The effect of nature sound-based music listening on pain and physiological parameters in surgical intensive care patients: a randomised-controlled trial

Sümeyye Eserer; Gizem Kubat Bakır; Sevcan Karataş

The effect of nature sound-based music listening on pain and physiological parameters in surgical intensive care patients: a randomised-controlled trial

Abstract

Aims: This study aimed to investigate the effects of nature sound-based music listening on pain and physiological parameters in surgical intensive care unit (ICU) patients. Methods: This randomized controlled trial with a pretest-posttest design was conducted in the ICUs of a state hospital in İstanbul between March and May 2024 with 108 patients who met the inclusion criteria. Patients were randomly assigned to the intervention (n=54) and control (n=54) groups using a lottery-based randomization method with sealed opaque envelopes. The envelopes were prepared by an independent healthcare staff member not involved in the study and were opened after baseline assessments to ensure allocation concealment. The intervention group listened to nature sound-based music via disposable headphones for 30 minutes, while the control group received routine care. Outcome measurements were conducted 15 minutes after the intervention. Data were collected using the Patient Information Form, Numeric Pain Rating Scale, and Physiological Parameters Assessment Form. Results: According to the pre-test results, there was no statistically significant difference in pain scores between the intervention and control groups (p=0.639). However, systolic blood pressure was significantly higher in the intervention group (p<0.05), indicating a potential imbalance and confounding factor, while no significant differences were found in other physiological parameters. Post-test results showed significant improvements in the intervention group in terms of pain score, systolic and diastolic blood pressure, heart rate, and oxygen saturation (p<0.05). In contrast, in the control group, pain scores, systolic and diastolic blood pressure, heart rate, and respiratory rate increased, while oxygen saturation decreased (p<0.05). Conclusion: Nature sound-based music listening is an effective non-pharmacological intervention for reducing pain and improving physiological parameters in intensive care patients. Despite baseline differences in systolic blood pressure, the intervention showed consistent beneficial effects. From a clinical perspective, integrating nature sound-based music listening into routine nursing care may enhance patient comfort, support physiological stabilization, and contribute to holistic, patient-centered care in intensive care settings.

Keywords

Supporting Institution

The authors declared that this study has received no financial support

Ethical Statement

To conduct the study, ethical approval was obtained from the Ethics Committee for Non-Interventional Health Sciences Research at Istanbul Yeni Yüzyıl University (Decision No: 2024/03-1241), and institutional permission was granted by the Istanbul Provincial Health Directorate (E-54230385-604.02-239139875).

References

Kumsar A, Yılmaz M. Ethical dilemmas encountered by nurses in intensive care units. Maltepe Univ J Nurs Sci Art. 2013;6(1):1-9.
Saqib M, Batool A, Iftikhar QUA, et al. Effect of music intervention on anxiety in critically ill patients: a meta-analysis of randomized controlled trials. J Crit Care. 2025;89:155133. doi:10.1016/j.jcrc.2025.155133
Ma Y, Yang X, Wang C, et al. Comparative efficacy of non-pharmacological interventions for anxiety in adult intensive care unit patients: a systematic review and network meta-analysis. Nurs Crit Care. 2024;29(6):1334-1345. doi:10.1111/nicc.13156
El-Kefraoui C, Do U, Miller A, et al. Impact of enhanced recovery pathways on patient-reported outcomes after abdominal surgery: a systematic review. Surg Endosc. 2023;37(10):8043-8056. doi:10.1007/s00464-023-10289-2
Devlin JW, Skrobik Y, Gélinas C, et al. Clinical practice guidelines for adult ICU patients. Crit Care Med. 2018;46(9):1532-1548. doi:10.1097/CCM.0000000000003299
Richard-Lalonde M, Gélinas C, Boitor M, et al. The effect of music on pain in ICU patients. J Pain Symptom Manage. 2020;59(6):1304-1319.e6. doi:10.1016/j.jpainsymman.2019.12.362
Rousseau AF, Martindale R. Nutritional modulation in ICU. Ann Intensive Care. 2024;14(1):121. doi:10.1186/s13613-024-01249-3
Bradt J, Dileo C. Music interventions for mechanically ventilated patients. Cochrane Database Syst Rev. 2014;(12):CD006902. doi:10.1002/ 14651858.CD006902.pub3

Vizeli DM, Şenturan L. Music therapy in angiography patients. Open J Nurs. 2012;2(3):165-169. doi:10.4236/ojn.2012.23025
Takmak Ş, Karaçar Y, Karaçar Hİ, Küçükakça Çelik G. Nature-based music intervention in COVID-19 patients. Intensiv Crit Care Nurs. 2023;79:103496. doi:10.1016/j.iccn.2023.103496
Monsalve-Duarte S, Betancourt-Zapata W, Suarez-Cañon N, et al. Music therapy in burn patients. Burns. 2022;48(3):510-521. doi:10.1016/j.burns.2021.09.018
Stobbe E, Bush E, Fitzke R, Delgado A. Nature sounds and ICU stress. Front Psychol. 2022;13:825312. doi:10.3389/fpsyg.2022.825312
Ghezeljeh NT, Haghani H. Nature sounds in coma patients. Complement Med J. 2019;9(2):3642-3656.
Sazak Y, Aytekin Kanadlı K, Olgun N. Music intervention in ICU. Hacettepe Univ Fac Nurs J. 2021;8(2):203-212.
Saadatmand V, Rejeh N, Heravi-Karimooi M, et al. Nature sounds in ventilated patients. Int J Nurs Stud. 2013;50(7):895-904. doi:10.1016/j.ijnurstu.2012.10.002
Jo H, Song C, Ikei H, et al. Forest sounds effects. Int J Environ Res Public Health. 2019;16(15):2649. doi:10.3390/ijerph16152649
Aghaie B, Rejeh N, Heravi-Karimooi M, et al. Nature sound therapy CABG patients. Int J Nurs Stud. 2014;51(4):526-538. doi:10.1016/j.ijnurstu.2013.08.004
Sun W, Yu H, Yu X, Chen Y. Nature sounds ICU study. Int J Environ Res Public Health. 2020;17(11):4065. doi:10.3390/ijerph17114065
Faul F, Erdfelder E, Lang AG, Buchner A. G*power 3. Behav Res Methods. 2007;39(2):175-191. doi:10.3758/BF03193146
Sarı Ozturk C, Kilicarslan Toruner E. Mandala mindfulness study. Perspect Psychiatr Care. 2022;58(4):2897-2909. doi:10.1111/ppc.13062
Han L, Li JP, Sit JW, et al. Music in coronary intervention. J Clin Nurs. 2010;19(7-8):1006-1014. doi:10.1111/j.1365-2702.2009.03011.x
Golino AJ, Leone R, Gollenberg A, et al. ICU music therapy. Am J Crit Care. 2023;32(2):109-115. doi:10.4037/ajcc2023573
Widiastuti L, Atrie UY, Wati L, et al. Music therapy systematic review. Open Access Maced J Med Sci. 2023.
Brown A, Green T, Miller R. Nature sounds pain relief. Pain Manag Nurs. 2019;20(4):289-295. doi:10.1016/j.pmn.2018.09.002
Wu P, Huang M, Lee W, Wang C, Shih W. Music in craniotomy. Complement Ther Med. 2017;32:56-60. doi:10.1016/j.ctim.2017.03.006
Akbaş Ş. Yoğun bakım hastalarına uygulanan müzik terapinin endotrakeal aspirasyon sırasındaki ağrı üzerine etkisinin değerlendirilmesi. Acıbadem Mehmet Ali Aydınlar Üniversitesi Sağlık Bilimleri Enstitüsü Hemşirelik Anabilim Dalı Yüksek Lisans Tezi, 2021, İstanbul, Turkiye.
Wong CL, Lui MMW, Choi KC. VR and pain trial. Trials. 2019;20(1):369. doi:10.1186/s13063-019-3475-6
Demir Ö, Arslantaş H. Relaxation and vital signs. Anadolu Nurs Health Sci J. 2016;19(1):10-17.
Horuz D, Kurçer MA. Music therapy COPD. Sci Stud J. 2017:79-88.
Özer N, Özlü Karaman Z, Arslan S, Güneş N. Music and postoperative pain. Pain Manag Nurs. 2013;14(1):20-28. doi:10.1016/j.pmn.2010.12.004
Beaulieu-Boire G, Bourque S, Chagnon F, et al. ICU music stress. J Crit Care. 2013;28(4):442-450. doi:10.1016/j.jcrc.2013.01.007
Liu YH, Chang MY, Chen CH. Music in labor pain. J Clin Nurs. 2010;19: 1065-1072. doi:10.1111/j.1365-2702.2009.03028.x
Foji S, Tadayonfar MA, Mohsenpour M, Rakhshani MH. Guided imagery. Complement Ther Clin Pract. 2015;21(2):119-123. doi:10.1016/j.ctcp.2015.02.002
Geensen R, Dirven TLA, Bax FHE, Klimek M, Jeekel J. Music interventions in patients undergoing surgery: a systematic review using strict inclusion criteria. Complement Ther Med. 2025;92:103195. doi:10. 1016/j.ctim.2025.103195
Thoma MV, La Marca R, Brönnimann R, et al. Music and cardiovascular system. Front Psychol. 2013;4:1-10. doi:10.3389/fpsyg.2013.00102
Bayındır S, Koçyiğit F. Music therapy ICU. Maltepe Med J. 2017;9:1.
Karadağ E, Karadakovan A. Music dialysis patients. Turk Clin J Nurs Sci. 2015;7(2):79-89.
Luis M, Doss R, Zayed B, Yacoub M. Oud music cardiac surgery. Glob Cardiol Sci Pract. 2019;(2):e201917. doi:10.21542/gcsp.2019.17
Erbay Dalli Ö, Yildirim Y, Bozkurt C. The effectiveness of music interventions on stress response in intensive care patients: a systematic review and meta-analysis. J Clin Nurs. 2023;32(11-12):2827-2845. doi:10. 1111/jocn.16401
Poulsen MJ, Coto J. Nursing music protocol and postoperative pain. Pain Manag Nurs. 2018;19(2):172-176. doi:10.1016/j.pmn.2017.09.003
Yiğit Ü, İlçe A, Karagöz İ. Music therapy vital signs. Turk J Sci Health. 2021;2(3):35-44.
Sariati S, Sholikhah DU, Narendri CM, Sari GM, Yahya QNQ. Music therapy and aromatherapy interventions in patients undergoing hemodialysis: a systematic review. Jurnal Ners. 2019;14(3):81-85.
Uzelli Y, Korhan Akın E, Baysan B, et al. Music therapy ventilated patients. Izmir Katip Celebi Univ Health Sci Fac J. 2016;1(3):21-27.
Forooghy M, Khosravi M, Haghani H. Music therapy autism. Adv Biomed Res. 2015;4:157. doi:10.4103/2277-9175.161584.
Wang Y, Tang H, Guo Q, et al. Music therapy lung surgery. J Altern Complement Med. 2015;21(11):667-672. doi:10.1089/acm.2014.0300

Details

Primary Language

English

Subjects

ICU Nursing

Journal Section

Research Article

Authors

Sümeyye Eserer
0000-0002-4739-1905
Türkiye

Gizem Kubat Bakır ^*
0000-0003-4294-0669
Türkiye

Sevcan Karataş
0000-0003-0247-3541
Türkiye

Publication Date

May 19, 2026

Submission Date

March 31, 2026

Acceptance Date

May 5, 2026

Published in Issue

Year 2026 Volume: 9 Number: 3

IZ

https://izlik.org/JA25NU35MC

Cite

RIS / Bibtex

APA

Eserer, S., Kubat Bakır, G., & Karataş, S. (2026). The effect of nature sound-based music listening on pain and physiological parameters in surgical intensive care patients: a randomised-controlled trial. Journal of Health Sciences and Medicine, 9(3), 812-822. https://izlik.org/JA25NU35MC

AMA

1.Eserer S, Kubat Bakır G, Karataş S. The effect of nature sound-based music listening on pain and physiological parameters in surgical intensive care patients: a randomised-controlled trial. J Health Sci Med / JHSM. 2026;9(3):812-822. https://izlik.org/JA25NU35MC

Chicago

Eserer, Sümeyye, Gizem Kubat Bakır, and Sevcan Karataş. 2026. “The Effect of Nature Sound-Based Music Listening on Pain and Physiological Parameters in Surgical Intensive Care Patients: A Randomised-Controlled Trial”. Journal of Health Sciences and Medicine 9 (3): 812-22. https://izlik.org/JA25NU35MC.

EndNote

Eserer S, Kubat Bakır G, Karataş S (May 1, 2026) The effect of nature sound-based music listening on pain and physiological parameters in surgical intensive care patients: a randomised-controlled trial. Journal of Health Sciences and Medicine 9 3 812–822.

IEEE

[1]S. Eserer, G. Kubat Bakır, and S. Karataş, “The effect of nature sound-based music listening on pain and physiological parameters in surgical intensive care patients: a randomised-controlled trial”, J Health Sci Med / JHSM, vol. 9, no. 3, pp. 812–822, May 2026, [Online]. Available: https://izlik.org/JA25NU35MC

ISNAD

Eserer, Sümeyye - Kubat Bakır, Gizem - Karataş, Sevcan. “The Effect of Nature Sound-Based Music Listening on Pain and Physiological Parameters in Surgical Intensive Care Patients: A Randomised-Controlled Trial”. Journal of Health Sciences and Medicine 9/3 (May 1, 2026): 812-822. https://izlik.org/JA25NU35MC.

JAMA

1.Eserer S, Kubat Bakır G, Karataş S. The effect of nature sound-based music listening on pain and physiological parameters in surgical intensive care patients: a randomised-controlled trial. J Health Sci Med / JHSM. 2026;9:812–822.

MLA

Eserer, Sümeyye, et al. “The Effect of Nature Sound-Based Music Listening on Pain and Physiological Parameters in Surgical Intensive Care Patients: A Randomised-Controlled Trial”. Journal of Health Sciences and Medicine, vol. 9, no. 3, May 2026, pp. 812-2, https://izlik.org/JA25NU35MC.

Vancouver

1.Sümeyye Eserer, Gizem Kubat Bakır, Sevcan Karataş. The effect of nature sound-based music listening on pain and physiological parameters in surgical intensive care patients: a randomised-controlled trial. J Health Sci Med / JHSM [Internet]. 2026 May 1;9(3):812-2. Available from: https://izlik.org/JA25NU35MC