Música para la reducción de la ansiedad y del estrés en pacientes con cardiopatía coronaria
References
Referencias de los estudios incluidos en esta revisión
Referencias de los estudios excluidos de esta revisión
Referencias adicionales
Referencias de otras versiones publicadas de esta revisión
Characteristics of studies
Characteristics of included studies [ordered by study ID]
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| Study characteristics | ||
| Methods | RCT | |
| Participants | Adult patients after CABG N randomized to music group: not reported N analyzed in music group: 33 N analyzed in control group: 34 N analyzed in music video group: 29 (not included in this review) Ethnicity: 100% white Country: USA | |
| Interventions | Three study groups: 1. Music group: listening to music through earphones 2. Control group: scheduled rest Music provided: (a) Country Western instrumental, (b) Fresh Aire by Steamroller, (c) Winter into Spring by Winston, (d) Prelude and Comfort Zone by Halpern Number of sessions: 2 | |
| Outcomes | Anxiety (STAI): posttest scores postop day 2, posttest scores postop day 3 Unable to use: | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: " The researcher randomly assigned subjects to one of the three intervention groups by drawing lots." (p.126) |
| Allocation concealment (selection bias) | Unclear risk | Not reported |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes. |
| Blinding of outcome assessment (detection bias) | Unclear risk | It is unclear whether outcome assessors were blinded |
| Incomplete outcome data (attrition bias) | Unclear risk | Not reported |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Partially supported by a grant from the American Heart Association‐Nebraska Affiliate |
| Study characteristics | ||
| Methods | Quasi‐RCT Cross‐over trial | |
| Participants | 10 adults in cardiac rehabilitation program Total N randomized: 10 N randomized to music first sequence: 5 N randomized to control first sequence: 5 N analyzed music first sequence: 5 N analyzed control first sequence: 5 Sex: 4 (40%) women, 6 (60%) men Ethnicity: not reported Country: USA | |
| Interventions | Two conditions: 1. Music condition: exercise on bicycle ergometer while listening to prerecorded music 2. Control condition: exercise on bicycle ergometer without music Music provided: participants selected from Jazz: selections from Fun and Games (C. Mangione); Classical: Brandengurg concertos Nos 2 and 6 (JS Bach); Country Western: selections from Greatest Hits (Kenny Rogers); Popular: selections from Unforgettable (Nat King Cole) or The best of the Supremes (The Supremes). Number of sessions: 3 in each condition | |
| Outcomes | Perceived exertion (Borg Scale of Rating of Perceived Exertion) Unable to use: HR, SBP: insufficient data reporting | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | High risk | Quote: "The participant was alternately assigned to either group A or B" (p.35). |
| Allocation concealment (selection bias) | High risk | Allocation concealment was not possible because of alternate assignment |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measure was used for subjective outcome. |
| Blinding of outcome assessment (detection bias) | Low risk | Not included in this review |
| Incomplete outcome data (attrition bias) | Low risk | No subject loss |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Unfunded research |
| Study characteristics | ||
| Methods | Quasi‐randomized trial 3‐arm parallel group design | |
| Participants | Adults undergoing CABG Total N randomized: 66 N randomized to music group: 33 N randomized to control group: 33 N analyzed in music group: 32 N analyzed in control group: 29 Mean age: 61.93 (SD 6.61) years Sex: 18 (28%) women, 48 (72%) men Ethnicity: 57 (94%) white Setting: 2 inpatient settings in hospitals Country: USA | |
| Interventions | Two study groups: 1. Music group: participants listened to audiocassette tapes intraoperatively and postoperatively via headphones 2. Control group: listened to blank cassette tape during surgery to keep surgeon blinded with no postoperative Music provided: Dreamflight II by Herb Ernst (no further info about the music was provided in the study report) Number of sessions: Once during surgery and then twice daily for duration of hospitalization Length of sessions: Duration of surgery and then 30 minutes Categorized as music medicine | |
| Outcomes | Postoperative stay (days): mean (SD) Surgical intensive care unit stay (days): mean (SD) Morphine and morphine equivalents: mean (SD) Meperidine: mean (SD) Depression: not included in this review since no standardized measurement tool was used | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Randomization method is not reported |
| Allocation concealment (selection bias) | Unclear risk | Not reported |
| Blinding of participants and personnel (performance bias) | Low risk | Blinding of participants was not possible. Use of blank tapes in the control group blinded the surgeon and medical staff |
| Blinding of outcome assessment (detection bias) | High risk | Subjective outcomes are not included in this review since no standardized measures were used |
| Blinding of outcome assessment (detection bias) | Unclear risk | It is unclear whether outcome assessors were blinded |
| Incomplete outcome data (attrition bias) | High risk | Attrition rate is 7.6% (n = 5). 3 participants were excluded because their hospitalization stay extended beyond the 2‐week study duration and the authors considered them outliers. 2 participants died in the hospital and their data were excluded. The reasons for exclusion are questionable and therefore the study was considered at high risk for attrition bias. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported by a grant from the American Academy of Family Physicians along with financial assistance from Fairview General Hospital. |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults with medical diagnosis of myocardial infarction (MI) confirmed by enzyme and ECG changes Total N randomized: 40 N analyzed in music group: 17 N analyzed in control group:18 Ethnicity: not reported Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to relaxing researcher‐selected music 2. Control group standard care | |
| Outcomes | Anxiety (STAI): posttest scores after the final session | |
| Notes | Some participants stated that they didn't care for the music; 2 would have liked different music | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Control was enhanced in the study by random assignment of subjects to two groups‐experimental and control‐using a table of random numbers" (p.67) |
| Allocation concealment (selection bias) | Unclear risk | Not reported |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of the participants was not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Low risk | No objective outcomes were used. |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: n = 5 (12.5%) |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | No report of funding |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adult patients during chest tube removal (CTR) N randomized to music group: 70 N analyzed in music group: 62 N analyzed in control group: 44 N analyzed in white noise group: 36 (not included in this review) Ethnicity: 97% white Country: USA | |
| Interventions | Three study groups: 1. Music group: listening to self‐selected music through earphones 2. Control group: standard care 3. White noise group; not used in this review | |
| Outcomes | Pain (NRS): posttest scores immediately following CTR | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: " Subjects were randomly assigned to groups by the primary investigator or research assistant who blindly drew a chip from a box containing 3 chips. The chips were labelled "C" for control group, "N" for noise group, and "M" for music group." (p.411) |
| Allocation concealment (selection bias) | Low risk | Quote: " Subjects were randomly assigned to groups by the primary investigator or research assistant who blindly drew a chip from a box containing 3 chips." |
| Blinding of participants and personnel (performance bias) | Low risk | Blinding of participants was not possible. Personnel were blinded:"the physician assistant or cardiovascular technician removing the chest tubes did not know which tape the patient was listening to." |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes. |
| Blinding of outcome assessment (detection bias) | Unclear risk | It is unclear whether outcome assessors were blinded. |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: n = 14 (11.6%). Reason for withdrawal is not reported. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported by a grant from the Epsilon Chi Chapter of Sigma Theta Tau International. |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adult cardiac patients with either intravascular sheets or an intra‐aortic balloon pump (IABP) in place. N randomized to music group: 75 N analyzed in music group: 75 N analyzed in control group: 65 Ethnicity: not reported Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to researcher‐selected music through headphones 2. Control group: standard care | |
| Outcomes | Psychological distress (POMS‐Short Form): posttest scores | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Patients were randomized to either the treatment or control group by means of a table of random numbers."(p.8) |
| Allocation concealment (selection bias) | Unclear risk | Not reported |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants were not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes. |
| Blinding of outcome assessment (detection bias) | Unclear risk | It is unclear whether outcome assessors were blinded. |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: n = 10 (7%). Data on all randomized participants were obtained for physiological data but there was a loss of 10 subjects for the POMS data. No reason was reported. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported by Eta Tau Chapter at Salem State College and Alpha Chi Chapter of Sigma Theta Tau International |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults with diagnosis of MI, acute coronary syndrome (ACS), or coronary artery disease (CAD), undergoing C‐clamp procedure after percutaneous coronary intervention N randomized to music group: 35 N analyzed in music group: 31 N analyzed in control group: 35 Sex: 18 (27%) women, 48 (73%) men Country: Hong Kong | |
| Interventions | Two study groups: 1. Music group: listening to self‐selected music during procedure through earphones 2. Control group: standard care | |
| Outcomes | HR, RR, SBP, DBP, oxygen saturation (O₂‐sat): measured every 15 minutes; measurement at 45 minutes used for this review | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: " Participants were included in the study and, using a random digit generated by research randomizer, they were randomized into the music group or control group."(p.673) |
| Allocation concealment (selection bias) | High risk | Quote: "No method for concealment of allocation was used" (personal communication with author) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding was not possible for the participants. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes. |
| Blinding of outcome assessment (detection bias) | High risk | Quote:"The intervention and data collection were carried out by the same researcher" |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: n = 4 (5.7%). 4 participants refused to continue. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | No reported funding |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults with MI N randomized to music group: 20 N randomized to control group: 20 N analyzed in music group: 20 N analyzed in control group: 20 Sex: 17 (43%) women, 23 (57%) men Ethnicity: 38 (95%) white, 2 (5%) other Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to self‐selected music 2. Control group: standard care | |
| Outcomes | Anxiety (STAI): change scores | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Subjects were then randomly assigned to the experimental or control groups by the researcher who drew from a box containing 20 slips of paper with "music" and 20 slips of paper with "rest" written on them" (p.66) |
| Allocation concealment (selection bias) | Low risk | Allocation concealment was ensured by draw of lots method |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participant was not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | High risk | Outcome assessors were not blinded |
| Incomplete outcome data (attrition bias) | Low risk | No loss of subjects |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Unfunded research study |
| Study characteristics | ||
| Methods | RCT 2‐arm parallel group | |
| Participants | Adults undergoing first‐time CABG or cardiac valve surgery Total N randomized: 173 N randomized to music group: 86 Sex: 23 (23%) women, 77 (77%) men | |
| Interventions | Two study groups: 1. Music group: listening to prerecorded music combined with nature sounds 2. Control group: 20 minutes of bed rest Music provided: participants were given the choice of four selections of music and nature sounds Number of sessions: 6 Duration of each session: 20 minutes Categorized as music medicine | |
| Outcomes | Pain (VAS): change scores Anxiety (VAS): change scores Satisfaction (VAS): change scores Relaxation (VAS): change scores HR, SBP, DBP: change scores | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Stratification for randomization was based on a pain level of 4 or less (the institutional pain level goal) or greater than 4. The randomization was blocked to ensure balanced allocation throughout the course of the study. There were 25 randomized blocks of 4 patients and 25 randomized blocks of 2 patients. Each set of 50 blocks was changed into a random order as well." (p.17) |
| Allocation concealment (selection bias) | Low risk | Quote: "The use of cards in sealed envelopes prevented the study coordinator who was enrolling patients from knowing to which group each patient was randomly assigned." (p.17) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Quote: "The study coordinator read to the patient a printed script and obtained measurements of pain, anxiety, satisfaction, and relaxation orally with a visual analog scale (VAS)." (p.18) |
| Blinding of outcome assessment (detection bias) | High risk | Study coordinator obtained the measurements |
| Incomplete outcome data (attrition bias) | High risk | Attrition rate = 73 (42%). Reasons for withdrawal were not reported. The report states that recruitment continued until 100 participants had completed all six sessions |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | The prerecorded music used in this study was donated by Ambience Medical and the study was funded in part by Richer J and Sharon M Mrocek. |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults in coronary care unit (CCU) with diagnosis of MI or other cardiac condition Total N analyzed: 24 Mean age: 62 years Ethnicity: not reported Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to researcher‐selected music through headphones 2. Congrol group: background CCU noise as heard through silent headphones | |
| Outcomes | HR: during session Mood change: not used in this review due to insufficient data | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "With the use of Latin square design, the three musical selections (A, B, C) were randomly assigned to be presented to the patients in one of three different orders: A, B, C; C, A, B: and B, C, A." (p.372) |
| Allocation concealment (selection bias) | Unclear risk | Not reported |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded |
| Blinding of outcome assessment (detection bias) | Low risk | Data for one subjective outcome were obtained but not used in this review because insufficient |
| Blinding of outcome assessment (detection bias) | Low risk | Outcome assessor was blinded. Control group participants wore a headset |
| Incomplete outcome data (attrition bias) | Unclear risk | Not reported |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | No report of funding |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults with unstable angina pectoris or acute MI N randomized to music group: unclear N analyzed in music group:19 N analyzed in control group:19 N analyzed in muscle relaxation group: 18 (not included in this review) Mean age: 60.6 years Ethnicity: all participants were Australian but no further information is provided Country: Australia | |
| Interventions | Two study groups: 1. Music group: listening to researcher‐selected music via earphones 2. Control group: standard care. | |
| Outcomes | Anxiety (STAI): posttest | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Table of random numbers (personal communication with author) |
| Allocation concealment (selection bias) | Low risk | Serially numbered opaque envelopes (personal communication with author) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | High risk | Outcome assessors were not blinded |
| Incomplete outcome data (attrition bias) | Unclear risk | Not reported |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported in part by a Cumberland College Research Grant |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults with CAD enrolled in standard university‐based 12‐week Phase II CR program. Total N analyzed: 30 Mean age: 62.6 (SD 10.5) years Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to researcher‐selected music through earphones 2. Congrol group: listening to a blank tape through earphones | |
| Outcomes | Anxiety (POMS‐SF, tension subscale): posttest | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | List of random numbers (personal communication with author) |
| Allocation concealment (selection bias) | Low risk | Recruiters were concealed to random sequence (personal communication with author) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Low risk | Outcome assessors were blinded (personal communication with author) |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: n = 3 (9%) |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported in part by a grant from the National Heart, Lung, and Blood Institute (HL45290). |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adult patients during CABG N randomized to music group: 21 assumed (not reported) N randomized to control group: 21 assumed (not reported) N randomized to guided imagery group: 21 assumed (not reported) N analyzed in music group: 17 Sex: 17 (30%) women, 39 (70%) men for total sample (including guided imagery group) Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to researcher‐selected music 2. Control group: standard care | |
| Outcomes | Anxiety (HADS, anxiety scale): 1 week postop | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Drawing of lots (personal communication with author) |
| Allocation concealment (selection bias) | High risk | None used (personal communication with author) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Low risk | No objective outcomes were included in this study |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: N = 6 (9.5%). 6 participants did not complete posttest. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Unfunded research study |
| Study characteristics | ||
| Methods | RCT 2‐arm parallel group design | |
| Participants | Adults who had undergone first‐time CABG and valvular surgery Total N randomized: 60 N randomized to music group: 30 N randomized to control group: 30 N analyzed in music group: 30 N analyzed in control group: 30 Mean age: 57.83 (SD 10.62) years Sex: 30 (50%) women, 30 (50%) men Ethnicity: not reported Setting: Inpatient Country: Iran | |
| Interventions | Two study groups: 1. Music group: participants listened to one pre‐recorded selection of music 2. Control group: participants were provided headphones with no music Music provided: participants selected their music after listening to one‐minute previews of each music option. Relaxation music pieces were selected with consideration for the cultural conditions of the society and the type of recommended music in the literature, i.e. with a tempo of 60 ‐ 80 beats (or even less) per minute Number of sessions: 1 Length of sessions: 30 minutes Categorized as music medicine | |
| Outcomes | Pain (0 ‐ 10 NRS): immediately postintervention (used in this review), 30 min after intervention, 1 hr after intervention | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Drawing of lots (personal communication with author) |
| Allocation concealment (selection bias) | Low risk | Drawing of lots concealed allocation |
| Blinding of participants and personnel (performance bias) | Low risk | Blinding of participants was not possible. Personnel were blinded |
| Blinding of outcome assessment (detection bias) | High risk | Self reports were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Low risk | This study did not address objective outcomes |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: 0 (0%) Quote: "All randomized patients were included in the analysis and there were no drop outs" (p.3) |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Funding for this study was provided by the Research Deputy and Student Research Committee of Mazandaran University of Medical Sciences |
| Study characteristics | ||
| Methods | RCT 2‐arm parallel group design | |
| Participants | Adults who had a heart attack or a heart condition or both, including coronary heart disease, angina, valve disease, or arrhythmia, and had a heart procedure or surgery, including CABG, surgery or percutaneous transluminal coronary angioplasty (PTCA) with stenting, a valve replacement, or placement of a pacemaker or implantable cardioverter defibrillator (ICD) Total N randomized: 10 N randomized in music therapy group: 5 N randomized on control group: 5 N analyzed in music therapy group: 4 N analyzed in control group: 5 Mean age: 68 years Sex: 5 (56%) women, 4 (44%) men Ethnicity: 39 (100%) white (Italian) Setting: a group meeting room in a neutral non‐medical setting Country: USA | |
| Interventions | Two study groups: 1. Music therapy group: each session had an opening, music‐assisted relaxation (MAR), active music therapy, and a closing. 2. Control group: standard care (wait‐list control) Music provided: the active music‐making component included song lyric analysis, expressive singing, songwriting, and instrumental improvisation. Instrumental music selections were drawn from the classical and new age genres. The selections had tempi of 60 to 70 beats per minute, were 3 to 6 minutes in length, and had consistent tempo, dynamics, and instrumentation. The selections gradually increased in length and complexity as the sessions progressed and then ended with a shorter, less complex selection for the last session. The relaxation scripts included autogenic and image‐based inductions Number of sessions: 6 weekly sessions over 6 weeks Length of sessions: not reported Categorized as music therapy | |
| Outcomes | Stress (Hassles Scale): posttest scores Anxiety (POMS): posttest scores Depression (POMS): posttest scores Mood disturbance (POMS): change scores Anger‐Hostility (POMS): posttest scores Vigor‐Activity (POMS): posttest scores | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Each person was given a number between 1 and 10. Using a random number generator (Haahr, n.d.), the investigator assigned each person to one of the groups. A coin toss determined that the first five numbers would comprise the experimental group and the last five numbers would comprise the comparison group." (p.51) |
| Allocation concealment (selection bias) | Low risk | Allocation was concealed through both the drawing of lots and flip of a coin |
| Blinding of participants and personnel (performance bias) | Low risk | Participants and personnel were unable to be blinded due to the interactive nature of the music therapy session |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Low risk | This study did not address objective outcomes |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: n = 1 (10%) One participant attended only one treatment session. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Unfunded research study |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults in phase II cardiac rehabilitation program Randomized to music group: 55 N analyzed in music therapy group: 35 Age: music therapy group: median age 65; control group: median age 64 Country: USA | |
| Interventions | Two study groups: 1. Music therapy group: standard care + one music therapy session every other week with a min of 4 music therapy session (max. 6 sessions) 2. Control group: standard care alone | |
| Outcomes | Trait anxiety (STAI‐T): posttest scores | |
| Notes | Follow‐up measures were taken at 1 month, 4 months, and 10 months. These were not included in this review. | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Patients' research study numbers (last 4 digits of their social security number) were recorded by the research assistant. A random‐number table was utilized by the hospital's research department staff to assign participants to condition one or two, based on their study number" (p.180). |
| Allocation concealment (selection bias) | Low risk | Central randomization was used |
| Blinding of participants and personnel (performance bias) | Low risk | In music therapy trials, participants and the music therapist cannot be blinding because of the active participation in music making |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Unclear risk | Not reported |
| Incomplete outcome data (attrition bias) | High risk | Attrition: n = 35 (34%). Reasons for participant loss: illness, non‐compliance, music therapist's leave of absence |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported by a grant from the Kulas Foundation, Cleveland OH |
| Study characteristics | ||
| Methods | RCT 2‐arm parallel group design | |
| Participants | Adults enrolled in cardiac rehab Phase II program after having undergone their 1st CABG N randomized to music group: unclear N randomized to control group: unclear N analyzed in music group: 15 Sex: 13 (43%) women, 17 (57%) men Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to researcher‐selected music during exercise session 2. Control group: standard care | |
| Outcomes | Mood (Rejeski's Feeling scale; +5 to ‐5): posttest (during 10th session) | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Drawing of lots (personal communication with author) |
| Allocation concealment (selection bias) | Low risk | Drawing of lots prevented knowledge of randomization sequence (personal communication with author) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were blinded |
| Blinding of outcome assessment (detection bias) | High risk | Self report was used for subjective measures |
| Blinding of outcome assessment (detection bias) | Low risk | No objective outcomes included in this study |
| Incomplete outcome data (attrition bias) | Low risk | Attrition: n = 3 (9%). No reason for participant loss is given |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Unclear risk | Unfunded research study |
| Study characteristics | ||
| Methods | RCT 2‐arm parallel group design | |
| Participants | Adults who underwent CABG or aortic valve replacement Total N randomized: 60 N randomized to music group: 30 N randomized to control group: 30 N analyzed in music group: 28 N analyzed in control group: 30 Mean age: 62 (SD 9.5) years Sex: 13 (22%) women, 47 (78%) men Ethnicity: not reported Setting: inpatient Country: Sweden | |
| Interventions | Two study groups: 1. Music group: participants listened to pre‐recorded music through a music pillow on their first postoperative day 2. Control group: provided a space for rest with reduced environmental stimuli Music provided: Quote from study report (p. 203): "The music was soft and relaxing, 60 to 80 beats per minute, included different melodies in new‐age style for 30 minutes, and played with a volume of 50 to 60 dB". Number of sessions: 1 Length of sessions: 30 minutes Categorized as music medicine | |
| Outcomes | HR: change scores RR, MAP, O₂‐sat: posttest scores S‐Cortisol: change scores Not used: Anxiety (NRS): not included in this review since range of scores but no SDs were reported. Pain (NRS): not included in this review since range of scores but no SDs were reported. | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "The patients were randomly allocated to 2 groups, 1 music group and 1 control group, using a computer‐generated randomization list created by the statistician" (p. 202). |
| Allocation concealment (selection bias) | Low risk | Quote: "Three special research nurses allocated the next available number on entry into the trial and conducted all interventions and outcome assessments. The code was revealed to the re‐ searcher once recruitment, data collection, and laboratory analyses were complete" (p.202) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | High risk | Outcome assessors were not blinded. However, low risk of bias for blood serum cortisol levels as lab technicians were blinded. |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: n = 2 (3.3%). Quote: "Two of those patients, who gave informed consent to participate in the music group, were excluded because of chest pain and the drainage procedure" (p. 203). |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Funding for this study was provided by grants received from the Research Committee of Orebro County Council. |
| Study characteristics | ||
| Methods | RCT 2‐arm parallel group design | |
| Participants | Adults with confirmed CAD diagnosis undergoing percutaneous transluminal coronary angiography procedures Total N randomized: 60 N randomized to music group: 30 N randomized to control group: 30 N analyzed in music group: 29 N analyzed in control group: 29 Mean age: 61.2 years Sex: 20 (34%) women, 38 (66%) men Ethnicity: no information provided Setting: inpatient Country: South Korea | |
| Interventions | Two study groups: 1. Music group: participants listened to sleep‐inducing music from 10:00 pm to 5:00 am the next morning 2. Control group: ear plugs were provided from 10:00 pm to 5:00 am the next morning Music provided: the sleep‐inducing album entitled Korean’s Brain, Delta wave Clinic Vol 1. by KK Park which included sequencing of nature sounds, delta wave control music, and Goldberg Variations BWV. 988 Number of sessions: 1 Length of sessions: 30 minutes Categorized as music medicine | |
| Outcomes | Quantity of sleep (min) Quality of sleep (Verran and Synder‐Halpern Sleeping Scale) | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "The 60 participants were randomly assigned to experimental group or control group using a card number. The participants having an even number were assigned to the experimental group, and those with an odd number were assigned to the control group". (p.730) |
| Allocation concealment (selection bias) | Low risk | Allocation was concealed by having participants draw the card number |
| Blinding of participants and personnel (performance bias) | Unclear risk | Blinding of participants was not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Low risk | Quote: "The research assistants were nurses having more than two years of experience in the CCU and who were blinded to which subject was assigned to the experimental group or the control group" (p.731) |
| Incomplete outcome data (attrition bias) | Low risk | Attrition rate: n = 2 (3.3%) One participant in the experimental group was excluded for having taken a sleep‐inducing drug taken, and one participant in the control group was transferred to another unit |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | No report of funding |
| Study characteristics | ||
| Methods | RCT 2‐arm parallel group design | |
| Participants | Adults, valve replacement or valve replacement and CABG Total N randomized: 68 N randomized to music therapy group:25 N randomized to placebo group: 23 (not used in this review) N randomized to control group: 20 N analyzed in music therapy group: 22 N analyzed in control group: 19 N randomized in placebo group: 22 Mean age: 65 (SD 9.5) years Sex: 14 (21%) women, 54 (79%) men Ethnicity: not reported Setting: inpatient Country: Denmark | |
| Interventions | Two study groups: 1. Music therapy group: music‐guided relaxation 2. Control group: standard care Music provided: (a) Easy listening, (b) classical, (c) specially composed (musicure), (d) jazz Number of sessions: 1 pre‐operative session and up to 4 postoperative sessions (most participants received 2 postop sessions) | |
| Outcomes | Anxiety (VAS): posttest 2nd postop session Mood (POMS): posttest 2nd postop session Pain (VAS): posttest 2nd postop session Use of strong opioids (mg): on day of 2nd session Use of mild opioids (mg): on day of 2nd session Use of paracetamol (gram): on day of 2nd session Length of hospital stay | |
| Notes | Most participants only received 2 sessions postoperatively. Therefore, data of the 2nd postop sessions was used for this analysis | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Random block |
| Allocation concealment (selection bias) | Low risk | Use of codes as group labels, recruiters did not know what group the codes identified (personal communication with author) |
| Blinding of participants and personnel (performance bias) | Low risk | Music therapist and participants could not be blinded given the interactive nature of the music therapy session |
| Blinding of outcome assessment (detection bias) | Unclear risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Unclear risk | Not reported |
| Incomplete outcome data (attrition bias) | Low risk | Attrition: n = 4 (8.8%). Withdrawals due to early discharge. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Unfunded research study |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults following non‐emergent CAB and/or valve replacement surgery N randomized to music group: unclear N randomized to control group: unclear N analyzed in music group: 50 Mean age: 63.5 years Setting: inpatient Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to self‐selected sedative music through earphones 2. Control group: standard care | |
| Outcomes | Anxiety (STAI): 6 measurement points. Due to high number of missing values, only posttests POD1 am, POD1 pm and POD2 am were used in research report | |
| Notes | N is highly variable due to high number of missing data | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Flip of coin |
| Allocation concealment (selection bias) | Low risk | Flip of coin prevented prior knowledge of randomization sequence |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded. |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | High risk | Outcome assessors were not blinded |
| Incomplete outcome data (attrition bias) | Unclear risk | Not reported |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported by a grant from the Allina Foundation Nursing Research Trust Fund. |
| Study characteristics | ||
| Methods | RCT 3‐arm parallel group design | |
| Participants | Adults awaiting CABG surgery or CABG plus aortic valve repair or replacement Total N randomized: 70 N randomized to music group: unclear N randomized to guided imagery: unclear (not used in this review) N randomized to control group: unclear N analyzed in music group: 17 N analyzed in control group: 19 N analyzed in guided imagery: 20 (not included in this review) Mean age: no information provided Sex: 8 (22%) women, 28 (78%) men Ethnicity: 36 (92%) white, 1 (3%) African‐American, 2 (5%) Hispanic Setting: inpatient and outpatient Country: USA | |
| Interventions | Two study groups: 1. Music group: participants listened to audiotapes at least once a day, every day, for 1 week before surgery. Participants were also asked to listen to their tapes intraoperatively 2. Control group: standard care which included access to CAM therapies, including audiotapes, upon request Music provided: Successful Surgery by Belleruth Naparstek without the pre‐recorded voice‐over providing imagery and affirmations Number of sessions: Varied Length of sessions: Varied Categorized as music medicine | |
| Outcomes | Anxiety (HADS ‐ anxiety subscale): change scores Depression (HADS ‐ depression subscale): change scores Mood disturbance (POMS): posttest scores | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "patients were randomly assigned via a coin toss" (p.215) |
| Allocation concealment (selection bias) | Low risk | Coin toss |
| Blinding of participants and personnel (performance bias) | High risk | Music was self‐administered at home after participants filled out baseline measurements |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Low risk | No objective outcomes were included in this study |
| Incomplete outcome data (attrition bias) | Low risk | Unclear how many participants were lost in the music and the control groups. In total (for 3 groups), 14 (20%) participants were lost. Reasons: 7 participants did not undergo CABG procedures or were transferred to another hospital; 7 did not complete the posttest. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Funding for this study was provided by the Foundation for the Advancement of Cardiac Therapies. |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults in ICU after CABG N randomized to music group: 20 N randomized to scheduled rest group: 21 (not included in this review) N randomized to control group: 21 N analyzed in music group: 19 N analyzed in scheduled rest: 21 (not included in this review) Setting: inpatient Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to self‐selected sedative music through earphones 2. Control group: standard care during chair rest. | |
| Outcomes | Anxiety (VAS): posttest | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Written informed consent was obtained, and participants were randomly assigned to the sedative music, scheduled rest, or control group using sealed envelopes with a varied block size prepared by the statistician. The investigator was blind to the block size and could not anticipate group assignment" (p.198) |
| Allocation concealment (selection bias) | Low risk | Serially numbered opaque sealed envelopes |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | High risk | Investigator measured objective outcomes |
| Incomplete outcome data (attrition bias) | Low risk | Attrition: n = 1 (2.4%). One participant was deleted from analysis because of extreme scores (outlier) |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported by Sigma Theta Tau Phi Chapter Research Grant, 2001–2002 |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults with confirmed diagnosis of MI, with STAI scores > 40 Total N randomized: 40 N analyzed in music group: 20 N analyzed in control group: 20 Mean age: 57.7 (SD 7.57) years Ethnicity: 36 (90%) white, 4 (10%) African‐American Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to researcher‐selected music through earphones 2. Control group: quiet, uninterrupted rest | |
| Outcomes | Anxiety (STAI): posttest scores | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Computer‐generated random number list (personal communication with author) |
| Allocation concealment (selection bias) | Low risk | Study recruiters were blind to allocation (personal communication with author) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | High risk | Outcome assessors were not blinded |
| Incomplete outcome data (attrition bias) | Low risk | No participant loss |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Unclear risk | Unfunded research study |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults with confirmed diagnosis of MI Total N randomized:45 N analyzed in music group: 15 N analyzed in control group:15 Mean age: 63 years Country: USA | |
| Interventions | Two study groups: 1. Music group: listening to researcher‐selected music through earphones 2. Control group: standard care | |
| Outcomes | Anxiety (STAI): posttest | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Computer‐generated random number list (personal communication with author) |
| Allocation concealment (selection bias) | Low risk | Study recruiters were blind to allocation (personal communication with author) |
| Blinding of participants and personnel (performance bias) | High risk | Blinding of participants was not possible. Personnel were not blinded |
| Blinding of outcome assessment (detection bias) | High risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | High risk | Outcome assessors were not blinded |
| Incomplete outcome data (attrition bias) | Low risk | No participant loss |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported in part by NSRA F 31; Marquette Medical Systems, Inc,; and Eta Nu Chapter of the Sigma Theta Tau International. |
| Study characteristics | ||
| Methods | RCT | |
| Participants | Adults less than 72 hrs post‐MI Total N randomized: 184 N randomized to music group who received 1 session (am): unclear N randomized to music group who received 2 sessions (am and pm):unclear N randomized to music group who received 2 sessions (am and noc):unclear N randomized to music group who received 3 sessions (am, pm, noc): unclear N randomized to standard care control group: unclear N randomized to quiet rest group: unclear (not included in this review) N analyzed in standard care group (N = 30) N analyzed in quiet rest group (N = 29) N analyzed in music listening group, 1 session in am (N = 30) N analyzed in music listening group, 2 sessions, am and pm (N = 30) N analyzed in music listening group, 2 sessions, am and noc (N = 30) N analyzed in music listening group, 3 sessions, am, pm, and noc (N = 30). Sex: 38 (64%) women, 22 (36%) men Age: no age data reported Etnicity: 117 (63.7%) white, 60 (32.4%) African‐American, 4 (2.2%) Asian, 1 (0.6%) Native American, 2 (1.1%) unknown (ethnicity per arm was not reported) Setting: inpatient Country: USA | |
| Interventions | Six study groups: (1) standard care group (N = 30), (2) quiet rest group (N = 29), (3) music listening group, 1 session in am (N = 30), (4) music listening group, 2 sessions, am and pm (N = 30), (5) music listening group, 2 sessions, am and noc (N = 30), and (6) music listening group, 3 sessions, am, pm, and noc (N = 30). Music used: patient‐selected relaxing music Number of sessions: 3 (only data of group 6 compared to group 1 was used for this analysis) Duration of session: 20 minutes Categorized as music medicine study. | |
| Outcomes | Anxiety (STAI): change scores HR, RR, SBP, HF HRV (variability power), myocardial oxygen (MVO₂) demand: change scores | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Computer‐generated random number list (personal communication with author) |
| Allocation concealment (selection bias) | Low risk | Study recruiters were blind to allocation (personal communication with author) |
| Blinding of participants and personnel (performance bias) | Unclear risk | Blinding of participants was not possible. Personnel were not blinded |
| Blinding of outcome assessment (detection bias) | Unclear risk | Self report measures were used for subjective outcomes |
| Blinding of outcome assessment (detection bias) | Unclear risk | Outcome assessors were not blinded |
| Incomplete outcome data (attrition bias) | Low risk | For all study arms combined, there was an attrition of n = 5 (2.7%). Reasons: 2 because of delirium tremors, 3 because of extensive periods of atrial fibrillation. |
| Selective reporting (reporting bias) | Unclear risk | Not sufficient information available to make judgment |
| Other bias | Low risk | Supported by NINR 5R01NR005004‐06 |
ACS: acute coronary syndrome; BSI: Brief Symptom Inventory; CABG: coronary artery bypass graft; CAD: coronary artery disease; CAM: complementary and alternative medicine ;CCU: coronary care unit; CES‐D: Center for Epidemiological Studies Depression Scale; CR: cardiac rehabilitation; DBP: diastolic blood pressure; ECG: electrocardiogram; HADS: Hospital Anxiety and Depression Scale; HR: heart rate; ICU: intensive care unit; LAAS: Linear Analogue Anxiety Scale; MI: myocardial infarction; mg: milligram; MPQ: McGill Pain Questionnaire; NRS: Numeric Rating Scale, POD: post‐operative days; POMS: Profile of Mood States; POMS‐SF: Profile of Mood States Short Form; POD: post‐operative day; RCT: randomized controlled trial; RR: respiratory rate; SBP: systolic blood pressure; SD: standard deviation; STAI: Spielberger State‐Trait Anxiety Inventory; STAI‐S: Spielberger State‐Trait Anxiety Inventory State Anxiety form; STAI‐T:Spielberger State‐Trait Anxiety Inventory Trait Anxiety form; VAS; Visual Analogue Scale; VRS: Verbal Rating Scale.
Characteristics of excluded studies [ordered by study ID]
Jump to:
| Study | Reason for exclusion |
| Not a randomized controlled trial | |
| This study was included in the original review but is now excluded because not all participants had confirmed CHD | |
| Not all participants had confirmed CHD | |
| Not a randomized controlled trial. Pretest‐posttest single group design | |
| Not a randomized controlled trial | |
| Not all participants had confirmed CHD | |
| Not a randomized controlled trial | |
| No standard care control group. Study compared music therapy with music listening | |
| Insufficient data available | |
| Insufficient data available | |
| Not a randomized controlled trial | |
| Not all participants had confirmed CHD | |
| Not all participants had confirmed CHD | |
| This study was included in the original review but is now excluded because not all participants had confirmed CHD | |
| Not all participants had confirmed CHD | |
| Not all participants had confirmed CHD | |
| Interquartile ranges are reported instead of standard deviations. This suggests that the outcome distribution was severely skewed. | |
| Insufficient data available | |
| The study intervention was a combination of relaxation training and music listening | |
| Not a randomized controlled trial | |
| Not a randomized controlled trial | |
| Participants received diagnostic angiography procedure | |
| Participants received diagnostic angiography procedure | |
| Participants received diagnostic angiography procedure | |
| Participants received diagnostic angiography procedure | |
| Not a randomized controlled trial | |
| Not all participants had confirmed CHD | |
| No standard care control group. Study compared music listening with music/imagery | |
| This study was included in the original review but is now excluded because not all participants had confirmed CHD | |
| No randomization used | |
| Group assignment was based on availability of space | |
| Experimental group was not randomized and there was no control group | |
| Insufficient data | |
| Not all participants had confirmed CHD | |
| Unclear randomization methods. Poor data reporting | |
| Lack of proper randomization method. In the thesis author explicitly states that only 4 CD players were available. If all CD players were in use, the next group of participants were placed in the control group | |
| Participants received diagnostic cerebral angiography procedure | |
| Participants received diagnostic angiography procedure | |
| Participants received diagnostic angiography procedure | |
| This study was included in the original review but is now excluded because not all participants had confirmed CHD |
Data and analyses
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1.1 Psychological distress Show forest plot | 5 | 228 | Mean Difference (IV, Fixed, 95% CI) | ‐1.26 [‐2.30, ‐0.22] |
| Analysis 1.1  Comparison 1: Music versus standard care, Outcome 1: Psychological distress | ||||
| 1.2 Anxiety (all measures) ‐ patient type Show forest plot | 10 | 353 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.70 [‐1.17, ‐0.22] |
| Analysis 1.2  Comparison 1: Music versus standard care, Outcome 2: Anxiety (all measures) ‐ patient type | ||||
| 1.2.1 anxiety (all measures) (MI) | 4 | 143 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.94 [‐1.95, 0.06] |
| 1.2.2 anxiety (all measures)(surgical/procedural) | 4 | 171 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.63 [‐1.25, ‐0.01] |
| 1.2.3 anxiety (all measures)(rehabilitation) | 2 | 39 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.38 [‐1.60, 0.83] |
| 1.3 Anxiety (all measures) ‐ music preference Show forest plot | 9 | 323 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.79 [‐1.29, ‐0.29] |
| Analysis 1.3  Comparison 1: Music versus standard care, Outcome 3: Anxiety (all measures) ‐ music preference | ||||
| 1.3.1 Anxiety (all measures) ‐ partcipant‐selected | 4 | 144 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.89 [‐1.42, ‐0.36] |
| 1.3.2 Anxiety (all measures) ‐ researcher‐selected | 5 | 179 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.74 [‐1.55, 0.08] |
| 1.4 State anxiety (STAI) ‐ patient type Show forest plot | 7 | 310 | Mean Difference (IV, Random, 95% CI) | ‐4.58 [‐7.78, ‐1.39] |
| Analysis 1.4  Comparison 1: Music versus standard care, Outcome 4: State anxiety (STAI) ‐ patient type | ||||
| 1.4.1 State anxiety (STAI) ‐ MI | 6 | 243 | Mean Difference (IV, Random, 95% CI) | ‐5.87 [‐7.99, ‐3.75] |
| 1.4.2 State anxiety (STAI) ‐ surgical/procedural | 1 | 67 | Mean Difference (IV, Random, 95% CI) | 0.40 [‐1.33, 2.13] |
| 1.5 State Anxiety (STAI) ‐ music preference Show forest plot | 7 | 310 | Mean Difference (IV, Random, 95% CI) | ‐4.58 [‐7.78, ‐1.39] |
| Analysis 1.5  Comparison 1: Music versus standard care, Outcome 5: State Anxiety (STAI) ‐ music preference | ||||
| 1.5.1 State Anxiety (STAI) ‐ participant‐preferred | 3 | 167 | Mean Difference (IV, Random, 95% CI) | ‐4.71 [‐10.76, 1.33] |
| 1.5.2 State Anxiety (STAI) ‐ researcher‐selected | 4 | 143 | Mean Difference (IV, Random, 95% CI) | ‐4.68 [‐8.27, ‐1.10] |
| 1.6 State Anxiety (STAI) ‐ music preference MI only Show forest plot | 6 | 243 | Mean Difference (IV, Random, 95% CI) | ‐5.87 [‐7.99, ‐3.75] |
| Analysis 1.6  Comparison 1: Music versus standard care, Outcome 6: State Anxiety (STAI) ‐ music preference MI only | ||||
| 1.6.1 State Anxiety (STAI) ‐ participant‐preferred | 2 | 100 | Mean Difference (IV, Random, 95% CI) | ‐7.36 [‐9.45, ‐5.27] |
| 1.6.2 State Anxiety (STAI) ‐ researcher‐selected | 4 | 143 | Mean Difference (IV, Random, 95% CI) | ‐4.68 [‐8.27, ‐1.10] |
| 1.7 Anxiety (non‐STAI)‐patient type Show forest plot | 7 | 248 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.43 [‐0.93, 0.06] |
| Analysis 1.7  Comparison 1: Music versus standard care, Outcome 7: Anxiety (non‐STAI)‐patient type | ||||
| 1.7.1 Anxiety (surgical/procedural) | 4 | 171 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.63 [‐1.25, ‐0.01] |
| 1.7.2 Anxiety (MI and rehabilitation) | 3 | 77 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.03 [‐0.61, 0.56] |
| 1.8 Anxiety (non‐STAI) ‐ music preference Show forest plot | 7 | 248 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.43 [‐0.93, 0.06] |
| Analysis 1.8  Comparison 1: Music versus standard care, Outcome 8: Anxiety (non‐STAI) ‐ music preference | ||||
| 1.8.1 Anxiety (non‐STAI) ‐ participant‐preferred | 4 | 144 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.89 [‐1.42, ‐0.36] |
| 1.8.2 Anxiety (non‐STAI) ‐ researcher‐selected | 3 | 104 | Std. Mean Difference (IV, Random, 95% CI) | 0.11 [‐0.28, 0.49] |
| 1.9 Depression Show forest plot | 6 | 217 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.11 [‐0.38, 0.16] |
| Analysis 1.9  Comparison 1: Music versus standard care, Outcome 9: Depression | ||||
| 1.10 Mood Show forest plot | 2 | 97 | Std. Mean Difference (IV, Random, 95% CI) | 1.08 [‐0.02, 2.17] |
| Analysis 1.10  Comparison 1: Music versus standard care, Outcome 10: Mood | ||||
| 1.11 Heart rate‐patient type Show forest plot | 13 | 828 | Mean Difference (IV, Random, 95% CI) | ‐3.40 [‐6.12, ‐0.69] |
| Analysis 1.11  Comparison 1: Music versus standard care, Outcome 11: Heart rate‐patient type | ||||
| 1.11.1 heart rate (surg ical/procedural) | 7 | 604 | Mean Difference (IV, Random, 95% CI) | ‐2.61 [‐5.62, 0.39] |
| 1.11.2 Heart rate (MI) | 5 | 194 | Mean Difference (IV, Random, 95% CI) | ‐4.75 [‐9.26, ‐0.25] |
| 1.11.3 Heart rate (rehab) | 1 | 30 | Mean Difference (IV, Random, 95% CI) | 4.50 [‐9.68, 18.68] |
| 1.12 Heart rate ‐ music preference Show forest plot | 13 | 828 | Mean Difference (IV, Random, 95% CI) | ‐3.62 [‐6.28, ‐0.95] |
| Analysis 1.12  Comparison 1: Music versus standard care, Outcome 12: Heart rate ‐ music preference | ||||
| 1.12.1 Heart rate ‐ participant‐selected music | 7 | 430 | Mean Difference (IV, Random, 95% CI) | ‐4.69 [‐9.40, 0.02] |
| 1.12.2 Heart rate ‐ researcher‐selected music | 6 | 398 | Mean Difference (IV, Random, 95% CI) | ‐2.67 [‐4.27, ‐1.07] |
| 1.13 Heart rate variability Show forest plot | 2 | 90 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.07 [‐0.34, 0.48] |
| Analysis 1.13  Comparison 1: Music versus standard care, Outcome 13: Heart rate variability | ||||
| 1.14 Respiratory rate ‐ music preference Show forest plot | 7 | 442 | Mean Difference (IV, Random, 95% CI) | ‐2.50 [‐3.61, ‐1.39] |
| Analysis 1.14  Comparison 1: Music versus standard care, Outcome 14: Respiratory rate ‐ music preference | ||||
| 1.14.1 Respiratory Rate ‐ participant‐selected | 3 | 186 | Mean Difference (IV, Random, 95% CI) | ‐4.42 [‐7.37, ‐1.46] |
| 1.14.2 Respiratory Rate ‐ researcher‐selected | 4 | 256 | Mean Difference (IV, Random, 95% CI) | ‐1.66 [‐2.20, ‐1.12] |
| 1.15 Systolic blood pressure Show forest plot | 11 | 775 | Mean Difference (IV, Fixed, 95% CI) | ‐5.52 [‐7.43, ‐3.60] |
| Analysis 1.15  Comparison 1: Music versus standard care, Outcome 15: Systolic blood pressure | ||||
| 1.16 Diastolic blood pressure Show forest plot | 9 | 685 | Mean Difference (IV, Fixed, 95% CI) | ‐1.12 [‐2.57, 0.34] |
| Analysis 1.16  Comparison 1: Music versus standard care, Outcome 16: Diastolic blood pressure | ||||
| 1.17 Mean A rterial Pressure Show forest plot | 3 | 158 | Mean Difference (IV, Fixed, 95% CI) | ‐0.91 [‐4.08, 2.26] |
| Analysis 1.17  Comparison 1: Music versus standard care, Outcome 17: Mean A rterial Pressure | ||||
| 1.18 Oxygen Saturation Show forest plot | 3 | 184 | Mean Difference (IV, Random, 95% CI) | ‐0.02 [‐1.65, 1.61] |
| Analysis 1.18  Comparison 1: Music versus standard care, Outcome 18: Oxygen Saturation | ||||
| 1.19 Pain Show forest plot | 8 | 630 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.43 [‐0.80, ‐0.05] |
| Analysis 1.19  Comparison 1: Music versus standard care, Outcome 19: Pain | ||||
| 1.19.1 One music session | 5 | 420 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.55 [‐1.16, 0.07] |
| 1.19.2 Two or more music sessions | 3 | 210 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.27 [‐0.55, ‐0.00] |
| 1.20 Length of hospital stay Show forest plot | 2 | 82 | Mean Difference (IV, Fixed, 95% CI) | ‐0.06 [‐1.03, 0.92] |
| Analysis 1.20  Comparison 1: Music versus standard care, Outcome 20: Length of hospital stay | ||||
| 1.21 Opioid intake Show forest plot | 2 | 90 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.25 [‐0.67, 0.16] |
| Analysis 1.21  Comparison 1: Music versus standard care, Outcome 21: Opioid intake | ||||
| 1.22 Quality of sleep Show forest plot | 2 | 122 | Std. Mean Difference (IV, Random, 95% CI) | 0.91 [0.03, 1.79] |
| Analysis 1.22  Comparison 1: Music versus standard care, Outcome 22: Quality of sleep | ||||
Funnel plot of comparison: 1 music versus standard care, outcome: 1.2 Anxiety (all measures) ‐ patient type.
Funnel plot of comparison: 1 music versus standard care, outcome: 1.11 Heart rate‐patient type.
Funnel plot of comparison: 1 music versus standard care, outcome: 1.15 Systolic blood pressure.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Comparison 1: Music versus standard care, Outcome 1: Psychological distress
Comparison 1: Music versus standard care, Outcome 2: Anxiety (all measures) ‐ patient type
Comparison 1: Music versus standard care, Outcome 3: Anxiety (all measures) ‐ music preference
Comparison 1: Music versus standard care, Outcome 4: State anxiety (STAI) ‐ patient type
Comparison 1: Music versus standard care, Outcome 5: State Anxiety (STAI) ‐ music preference
Comparison 1: Music versus standard care, Outcome 6: State Anxiety (STAI) ‐ music preference MI only
Comparison 1: Music versus standard care, Outcome 7: Anxiety (non‐STAI)‐patient type
Comparison 1: Music versus standard care, Outcome 8: Anxiety (non‐STAI) ‐ music preference
Comparison 1: Music versus standard care, Outcome 9: Depression
Comparison 1: Music versus standard care, Outcome 10: Mood
Comparison 1: Music versus standard care, Outcome 11: Heart rate‐patient type
Comparison 1: Music versus standard care, Outcome 12: Heart rate ‐ music preference
Comparison 1: Music versus standard care, Outcome 13: Heart rate variability
Comparison 1: Music versus standard care, Outcome 14: Respiratory rate ‐ music preference
Comparison 1: Music versus standard care, Outcome 15: Systolic blood pressure
Comparison 1: Music versus standard care, Outcome 16: Diastolic blood pressure
Comparison 1: Music versus standard care, Outcome 17: Mean A rterial Pressure
Comparison 1: Music versus standard care, Outcome 18: Oxygen Saturation
Comparison 1: Music versus standard care, Outcome 19: Pain
Comparison 1: Music versus standard care, Outcome 20: Length of hospital stay
Comparison 1: Music versus standard care, Outcome 21: Opioid intake
Comparison 1: Music versus standard care, Outcome 22: Quality of sleep
| Music versus standard care for coronary heart disease | ||||||
| Patient or population: people with coronary heart disease | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
|---|---|---|---|---|---|---|
| Assumed risk | Corresponding risk | |||||
| Control | Music versus standard care | |||||
| Psychological Distress | The mean psychological distress in the intervention groups was | 228 | ⊕⊕⊝⊝ | |||
| Anxiety (all measures) | The mean anxiety (all measures) in the intervention groups was | 353 | ⊕⊝⊝⊝ | |||
| State anxiety (MI patients) | The mean state anxiety (MI patients) in the intervention groups was | 243 | ⊕⊕⊝⊝ | |||
| Heart rate | The mean heart rate in the intervention groups was | 828 | ⊕⊝⊝⊝ | |||
| Respiratory rate | The mean respiratory rate in the intervention groups was | 442 | ⊕⊝⊝⊝ | |||
| Systolic blood pressure | The mean systolic blood pressure in the intervention groups was | 775 | ⊕⊕⊝⊝ | |||
| Pain | The mean pain in the intervention groups was | 562 | ⊕⊝⊝⊝ | |||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1The majority of the trials were assessed as being at high risk of bias | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1.1 Psychological distress Show forest plot | 5 | 228 | Mean Difference (IV, Fixed, 95% CI) | ‐1.26 [‐2.30, ‐0.22] |
| 1.2 Anxiety (all measures) ‐ patient type Show forest plot | 10 | 353 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.70 [‐1.17, ‐0.22] |
| 1.2.1 anxiety (all measures) (MI) | 4 | 143 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.94 [‐1.95, 0.06] |
| 1.2.2 anxiety (all measures)(surgical/procedural) | 4 | 171 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.63 [‐1.25, ‐0.01] |
| 1.2.3 anxiety (all measures)(rehabilitation) | 2 | 39 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.38 [‐1.60, 0.83] |
| 1.3 Anxiety (all measures) ‐ music preference Show forest plot | 9 | 323 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.79 [‐1.29, ‐0.29] |
| 1.3.1 Anxiety (all measures) ‐ partcipant‐selected | 4 | 144 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.89 [‐1.42, ‐0.36] |
| 1.3.2 Anxiety (all measures) ‐ researcher‐selected | 5 | 179 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.74 [‐1.55, 0.08] |
| 1.4 State anxiety (STAI) ‐ patient type Show forest plot | 7 | 310 | Mean Difference (IV, Random, 95% CI) | ‐4.58 [‐7.78, ‐1.39] |
| 1.4.1 State anxiety (STAI) ‐ MI | 6 | 243 | Mean Difference (IV, Random, 95% CI) | ‐5.87 [‐7.99, ‐3.75] |
| 1.4.2 State anxiety (STAI) ‐ surgical/procedural | 1 | 67 | Mean Difference (IV, Random, 95% CI) | 0.40 [‐1.33, 2.13] |
| 1.5 State Anxiety (STAI) ‐ music preference Show forest plot | 7 | 310 | Mean Difference (IV, Random, 95% CI) | ‐4.58 [‐7.78, ‐1.39] |
| 1.5.1 State Anxiety (STAI) ‐ participant‐preferred | 3 | 167 | Mean Difference (IV, Random, 95% CI) | ‐4.71 [‐10.76, 1.33] |
| 1.5.2 State Anxiety (STAI) ‐ researcher‐selected | 4 | 143 | Mean Difference (IV, Random, 95% CI) | ‐4.68 [‐8.27, ‐1.10] |
| 1.6 State Anxiety (STAI) ‐ music preference MI only Show forest plot | 6 | 243 | Mean Difference (IV, Random, 95% CI) | ‐5.87 [‐7.99, ‐3.75] |
| 1.6.1 State Anxiety (STAI) ‐ participant‐preferred | 2 | 100 | Mean Difference (IV, Random, 95% CI) | ‐7.36 [‐9.45, ‐5.27] |
| 1.6.2 State Anxiety (STAI) ‐ researcher‐selected | 4 | 143 | Mean Difference (IV, Random, 95% CI) | ‐4.68 [‐8.27, ‐1.10] |
| 1.7 Anxiety (non‐STAI)‐patient type Show forest plot | 7 | 248 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.43 [‐0.93, 0.06] |
| 1.7.1 Anxiety (surgical/procedural) | 4 | 171 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.63 [‐1.25, ‐0.01] |
| 1.7.2 Anxiety (MI and rehabilitation) | 3 | 77 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.03 [‐0.61, 0.56] |
| 1.8 Anxiety (non‐STAI) ‐ music preference Show forest plot | 7 | 248 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.43 [‐0.93, 0.06] |
| 1.8.1 Anxiety (non‐STAI) ‐ participant‐preferred | 4 | 144 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.89 [‐1.42, ‐0.36] |
| 1.8.2 Anxiety (non‐STAI) ‐ researcher‐selected | 3 | 104 | Std. Mean Difference (IV, Random, 95% CI) | 0.11 [‐0.28, 0.49] |
| 1.9 Depression Show forest plot | 6 | 217 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.11 [‐0.38, 0.16] |
| 1.10 Mood Show forest plot | 2 | 97 | Std. Mean Difference (IV, Random, 95% CI) | 1.08 [‐0.02, 2.17] |
| 1.11 Heart rate‐patient type Show forest plot | 13 | 828 | Mean Difference (IV, Random, 95% CI) | ‐3.40 [‐6.12, ‐0.69] |
| 1.11.1 heart rate (surg ical/procedural) | 7 | 604 | Mean Difference (IV, Random, 95% CI) | ‐2.61 [‐5.62, 0.39] |
| 1.11.2 Heart rate (MI) | 5 | 194 | Mean Difference (IV, Random, 95% CI) | ‐4.75 [‐9.26, ‐0.25] |
| 1.11.3 Heart rate (rehab) | 1 | 30 | Mean Difference (IV, Random, 95% CI) | 4.50 [‐9.68, 18.68] |
| 1.12 Heart rate ‐ music preference Show forest plot | 13 | 828 | Mean Difference (IV, Random, 95% CI) | ‐3.62 [‐6.28, ‐0.95] |
| 1.12.1 Heart rate ‐ participant‐selected music | 7 | 430 | Mean Difference (IV, Random, 95% CI) | ‐4.69 [‐9.40, 0.02] |
| 1.12.2 Heart rate ‐ researcher‐selected music | 6 | 398 | Mean Difference (IV, Random, 95% CI) | ‐2.67 [‐4.27, ‐1.07] |
| 1.13 Heart rate variability Show forest plot | 2 | 90 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.07 [‐0.34, 0.48] |
| 1.14 Respiratory rate ‐ music preference Show forest plot | 7 | 442 | Mean Difference (IV, Random, 95% CI) | ‐2.50 [‐3.61, ‐1.39] |
| 1.14.1 Respiratory Rate ‐ participant‐selected | 3 | 186 | Mean Difference (IV, Random, 95% CI) | ‐4.42 [‐7.37, ‐1.46] |
| 1.14.2 Respiratory Rate ‐ researcher‐selected | 4 | 256 | Mean Difference (IV, Random, 95% CI) | ‐1.66 [‐2.20, ‐1.12] |
| 1.15 Systolic blood pressure Show forest plot | 11 | 775 | Mean Difference (IV, Fixed, 95% CI) | ‐5.52 [‐7.43, ‐3.60] |
| 1.16 Diastolic blood pressure Show forest plot | 9 | 685 | Mean Difference (IV, Fixed, 95% CI) | ‐1.12 [‐2.57, 0.34] |
| 1.17 Mean A rterial Pressure Show forest plot | 3 | 158 | Mean Difference (IV, Fixed, 95% CI) | ‐0.91 [‐4.08, 2.26] |
| 1.18 Oxygen Saturation Show forest plot | 3 | 184 | Mean Difference (IV, Random, 95% CI) | ‐0.02 [‐1.65, 1.61] |
| 1.19 Pain Show forest plot | 8 | 630 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.43 [‐0.80, ‐0.05] |
| 1.19.1 One music session | 5 | 420 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.55 [‐1.16, 0.07] |
| 1.19.2 Two or more music sessions | 3 | 210 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.27 [‐0.55, ‐0.00] |
| 1.20 Length of hospital stay Show forest plot | 2 | 82 | Mean Difference (IV, Fixed, 95% CI) | ‐0.06 [‐1.03, 0.92] |
| 1.21 Opioid intake Show forest plot | 2 | 90 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.25 [‐0.67, 0.16] |
| 1.22 Quality of sleep Show forest plot | 2 | 122 | Std. Mean Difference (IV, Random, 95% CI) | 0.91 [0.03, 1.79] |
