Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support
JAMAPublished 20 May 2013Open access
Linda L. Chlan, Craig Weinert, Annie Heiderscheit, Mary Fran Tracy, Debra J. Skaar, Jill Guttormson
Citations297
SJR quartileQ1
SJR score5.35
SNIP10.71
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Listening to self-initiated patient-directed music with preferred selections tailored by a music therapist whenever desired can reduce anxiety and sedative exposure during ventilatory support in critically ill patients, which resulted in greater reduction in anxiety compared with usual care, but not compared with NCH.
Abstract
clinicaltrials.gov Identifier: NCT00440700.
Keywords
PsychologyMedicineHealth Professions
AnesthesiologyLorazepam Is an Independent Risk Factor for Transitioning to Delirium in Intensive Care Unit Patients
1,250 Citations2005Pratik P. Pandharipande, Ayumi Shintani +6 more
Lorazepam administration is an important and potentially modifiable risk factor for transitioning into delirium even after adjusting for relevant covariates and increasing age and Acute Physiology and Chronic Health Evaluation II scores were also independent predictors of transitioning to delirity.
The LancetA protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial
897 Citations2010Thomas Strøm, Torben Martinussen +1 more
No sedation of critically ill patients receiving mechanical ventilation is associated with an increase in days without ventilation, and a multicentre study is needed to establish whether this effect can be reproduced in other facilities.
Heart & LungEffectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance
308 Citations1998Linda L. Chlan
Critical Care MedicineCanadian survey of the use of sedatives, analgesics, and neuromuscular blocking agents in critically ill patients*
300 Citations2006Sangeeta Mehta, Lisa Burry +8 more
There is significant variation in critical care sedation, analgesia, and neuromuscular blockade practice, and younger physicians (<40 yrs) are more likely to practice daily interruption.
A mixed model approach for intent-to-treat analysis in longitudinal clinical trials with missing values
297 Citations2009Hrishikesh Chakraborty
A detailed investigation based on simulation studies suggests that the mixed model approach without any ad hoc imputation is more powerful than other options for ITT analyses of longitudinal controlled clinical trial data with missing values.
DrugsPatient-Controlled Analgesia in the Management of Postoperative Pain
230 Citations2006Mona Momeni, Manuela Crucitti +1 more
With the introduction of an Acute Pain Service, management of postoperative pain can be improved and the use of PCA in hospitals has been increasing because of its proven advantages over conventional intramuscular injections.
Heart & LungEffects of music therapy on anxiety in ventilator-dependent patients
201 Citations2001Hay Wong, Violeta López +1 more
Music therapy is an effective nursing intervention in decreasing anxiety in ventilator-dependent patients and its use should be incorporated into the care of mechanically ventilated patients.
Critical Care MedicineSedation in the intensive care unit
187 Citations2000Christopher C. Young, Nancy Knudsen +2 more
An individualized approach to sedation based on knowledge of drug pharmacology is needed because of confounding variables including concurrent patient illness, depth of sedation, and concomitant use of analgesic agents.
Anesthesia & AnalgesiaMusic Decreases Sedative Requirements During Spinal Anesthesia
186 Citations2001Charles Lepage, Pierre Drolet +3 more
It is concluded that patients listening to music require less midazolam to achieve a similar degree of relaxation as controls and that measures of anxiety obtained from the STAI and the VAS 0–10 are positively, but only moderately, correlated.
Critical Care MedicineEpidemiology of sedation and sedation adequacy for mechanically ventilated patients in a medical and surgical intensive care unit*
166 Citations2007Craig Weinert, Andrew D. Calvin
Critical Care ClinicsOptimal Intravenous Dosing Strategies for Sedatives and Analgesics in the Intensive Care Unit
131 Citations1995Juliana Barr, A. Donner
There is a high degree of interpatient variability among critically ill patients, and medication dosing must be tailored to individual patients' needs, so the best ways to achieve and maintain optimal levels of sedation and analgesia while minimizing the risk of oversedation and side effects are to initiate sedation in an incremental fashion and gradually increase the infusion rate.
Gastrointestinal EndoscopyRelaxation music decreases the dose of patient-controlled sedation during colonoscopy: A prospective randomized controlled trial
114 Citations2002Danny W.H. Lee, Kin-Wing Chan +6 more
Music can decrease the dose of sedative medication required for colonoscopy and the combination of music and patient-controlled sedation was the best-accepted mode of sedation among 3 groups.
Journal of Music TherapyThe Influence of Subject-Selected versus Experimenter-Chosen Music on Affect, Anxiety, and Relaxation
102 Citations1993Michael H. Thaut, William B. Davis
Critical Care MedicineUse of sedatives, opioids, and neuromuscular blocking agents in patients with acute lung injury and acute respiratory distress syndrome*
100 Citations2008Alejandro C. Arroliga, Bruce Thompson +6 more
The use of sedatives, opioids, and neuromuscular blocking agents (NMBAs) may delay weaning and prolong intensive care unit length of stay and was associated with a longer time to achieve important weaning landmarks.
Critical Care NurseDistress during mechanical ventilation: patients' perceptions
92 Citations1990MM Johnson, Sexton Dl
Applied Nursing ResearchA pilot study on coexisting symptoms in intensive care patients
91 Citations2006Denise T. Li, Kathleen Puntillo
This pilot study prospectively evaluated the perceptions on nine symptoms of ICU patients receiving ventilation and found that many symptoms existed at substantial levels and that there was evidence of association among symptoms.
American Journal of Critical CarePsychophysiologic responses of mechanically ventilated patients to music: a pilot study
84 Citations1995LL Chlan
Data indicated that music listening decreased heart rate, respiratory rate, and Profile of Mood States scores, indicating relaxation and mood improvement.
Journal of Advanced NursingRelationship between two anxiety instruments in patients receiving mechanical ventilatory support
80 Citations2004Linda L. Chlan
Initial validation of the VAS-A as a justifiable instrument to measure anxiety in patients receiving mechanical ventilatory support is provided and researchers are advised to balance reliability and validity properties with response burden.
Critical Care ClinicsAltering Intensive Care Sedation Paradigms to Improve Patient Outcomes
74 Citations2009Richard R. Riker, Gilles L. Fraser
There are now reliable and valid ways to monitor pain and delirium in ICU patients and dexmedetomidine reduces the incidence ofDelirium, reduces the duration of mechanical ventilation, and appears to be cost effective.
AACN Clinical Issues Advanced Practice in Acute & Critical CareMusic Therapy as a Nursing Intervention for Patients Supported by Mechanical Ventilation
71 Citations2000Linda L. Chlan
The theoretical basis of music therapy for relaxation and anxiety reduction is detailed, the research testing the intervention in patients supported by mechanical ventilation is highlighted, and areas of needed research to extend further the implementation ofMusic therapy in critical care nursing practice are discussed.
Acta Anaesthesiologica ScandinavicaComparison of alfetanil and ketamine in combination with propofol for patient‐controlled sedation during fiberoptic bronchoscopy
70 Citations2005Jung‐Won Hwang, Young-Tae Jeon +3 more
The clinical efficacy of propofol/ketamine with prop ofol/alfentanil for patient‐controlled sedation (PCS) during fiberoptic bronchoscopy is compared.
Critical Care ClinicsAnxiety and Delirium in the Intensive Care Unit
60 Citations1994James R. McCartney, Robert Boland
Assessment of the contributing causes of agitation is essential if patients are to be managed properly, and the root causes need to be corrected before a favorable outcome will ensue.
Music Therapy PerspectivesA Tool for Music Preference Assessment in Critically III Patients Receiving Mechanical Ventilatory Support
58 Citations2009Linda L. Chlan, Annie Heiderscheit
The development and implementation of the Music Assessment Tool (MAT) is described to assist professionals in ascertaining patients' music preferences in the challenging, dynamic clinical environment of the intensive care unit (ICU).
Critical Care ClinicsSedation for the Mechanically Ventilated Patient
54 Citations1995Anthony J. Mazzeo
The potential benefits of sedation for the mechanically ventilated patient include the alleviation of anxiety and pain, which may result in a reduction of oxygen consumption.
Nursing ResearchPatterns of Anxiety in Critically Ill Patients Receiving Mechanical Ventilatory Support
48 Citations2011Linda L. Chlan, Kay Savik
This study describes anxiety ratings for a subgroup of mechanically ventilated patients over the duration of enrollment in a multisite clinical trial, to discern any pattern of change in anxiety ratings, to determine if anxiety decreases over time, and to explore the influence of sedative exposure.
Critical Care ClinicsPatients Requiring Sedation
38 Citations1995Avery Tung, Myer H. Rosenthal
New indications for sedation have been proposed, including enforcing sleep/wake cycles, manipulating cellular metabolism, and preventing myocardial ischemia, but the evidence supporting the efficacy of these new indications is not yet complete.
Critical Care ClinicsAdvantages and Disadvantages of Combining Sedative Agents
22 Citations1995Daniel P. Stoltzfus
The current status of research regarding combination sedative therapy is reviewed, with a focus on the use of small doses of agents from different drug classes to treat concomitant behavioral problems.
PubMedSedation in the Intensive Care Unit. The basis of the problem.
15 Citations2002Giorgio Conti, Giovanna Mercurio +3 more
The authors focus the importance of an individualized sedative approach which provides pain relief and modulates stress response, allowing patients to be easily arousable and cooperative as necessary.
AACN Advanced Critical CareEndocrine Responses to the Stress of Critical Illness
7 Citations1992Pamela J. Sikes
The physiologic and pathophysiologic basis underlying endocrine responses to the stress of critical illness is described and the critical care nurse is challenged by the complexity of this patient and needs to be familiar with the endocrine response for assessment and clinical interventions to be meaningful.
Contemporary Clinical TrialsData acquisition for a patient-directed intervention protocol in the dynamic intensive care unit setting
3 Citations2011Linda L. Chlan, Robert Patterson +1 more
Modifications of commercially available headphones and the application of a data logging device to capture frequency and length of protocol use (music listening or headphones only for noise cancellation) without burdening participants or busy ICU nurses are described.