The relationship of absorption to the effects of music therapy on anxiety and relaxation for mechanically ventilated patients (mechanical ventilation)

Abstract: Numerous adverse patient responses are associated with mechanical ventilation, including anxiety and the inability to relax. In order to treat these responses, sedatives are frequently administered to mechanically ventilated patients (MVPs), which are warranted at times yet cause numerous adverse side effects. Previous research examining music therapy for relaxation and anxiety reduction have excluded MVPs; results have been inconsistent. The purpose of this study was to test the effectiveness of music therapy on anxiety and relaxation for MVPs, and to explore the influence of the absorption personality trait (disposition for experiencing altered states of awareness) as one variable that may explain differential responses to the intervention. MVPs were recruited from four Midwestern ICUs for this two group pretest, posttest repeated measures experimental and correlational design study, based on psychophysiologic responses to music and the relaxation response. A total of 54 subjects were randomized to either an experimental music listening condition or to a control rest condition. Heart rate (HR) and respiratory rate (RR) were measured at baseline and at 5 minute intervals for 35 minutes. State anxiety was measured at baseline and posttest. Absorption was measured at baseline only. Mean pretest anxiety was 17.7 (control) and 17.3 (experimental); posttest anxiety scores were 16.2 and 10.1 respectively. Independent t-test indicated significant posttest state-anxiety scores between groups (t (49) = 5.47; p $<$.001). Repeated measures ANOVA were significant for HR and RR over time (F (1,7) = 54.3; p $<$.001; F (1,7) = 90.8; p $<$.001 respectively); and over time between groups (F (7,329) = 6.0; p $<$.001; F (7,329) = p $<$.001 respectively); and over time between groups (F (7,329) = 6.0; p $<$.001; F (7,329) = 12.2; p $<$.001 respectively). HR and RR decreased over time differentially for those subjects in the experimental group. Hierarchical multiple regression (HMR) was significant for the regression of posttest state anxiety on absorption + treatment (R$/sp2$ =.36; p $<$.001); experimental condition accounted for 34% of the variance. HMR was not significant for posttest HR or RR. A single music listening period was found to be effective for decreasing anxiety and promoting relaxation via non-pharmacological means. Absorption was not found to significantly influence the posttest dependent measures, which requires further exploration in nursing intervention research.

Keyword(s): Health Sciences. Nursing

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