Foraker Amy B, Love Pamela
School of Nursing, Colorado State University-Pueblo, Pueblo, CO.
School of Nursing, Colorado State University-Pueblo, Pueblo, CO; College of Health Sciences, Midwestern University, Glendale, AZ.
J Perianesth Nurs. 2025 Jun;40(3):492-499.e3. doi: 10.1016/j.jopan.2024.06.113. Epub 2024 Dec 4.
Define the impact of the implementation of evidence-based music medicine (MM) on pain management outcomes after abdominal and pelvic surgery when combined with usual care.
This quality improvement project implemented MM in a hospital postanesthesia care unit using a pretest-posttest design. The Roy Adaptation Model and Kotter's Change theory guided all project phases.
Nursing staff were educated in-person, via electronic formats and paper handouts. A convenience sample of adults who underwent abdominal or pelvic surgery was offered a preselected MM playlist (via earphones and MP3 players) in addition to usual care during the Phase I recovery period. The outcomes included administered opioids (oral morphine milligram equivalents), pain levels (numerical rating scale), heart rate, respiratory rate, and systolic blood pressure. The outcomes for those who accepted MM (music group) were compared to those for patients admitted to the postanesthesia care unit 1 month before project implementation (baseline group).
The music group data revealed highly significant reductions in heart rate (P = .008, Cohen's d = 0.57) and systolic blood pressure (P < .001, Cohen's d = 0.78) at 30 minutes compared with pretest data. In contrast, the baseline group data showed no effect on systolic blood pressure levels (P = .274). The music group showed higher clinical significance (1.8 to >2-fold higher effect size) on reducing numerical rating scale scores at 30 minutes (music group: P < .001, Cohen's d = 1.19; baseline group: P = .008, Cohen's d = 0.55) and the final period in phase I (music group: P < .001, Cohen's d = 1.71; baseline group: P < .001, Cohen's d = 0.93). The mean morphine milligram equivalents dose for the music group (29.5 ± SD 19.8) compared with the baseline group (33.0 ± SD 26.6) was not significantly different (P = .376, Cohen's d = 0.18).
Adding MM with usual care leads to statistically and clinically significant reductions in pain indicators in adults who had abdominal or pelvic surgeries versus usual care alone.
确定循证音乐疗法（MM）与常规护理相结合时，对腹部和盆腔手术后疼痛管理结果的影响。
本质量改进项目在医院麻醉后护理单元采用前后测试设计实施MM。罗伊适应模式和科特变革理论指导了项目的所有阶段。
通过面对面、电子形式和纸质手册对护理人员进行培训。在第一阶段恢复期，除常规护理外，为接受腹部或盆腔手术的成年便利样本提供预先选定的MM播放列表（通过耳机和MP3播放器）。结果包括给予的阿片类药物（口服吗啡毫克当量）、疼痛水平（数字评分量表）、心率、呼吸频率和收缩压。将接受MM治疗的患者（音乐组）的结果与项目实施前1个月入住麻醉后护理单元的患者（基线组）的结果进行比较。
音乐组数据显示，与测试前数据相比，30分钟时心率（P = 0.008，科恩d值 = 0.57）和收缩压（P < 0.001，科恩d值 = 0.78）显著降低。相比之下，基线组数据显示对收缩压水平无影响（P = 0.274）。音乐组在30分钟时降低数字评分量表分数方面具有更高的临床意义（效应大小高1.8至2倍以上）（音乐组：P < 0.001，科恩d值 = 1.19；基线组：P = 0.008，科恩d值 = 0.55）以及第一阶段的最后阶段（音乐组：P < 0.001，科恩d值 = 1.71；基线组：P < 0.001，科恩d值 = 0.93）。音乐组的平均吗啡毫克当量剂量（29.5 ±标准差19.8）与基线组（33.0 ±标准差26.6）相比无显著差异（P = 0.376，科恩d值 = 0.18）。
与单纯常规护理相比，腹部或盆腔手术成年患者在常规护理基础上加用MM可使疼痛指标在统计学和临床上显著降低。
