Research Briefs ColumnsA Review of the Evidence for Music Intervention to Manage Anxiety in Critically Ill Patients Receiving Mechanical Ventilatory Support
Section snippets
Anxiety in mechanically ventilated patients
Mechanical ventilation creates distressing physiological and psychological experiences for patients. Because of the placement of the endotracheal tube, patients are unable to speak, eat, or swallow. Psychological stressors include fear of the unknown and dying, thirst, sleeplessness, agitation, pain, frustration with being restrained, immobility, noise, confusion, loneliness, powerlessness, sensory deprivation and overload, inability to match one's own breathing pattern with the ventilator, and
Music intervention for reducing anxiety
Music promotes relaxation via physiological and/or psychological entrainment (Maranto, 1993). Entrainment is a physics principle in which two objects vibrating at similar frequencies tend to cause mutual sympathetic resonance and vibrate at the same frequency (Maranto, 1993). Entrainment is achieved by using music to directly elicit relaxation (Maranto, 1993). Musical stimuli and physiological processes (heartbeat, respiratory rate, blood pressure, temperature, adrenal hormones) are composed of
Directions for future research and practice
In summary, being critically ill and receiving mechanical ventilatory support causes anxiety. Pharmacologic interventions are necessary to promote comfort and ventilator synchrony, but these potent medications have limitations. There is a need for nurses to carefully implement evidence-based adjunctive interventions that complement the pharmacologic treatment. A simple and promising adjunctive intervention to reduce anxiety associated with ventilatory support is music. Although many patients
References (31)
- et al.
Optimal intravenous dosing strategies for sedatives and analgesics in the intensive care unit
Critical Care Clinics
(1995) The cost of sedating and paralyzing the critically ill patient
Critical Care Clinics
(1995)Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance
Heart & Lung
(1998)Description of anxiety levels by individual differences and clinical factors in patients receiving mechanical ventilatory support
Heart and Lung: The Journal of Acute and Critical Care
(2003)- et al.
Long-term propofol infusion and cardiac failure in adult head-injured patients
Lancet
(2001) - et al.
Mortality and morbidity amongst sedated intensive care patients
Resuscitation
(1988) - et al.
Qualitative analysis of patients' work during mechanical ventilation and weaning
Heart and Lung
(1997) Sedation for the mechanically ventilated patient
Critical Care Clinics
(1995)- et al.
Anxiety and delirium in the intensive care unit
Critical Care Clinics
(1994) Advantages and disadvantages of combining sedative agents
Critical Care Clinics
(1995)