The effects of music interventions on anxiety in the patient after coronary artery bypass grafting

doi:10.1016/S0147-9563(05)80007-X

Heart & Lung

Volume 24, Issue 2, March–April 1995, Pages 124-132

https://doi.org/10.1016/S0147-9563(05)80007-X Get rights and content

Objective: To examine the influence during the early postoperative period of selected nursinginterventions on mood and anxiety of patients undergoing heart surgery.

Design: Prospective, repeated measures, quasiexperimental, random assignment.

Setting: The cardiovascular intensive care and progressive care units of a midwestern communityhospital were used as the setting for this study.

Patients: Ninety-six patients who underwent elective, heart bypass surgery; the mean age of thesubjects was 67 years, with an age range of 37 to 84 years. Most subjects were men (n=65, 68%).

Outcome Measures: Physiologic measures of anxiety and mood include blood pressure andheart rate. Additional measures included the use of Spielberger's state-trait anxiety inventory (STAI) and patient verbal ratings of both mood and anxiety with use of a numeric rating scale (NRS).

Intervention: Patients were randomly assigned to one of three groups: (1) music therapy, (2) music-video therapy, or (3) scheduled rest group. Subjects in the groups received their assigned 30-minute intervention at two episodes on postoperative days 2 and 3. Subjects had physiologic measures of blood pressure and heart rate measured immediately before the intervention and at 10-minute intervals throughout the intervention. Mood and anxiety were evaluated by having subjects use a NRS (i.e., 0 to 10) to give rating of mood and anxiety immediately before and after each session. Anxiety was further measured with the STAI. A baseline measure of STAI was taken before surgery; patients also completed the “state” anxiety tool before the intervention session on postoperative day 2 and on completion of the session on postoperative day 3.

Results: With use of an analysis of covariance (ANCOVA), subjects' mood ratings showed significant improvement in mood among subjects in the “music intervention” group after the second intervention when controlling for the preintervention rating of mood, F(2, 87)=4.33, p=0.016. However, no significant differences were reported for anxiety ratings as measured by the NRS and state anxiety instruments. With use of repeated measures analysis of variance (ANOVA), there were no significant interactions between the intervention groups and time for any of the physiologic variables. However, there were significant main effects over time for heart rate and systolic and diastolic blood pressure, which indicated a generalized physiologic relaxation response.

Conclusions: Although none of the three interventions was overwhelmingly superior, the overall response by all intervention groups demonstrated a generalized relaxation response. It is also important to note that there was reduced anxiety and improved mood within all three groups.

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Eight studies examined the effect of music on anxiety [18,20,23,25,26,35,36,39]. using different methods including a Visual Analogue Scale (VAS) or Numeric Rating Scale (NRS) [25,26,35,36,39], the state anxiety portion of Spielbergers’ State Anxiety Inventory (SAI), [20,23] the Trait portion of the STAI [26,35] and a ten point Likert type scale [18]. Three [18,26,39] of the six studies using the VAS, NRS or Likert scale found lower postoperative anxiety scores among patients in the music group.
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¹: Partially supported by a grant from the American Heart Association-Nebraska Affiliate.

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The effects of music interventions on anxiety in the patient after coronary artery bypass grafting1

Appl Nurs Res

Pain

Appl Nurs Res

Lancet

AORN

AORN J

Psychosocial aspects of critical care nursing

Crit Care Nurse

Anxiety in hospitalized patients

R Soc Health J

Stressors associated with coronary bypass surgery

Nurs Res

The thoughts and feelings of patients in the waiting period prior to cardiac surgery: a descriptive study

Heart Lung

The nurse's role in giving preoperative information to reduce anxiety in patients admitted to hospital for elective minor surgery

J Adv Nurs

Environment, anxiety and postoperative pain

West J Nurs Res

The CCU patient: anxiety and annoyance to noise

Crit Care Nurs Q

Relationship of anxiety to development of postoperative delirium

J Gerontol Nurs

Anxiety in surgical patients

Psychol Med

Preoperative teaching: easing the patient's anxiety

Todays OR Nurse

Effects of information about a threatening procedure on patient's expectations & emotional distress

Nurs Res

Sensation information, self-instruction and responses to dental surgery

Res Nurs Health

The effect of family involvement on patients' manifestations of post-cardiotomy psychosis

Heart Lung