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Mekanik Ventilatöre Bağlı Hastalarda Anksiyete Yönetiminde Müzik Terapinin Yeri

Year 2007, Volume: 11 Issue: 2, 83 - 88, 01.12.2007

Abstract

Mekanik ventilasyon yoğun bakım ünitesinde yay- gın olarak kullanılan bir tedavi yöntemidir. İnsan yaşamının sürdürülmesini sağlamasına rağmen, mekanik ventilasyon desteğinde kalan hastalar korku, ajitasyon, rahatsızlık, hareketsizlik, dis- pne, konfüzyon, iletişim sorunları ve gevşemenin sağlanamaması gibi çok sayıda stres faktörü- ne maruz kalırlar. Anksiyete, hastanede yatan hastalar arasında yaygın bir fenomendir, üstelik ventilatöre bağlı hastalarda yaygın olarak görül- mektedir. Mekanik ventilasyon desteğinde olan hastalarla yapılan bir çalışmada, hastalar mekanik ventilasyonu “en insani olmayan tedavi’’ olarak tanımlamışlardır. Mekanik ventilasyon desteğin- de olan hastaların anksiyete tedavisinde, sıklıkla intravenöz sedatif ilaçlar kullanılmaktadır. Fakat, sedatifler uzun ya da kısa dönemde ortaya çıka- bilen çok fazla istenmeyen yan etkiye sahiptir. Bu durum ventilatöre bağlı hastalar için farmakolo- jik olmayan alternatif girişimlerin araştırılmasını gerektirmektedir. Müzik terapi de ventilatöre bağlı hastaların anksiyete yönetiminde etkili bir hemşi- relik girişimidir

References

  • Aldridge D, Gustorff D, Hannich HJ. Where am I? Music therapy applied to coma patients. J R Soc Med 1990;83:345-6.
  • Alasad J, Ahmad M. Communication with critically ill patients. J Adv Nurs 2005;50:356-62.
  • Chlan L. Effectiveness of a music therapy interven- tion on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung 1998;27:169-76.
  • Chlan LL. Relationship between two anxiety instru- ments in patients receiving mechanical ventilatory support. J Adv Nurs 2004;48:493-9.
  • Chang SC, Chen CH. Effects of music therapy on women's physiologic measures, anxiety, and satis- faction during cesarean delivery. Res Nurs Health 2005;28:453-61.
  • 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;7:80-3.
  • Johnson P, St John W, Moyle W. Long-term mechani- cal ventilation in a critical care unit: existing in an uneveryday world. J Adv Nurs 2006;53:551-8.
  • Roberts B, Chaboyer W. Patients‘ dreams and unreal experiences following intensive care unit admission. Nurs Crit Care 2004;9:173-80.
  • Hamel MB, Phillips RS, Davis RB, Teno J, Connors AF, Desbiens N, et al. Outcomes and cost-effective- ness of ventilator support and aggressive care for patients with acute respiratory failure due to pneu- monia or acute respiratory distress syndrome. Am J Med 2000;109:614-20.
  • Wong HL, Lopez-Nahas V, Molassiotis A. Effects of music therapy on anxiety in ventilator-dependent patients. Heart Lung 2001;30:376-87.
  • Gagner-Tjellesen D, Yurkovich EE, Gragert M. Use of music therapy and other ITNIs in acute care. J Psychosoc Nurs Ment Health Serv 2001;39:26-37.
  • Almerud S, Petersson K. Music therapy-a com- plementary treatment for mechanically ventilated intensive care patients. Intensive Crit Care Nurs 2003;19:21-30.
  • Chlan L. Integrating nonpharmacological, adjunc- tive interventions into critical care practice: a means to humanize care? Am J Crit Care 2002;11:14-6.
  • Sarıcaoğlu F, Akıncı SB, Dal D, Aypar Ü. Yoğun bakım hastalarında analjezi ve sedasyon. Available from:http://www.medinfo.hacettepe.edu.tr/tebad/ dergi/dergi2005_2.htm
  • Chlan L. A single session of music therapy decreased anxiety and improved relaxation in adults who required mechanical ventilation. Evidence-Based Nursing 1999;2:49.
  • Esch T, Guarna M, Bianchi E, Zhu W, Stefano GB. Commonalities in the central nervous system's involvement with complementary medical thera- pies: limbic morphinergic processes. Med Sci Monit 2004;10:MS6-17.
  • Besel JM. The effects of music therapy on comfort in the mechanically ventilated patient in the intensive care unit. Approved for the Division of Graduate Education; 2006. p. 1-101.
  • Öz F. Sağlık alanında temel kavramlar. Ankara: İmaj ve Dış Ticaret A.Ş; 2004.
  • Yıldırım YK. Diyaliz hastalarında progresif gevşeme yöntemlerinin kaygı düzeyi ve yaşam kalitesine olan etkisinin incelenmesi. [Yüksek Lisans Tezi], İzmir: E.Ü. Sağlık Bilimleri Enstitüsü; 2002.
  • Kaplan HI, Sadock BJ, Grebb JA. Kaplan and Sadock‘s synopsis of psychiatry. 7th ed. Baltimore: Williams & Wilkins; 1994.
  • Scully JH. Psychiatry. New York: Williams & Wilkins; 1990.
  • Kaçmaz N. Yoğun bakım hastalarının psikolojik sorunları ve hemşirelik yaklaşımları. Yoğun Bakım Hemşireliği Dergisi 2002;6:75-81.
  • Sekmen K, Hatipoğlu S. Yoğun bakım ünitesi teknolojik ortamın hasta ve ailesi üzerine etkileri. Yoğun Bakım Hemşireleri Dergisi 1999;3:22-26.
  • Elliott R, Wright L. Verbal communication: what do critical care nurses say to their unconscious or sedated patients? J Adv Nurs 1999;29:1412-20.
  • Thomas LA. Clinical management of stressors per- ceived by patients on mechanical ventilation. AACN Clin Issues 2003;14:73-81.
  • Chlan LL. Description of anxiety levels by indi- vidual differences and clinical factors in patients receiving mechanical ventilatory support. Heart Lung 2003;32:275-82.
  • McKinley S, Coote K, Stein-Parbury J. Development and testing of a faces scale for the assessment of anxi- ety in critically ill patients. J Adv Nurs 2003;41:73-9.
  • Daykin N, Bunt L, McClean S. Music and healing in cancer care: A survey of supportive care providers. The Arts in Psychotherapy 2006;33:402-13.
  • Salamon E, Bernstein SR, Kim SA, Kim M, Stefano GB. The effects of auditory perception and musical preference on anxiety in naive human subjects. Med Sci Monit 2003;9:CR396-9.
  • Çam S. Kanser hastalarına dinletilen müziğin, kemoterapi yan etkilerine ve durumluluk-sürekli kaygı düzeylerine etkisinin incelenmesi. [Yüksek Lisans Tezi], İzmir: Ege Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Programı; 2003.
  • Hilliard RE. The effect of music therapy sessions on compassion fatigue and team building of profes- sional hospice caregivers. The Arts in Psychotherapy 2006;33:395-401.
  • Gallagher LM, Lagman R, Walsh D, Davis MP, Legrand SB. The clinical effects of music therapy in palliative medicine. Support Care Cancer 2006; 14:859-66.
  • Malathum P. The effect of music therapy on anxiety, physiological responses, and weaning parameters ın patients during weaning from mechanical ventila- tion. Critical Care Medicine 2004;2:123.
  • Lindgren VA, Ames NJ. Caring for patients on mechanical ventilation: what research indicates is best practice. Am J Nurs 2005;105:50-60.
  • Lee OK, Chung YF, Chan MF, Chan WM. Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. J Clin Nurs 2005;14:609-20.
  • Tsay SL, Wang JC, Lin KC, Chung UL. Effects of acupressure therapy for patients having prolonged mechanical ventilation support. J Adv Nurs 2005; 52:142-50.
  • Chlan LL, Engeland WC, Anthony A, Guttormson J. Influence of music on the stress response in patients receiving mechanical ventilatory support: a pilot study. Am J Crit Care 2007;16:141-5.

Music Therapy in Anxiety Management of Mechanical Ventilator Dependent Patients

Year 2007, Volume: 11 Issue: 2, 83 - 88, 01.12.2007

Abstract

Mechanical ventilation is a common treatment modality in the intensive care unit. Despite its life- saving nature, patients undergoing mechanical ventilation are susceptible to numerous stress- ful factors such as fear, agitation, discomfort, immobility, dyspnea, confusion, communication problems, and inability to relax. Anxiety is a com- mon phenomenon among hospitalized patients. It is also commonly found among ventilator- dependent patients. According to a research which was made with mechanical ventilation-depend- ent patients, the patients defined mechanical ventilation as “most non-humanistic treatment”. Intravenous sedative drugs are often used in anxi- ety treatments of mechanical ventilation-depend- ent patients. However, sedatives have too many undesired side effects that may result in short- or long-term complications. Therefore, additional research is required for examining alternative non- pharmacologic interventions for ventilator-depend- ent patients. One of them is music therapy as an effective nursing intervention to manage anxiety in ventilator-dependent patients

References

  • Aldridge D, Gustorff D, Hannich HJ. Where am I? Music therapy applied to coma patients. J R Soc Med 1990;83:345-6.
  • Alasad J, Ahmad M. Communication with critically ill patients. J Adv Nurs 2005;50:356-62.
  • Chlan L. Effectiveness of a music therapy interven- tion on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung 1998;27:169-76.
  • Chlan LL. Relationship between two anxiety instru- ments in patients receiving mechanical ventilatory support. J Adv Nurs 2004;48:493-9.
  • Chang SC, Chen CH. Effects of music therapy on women's physiologic measures, anxiety, and satis- faction during cesarean delivery. Res Nurs Health 2005;28:453-61.
  • 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;7:80-3.
  • Johnson P, St John W, Moyle W. Long-term mechani- cal ventilation in a critical care unit: existing in an uneveryday world. J Adv Nurs 2006;53:551-8.
  • Roberts B, Chaboyer W. Patients‘ dreams and unreal experiences following intensive care unit admission. Nurs Crit Care 2004;9:173-80.
  • Hamel MB, Phillips RS, Davis RB, Teno J, Connors AF, Desbiens N, et al. Outcomes and cost-effective- ness of ventilator support and aggressive care for patients with acute respiratory failure due to pneu- monia or acute respiratory distress syndrome. Am J Med 2000;109:614-20.
  • Wong HL, Lopez-Nahas V, Molassiotis A. Effects of music therapy on anxiety in ventilator-dependent patients. Heart Lung 2001;30:376-87.
  • Gagner-Tjellesen D, Yurkovich EE, Gragert M. Use of music therapy and other ITNIs in acute care. J Psychosoc Nurs Ment Health Serv 2001;39:26-37.
  • Almerud S, Petersson K. Music therapy-a com- plementary treatment for mechanically ventilated intensive care patients. Intensive Crit Care Nurs 2003;19:21-30.
  • Chlan L. Integrating nonpharmacological, adjunc- tive interventions into critical care practice: a means to humanize care? Am J Crit Care 2002;11:14-6.
  • Sarıcaoğlu F, Akıncı SB, Dal D, Aypar Ü. Yoğun bakım hastalarında analjezi ve sedasyon. Available from:http://www.medinfo.hacettepe.edu.tr/tebad/ dergi/dergi2005_2.htm
  • Chlan L. A single session of music therapy decreased anxiety and improved relaxation in adults who required mechanical ventilation. Evidence-Based Nursing 1999;2:49.
  • Esch T, Guarna M, Bianchi E, Zhu W, Stefano GB. Commonalities in the central nervous system's involvement with complementary medical thera- pies: limbic morphinergic processes. Med Sci Monit 2004;10:MS6-17.
  • Besel JM. The effects of music therapy on comfort in the mechanically ventilated patient in the intensive care unit. Approved for the Division of Graduate Education; 2006. p. 1-101.
  • Öz F. Sağlık alanında temel kavramlar. Ankara: İmaj ve Dış Ticaret A.Ş; 2004.
  • Yıldırım YK. Diyaliz hastalarında progresif gevşeme yöntemlerinin kaygı düzeyi ve yaşam kalitesine olan etkisinin incelenmesi. [Yüksek Lisans Tezi], İzmir: E.Ü. Sağlık Bilimleri Enstitüsü; 2002.
  • Kaplan HI, Sadock BJ, Grebb JA. Kaplan and Sadock‘s synopsis of psychiatry. 7th ed. Baltimore: Williams & Wilkins; 1994.
  • Scully JH. Psychiatry. New York: Williams & Wilkins; 1990.
  • Kaçmaz N. Yoğun bakım hastalarının psikolojik sorunları ve hemşirelik yaklaşımları. Yoğun Bakım Hemşireliği Dergisi 2002;6:75-81.
  • Sekmen K, Hatipoğlu S. Yoğun bakım ünitesi teknolojik ortamın hasta ve ailesi üzerine etkileri. Yoğun Bakım Hemşireleri Dergisi 1999;3:22-26.
  • Elliott R, Wright L. Verbal communication: what do critical care nurses say to their unconscious or sedated patients? J Adv Nurs 1999;29:1412-20.
  • Thomas LA. Clinical management of stressors per- ceived by patients on mechanical ventilation. AACN Clin Issues 2003;14:73-81.
  • Chlan LL. Description of anxiety levels by indi- vidual differences and clinical factors in patients receiving mechanical ventilatory support. Heart Lung 2003;32:275-82.
  • McKinley S, Coote K, Stein-Parbury J. Development and testing of a faces scale for the assessment of anxi- ety in critically ill patients. J Adv Nurs 2003;41:73-9.
  • Daykin N, Bunt L, McClean S. Music and healing in cancer care: A survey of supportive care providers. The Arts in Psychotherapy 2006;33:402-13.
  • Salamon E, Bernstein SR, Kim SA, Kim M, Stefano GB. The effects of auditory perception and musical preference on anxiety in naive human subjects. Med Sci Monit 2003;9:CR396-9.
  • Çam S. Kanser hastalarına dinletilen müziğin, kemoterapi yan etkilerine ve durumluluk-sürekli kaygı düzeylerine etkisinin incelenmesi. [Yüksek Lisans Tezi], İzmir: Ege Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Programı; 2003.
  • Hilliard RE. The effect of music therapy sessions on compassion fatigue and team building of profes- sional hospice caregivers. The Arts in Psychotherapy 2006;33:395-401.
  • Gallagher LM, Lagman R, Walsh D, Davis MP, Legrand SB. The clinical effects of music therapy in palliative medicine. Support Care Cancer 2006; 14:859-66.
  • Malathum P. The effect of music therapy on anxiety, physiological responses, and weaning parameters ın patients during weaning from mechanical ventila- tion. Critical Care Medicine 2004;2:123.
  • Lindgren VA, Ames NJ. Caring for patients on mechanical ventilation: what research indicates is best practice. Am J Nurs 2005;105:50-60.
  • Lee OK, Chung YF, Chan MF, Chan WM. Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. J Clin Nurs 2005;14:609-20.
  • Tsay SL, Wang JC, Lin KC, Chung UL. Effects of acupressure therapy for patients having prolonged mechanical ventilation support. J Adv Nurs 2005; 52:142-50.
  • Chlan LL, Engeland WC, Anthony A, Guttormson J. Influence of music on the stress response in patients receiving mechanical ventilatory support: a pilot study. Am J Crit Care 2007;16:141-5.
There are 37 citations in total.

Details

Other ID JA37KD53GZ
Journal Section Article
Authors

Leyla Khorshıd This is me

Esra Akın This is me

Publication Date December 1, 2007
Published in Issue Year 2007 Volume: 11 Issue: 2

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Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

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