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Metaanálisis2013Financiación no declarada

Music interventions for preoperative anxiety

Bradt J, Dileo C, Shim M

The Cochrane database of systematic reviews · 221 citas

Etiquetas de revisión

Financiación no declarada

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Cómo se estudió

Diseño
Metaanálisis (indexado por PubMed)
Estudiado en
Personas
Resultado principal
Marcadores de salud y funcionamiento

Quién lo pagó

Financiación
Financiación no declarada

Publicación

Publicado
2013-06-06 · Cochrane Database Syst Rev · vol. 2013 · número 6 · pág. CD006908
Editorial
Elsevier BV
Citado
414 citas · más que el 100% de estudios similares · 26.6× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
124 trabajos
Acceso
Acceso abierto (copia en repositorio)
Áreas de investigación
Music Therapy and Health · Enhanced Recovery After Surgery · Intensive Care Unit Cognitive Disorders
Palabras clave
Anxiety, Psychological intervention, Medicine, Music therapy, PsycINFO, MEDLINE, Cochrane Library, CINAHL, Intervention (counseling), Randomized controlled trial, Physical therapy, Psychiatry, Surgery
MeSH
humans, music therapy, preoperative care, surgical procedures, operative, anxiety, blood pressure, heart rate, randomized controlled trials as topic

3 autores

  • Joke Bradt🇺🇸Drexel University
  • Cheryl Dileo🇺🇸Temple University
  • Minjung Shim🇺🇸Drexel University

Resumen

El texto original del estudio, en el idioma en que se publicó.

Background

Patients awaiting surgical procedures often experience significant anxiety. Such anxiety may result in negative physiological manifestations, slower wound healing, increased risk of infection, and may complicate the induction of anaesthesia and impede postoperative recovery. To reduce patient anxiety, sedatives and anti-anxiety drugs are regularly administered before surgery. However, these often have negative side effects and may prolong patient recovery. Therefore, increasing attention is being paid to a variety of non-pharmacological interventions for reduction of preoperative anxiety such as music therapy and music medicine interventions. Interventions are categorized as 'music medicine' when passive listening to pre-recorded music is offered by medical personnel. In contrast, music therapy requires the implementation of a music intervention by a trained music therapist, the presence of a therapeutic process, and the use of personally tailored music experiences. A systematic review was needed to gauge the efficacy of both music therapy and music medicine interventions for reduction of preoperative anxiety.

Objectives

To examine the effects of music interventions with standard care versus standard care alone on preoperative anxiety in surgical patients.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7), MEDLINE (1950 to August 2012), CINAHL (1980 to August 2012), AMED (1985 to April 2011; we no longer had access to AMED after this date), EMBASE (1980 to August 2012), PsycINFO (1967 to August 2012), LILACS (1982 to August 2012), Science Citation Index (1980 to August 2012), the specialist music therapy research database (March 1 2008; database is no longer functional), CAIRSS for Music (to August 2012), Proquest Digital Dissertations (1980 to August 2012), ClinicalTrials.gov (2000 to August 2012), Current Controlled Trials (1998 to August 2012), and the National Research Register (2000 to September 2007). We handsearched music therapy journals and reference lists, and contacted relevant experts to identify unpublished manuscripts. There was no language restriction.

Selection criteria

We included all randomized and quasi-randomized trials that compared music interventions and standard care with standard care alone for reducing preoperative anxiety in surgical patients.

Data collection and analysis

Two review authors independently extracted the data and assessed the risk of bias. We contacted authors to obtain missing data where needed. Where possible, results were presented in meta analyses using mean differences and standardized mean differences. Post-test scores were used. In cases of significant baseline differences, we used change scores.

Main results

We included 26 trials (2051 participants). All studies used listening to pre-recorded music. The results suggested that music listening may have a beneficial effect on preoperative anxiety. Specifically, music listening resulted, on average, in an anxiety reduction that was 5.72 units greater (95% CI -7.27 to -4.17, P < 0.00001) than that in the standard care group as measured by the Stait-Trait Anxiety Inventory (STAI-S), and -0.60 standardized units (95% CI -0.90 to -0.31, P < 0.0001) on other anxiety scales. The results also suggested a small effect on heart rate and diastolic blood pressure, but no support was found for reductions in systolic blood pressure, respiratory rate, and skin temperature. Most trials were assessed to be at high risk of bias because of lack of blinding. Blinding of outcome assessors is often impossible in music therapy and music medicine studies that use subjective outcomes, unless in studies in which the music intervention is compared to another treatment intervention. Because of the high risk of bias, these results need to be interpreted with caution.None of the studies included wound healing, infection rate, time to discharge, or patient satisfaction as outcome variables. One large study found that music listening was more effective than the sedative midazolam in reducing preoperative anxiety and equally effective in reducing physiological responses. No adverse effects were identified.

Authors' conclusions

This systematic review indicates that music listening may have a beneficial effect on preoperative anxiety. These findings are consistent with the findings of three other Cochrane systematic reviews on the use of music interventions for anxiety reduction in medical patients. Therefore, we conclude that music interventions may provide a viable alternative to sedatives and anti-anxiety drugs for reducing preoperative anxiety.

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.

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