Elazığ Fethi Sekin City Hospital, Elazığ, Turkey.
Faculty of Nursing, Department of Nursing Fundamentals, Ataturk University, Erzurum, Turkey.
Nurs Crit Care. 2024 Mar;29(2):357-365. doi: 10.1111/nicc.12952. Epub 2023 Aug 3.
Agitation and incompliance with the treatment may be observed in patients undergoing continuous positive airway pressure (CPAP), which may cause inadequate oxygenation, sedation, termination of CPAP or intubation of the patient.
This study was conducted to determine the effect of listening to music during CPAP on the agitation levels of intensive care patients who underwent CPAP as a result of COVID-19 and their compliance with the treatment.
This study was a prospective, randomized, controlled clinical trial. Seventy-six intensive care patients with COVID-19 were included in this study and assigned to the music and control groups via the block randomization method. The study was completed with 70 patients. The patients and outcome assessors were not blinded in this study. The Richmond Agitation and Sedation Scale (RASS) level, respiratory rate, oxygen saturation (SpO ) and mask air leakage amount were the outcome measures.
The mean RASS score of the patients in the intervention group was 2.14 ± 0.69 before CPAP, 1.63 ± 064 at the 1st minute, 0.89 ± 0.58 at the 15th minute and 0.74 ± 0.61 at the 30th minute. The mean RASS score of the patients in the control group was 2.06 ± 0.53 before CPAP, 1.80 ± 0.58 at the 1st minute, 1.43 ± 0.60 at the 15th minute and 1.46 ± 0.61 at the 30th minute of CPAP. There was a statistically significant difference between the groups at the 15th and 30th minutes (t = -3.81, p < .001; t = -4.89, p < .001 respectively). The mean respiratory rate, SpO and mask air leakage amount were compared between the groups. There was a statistically significant difference in favour of the intervention group at the 15th minute (t = -2.47, p < .001; t = 2.57, p < .001; t = 2.93, p < .001 respectively) and 30th minute (t = -3.17, p < .001; t = 3.46, p < .001; t = -3.93, p < .001 respectively).
The study results show that listening to music during CPAP reduces the agitation levels of patients and helps them comply with the treatment.
Music may be a beneficial application for patients who are agitated and unable to comply with CPAP therapy. This is an easy and applicable method, which can protect patients from the adverse effects of failed CPAP.
持续气道正压通气（CPAP）治疗过程中可能会出现躁动和不配合，这可能导致氧合不足、镇静、CPAP 治疗终止或患者插管。
本研究旨在确定 COVID-19 患者接受 CPAP 治疗时，在 CPAP 期间听音乐对患者躁动水平和治疗依从性的影响。
这是一项前瞻性、随机、对照临床试验。本研究纳入了 76 例因 COVID-19 接受 CPAP 治疗的重症监护患者，并采用区组随机分组法将其分为音乐组和对照组。共有 70 例患者完成了研究。在这项研究中，患者和结果评估者均未设盲。观察指标为 Richmond 躁动-镇静量表（RASS）评分、呼吸频率、氧饱和度（SpO ）和面罩漏气量。
干预组患者 CPAP 前的平均 RASS 评分为 2.14±0.69，CPAP 第 1 分钟时为 1.63±0.64，第 15 分钟时为 0.89±0.58，第 30 分钟时为 0.74±0.61。对照组患者 CPAP 前的平均 RASS 评分为 2.06±0.53，CPAP 第 1 分钟时为 1.80±0.58，第 15 分钟时为 1.43±0.60，第 30 分钟时为 1.46±0.61。第 15 分钟和第 30 分钟时组间差异具有统计学意义（t=-3.81，p<0.001；t=-4.89，p<0.001）。对两组的平均呼吸频率、SpO 和面罩漏气量进行了比较。第 15 分钟（t=-2.47，p<0.001；t=2.57，p<0.001；t=2.93，p<0.001）和第 30 分钟（t=-3.17，p<0.001；t=3.46，p<0.001；t=-3.93，p<0.001）时，干预组的差异具有统计学意义。
研究结果表明，CPAP 期间听音乐可降低患者的躁动水平，有助于提高其治疗依从性。
音乐可能是躁动和不能配合 CPAP 治疗的患者的有益应用。这是一种简单易行的方法，可以保护患者免受 CPAP 治疗失败的不良影响。
