Taylor-Piliae Ruth E, Chair Sek-Ying
Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way, Box 0610, San Francisco, CA 94143-0610, USA.
Eur J Cardiovasc Nurs. 2002 Oct;1(3):203-11. doi: 10.1016/S1474-5151(02)00037-3.
Unrelieved anxiety can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. Nursing interventions using music therapy or sensory information among patients with coronary artery disease has resulted in anxiety reduction, though results in Chinese subjects has not previously been published.
To determine the effects of using nursing interventions of music therapy or sensory information, on reducing anxiety and uncertainty, and improving negative mood among Chinese subjects immediately prior to cardiac catheterization.
An experimental three-group repeated measures design for this pilot study was used. Forty-five hospitalized adults (15/group) undergoing cardiac catheterization were randomly assigned to either (1) a music therapy intervention, (2) a sensory information intervention or (3) treatment as usual (control). Anxiety, uncertainty and mood state were measured using self-reported questionnaires and physiological measures were made at baseline, post-intervention to determine their effect and post-cardiac catheterization to determine whether these interventions had any long-lasting effect.
The control group was found to be significantly older (P=0.001) than the two experimental groups. Older age was associated with lower anxiety scores (r=-0.31, P=0.04 at baseline; r=-0.30, P=0.04 post-intervention; r=-0.22, P=0.15 post-cardiac catheterization). After controlling for age, the use of music therapy or sensory information did not significantly reduce anxiety, improve mood state, reduce uncertainty, decrease heart or respiratory rate among subjects undergoing cardiac catheterization.
The non-significant result may have been affected by the small sample, and the social and cultural expectations regarding the public display of emotions among Chinese populations.
焦虑得不到缓解会导致交感神经系统活动增加,进而使心脏负荷加重。针对冠心病患者采用音乐疗法或感官信息的护理干预已使焦虑减轻,不过此前尚未发表过针对中国受试者的研究结果。
确定在心脏导管插入术前即刻,采用音乐疗法或感官信息的护理干预对减轻中国受试者的焦虑和不确定性以及改善其负面情绪的效果。
本试点研究采用实验性三组重复测量设计。45名接受心脏导管插入术的住院成年人(每组15人)被随机分为:(1)音乐疗法干预组;(2)感官信息干预组;(3)常规治疗组(对照组)。使用自我报告问卷测量焦虑、不确定性和情绪状态,并在基线、干预后测量生理指标以确定其效果,在心脏导管插入术后测量以确定这些干预是否有任何长期影响。
发现对照组比两个实验组年龄显著更大(P = 0.001)。年龄较大与较低的焦虑评分相关(基线时r = -0.31,P = 0.04;干预后r = -0.30,P = 0.04;心脏导管插入术后r = -0.22,P = 0.15)。在控制年龄因素后,对于接受心脏导管插入术的受试者,使用音乐疗法或感官信息并未显著减轻焦虑、改善情绪状态、降低不确定性、降低心率或呼吸频率。
结果不显著可能受到样本量小以及中国人群在公众场合表达情绪的社会文化期望的影响。