音乐干预对剖宫产产妇焦虑和应激的影响：一项对照、随机研究。
Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study.
机构信息
Clinic for Gynecology and Obstetrics, Helios University Hospital Wuppertal, University Witten/Herdecke, Heusnerstr 40, 42283, Wuppertal, Germany.
Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany.
出版信息
BMC Pregnancy Childbirth. 2018 Nov 3;18(1):435. doi: 10.1186/s12884-018-2069-6.
BACKGROUND
Stress and anxiety during pregnancy and childbirth have negative consequences for both mother and child. There are indications that music has a positive effect in this situation. The present study investigates the influence of music during the caesarean on anxiety and stress of the expectant mother.
METHODS
The SAMBA study is a single-centre, controlled, randomized study including 304 patients. Women in the intervention group heard music via loudspeakers from one of four self-selected genres. The control group had standard treatment without music. The caesarean was performed in regional Anesthesia. At admission, at skin incision, during skin suture and two hours after completion of surgery, different subjective (State-Trait Anxiety Inventory, visual analogue scale for anxiety) and objective parameters (salivary cortisol/amylase, heart rate, blood pressure) were collected. Mixed-factorial Analysis of variances as well as independent sample t-tests were applied for data analysis.
RESULTS
At skin suture, significantly lower anxiety levels were reported in the intervention group regarding State anxiety (31.56 vs. 34.41; p = .004) and visual analogue scale for anxiety (1.27 vs. 1.76; p = .018). Two hours after surgery, the measured visual analogue scale for anxiety score in the intervention group was still significantly lower (0.69 vs. 1.04; p = .018). The objective parameters showed significant differences between the groups in salivary cortisol increase from admission to skin suture (12.29 vs. 16.61 nmol/L; p = .043), as well as systolic blood pressure (130.11 vs. 136.19 mmHg; p = .002) and heart rate (88.40 vs. 92.57/min; p = .049) at skin incision.
CONCLUSIONS
Music during caesarean is an easy implementable and effective way of reducing stress and anxiety of the expectant mother.
TRIAL REGISTRATION
German registry for clinical trials ( DRKS00007840 ). Registered 16/06/2015. Retrospectively registered.
背景
孕期和分娩期的压力和焦虑会对母婴双方都产生负面影响。有迹象表明，音乐对此有积极的影响。本研究旨在调查剖宫产术中音乐对产妇焦虑和压力的影响。
方法
SAMBA 研究是一项单中心、对照、随机研究，纳入了 304 名患者。干预组的女性通过扬声器听取了她们自行选择的四种类型之一的音乐。对照组则采用标准的无音乐治疗。剖宫产采用区域麻醉。在入院时、皮肤切开时、皮肤缝合时和手术完成后两小时，收集了不同的主观（状态特质焦虑量表、焦虑视觉模拟量表）和客观参数（唾液皮质醇/淀粉酶、心率、血压）。采用混合因子方差分析和独立样本 t 检验进行数据分析。
结果
在皮肤缝合时，干预组的状态焦虑（31.56 分 vs. 34.41 分；p=0.004）和焦虑视觉模拟量表（1.27 分 vs. 1.76 分；p=0.018）的焦虑水平显著较低。手术后两小时，干预组的测量焦虑视觉模拟量表评分仍显著较低（0.69 分 vs. 1.04 分；p=0.018）。客观参数显示，从入院到皮肤缝合时，两组间唾液皮质醇的增加有显著差异（12.29 分 vs. 16.61 nmol/L；p=0.043），以及收缩压（130.11 分 vs. 136.19 毫米汞柱；p=0.002）和心率（88.40 分 vs. 92.57 次/分；p=0.049）在皮肤切开时也有显著差异。
结论
剖宫产术中使用音乐是一种简单易行且有效的减轻产妇压力和焦虑的方法。
临床试验注册
德国临床试验注册处（DRKS00007840）。注册于 2015 年 6 月 16 日。回顾性注册。
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