Iriarte Roteta Andrea
Escuela Universitaria de Enfermeria, Universidad de Navarra. Navarra. Spain.
Enferm Intensiva. 2003 Apr-Jun;14(2):43-8. doi: 10.1016/s1130-2399(03)78103-6.
The aim of this review is to find out whether or not music therapy is an effective nursing intervention to decrease anxiety and promote relaxation in ventilator-dependent patients. For the purpose of this review, relaxation has been considered as a reduction in state anxiety and physiologic signs (heart rate, blood pressure or respiratory rate). A comprehensive search has been conducted in electronic databases (Cochrane Library, Medline, CINHAL, Embase and PsycLit) in order to identify systematic reviews on music therapy effectiveness or randomised control trials that compare the effectiveness of music therapy versus no music or other relaxation techniques in patients receiving ventilatory assistance. Three studies, two randomised control trials and a systematic review accomplished the inclusion criteria of this review. All studies found a significant difference between groups on the mean post-test state anxiety, concluding that there was a greater reduction in state anxiety in the experimental condition due to the intervention. Findings in terms of physiologic measures have been contradictory from study to study, reaching different conclusions. None of the three studies have accomplished the quality criteria established for this review. Some methodological limitations make their results be not fully reliable and therefore, it has not been possible to reach a satisfactory answer. Further and more rigorous research is needed on this area, as there is not enough valid research to conclude that music therapy is an effective nursing intervention for decreasing patients' anxiety. As it causes no harm and is a relatively inexpensive intervention, it would be worth exploring its effects on different kind of outcomes and settings.
本综述的目的是探究音乐疗法是否为一种有效的护理干预措施,以减轻依赖呼吸机患者的焦虑并促进其放松。就本综述而言,放松被视为状态焦虑和生理体征(心率、血压或呼吸频率)的降低。为了确定关于音乐疗法有效性的系统评价,或比较音乐疗法与无音乐或其他放松技巧在接受通气辅助患者中的有效性的随机对照试验,我们在电子数据库(考克兰图书馆、医学索引数据库、护理学与健康领域数据库、荷兰医学文摘数据库和心理学文摘数据库)中进行了全面检索。三项研究,两项随机对照试验和一项系统评价符合本综述的纳入标准。所有研究均发现,两组在测试后平均状态焦虑方面存在显著差异,得出结论:由于干预,实验组的状态焦虑降低幅度更大。在生理指标方面,各研究结果相互矛盾,得出了不同结论。这三项研究均未达到为本综述设定的质量标准。一些方法学上的局限性使得其结果不完全可靠,因此,无法得出令人满意的答案。由于没有足够有效的研究来得出音乐疗法是减轻患者焦虑的有效护理干预措施这一结论,因此需要在该领域进行进一步更严格的研究。由于其无害且是一种相对廉价的干预措施,探索其对不同类型结果和环境的影响将是值得的。