Department of Trauma and Critical Care Surgery, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America.
Institute for Health & Aging, University of California San Francisco, San Francisco, California, United States of America.
PLoS One. 2024 Oct 24;19(10):e0312175. doi: 10.1371/journal.pone.0312175. eCollection 2024.
Patients experience high symptom burden during critical care hospitalization and mechanical ventilation. Medications are of limited effectiveness and are associated with increased morbidity such as delirium and long-term cognitive and psychological impairments. Music-based interventions have been used for pain and anxiety management in critical care but remain understudied in terms of music selection and range of symptoms. This study aimed to describe the ways in which a diverse sample of critically ill adults used personalized music listening and their perceptions of the effects of music listening on symptom experience after critical injury.
Semi-structured interviews (N = 14) of adult patients, families and friends who were provided with personalized music in an urban, academic, neurotrauma intensive care unit were collected and analyzed with grounded theory methodology. Open coding of transcripts, field notes and memos was performed using Atlas.ti.9.1. Recruitment and data collection were deemed complete once thematic saturation was achieved.
We identified 6 uses of personalized music listening in critical care: 1) Restoring consciousness; 2) Maintaining cognition; 3) Humanizing the hospital experience; 4) Providing a source of connection; 5) Improving psychological wellbeing; and 6) Resolving the problems of silence. Patients used music to address psychological experiences of loneliness, fear, confusion, and loss of control. Personalized music helped patients maintain their identity and process their trauma. Additional benefits of music included experiencing pleasure, hope, resilience, and feelings of normalcy. Patients disliked being sedated and used music to wake up. Findings also highlighted the problem of the lack of meaningful stimulation in critical care.
Critically injured adults used personalized music to achieve psychological and cognitive homeostasis during critical care hospitalization. These results can inform future studies designed to explore the use of music-based interventions to prevent and treat the cognitive and emotional morbidity of critical care.
患者在重症监护住院和机械通气期间会经历高症状负担。药物的效果有限，并且与增加发病率相关，例如谵妄和长期认知和心理障碍。基于音乐的干预措施已用于重症监护中的疼痛和焦虑管理，但在音乐选择和症状范围方面的研究仍不足。本研究旨在描述多样化的重症患者群体如何使用个性化音乐聆听，以及他们对音乐聆听对重症损伤后症状体验影响的看法。
对在城市、学术性神经创伤重症监护病房接受个性化音乐的成年患者、家属和朋友进行半结构式访谈（N=14），并使用扎根理论方法进行分析。使用 Atlas.ti.9.1 对转录本、现场笔记和备忘录进行开放式编码。一旦达到主题饱和，即完成招募和数据收集。
我们确定了重症监护中个性化音乐聆听的 6 种用途：1）恢复意识；2）维持认知；3）使医院体验人性化；4）提供联系的来源；5）改善心理健康；6）解决沉默的问题。患者使用音乐来解决孤独、恐惧、困惑和失控等心理体验。个性化音乐帮助患者保持身份并处理创伤。音乐的其他好处包括体验愉悦、希望、韧性和正常感。患者不喜欢被镇静，并使用音乐唤醒自己。研究结果还强调了重症监护中缺乏有意义刺激的问题。
重症患者在重症监护住院期间使用个性化音乐来实现心理和认知的平衡。这些结果可以为未来旨在探索使用基于音乐的干预措施预防和治疗重症监护的认知和情感发病率的研究提供信息。
