Amanda J. Golino is a clinical nurse specialist, Catherine Christopher is director of physical medicine and rehabilitation, and Debra Stanger is the Magnet program director, Inova Loudoun Hospital, Leesburg, Virginia. Raymond Leone is director of medical music therapy, A Place to Be, Middleburg, Virginia. Audra Gollenberg is an associate professor of public health and Anthony Meadows is an associate professor of music therapy, Shenandoah University, Winchester, Virginia. Theresa M. Davis is clinical operations director of enVision eICU, INOVA Telemedicine, and Mary Ann Friesen is nursing research and evidence-based practice coordinator, Inova Health System, Falls Church, Virginia. Zhiwei Zhang is an associate professor and director of the Statistical Collaboratory, University of California, Riverside, California.
Am J Crit Care. 2019 Jan;28(1):48-55. doi: 10.4037/ajcc2019792.
Nonpharmacological interventions appear to benefit many patients and do not have the side effects commonly associated with medications. Music-based experiences may benefit critical care patients.
To examine the effect of an active music therapy intervention on physiological parameters and self-reported pain and anxiety levels of patients in the intensive care unit.
A study was conducted using a pretest-posttest, within-subject, single-group design. The study population consisted of a convenience sample of 52 patients. Study participants received a 30-minute music therapy session consisting of either a relaxation intervention or a "song choice" intervention. The music therapist recorded the patients' vital signs before and after the intervention, and patients completed self-assessments of their pain and anxiety levels before and after the intervention.
After the intervention, significant decreases (all < .001) were found in respiratory rate (mean difference, 3.7 [95% CI, 2.6-4.7] breaths per minute), heart rate (5.9 [4.0-7.8] beats per minute), and self-reported pain (1.2 [0.8-1.6] points) and anxiety levels (2.7 [2.2-3.3] points). No significant change in oxygen saturation level was observed. Outcomes differed between the 2 intervention groups: patients receiving the relaxation intervention often fell asleep.
The results of this study support active music therapy as a nonpharmacological intervention in intensive care units. This study may lay the groundwork for future research on music therapy in critical care units using larger, more diverse samples.
非药物干预措施似乎对许多患者有益，而且没有与药物治疗相关的常见副作用。基于音乐的体验可能对重症监护患者有益。
研究主动音乐治疗干预对重症监护病房患者的生理参数以及自我报告的疼痛和焦虑水平的影响。
采用前后测、单组自身对照的研究设计进行了一项研究。研究人群由 52 名方便抽样的患者组成。研究参与者接受了 30 分钟的音乐治疗，包括放松干预或“歌曲选择”干预。音乐治疗师在干预前后记录患者的生命体征，患者在干预前后完成自我评估疼痛和焦虑水平。
干预后，呼吸频率（平均差异，3.7[95%置信区间，2.6-4.7]次/分钟）、心率（5.9[4.0-7.8]次/分钟）和自我报告的疼痛（1.2[0.8-1.6]分）和焦虑水平（2.7[2.2-3.3]分）显著降低（均<0.001）。未观察到氧饱和度水平的显著变化。两种干预组的结果不同：接受放松干预的患者经常入睡。
本研究支持主动音乐治疗作为重症监护病房的非药物干预措施。本研究可能为未来在重症监护病房使用更大、更多样化的样本进行音乐治疗的研究奠定基础。
