The Effect of Music Therapy on

Post-operative Pain and

Patient Satisfaction in

Adult Orthopedic Patients

Presenter: Melissa A. Schneider, RN-BC, DNP, ONC

Objectives

• Briefly review potential pain issues in the

post-operative patient

• Discuss the relationship of music therapy

and its use as an adjunct to pain

management

• Review the study results and the impact on

patient care

Background

• Pain doesn’t discriminate!

• 50-75% of patients do not receive adequate relief from post-op pain

• Uncontrolled pain causes additional problems in the post-op period

• This is especially true in orthopedic surgery

• Pain perception is very individualized

• Patients need to feel that they have some

control over their pain management

• Some patients worry about side effects

and/or addiction

• Better pain control = increased

satisfaction with overall hospital

experience

Successful Pain Management:

• Requires a multifaceted

approach

• Needs to include non-

pharmacological

techniques/adjunctive

therapies

Literature Review

• Searched for studies to

support the use of music

therapy

• Variety of studies using

different populations, but

limited studies in the

orthopedic patient

• AORN – systematic review

of 42 RCT’s

Music Therapy:

• Is a non-traditional

approach for relief of

pain

• Has existed for a long

time in some cultures

• Recently has received

increased attention in

hospitalized patients

Music Therapy:

• Based on the theory of holistic

nursing

• Is non-invasive, inexpensive & safe

• Does not require a physician’s order

• Can easily be incorporated into

nursing care

• Has minimal legal/ethical issues

PICO question:

P - Adult orthopedic patients in the post-

operative period

I - Listening to Music on portable CD player

C - Pre & post pain scores

O – Decrease in pain & increase in pt

satisfaction

Population -

Inclusion criteria:

Adult (18 or older),

orthopedic patients, English

speaking, able to

understand/sign consent,

hospital stay of > 24 hrs,

ability to complete log sheets

Intervention –

How did we decide on the type music &

player to be used?

• Based on recommendations from studies: Slow &

flowing music with 60-80 bpm, recorded vs live,

instrumental, repetitive

• Portable CD player - ease of use, cost,

ability to clean between patients

Comparison -

Used NRS for pain scores (1-10)

Had patient record pre & post scores

plus time listened (log sheet)

Also did satisfaction survey at d/c

Outcomes –

Results:

Total # of patients = 42

Total # of pain logs = 59

Total # of satisfaction surveys

completed at discharge = 34

Results – con’t

DISCHARGE QUESTIONNAIRE

MUSIC & PAIN STUDY

How satisfied were you with your overall pain control during this hospital stay?

(Please grade your response 5 to 1 with 5 being most satisfied & 1 being very dissatisfied)

Very Satisfied 5 4 3 2 1 Very Dissatisfied

Did you find that listening to the music was helpful with your pain relief?

(Please grade your response 5 to 1 with 5 being very helpful & 1 being not helpful at all)

Very Helpful 5 4 3 2 1 Not helpful at all

Did you find the equipment easy to use?

(Please grade your response 5 to 1 with 5 being very easy to use & 1 being very difficult)

Very Easy 5 4 3 2 1 Very difficult

Would you recommend this music therapy to others?Yes No

Please add any additional comments below.

Thank you for participating in our study – we wish you well in your recovery.

Results – con’t

IMPLICATIONS FOR PRACTICE:

• Music therapy supported as an adjunct to

pain management

• Easy for patients to do; can be included in

teaching about interventions for pain

• Limited cost, limited risk, physician’s

order is not necessary

• Possibilities for other populations

SPECIAL THANKS TO:

• Brenda Artz, RN, MS, CCRN (co-investigator)

• Lori Abel, RN, MEd, ONC (data collection)

• Ted Bell, MS & Rod Grim, MA (research department)

• Staff of Tower 3

• Eta Eta Chapter of STTI (Stafford Scholarship)

• Emig Research Center (grant)

• Greg Maroney (music)

References

American Music Therapy Association. (2010). Music therapy makes a difference. Retrieved from http://www.musictherapy.org

Berger, J. S. (2003). Music for your practice. Home Healthcare Nurse, 21(2), 25-30.

Cepeda, M. S., Carr, D. B., Lau, J., & Alvarez, H. (2006). Music for pain relief. The Cochrane Database of Systematic Reviews, 2, . doi:10.1002/14651858.CD004843.pub2

D-Arcy, Y. (2006). Treating pain after total joint replacement. Nursing2006, 36(5), 26-28.

Ebneshahidi, A., & Mohseni, M. (2008). The effect of patient-selected music on early postoperative pain, anxiety, and hemodynamic profile in cesarean section surgery. The Journal of Alternative and Complementary Medicine, 14, 827-831. doi:10.1089/acm.2007.0752

Flaherty, E. (2008). Using pain rating scales with older adults. American Journal of Nursing, 108(6), 40-47.

References, con’t

Godfrey, H. (2005). Understanding pain, part 1: Physiology of pain.

British Journal of Nursing, 14, 846-852.

Good, M., Albert, J. M., Anderson, G. C., Wotman, S., Cong, X., Lane,

D., Ahn, S. (2010). Supplementing relaxation and music for pain after

surgery. Nursing Research, 59, 259-269.

Joanna Briggs Institute (2009). Music as an intervention in hospitals. Best

Practice, 13(3), 13-16.

Kenyon, T. (2007). Effects of music therapy on surgical and cancer

patients. Breast Care, 2, 217-220. doi:10.1159/0001-5380

Lim, P. H., & Locsin, R. (2006). Music as nursing intervention for pain in

five Asian countries. International Nursing News, 53, 189-196.

McCaffrey, R. (2008). Music listening: Its effects in creating a healing

environment. Journal of Psychosocial Nursing, 46(10), 39-44.

References, con’t

McCaffrey, R., Frock, T. L., & Garguilo, H. (2003). Understanding chronic pain and the mind-body connection. Holistic Nursing Practice, 17, 281-287.

McCaffrey, R., & Locsin, R. (2006). The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery.Holistic Nursing Practice, 20(5), 218-224.

Nilsson, U. (2008). The anxiety and pain reducing effects of music interventions: A systematic review. AORN, 87, 780-807.

Richards, T., Johnson, J., Sparks, A., & Emerson, H. (2007). The effect of music therapy on patients' perception and manifestation of pain,anxiety, and patient satisfaction. MEDSURG Nursing, 16(1), 7-14.

Sand-Jecklin, K., & Emerson, H. (2010). The impact of live therapeutic music intervention on patients' experience of pain, anxiety, and muscle tension. Holistic Nursing Practice, 24(1), 7-15.

References, con’t

Sendelbach, S. E., Halm, M. A., Doran, K. A., Miller, E. H., & Gaillard,

P. (2006). Effects of music therapy on physiological and psychological

outcomes for patients undergoing cardiac surgery. Journal of

Cardiovascular Nursing, 21(3), 194-200.

Thomas, K. M., & Sethares, K. A. (2010). Is guided imagery effective in

reducing pain and anxiety in the postoperative total joint arthroplasty

patient? Orthopaedic Nursing, 29, 393-399.

Tracy, S., Dufault, M., Kogut, S., Martin, V., Rossi, S., & Willey-Temkin,

C. (2006). Translating best practices in nondrug postoperative pain

management. Nursing Research, 55(2S), S57-S67.

THANKS FOR YOUR

ATTENTION!

QUESTIONS?