Full title: Nonpharmacological interventions to manage common symptoms in patients receiving mechanical ventilation.

Patients receiving mechanical ventilation can experience symptoms such as pain, anxiety, agitation, and lack of sleep while in the intensive care unit, all of which can affect healing. Nonpharmacological complementary therapies can be used as adjuncts to sedatives and analgesics. By incorporating appropriate use of complementary therapies in conjunction with mainstream medical therapies, nurses can decrease patients' anxiety, promote sleep, and promote a healing environment to improve outcomes. Minimizing noise and providing access to natural light help promote a healing environment. Methods to promote sleep include relaxation techniques such as progressive muscle relaxation and massage and communication with patients' and their families to determine the patients' normal sleep patterns. Complementary therapies to relieve anxiety and agitation include music intervention, imagery, presence, and animal-assisted therapy.

Crit Care Nurse. 2011 Jun;31(3):19-28. Tracy MF, Chlan L.

OBJECTIVES: This study explored the effectiveness of group music intervention against agitated behavior in elderly persons with dementia. METHODS: This was an experimental study using repeated measurements. Subjects were elderly persons who suffered from dementia and resided in nursing facilities. In total, 104 participants were recruited by permuted block randomization and of the 100 subjects who completed this study, 49 were in the experimental group and 51 were in the control group. The experimental group received a total of twelve 30-min group music intervention sessions, conducted twice a week for six consecutive weeks, while the control group participated in normal daily activities. In order to measure the effectiveness of the therapeutic sessions, assessments were conducted before the intervention, at the 6th and 12th group sessions, and at 1 month after cessation of the intervention. Longitudinal effects were analyzed by means of generalized estimating equations (GEEs). RESULTS: After the group music therapy intervention, the experimental group showed better performance at the 6th and 12th sessions, and at 1 month after cessation of the intervention based on reductions in agitated behavior in general, physically non-aggressive behavior, verbally non-aggressive behavior, and physically aggressive behavior, while a reduction in verbally aggressive behavior was shown only at the 6th session. CONCLUSIONS: Group music intervention alleviated agitated behavior in elderly persons with dementia. We suggest that nursing facilities for demented elderly persons incorporate group music intervention in routine activities in order to enhance emotional relaxation, create inter-personal interactions, and reduce future agitated behaviors.

Int J Geriatr Psychiatry. 2011 Jul;26(7):670-8. doi: 10.1002/gps.2580. Epub 2010 Jul 29. Lin Y, Chu H, Yang CY, Chen CH, Chen SG, Chang HJ, Hsieh CJ, Chou KR. Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taiwan.

BACKGROUND: Centrifuge training is an important method of improving the hypergravity tolerance of pilots, cosmonauts, and Chinese astronauts. However, the concomitants of tension or anxiety often impede training. Guided imagery (GI), a mind-body relaxation technique, provides a behavioral and cognitive means whereby individuals are able to exert control over the focus of attention. This study aims to investigate the immediate effects of GI for reducing stress in centrifuge training.

METHODS: There were 12 healthy young men who were randomly assigned to a GI group or music group. We measured changes in heart rate during centrifuge training, in heart rate variability before and after centrifuge training, and also evaluated relaxation and anxiety in three phases: before intervention, after intervention, and following centrifuge training.

RESULTS: The change in the pattern of anxiety was different in the two groups over the three phases. Anxiety (measured by State Anxiety Inventory) in the GI group changed from 31.7 +/- 5.9 to 26.8 +/- 2.6 and 27.8 +/- 4.1, whereas for the music group this changed from 32.2 +/- 7.6 to 31.2 +/- 8.3 and 26.8 +/- 6.8. During centrifuge training, the maximal HR for the GI group (101.2 +/- 8.8) was lower than that of the music group (123.0 +/- 19.1). In addition GI showed a decrease in low frequency (LF, 0.04-0.15 Hz) components and an increase in high frequency (HF, 0.15-0.4 Hz) components before and after centrifuge training.

CONCLUSION: GI was capable of decreasing tension, anxiety, and sympathetic nervous system activity pre- or post-centrifugation.

Aviat Space Environ Med. 2011 Feb;82(2):92-6. Jing X, Wu P, Liu F, Wu B, Miao D. State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, China.

FULL TITLE: Home-based music therapy--a systematic overview of settings and conditions for an innovative service in healthcare.

BACKGROUND: Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. METHODS: The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. RESULTS: A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. CONCLUSIONS: We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from music therapists, patients and their families HBMT is also interesting as a blueprint for home based care for other groups of caregivers.

BMC Health Serv Res. 2010 Oct 14;10:291. Schmid W, Ostermann T. The German Center for Neurodegenerative Diseases DZNE, Witten, Germany.

There has been much written to support music therapy as an adjunct in managing pain and anxiety in palliative care patients in Western societies, but little written on its use in developing countries. In light of increasing numbers of terminally ill patients in Tanzania owing to HIV/AIDS and cancer, limited access to opioids, and a growing interest in palliative care support, this study looks at the application of music in this context. The study reviews the history and principles of therapeutic music and outlines its role in palliative care. A qualitative study was conducted by questionnaire of 17 professionals involved in home-based palliative care in Tanzania. Findings include beliefs about the power of music, how music is being used to bring comfort to the dying patient, and the most important aspects of helpful music to many Tanzanian palliative care patients. Music can powerfully affect body, mind and spirit. It is vocal music, which is an accepted therapeutic music tool used to bring comfort to the palliative care patient and their family members. Finally, music is an active and participatory activity in Tanzanian culture, even for the dying.

Int J Palliat Nurs. 2010 Oct;16(10):499-504. Hartwig R. hartwig@gmail.com

FULL TITLE: The effectiveness of music in pediatric healthcare: a systematic review of randomized controlled trials.

The aim of this study was to systematically review the effectiveness of music on pediatric health-related outcomes. Five electronic databases were searched for randomized controlled/crossover trial designs published between 1984 and 2009. Eligible studies used music as a therapy or intervention, included participants 1 to 18 years, and focused on at least one health-related outcome (with the exclusion of procedural pain). Seventeen studies met the inclusion criteria. Quantitative synthesis was hampered by an inability to aggregate data arising from heterogeneity of interventions, outcomes and measurement tools. Qualitative synthesis revealed significant improvements in one or more health outcomes within four of seven trials involving children with learning and developmental disorders; two of three trials involving children experiencing stressful life events; and four of five trials involving children with acute and/or chronic physical illness. No significant effects were found for two trials involving children with mood disorders and related psychopathology. These findings offer limited qualitative evidence to support the effectiveness of music on health-related outcomes for children and adolescents with clinical diagnoses. Recommendations for establishing a consensus on research priorities and addressing methodological limitations are put forth to support the continued advancement of this popular intervention.

Evid Based Complement Alternat Med. 2011;2011:464759. Treurnicht Naylor K, Kingsnorth S, Lamont A, McKeever P, Macarthur C. Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada M4G 1R8.

FULL TITLE: Effects of music therapy on subjective sensations and heart rate variability in treated cancer survivors: a pilot study.

OBJECTIVE: Data on the effects of music therapy on subjective sensations and the physiological parameters of heart rate variability (HRV) in treated cancer survivors are scarce. The aim of this study was to determine whether or not music therapy affects the sensations of fatigue, comfort, and relaxation in cancer survivors, and affects the activities of the sympathetic and parasympathetic nervous systems as indicated by HRV parameters. METHODS: Twenty-three patients aged 30-67 years and with cancer that had been treated at least 6 months previously received music therapy for about 2h, which included singing, listening to music, learning the recorder, and performing music. Subjective sensations and electrocardiogram were recorded before and after the music therapy. The low-frequency and high-frequency components of HRV were assessed by the frequency analysis of sequential R wave to R wave intervals of electrocardiogram obtained from 5-min recordings. Subjective sensations were quantitatively assessed using a visual analog mood scale. RESULTS: Two hours of music therapy significantly increased relaxation sensations and significantly decreased fatigue sensation in treated cancer survivors. Moreover, the HRV parameters showed that parasympathetic nervous system activity increased and sympathetic nervous system activity decreased. CONCLUSION: This study provides preliminary evidence that music therapy may be clinically useful for promoting relaxation sensation and increasing parasympathetic nervous system activity in treated cancer survivors.

Complement Ther Med. 2010 Oct;18(5):224-6. Chuang CY, Han WR, Li PC, Young ST. Institute of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan. g39304001@ym.edu.tw

FULL TITLE: Efficacy of music therapy treatment based on cycles of sessions: a randomised controlled trial.

We undertook a randomised controlled trial to assess whether a music therapy (MT) scheme of administration, including three working cycles of one month spaced out by one month of no treatment, is effective to reduce behavioural disturbances in severely demented patients. Sixty persons with severe dementia (30 in the experimental and 30 in the control group) were enrolled. Baseline multidimensional assessment included demographics, Mini Mental State Examination (MMSE), Barthel Index and Neuropsychiatry Inventory (NPI) for all patients. All the patients of the experimental and control groups received standard care (educational and entertainment activities). In addition, the experimental group received three cycles of 12 active MT sessions each, three times a week. Each 30-min session included a group of three patients. Every cycle of treatment was followed by one month of wash-out. At the end of this study, MT treatment resulted to be more effective than standard care to reduce behavioural disorders. We observed a significant reduction over time in the NPI global scores in both groups (F(7,357) = 9.06, p < 0.001) and a significant difference between groups (F(1,51) = 4.84, p < 0.05) due to a higher reduction of behavioural disturbances in the experimental group at the end of the treatment (Cohen's d = 0.63). The analysis of single NPI items shows that delusions, agitation and apathy significantly improved in the experimental, but not in the control group. This study suggests the effectiveness of MT approach with working cycles in reducing behavioural disorders of severely demented patients.

Aging Ment Health. 2010 Nov;14(8):900-4. Raglio A, Bellelli G, Traficante D, Gianotti M, Ubezio MC, Gentile S, Villani D, Trabucchi M. Sospiro Foundation, Cremona, Italy. raglioa@tin.it Comment in: Aging Ment Health. 2010 Nov;14(8):891-9.

It has been reported for more than 100 years that patients with severe nonfluent aphasia are better at singing lyrics than they are at speaking the same words. This observation led to the development of melodic intonation therapy (MIT). However, the efficacy of this therapy has yet to be substantiated in a randomized controlled trial. Furthermore, its underlying neural mechanisms remain unclear. The two unique components of MIT are the intonation of words and simple phrases using a melodic contour that follows the prosody of speech and the rhythmic tapping of the left hand that accompanies the production of each syllable and serves as a catalyst for fluency. Research has shown that both components are capable of engaging fronto-temporal regions in the right hemisphere, thereby making MIT particularly well suited for patients with large left hemisphere lesions who also suffer from nonfluent aphasia. Recovery from aphasia can happen in two ways: either through the recruitment of perilesional brain regions in the affected hemisphere, with variable recruitment of right-hemispheric regions if the lesion is small, or through the recruitment of homologous language and speech-motor regions in the unaffected hemisphere if the lesion of the affected hemisphere is extensive. Treatment-associated neural changes in patients undergoing MIT indicate that the unique engagement of right-hemispheric structures (e.g., the superior temporal lobe, primary sensorimotor, premotor and inferior frontal gyrus regions) and changes in the connections across these brain regions may be responsible for its therapeutic effect.

Future Neurol. 2010 Sep;5(5):657-665. Schlaug G, Norton A, Marchina S, Zipse L, Wan CY. Department of Neurology, Music, Neuroimaging & Stroke Recovery Laboratories, Beth Israel Deaconess Medical Center & Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.

FULL TITLE: Effect of "developmental speech and language training through music" on speech production in children with autism spectrum disorders.

The study compared the effect of music training, speech training and no-training on the verbal production of children with Autism Spectrum Disorders (ASD). Participants were 50 children with ASD, age range 3 to 5 years, who had previously been evaluated on standard tests of language and level of functioning. They were randomly assigned to one of three 3-day conditions. Participants in music training (n = 18) watched a music video containing 6 songs and pictures of the 36 target words; those in speech training (n = 18) watched a speech video containing 6 stories and pictures, and those in the control condition (n = 14) received no treatment. Participants' verbal production including semantics, phonology, pragmatics, and prosody was measured by an experimenter designed verbal production evaluation scale. Results showed that participants in both music and speech training significantly increased their pre to posttest verbal production. Results also indicated that both high and low functioning participants improved their speech production after receiving either music or speech training; however, low functioning participants showed a greater improvement after the music training than the speech training. Children with ASD perceive important linguistic information embedded in music stimuli organized by principles of pattern perception, and produce the functional speech.

J Music Ther. 2010 Spring;47(1):2-26. Lim HA. Sam Houston State University, USA.

Most medical treatments of Parkinson's disease (PD) are aimed at the reduction of motor symptoms. However, even when motor improvements are evident, patients often report a deterioration of their daily lives. Thus, to achieve a global improvement in personal well-being, not only drugs, but also complementary therapies, such as physical exercise, occupational and speech therapy, and active music therapy, have been used. We hypothesized that theater could reduce clinical disability and improve the quality of life of PD patients (primary end points) more efficiently than other complementary therapies because (1) in order to impersonate a character, patients are forced to regain the control of their bodies; and (2) while being part of a group, patients have a high degree of social interaction. The need to regain the control of their bodies and their social functioning is very likely to deeply motivate patients. To assess this hypothesis, we ran a randomized, controlled, and single-blinded study that lasted 3 years, on 20 subjects affected by a moderate form of idiopathic PD, in stable treatment with L-dopa and L-dopa agonists, and without severe sensory deficits. Ten patients were randomly assigned to an active theater program (in which patients were required to participate), while the others underwent physiotherapy (control group), the most common nonpharmacological treatment for PD rehabilitation. Patients of both groups were evaluated at the beginning of each year, using five clinical rating scales (Unified Parkinson's Disease Rating Scale [UPDRS], Schwab and England Scale, Parkinson's Disease Quality of Life [PDQ39] Scale, Epworth Sleepiness Scale, and Hamilton Depression Rating Scale). The theater patients showed progressive improvements and, at the end of the third year, they showed significant improvements in all clinical scales. Conversely, the control patients did not exhibit significant ameliorations with time. Thus, the present study provides the first scientific evidence that active theater, coupled with conventional medical treatments, represents a valid complementary therapeutic intervention for PD treatment.

ScientificWorldJournal. 2010 Nov 16;10:2301-13. Modugno N, Iaconelli S, Fiorlli M, Lena F, Kusch I, Mirabella G. IRCCS Neuromed, Pozzilli (IS), Italy.

FULL TITLE: Effect of group music activity as an adjunctive therapy on psychotic symptoms in patients with acute schizophrenia.

The effect of group music activity as an adjunctive therapy on psychotic symptoms was evaluated in 67 patients with schizophrenia from an acute psychiatric ward of a regional hospital in south Taiwan. A pretest-posttest, two-group repeated measures design was used. The experimental group received 50-minute sessions of group musical activity five times a week for 2 weeks in addition to standard care. The severity of psychotic symptoms was assessed using the Brief Psychiatric Rating Scale (BPRS). Group music activity significantly reduced the scores in total and subscales of the BPRS in patients with acute schizophrenia.

Arch Psychiatr Nurs. 2010 Dec;24(6):429-34. Peng SM, Koo M, Kuo JC. Department of Psychiatry, Dalin Tzu Chi General Hospital, Dalin, Chiayi, Taiwan.

Perioperative patient anxiety is a pervasive problem that can have far-reaching effects. Among these effects are increased postoperative pain, increased risk for infection, and longer healing times. Many factors affect perioperative patient anxiety, including the need for surgery, perceived loss of control, fear of postoperative pain, and alteration of body image. This systematic review of current literature was undertaken to identify evidence-based interventions for decreasing patient anxiety in perioperative practice. According to the current research literature, perioperative education and music therapy can be used to successfully reduce surgical patients' anxiety.

AORN J. 2010 Oct;92(4):445-57; quiz 458-60. Bailey L. Inova Fairfax Hospital Ambulatory Surgery Center, Fairfax, VA, USA.

FULL TITLE: Music therapy protocol development to enhance swallowing training for stroke patients with dysphagia.

Considering the devastating condition of dysphagia, it is necessary to provide intensive therapeutic regimen based on interdisciplinary approach. In this aspect, music-enhanced swallowing protocol was developed through a pilot study. Then, the modified protocol from a pilot study was examined with 8 stroke patients in a local hospital. The protocol was designed to improve oral motor control, laryngeal elevation, breathing, and swallowing functions. The dependent variables measured included reflex, respiration, and laryngeal functions using the Frenchay Dysarthria assessment. Results from the initial to the midevaluation showed that pitch in the laryngeal category were statistically significant after 6th sessions. After the 12th session, when the final evaluation was compared with the initial assessment, additional categories revealed statistically significant changes. It is recommended that this study should be replicated with a control group and a larger sample using either FEES or video fluoroscopy for scientific data to further substantiate music therapy outcomes in stroke rehabilitation.

J Music Ther. 2010 Summer;47(2):102-19. Kim SJ. Myongji University, Seoul, Korea.

FULL TITLE: The effect of preferred music on mood and performance in a high-cognitive demand occupation.

Mild positive affect has been shown in the psychological literature to improve cognitive skills of creative problem-solving and systematic thinking. Individual preferred music listening offers opportunity for improved positive affect. The purpose of this study was to examine the effect of preferred music listening on state-mood and cognitive performance in a high-cognitive demand occupation. Twenty-four professional computer information systems developers (CISD) from a North American IT company participated in a 3-week study with a music/no music/music weekly design. During the music weeks, participants listened to their preferred music "when they wanted, as they wanted." Self-reports of State Positive Affect, State Negative Affect, and Cognitive Performance were measured throughout the 3 weeks. Results indicate a statistically significant improvement in both state-mood and cognitive performance scores. "High-cognitive demand" is a relative term given that challenges presented to individuals may occur on a cognitive continuum from need for focus and selective attention to systematic analysis and creative problem-solving. The findings and recommendations have important implications for music therapists in their knowledge of the effect of music on emotion and cognition, and, as well, have important implications for music therapy consultation to organizations.

J Music Ther. 2010 Summer;47(2):137-54. Lesiuk T. University of Miami, USA.

What does music have to do with hypnotherapy and change work? The answer has to do with how powerful music can be – whether guiding a listener in a certain direction or enhancing his or her emotions.

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BACKGROUND: Music therapy is a promising approach widening the potential applications of psychotherapy. Music influences both, psychologic and physiologic parameters, and children are especially responsive to this form of therapy. Many aspects of its action mechanisms remain to be elucidated, underscoring the need for evidence-based medicine (EBM) for clinical use of music therapy. AIMS: This review seeks to highlight some of the issues of music therapy research and to initiate a discussion about the need for international multicenter cooperation to bring scientifically sound evidence of the benefits of music therapy in pediatric patients. METHODS: Scientific bibliographic databases were searched for randomized controlled trials on use of music therapy for children. Identified articles were evaluated according to criteria for scientific quality. RESULTS: Twenty-eight studies were identified. Most of the trials were biased by the number of participants, and some trials showed the need to improve design of control groups. Indeed, the novelty of this area of study has produced a large number of different studies (with variability in diagnoses, interventions, control groups, duration, and/or outcome parameters), and there is a need for a more homogeneous and systematic approach. Available studies highlight the need to address reproducibility issues. CONCLUSIONS: This analysis identifies the need for a subsequent series of clinical studies on the efficacy of music in the pediatric population, with more focus on eligibility criteria with respect to EBM and reproducibility.

J Altern Complement Med. 2010 Oct;16(10):1089-95. Mrázová M, Celec P. Department of Child Psychiatry, Charles University, 2nd Medical School, Prague, Czech Republic.

The purpose of this study was to examine possible relationships between personality, burnout level, longevity, and demographic variables among professional music therapists. The Sixteen Personality Factor Questionnaire (16PF) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were used to test personality and burnout. Subjects were 137 professional music therapists from all seven American Music Therapy Association (AMTA) regions with an overall average longevity of 17.85 years. The 16PF showed the personality traits that most describe music therapists are emotional sensitivity, reasoning, apprehension, warmth, openness to change, self-reliance, extraversion, anxiety, abstractedness, rule-consciousness, and self-control. Logistic regressions showed that the personality factor of anxiety (p < .007) significantly predicts the MBI-HSS subscale of emotional exhaustion and the personality factor of dominance (p < .01) significantly predicts the MBI-HSS subscale of personal accomplishment. While no personality factor significantly predicts the MBI-HSS subscales of depersonalization, social boldness (p < 0.07) and vigilance (p < .09) strongly contributed to this relationship. Logistic regressions also showed that highest degree earned is significantly (p < .000) predictive of longevity. Since the overall burnout level was in the average range, in essence this study described the profile of music therapists who are staying and thriving in the profession.

J Music Ther. 2010 Summer;47(2):155-79. Vega VP. Loyola University, New Orleans, USA.

FULL TITLE: The efficiency and duration of the analgesic effects of musical therapy on postoperative pain.

OBJECTIVES: The aim of this study was first to find out the effect of music therapy on postoperative analgesia and second to determine the duration of its effect. METHODS: Seventy patients who were undergoing elective cesarean delivery were enrolled. The patients were randomly allocated into two groups as follows: In Group 1, patients listened to music through a headphone for one hour after surgery, while in Group 2, patients did not listen to any music during the same period. In the postanesthesia care unit, patients were connected to a Patient Controlled Analgesia (PCA) device. The PCA device (tramadol 3 mg/ml) was set to deliver a bolus of 20 mg, with a lockout interval of 15 min and 4-hour maximal dose of 150 mg. Postoperative pain was assessed with a visual analog scale (VAS) and consumption of tramadol was recorded at 4, 8, 12, 16, 20 and 24 hours. RESULTS: There was a significant decrease in Group 1 with respect to PCA delivery frequency at the 4th hour postoperatively (p<0.05). Concerning the postoperative tramadol consumption, values measured at the 4th hour were significantly lower in Group 1 (p<0.05). The total amount of tramadol consumption and additional analgesic use in the postoperative 24 hours were again lower in Group 1 when compared with Group 2 (p<0.05). All VAS values were lower in Group 1 when compared with Group 2 (p<0.05). CONCLUSION: We suggest that music therapy given after surgery decreases postoperative pain in the first 24 hours and the analgesic consumption during the first four hours.

Agri. 2010 Oct;22(4):145-50. Sen H, Yanarate? O, S?zlan A, K?l?ç E, Ozkan S, Da?l? G. Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy, Haydarpa?a Training Hospital, ?stanbul, Turkey. drhuseyinsen@hotmail.com

BACKGROUND: Mechanical ventilation often causes major distress and anxiety in patients. Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients; however its efficacy for mechanically ventilated patients needs to be evaluated. OBJECTIVES: To examine the effects of music interventions with standard care versus standard care alone on anxiety and physiological responses in mechanically ventilated patients. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 1), MEDLINE, CINAHL, AMED, EMBASE, PsycINFO, LILACS, Science Citation Index, www.musictherapyworld.net, CAIRSS for Music, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, the National Research Register, and NIH CRISP (all to January 2010). We handsearched music therapy journals and reference lists and contacted relevant experts to identify unpublished manuscripts. There was no language restriction. SELECTION CRITERIA: We included all randomized and quasi-randomized controlled trials that compared music interventions and standard care with standard care alone for mechanically ventilated patients. DATA COLLECTION AND ANALYSIS: Two authors independently extracted the data and assessed the methodological quality. Additional information was sought from the trial researchers, when necessary. Results were presented using mean differences for outcomes measured by the same scale and standardized mean differences for outcomes measured by different scales. Post-test scores were used. In cases of significant baseline difference, we used change scores. MAIN RESULTS: We included eight trials (213 participants). Music listening was the main intervention used, and seven of the studies did not include a trained music therapist. Results indicated that music listening may be beneficial for anxiety reduction in mechanically ventilated patients; however, these results need to be interpreted with caution due to the small sample size. Findings indicated that listening to music consistently reduced heart rate and respiratory rate, suggesting a relaxation response. No strong evidence was found for blood pressure reduction.Music listening did not improve oxygen saturation level.No studies could be found that examined the effects of music interventions on quality of life, patient satisfaction, post-discharge outcomes, mortality, or cost-effectiveness. AUTHORS' CONCLUSIONS: Music listening may have a beneficial effect on heart rate, respiratory rate, and anxiety in mechanically ventilated patients. However, the quality of the evidence is not strong. Most studies examined the effects of listening to pre-recorded music. More research is needed on the effects of music offered by a trained music therapist.

Cochrane Database Syst Rev. 2010 Dec 8;12:CD006902. Bradt J, Dileo C, Grocke D. The Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, 2001 N 13 Street, Philadelphia, PA, USA, 19122.

BACKGROUND: Most postoperative patients have unrelieved pain despite the use of patient-controlled analgesia. Nurses need additional effective modalities. Relaxation and music (RM), in addition to analgesics, have been shown to reduce pain more than do analgesics alone. OBJECTIVES: The objectives of the study were to test an intervention of patient teaching for pain management (PT) and compare it with RM for immediate and general effects on postoperative pain. METHODS: Patients having abdominal surgery and receiving patient-controlled analgesia aged 18-75 years (n = 517) were randomized to four groups: PT, RM, a combination (PTRM), and a control. A 2 x 2 factorial design was used to assess PT-Effects and RM-Effects. Immediate effects on pain were measured on visual analogue sensation and distress scales before and after five 20-min tests in the first 2 days. Because participants also listened independently, general nonimmediate effects were examined at eight other times. RESULTS: Using multivariate analysis of covariance with contrasts and pretest control, immediate RM-Effects on pain were found at Day 1 a.m. (p < .001), Day 1 p.m. (p = .04), and Day 2 a.m. (p = .04). No PT-Effects or nonimmediate RM-Effects were found. DISCUSSION: Patient teaching did not result in less pain and did not support the theoretical proposition that PT reduces pain. However, the immediate RM-Effects supported the proposition that nonpharmacological adjuvants to analgesics can ease pain without adding side effects.

Nurs Res. 2010 Jul-Aug;59(4):259-69. Good M, Albert JM, Anderson GC, Wotman S, Cong X, Lane D, Ahn S. Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, USA. mpg@case.edu

Music permeates the medical literature regarding disease therapy. However, there are only few articles concerning music as a tool for development of cultural competency and interpersonal relations. We share our experience of forming a musical act of students and faculty at a medical school. We believe that this group has encouraged medical humanism and enhanced communication in the learning environment.

Med Teach. 2011;33(1):76-7. Ortega RA, Andreoli MT, Chima RS. Boston University School of Medicine, USA.

Music has been applied for balancing energies that have been disturbed by the stress of modern life. The objective of the present study was to verify the effect of music in labor and on the newborn, when submitted to the same melodies heard by their own mothers during pregnancy. Pregnant women, Health Center users, were submitted to musical sensitization sessions since their fifth month of pregnancy. During labor, the melodies previously selected by the pregnant women were played all the time with a thirty-minute break for every two hours of music. Data collection was performed through interviews performed after labor, at different moments, and the mother' statements were qualitatively analyzed. According to the women's words, music minimized the distress of labor and made it easier for the baby to adjust in the first months of life.

Tabarro CS, de Campos LB, Galli NO, Novo NF, Pereira VM. Rev Esc Enferm USP. 2010 Jun;44(2):445-52. Setor de Educação Continuada do Hospital Sanatorinhos de Itu, Itu, SP, Brasil. casotilo@yahoo.com.br

Music therapy, as a part of arts therapies, is used as a therapeutical tool for restoring, maintaining and improving the mental, physical and emotional health of human beings. The main mission of receptive music therapy is not found on the performance level, but on the level of attentive and intimate music listening that is not passive at all, contributing to musical pleasure and to wellbeing. At first we introduce the basic vocabulary used in receptive music therapy, flow experience and the main dimensions (bio-psycho-social) influenced by stimulating music listening. We also present the aims of this psycho-pedagogical project: The focus lies on determining the sensitivity of physically handicapped persons to different music stimuli (music styles). In this case, we can talk of the degree of music reception. We worked in an institution for persons suffering from a physical handicap. The applied methodology is based on the psycho-musical survey by Verdeau-Paillès (1). This psychological record consists in a basic interview and a test of music listening performances leading to the construction of a summary graph and the final receptivity psychogram. An observational frame conceived by Schiltz (2) and adapted to the actual situation offers the possibility of making exact observations as to non-verbal and verbal variables during the therapeutical sessions. Thus, we can present the results of descriptive and non-parametric statistical procedures, but also the results of case studies. The statistical tests used were Wilcoxon's sign-rank test for a pre-post comparison of variables related to non-verbal and verbal behaviour (two different sessions of music therapy with similar contents) and Spearman's Rho which permitted us to compute the correlations between non-verbal expression and verbal communication (N=14). Finally we conclude that our patients considered their musical experience as very positive. The results of the personal interview and the psycho-musical survey brought about several interesting statistical findings on how receptive music therapy physically and psychologically influenced the patients.

Scholer M. Bull Soc Sci Med Grand Duche Luxemb. 2010;Spec No 1(1):193-203. Universität Trier. scholermyriam@gmx.net

Undergoing a procedure that requires anesthesia can be anxiety provoking. Anxiety is associated with increases in heart rate and blood pressure and other changes that can have a negative impact preoperatively; during the induction, maintenance, and emergence phases of anesthesia; and postoperatively. Music therapy is a nonpharmacological intervention that has the ability to reduce anxiety levels in some patients. This review presents research studies that have been conducted on the effects of music therapy for patients in different clinical settings. In general, the majority of the published articles reviewed revealed that listening to music was beneficial to the patient no matter the setting. Offering a music selection to patients before anesthesia could enhance its positive effect. Perianesthesia nurses could easily develop a protocol for different situations where patients will be exposed to interventions where the use of general or local anesthesia is expected.

Wakim JH, Smith S, Guinn C. J Perianesth Nurs. 2010 Aug;25(4):226-32. The University of Tennessee at Chattanooga, School of Nursing, Department 1051, 615 McCallie Avenue, Chattanooga, TN 37403, USA. Judith-Wakim@utc.edu

Full TitleAn overview of intervention options for promoting adaptive behavior of persons with acquired brain injury and minimally conscious state.

This paper presents an overview of the studies directed at helping post-coma persons with minimally conscious state improve their adaptive behavior. Twenty-one studies were identified for the 2000-2010 period (i.e., a period in which an intense debate has occurred about diagnostic, rehabilitative, prognostic, and ethical issues concerning people with severe acquired brain injury). Three of the 21 studies involved transcortical magnetic or deep brain stimulation. Six studies focused on the provision of multisensory stimulation or music therapy. The remaining 12 studies involved the use of response-related (contingent) stimulation and assistive technology. The outcomes of the studies, which were generally reported as positive, were discussed in terms of (a) the size (quantitative relevance) of the changes obtained, (b) the credibility/reliability of the changes, in light of the methodological conditions of the studies, and (c) the level of engagement and interaction involvement of the participants. Relevant issues for future research were also examined.

Lancioni GE, Bosco A, Belardinelli MO, Singh NN, O'Reilly MF, Sigafoos J. Res Dev Disabil. 2010 Jul 19. University of Bari, Italy.

Patient stress and anxiety are common preoperatively and during dermatologic procedures and surgeries. Stress and anxiety can occasionally interfere with performance of procedures or surgery and can induce hemodynamic instability, such as elevated blood pressure or syncope, as well as producing considerable discomfort for some patients. Detection of excess stress and anxiety in patients can allow the opportunity for corrective or palliative measures. Slower breathing, biofeedback, progressive muscular relaxation, guided imagery, hypnosis, meditation and music can help calm and rebalance the patient's autonomic nervous system and immune functioning. Handheld miniaturized heart rate variability biofeedback devices are now available. The relaxation response can easily be taught. Guided imagery can be recorded or live. Live rapid induction hypnosis followed by deepening and then self-guided imagery requires no experience on the part of the patient but does require training and experience on the part of a provider. Recorded hypnosis inductions may also be used. Meditation generally requires more prior experience and training, but is useful when the patient already is skilled in it. Live, guided meditation or meditation recordings may be used. Relaxing recorded music from speakers or headphones or live performance music may also be employed to ease discomfort and improve the patient's attitude for dermatologic procedures and surgeries.

Shenefelt PD. J Drugs Dermatol. 2010 Jul;9(7):795-9. Department of Dermatology and Cutaneous Surgery, University of South Florida, College of Medicine, Tampa, FL 33612, USA. pshenefe@health.usf.edu

In this randomized, controlled multi-site study, the pacifier-activated-lullaby system (PAL) was used with 68 premature infants. Dependent variables were (a) total number of days prior to nipple feeding, (b) days of nipple feeding, (c) discharge weight, and (d) overall weight gain. Independent variables included contingent music reinforcement for non-nutritive sucking for PAL intervention at 32 vs. 34 vs. 36 weeks adjusted gestational age (AGA), with each age group subdivided into three trial conditions: control consisting of no PAL used vs. one 15-minute PAL trial vs. three 15-minute PAL trials. At 34 weeks, PAL trials significantly shortened gavage feeding length, and three trials were significantly better than one trial. At 32 weeks, PAL trials lengthened gavage feeding. Female infants learned to nipple feed significantly faster than male infants. It was noted that PAL babies went home sooner after beginning to nipple feed, a trend that was not statistically significant.

Standley JM, Cassidy J, Grant R, Cevasco A, Szuch C, Nguyen J, Walworth D, Procelli D, Jarred J, Adams K. Pediatr Nurs. 2010 May-Jun;36(3):138-45. Florida State University and Tallahassee Memorial HealthCare, Tallahassee, FL, USA.

The authors analyzed results of using music in work therapy rehabilitation complex in able-bodied patients with spinal injury. Efficiency of the therapy was demonstrated. Findings are that the patients demonstrate positive change in views, interests, desires, attitude to the personal condition and surroundings, tendency to overcome the disease, to realize compensatory resources of the body, more motivation to work--that serves as a good basis for further work rehabilitation of the patients.

[No authors listed] Med Tr Prom Ekol. 2010;(6):46-8.

Full Title Effects of Music Therapy on Psychological Symptoms and Heart Rate Variability in Patients with Dementia. A Pilot Study.

We assessed the effects of music therapy (MT) on behavioral and psychological symptoms (BPSD) in dementia associated with changes in physiological parameters, as heart rate (HR) and heart rate variability (HRV). Twenty subjects were randomly assigned to MT treatment or standard care; all patients underwent neuropsychological assessment and ECG Holter recordings before and after the 15-week treatment. The treatment included 30 MT sessions. Depression significantly decreased (p=0.021) in the MT group. PNN50 improved in 50% patients of the MT group, but in none of the control group (p=0.013). MT may improve symptoms of depression and increase HRV in demented patients.

Raglio A, Oasi O, Gianotti M, Manzoni V, Bolis S, Ubezio MC, Gentile S, Villani D, Stramba-Badiale M. Curr Aging Sci. 2010 Jul 5. Sospiro Foundation, Piazza Libertà, 2 - 26048 Sospiro, Cremona, Italy. raglioa@tin.it.

BACKGROUND: Music therapy in chronic tonal tinnitus according to the "Heidelberger model" presents an effective treatment, which is substantiated by neuroscientific and psychological evaluation.

METHOD: The music therapy approach was specifically extended to include noisiform tinnitus, taking sound quality and cardiovascular influences into consideration. Outcome criteria were psychological tinnitus load, psychophysiologic parameters and brain imaging procedures.

RESULTS: Psychological outcomes of the pilot study indicate that 21 of the 23 patients (i.e. more than 90%) achieved a reliable reduction of symptoms (TQ scores: pre: 40.1+/-11.4; post: 27.9+/-12.8; at 3-month-follow-up: 24.0+/-12.2). Results of the imaging examinations demonstrated neuroplastic changes in the putamen and insula. Psychophysiological measurements indicate cardiovascular influences on noisiform tinnitus.

DISCUSSION: Therapy success depends on the sound quality of the tinnitus; therefore, any treatment should take this into consideration. Cardiovascular influences were important insofar as active control of the heart rate was an important predictor of long-term therapy outcome. Overall, brain imaging data confirm the top-down-model of tinnitus generation.

Argstatter H, Krick C, Plinkert P, Bolay HV. HNO. 2010 Sep 1. Deutsches Zentrum für Musiktherapieforschung (Viktor Dulger Institut), Heidelberg, Deutschland, heike.argstatter@fh-heidelberg.de.

BACKGROUND: Arterial Hypertension (AH) is a mass disease, with consequences for the cardiocirculatory system, since its complications raise the rates of morbidity and mortality. Controlling blood pressure (BP) reduces complications and may preserve the quality of life (QOL) of patients. Studies show positive effects of music therapy as an adjuvant in the treatment of several diseases. OBJECTIVE: to evaluate the effect of music therapy on the QOL and BP control of hypertensive patients. METHODS: This was a controlled clinical study that evaluated patients of both genders, aged over 50 years, with stage 1 hypertension, in use of medication and enrolled in multidisciplinary service for treatment of hypertension. They were divided into an experimental group (EG) and a control group (CG). The EG, in addition to the conventional treatment, participated in weekly music therapy sessions for twelve weeks. The CG received the standard treatment of the service. Before and after the intervention, the SF-36 questionnaire was applied in both groups, and the BP of each patient was measured. The voice, an important element of communication, reflecting the patient's physical, mental and emotional state, was the main resource used. Statistics: Student T-test and Wilcoxon test were considered significant at p <0.05. RESULTS: The groups were initially similar in gender, age, education, and the assessed QOL. In the initial and final comparison of EG patients, we observed a significant improvement on the QOL (p <0.05) and BP control (p <0.05), with no change in adhesion. CONCLUSIONS: Music therapy has contributed to an improvement on the QOL and BP control of patients, suggesting that this activity may represent a therapeutic approach to help strengthen the programs of multidisciplinary care of hypertensive patients.

Arq Bras Cardiol. 2009 Nov;93(5):534-40. Zanini CR, Jardim PC, Salgado CM, Nunes MC, de Urzêda FL, Carvalho MV, Pereira DA, Jardim Tde S, de Souza WK. Liga de Hipertensão Arterial, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, GO, Brasil. mtclaudiazanini@gmail.com

BACKGROUND: Music therapy in end-of-life care aims to improve a person's quality of life by helping relieve symptoms, addressing psychological needs, offering support, facilitating communication, and meeting spiritual needs. In addition, music therapists assist family and caregivers with coping, communication, and grief/bereavement. OBJECTIVES: To examine effects of music therapy with standard care versus standard care alone or standard care combined with other therapies on psychological, physiological, and social responses in end-of-life care. SEARCH STRATEGY: We searched CENTRAL, MEDLINE, CINAHL, EMBASE, PSYCINFO, LILACS, CancerLit, Science Citation Index, www.musictherapyworld.de, CAIRSS for Music, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, and the National Research Register to September 2009. We handsearched music therapy journals and reference lists, and contacted experts to identify unpublished manuscripts. There was no language restriction. SELECTION CRITERIA: We included all randomized and quasi-randomized controlled trials that compared music interventions and standard care with standard care alone or combined with other therapies in any care setting with a diagnosis of advanced life-limiting illness being treated with palliative intent and with a life expectancy of less than two years. DATA COLLECTION AND ANALYSIS: Data were extracted, and methodological quality was assessed, independently by review authors. Additional information was sought from study authors when necessary. Results are presented using weighted mean differences for outcomes measured by the same scale and standardized mean differences for outcomes measured by different scales. Posttest scores were used. In cases of statistically significant baseline difference, we used change scores. MAIN RESULTS: Five studies (175 participants) were included. There is insufficient evidence of high quality to support the effect of music therapy on quality of life of people in end-of-life care. Given the limited number of studies and small sample sizes, more research is needed.No strong evidence was found for the effect of music therapy on pain or anxiety.These results were based on two small studies. There were insufficient data to examine the effect of music therapy on other physical, psychological, or social outcomes. AUTHORS' CONCLUSIONS: A limited number of studies suggest there may be a benefit of music therapy on the quality of life of people in end-of-life care. However, the results stem from studies with a high risk of bias. More research is needed.

Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007169. Bradt J, Dileo C. The Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, Presser Hall, 2001 North 13 Street, Philadelphia, USA.

OBJECTIVE: To observe clinical therapeutic effects of acupuncture combined with music therapy for treatment of cerebral palsy. METHODS: Sixty children with cerebral palsy were randomly divided into an acupuncture group (Group Acup.) and an acupuncture plus music group (Group Acup.+ M). Simple acupuncture was applied in Group Acup., and acupuncture at 5 groups of points plus music were applied in Group Acup. +M. The treatment was given once every two days with 3 treatments weekly, and 36 treatments constituted a therapeutic course. Therapeutic effects including movement improvement were observed for comparison after 3 courses of treatments. RESULTS: The comprehensive functions were elevated in both groups, and the total effective rate in Group Acup. + M was obviously better than that in Group Acup (P < 0.05). Movement functions were also improved in both groups, but the differences in improvement of creeping and kneeling, standing, and walking were significant between the two groups (P < 0.01), showing the effect in Group Acup. + M was better than that in Group Acup.. CONCLUSION: The therapy of acupuncture plus music gained better therapeutic effect on cerebral palsy than simple acupuncture, which provided new thoughts for treating the disease by comprehensive therapies.

J Tradit Chin Med. 2009 Dec;29(4):243-8. Yu HB, Liu YF, Wu LX. Department of Acupuncture, Shenzhen TCM Hospital of Guangdong Province, Shenzhen 518000, China.

Bone marrow biopsy and aspiration are commonly used for diagnosing, treating, and following up after treatment for blood disorders and solid tumors. For adults, the infiltration of local anesthesia at the biopsy site has been used as the principal form of analgesia for bone marrow biopsy and aspiration. Pain relief during these procedures is often incomplete, especially during aspiration of the bone marrow, and pain is likely to contribute to patient anxiety. Researchers at the Tabriz Hematology and Oncology Center in Iran conducted a study to quantify and evaluate the effectiveness of music therapy interventions on pain and anxiety control for 100 patients undergoing bone marrow biopsy and aspiration. Participants in the study were randomly assigned to one of two groups: one group listened to music during the procedure, and the other did not. Patients completed the Spielberger State-Trait Anxiety Inventory both before and after the procedure and reported pain severity by using a visual analog scale. Results showed that participants who listened to music had lower state anxiety and pain levels than those who did not listen to music. Copyright © 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

AORN J. 2010 Jun;91(6):746-751. Shabanloei R, Golchin M, Esfahani A, Dolatkhah R, Rasoulian M.

AIMS: The purpose of the study was to investigate the effects of music on pain reaction and anxiety during labour. BACKGROUND: Music therapy has been used on clinical medicine. Only few scientific studies validate the value on labour women. DESIGN: Randomised controlled trial. METHODS: Sixty primiparas expected to have a normal spontaneous delivery were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received routine care and music therapy, whereas the control group received routine care only. A self-report visual analogue scale for pain and a nurse-rated present behavioural intensity were used to measure labour pain. Anxiety was measured with a visual analogue scale for anxiety and finger temperature. Pain and anxiety between groups were compared during the latent phase (2-4 cm cervical dilation) and active phase (5-7 cm) separately. RESULTS: Our results revealed that compared with the control group, the experimental group had significantly lower pain, anxiety and a higher finger temperature during the latent phase of labour. However, no significant differences were found between the two groups on all outcome measures during the active phase. CONCLUSIONS: This study provides evidence for the use of music as an empirically based intervention of women for labour pain and anxiety during the latent phase of labour. RELEVANCE TO CLINICAL PRACTICE: The findings support that music listening is an acceptable and non-medical coping strategy for labouring women. Especially, apply in reducing the pain and anxiety for women who are at the early phase of labour.

J Clin Nurs. 2010 Apr;19(7-8):1065-72. Liu YH, Chang MY, Chen CH. Fooyin University, Kaohsiung, Taiwan.

Full Title: The Efficacy of Music Therapy Protocols for Decreasing Pain, Anxiety, and Muscle Tension Levels During Burn Dressing Changes: A Prospective Randomized Crossover Trial

The purpose of this study was to explore the efficacy of two music therapy protocols on pain, anxiety, and muscle tension levels during dressing changes in burn patients. Twenty-nine inpatients participated in this prospective, crossover randomized controlled trial. On two consecutive days, patients were randomized to receive music therapy services either on the first or second day of the study. On control days, they received no music. On music days, patients practiced music-based imagery (MBI), a form of music-assisted relaxation with patient-specific mental imagery before and after dressing changes. Also, on music days during dressing changes, the patients engaged in music alternate engagement (MAE), which consisted of active participation in music making. The dependent variables were the patients' subjective ratings of their pain and anxiety levels and the research nurse's objective ratings of their muscle tension levels. Two sets of data were collected before, three sets during, and another two sets after dressing changes. The results showed significant decrease in pain levels before (P < .025), during (P < .05), and after (P < .025) dressing changes on days the patients received music therapy in contrast to control days. Music therapy was also associated with a decrease in anxiety and muscle tension levels during the dressing changes (P < .05) followed by a reduction in muscle tension levels after dressing changes (P < .025). Music therapy significantly decreases the acute procedural pain, anxiety, and muscle tension levels associated with daily burn care.

J Burn Care Res. 2010 May 21. Tan X, Yowler CJ, Super DM, Fratianne RB. From the *The Music Settlement, Cleveland, Ohio; and daggerMetroHealth Medical Center; Campus of Case Western Reserve, University School of Medicine, Cleveland, Ohio.

Full Title: The effects of music therapy on postpartum blues and maternal attachment of puerperal women

PURPOSE: The purpose of this study was to determine the effects of music therapy on postpartum blues and maternal attachment of puerperal women. METHODS: The research design was a nonequivalent control group non-synchronized design. The participants were puerperal women who agreed to participate in this study and through a convenience sampling, 60 puerperal women were recruited (30 in the experimental group, 30 in the control group). After measuring postpartum blues and maternal attachment, music therapy was provided to the experimental group over 40 min, once a day, and for 8 days. Then, postpartum blues and maternal attachment for the experimental and control group were measured again on the 8th day. The data were analyzed using the SPSS WIN 12.0 Program. RESULTS: The first hypothesis that "the degree of postpartum blues for the experimental group who participated in music therapy would be lower than that of the control group" was accepted (t=4.350, p<.001). The second hypothesis that "the degree of maternal attachment of the experimental group who participated in music therapy would be higher than that of the control group" was accepted (t=4.828, p<.001). CONCLUSION: These findings indicate that music therapy has positive influences on decreasing postpartum blues and increasing maternal attachment of puerperal women.

J Korean Acad Nurs. 2010 Feb;40(1):60-8. Lee SM. Department of Nursing, Catholic University of Daegu, Daegu, Korea. selva88@hanmail.net.

This article reviews the evidence for using music therapy with young people who are supported by mechanical ventilation. The author argues that music therapy is essential for developing a holistic approach focusing on the developmental level of a child or young person, as well as being an inexpensive, non-pharmacological, non-invasive therapy, with significant physiological and psychological benefits. She argues that more research is needed in this area to develop a sound evidence base on which guidelines to inform practice could be based.

Paediatr Nurs. 2010 Apr;22(3):14-20. Austin D. Basingstoke and North Hampshire Foundation Trust, Hampshire.

Pain is a normal finding in the postoperative patient, and noise can accentuate one's perception of discomfort. In this study, physiological measurements, intravenous (IV) opioid administration, length of stay, and satisfaction for postoperative patients who listened to music were compared with patients not provided music during their PACU stay. Of the 213 subjects enrolled, 163 experienced postoperative pain. The mean change in experimental subjects' respiratory rate was significantly lower than the controls. Decreases in heart rate and blood pressure from admission to discharge were similar between the two groups. On average, peripheral oxygen saturation and opioid pain control were not significantly different between control and experimental subjects. Subjects provided with music reported acceptable noise levels and increased satisfaction with their PACU experience. Music intervention is therefore a viable, minimal cost, and alternative therapy that PACU nurses can use to assist patients coping with postoperative pain. Copyright 2010 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

J Perianesth Nurs. 2010 Apr;25(2):79-87. Easter B, DeBoer L, Settlemyre G, Starnes C, Marlowe V, Tart RC. Catawba Valley Medical Center PACU, Hickory, NC 28602, USA. beaster@catawbavalleymc.org