Ames Nancy, Shuford Rebecca, Yang Li, Moriyama Brad, Frey Meredith, Wilson Florencia, Sundaramurthi Thiruppavai, Gori Danelle, Mannes Andrew, Ranucci Alexandra, Koziol Deloris, Wallen Gwenyth R
Nursing Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Pharmacy Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Integr Med Insights. 2017 Jul 20;12:1178633717716455. doi: 10.1177/1178633717716455. eCollection 2017.
Music listening may reduce the physiological, emotional, and mental effects of distress and anxiety. It is unclear whether music listening may reduce the amount of opioids used for pain management in critical care, postoperative patients or whether music may improve patient experience in the intensive care unit (ICU).
A total of 41 surgical patients were randomized to either music listening or controlled non-music listening groups on ICU admission. Approximately 50-minute music listening interventions were offered 4 times per day (every 4-6 hours) during the 48 hours of patients' ICU stays. Pain, distress, and anxiety scores were measured immediately before and after music listening or controlled resting periods. Total opioid intake was recorded every 24 hours and during each intervention.
There was no significant difference in pain, opioid intake, distress, or anxiety scores between the control and music listening groups during the first 4 time points of the study. However, a mixed modeling analysis examining the pre- and post-intervention scores at the first time point revealed a significant interaction in the Numeric Rating Scale (NRS) for pain between the music and the control groups ( = .037). The Numeric Rating Score decreased in the music group but remained stable in the control group. Following discharge from the ICU, the music group's interviews were analyzed for themes.
Despite the limited sample size, this study identified music listening as an appropriate intervention that improved patients' post-intervention experience, according to patients' self-report. Future mixed methods studies are needed to examine both qualitative patient perspectives and methodology to improve music listening in critical care units.
听音乐可能会减轻痛苦和焦虑带来的生理、情绪及心理影响。目前尚不清楚听音乐是否能减少重症监护病房（ICU）的术后患者用于疼痛管理的阿片类药物用量，或者音乐是否能改善ICU患者的体验。
共有41名外科手术患者在入住ICU时被随机分为听音乐组或非音乐对照组。在患者入住ICU的48小时内，每天提供约50分钟的音乐聆听干预4次（每4 - 6小时一次）。在听音乐或对照休息期前后立即测量疼痛、痛苦和焦虑评分。每24小时及每次干预期间记录阿片类药物的总摄入量。
在研究的前4个时间点，对照组和听音乐组在疼痛、阿片类药物摄入量、痛苦或焦虑评分方面没有显著差异。然而，对第一个时间点干预前后评分进行的混合模型分析显示，音乐组和对照组在疼痛数字评分量表（NRS）上存在显著交互作用（P = 0.037）。音乐组数字评分得分下降，而对照组保持稳定。ICU出院后，对音乐组的访谈进行了主题分析。
尽管样本量有限，但根据患者的自我报告，本研究确定听音乐是一种合适的干预措施，可改善患者干预后的体验。未来需要进行混合方法研究，以考察患者的定性观点和改进ICU音乐聆听的方法。
