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A Review of the Evidence for Music Intervention to Manage Anxiety in Critically Ill Patients Receiving Mechanical Ventilatory Support

https://doi.org/10.1016/j.apnu.2008.12.005Get rights and content

Critically ill patients receiving mechanical ventilatory support experience profound anxiety with this common treatment modality. Music intervention is one adjunctive therapy that can be implemented to allay anxiety. This article reviews the evidence support music as an adjunctive intervention with mechanically ventilated patients.

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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

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