Critique of the effect of complementary music therapy on the patient’s postoperative state anxiety, pain control, and environmental noise satisfaction

8/9/2019 Critique of the effect of complementary music therapy on the patient’s postoperative state anxiety, pain control, a…

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Running Head: CRITIQUE OF COMPLEMENTARY MUSIC THERAPY

Critique of the effect of complementary music therapy on the patient’s postoperative state

anxiety, pain control, and environmental noise satisfaction

Andrew Adlaon

Southwestern Adventist University

NURSIN R!S!ARC"

NURS #$%

&enora '( )ollett, *h', RN

+uly $%, $%#

Information a-out the Authors

.ressa Comeaux, APRN, FNP-C, CEN is a CICU Staff Nuse and !at "f Patient Cae

Se#i$es at Our Lady of the Lake Regional Medical Center in %at"n R"uge, LA&

Susan Steele/0oses, 'NS, APRN-CNS, AOCN, is t(e Resea$( 'ie$t" "f A$ade)i$

Affais in Our Lady of the Lake Regional Medical Center in %at"n R"uge, LA&

1rief Summary of the Article

T(e !u!"se "f t(e stud* +as t" dete)ine t(e effe$t "f )usi$ t(ea!* "n state aniet*,

!ain )anage)ent, and en#i"n)enta n"ise !e$e!ti"n "n !"st"!eati#e !atients in additi"n t"

taditi"na anagesi$s& A .uasi-e!ei)enta n"n-e.ui#aent $"nt" g"u! design +as used in t(is

stud* +it( !ati$i!ants assigned /ased "n "") assign)ent at(e t(an and")*& Pati$i!ants in


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CRITIQUE OF COMPLEMENTARY MUSIC THERAPY

A (a+a* +ee t(e $"nt" g"u! and e$ei#ed t(e standad "f $ae& T("se in % (a+a* e$ei#ed

t(e inte#enti"n "f $")!e)enta* )usi$ t(ea!* in additi"n t" t(e standad "f $ae& Ea$(

!ati$i!ant +as en"ed f" a t"ta "f 0 da*s " unti dis$(age, +(i$(e#e $a)e fist& 'ata +as

$"e$ted u!"n en")ent 1Ti)e One2 and f" t(e net 3 $"nse$uti#e da*s 1Ti)e T+" and Ti)e

T(ee2& T(e inte#enti"n +as instu$ted isten t" n"n-*i$a "+ de$i/e 1ess t(an 45 d/2 !e-

!"ga))ed )usi$, f" at east 05 )inutes afte t(ei !es$i/ed anagesia +as gi#en&

State tait aniet*, !ain, and en#i"n)enta n"ise satisfa$ti"n +ee assessed using t(e State-

Tait Aniet* In#ent"* and t+" standadi6ed .uesti"nnaies& T(e findings

suggest )usi$ t(ea!* )a* de$ease !ain and en#i"n)enta n"ise !e$e!ti"n, /ut )a* (a#e n"

effe$t "n state aniet*& Use "f )usi$ t(ea!* $"ud i)!"#e !atients7 !"st"!eati#e e!eien$e /*

in$easing t(ei !ain )anage)ent and +(ite n"ise satisfa$ti"n&

Critique of the effect of complementary music therapy on the patient’s postoperative state

anxiety, pain control, and environmental noise satisfaction

Introduction

Research *ro-lem

T(e "#eiding !"/e) t(is ati$e addessed in t(e #e* fist senten$e +as uneie#ed

!"st"!eati#e !ain& T(e fist !aaga!( !"ints "ut t(at +(ie anagesi$s $an )itigate )an*

instan$es "f !ain, !"st"!eati#e !ain is "ften !esent +it( dug t(ea!* a"ne 1C")eau 8

Steee-M"ses, 3590, !& 0902& T(e ati$e /uids a #e* !esuasi#e agu)ent t(at )usi$ t(ea!*, in

additi"n t" taditi"na anagesi$s, $an ae#iate s")e "f t(at !ain /* "+eing aniet* e#es,

!"#iding a dista$t" f") ("s!ita en#i"n)enta n"ise, and !")"ting eaati"n&

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T(e esea$( !"/e) is "f geat signifi$an$e t" nusing /e$ause an* )et("d t(at $an

!"ssi/* edu$e !atient !ain +i "n* en(an$e t(e !atient e!eien$e sin$e a !atients

!"st"!eati#e $")f"t and +e-/eing +i in$ease as !ain e#e de$eases& C")!e)enta*

)usi$ t(ea!* f" !ain )anage)ent $"ud )a;e su/stantia $"nti/uti"ns t" nusing !a$ti$e and

!"i$* /e$ause it is a eati#e* ine!ensi#e and eas* teat)ent t" a!!*& T(e esea$( !"/e)

and t(e +a* t(e esea$( +as $"ndu$ted fits +e +it(in t(e /"undaies "f t(e !"siti#ist

!aadig)&

*urpose and "ypothesis

T(e esea$( ati$e (ad a #e* $ea (eading +(i$( a/eed t(e !u!"se and t(e (*!"t(esis, /ut

did n"t (a#e an "/#i"us esea$( .uesti"n& T(e !u!"se "f t(e stud* +as t"


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.heoretical )ramewor2 and 'efinitions

T(e esea$(es used a t(e"eti$a dei#e* )"de $aed Reati"ns(i!-%ased Cae 1R%C2

t(at e)!(asi6e


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(e)at""g*-"n$""g* diagn"sis& T(e esea$(es "/tained a $"n#enien$e sa)!e t"ta "f D9

!ati$i!ants and s!it t(e) int" t+" g"u!s& "u! A $"ntained 33 !e"!e and +as t" /e t(e

$"nt" t(at e$ei#ed t(e standad "f $ae& "u! % $"ntained 9 !e"!e +(" +ee t" e$ei#e t(e

)usi$ t(ea!* in additi"n t" t(e standad "f $ae 1C")eau 8 Steee-M"ses, 3590, !& 09>2&

Sin$e a $"n#enien$e sa)!ing design +as used, t(e sa)!ing !an $an definite* /e

i)!"#ed& Using an* f") "f t(e #ai"us !"/a/iit*-sa)!ing )et("ds 1and"), si)!e and"),

statified and"), et$&2 +"ud /e a st"nge atenati#e t" t(e $"n#enien$e sa)!ing used& T(e

design t(e* used +as n"t "ne t(at $"ud *ied a #e* g""d e!esentati#e sa)!e "f t(e

!"!uati"n, and t(e sa)!e si6e +as #e* s)a +it( "n* 9 !e"!e e$ei#ing t(e inte#enti"n&

H"+e#e, t(e s)a sa)!e see$ti"n is !"/a/* due t" t(e fa$t t(at t(is is a !i"t e!ei)ent and

"n* a !at "f a age stud*&

Pi"t studies ae usua* s)a-s$ae studies t(at (e! e#auate t(e sa)!e si6e, $"st, and

ti)e in "de t" i)!"#e t(e fu-s$ae esea$( stud*& T(e use "f !"+e ana*sis and sa)!e

)"tait* +as n"t )enti"ned& It is un$ea +(et(e #unea/e !"!uati"ns 1e$"n")i$a*

disad#antaged, !egnant, ede*, et$&2 +ee used /e$ause "n* gende and a$e 1Cau$asian and

Afi$an A)ei$an2 +ee gi#en in t(e de)"ga!(i$ data 1C")eau 8 Steee-M"ses, 3590, !&

09>2& H"+e#e, t(e in$usi"n $iteia in$uded t("se 9B " "de and t("se aet and "iented, s"

#unea/e !e"!e i;e $(iden and t(e )enta* i +ee n"t used&

'esi3n and *rocedures

Research 'esi3n

T(e design used in t(is stud* +as a .uasi-e!ei)enta n"n-e.ui#aent $"nt" g"u!

t*!e& Patients in (a+a* A +ee in t(e $"nt" +(ie t(e !atients in (a+a* % +ee in t(e

inte#enti"n g"u!& A t"ta "f t(ee su#e*s t(at )easued aniet* state, !ain )anage)ent

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satisfa$ti"n, and en#i"n)enta n"ise satisfa$ti"n +ee used& T(e fist su#e* +as t" /e fied /*

t(e !ati$i!ants at en")ent 1Ti)e One2, t(e se$"nd su#e* t" /e fied "ne da* afte 1Ti)e

T+"2, and t(e ast su#e* t" /e fied "n t(e t(id da* " at dis$(age, +(i$(e#e $a)e fist 1Ti)e

T(ee2 1C")eau 8 Steee-M"ses, 3590, !& 09>2&

T(e inte#enti"n $"nsisted "f !e-!"ga))ed MP0 !a*es, in additi"n t" t(e usua

standad "f $ae& T(e !a*es $"ntained n"n-*i$a "+ de$i/e 145d%2 )usi$, and t("se in t(e

inte#enti"n g"u! +ee en$"uaged t" isten t(e s"ngs f" at east 05 )inutes afte t(e

!es$i/ed anagesia +as gi#en& Patient an"n*)it* +as ;e!t inta$t /* !a$ing su#e*s int"

en#e"!es t(at $"ntained (a+a* assign)ent, !ati$i!ant nu)/e, and da* "f $")!eti"n&

T(is +as n"t t(e )"st ig""us design t(at $"ud (a#e /een used /e$ause t(e se!aati"n

"f t(e $"nt" and inte#enti"n g"u!s +as n"t /ased "n and")ness, /ut "n t(e (a+a* at +(i$(

t(e* +ee ad)itted& Patient anagesia +as n"t $"nt"ed and (is )a* (a#e infuen$ed s")e "f

t(e !e$ei#ed !ain e#es in /"t( g"u!s& T(e stud* as" e!"ts t(at s")e !atients )a* (a#e

istened t" t(ei "+n )usi$ and s;e+ed s")e findings& 'ata +as $"e$ted at "ne-da* inte#as

f" t(ee $"nse$uti#e da*s f" a t"ta "f t(ee data !"ints& Sin$e t(e stud* +as "";ing at ("+

)usi$ affe$ted !ain, a fe+ )"e data $"e$ti"n !"ints )a* /e usefu /e$ause !ain $an $(ange

fai* .ui$;* and is n"t a+a*s $"nstant "#e a t(ee-da* !ei"d&

T" en(an$e statisti$a $"n$usi"n #aidit* t(e esea$(es used a $a$uated !"/a/iit*

#aue "f 5&559 1C")eau 8 Steee-M"ses, 3590, !& 0942& In t(e +"d "f statisti$s, a P5&559 is

statisti$a* highly signifi$ant 1ess t(an 9 in 9555 $(an$e "f /eing +"ng2& T(e inte#enti"n

effe$ti#eness +as ana*6ed "#e ti)e, and t(e !ain )anage)ent and en#i"n)enta n"ise

satisfa$ti"n t-s$"es +ee G&0B> and D&0G9, es!e$ti#e* 1C")eau 8 Steee-M"ses, 3590, !&

0942& T(ese esuts !"inted t" a da)ati$ i)!"#e)ent in /"t( !ain )anage)ent and n"ise

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satisfa$ti"n& H"+e#e, t(ee +as n" statisti$a e#iden$e "f a $(ange in state aniet* 1t9&DG

!5&9>2 1C")eau 8 Steee-M"ses, 3590, !& 0942&

'ata Collection

Patients +ee as;ed t" $")!ete a 35-ite) State-Tait Aniet* In#ent"* 1STAI2 F") Y-

9 t(at )easued state aniet* feeings i;e $a) " ne#"usness& An"t(e 35-ite) STAI F") Y-3

+as used t" )easue trait aniet* feeings i;e inade.ua$* " (a!!iness& T+" "t(e standadi6ed

.uesti"nnaies +ee i)!e)ented t" )easue satisfa$ti"n +it( !ain )anage)ent and

en#i"n)enta n"ise& T(e .uesti"nnaies used a D-!"int Li;e s$ae t" en(an$e data .uait*&

Afte t(e initia su#e* 1Ti)e One2 and t(e t+" f""+-u! su#e*s 1Ti)e T+" and T(ee2 +ee

finis(ed, a t(ee .uesti"nnaies +ee !a$ed in indi#idua +(ite en#e"!es& T(e t(ee en#e"!es

+ee t(en !a$ed int" a )ania en#e"!e $"ntaining "n* t(e (a+a* assign)ent, !ati$i!ant

nu)/e, and da* "f $")!eti"n t" )aintain !atient an"n*)it*&

A "f t(e data used $a)e f") sef-e!"ts in .uesti"nnaies& Adding )"e )et("ds i;e

"/se#ati"n and /i"-!(*si""gi$ )easues +"ud (e! stengt(en t(e findings f"und /e$ause

sef-e!"ts d" $")e +it( its "+n +ea;nesses& H"+ $an +e /e sue t(e !ati$i!ants ea* fet t(e

+a* t(e* said t(e* didJ 'id t(e* e!"t ess !ain in "de t" !ease " (e! t(e esea$(esJ

K(ie t(e .uesti"nnaies ae easie t" i)!e)ent and e!i$ate, t(e esea$(es state t(at

t(e .uesti"nnaie +as tedi"us, and s")e+(at e!etiti#e& T(is )a* (a#e s;e+ed s")e "f t(e

esuts f") !atients ?ust ?"tting d"+n ans+es t" get it "#e +it(& A st"nge )et("d "f sef-

e!"t +"ud (a#e /een fa$e-t"-fa$e inte#ie+s& T(is +"ud as" a"+ t(e inte#ie+e t" "/se#e

t(e !ati$i!ants /e(a#i" and fa$ia e!essi"ns t(at $"ud (e! inte!et t(e es!"nses "f

!ati$i!ants& T(e !"$edues f" data $"e$ti"n +ee effe$ti#e in )aintaining !atient an"n*)it*&

G


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T(is stud* +as !"#ided ee)!t status /* t(e Nusing Resea$( C"un$i and Cini$a Resea$(

Steeing C"))ittee "f OLOL-RMC 1C")eau 8 Steee-M"ses, 3590, !& 09>2

'ata Analysis and Results

.ool

T(ee +ee a t"ta "f f"u su#e*s used t" gat(e !atient data: STAI F") Y-9, Stai F")

Y-3, a !ain )anage)ent .uesti"nnaie, and an en#i"n)enta n"ise .uesti"nnaie& T(e State-

Tait Aniet* In#ent"* 1STAI2 F") (as t+" su/s$aes: STAI F") Y-9 and STAI F") Y-3&

F") Y-9 (ad 35 .uesti"ns t(at )easued current feeings i;e $a)ness " ne#"usness at t(at

#e* )")ent, and (ad a C("n/a$(s a!(a "f 5&43& STAI F") Y-3 $"ntained 35 .uesti"ns t(at

)easued t(e usual e)"ti"n feeings t(e* fet a t(e ti)e i;e inade.ua$* " (a!!iness, and (ad

a C("n/a$(s a!(a "f 5&B4& T(e !ain )anage)ent .uesti"nnaie $"ntained a singe ite):

2& %"t( .uesti"nnaies

used a D-!"int Li;et s$ae t" ate t(e ite) f") 9 1n"t at a2 t" D 1#e* )u$( s"& T(e $"effi$ient

"f dete)inati"n f" t(e !ain and n"ise .uesti"nnaie +as 5&G3 and 5&GD, es!e$ti#e* 1C")eau

8 Steee-M"ses, 3590, !& 09>2&

0easurement

T(e !a!e "ffes )easue)ent eia/iit* /* in$uding t(e C"n/a$(s a!(a #aues and

t(e $"effi$ients "f dete)inati"n f" t(e #ai"us su#e*s& T(e $ited stud* f" t(e STAI in#ent"*

+as /ased "n a stud* f") 9G5, and f")s Y-9 and Y-3 (ad a!(a #aues "f 5&43 and 5&B4,

es!e$ti#e*& C"n/a$(s a!(a #aues )easue intena $"nsisten$*, and t(e $"se t(e #aues ae

t" 9&5, t(e /ette& Sin$e t(e Y-9 f") )easuing $uent state feeings +as /e"+ 5&G, t(e esuts

B


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f" t(at test s("ud /e ta;en +it( $auti"n& T(e Y-3 f") )easuing usua e)"ti"na feeings

a!!eas t" (a#e ade.uate eia/iit*&

T(e !ain and n"ise .uesti"nnaies +ee /ased "n a stud* f") 3595, and (ad $"effi$ients

"f dete)inati"n "f 5&G3 and 5&GD, es!e$ti#e*& A $"effi$ient "f dete)inati"n )easues ("+

)u$( "f t(e es!"nse #aia/e $an /e e!ained /* t(e e!anat"* #aia/es& %"t( .uesti"nnaies

(ad "#e G5 $"eati"n t" t(e #aia/es /eing tested 1!ain )anage)ent and en#i"n)enta

n"ise2, +it( t(e "t(e 3B-34 esuting f") "t(e fa$t"s& Sin$e $"effi$ients "f dete)inati"n

ange f") 5&55 t" 9&55, t(e #aues "f /"t( .uesti"nnaies indi$ate fai* st"ng eia/iit* in t(e

su#e*s&

Statistical Analysis

T(e !a!e "utined des$i!ti#e statisti$s t" su))ai6e t(e de)"ga!(i$s "f t(e sa)!e

and s("+ed a t(e diffeent #aia/es 1statetait aniet*, !ain )anage)enten#i"n)enta n"ise

satisfa$ti"n2 and t(e esuts "f a $")!aati#e ana*sis t"get(e "n a ta/e& T(e esea$(es used a

!aied t-test t" $")!ae t(e )ean diffeen$es +it(in g"u!s, and an inde!endent t-test t" ana*6e

t(e g"u!s t(e)se#es&

%"t( tests +ee a!!"!iate tests sin$e it +as a $")!ais"n "f "n* t+" g"u!s& T(e

findings suggest a statisti$a* signifi$ant i)!"#e)ent in !ain )anage)ent satisfa$ti"n and

en#i"n)enta n"ise satisfa$ti"n& H"+e#e, t(ee +as n" statisti$a* signifi$ant $(ange in state

aniet*& T(e statisti$a inf")ati"n +as "gani6ed $ea*, and t(e ta/e +as eas* t" ead& O#ea,

t(e findings a!!ea t" su!!"t t(e (*!"t(esis t(at )usi$a t(ea!* $an aid !"st"!eati#e !atients

+it( !ain and en#i"n)enta n"ise )anage)ent&


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'iscussion

At Ti)e One, en#i"n)enta n"ise satisfa$ti"n +as sig(t* (ig(e in t(e $"nt" g"u!

$")!aed t" t(e )usi$ g"u!& T(e esea$(es atti/uted t(is dis$e!an$* t" en"#ati"ns "n t(e A

(a+a*& T(at (a+a* (ad t(e /eds /e(ind a d"u/e +a and fut(e f") t(e d"", and a$"usti$

ties in t(e "") 1C")eau 8 Steee-M"ses, 3590, !& 09G2& K(ie t(is diffeen$e in e!ei)enta

at)"s!(ee /et+een t(e t+" g"u!s $an /e a $edi/e t(eat t" t(e findings, t(e )ain "ut$")e "f

!ain )anage)ent is n"t affe$ted /* t(e diffeent "") a*"uts& In t(e end, t(e "ut$")es "f t(e

stud* !at* su!!"t t(e (*!"t(esis t(at )usi$ t(ea!* $an aid taditi"na anagesi$s in )anaging

!ain and en#i"n)enta n"ise satisfa$ti"n&

H"+e#e, t(e esuts did n"t su!!"t t(e t(e"* t(at )usi$ +"ud (a#e an effe$t "n state

aniet*& T(e ati$e addesses t(e a$; "f su!!"ting e#iden$e f" )usi$ t(ea!* "n state aniet*

/* !"inting "ut t(at )"st "f t(e !atients "n t(e unit (ad sugi$a "n$""g* diagn"ses& If t(e

diagn"ses +ee eati#e* ne+, it is undestanda/e ("+ )usi$ +"ud (a#e itte affe$t "n t(ei

$uent aniet*&

Nursin3 Implications

T(e aut("s state t(at t(e nusing i)!i$ati"ns ae !"f"und /e$ause it !"#ides e#iden$e

t(at )usi$, a eati#e* eas* and ine!ensi#e t(ea!*, $an /e used t" in$ease !ain )anage)ent

and en#i"n)enta n"ise satisfa$ti"n in !"st"!eati#e !atients& T(e !a!e suggests t(e ("s!ita

!"#ide )!0 !a*es +it( dis!"sa/e ea /uds t" !atients, " t" si)!* en$"uage fa)i*

)e)/es t" /ing t(ei "+n de#i$es and !a* )usi$ f" t(e !atient&

K(ie etting t(e fa)i* /ing t(ei "+n de#i$e t" !a* )usi$ see)s a!!"!iate, t(e

see$ti"n "f )usi$ s("ud as" /e ta;en int" a$$"unt& T(e stud* used non-lyrical low decibel

)usi$ f" at east 05 )inutes afte e$ei#ing anagesia& T(e !a!e d"es n"t )enti"n an* studies

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t(at used *i$a #s& n"n-*i$a )usi$ f" )usi$ t(ea!*, /ut it is s")et(ing t" $"nside sin$e

!atients )a* isten t" !"!ua *i$a )usi$ instead "f instu)entas&

&imitations and Recommendations

T(e esea$(es d" a #e* g""d ?"/ in !"inting "ut s!e$ifi$ stud* i)itati"ns and t(e

e$"))endati"ns f" futue esea$(& T(e* !"int "ut t(e a$; "f and")ness in !atient

assign)ent, and in$uded e!"ts "f !atients in t(e $"nt" g"u! +(" istened t" t(ei "+n )usi$

" "n t(e tee#isi"n& Sin$e t(is +as a !i"t stud*, t(e esea$(es ad#"$ate du!i$ating t(e stud*

+it( a age sa)!e and #ai"us !atient !"!uati"ns& Last*, t(e* ad)it t(e STAI Questi"nnaie

)a* (a#e /een ties")e and e!etiti#e t" s")e "f t(e !atients, es!e$ia* t(e "nes +it( ne+

"n$""gi$a diagn"ses& T(e esea$(es suggest i)!e)enting t(e inte#enti"n eaie in t(e

!e"!eati#e !(ase )a* gi#e additi"na /enefits&

Conclusion of Student

O#ea, I t(in; t(e stud* ("ds )eit in s("+ing t(e effe$t "f )usi$ "n )anaging !ain

and en#i"n)enta n"ise& T(e esuts ae $etain* ee#ant t" )e /e$ause I#e a+a*s n"ti$ed

t(at I) a/e t" ee$ise and !us( t("ug( )"e !ain +(en I isten t" )usi$, /ut t(ats ?ust s")e

ane$d"ta e#iden$e /e$ause I ;n"+ !e"!e +(" !efe n" )usi$ duing ee$ise&

One ad#antage "f t(e stud* is t(e eati#e* $(ea! $"st& Kit( t(e )a?"it* "f !("nes /eing

a/e t" !a* )usi$, it +"ud /e #e* eas* t" su!!* !atients +it( n"n-*i$a s"ngs f" t(ea!*&

H"+e#e, I fee t(at t(e esuts "f t(is stud* s("ud /e f"und in )"e studies /ef"e t(e !a$ti$e

is i)!e)ented e#e*+(ee&

99


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Reference

C")eau, T&, 8 Steee-M"ses, S& 135902& T(e effe$t "f $")!e)enta* )usi$ t(ea!* "n t(e

!atient& Medsurg Nursing , 221>2, 090-09B& Retie#ed f")

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Critique of the effect of complementary music therapy on the patient’s postoperative state anxiety, pain control, and environmental noise satisfaction