Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran.
Int J Nurs Stud. 2013 Jul;50(7):895-904. doi: 10.1016/j.ijnurstu.2012.11.018. Epub 2012 Dec 14.
Few studies have been conducted to investigate the effect of nature-based sounds (N-BS) on agitation, anxiety level and physiological signs of stress in patients under mechanical ventilator support. Non-pharmacological nursing interventions such as N-BS can be less expensive and efficient ways to alleviate anxiety and adverse effects of sedative medications in patients under mechanical ventilator support.
This study was conducted to identify the effect of the nature-based sounds' intervention on agitation, anxiety level and physiological stress responses in patients under mechanical ventilation support.
A randomized placebo-controlled trial design was used to conduct this study. A total of 60 patients aged 18-65 years under mechanical ventilation support in an intensive care unit were randomly assigned to the control and experimental groups. The patients in the intervention group received 90 min of N-BS. Pleasant nature sounds were played to the patients using media players and headphones. Patients' physiological signs were taken immediately before the intervention and at the 30th, 60th, 90th minutes and 30 min after the procedure had finished. The physiological signs of stress assessed were heart rate, respiratory rate, and blood pressure. Data were collected over eight months from Oct 2011 to June 2012. Anxiety levels and agitation were assessed using the Faces Anxiety Scale and Richmond Agitation Sedation Scale, respectively.
The experimental group had significantly lower systolic blood pressure, diastolic blood pressure, anxiety and agitation levels than the control group. These reductions increased progressively in the 30th, 60th, 90th minutes, and 30 min after the procedure had finished indicating a cumulative dose effect.
N-BS can provide an effective method of decreasing potentially harmful physiological responses arising from anxiety in mechanically ventilated patients. Nurses can incorporate N-BS intervention as a non-pharmacologic intervention into the daily care of patients under mechanical ventilation support in order to reduce their stress and anxiety.
很少有研究调查自然声音（N-BS）对接受机械通气支持的患者的躁动、焦虑水平和应激生理指标的影响。 与药物干预相比，自然声音等非药物护理干预措施可能是一种更经济有效的减轻接受机械通气支持的患者焦虑和镇静药物不良反应的方法。
本研究旨在确定自然声音干预对接受机械通气支持的患者的躁动、焦虑水平和应激生理反应的影响。
采用随机安慰剂对照试验设计进行了本研究。 共有 60 名年龄在 18-65 岁之间的接受机械通气支持的重症监护病房患者被随机分配到对照组和实验组。 干预组患者接受 90 分钟的自然声音干预。 通过媒体播放器和耳机向患者播放宜人的自然声音。 在干预前、30 分钟、60 分钟、90 分钟和干预结束后 30 分钟时采集患者的生理指标。 评估的应激生理指标包括心率、呼吸率和血压。 数据收集时间为 2011 年 10 月至 2012 年 6 月，共 8 个月。 使用面部焦虑量表和里士满躁动镇静量表评估焦虑水平和躁动程度。
实验组的收缩压、舒张压、焦虑和躁动水平明显低于对照组。 这些降低在 30 分钟、60 分钟、90 分钟和干预结束后 30 分钟时逐渐增加，表明存在累积剂量效应。
自然声音可以提供一种有效方法来减轻接受机械通气的患者因焦虑引起的潜在有害生理反应。 护士可以将自然声音干预作为非药物干预措施纳入机械通气支持患者的日常护理中，以减轻他们的压力和焦虑。
