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Nonpharmacologic Adjuvant Treatment in Pain and Anxiety Management in Intensive Care Unit: Music Therapy

Year 2017, Volume: 9 Issue: 1, 14 - 17, 01.04.2017

Abstract

Objective: The pain and the effect of anxiety management in support of music in mechanically ventilated intensive care patient is to identify through a variety of physiological variables. Methods: This study was undertaken in 2015 with Glaskow Coma Scale GKS 6E-9E, 40 intensive care unit patients between the ages of 18-65. Classical Turkish Music was listened to the patients with 30 minutes consecutive for 3 days at the same o’clock 10:00 am . Patients’ anxiety and pain scores were assessed by physiological parameters such as heart rate HR , peripheral oxygen saturation SpO2 , mean blood pressure MBP , tidal volume TV and respiratory rate f in mechanical ventilator before and during music for 30 minutes. Results: Patients were compared with Mann Whitney U test for 3 days before and after music values, HR, SpO2 and respiratory f were statistically significant p< 0.05 , but there was no significant difference between MBP and TV values. When Face Skala was compared with Mann Whitney U test, a significant difference was found in % 95 confidence interval p=0.00 . Conclusion: We concluded that music therapy can be used effectively in the non-drug control of pain and reducing the anxiety and the pain in intensive care patients. We expect to be among the routine intensive care practices as non-pharmacologic adjuvant in the future because of the increased patient comfort and lack of side effects.

References

  • Chlan L, Tracy MF, Nelson B, Walker J. Feasibility of a music intervention protocol for patients receiving mechanical ventilatory support. Altern Ther Health Med 2001;7(6):80-83.
  • Bradt J, Dileo C. Music interventions for mechan- ically ventilated patients. Cochrane Database Syst Rev. 2014; 12:CD006902.
  • Thaut MH. The future of music in therapy and medicine. Annals of the New York Academy of Sciences 2005;1060:303-308.
  • Nilsson U. The anxiety and pain-reducing effects of music interventions: a systematic review. AORN J 2008;87(4):780-807.
  • Jenkins MDA. Descriptive study of subject indexing and abstracting in international index to music pe- riodicals rilm abstracts of music literatüre and the music index online. Notes 2001;834:834-863
  • Chang SC, Chen CH. Effects of musictherapy on women’s physiologic measures, anxiety, and sat- isfaction during cesarean delivery. Res Nurs Health 2005;28(6):453-461.
  • Lee OK, Chung YF, Chan MF, Chan WM. Music and its effecton the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. J Clin Nurs 2005;14(5):609-620.
  • Tsay SL, Wang JC, Lin KC, Chung UL. Effects of acupressure therapy for patients having pro- longed mechanical ventilation support. J Adv Nurs 2005;52(2):142-150.
  • Wong HL, Lopez-Najas V, Molassiotis A. Effects of musictherapy on anxiety in ventilator- dependent patients. HeartLung 2001; 30:376-387.
  • Sanjuán Naváis M, Via Clavero G, Vázquez Guil- lamet B, Moreno Duran AM, Martínez Estalella G. Efecto de la mşsica sobre la ansiedad y el dolor en pacientes con ventilación mecánica. Enferm Inten- siva. 2013; 24(2): 63-71
  • Han L, Li JP, Sit JW, Chung L, Jiao ZY, Ma WG. Ef- fects of music intervention on physiological stress response and anxiety level of mechanically ventilat- ed patients in China: a randomised controlled trial. J Clin Nurs. 2010;19:978-987.
  • Chlan LL, Weinert CR, Heiderscheit A, Tracy MF, Skaar DJ, Guttormson JL, et al. Effects of patient-di- rected music intervention on anxiety and sedative exposure in critically ill patients receiving mechan- ical ventilatory support: a randomized clinical trial. JAMA 2013;309:2335-2344.
  • Chlan L. Effectiveness of a music therapy interven- tion on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung. 1998;27:169- 176.
  • Yaman Aktaş Y, Karabulut N. The effects of music therapy in endotracheal suctioning of mechanically ventilated patients. Nurs Crit Care. 2015 Feb 26. doi: 10.1111/nicc.12159.
  • Dijkstra BM, Gamel C, Bijl JJ, Bots ML, Kesecioglu J. The effects of music on physiological responses and sedation scores sedated, mechanically venti- lated patients. J Clin Nurs. 2010;19:1030-1039.
  • K Szilágyi A, Diószeghy C, Fritşz G, Gál J, Varga K. Shortening the length of stay and mechanical ven- tilation time by using positive suggestions via MP3 players for ventilated patients. Interv Med Appl Sci. 2014;6(1):3-15.
  • Chanques G, Jaber S, Barbotte E, Violet S, Sebanne M, Perrigault PF, et al. Impact of systematic evalua- tion of pain and agitation in an intensive care unit. Crit Care Med. 2006;34:1691-1699.
  • Chlan L, Engeland WC, Anthony A, Guttormson J. Influence of music on the stress response in pa- tients receiving mechanical ventilator support: a pilot study. AJCC. 2007;16:141-145.

Yoğun Bakım Ünitesinde Ağrı ve Anksiyete Yönetiminde Nonfarmakolojik Adjuvan Tedavi: Müzik Terapi

Year 2017, Volume: 9 Issue: 1, 14 - 17, 01.04.2017

Abstract

Amaç: Mekanik ventilatör desteği alan yoğun bakım hastalarında müziğin ağrı ve anksiyete yönetimi üzerine etkisini çeşitli fizyolojik değişkenler üzerinden tespitini sağlamaktır. Gereç ve Yöntem: Çalışma 2015 yılı içinde Glaskow Koma Skalası GKS 6E-9E olan, 18-65 yaş arası 40 yoğun bakım hastası dahil edilerek yapıldı. Hastalara 30 dk. süre ile 3 gün arka arkaya, aynı saatte saat 10:00 Klasik Türk Müziği dinletildi. Hastaların ağrı değerlendirmesi yüz ifadesi skalası ile anksiyetleri ise fizyolojik parametrelerden KAH kalp atım hızı , periferik oksijen satürasyonu SpO2 , ortalama kan basıncı OKB , mekanik ventilatördeki tidal volüm TV ve solunum sayısı f değerleri müzikten önce ve müzik esnasında 30 dk boyunca belli aralıklarla kaydedilerek değerlendirildi. Bulgular: Hastalar Mann Whitney U testine göre 3 gün boyunca müzik öncesi ve sonrası değerler kıyaslandığında KAH, SpO2 ve solunum f değerlerinde istatistiksel olarak anlamlı iken p< 0.05 , OKB ve TV değerlerinde anlamlı bir fark saptanmamıştır. Yüz skalası Mann Whitney U Testi ile kıyaslandığında % 95 güven aralığında anlamlı fark çıkmıştır p=0.00 . Sonuç: Yoğun bakım hastalarındaki ağrı ve anksiyetelerinin azaltılmasında, ağrının ilaç dışı kontrolünde müzik terapinin etkin olarak kullanılabileceğini düşünmekteyiz. Hasta konforunu arttırması ve yan etkisinin olmaması nedeniyle ilerleyen zamanlarda nonfarmakolojik adjuvan olarak rutin yoğun bakım uygulamaları arasında yer alacağını öngörmekteyiz.

References

  • Chlan L, Tracy MF, Nelson B, Walker J. Feasibility of a music intervention protocol for patients receiving mechanical ventilatory support. Altern Ther Health Med 2001;7(6):80-83.
  • Bradt J, Dileo C. Music interventions for mechan- ically ventilated patients. Cochrane Database Syst Rev. 2014; 12:CD006902.
  • Thaut MH. The future of music in therapy and medicine. Annals of the New York Academy of Sciences 2005;1060:303-308.
  • Nilsson U. The anxiety and pain-reducing effects of music interventions: a systematic review. AORN J 2008;87(4):780-807.
  • Jenkins MDA. Descriptive study of subject indexing and abstracting in international index to music pe- riodicals rilm abstracts of music literatüre and the music index online. Notes 2001;834:834-863
  • Chang SC, Chen CH. Effects of musictherapy on women’s physiologic measures, anxiety, and sat- isfaction during cesarean delivery. Res Nurs Health 2005;28(6):453-461.
  • Lee OK, Chung YF, Chan MF, Chan WM. Music and its effecton the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. J Clin Nurs 2005;14(5):609-620.
  • Tsay SL, Wang JC, Lin KC, Chung UL. Effects of acupressure therapy for patients having pro- longed mechanical ventilation support. J Adv Nurs 2005;52(2):142-150.
  • Wong HL, Lopez-Najas V, Molassiotis A. Effects of musictherapy on anxiety in ventilator- dependent patients. HeartLung 2001; 30:376-387.
  • Sanjuán Naváis M, Via Clavero G, Vázquez Guil- lamet B, Moreno Duran AM, Martínez Estalella G. Efecto de la mşsica sobre la ansiedad y el dolor en pacientes con ventilación mecánica. Enferm Inten- siva. 2013; 24(2): 63-71
  • Han L, Li JP, Sit JW, Chung L, Jiao ZY, Ma WG. Ef- fects of music intervention on physiological stress response and anxiety level of mechanically ventilat- ed patients in China: a randomised controlled trial. J Clin Nurs. 2010;19:978-987.
  • Chlan LL, Weinert CR, Heiderscheit A, Tracy MF, Skaar DJ, Guttormson JL, et al. Effects of patient-di- rected music intervention on anxiety and sedative exposure in critically ill patients receiving mechan- ical ventilatory support: a randomized clinical trial. JAMA 2013;309:2335-2344.
  • Chlan L. Effectiveness of a music therapy interven- tion on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung. 1998;27:169- 176.
  • Yaman Aktaş Y, Karabulut N. The effects of music therapy in endotracheal suctioning of mechanically ventilated patients. Nurs Crit Care. 2015 Feb 26. doi: 10.1111/nicc.12159.
  • Dijkstra BM, Gamel C, Bijl JJ, Bots ML, Kesecioglu J. The effects of music on physiological responses and sedation scores sedated, mechanically venti- lated patients. J Clin Nurs. 2010;19:1030-1039.
  • K Szilágyi A, Diószeghy C, Fritşz G, Gál J, Varga K. Shortening the length of stay and mechanical ven- tilation time by using positive suggestions via MP3 players for ventilated patients. Interv Med Appl Sci. 2014;6(1):3-15.
  • Chanques G, Jaber S, Barbotte E, Violet S, Sebanne M, Perrigault PF, et al. Impact of systematic evalua- tion of pain and agitation in an intensive care unit. Crit Care Med. 2006;34:1691-1699.
  • Chlan L, Engeland WC, Anthony A, Guttormson J. Influence of music on the stress response in pa- tients receiving mechanical ventilator support: a pilot study. AJCC. 2007;16:141-145.
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Serpil Bayındır This is me

Fatma Koçyiğit This is me

Publication Date April 1, 2017
Published in Issue Year 2017 Volume: 9 Issue: 1

Cite

Vancouver Bayındır S, Koçyiğit F. Yoğun Bakım Ünitesinde Ağrı ve Anksiyete Yönetiminde Nonfarmakolojik Adjuvan Tedavi: Müzik Terapi. Maltepe tıp derg. 2017;9(1):14-7.