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基于音乐的程序支持干预措施的系统评价。

A systematic review of music-based interventions for procedural support.

作者信息

Yinger Olivia Swedberg, Gooding Lori F

机构信息

University of Kentucky

University of Kentucky.

出版信息

J Music Ther. 2015 Spring;52(1):1-77. doi: 10.1093/jmt/thv004. Epub 2015 Apr 15.

Abstract

BACKGROUND

Individuals undergoing medical procedures frequently experience pain and anxiety. Music-based interventions have the potential to help alleviate these symptoms.

OBJECTIVE

This review investigated the effects of music-based interventions (music therapy and music medicine) on pain and anxiety in children and adults undergoing medical procedures.

METHODS

This systematic review examined randomized controlled trial music intervention studies to manage patient-reported pain and/or anxiety during medical procedures. All studies were published in English and peer-reviewed journals. Quality and risk of bias were assessed using criteria from the Checklist to Evaluate a Report of a Nonpharmacological Trial (CLEAR-NPT).

RESULTS

Fifty studies met inclusion criteria, the majority of which (84%) had a high risk of bias. It was not possible to perform a meta-analysis because studies varied greatly in terms of medical procedure and intervention type. Results varied across studies, with approximately half (48%) indicating less anxiety for music intervention participants; fewer studies (36%) reported less pain for music intervention participants.

CONCLUSIONS

There is a need to clearly define and differentiate between music therapy and music medicine interventions in procedural support research. Further research is necessary to determine which patients would benefit most from music interventions during medical procedures, and which interventions are most beneficial. To improve research quality and reduce risk of bias, when designing studies investigators need to carefully consider factors related to design, including randomization, treatment allocation concealment, blinding outcome assessors, and intention-to-treat analysis. In addition, more detailed intervention reporting is needed when publishing results.

摘要

背景

接受医疗程序的个体经常经历疼痛和焦虑。基于音乐的干预措施有可能帮助缓解这些症状。

目的

本综述调查了基于音乐的干预措施(音乐疗法和音乐医学)对接受医疗程序的儿童和成人的疼痛和焦虑的影响。

方法

本系统综述审查了随机对照试验音乐干预研究,以管理患者在医疗程序中报告的疼痛和/或焦虑。所有研究均发表于英文同行评审期刊。使用《非药物试验报告评估清单》(CLEAR-NPT)的标准评估质量和偏倚风险。

结果

50项研究符合纳入标准,其中大多数(84%)存在高偏倚风险。由于研究在医疗程序和干预类型方面差异很大,因此无法进行荟萃分析。研究结果各不相同,约一半(48%)表明音乐干预参与者的焦虑程度较低;较少的研究(36%)报告音乐干预参与者的疼痛较轻。

结论

在程序支持研究中,需要明确界定音乐疗法和音乐医学干预措施并加以区分。有必要进行进一步研究,以确定哪些患者在医疗程序中最能从音乐干预中获益,以及哪些干预措施最有益。为了提高研究质量并降低偏倚风险,研究人员在设计研究时需要仔细考虑与设计相关的因素,包括随机化、治疗分配隐藏、结果评估者盲法和意向性分析。此外,在发表结果时需要更详细地报告干预措施。

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