Music Therapy for Post Operative Cardiac Patients

A Randomized Controlled Trial Evaluating Guided Relaxation with Music and Music Listening on Anxiety, Pain, and Mood

Publikation: Bog/antologi/afhandling/rapportPh.d.-afhandlingForskning

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Resumé

MUSIKTERAPI MED POSTOPERATIVE HJERTEPATIENTER

En Randomiseret Kontrolleret Klinisk Undersøgelse af Effekten af Guidet MusikAfspænding og MusikLytning på Angst, Smerte og Stemningsleje

Bagrund

Denne undersøgelse er den første kontrollerede randomiserede kliniske forskning, som er foretaget inden for første fase af rehabilitering efter en hjerteoperation og har undersøgt virkningen af en

receptiv musikterapimetode. Forskellige former for aktive og receptive musikterapimetoder har vist signifikant større effekt end behandling med musikmedicin. Musiklytning og receptiv musikterapi (som 'Guided Imagery and Music') er foreslået at være gavnlig for patienter både før og efter

hjerteoperation og i efterfølgende rehabilitering. Hensigten med den foreliggende undersøgelse var derfor at udforske både en musikterapi og en musikmedicin intervention. Det blev antaget, at Guidet Musik Afspænding, GMA, var potentielt gavnlig for postoperative hjertepatienter ved at befordre afspænding og støtte patienterne i at komme sig ved at tilbyde hvileperioder i form af lytning til

beroligende musik som baggrund for en systematisk guidning af patienter i en kropslig afspænding.

Metode

Deltagere var 68 patienter (umiddelbart efter randomisering blev operation aflyst for fem af deltagerne), i alderen fra 40 - 80 år, som fik foretaget en hjerteklapoperation som enkelt procedure eller som led i en dobbelt procedure, der samtidigt omfattede en coronar bypass operation (CABG).

Deltagerne blev tilfældigt fordelt i en af tre grupper: Guidet MusikAfspænding (GMA), MusikLytning (ML) eller en kontrolgruppe med planlagt hvile uden (No) Musik (NM). Deltagere i GMA og ML grupperne valgte deres foretrukne musikstil på baggrund af fire eksempler: (1) easy listening, (2) klassisk, (3) specialkomponeret (MusiCure) og (4) jazz. Deltagerne fik en session før

deres operation og tre efter operationen, mens de stadig var indlagt på hjerte-lungekirurgisk afdeling. Hver session varede 35 minutter. Deltagernes selv-rapporterede i strukturerede spørgeskemaer deres oplevede angst, smerte og stemningsleje før og efter operation. Data blev desuden indsamlet vedrørende indlæggelsestid, deltagernes tilfredshed med indlæggelsen og deres

indtag af smertestillende medicin. Deltagerne selv-rapportede desuden hvilken betydning, de tillagde hvile/afspænding, musik og guidning. Derudover prioriterede deltagerne i GMA og ML grupperne, hvilke elementer i musik og guidning, der havde betydning for deres udbytte af hvilen/afspændingen.

Resultater

Resultaterne var vekslende, og der manglede statistisk signifikans ved sammenligning mellem grupperne på forskellige tidspunkter, hvor data blev indsamlet. Sammenlignende analyser (Linear Mixed-effects Models) fandt signifikante resultater i forskelle over tid. Under indlæggelsen

rapporterede GMA gruppen betydningen af deres sessioner med et højere gennemsnit end de to andre grupper, ML og NM. Deltagerne i begge interventioner, GMA og ML, prioriterede 'melodi' og 'tempo' som afgørende elementer for deres valg af musikstil. Stemmekvalitet blev prioriteret

højest for deltagernes udbytte af GMA interventionen. Drop-out fra undersøgelsen skyldtes til dels de postoperative vanskeligheder, som patienter oplevede ved at deltage (og give data) før og efter hvileperioder.

Konklusion

Patientudsnittet var relativt lille, hvilket reducerer den statistiske styrke. Alligevel viser resultaterne tendens til at støtte fund fra tidligere undersøgelser, som har involveret interventioner med postoperative patienter. Fremtidig forskning kan vise, om GMA kan vise sig gavnlig for bredere populationer. GMA er non-invasiv, relativt økonomisk, og er en attraktiv og ikke-krævende behandlingsform for patienterne. Endelig kunne denne interventions potentiale overvejes som
forebyggende behandling til at reducere de stressfaktorer, som kan føre til hjertesygdomme.

OriginalsprogEngelsk
Udgivelses stedAalborg
ForlagInDiMedia, Department of Communication, Aalborg University
Antal sider352
StatusUdgivet - 2008

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Music Therapy
Music
Anxiety
Randomized Controlled Trials
Pain
Length of Stay

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@phdthesis{106ab820e6c811ddb0a4000ea68e967b,
title = "Music Therapy for Post Operative Cardiac Patients: A Randomized Controlled Trial Evaluating Guided Relaxation with Music and Music Listening on Anxiety, Pain, and Mood",
abstract = "BackgroundThis study is the first controlled research study undertaken in the early phase of rehabilitation aftercardiac surgery investigating the effect of a receptive music therapy method. Various forms ofmusic therapy interventions including both active and receptive methods were reported to besignificantly more effective than music treatment with music medicine. Music listening andreceptive music therapy (such as Guided Imagery and Music) have been proposed to help patientsboth before heart surgery and during the recovery phase. This study therefore intended to exploreboth a music therapy and a music medicine intervention. Guided Relaxation with Music wasconsidered potentially helpful for post operative cardiac patients in order to induce relaxation andfacilitate recovery involving listening to relaxing music as a background while systematicallyguiding patients through a process of bodily relaxation.MethodParticipants were 68 patients (following randomization the operation was cancelled for five of theseparticipants), age range from 40 to 80 years, who had a heart valve operation as a single procedure,or as part of a double procedure including a concurrent coronary artery bypass surgery (CABG).The participants were randomly assigned to one of three groups: Guided Relaxation with Music(GRM), Music Listening (ML), or a control group of rest with No Music (NM). Participants in theGRM and ML groups chose their preferred music style using four examples from which they couldchoose: (1) easy listening, (2) classical, (3) specially composed (MusiCure) and (4) jazz. Theparticipants were given one session before and three after their operation, while they were stillhospitalized in the heart-lung surgical unit. Each session lasted 35 minutes. Repeated measurementswere made of participants' self-reporting of anxiety, pain and mood before and after surgery. Datawere also collected on length of hospital stay, participants' satisfaction with the hospitalisation, andon participants' intake of analgesic medication. Participants self-reported through questionnaires onthe importance of rest/ relaxation, music and the guiding procedure. Participants in the GRM andML groups prioritized which elements of music and the guiding procedure had an impact on theirbenefits of the rest/ relaxation.ResultsThere were quite variable results, lacking significance when comparing between groups, at differenttime points. Some significant results were found when looking at change over time. Duringhospitalization the GRM group reported the importance of their sessions with a higher mean scorethan did the other two groups (ML and NM). Participants in both intervention groups, GRM andML, prioritized 'melody' and 'tempo' as important elements in choosing their preferred style ofmusic. Voice quality was of high priority for participants to benefit from the GRM intervention.Attrition in the study was caused partly by difficulties participants experienced postoperatively insupplying data before and after treatment.ConclusionThe sample was relatively small reducing the statistical power. However, the results tend to supportfindings from previous studies that have involved interventions with post-operative patients. Futureresearch should investigate whether GRM would prove beneficial for wider populations. GRM isnon-invasive, relatively economical, and may be an attractive and non-demanding procedure forpatients. In future research the potential of this intervention could be considered as a preventivetherapy to reduce the stress factors that can lead to heart disease.",
author = "Karin Schou",
year = "2008",
language = "English",
publisher = "InDiMedia, Department of Communication, Aalborg University",

}

Music Therapy for Post Operative Cardiac Patients : A Randomized Controlled Trial Evaluating Guided Relaxation with Music and Music Listening on Anxiety, Pain, and Mood. / Schou, Karin.

Aalborg : InDiMedia, Department of Communication, Aalborg University, 2008. 352 s.

Publikation: Bog/antologi/afhandling/rapportPh.d.-afhandlingForskning

TY - BOOK

T1 - Music Therapy for Post Operative Cardiac Patients

T2 - A Randomized Controlled Trial Evaluating Guided Relaxation with Music and Music Listening on Anxiety, Pain, and Mood

AU - Schou, Karin

PY - 2008

Y1 - 2008

N2 - BackgroundThis study is the first controlled research study undertaken in the early phase of rehabilitation aftercardiac surgery investigating the effect of a receptive music therapy method. Various forms ofmusic therapy interventions including both active and receptive methods were reported to besignificantly more effective than music treatment with music medicine. Music listening andreceptive music therapy (such as Guided Imagery and Music) have been proposed to help patientsboth before heart surgery and during the recovery phase. This study therefore intended to exploreboth a music therapy and a music medicine intervention. Guided Relaxation with Music wasconsidered potentially helpful for post operative cardiac patients in order to induce relaxation andfacilitate recovery involving listening to relaxing music as a background while systematicallyguiding patients through a process of bodily relaxation.MethodParticipants were 68 patients (following randomization the operation was cancelled for five of theseparticipants), age range from 40 to 80 years, who had a heart valve operation as a single procedure,or as part of a double procedure including a concurrent coronary artery bypass surgery (CABG).The participants were randomly assigned to one of three groups: Guided Relaxation with Music(GRM), Music Listening (ML), or a control group of rest with No Music (NM). Participants in theGRM and ML groups chose their preferred music style using four examples from which they couldchoose: (1) easy listening, (2) classical, (3) specially composed (MusiCure) and (4) jazz. Theparticipants were given one session before and three after their operation, while they were stillhospitalized in the heart-lung surgical unit. Each session lasted 35 minutes. Repeated measurementswere made of participants' self-reporting of anxiety, pain and mood before and after surgery. Datawere also collected on length of hospital stay, participants' satisfaction with the hospitalisation, andon participants' intake of analgesic medication. Participants self-reported through questionnaires onthe importance of rest/ relaxation, music and the guiding procedure. Participants in the GRM andML groups prioritized which elements of music and the guiding procedure had an impact on theirbenefits of the rest/ relaxation.ResultsThere were quite variable results, lacking significance when comparing between groups, at differenttime points. Some significant results were found when looking at change over time. Duringhospitalization the GRM group reported the importance of their sessions with a higher mean scorethan did the other two groups (ML and NM). Participants in both intervention groups, GRM andML, prioritized 'melody' and 'tempo' as important elements in choosing their preferred style ofmusic. Voice quality was of high priority for participants to benefit from the GRM intervention.Attrition in the study was caused partly by difficulties participants experienced postoperatively insupplying data before and after treatment.ConclusionThe sample was relatively small reducing the statistical power. However, the results tend to supportfindings from previous studies that have involved interventions with post-operative patients. Futureresearch should investigate whether GRM would prove beneficial for wider populations. GRM isnon-invasive, relatively economical, and may be an attractive and non-demanding procedure forpatients. In future research the potential of this intervention could be considered as a preventivetherapy to reduce the stress factors that can lead to heart disease.

AB - BackgroundThis study is the first controlled research study undertaken in the early phase of rehabilitation aftercardiac surgery investigating the effect of a receptive music therapy method. Various forms ofmusic therapy interventions including both active and receptive methods were reported to besignificantly more effective than music treatment with music medicine. Music listening andreceptive music therapy (such as Guided Imagery and Music) have been proposed to help patientsboth before heart surgery and during the recovery phase. This study therefore intended to exploreboth a music therapy and a music medicine intervention. Guided Relaxation with Music wasconsidered potentially helpful for post operative cardiac patients in order to induce relaxation andfacilitate recovery involving listening to relaxing music as a background while systematicallyguiding patients through a process of bodily relaxation.MethodParticipants were 68 patients (following randomization the operation was cancelled for five of theseparticipants), age range from 40 to 80 years, who had a heart valve operation as a single procedure,or as part of a double procedure including a concurrent coronary artery bypass surgery (CABG).The participants were randomly assigned to one of three groups: Guided Relaxation with Music(GRM), Music Listening (ML), or a control group of rest with No Music (NM). Participants in theGRM and ML groups chose their preferred music style using four examples from which they couldchoose: (1) easy listening, (2) classical, (3) specially composed (MusiCure) and (4) jazz. Theparticipants were given one session before and three after their operation, while they were stillhospitalized in the heart-lung surgical unit. Each session lasted 35 minutes. Repeated measurementswere made of participants' self-reporting of anxiety, pain and mood before and after surgery. Datawere also collected on length of hospital stay, participants' satisfaction with the hospitalisation, andon participants' intake of analgesic medication. Participants self-reported through questionnaires onthe importance of rest/ relaxation, music and the guiding procedure. Participants in the GRM andML groups prioritized which elements of music and the guiding procedure had an impact on theirbenefits of the rest/ relaxation.ResultsThere were quite variable results, lacking significance when comparing between groups, at differenttime points. Some significant results were found when looking at change over time. Duringhospitalization the GRM group reported the importance of their sessions with a higher mean scorethan did the other two groups (ML and NM). Participants in both intervention groups, GRM andML, prioritized 'melody' and 'tempo' as important elements in choosing their preferred style ofmusic. Voice quality was of high priority for participants to benefit from the GRM intervention.Attrition in the study was caused partly by difficulties participants experienced postoperatively insupplying data before and after treatment.ConclusionThe sample was relatively small reducing the statistical power. However, the results tend to supportfindings from previous studies that have involved interventions with post-operative patients. Futureresearch should investigate whether GRM would prove beneficial for wider populations. GRM isnon-invasive, relatively economical, and may be an attractive and non-demanding procedure forpatients. In future research the potential of this intervention could be considered as a preventivetherapy to reduce the stress factors that can lead to heart disease.

M3 - Ph.D. thesis

BT - Music Therapy for Post Operative Cardiac Patients

PB - InDiMedia, Department of Communication, Aalborg University

CY - Aalborg

ER -