音乐疗法对择期骨科手术后住院患者的影响：一项随机对照试验。
Impact of Music Therapy on Hospitalized Patients Post-Elective Orthopaedic Surgery: A Randomized Controlled Trial.
作者信息
Gallagher Lisa M, Gardner Vickie, Bates Debbie, Mason Shelley, Nemecek Jeanine, DiFiore Jacquelyn Baker, Bena James, Li Manshi, Bethoux Francois
机构信息
Lisa M. Gallagher, MA, MT-BC, Research Program Manager, Arts and Medicine Institute, and Cleveland Clinic, Cleveland, OH Vickie Gardner, MSN, RN, Nurse Manager, Euclid Hospital, Cleveland, OH. Debbie Bates, MMT, MT-BC, Music Therapy Manager, Arts and Medicine Institute, and Cleveland Clinic, Cleveland, OH. Shelley Mason, CNP, RN, Certified Nurse Practitioner, Cleveland Clinic, Euclid Hospital, Cleveland, OH. Jeanine Nemecek, MSN, RN, Director of Surgical Services, Euclid Hospital, Cleveland, OH. Jacquelyn Baker DiFiore, RN, Cleveland Clinic, Euclid Hospital, Cleveland, OH; currently, Chief Nursing Officer, Ashtabula County Medical Center. James Bena, MS, Lead Biostatistician, Cleveland Clinic, Quantitative Health Sciences, Cleveland, OH. Manshi Li, MS, Statistical Programmer I, Cleveland Clinic, Quantitative Health Sciences, Cleveland, OH. Francois Bethoux, MD, Cleveland Clinic Medical Director, Arts and Medicine Institute; Director, Mellen Center Rehabilitation Services, Neurological Institute.
出版信息
Orthop Nurs. 2018 Mar/Apr;37(2):124-133. doi: 10.1097/NOR.0000000000000432.
BACKGROUND
Music therapy (MT) research has demonstrated positive effects on fatigue, depressed mood, anxiety, and pain in perioperative care areas. However, there has been limited research on the effects of MT for surgical patients on orthopaedic units.
PURPOSE
The purpose of this study was to understand the impact of MT sessions on post-elective orthopaedic surgery patients' pain, mood, nausea, anxiety, use of narcotics and antiemetics, and length of stay.
METHODS
This was a randomized controlled study with an experimental arm (MT sessions) and a control arm (standard medical care). Patients received MT within 24 hours of admission to the unit, as well as every day of their stay. Same-day pre- and postdata were collected 30 minutes apart for both arms, including patient self-reported mood, pain, anxiety, and nausea. Use of medications and length of stay were gleaned from the electronic medical record.
RESULTS
Data were obtained for 163 patients, age 60.5 ± 11.1 years, 56% of whom were male. Joints targeted by surgeries were hips (54%), knees (42%), and shoulders (4%). There were significantly greater changes favoring the MT group on Day 1 (pain, anxiety, and mood), Day 2 (pain, anxiety, mood, and nausea), and Day 3 (pain, anxiety, and mood). Among participants with a pre-pain score of 2 or more on Day 1, a decrease of at least 2 points was noted in 36% of the MT group and 10% of the control group (P < .001). Overall, 73% of MT patients versus 41% of control patients reported improved pain (P < .001). No significant between-group differences in medications or length of stay were noted.
CONCLUSIONS
We observed greater same-day improvements of pain, emotional status, and nausea with MT sessions, compared to usual care, in patients hospitalized after elective orthopaedic surgeries. Effects on narcotic and antiemetic usage, as well as length of stay, were not observed. More research needs to be conducted to better understand the benefits of MT pre- and post-elective orthopaedic surgery.
背景
音乐疗法（MT）研究已证明其在围手术期护理领域对疲劳、情绪低落、焦虑和疼痛有积极影响。然而，关于音乐疗法对骨科病房手术患者影响的研究有限。
目的
本研究的目的是了解音乐疗法课程对择期骨科手术后患者的疼痛、情绪、恶心、焦虑、麻醉药品和止吐药的使用以及住院时间的影响。
方法
这是一项随机对照研究，分为试验组（音乐疗法课程）和对照组（标准医疗护理）。患者在入院后24小时内接受音乐疗法，住院期间每天接受治疗。两组均在同一天前后间隔30分钟收集数据，包括患者自我报告的情绪、疼痛、焦虑和恶心。从电子病历中获取药物使用情况和住院时间。
结果
共获得163例患者的数据，年龄60.5±11.1岁，其中56%为男性。手术针对的关节为髋关节（占54%）、膝关节（占42%）和肩关节（占4%）。在第1天（疼痛、焦虑和情绪）、第2天（疼痛、焦虑、情绪和恶心）和第3天（疼痛、焦虑和情绪），音乐疗法组的改善明显更大。在第1天疼痛评分≥2分的参与者中，音乐疗法组36%的患者疼痛评分至少降低2分，而对照组为10%（P<0.001）。总体而言，73%的音乐疗法患者报告疼痛改善，而对照组为41%（P<0.001）。两组在药物使用或住院时间方面无显著差异。
结论
我们观察到，与常规护理相比，择期骨科手术后住院患者通过音乐疗法课程在同一天内疼痛、情绪状态和恶心的改善更大。未观察到对麻醉药品和止吐药使用以及住院时间的影响。需要进行更多研究以更好地了解音乐疗法在择期骨科手术前后的益处。
Zotero 插件