bruder AL, Gururaja A, Narayani N, Kleinpell R, Schlesinger JJ. Patients' Perceptions of Virtual Live Music in the Intensive Care Unit. Am J Crit Care 2024; 33:54-59. [PMID: 38161170 DOI: 10.4037/ajcc2024140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Implementing music in the intensive care unit has increased in popularity because the environment can be stressful and anxiety inducing for many patients. In hospital settings, therapeutic music can be beneficial for patients' well-being and recovery. Although live music typically involves a face-to-face encounter between the musician and patient, the COVID-19 pandemic has prompted a change to virtual live therapeutic music, using technology to present music in real time (eg, with a tablet computer). OBJECTIVE To generate novel findings regarding patients' perceptions of virtual live therapeutic music, which has been little studied compared with live or recorded music.. METHODS Fifty patients in Vanderbilt University Medical Center intensive care units listened to virtual live music played by a volunteer musician via an online video communication platform. Patients' responses to 5 survey questions were transcribed and analyzed qualitatively and quantitatively using data analysis software. RESULTS Seven major themes describing the familiarity and significance of music for patients were identified. Forty-seven patients (94%) experienced positive emotions from the music, 46 (92%) indicated that music was a significant part of their lives, 28 (56%) accessed a cherished memory, and 45 (90%) indicated that they would not change anything. CONCLUSIONS Therapeutic virtual music was well received and provided tangible benefits to patients. Additional research would provide information on patients' outcomes and differences between live and virtual live music.
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Affiliation(s)
- Alexandra L Bruder
- Alexandra L. Bruder is a medical student at the Ohio State University College of Medicine, Columbus, and was a lead research assistant, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee during the study
| | - Akash Gururaja
- Akash Gururaja is a research associate, Department of Anesthesiology, Vanderbilt University Medical Center
| | - Nikita Narayani
- Nikita Narayani is a research associate, Department of Anesthesiology, Vanderbilt University Medical Center
| | - Ruth Kleinpell
- Ruth Kleinpell is an associate dean for clinical scholarship and a professor, Vanderbilt University School of Nursing, Nashville
| | - Joseph J Schlesinger
- Joseph J. Schlesinger is a professor of anesthesiology and critical care medicine, Department of Anesthesiology, Vanderbilt University Medical Center
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Takmak Ş, Karaçar Y, Karaçar Hİ, Küçükakça Çelik G. The effect of nature-based music intervention on adaptation and anxiety levels in patients with COVID-19 placed in the prone position: A randomized controlled trial. Intensive Crit Care Nurs 2023; 79:103496. [PMID: 37542800 DOI: 10.1016/j.iccn.2023.103496] [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: 01/03/2023] [Revised: 07/02/2023] [Accepted: 07/16/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE To examine the effect of listening to nature-based music on anxiety, physiological parameters, and adjustment to the prone position in conscious and hypoxemic COVID-19 patients. DESIGN A single-blinded randomized control trial design. SETTING The study was conducted in the intensive care unit of a state hospital in Turkey. Sixty-four patients were randomized into an intervention group and a control group. METHODS A nature-based music intervention was applied in addition to routine care to the intervention group in the prone position, while the control group received routine care in the same position. The study outcomes included state-trait anxiety, physiological parameters, and prone time within 24 h. Measurements were performed in the supine position (Time: T0), in the 30th minute in the prone position (T1), and in the 30th minute of the supine position given following the prone position (T2). Data analysis included independent samples t-test in independent groups and repeated measures ANOVA in dependent groups. RESULTS State anxiety fell statistically significantly in the intervention group compared to that of the control group (39.1 ± 6.6 vs. 43.4 ± 7.9, p = 0.025). At T2, the heart rate of the intervention group did not increase, but it increased significantly in the control group compared to T0 and T1 values (87.8 ± 9.8 vs. 91.1 ± 10.8; p = 0.000). The oxygen saturation of the intervention group increased significantly compared to that of the control group (94.5 ± 2.3 vs. 93.4 ± 1.9, p = 0.035). The prone position time of the intervention group was significantly greater than that of the control group (11.5 ± 1.5 vs. 10.8 ± 1.1, p = 0.04). CONCLUSIONS It was found that nature-based music intervention applied to conscious and hypoxemic COVID-19 patients in the prone position improved anxiety and oxygen saturation and increased the prone position time. IMPLICATIONS FOR CLINICAL PRACTICE Listening to nature-based music in prone position may reduce anxiety in conscious patients with hypoxemic respiratory failure, it may increase adjustment to the prone position, and it may improve oxygenation and heart rate.
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Affiliation(s)
- Şenay Takmak
- Department of Nursing, Faculty of Health Science, Kütahya Health Science Universıty Kütahya, Turkey
| | - Yeliz Karaçar
- Department of Psychiatric Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey.
| | | | - Gülden Küçükakça Çelik
- Department of Nursing, Faculty of Semra and Vefa Küçük Health Science, Nevşehir Hacı Bektaş University Nevşehir, Turkey
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Kuyler A, Johnson E. Critically ill patients' experiences of nursing care and the effect on their personhood: A retrospective study. Nurs Open 2023; 10:6903-6911. [PMID: 37488769 PMCID: PMC10495702 DOI: 10.1002/nop2.1944] [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: 01/24/2023] [Revised: 06/08/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
AIM This study aims to report patients' experiences of nursing care in the critical care unit and the resulting effect of such care on the personhood of patients. DESIGN AND METHOD The study adopted a qualitative design and aimed to include both descriptive and exploratory information. It involved a single participant group comprising ten previously critically ill patients with whom retrospective, semi-structured interviews were conducted in a natural setting during 2018. Private hospitals in Gauteng, South Africa, were targeted for data collection. RESULTS The findings of this study were categorised and described according to Kitwood's conceptualisation of person-centred care. Five categories were identified by patients as impacting their personhood and perceived person-centred care. CONCLUSION Nurses ability to support perceived personhood of patients during person-centred care is integral to the betterment of the patient. Patient's experiences of nursing care can often be affected if they perceive their personhood as not being valued by nurses. This study creates increased awareness of these components to ensure that patient-nurse relationships are established adequately to meet both the patients' and the nurses' needs.
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Affiliation(s)
- Ariné Kuyler
- Centre of AACUniversity of PretoriaHatfieldSouth Africa
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Kakar E, Ottens T, Stads S, Wesselius S, Gommers DAMPJ, Jeekel J, van der Jagt M. Effect of a music intervention on anxiety in adult critically ill patients: a multicenter randomized clinical trial. J Intensive Care 2023; 11:36. [PMID: 37592358 PMCID: PMC10433648 DOI: 10.1186/s40560-023-00684-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/28/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Previous studies show positive effect of music on reducing anxiety, pain, and medication requirement. Anxiety has become a more pertinent issue in the intensive care unit (ICU) since wakefulness is preferred according to recent guidelines. Nevertheless, evidence on the effect of music in ICU patients is scarce. Therefore, we studied the effect of music intervention on anxiety in ICU patients. METHODS A multicenter randomized clinical trial was conducted between August 2020 and December 2021 in ICU's at an academic medical centre and two regional hospitals. Adult critically ill patients were eligible when hemodynamically stable and able to communicate (Richmond agitation-sedation scale (RASS) of at least - 2). Patients in the intervention arm were offered music twice daily during three days for at least 30 min per session. Patients in the control group received standard care. The primary outcome was anxiety level assessed with the visual analogue scale for anxiety [VAS-A; range 0-10] twice daily (morning and evening). Secondary outcomes included; 6-item state-trait anxiety inventory (STAI-6), sleep quality, delirium, heart rate, mean arterial pressure, pain, RASS, medication, ICU length of stay, patients' memory and experience of ICU stay. RESULTS 94 patients were included in the primary analysis. Music did not significantly reduce anxiety (VAS-A in the intervention group; 2.5 (IQR 1.0-4.5), 1.8 (0.0-3.6), and 2.5 (0.0-3.6) on day 1, 2, and 3 vs. 3.0 (0.6-4.0), 1.5 (0.0-4.0), and 2.0 (0.0-4.0) in the control group; p > 0.92). Overall median daily VAS-A scores ranged from 1.5 to 3.0. Fewer patients required opioids (21 vs. 29, p = 0.03) and sleep quality was lower in the music group on study day one [5.0 (4.0-6.0) vs. 4.5 (3.0-5.0), p = 0.03]. Other outcomes were similar between groups. CONCLUSIONS Anxiety levels in this ICU population were low, and music during 3 days did not decrease anxiety. This study indicates that efficacy of music is context and intervention-dependent, given previous evidence showing decreased anxiety. Trial registration Netherlands Trial Register: NL8595, Registered, 1 April 2020. CLINICALTRIALS gov ID: NCT04796389, Registered retrospectively, 12 March 2021.
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Affiliation(s)
- Ellaha Kakar
- Department of Intensive Care, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, Room NA-2123, 3015 GD, Rotterdam, The Netherlands.
- Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Thomas Ottens
- Department of Intensive Care, Haga Teaching Hospital, The Hague, The Netherlands
| | - Susanne Stads
- Department of Intensive Care, Ikazia Hospital, Rotterdam, The Netherlands
| | - Sanne Wesselius
- Department of Intensive Care, Haga Teaching Hospital, The Hague, The Netherlands
| | - Diederik A M P J Gommers
- Department of Intensive Care, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, Room NA-2123, 3015 GD, Rotterdam, The Netherlands
| | - Johannes Jeekel
- Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Mathieu van der Jagt
- Department of Intensive Care, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, Room NA-2123, 3015 GD, Rotterdam, The Netherlands
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Zou J, Chen Q, Wang J, Gu M, Jiang X, Mao M. Effects of virtual reality for psychological health of ICU patients: a study protocol for systematic review and meta-analysis. BMJ Open 2023; 13:e073660. [PMID: 37479513 PMCID: PMC10364162 DOI: 10.1136/bmjopen-2023-073660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION Virtual reality (VR) has been shown to have a certain influence on the psychological health of intensive care unit (ICU) patients. However, its specific effects-particularly on psychological health problems, such as psychological well-being, quality of life (QOL) and patient satisfaction-remain unclear. METHOD AND ANALYSIS This study follows the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guidelines. Electronic data search is carried out on PubMed, Web of Science, CINAHL, EBSCO, EMBASE, Cochrane Library, PsycINFO, China National Knowledge Infrastructure, Wan Fang, VIP and Chinese Biology Medicine Database. The inclusion criteria follow the PICO principle, wherein ICU patients who have been hospitalised for 24 hours or more are included. Studies using VR-based interventions to improve the psychological health of ICU patients, compared with waitlist controls or traditional therapy groups; outcome assessments containing psychological well-being, QOL and patient satisfaction; and those designed as randomised controlled trials (RCTs) and quasi-experimental research are included. Search time is from inception of each database to July 2023. No language restriction is considered. Studies for inclusion are screened by two independent reviewers for data extraction. Any dispute is resolved through discussion. Unresolved disputes are decided on by consulting a third author. For the risk of bias assessment in RCTs and non-RCTs, the Cochrane risk-of-bias tool for randomised trials and risk of bias in non-randomised studies of interventions tool are used, respectively. For meta-analysis, RevMan V.5.3 is used. ETHICS AND DISSEMINATION This protocol study does not include clinical research and thus does not require ethical approval. Research findings will be released in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023400428.
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Affiliation(s)
- Junjun Zou
- Department of Nursing, Changshu No 1 People's Hospital, Changshu, Jiangsu, China
| | - Qian Chen
- Department of Nursing, Changshu No 1 People's Hospital, Changshu, Jiangsu, China
| | - Jiajia Wang
- Department of Nursing, Changshu No 1 People's Hospital, Changshu, Jiangsu, China
| | - Mengqian Gu
- Department of Nursing, Changshu No 1 People's Hospital, Changshu, Jiangsu, China
| | - Xiaoquan Jiang
- Department of Nursing, Changshu No 1 People's Hospital, Changshu, Jiangsu, China
| | - Mingyue Mao
- Department of Nursing, Changshu No 1 People's Hospital, Changshu, Jiangsu, China
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Obaya HE, Abdeen HA, Salem AA, Shehata MA, Aldhahi MI, Muka T, Marques-Sule E, Taha MM, Gaber M, Atef H. Effect of aerobic exercise, slow deep breathing and mindfulness meditation on cortisol and glucose levels in women with type 2 diabetes mellitus: a randomized controlled trial. Front Physiol 2023; 14:1186546. [PMID: 37520826 PMCID: PMC10373883 DOI: 10.3389/fphys.2023.1186546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Background: Aerobic exercise combined with breathing exercise can be an integral part of diabetes mellitus treatment. This single-center, randomized, parallel-group study investigated the effect of the combination of aerobic exercise with slow deep breathing and mindfulness meditation on the glucose and cortisol levels of women with type 2 diabetes mellitus (T2DM). Materials and Methods: Fifty-eight middle-aged women with T2DM (mean age: 45.67 ± 2.92 years) were randomly assigned to either the aerobic training group (AT: n = 29; mean age [46.1 ± 2.7 years]) or the aerobic exercise combined with slow deep breathing and mindfulness meditation (AT + DMM: n = 29; mean age [45.24 ± 3.14 years]). Aerobic exercise was performed at 60%-75% of the maximum heart rate. The women in each group were asked to perform the training three times weekly over a 6-week period. The duration of each session was 40 min for the AT group and 60 min for the AT + DMM group. The two groups were asked to perform aerobic exercise at 60%-75% of the maximum heart rate. Their fasting blood glucose (FBG) and serum cortisol levels were measured at the baseline and after the 6 weeks. Results: Compared with the AT group, the group undertaking 6 weeks of aerobic training combined with slow, deep breathing exercises and mindfulness meditation showed significantly lower levels of FBG (p = 0.001) and cortisol levels (p = 0.01) than the AT group. Conclusion: The addition of slow deep breathing and mindfulness meditation to aerobic exercise can better control the glucose and cortisol levels of women with T2DM and thereby improve their outcomes and decrease their cardiometabolic risk.
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Affiliation(s)
- Hany Ezzat Obaya
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Heba Ahmed Abdeen
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Alae Ahmed Salem
- Outpatients’ Clinic of Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Mai Ali Shehata
- Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Epistudia, Bern, Switzerland
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispecialty Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Mona Mohamed Taha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Marwa Gaber
- Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Hady Atef
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- School of Allied Health Professions, Keele University, Staffordshire, United Kingdom
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Knauert MP, Ayas NT, Bosma KJ, Drouot X, Heavner MS, Owens RL, Watson PL, Wilcox ME, Anderson BJ, Cordoza ML, Devlin JW, Elliott R, Gehlbach BK, Girard TD, Kamdar BB, Korwin AS, Lusczek ER, Parthasarathy S, Spies C, Sunderram J, Telias I, Weinhouse GL, Zee PC. Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2023; 207:e49-e68. [PMID: 36999950 PMCID: PMC10111990 DOI: 10.1164/rccm.202301-0184st] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Background: Sleep and circadian disruption (SCD) is common and severe in the ICU. On the basis of rigorous evidence in non-ICU populations and emerging evidence in ICU populations, SCD is likely to have a profound negative impact on patient outcomes. Thus, it is urgent that we establish research priorities to advance understanding of ICU SCD. Methods: We convened a multidisciplinary group with relevant expertise to participate in an American Thoracic Society Workshop. Workshop objectives included identifying ICU SCD subtopics of interest, key knowledge gaps, and research priorities. Members attended remote sessions from March to November 2021. Recorded presentations were prepared and viewed by members before Workshop sessions. Workshop discussion focused on key gaps and related research priorities. The priorities listed herein were selected on the basis of rank as established by a series of anonymous surveys. Results: We identified the following research priorities: establish an ICU SCD definition, further develop rigorous and feasible ICU SCD measures, test associations between ICU SCD domains and outcomes, promote the inclusion of mechanistic and patient-centered outcomes within large clinical studies, leverage implementation science strategies to maximize intervention fidelity and sustainability, and collaborate among investigators to harmonize methods and promote multisite investigation. Conclusions: ICU SCD is a complex and compelling potential target for improving ICU outcomes. Given the influence on all other research priorities, further development of rigorous, feasible ICU SCD measurement is a key next step in advancing the field.
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Dallı ÖE, Yıldırım Y, Aykar FŞ, Kahveci F. The effect of music on delirium, pain, sedation and anxiety in patients receiving mechanical ventilation in the intensive care unit. Intensive Crit Care Nurs 2023; 75:103348. [PMID: 36470699 DOI: 10.1016/j.iccn.2022.103348] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES To examine the effects of music for patients under mechanical ventilation support in the intensive care unit on their delirium, pain, sedation, and anxiety. RESEARCH METHODOLOGY/DESIGN A single-blind, randomized, controlled trial. SETTING The study was conducted with delirium positive patients between August 2020 and September 2021 in the medical/surgical intensive care unit of a university hospital in Turkey. METHODS The study sample was selected through a simple and stratified randomization method; patients who met the inclusion criteria were assigned to the music, noise reduction or control group. The data were collected by using a Confusion Assessment Method for the ICU (CAM-ICU), CAM-ICU-7, Critical Care Pain Observation Tool (CPOT), Richmond Agitation-Sedation Scale (RASS), Facial Anxiety Scale (FAS), PRE-DELIRIC model, and Glasgow Coma Scale (GCS). The interventions were repeated twice a day for five days. RESULTS A total of 36 patients were included, with 12 patients in each group. Significant decreases were found in the severity of delirium and pain and the level of sedation and anxiety in the music compared to the other groups (p < 0.05). The number of patients with delirium and the number of days with mechanical ventilation was found to be significantly lower in the music group compared to the other groups (p < 0.05). CONCLUSION Music intervention may be used as a nursing intervention to control delirium, pain, need for sedation and anxiety in intensive care unit patients. However, additional studies with larger sample is needed to validate findings.
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Affiliation(s)
- Öznur Erbay Dallı
- Bursa Uludag University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Nilüfer, Bursa 16059, Turkey.
| | - Yasemin Yıldırım
- Ege University Faculty of Nursing, Department of Internal Medicine Nursing, Bornova, Izmir 35100, Turkey.
| | - Fisun Şenuzun Aykar
- Izmir Tınaztepe University, Faculty of Health Sciences, Department of Nursing Buca, Izmir 35100, Turkey.
| | - Ferda Kahveci
- Bursa Uludag University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, Nilüfer, Bursa 16059, Turkey.
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Wen X, Shi J, Tan W, Jiang H, Wang D, Su J, Yang G, Zhang B. Effects of aromatherapy and music therapy on patients' anxiety during MRI examinations: a randomized controlled trial. Eur Radiol 2023; 33:2510-2518. [PMID: 36335480 DOI: 10.1007/s00330-022-09230-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/01/2022] [Accepted: 10/09/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Many patients experience anxiety during MRI examinations. However, little attention has been focused on decreasing patient anxiety and minimizing on-site cancellations. Here, we aimed to investigate the effects of aromatherapy and music therapy on alleviating anxiety during MRI examinations. METHODS This single-center, double-blinded, randomized control trial was conducted between November 1, 2021, and January 10, 2022. Patients undergoing MRI examinations were assigned randomly into either the aromatherapy group (AG), music therapy group (MG), aromatherapy plus music therapy group (AMTG), or routine care group (RG) at a ratio of 1:1:1:1. Aromatherapy was conducted through inhalation of lavender oil. Music therapy was performed using Pachelbel's Canon in D major. The primary outcome was the change in anxiety before and after the MRI scan, assessed using both the State-Trait Anxiety Inventory form 1 (STAI-1) and Self-Rating Anxiety Scale (SAS). The second outcome was the participant's comfort, measured using Kolcaba's General Comfort Questionnaire (GCQ). RESULTS A total of 200 participants (mean age: 48.3 ± 14.9 years; 126 [63.0%] females) were enrolled, with 50 per group. The mean anxiety scores of the AMTG showed greater reduction compared with the AG, MG, and RG (ΔSTAI-1: 6.5 vs 2.6 vs 2.7 vs 1.9, p < 0.001; ΔSAS: 4.0 vs 1.4 vs 1.7 vs 0.6, p < 0.001). The mean GCQ score of the AMTG was higher compared with the AG, MG, and RG (98.0 vs 92.6 vs 91.2 vs 89.2, respectively, p < 0.001). CONCLUSION Aromatherapy combined with music therapy is effective for reducing patients' anxiety and improving their comfort level during MRI scans. KEY POINTS • In this randomized control trial of 200 participants undergoing MRI scans, aromatherapy plus music therapy is effective in reducing STAI-1 and SAS, as well as improving GCQ scores. • Although there was a significant difference between the aromatherapy plus music therapy and the single-intervention modalities, no significant differences were observed between the aromatherapy and music therapy themselves for state anxiety and comfort score. • Aromatherapy plus music therapy is a safe, non-invasive, nonpharmacological, and inexpensive patient-centered intervention for reducing anxiety and improving comfort in adults undergoing MRI examinations.
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Affiliation(s)
- Xueke Wen
- Department of Radiology, The First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou, China
| | - Jinghua Shi
- Department of Nursing, The First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou, China
| | - Wei Tan
- Department of Management, The First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou, China
| | - Hu Jiang
- Department of Nursing, The First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou, China
| | - Daiqiong Wang
- Department of Nursing, The First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou, China
| | - Jiaqiong Su
- Department of Nursing, The First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou, China
| | - Guanghui Yang
- Department of Nursing, The First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou, China
| | - Bin Zhang
- Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613 Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China.
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Eseadi C, Ngwu MO. Significance of music therapy in treating depression and anxiety disorders among people with cancer. World J Clin Oncol 2023; 14:69-80. [PMID: 36908676 PMCID: PMC9993142 DOI: 10.5306/wjco.v14.i2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/16/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023] Open
Abstract
Globally, cancer cases and mortality have recently escalated and have attracted global concern. The clinical diagnosis and manifestation of cancer can result in significant mental health issues like depression and anxiety disorders. The tendency of people with cancer to suffer from psychological disorders such as anxiety and depression is usually high. A significant number of deaths related to cancer may likely not be from the killer disease but from psychological disorders associated with the illness. The utilization of music as a remedial approach to healing mental disorders cannot be overstated. Thus, identifying the impacts of music therapy in dealing with depression and anxiety disorders among people with cancer is relevant, as the majority of methods used in treating cancer have some side effects which may trigger psychological disorders in cancer patients. Ultimately, this study explored the significance of music therapy in treating depression and anxiety disorders among people with cancer. To achieve the aim of this study, the authors employed a narrative literature review to investigate the significance of music therapy in addressing depression and anxiety disorders among people with cancer. The type of literature review employed in this study is to provide an understanding of the selected research papers. The review found that music therapy significantly reduces depression and anxiety disorders among breast cancer, lung cancer, prostate cancer, and colorectal cancer patients. It is needful for healthcare providers to incorporate music therapy interventions while treating people with cancer. This will help reduce cancer deaths resulting from psychological disorders rather than the killer disease, cancer. However, the standardized procedures and evaluation criteria for applying music-based intervention strategies in oncology medicine still need to be further established and improved.
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Affiliation(s)
- Chiedu Eseadi
- Department of Educational Psychology, University of Johannesburg, Gauteng 2006, South Africa
| | - Millicent O Ngwu
- Department of Sociology and Anthropology, University of Nigeria, Nsukka 41001, Enugu, Nigeria
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Rossetti A, Loewy J, Chang-Lit W, van Dokkum NH, Baumann E, Bouissou G, Mondanaro J, O’Connor T, Asch-Ortiz G, Mitaka H. Effects of Live Music on the Perception of Noise in the SICU/PICU: A Patient, Caregiver, and Medical Staff Environmental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3499. [PMID: 36834194 PMCID: PMC9958835 DOI: 10.3390/ijerph20043499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Intensive Care Units (ICUs) require a multidisciplinary team that consists of, but is not limited to, intensivists (clinicians who specialize in critical illness care), pharmacists and nurses, respiratory care therapists, and other medical consultants from a broad range of specialties. The complex and demanding critical care environment provides few opportunities for patients and personal and professional caregivers to evaluate how sound effects them. A growing body of literature attests to noise's adverse influence on patients' sleep, and high sound levels are a source of staff stress, as noise is an ubiquitous and noxious stimuli. Vulnerable patients have a low threshold tolerance to audio-induced stress. Despite these indications, peak sound levels often register as high, as can ventilators, and the documented noise levels in hospitals continue to rise. This baseline study, carried out in two hospitals' Surgical and Pediatric Intensive Care Units, measured the effects of live music on the perception of noise through surveying patients, personal caregivers and staff in randomized conditions of no music, and music as provided by music therapists through our hospital system's environmental music therapy program.
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Affiliation(s)
- Andrew Rossetti
- The Louis Armstrong Center for Music and Medicine, Mount Sinai Health System, Icahn School of Medicine, New York, NY 10003, USA
| | - Joanne Loewy
- The Louis Armstrong Center for Music and Medicine, Mount Sinai Health System, Icahn School of Medicine, New York, NY 10003, USA
| | | | | | - Erik Baumann
- International Association for Music and Medicine, Lima 15074, Peru
| | | | - John Mondanaro
- Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai Hospital, New York, NY 10019, USA
| | - Todd O’Connor
- The Mount Sinai Kravis Children’s Hospital, New York, NY 10029, USA
| | - Gabriela Asch-Ortiz
- Morgan Stanley Children’s Hospital, New York-Presbyterian, New York, NY 10032, USA
| | - Hayato Mitaka
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98195, USA
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Burkhart RJ, Hecht CJ, McNassor R, Mistovich RJ. Interventions to Reduce Pediatric Anxiety During Orthopaedic Cast Room Procedures: A Systematic and Critical Analysis Review. JBJS Rev 2023; 11:01874474-202302000-00006. [PMID: 36791237 DOI: 10.2106/jbjs.rvw.22.00181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Cast room procedures can be a source of considerable distress for pediatric patients. High levels of anxiety can make it difficult to perform procedures effectively and may negatively affect the doctor-patient relationship. We sought to evaluate available interventions to reduce anxiety in pediatric patients undergoing orthopaedic cast room procedures. METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines, we performed a systematic review to answer our study question (PROSPERO registration of the study protocol: CRD42022333001, May 28, 2022). PubMed, EBSCO host, MEDLINE, Cochrane, and Google Scholar electronic databases were used to identify all studies evaluating interventions to reduce pediatric anxiety during orthopaedic cast room procedures between January 1, 1975, and June 1, 2022. The quality of included studies was assessed using the Jadad scale. RESULTS Our initial search yielded 1,490 publications, which were then screened for appropriate studies that aligned with the purpose of our review. Fourteen studies comprising 8 prospective cohort and 6 randomized controlled trials were included. The total sample size of included studies consisted of 1,158 patients with participant age ranging from 1 to 21 years. The interventions investigated included noise reduction headphones, musical therapy, inclusion of a certified child life specialist, casting shears, virtual reality, Bedside Entertainment and Relaxation Theater (BERT), children's and instructional videos, and video games. Most of the included interventions were effective at reducing anxiety during cast room procedures. However, there was variation in anxiety reduction across cast room procedure and treatment modality. CONCLUSION The use of physical or technology-based distraction tools can play an important interventional role in improving patient satisfaction during cast room procedures. The majority were inexpensive, readily applicable to the clinical setting, and of negligible risk to the patient. LEVEL OF EVIDENCE Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Robert J Burkhart
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Christian J Hecht
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Ryan McNassor
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - R Justin Mistovich
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio.,MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
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31
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Tan MZY. Gymnopédie: music in the ICU. Intensive Care Med 2023; 49:267-268. [PMID: 36434100 DOI: 10.1007/s00134-022-06935-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Mark Z Y Tan
- ST6 Anaesthesia and Intensive Care Medicine, Northwest Deanery, Health Education England Northwest, Manchester, UK.
- NIHR Academic Clinical Fellow, Humanitarian and Conflict Response Institute, University of Manchester, Manchester, UK.
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Yang X, Cao L, Zhang T, Qu X, Chen W, Cheng W, Qi M, Wang N, Song W, Wang N. More is less: Effect of ICF-based early progressive mobilization on severe aneurysmal subarachnoid hemorrhage in the NICU. Front Neurol 2022; 13:951071. [PMID: 36588882 PMCID: PMC9794623 DOI: 10.3389/fneur.2022.951071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Aneurysmal subarachnoid hemorrhage (aSAH) is a type of stroke that occurs due to a ruptured intracranial aneurysm. Although advanced therapies have been applied to treat aSAH, patients still suffer from functional impairment leading to prolonged stays in the NICU. The effect of early progressive mobilization as an intervention implemented in the ICU setting for critically ill patients remains unclear. Methods This retrospective study evaluated ICF-based early progressive mobilization's validity, safety, and feasibility in severe aSAH patients. Sixty-eight patients with aSAH with Hunt-Hess grades III-IV were included. They were divided into two groups-progressive mobilization and passive movement. Patients in the progressive mobilization group received progressive ICF-based mobilization intervention, and those in the passive movement group received passive joint movement training. The incidence of pneumonia, duration of mechanical ventilation, length of NICU stay, and incidence of deep vein thrombosis were evaluated for validity. In contrast, the incidence of cerebral vasospasm, abnormally high ICP, and other safety events were assessed for safety. We also described the feasibility of the early mobilization initiation time and the rate of participation at each level for patients in the progressive mobilization group. Results The results showed that the incidence of pneumonia, duration of mechanical ventilation, and length of NICU stay were significantly lower among patients in the progressive mobilization group than in the passive movement group (P = 0.031, P = 0.004, P = 0.012), but the incidence of deep vein thrombosis did not significantly differ between the two groups. Regarding safety, patients in the progressive mobilization group had a lower incidence of cerebral vasospasm than those in the passive movement group. Considering the effect of an external ventricular drain on cerebral vasospasm (P = 0.015), we further analyzed those patients in the progressive mobilization group who had a lower incidence of cerebral vasospasm in patients who did not have an external ventricular drain (P = 0.011). Although we found 2 events of abnormally increased intracranial pressure in the progressive mobilization group, there was no abnormal decrease in cerebral perfusion pressure in the 2 events. In addition, among other safety events, there was no difference in the occurrence of adverse events between the two groups (P = 0.073), but the number of potential adverse events was higher in the progressive mobilization group (P = 0.001). Regarding feasibility, patients in the progressive mobilization group were commonly initiated 72 h after admission to the NICU, and 47.06% were in the third level of the mobilization protocol. Discussion We conclude that the ICF-based early progressive mobilization protocol is an effective and feasible intervention tool. For validity, more mobilization interventions might lead to less pneumonia, duration of mechanical ventilation and length of stay for patients with severe aSAH in the NICU, Moreover, it is necessary to pay attention over potential adverse events (especially line problems), although we did not find serious safety events.
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Affiliation(s)
- Xiaolong Yang
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lei Cao
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Tiantian Zhang
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xin Qu
- Intensive Care Unit, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wenjin Chen
- Intensive Care Unit, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Weitao Cheng
- Intensive Care Unit, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Meng Qi
- Intensive Care Unit, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Na Wang
- Intensive Care Unit, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Weiqun Song
- Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China,*Correspondence: Weiqun Song
| | - Ning Wang
- Intensive Care Unit, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China,Ning Wang
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Wu C, Hou G, Lin Y, Sa Z, Yan J, Zhang X, Liang Y, Yang K, Zhang Y, Lang H. Exploring links between Chinese military recruits' psychological stress and coping style from the person-environment fit perspective: The chain mediating effect of self-efficacy and social support. Front Psychol 2022; 13:996865. [PMID: 36405197 PMCID: PMC9673819 DOI: 10.3389/fpsyg.2022.996865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
The choice of coping style of recruits under psychological stress in the process of military task execution has been an important topic in the promotion of military operations and cohesion of military forces. Taking a positive coping style under psychological stress can help recruits overcome the negative effects of stress and improve military morale and group combat effectiveness. Although soldiers' psychological stress in the process of military mission execution having an impact on coping style has been studied by a large body of literature, very little literature has focused on the mechanism of self-efficacy and social support between recruits' psychological stress and coping style from the person-environment fit perspective. Therefore, this study was conducted to analyze the impact of recruits' psychological stress on coping style through a chain mediation model and to discuss the role of self-efficacy and social support in this relationship. Two waves of survey data were utilized to test the research hypotheses on a sample of 1028 Chinese recruits performing military tasks. The results indicated that recruits' psychological stress negatively impacted positive coping styles and positively correlated with negative ones. In addition, self-efficacy and social support mediated the relationship between psychological stress and positive coping style, and self-efficacy mediated the relationship between psychological stress and negative coping style. More importantly, self-efficacy and social support play the chain mediating effect between psychological stress and positive coping style.
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Affiliation(s)
- Chao Wu
- Department of Nursing, Fourth Military Medical University, Xi'an, China
| | - Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yawei Lin
- Department of Nursing, Fourth Military Medical University, Xi'an, China
| | - Zhen Sa
- 69245 Troops of the Chinese People's Liberation Army, Xinjiang, China
| | - Jiaran Yan
- Department of Nursing, Fourth Military Medical University, Xi'an, China
| | - Xinyan Zhang
- Department of Engineer, Army 75 Group Military Hospital, Kunming, China
| | - Ying Liang
- 69243 Troops of the Chinese People's Liberation Army, Xinjiang, China
| | - Kejian Yang
- The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
- *Correspondence: Kejian Yang
| | - Yuhai Zhang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, Xi'an, China
- Yuhai Zhang
| | - Hongjuan Lang
- Department of Nursing, Fourth Military Medical University, Xi'an, China
- Hongjuan Lang
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Monteiro JLGC, da Silva Barbirato D, Moraes SLD, Pellizzer EP, do Egito Vasconcelos BC. Does listening to music reduce anxiety and pain in third molar surgery?-a systematic review. Clin Oral Investig 2022; 26:6079-6086. [PMID: 35999384 DOI: 10.1007/s00784-022-04640-5] [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: 12/07/2021] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To perform a systematic review on the effects of listening to music in reducing preoperative anxiety and pain (intra or postoperative) in third molar extractions. MATERIAL AND METHODS A systematic review modeled according to the PRISMA guidelines was conducted. The MEDLINE/PubMed, Cochrane Library, Embase, and Scopus databases were searched for relevant reports. To be included in the study sample, the studies were required to be randomized controlled trials (RCT) on the effects of listening to music on outcomes of third molar extraction. Two reviewers independently extracted the relevant data from the reports. RESULTS A total of 1882 studies were retrieved after the duplicates were removed. After applying the inclusion criteria, five studies were included for qualitative analysis. In 4 studies, music was played before and during the extraction of the impacted third molars. In one study, music was played only before the procedure. The genres varied from classic piano music to rock, pop, jazz, folk, and even hymns. Overall, music listening was beneficial for patients in reducing preoperative anxiety or anxiety during the procedure compared to control. However, only one study demonstrated a statistically significant decrease in systolic blood pressure. CONCLUSIONS Music may be an effective non-pharmacological measure to reduce preoperative anxiety in patients scheduled for third molar extraction; however, the hemodynamic effects and the effects on pain (both perioperative and postoperative) should be further explored. CLINICAL RELEVANCE The side effects of certain medications may be avoided if listening to music is used in third molar extractions.
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Affiliation(s)
- João Luiz Gomes Carneiro Monteiro
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Rua Arnóbio Marquês, 310 - Santo Amaro, Recife, PA, 50100-130, Brazil
| | - Davi da Silva Barbirato
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Rua Arnóbio Marquês, 310 - Santo Amaro, Recife, PA, 50100-130, Brazil
| | | | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Belmiro Cavalcanti do Egito Vasconcelos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Rua Arnóbio Marquês, 310 - Santo Amaro, Recife, PA, 50100-130, Brazil.
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Chen L, Yin J, Zheng Y, Zhao C, Zhang H, Li J, Ji D, Zhang Y. The effectiveness of music listening for critically ill patients: A systematic review. Nurs Crit Care 2022. [DOI: 10.1111/nicc.12825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Lixia Chen
- Faculty of Nursing Xi'an Jiaotong University Health Science Center Xi'an China
| | - Juan Yin
- School of Nursing Dalian University Dalian China
| | - Yanan Zheng
- School of Nursing Dalian University Dalian China
| | | | - Han Zhang
- Nursing Department Affiliated Zhongshan Hospital of Dalian University Dalian China
| | - Jianhua Li
- Nursing Department Affiliated Zhongshan Hospital of Dalian University Dalian China
| | - Daihong Ji
- Nursing Department Affiliated Zhongshan Hospital of Dalian University Dalian China
| | - Yin‐Ping Zhang
- Faculty of Nursing Xi'an Jiaotong University Health Science Center Xi'an China
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The Effect of Inhalation Aromatherapy and Music Therapy on Anxiety in Patients Undergoing Shockwave Lithotripsy: A Randomized Controlled Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8015798. [PMID: 35815287 PMCID: PMC9259239 DOI: 10.1155/2022/8015798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/01/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
Abstract
Patients undergoing shock wave lithotripsy (SWL) have a high level of anxiety. This study was aimed to compare the effect of music therapy and aromatherapy on patients' anxiety levels during SWL. In this clinical trial, 176 patients undergoing SWL were randomly assigned to four groups: music therapy, aromatherapy, combined music therapy and aromatherapy, and control. The state-trait anxiety inventory (STAI) was used to collect data. In the aromatherapy group, three drops of rosemary essential oil were used during SWL. For the music therapy group, soft music was played during SWL. In the music therapy and aromatherapy group, soft music and three drops of rosemary essential oil were used simultaneously. In the control group, three drops of aromatic distilled water were used. The results showed that all patients had moderate anxiety before the intervention. The analysis of variance test did not show a statistically significant difference between the groups, but this difference was significant after the intervention. The levels of anxiety after the intervention were higher in the music therapy, aromatherapy, and combined music therapy and aromatherapy groups than in the control group. The results of the paired t-test showed the level of anxiety after the intervention was significantly increased in the intervention group (P < 001). In conclusion, the results indicated that music therapy, aromatherapy, and combined music therapy and aromatherapy had no effect on reducing patients' anxiety during SWL.
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Eickholt J, Baker FA, Clark IN. Positive Psychology in Therapeutic Songwriting for People Living with Late-Life Depression—An Intervention Protocol. Brain Sci 2022; 12:brainsci12050626. [PMID: 35625012 PMCID: PMC9139126 DOI: 10.3390/brainsci12050626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: An increasing number of people are living with late-life depression, yet non-pharmacological treatments to help manage symptoms are limited. Two interventions, positive psychology and music therapeutic songwriting, have independently led to decreased depressive symptoms and an improved wellbeing in older people over 65 years old. (2) Methods: This article describes the development of a therapeutic songwriting program for people living with late-life depression. Knowledge from positive psychology and therapeutic songwriting was combined to maximize the potential benefits. (3) Results: The intervention program has ten weekly 45 min sessions that incorporate elements from positive psychology into therapeutic songwriting. Using a three-song approach encompassing ongoing musical practices, different positive psychology interventions were incorporated to support the experiences associated with a flourishing life. The intervention protocol for older people presented here is distinct from previous deficit-orientated approaches in that it shifts the focus to positive experiences, resources, and the individual’s ability to decrease their own depressive symptoms and improve their wellbeing. (4) Discussion: This protocol presenting a therapeutic songwriting program meets the need to develop new non-pharmacological treatment options. However, further studies are needed to examine the feasibility and impact of the intervention program on late-life depression and wellbeing in older people.
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Affiliation(s)
- Jasmin Eickholt
- Creative Arts & Music Therapy Research Unit, Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC 3006, Australia; (F.A.B.); (I.N.C.)
- Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97070 Würzburg, Germany
- Correspondence:
| | - Felicity A. Baker
- Creative Arts & Music Therapy Research Unit, Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC 3006, Australia; (F.A.B.); (I.N.C.)
- Centre for Research in Music and Health, Norwegian Academy of Music, 0010 Oslo, Norway
| | - Imogen N. Clark
- Creative Arts & Music Therapy Research Unit, Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC 3006, Australia; (F.A.B.); (I.N.C.)
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Brain Melody Interaction: Understanding Effects of Music on Cerebral Hemodynamic Responses. MULTIMODAL TECHNOLOGIES AND INTERACTION 2022. [DOI: 10.3390/mti6050035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Music elicits strong emotional reactions in people, regardless of their gender, age or cultural background. Understanding the effects of music on brain activity can enhance existing music therapy techniques and lead to improvements in various medical and affective computing research. We explore the effects of three different music genres on people’s cerebral hemodynamic responses. Functional near-infrared spectroscopy (fNIRS) signals were collected from 27 participants while they listened to 12 different pieces of music. The signals were pre-processed to reflect oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) concentrations in the brain. K-nearest neighbor (KNN), random forest (RF) and a one-dimensional (1D) convolutional neural network (CNN) were used to classify the signals using music genre and subjective responses provided by the participants as labels. Results from this study show that the highest accuracy in distinguishing three music genres was achieved by deep learning models (73.4% accuracy in music genre classification and 80.5% accuracy when predicting participants’ subjective rating of emotional content of music). This study validates a strong motivation for using fNIRS signals to detect people’s emotional state while listening to music. It could also be beneficial in giving personalised music recommendations based on people’s brain activity to improve their emotional well-being.
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Cui N, Yan X, Zhang Y, Chen D, Zhang H, Zheng Q, Jin J. Non-Pharmacological Interventions for Minimizing Physical Restraints Use in Intensive Care Units: An Umbrella Review. Front Med (Lausanne) 2022; 9:806945. [PMID: 35573001 PMCID: PMC9091438 DOI: 10.3389/fmed.2022.806945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/29/2022] [Indexed: 01/08/2023] Open
Abstract
Background There is a relationship between the application of physical restraints and negative physiological and psychological effects on critically ill patients. Many organizations have supported and advocated minimizing the use of physical restraints. However, it is still common practice in many countries to apply physical restraints to patients in intensive care. Objective This study aimed to assess the effectiveness of various non-pharmacological interventions used to minimize physical restraints in intensive care units and provide a supplement to the evidence summary for physical restraints guideline adaptation. Methods Based on the methodology of umbrella review, electronic databases, including Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, MEDLINE, EMBASE, CINAHL, Web of Science, PsycInfo/Psyc Articles/Psychology and Behavioral Science Collection, China National Knowledge Infrastructure, SinoMed, and Wanfang Data, were searched to identify systematic reviews published from January 2016 to December 2020. Two independent reviewers undertook screening, data extraction, and quality appraisal. The methodological quality of systematic reviews was evaluated by AMSTAR 2. Evidence quality of each intervention was assessed according to GRADE. The corrected covered area was calculated as a measure of overlap. Results A total of 47 systematic reviews were included in the umbrella review, of which six were evaluated as high quality, five were of moderate quality, and the rest were of low or critically low quality. The corrected covered area range was from 0.0 to 0.269, which indicated that there was mild overlap between systematic reviews. The included systematic reviews evaluated various types of non-pharmacological interventions for minimizing physical restraints in intensive care units, which included multicomponent interventions involving healthcare professionals' education, family engagement/support, specific consultations and communication, rehabilitation and mobilization (rehabilitation techniques, early mobilization, inspiratory muscle training), interventions related to reducing the duration of mechanical ventilation (weaning modes or protocols, ventilator bundle or cough augmentation techniques, early tracheostomy, high-flow nasal cannula), and management of specific symptoms (delirium, agitation, pain, and sleep disturbances). Conclusion The number of systematic reviews related to physical restraints was limited. Multicomponent interventions involving healthcare professionals' education may be the most direct non-pharmacological intervention for minimizing physical restraints use in intensive care units. However, the quality of evidence was very low, and conclusions should be taken with caution. Policymakers should consider incorporating non-pharmacological interventions related to family engagement/support, specific consultations and communication, rehabilitation and mobilization, interventions related to reducing the duration of mechanical ventilation, and management of specific symptoms as part of the physical restraints minimization bundle. All the evidence contained in the umbrella review provides a supplement to the evidence summary for physical restraints guideline adaptation. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=242586, identifier: CRD42021242586.
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Affiliation(s)
- Nianqi Cui
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China
| | - Xiaoli Yan
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuping Zhang
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China
| | - Dandan Chen
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Zhang
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiong Zheng
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingfen Jin
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China
- Key Laboratory of the Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, China
- Changxing Branch Hospital of SAHZU, Huzhou, China
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Fang Y, Jing Q, Cao S, Sun X, Zhang H, Tian L, Li C. The Effect of Relaxation Therapy on Hypoxia During Intravenous Propofol Anesthesia in Patients With Pre-operative Anxiety: A Prospective Randomized Controlled Trial. Front Med (Lausanne) 2022; 9:797337. [PMID: 35372439 PMCID: PMC8965251 DOI: 10.3389/fmed.2022.797337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
Background This study aimed to investigate the effect of relaxation therapy on hypoxia during intravenous propofol anesthesia in patients with pre-operative anxiety. Methods Two-hundred and eighty patients were randomly categorized in the experimental group (relaxation therapy group) and control group. The Spielberger State-Trait Anxiety Inventory (S-STAI) was administered 30 to 60 min pre-operatively to assess the patient's current anxiety status and select appropriate patients. Patients in the experimental group received pre-surgical relaxation therapy. Decrease in oxygen saturation during the procedure was recorded for each patient group, and the relevant data were compared between the two groups. Results The basic S-STAI scores of the experimental and control groups were 56.88 ± 2.91 and 57.27 ± 3.56, respectively (p = 0.331). The difference was not statistically significant. The incidence of hypoxia in the experimental group during painless artificial abortion [routine blood oxygen saturation (SpO2) <95%, duration >15 s] decreased from 30 to 12.3%. Conclusion Relaxation therapy may effectively reduce the incidence of hypoxia during painless artificial abortion by using less dose of propofol. It may help patients relieve their anxiety and improve perioperative safety. Trial Registration Chinese Clinical Trial Registry (ChiCTR2000032109).
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Affiliation(s)
- Yiling Fang
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.,Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Department of General Practice, Zhangjiagang First People's Hospital, Affiliated to Soochow University School of Medicine, Suzhou, China
| | - Qi Jing
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.,Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Silu Cao
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.,Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoru Sun
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Hui Zhang
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Tian
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Cheng Li
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
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Pant U, Frishkopf M, Park T, Norris CM, Papathanassoglou E. A Neurobiological Framework for the Therapeutic Potential of Music and Sound Interventions for Post-Traumatic Stress Symptoms in Critical Illness Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053113. [PMID: 35270804 PMCID: PMC8910287 DOI: 10.3390/ijerph19053113] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022]
Abstract
Overview: Post traumatic stress disorder (PTSD) has emerged as a severely debilitating psychiatric disorder associated with critical illness. Little progress has been made in the treatment of post-intensive care unit (ICU) PTSD. Aim: To synthesize neurobiological evidence on the pathophysiology of PTSD and the brain areas involved, and to highlight the potential of music to treat post-ICU PTSD. Methods: Critical narrative review to elucidate an evidence-based neurobiological framework to inform the study of music interventions for PTSD post-ICU. Literature searches were performed in PubMed and CINAHL. The Scale for the Assessment of Narrative Review Articles (SANRA) guided reporting. Results: A dysfunctional HPA axis feedback loop, an increased amygdalic response, hippocampal atrophy, and a hypoactive prefrontal cortex contribute to PTSD symptoms. Playing or listening to music can stimulate neurogenesis and neuroplasticity, enhance brain recovery, and normalize stress response. Additionally, evidence supports effectiveness of music to improve coping and emotional regulation, decrease dissociation symptoms, reduce depression and anxiety levels, and overall reduce severity of PTSD symptoms. Conclusions: Despite the lack of music interventions for ICU survivors, music has the potential to help people suffering from PTSD by decreasing amygdala activity, improving hippocampal and prefrontal brain function, and balancing the HPA-axis.
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Affiliation(s)
- Usha Pant
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87th Ave, Edmonton, AB T6G 1C9, Canada; (U.P.); (T.P.); (C.M.N.)
| | - Michael Frishkopf
- Department of Music, Faculty of Arts, University of Alberta, 3-98 Fine Arts Building, Edmonton, AB T6G 2C9, Canada;
- Faculty of Medicine and Dentistry, University of Alberta, Walter C. MacKenzie Health Sciences Centre, Edmonton, AB T6G 2R7, Canada
- Canadian Centre for Ethnomusicology (CCE), University of Alberta, 11204-89 Ave NW, Edmonton, AB T6G 2J4, Canada
| | - Tanya Park
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87th Ave, Edmonton, AB T6G 1C9, Canada; (U.P.); (T.P.); (C.M.N.)
| | - Colleen M. Norris
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87th Ave, Edmonton, AB T6G 1C9, Canada; (U.P.); (T.P.); (C.M.N.)
- Faculty of Medicine and Dentistry, University of Alberta, Walter C. MacKenzie Health Sciences Centre, Edmonton, AB T6G 2R7, Canada
- School of Public Health, University of Alberta, ECHA 4-081, 11405-87 Ave NW, Edmonton, AB T6G 1C9, Canada
- Cardiovascular Health and Stroke Strategic Clinical Network, Alberta Health Services Corporate Office Seventh Street Plaza 14th Floor, North Tower 10030-107 Street NW, Edmonton, AB T5J 3E4, Canada
| | - Elizabeth Papathanassoglou
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), University of Alberta, 11405-87th Ave, Edmonton, AB T6G 1C9, Canada; (U.P.); (T.P.); (C.M.N.)
- Neurosciences Rehabilitation & Vision Strategic Clinical Network, Alberta Health Services Corporate Office Seventh Street Plaza 14th Floor, North Tower 10030-107 Street NW, Edmonton, AB T5J 3E4, Canada
- Correspondence:
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Hope During the COVID-19 Epidemic Decreased Anxiety and Depression Symptoms Mediated by Perceived Stress: Coping Style Differences Among Patients with COVID-19. Curr Med Sci 2022; 42:885-894. [PMID: 35896933 PMCID: PMC9328620 DOI: 10.1007/s11596-022-2624-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 01/21/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aimed to investigate whether perceived stress mediated the relationship between hope and anxiety/depression symptoms among patients with COVID-19 during the epidemic. In addition, the potential moderating effect of coping styles was examined. METHODS From February 26 to March 10, 2020, patients with COVID-19 were asked to complete a questionnaire online, which included demographic characteristics, as well as the SCL-90-Anxiety, SCL-90-Depression, Chinese Perceived Stress Scale (CPSS), Herth Hope Index (HHI), and Trait Coping Style Questionnaire (TCSQ). Hierarchical linear regression was performed to explore independent factors of anxiety/depression. A multi-group structural equation modeling with the collected data from patients in the Negative Coping style (NC) group and Positive Coping style (PC) group was used to test the hypothesized mechanism. RESULTS In total, 382 valid questionnaires of patients were obtained, including 96 from NC patients and 286 from PC patients. In the hierarchical linear regression, hope and perceived stress were independent risk factors for both anxiety and depression in the total sample and PC group. However, hope was not independently related to anxiety/depression in the NC group. As hypothesized, the hope of patients had significant and negative indirect effects on both anxiety and depression that were mediated by perceived stress, However, the direct effect from stress on anxiety and depression was stronger for NC patients than for PC patients. Besides, hope had significant direct effects on anxiety/depression in PC patients, but not in NC patients. CONCLUSION During the COVID-19 epidemic, perceived stress could mediate the relationship between hope and anxiety/depression symptoms among COVID-19 patients, with coping style moderating this cultivation process.
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Karnatovskaia LV, Varga K, Niven AS, Schulte PJ, Mujic M, Gajic O, Bauer BA, Clark MM, Benzo RP, Philbrick KL. A pilot study of trained ICU doulas providing early psychological support to critically ill patients. Crit Care 2021; 25:446. [PMID: 34930440 PMCID: PMC8691072 DOI: 10.1186/s13054-021-03856-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background Over a third of critical illness survivors suffer from mental health problems following hospitalization. Memories of delusional experiences are a major risk factor. In this project, ICU doulas delivered a unique positive suggestion intervention targeting the vulnerable time period during critical illness when these memories are formed. Methods Adult critically ill patients were recruited for this single-arm, prospective pilot study. These ICU patients received a positive suggestion intervention daily during their ICU stay in parallel with their medical treatment. The intervention was designed to be delivered over a minimum of two sessions. Feasibility was defined as intervention delivery on ≥ 70% of ICU days after patient enrollment. As a secondary analysis, psychometric questionnaires were compared to those of a historic control cohort of patients receiving standard care in the ICU using adjusted linear regression models. Results Of the 97 patients who received the intervention and were alive at the end of their ICU course, 54 were excluded from analyses mostly for having received only one session because of a short ICU length of stay of < 2 days, transitioning to comfort care or not wanting to answer the study questionnaires. Forty-three patients who completed 2 or more sessions of the positive therapeutic suggestion intervention provided by two trained ICU doulas received it for a median of 4 days (IQR 3, 5), with each session lasting for a median of 20 min (IQR 14, 25). The intervention was delivered on 71% of days, meeting our pre-determined feasibility goal. Compared to historical controls (N = 299), patients receiving the intervention had higher severity of illness and longer length of stay. When adjusted for baseline differences, patients both with and without mechanical ventilation who received the intervention scored lower on the Hospital Anxiety and Depression Scale (HADS)—Depression subscale. The intervention was also associated with reduced HADS-Anxiety subscale among ventilated patients. Conclusions Positive therapeutic suggestion delivered by ICU doulas is feasible in the ICU setting. A randomized trial is warranted to better delineate the role that positive suggestion and ICU doulas may play in ongoing interprofessional efforts to humanize critical care medicine. The study was registered on clinicaltrials.gov (NCT03736954) on 03/14/2018 prior to the first patient enrollment https://clinicaltrials.gov/ct2/show/NCT03736954?cond=ICU+Doulas+Providing+Psychological+Support&draw=2&rank=1. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-021-03856-3.
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Affiliation(s)
- Lioudmila V Karnatovskaia
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Katalin Varga
- Affective Psychology Department, Eötvös Loránd University, Budapest, Hungary
| | - Alexander S Niven
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Phillip J Schulte
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Midhat Mujic
- Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Ognjen Gajic
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Brent A Bauer
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Roberto P Benzo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kemuel L Philbrick
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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Palmer PK, Wehrmeyer K, Florian MP, Raison C, Idler E, Mascaro JS. The prevalence, grouping, and distribution of stressors and their association with anxiety among hospitalized patients. PLoS One 2021; 16:e0260921. [PMID: 34871325 PMCID: PMC8648119 DOI: 10.1371/journal.pone.0260921] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/22/2021] [Indexed: 11/18/2022] Open
Abstract
Anxiety is prevalent among hospital inpatients and it has harmful effects on patient well-being and clinical outcomes. We aimed to characterize the sources of hospital distress and their relationship to anxiety. We conducted a cross-sectional study of inpatients (n = 271) throughout two Southeastern U.S. metropolitan hospitals. Participants completed a survey to identify which of 38 stressors they were experiencing. They also completed the State Trait Anxiety Inventory six-item scale. We evaluated the prevalence of stressors, their distribution, and crude association with anxiety. We then used multivariate logistic regression to estimate the association between stressors and clinically relevant anxiety, with and without adjusting for demographic variables. We used factor analysis to describe the interrelationships among stressors and to examine whether groups of stressors tend to be endorsed together. The following stressors were highly endorsed across all unit types: pain, being unable to sleep, feelings of frustration, being overwhelmed, and fear of the unknown. Stressors relating to isolation/meaninglessness and fear/frustration tend to be endorsed together. Stressors were more frequently endorsed by younger, female, and uninsured or Medicaid-insured patients and being female and uninsured was associated with anxiety in bivariate analysis. After controlling for the sources of distress in multivariate linear analysis, gender and insurance status no longer predicted anxiety. Feelings of isolation, lack of meaning, frustration, fear, or a loss of control were predictive. Study results suggest that multiple stressors are prevalent among hospital inpatients and relatively consistent across hospital unit and disease type. Interventions for anxiety or emotional/spiritual burden may be best targeted to stressors that are frequently endorsed or associated with anxiety, especially among young and female patients.
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Affiliation(s)
- Patricia K. Palmer
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, Georgia, United States of America
- * E-mail:
| | - Kathryn Wehrmeyer
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Marianne P. Florian
- Graduate Division of Religion, Emory University, Atlanta, Georgia, United States of America
| | - Charles Raison
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, Georgia, United States of America
- School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Ellen Idler
- Department of Sociology and Rollins School of Public Health, Emory University; Atlanta, Georgia, United States of America
| | - Jennifer S. Mascaro
- Department of Spiritual Health, Emory University Woodruff Health Sciences Center, Atlanta, Georgia, United States of America
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
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Chen YF, Chang MY, Chow LH, Ma WF. Effectiveness of Music-Based Intervention in Improving Uncomfortable Symptoms in ICU Patients: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111500. [PMID: 34770015 PMCID: PMC8582781 DOI: 10.3390/ijerph182111500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/18/2021] [Accepted: 10/29/2021] [Indexed: 12/01/2022]
Abstract
Background: Intensive care unit (ICU) patients experience multiple uncomfortable symptoms, which may be alleviated using music-based intervention, a nondrug treatment. This umbrella review aims to combine the data of systematic reviews and/or meta-analyses to evaluate the effectiveness of music-based intervention in improving uncomfortable symptoms in ICU patients. Methods: A comprehensive literature search was performed on the PubMed, Embase, Cochrane Library, Airiti Library, CINAHL, ProQuest, and Web of Science databases, and Epistemonikos. The search had no language restrictions, and articles on the improvement of symptoms using music-based intervention in adult ICU patients were included. This review protocol was registered on PROSPERO (CRD42021240327). Results: This umbrella review retrieved 5 systematic reviews and 41 original studies, including 39 randomized controlled trials, and 2 nonrandomized controlled trials. Diverse music was the most common music type used for music-based intervention, the intervention music was typically decided by the study participants (61%), and most subjects underwent one intervention session (78%). Furthermore, most music intervention sessions lasted for 30 min (44%). The positive results included decreased anxiety, decreased pain, decreased agitation, decreased anesthesia dose and sedative use, decreased chances of delirium, decreased feelings of uncomfort, and improved sleep quality. Conclusions: A systematic review on the effectiveness of music-based intervention in improving uncomfortable symptoms in ICU patients revealed that 20–30 min intervention sessions showed the best improvement in the uncomfortable symptoms in patients. This study provides a basis for using music-based intervention to relieve the uncomfortable symptoms in critically ill ICU patients, and a reference for empirical clinical practice.
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Affiliation(s)
- Yu-Fen Chen
- Department of Public Health, China Medical University, Taichung 406040, Taiwan;
- Department of Nursing, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Mei-Yu Chang
- Department of Nursing, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Lok-Hi Chow
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 112201, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Research Division, Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Wei-Fen Ma
- Ph.D. Program for Health Science and Industry, China Medical University, Taichung 406404, Taiwan
- School of Nursing, China Medical University Hospital, Taichung 406040, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan
- Correspondence: ; Tel.: +886-4-2205-3366 (ext. 7107); Fax: +886-04-2299-0348
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Kakar E, Van Mol M, Jeekel J, Gommers D, van der Jagt M. Study protocol for a multicentre randomised controlled trial studying the effect of a music intervention on anxiety in adult critically ill patients (The RELACS trial). BMJ Open 2021; 11:e051473. [PMID: 34642197 PMCID: PMC8513337 DOI: 10.1136/bmjopen-2021-051473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Anxiety is common in critically ill patients and has likely become more prevalent in the recent decade due to the imperative of the recent Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients (PADIS) to use low levels of sedation and strive for wakefulness. However, management of anxiety has not been included in the PADIS guidelines, and there is lack of evidence to treat it in spite of its growing importance. Administration of sedative and analgesic medication is often chosen to reduce anxiety, especially when associated with agitation. Sedatives are associated with prolonged mechanical ventilation, delirium and muscle wasting and are therefore preferably minimised. Previous studies have suggested positive effects of music interventions on anxiety in the critically ill. Therefore, we aim to study the effect of music intervention on anxiety in adult critically ill patients. METHODS AND DESIGN A multicentre randomised controlled trial was designed to study the effect of a music intervention on the level of anxiety experienced by adult patients admitted to the intensive care unit (ICU). One hundred and four patients will be included in three centres in the Netherlands. Patient recruitment started on 24-08-2020 and is ongoing in three hospitals. The primary outcome is self-reported anxiety measured on the visual analogue scale. Secondary outcomes include anxiety measured using the six-item State-Trait Anxiety Inventory, sleep quality, agitation and sedation level, medication requirement, pain, delirium, complications, time spend on mechanical ventilation, physical parameters and ICU memory and experience. ETHICS AND DISSEMINATION The Medical Ethics Review Board of Erasmus MC University Medical Centre Rotterdam, The Netherlands, has approved this protocol. The study is being conducted in accordance with the Declaration of Helsinki. Results of this trial will be published in peer-reviewed scientific journals and conference presentations. TRIAL REGISTRATION NUMBER NCT04796389.
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Affiliation(s)
- Ellaha Kakar
- General surgery, Erasmus MC, Rotterdam, South-Holland, The Netherlands
- Intensive Care Adults, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
| | - Margo Van Mol
- Intensive Care Adults, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
| | | | - Diederik Gommers
- Intensive Care Adults, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
| | - Mathieu van der Jagt
- Intensive Care Adults, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
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Bae IL, Kim YS, Hur MH. The effects of listening to healing beat music on adults' recovery from exposure to stressful stimuli: A randomized controlled trial. Integr Med Res 2021; 11:100753. [PMID: 34504763 PMCID: PMC8411010 DOI: 10.1016/j.imr.2021.100753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background Musical auditory stimulation can affect the brain and autonomic nervous system, resulting in psychological and physical relaxation. In particular, listening to healing beat music with a tempo synchronized with an individual's heart rate can make a person feel comfortable. This study investigated whether healing beat music, utilized as a heartbeat-matched auditory stimulus, could be employed to improve patient recovery after exposure to stressful stimuli. Methods This study was a randomized controlled trial and participants were adults above age of 20 who voluntarily participated. As outcome variables, stress index, BIS index, sympathetic nerve activity, and blood pressure were measured and compared at 5 min intervals. Results Following the treatment, the stress index (F = 3.78, p < .001), BIS index (F = 5.61, p < .001), and systolic blood pressure (F = 3.14, p =.019) of the a healing beat music listening group (HBMG) were significantly lower than those of the control group (CG). More specifically, the stress index (P <.05) and the BIS index (P <.05) of the HBMG were lower than the indices of the preferred music listening group (PMG) and the CG at 30 min. Conclusions Listening to healing beat music with a tempo synchronized with the heart rates of the participants had the effect of lowering stress index and systolic pressure. Accordingly, healing beat music may be utilized as a treatment method to relieve stress in both clinical and daily life contexts.
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Affiliation(s)
- Ik-Lyul Bae
- College of Nursing, International University of Korea, Jinju, South Korea
| | - Yeon-Suk Kim
- Department of Nursing, Woosong College, Daejeon, South Korea
| | - Myung-Haeng Hur
- College of Nursing, Eulji University, Uijeongbu, South Korea
- Corresponding author at: College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si, Gyenggi-do 11759, South Korea.
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Pasieka JL. Shinrin-yoku, yoga and other strategies in the fight against COVID-19. Surgery 2021; 171:94-95. [PMID: 34548159 PMCID: PMC8405594 DOI: 10.1016/j.surg.2021.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 11/01/2022]
Affiliation(s)
- Janice L Pasieka
- Clinical Professor of Surgery and Oncology, Section General Surgery, Division Endocrine Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Hajdarevic S, Fallbjörk U, Fransson P, Åström S. Need of support perceived by patients primarily curatively treated for breast, colorectal, or prostate cancer and close to discharge from hospital-A qualitative study. J Clin Nurs 2021; 31:1216-1227. [PMID: 34288184 DOI: 10.1111/jocn.15977] [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: 02/25/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022]
Abstract
AIM To describe perceived needs of support among patients close to discharge from the hospital and at the end of primary curative radiotherapy for breast, colorectal or prostate cancer. BACKGROUND Few studies have specifically explored patients' early support needs when ending primary curative treatment. DESIGN Qualitative interview study design. METHODS A purposive sample of 27 participants with breast, colorectal or prostate cancer aged 33-88 years. The interviews were analysed by qualitative content analysis. Reporting followed the COREQ guidelines. RESULTS Personal support to reach a sense of control and Social support for personal growth were two main themes, highlighting that people required adapted support from health care since needs of support could change over time. This support from health care was also relying on that trust-based relationships were developed. Through mutuality with others and engagement in meaningful activities people became enabled and felt further supported. Personal support from health care seems specifically important for the patients' feelings of control and could be a facilitator for patients to identify further support for personal growth in how to manage, on the one hand, illness and insecurity, and on the other, their well-being and everyday life with cancer. CONCLUSION To empower patients who are ending primary treatment and being close to discharge from hospital, healthcare professionals should recognise patients' shifting needs and adapt the support. Adapted support is significant for patients' sense of safety. Biomedical information is not sufficient to fully support patients. RELEVANCE TO CLINICAL PRACTICE Offering easy access to supportive care when primary treatment is finished could diminish people's stress, insecurity and avoidable use of healthcare services. Even after discharge, nurses preferably should adapt and offer support tailored to patients' needs. Such support may improve patients' sense of control and safety, trust in health care, feelings of community and encourage personal growth.
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Affiliation(s)
| | | | - Per Fransson
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Sture Åström
- Department of Nursing, Umeå University, Umeå, Sweden
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Carling C, Leprince C, Pavillon T, Guétin S, Thivilier F. Feasibility and Effectiveness of a Novel Smartphone Music Application on Anxiety and Sleep in Elite Soccer Coaches. JOURNAL OF SPORTS SCIENCE AND MEDICINE 2021; 20:546-547. [PMID: 34267595 DOI: 10.52082/jssm.2021.546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/15/2021] [Indexed: 11/24/2022]
Abstract
A considerable body of research has examined stress and wellbeing in athletes (e.g., Arnold et al., 2017). In contrast, similar experiences in sports coaches have received considerably less attention although these are widely exposed to numerous stressors which can potentially influence their well-being and performance. In 2017, a meta-analysis (Norris et al., 2017) highlighted various stressors influencing the performance of coaches. These include external scrutiny from the public and media, the need to constantly maintain high standards during training and competition and organizational stressors relating to administration, finances, overload, and environment. Regarding the elite football setting specifically, coaches must regularly deal with stressors such as job insecurity (Bentzen et al., 2020) and cope with the stress and adversity associated to a highly pressurized workplace environment (Knights and Ruddock-Hudson, 2016). These stressors can cause anxiety, in addition to sleep disturbance, thus there is a clear need to help coaches find ways to deal with such difficulties. In clinical health settings, music-based therapeutic interventions are systematically shown to help improve sleep quality (Chen et al., 2021) and anxiety levels (Umbrello et al., 2019). In sports settings, listening to music demonstrated a positive effect in reducing pre-competition anxiety levels in a cohort of elite shooters (John, Verma, Khanna, 2012) and amateur athletes (Elliott et al., 2014) respectively. Yet to our knowledge no study has investigated the potential benefits of music in sports coaches. In this preliminary study, we investigated 1) the feasibility of implementing a novel smartphone music application in a cohort of elite soccer coaches, and 2) its effectiveness in helping them fall asleep and reducing anxiety levels.
A total of 10 elite French soccer coaches (age 28.4 ± 3.9 years, working in clubs belonging to the 4 highest standards of football in France: Ligue 1: n=1, Ligue 2: n=3, Division 3: n=1 and Division 4: n=5) were invited to participate in the present study which was also proposed as part of their personal development plan during a year-long elite coach development course. Prior to their inclusion, participants were informed about the implementation of the study by means of an information document and oral presentation by the research team and were asked to sign an informed consent form to participate. The participants were asked to download the music application (Music Care©, Paris, France) on their personal smartphone/tablet and provided with a headphone set. This music application is typically used in health care settings (see www.music-care.com/en/clinical-evidence.html for list of related research works) and offers personalized music listening according to the patient’s therapeutic need (pain, anxiety, sleep) and musical preferences (e.g., classic, jazz, traditional…). The music sequences (each 20min duration) aim to progressively bring the user into a state of relaxation, and naturally treat pain, anxiety, and sleep disorders. Each participant was instructed to use the application at home in the morning on waking up (choice of anxiety or awakening session) and in the evening prior to falling asleep (sleep session) over a 1-month period. They were asked to record the date, time and duration of each session in a personal diary. Following the sleep session, participants were also requested to respond to the question: did the session help you to fall asleep: yes, no or I don’t know? Finally, immediately before and at the end of each anxiety/awakening session, participants used a Likert scale to rate their current anxiety level (0=no anxiety to 10=maximal anxiety). Data are presented as means, standard deviations and range values unless stated. Owing to the non-normality of the dataset collected for the pre-post session anxiety score ratings, Wilcoxon’s signed-rank non-parametric test was used to compare mean data (significance level, p<0.05). Cohen’s Effect Sizes were also calculated and classified as trivial (<0.2), small (>0.2–0.6), moderate (>0.6–1.2), large (>1.2–2.0) and very large (>2.0–4.0). The BiostaTGV (INSERM, France) package was used for all statistical calculations.
Results showed that out of the 10 participants, two did not choose to download the application while among the remaining 8, 2 did not record any information on their music sessions. Regarding the 6 remaining participants, half completed at least one session per day over the 30-day period while an average of 25 sessions were completed per participant (range: 18 to 29). In total, 150 sessions were completed by the participants of which 64% (n=96) were used to aid sleep, 19% (n=28) anxiety and 17% (n=26) wake-up respectively. Each music session was completed in its entirety (20mins duration) on 99.3% occasions. Of the 96 sleep-related sessions completed, 62.5% (n=60) were considered by the participants to have aided them in falling asleep (Figure 1). The comparison of anxiety levels demonstrated a significant reduction in mean values for the pre- versus post-session scores: 6.0±1.0 vs. 4.3±1.5, -28%, p < 0.0001, effect size=1.2 (large).
To the best of our knowledge, this investigation is the first to report the feasibility of implementing a novel therapeutic music smartphone application in a group of elite soccer coaches and determine its effects on their current anxiety levels and helping them fall asleep. Altogether, 40% of coaches (4 out of 10) chose not to use the application which is greater than the 20% drop-out rates frequently reported in randomised controlled studies. However, half of the 6 remaining participants completed at least one music session per day over the 30-day period while an average of 25 sessions (with nearly all listened to in their entirety) were completed per participant demonstrating in our opinion a satisfactory level of feasibility. The coaches most often chose sleep sessions (64% of the total) of which nearly two thirds were considered to have helped them to fall asleep. Anxiety sessions were less frequently utilised but nevertheless helped to significantly reduce the coaches’ current anxiety levels (-28% reduction). These positive results follow those observed in clinical health settings (Chen et al., 2021; Umbrello et al., 2019) and athletes (Elliot et al., 2014, John et al., 2012). As such, we suggest that music can be used by elite soccer coaches as a tool to aid anxiety and falling asleep. Further research is nevertheless required to determine why not all the coaches used the application or tended to use it for sleep rather than anxiety purposes. Similarly, a stronger experimental approach employing a longitudinal randomized controlled study design, a larger sample size to increase statistical power in addition to inclusion of qualitative (e.g., questionnaires) and quantitative (e.g., physiological responses) metrics is necessary. We estimate that to achieve a statistical power level of 90%, a sample size of 62 participants (accounting for a 20% drop out rate) would be necessary for a future randomized controlled study.
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Affiliation(s)
| | | | | | - Stéphane Guétin
- Clinical Psychology and Psychopathology Laboratory (EA4056) University Paris 5 - René Descartes - France
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