Music interventions for preoperative anxiety

Joke Bradt; Cheryl Dileo; Minjung Shim

doi:10.1002/14651858.CD006908.pub2

Cochrane Database of Systematic Reviews

Intervenciones con música para la ansiedad preoperatoria

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DOI:

https://doi.org/10.1002/14651858.CD006908.pub2 Copiar DOI

Base de datos:

Cochrane Database of Systematic Reviews

Versión publicada:

06 junio 2013see what's new

Tipo:

Intervention

Etapa:

Review

Grupo Editorial Cochrane:

Grupo Cochrane de Anestesia

Copyright:

Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

Joke Bradt

Correspondencia a: Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, USA

[email protected]
Cheryl Dileo

Department of Music Therapy and The Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, Philadelphia, USA
Minjung Shim

Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, USA

Contributions of authors

Conceiving the review: Cheryl Dileo (CD) and Joke Bradt (JB)
Co‐ordinating the review: JB
Undertaking manual searches: JB and research assistants
Screening search results: JB and Minjung Shim (MS)
Organizing retrieval of papers: JB
Screening retrieved papers against inclusion criteria: JB and MS
Appraising quality of papers: JB and MS
Abstracting data from papers: JB and MS
Writing to authors of papers for additional information: JB and MS
Providing additional data about papers: JB
Obtaining and screening data on unpublished studies: JB and MS
Data management for the review: JB
Entering data into Review Manager (RevMan 5.1): JB and MS
RevMan statistical data: JB
Other statistical analysis not using RevMan: JB
Double entry of data: JB and MS
Interpretation of data: JB and CD
Statistical inferences: JB
Writing the review: JB
Securing funding for the review: CD
Performing previous work that was the foundation of the present study: JB and CD
Guarantor for the review (one author): JB
Person responsible for reading and checking review before submission: JB and CD

Sources of support

Internal sources

No sources of support supplied

External sources

State of Pennsylvania Formula Fund, USA.

This grant only supported the protocol preparation work for this Cochrane review

Declarations of interest

JB and CD are music therapists.

MS: none known

Acknowledgements

We would like to thank Nicola Petrucci (content editor), Nathan Pace (Statistical editor), Claire Ghetti, Fred J Schwartz (peer reviewers) and Ann Fonfa (consumer representative ) for their help and editorial advice during the preparation of this systematic review. We would like to thank and acknowledge Dr Nicola Petrucci (content editor), Dr Fred J Schwartz, Dr M Soledad Cepeda, Prof Bryan C Hunter, and Dr Megan Prictor (peer reviewers) for commenting on the protocol for the systematic review. Finally, we would like to thank Dr Kathleen Murphy for her assistance in retrieval of articles for this review.

Version history

Published

Title

Stage

Authors

Version

2013 Jun 06

Music interventions for preoperative anxiety

Review

Joke Bradt, Cheryl Dileo, Minjung Shim

https://doi.org/10.1002/14651858.CD006908.pub2

2008 Jan 23

Music for preoperative anxiety

Protocol

Cheryl Dileo, Joke Bradt, Kathy Murphy

https://doi.org/10.1002/14651858.CD006908

Differences between protocol and review

The protocol title 'Music for preoperative anxiety' has been revised to 'Music interventions for preoperative anxiety'.

Notes

At the time of this review, we identified a published journal article (Beccaloni 2011) that plagiarized a section of the background text of the published protocol of this review (Dileo 2008). After an investigation, the following plan of action was agreed upon: the author will revise the abstract to include quotations around the directly quoted material as well as inclusion of the appropriate reference. This revision as well as an erratum addressing the issue will be published in the Journal of Perianesthesia Nursing 28(2):April 2013.

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Humans;

PICO

Population

Intervention

Comparison

Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Figure 1

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

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Figure 2

Excluded Study flow diagram.

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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Figure 4

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Analysis 1.1

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

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Analysis 1.2

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

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Analysis 1.3

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

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Analysis 1.4

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

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Analysis 1.5

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

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Analysis 1.6

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

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Analysis 1.7

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

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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)	⊕⊕⊝⊝ low^1,2
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 low^1,3,4
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 low^1,4,5
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 low^1,4,6
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 low^1,4,7
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 low^1,8
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%.

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

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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]

Comparison 1. Music versus standard care

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Intervenciones con música para la ansiedad preoperatoria

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