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The effects of music on physiological responses and sedation scores in sedated, mechanically ventilated patients

Authors

  • Boukje M Dijkstra,

    1. Authors:Boukje M Dijkstra, RN, MSc, Critical Care Nurse, Department of Critical Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands and (From February 2009) Researcher, Accident & Emergency Department, University Medical Centre St Radboud, Nijmegen, The Netherlands; Claudia Gamel, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Jaap J van der Bijl, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Michiel L Bots, MD, PhD, Associate Professor of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands; Jozef Kesecioglu, MD, PhD, Professor, Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • Claudia Gamel,

    1. Authors:Boukje M Dijkstra, RN, MSc, Critical Care Nurse, Department of Critical Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands and (From February 2009) Researcher, Accident & Emergency Department, University Medical Centre St Radboud, Nijmegen, The Netherlands; Claudia Gamel, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Jaap J van der Bijl, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Michiel L Bots, MD, PhD, Associate Professor of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands; Jozef Kesecioglu, MD, PhD, Professor, Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • Jaap J Van Der Bijl,

    1. Authors:Boukje M Dijkstra, RN, MSc, Critical Care Nurse, Department of Critical Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands and (From February 2009) Researcher, Accident & Emergency Department, University Medical Centre St Radboud, Nijmegen, The Netherlands; Claudia Gamel, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Jaap J van der Bijl, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Michiel L Bots, MD, PhD, Associate Professor of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands; Jozef Kesecioglu, MD, PhD, Professor, Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • Michiel L Bots,

    1. Authors:Boukje M Dijkstra, RN, MSc, Critical Care Nurse, Department of Critical Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands and (From February 2009) Researcher, Accident & Emergency Department, University Medical Centre St Radboud, Nijmegen, The Netherlands; Claudia Gamel, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Jaap J van der Bijl, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Michiel L Bots, MD, PhD, Associate Professor of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands; Jozef Kesecioglu, MD, PhD, Professor, Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • Jozef Kesecioglu

    1. Authors:Boukje M Dijkstra, RN, MSc, Critical Care Nurse, Department of Critical Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands and (From February 2009) Researcher, Accident & Emergency Department, University Medical Centre St Radboud, Nijmegen, The Netherlands; Claudia Gamel, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Jaap J van der Bijl, RN, PhD, Associate Professor, Department of Nursing Science, University Medical Centre Utrecht, Utrecht, The Netherlands; Michiel L Bots, MD, PhD, Associate Professor of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands; Jozef Kesecioglu, MD, PhD, Professor, Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
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Boukje M Dijkstra, Researcher, Afdeling Intensive Care, IC-unit H35, Huispostnummer 603, Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen, The Netherlands. Telephone: 024 3619064.
E-mail: bm.dijkstra@ic.umcn.nl

Abstract

Aims and objectives.  A pilot study designed as future randomised controlled trial was carried out to determine the effects of music on physiological responses and sedation scores in sedated, mechanically ventilated patients.

Background.  Mechanically ventilated ICU patients, even when receiving intravenous sedatives, may experience stress and anxiety. One possible intervention to reduce stress and anxiety is listening to music.

Design.  A randomised controlled trial design with repeated measures was used.

Methods.  Data were collected over a six-month period in 2006. Twenty subjects were randomly assigned to either the experimental or control group. Subjects in the experimental group listened to music three times for 30 minutes over two days; subjects in the control group undertook three 30 minute rest periods. Physiological effects of music on systolic, diastolic and mean arterial blood pressure and heart and respiratory rate were assessed. Sedation scores were also measured.

Results.  Physiological parameters did not show a significant difference between the groups. Patients in the experimental group showed significantly higher Ramsay (sedation) scores than patients in the control group after the first session. The higher scores indicate that patients were less responsive to external stimuli.

Conclusion.  Our results suggest that listening to music leads to higher sedation scores in sedated, mechanically ventilated ICU patients. No significant decreases in physiological parameters were observed. Listening to music showed no negative changes in the condition of these patients. Future research should focus on the use of other measures, such as stress hormones, to assess stress in sedated, mechanically ventilated ICU patients.

Relevance to clinical practice.  For the sedated, mechanically ventilated ICU patient, the benefit of music may lie in the associated (deeper) level of sedation that is achieved, which in turn may make the patient less susceptible to stress and anxiety.

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