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竖琴音乐对血管和胸外科手术患者的影响。

The effects of harp music in vascular and thoracic surgical patients.

作者信息

Aragon Daleen, Farris Carla, Byers Jacqueline F

机构信息

Department of Vascular and Thoracic Surgery and Critical Care, Orlando Regional Healthcare System, University of Central Florida-Orlando, USA.

出版信息

Altern Ther Health Med. 2002 Sep-Oct;8(5):52-4, 56-60.

Abstract

CONTEXT

Music has been used in the acute clinical care setting as an adjunct to current treatment modalities. Previous studies have indicated that some types of music may benefit patients by reducing pain and anxiety, and may have an effect on physiological measures.

OBJECTIVE

To evaluate the scientific foundation for the implementation of a complementary therapy, harp playing. The research questions for this pilot study were: Does live harp playing have an effect on patient perception of anxiety, pain, and satisfaction? Does live harp playing produce statistically and clinically significant differences in physiological measures of heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation?

DESIGN

A prospective, quasiexperimental, repeated measures design was used with a convenience sampling.

SETTING

Orlando Regional Medical Center, Orlando Fla.

PATIENTS

Subjects wer eligible for the study if they were postoperative and admitted to a hard-wired-bedside-monitored room of the Vascular Thoracic Unit within the 3 days of the study period.

INTERVENTION

A singl e20-minute live harp playing session.

MAIN OUTCOME MEASURES

Visual analog scales (VAS) were used to measure patient anxiety and pain. Patient satisfaction was measured with a 4-item questionnaire. Physiological measures (heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation) were recorded from the bedside monitor.

METHODS

Visual analog scales (VAS) were completed just before harp playing, 20 minutes after harp playing was started, and 10 minutes after completion. Patient satisfaction with the experience was measured with a 4-item questionnaire. Physiological measures (heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation) were recorded from the bedside monitor at baseline (5 minutes before study setup), at zero, 5, 10, 15, and 20 minutes after harp playing began, and at 5 and 10 minutes after harp playing stopped.

RESULTS

Seventeen patients were used in this study, with a retrospective power of .91. Results indicate that listening to live harp music has a positive effect on patient perception of anxiety (P=.000), pain (P=.000) and satisfaction. Live harp playing also produced statistically significant differences in physiological measures of systolic blood pressure (P=.046), and oxygen saturation (P=.011). Although all values over time trended downward, the changes of other variables were not adequate to achieve statistical or clinical significance.

CONCLUSION

Subjects in this study experienced decreased pain and anxiety with the harp intervention, and slight reductions in physiologic variable values. It is not possible in this study to determine if the results were due to the harp music, the presence of the harpist and data collector, or both. Future research is recommended using a control group and comparison of live versus recorded harp music with a wider variety of diagnoses and procedures.

摘要

背景

音乐已被用于急性临床护理环境中,作为当前治疗方式的辅助手段。先前的研究表明,某些类型的音乐可能通过减轻疼痛和焦虑使患者受益,并且可能对生理指标产生影响。

目的

评估实施一种补充疗法——竖琴演奏的科学依据。这项初步研究的研究问题是:现场竖琴演奏对患者的焦虑、疼痛感知及满意度有影响吗?现场竖琴演奏在心率、收缩压和舒张压、呼吸频率及血氧饱和度的生理指标上会产生统计学和临床显著差异吗?

设计

采用前瞻性、准实验性、重复测量设计,并进行便利抽样。

地点

佛罗里达州奥兰多市的奥兰多地区医疗中心。

患者

研究期间3天内术后入住血管胸科单元有床边硬连线监测设备房间的患者符合研究条件。

干预

进行一次20分钟的现场竖琴演奏。

主要结局指标

采用视觉模拟量表(VAS)测量患者焦虑和疼痛程度。用一份4项问卷测量患者满意度。从床边监测仪记录生理指标(心率、收缩压和舒张压、呼吸频率及血氧饱和度)。

方法

在竖琴演奏前、演奏开始20分钟后及结束10分钟后完成视觉模拟量表(VAS)。用一份4项问卷测量患者对该体验的满意度。在基线(研究准备前5分钟)、竖琴演奏开始后0、5、10、15和20分钟以及竖琴演奏停止后5和10分钟从床边监测仪记录生理指标(心率、收缩压和舒张压、呼吸频率及血氧饱和度)。

结果

本研究纳入17名患者,回顾性检验效能为0.91。结果表明,聆听现场竖琴音乐对患者的焦虑(P = 0.000)、疼痛(P = 0.000)感知及满意度有积极影响。现场竖琴演奏在收缩压(P = 0.046)和血氧饱和度(P = 0.011)的生理指标上也产生了统计学显著差异。尽管所有指标随时间推移呈下降趋势,但其他变量的变化不足以达到统计学或临床显著性。

结论

本研究中的受试者通过竖琴干预疼痛和焦虑减轻,生理变量值略有降低。本研究无法确定结果是由于竖琴音乐、竖琴演奏者和数据收集者的在场,还是两者共同作用。建议未来研究使用对照组,并比较现场与录制的竖琴音乐,纳入更多样化的诊断和程序。

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