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تاثیر مداخلات موسیقی بر کاهش اضطراب پیش از انجام جراحی

Appendices

Appendix 1. Search strategy for CENTRAL, The Cochrane Library

#1 MeSH descriptor Anxiety explode all trees
#2 MeSH descriptor Stress, Psychological explode all trees
#3 MeSH descriptor Panic explode all trees
#4 MeSH descriptor Fear explode all trees
#5 (anxiety near (reduct* or alleviat*))
#6 anxiety:ti,ab
#7 sedation or sedative
#8 (anxioly* or stress or distress or fear):ti,ab
#9 (#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8)
#10 surgery or surgical or preoperative
#11 MeSH descriptor Surgical Procedures, Operative explode all trees
#12 MeSH descriptor Preoperative Care explode all trees
#13 (#10 OR #11 OR #12)
#14 (#9 AND #13)
#15 MeSH descriptor Anti‐Anxiety Agents explode all trees
#16 MeSH descriptor Conscious Sedation explode all trees
#17 MeSH descriptor Analgesia explode all trees
#18 (#15 OR #16 OR #17)
#19 (#14 OR #18)
#20 MeSH descriptor Music explode all trees
#21 MeSH descriptor Music Therapy explode all trees
#22 (music near compos*)
#23 music near rhythm*
#24 music* or melod*
#25 singing or sing or song or songs or improvis*
#26 (#20 OR #21 OR #22 OR #23 OR #24 OR #25)
#27 (#19 AND #26)

Appendix 2. MEDLINE search strategy (OvidSP)

1 exp anxiety/
2 Stress, Physiological/ or Stress, Psychological/
3 exp panic/ or exp fear/
4 (anxiety adj5 (reduct$ or alleviat$)).tw.
5 anxiety.ab.
6 (sedation or sedative).tw.
7 (anxioly$ or stress or distress or fear).ab.
8 or/1‐7
9 (surgery or surgical or preoperative).tw.
10 exp surgery/
11 exp Preoperative Care/
12 or/9‐11
13 8 and 12
14 exp Anti‐Anxiety Agents/
15 exp Conscious Sedation/
16 exp analgesia/
17 or/14‐16
18 13 or 17
19 exp music/
20 exp music therapy/
21 (music adj5 compos$).tw.
22 (music adj5 rhythm$).tw.
23 (music$ or melod$).tw.
24 (singing or sing or song or songs or improvis$).tw.
25 or/19‐24
26 randomized controlled trial.pt.
27 controlled clinical trial.pt.
28 randomized.ab.
29 placebo.ab.
30 clinical trials as topic.sh.
31 randomly.ab.
32 trial.ti.
33 or/26‐32
34 humans.sh.
35 33 and 34
36 18 and 25 and 35

Appendix 3. EMBASE search strategy (OvidSP)

1 exp Anxiety/
2 exp Stress/
3 exp Panic/
4 exp Fear/
5 (anxiety adj5 (reduct$ or alleviat$)).mp.
6 anxiety.ab.
7 (sedation or sedative).mp.
8 (anxioly$ or s! tress or distress or fear).ab.
9 or/1‐8
10 (surgery or surgical or preoperative).mp.
11 exp surgery/
12 exp Preoperative Care/
13 or/10‐12
14 13 and 9
15 exp Anxiolytic Agent/
16 exp Conscious Sedation/
17 exp Analgesia/
18 or/15‐17
19 18 or 14
20 exp Music Therapy/ or exp Music/
21 (music adj5 compos$).mp.
22 (music adj5 rhythm$).mp.
23 (music$ or melod$).mp.
24 (singing or sing or song or songs or improvis$).mp.
25 or/20‐24
26 25 and 19
27 (RANDOMIZED‐CONTROLLED‐TRIAL/ or RANDOMIZATION/ or CONTROLLED‐STUDY/ or MULTICENTER‐STUDY/ or PHASE‐3‐CLINICAL‐TRIAL/ or PHASE‐4‐CLINICAL‐TRIAL/ or DOUBLE‐BLIND‐PROCEDURE/ or SINGL! E‐BLIND‐PROCEDURE/ or (RANDOM* or CROSS?OVER* or FACTORIAL* or PLACEBO* or VOLUNTEER* or ((SINGL* or DOUBL* or TREBL* or TRIPL*) adj3 (BLIND* or MASK*))).ti,ab.) and human*.ec,hw,fs.
28 27 and 26

Appendix 4. CINAHL search strategy (EBSCOhost)

S1 MJ anxiety
S2 MJ Stress
S3 MJ panic
S4 MJ fear
S5 (anxiety and (reduct* or alleviat*))
S6 AB anxiety
S7 sedation or sedative
S8 AB anxioly* or stress or distress or fear
S9 S8 or S7 or S6 or S5 or S4 or S3 or S2 or S1
S10 surgery or surgical or preoperative
S11 MJ surgery
S12 MJ Preoperative Care
S13 S12 or S11 or S10
S14 S13 and S9
S15 MW AntiAnxiety Agents
S16 MJ Conscious Sedation
S17 MJ analgesia
S18 S17 or S16 or S15
S19 S18 or S14
S20 MJ music
S21 MJ music therapy
S22 music and compos*
S23 music and rhythm*
S24 music* or melod*
S25 singing or sing or song or songs or improvis*
S26 S25 or S24 or S23 or S22 or S21 or S20
S27 S26 and S19

Appendix 5. PsycINFO search strategy (OvidSP)

1 exp anxiety/
2 exp Stress/
3 exp panic/ or exp fear/
4 (anxiety adj5 (reduct$ or alleviat$)).tw.
5 anxiety.ab.
6 (sedation or sedative).tw.
7 (anxioly$ or stress or distress or fear).ab.
8 or/1‐7
9 (surgery or surgical or preoperative).tw.
10 exp surgery/
11 exp Surgical Patients/
12 or/9‐11
13 8 and 12
14 exp Tranquilizing Drugs/
15 exp Sedatives/
16 exp Analgesia/
17 (conscious adj5 sedation).tw.
18 or/14‐17
19 13 or 18
20 exp music/
21 exp music therapy/
22 (music adj5 compos$).tw.
23 (music adj5 rhythm$).tw.
24 (music$ or melod$).tw.
25 (singing or sing or song or songs or improvis$).tw.
26 or/20‐25
27 empirical study.md.
28 followup study.md.
29 longitudinal study.md.
30 prospective study.md.
31 quantitative study.md.
32 "2000".md.
33 treatment effectiveness evaluation/
34 exp hypothesis testing/
35 repeated measures/
36 exp experimental design/
37 placebo$.ti,ab.
38 random$.ti,ab.
39 (clin$ adj25 trial$).ti,ab.
40 ((singl$ or doubl$ or trebl$ or tripl$) adj (blind$ or mask$)).ti,ab.
41 or/27‐40
42 26 and 19 and 41
43 limit 42 to human

Appendix 6. LILACS search strategy (Virtual Health Library)

music [Words] and preoperative [Words]

music [Words] and surgery [Words]

music [Words] and surgical [Words]

music [Words] and presurgical [Words]

music [Words] and sedation [Words]

music [Words] and sedative [Words]

Appendix 7. AMED search strategy (OvidSP)

1 exp anxiety/
2 exp Stress psychological/
3 exp panic/ or exp fear/
4 (anxiety adj5 (reduct$ or alleviat$)).tw.
5 anxiety.ab.
6 (sedation or sedative).tw.
7 (anxioly$ or stress or distress or fear).ab.
8 or/1‐7
9 (surgery or surgical or preoperative).tw.
10 exp surgery/
11 exp Preoperative Care/
12 or/9‐11
13 8 and 12
14 Anti‐Anxiety Agents.mp.
15 Conscious Sedation.tw.
16 exp analgesia/
17 16 or 15 or 14
18 13 or 17
19 exp music/
20 exp music therapy/
21 (music adj5 compos$).tw.
22 (music adj5 rhythm$).tw.
23 (music$ or melod$).tw.
24 (singing or sing or song or songs or improvis$).tw.
25 or/19‐24
26 randomized controlled trial.pt.
27 controlled clinical trial.pt.
28 randomized.ab.
29 placebo.ab.
30 exp Clinical trials/
31 trial.ti.
32 trial.ti.
33 or/26‐32
34 humans.sh.
35 33 and 34
36 18 and 25 and 35

Appendix 8. Social Science Citation Index search strategy (ISI)

#1  TS = anxiety or TS=stress or TS=(panic or fear) or TS=(anxiety SAME (reduct* OR alleviat*)) or TS = (sedation OR sedative) or TS = (anxioly* OR distress)
#2   TS = (surgery or surgical or preoperative) or TS=(preoperative care)
#3   #1 and #2
#4  TS = (anti‐anxiety agents) or TS=(Conscious Sedation) or TS = (analgesia or analgesic*)
#5  #4 or #3
#6  TS = music or TS = (music therapy) or TS = (music SAME compos$) or TS = (music SAME rhythm*) or TS = (music* or melod*) or TS = (singing or sing or song or songs or improvis*)
#7  #6 and #5
#8  TS=(random allocation) or TS=(controlled clinical trial$) or TS=(randomized controlled trial$) or TS=(double blind method$) or TS=(single‐blind method$) or TS=(Clinical trial$) or TS=placebo$ or TS=random$ or TS=(comparative study) or TS=(evaluation studies) or TS=(follow up studies) or TS=(prospective studies) or TS=(control$ or prospectiv$ or volunteer$)
#9 #8 and #7 

Appendix 9. The specialist music therapy research database search strategy

Research database is no longer functional. Archives of research reports, dissertations and conference proceedings were handsearched.

Appendix 10. CAIRSS for Music search strategy (Webvoyage)

(stress anxiety)[ in Keyword Anywhere ]AND(surgery surgical preoperative pre operative presurgical pre surgical sedative sedation)[ in Keyword Anywhere ]

Appendix 11. Proquest Digital Dissertations search strategy

("music therapy") AND (stress) AND (preoperative) OR (surgery)

cabs(music therapy) AND cabs(conscious sedation)

cabs(music therapy) AND (cabs(analgesic) OR cabs(sedation) OR cabs(sedative)) AND cabs(surgery)

cabs(music therapy) AND cabs(anxiety) AND (cabs(surgical) OR cabs(preoperative))

(cabs(song) OR cabs(singing) OR cabs(sing)) AND cabs(analgesia)

(cabs(listening) OR cabs(improvisation)) AND cabs(analgesia)

(cabs(listening) OR (improvisation)) AND cabs(anxiety) AND (cabs(preoperative) OR cabs(surgery))

(cabs(listening) OR cabs(improvisation)) AND (cabs(sedation) OR cabs(sedative))

(cabs(singing) OR cabs(sing) OR cabs(song)) AND (cabs(sedation) OR cabs(sedative))

(cabs(singing) OR cabs(sing) OR cabs(song)) AND cabs(conscious sedation)

(singing) OR (sing) OR (song) AND (preoperative) OR (surgery)

cabs(music) AND (cabs(anti anxiety agents) OR cabs(conscious sedation))

cabs(music) AND cabs(conscious sedation)

(music) AND ("preoperative") OR (surgery) AND (sedation) OR (sedative)

cabs(music) AND cabs(conscious sedation)

(music) AND cabs((anti anxiety agents OR conscious sedation))

(music)AND (anxiety) AND (preoperative) OR (surgery)

(music) AND (anxieties) OR (anti anxiety agent) OR (conscious sedation)

Appendix 12. ClinicalTrials.gov search strategy

Music

Appendix 13. Current Controlled Trials search strategy

Music

Appendix 14. National Research Register search strategy

Music and anxiety

Music and stress

Funnel plot of comparison: 1 Music versus standard care, outcome: 1.1 State Anxiety STAI.
Figuras y tablas -
Figure 1

Funnel plot of comparison: 1 Music versus standard care, outcome: 1.1 State Anxiety STAI.

Excluded Study flow diagram.
Figuras y tablas -
Figure 2

Excluded Study flow diagram.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 3

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.
Figuras y tablas -
Figure 4

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 State anxiety STAI).
Figuras y tablas -
Analysis 1.1

Comparison 1 Music versus standard care, Outcome 1 State anxiety STAI).

Comparison 1 Music versus standard care, Outcome 2 Anxiety (non‐STAI).
Figuras y tablas -
Analysis 1.2

Comparison 1 Music versus standard care, Outcome 2 Anxiety (non‐STAI).

Comparison 1 Music versus standard care, Outcome 3 Heart rate.
Figuras y tablas -
Analysis 1.3

Comparison 1 Music versus standard care, Outcome 3 Heart rate.

Comparison 1 Music versus standard care, Outcome 4 Heart rate variability ‐ LF/HF ratio.
Figuras y tablas -
Analysis 1.4

Comparison 1 Music versus standard care, Outcome 4 Heart rate variability ‐ LF/HF ratio.

Comparison 1 Music versus standard care, Outcome 5 Systolic blood pressure.
Figuras y tablas -
Analysis 1.5

Comparison 1 Music versus standard care, Outcome 5 Systolic blood pressure.

Comparison 1 Music versus standard care, Outcome 6 Diastolic blood pressure.
Figuras y tablas -
Analysis 1.6

Comparison 1 Music versus standard care, Outcome 6 Diastolic blood pressure.

Comparison 1 Music versus standard care, Outcome 7 Respiratory rate.
Figuras y tablas -
Analysis 1.7

Comparison 1 Music versus standard care, Outcome 7 Respiratory rate.

Summary of findings for the main comparison. Music interventions versus standard care for preoperative anxiety

Patient or population: patients with preoperative anxiety
Settings: In‐patient
Intervention: Music
Comparison: standard care

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Standard care

Music

Preoperative anxiety (STAI)
STAI. Scale from: 20 to 80.

The mean preoperative anxiety (stai) ranged across control groups from
37.63 to 44.43 points

The mean preoperative anxiety (stai) in the intervention groups was
5.72 lower
(7.27 to 4.17 lower)

896
(13 studies)

⊕⊕⊝⊝
low1

Preoperative anxiety (non‐STAI)
VAS, NRS

The mean preoperative anxiety (non‐stai) in the intervention groups was
0.60 standard deviations lower
(0.9 to 0.31 lower)

504
(7 studies)

⊕⊕⊝⊝
low1,2

Heart rate

The mean heart rate ranged across control groups from
70.06 to 86.44 beats per minute

The mean heart rate in the intervention groups was
2.77 lower
(4.76 to 0.78 lower)

1109
(16 studies)

⊕⊝⊝⊝
very low1,3,4

Heart rate variability
LF/HF ratio

The mean heart rate variability ranged across control groups from
1.77 to 2.6 LF/HF ratio

The mean heart rate variability in the intervention groups was
0.37 lower
(1.16 lower to 0.42 higher)

241
(2 studies)

⊕⊝⊝⊝
very low1,4,5

Systolic blood pressure

The mean systolic blood pressure ranged across control groups from
125.87 to 152 mm Hg

The mean systolic blood pressure in the intervention groups was
4.82 lower
(12.13 lower to 2.49 higher)

809
(14 studies)

⊕⊝⊝⊝
very low1,4,6

Diastolic blood pressure

The mean diastolic blood pressure ranged across control groups from
74.5 to 90 mm Hg

The mean diastolic blood pressure in the intervention groups was
2.37 lower
(4.03 to 0.71 lower)

786
(13 studies)

⊕⊝⊝⊝
very low1,4,7

Respiratory rate

The mean respiratory rate ranged across control groups from
16 to 23.2 breaths per minute

The mean respiratory rate in the intervention groups was
0.97 higher
(0.82 to 1.11 higher)

375
(6 studies)

⊕⊝⊝⊝
very low1,8

*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).
CI: Confidence interval;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 The majority of the trials were assessed as high risk of bias studies
2 All point estimates favour music although the magnitude of the effect differs across studies.
3 Results were inconsistent across studies as evidenced by I² =79%.
4 Wide confidence interval
5 Results were inconsistent across studies as evidenced by I² =69%.
6 Results were inconsistent across studies as evidenced by I² =98%.
7 Results were inconsistent across studies as evidenced by I² =82%.
8 Results were inconsistent across studies as evidenced by I² =96%.

Figuras y tablas -
Summary of findings for the main comparison. Music interventions versus standard care for preoperative anxiety
Comparison 1. Music versus standard care

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 State anxiety STAI) Show forest plot

13

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 All studies

13

896

Mean Difference (IV, Random, 95% CI)

‐5.72 [‐7.27, ‐4.17]

1.2 Adequate randomization

4

435

Mean Difference (IV, Random, 95% CI)

‐5.76 [‐7.94, ‐3.57]

2 Anxiety (non‐STAI) Show forest plot

7

Std. Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 All studies

7

504

Std. Mean Difference (IV, Random, 95% CI)

‐0.60 [‐0.90, ‐0.31]

2.2 Adequate randomization

3

182

Std. Mean Difference (IV, Random, 95% CI)

‐0.41 [‐0.71, ‐0.12]

3 Heart rate Show forest plot

16

Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 All studies

16

1109

Mean Difference (IV, Random, 95% CI)

‐2.77 [‐4.76, ‐0.78]

3.2 Adequate randomization

6

525

Mean Difference (IV, Random, 95% CI)

‐2.44 [‐5.95, 1.07]

4 Heart rate variability ‐ LF/HF ratio Show forest plot

2

241

Mean Difference (IV, Random, 95% CI)

‐0.37 [‐1.16, 0.42]

5 Systolic blood pressure Show forest plot

14

Mean Difference (IV, Random, 95% CI)

Subtotals only

5.1 All studies

14

809

Mean Difference (IV, Random, 95% CI)

‐4.82 [‐12.13, 2.49]

5.2 Adequate randomization

5

424

Mean Difference (IV, Random, 95% CI)

‐5.80 [‐18.96, 7.36]

6 Diastolic blood pressure Show forest plot

13

Mean Difference (IV, Random, 95% CI)

Subtotals only

6.1 All studies

13

786

Mean Difference (IV, Random, 95% CI)

‐2.37 [‐4.03, ‐0.71]

6.2 Adequate randomization

5

424

Mean Difference (IV, Random, 95% CI)

‐2.74 [‐5.65, 0.17]

7 Respiratory rate Show forest plot

6

375

Mean Difference (IV, Fixed, 95% CI)

0.97 [0.82, 1.11]

Figuras y tablas -
Comparison 1. Music versus standard care