The Effect of Oriental Medicine Music Therapy on Idiopathic Chronic Fatigue. Gender Differences When Using Sedative Music During Colonoscopy Effect of sleep-inducing music on sleep in persons with percutaneous transluminal coronary angiography in the cardiac care unit. Individual music therapy for depression: randomised controlled trial. Original sound compositions reduce anxiety in emergency department patients: a randomised controlled trial. Effects of a music intervention on patients undergoing cerebral angiography: a pilot study The effectiveness of neuro-music therapy according to the Heidelberg model compared to a single session of educational counseling as treatment for tinnitus: a controlled trial. The Effects of Music Therapy on Vital Signs, Feeding, and Sleep in Premature Infants Effect of the combination of music and nature sounds on pain and anxiety in cardiac surgical patients: a randomized study. The Effect of Music on Anxiety and Cardiovascular Indices in Patients Undergoing Coronary Artery Bypass Graft: A Randomized Controlled Trial Sensorimotor Plasticity after Music-Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation Comparing the effects of different individualized music interventions for elderly individuals with severe dementia Group music therapy for patients with persistent post-traumatic stress disorder--an exploratory randomized controlled trial with mixed methods evaluation. Does music influence stress in mechanically ventilated patients? The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study Music therapy CD creation for initial pediatric radiation therapy: a mixed methods analysis. Perioperative music or headsets to decrease anxiety. Familiar Music as an Enhancer of Self-Consciousness in Patients with Alzheimer's Disease Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial. Effects of music therapy on intravitreal injections: a randomized clinical trial. The Effects of Music Intervention in the Management of Chronic Pain: A Single-Blind, Randomized, Controlled Trial The effect of group music therapy on mood, speech, and singing in individuals with Parkinson's disease--a feasibility study. Effects of music intervention on physiological stress response and anxiety level of mechanically ventilated patients in China: a randomised controlled trial. A Pacifier-Activated Music Player With Mother’s Voice Improves Oral Feeding in Preterm Infants Perioperative music and its effects on anxiety, hemodynamics, and pain in women undergoing mastectomy. Specific music therapy techniques in the treatment of primary headache disorders in adolescents: a randomized attention-placebo-controlled trial. The effects of modified melodic intonation therapy on nonfluent aphasia: a pilot study. Effect of music as nursing intervention for people diagnosed with fibromyalgia. Alleviating distress during antepartum hospitalization: a randomized controlled trial of music and recreation therapy. Effects of music on physiological and behavioral responses of premature infants: a randomized controlled trial. Effect of lullaby and classical music on physiologic stability of hospitalized preterm infants: a randomized trial. Psychophysiological Responses to Sedative Music in Patients Awaiting Cardiac Catheterization Examination: A Randomized Controlled Trial A Pilot Study to Assess the Effects of a Guided Imagery Audiotape Intervention on Psychological Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery A randomised controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety. Music as a therapeutic intervention on an inpatient neuroscience unit. Cortisol and anxiety response to a relaxing intervention on pregnant women awaiting amniocentesis Effects of group songwriting on motivation and readiness for treatment on patients in detoxification: a randomized wait-list effectiveness study. AIR: Advances in Respiration - Music therapy in the treatment of chronic pulmonary disease. Effects of music therapy on change readiness and craving in patients on a detoxification unit. Intraoperative stress and anxiety reduction with music therapy: a controlled randomized clinical trial of efficacy and safety. Supplementing Relaxation and Music for Pain After Surgery The effects of sedative music on sleep quality of older community-dwelling adults in Singapore. Effects of music therapy on pain among female breast cancer patients after radical mastectomy: results from a randomized controlled trial The effect of music therapy on relaxation, anxiety, pain perception, and nausea in adult solid organ transplant patients. The Effect of Music-Based Listening Interventions on the Volume, Fat Content, and Caloric Content of Breast Milk–Produced by Mothers of Premature and Critically Ill Infants Does live music benefits patients with brain and spinal injury? Music and biological stress dampening in mechanically-ventilated patients at the intensive care unit ward-a prospective interventional randomized crossover trial. Efficacy of musical interventions in dementia: evidence from a randomized controlled trial. The effect of songwriting on knowledge of coping skills and working alliance in psychiatric patients: a randomized clinical effectiveness study. Music during interventional radiological procedures, effect on sedation, pain and anxiety: a randomised controlled trial. Minimising preoperative anxiety with music for day surgery patients - a randomised clinical trial. The effects of music therapy on pain in patients with neuropathic pain. The Effects of a Designer Music Intervention on Patients' Anxiety, Pain, and Experience of Colonoscopy: A Short Report on a Pilot Study Effect of listening to music and essential oil inhalation on patients undergoing screening CT colonography: a randomized controlled trial. Effects of music therapy on labour pain and anxiety in Taiwanese first-time mothers. Effects of Music Therapy on Drug Avoidance Self-Efficacy in Patients on a Detoxification Unit: A Three-Group Randomized Effectiveness Study A group music intervention using percussion instruments with familiar music to reduce anxiety and agitation of institutionalized older adults with dementia. The Impact of Group Music Therapy on Depression and Cognition in Elderly Persons With Dementia Evidence That Music Listening Reduces Preoperative Patients’ Anxiety Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage. The effect of music on postoperative pain and anxiety. Pain relief effect of breast feeding and music therapy during heel lance for healthy-term neonates in China: a randomized controlled trial. A clinical randomized controlled trial of music therapy and progressive muscle relaxation training in female breast cancer patients after radical mastectomy: results on depression, anxiety and length of hospital stay. Preoperative music intervention for patients undergoing cesarean delivery. Effectiveness of music interventions for women with high anxiety during coronary angiographic procedures: a randomized controlled A randomized controlled trial exploring the effect of music on agitated behaviours and anxiety in older people with dementia Effects of Music Therapy and Music-Assisted Relaxation and Imagery on Health-Related Outcomes in Diabetes Education Effects of lyric analysis interventions on treatment motivation in patients on a detoxification unit: a randomized effectiveness study. A Randomized Controlled Trial to Determine the Effects of Music and Relaxation Interventions on Perceived Anxiety in Hospitalized Patients Receiving Orthopaedic or Cancer Treatment Effects of music therapy on pain and anxiety in patients undergoing port catheter placement procedure. A randomized controlled trial of the effects of listening to non-commercial music on quality of nocturnal sleep and relaxation indices in patients in medical intensive care unit. Music as an auxiliary analgesic during first trimester surgical abortion: a randomized controlled trial. Music Interventions in Patients During Coronary Angiographic Procedures: A Randomized Controlled Study of the Effect on Patients' Anxiety and Well-Being Effects of jazz on postoperative pain and stress in patients undergoing elective hysterectomy. Effects of listening to music on pain intensity and pain distress after surgery: an intervention. Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery. Listening to music during electromyography does not influence the examinee's anxiety and pain levels. Effect of singing on respiratory function, voice, and mood after quadriplegia: a randomized controlled trial. Effects of music therapy on self- and experienced stigma in patients on an acute care psychiatric unit: a randomized three group effectiveness study. The effect of music reinforcement for non-nutritive sucking on nipple feeding of premature infants. Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial. Music therapy reduces pain in palliative care patients: a randomized controlled trial. Effects of group music intervention on psychiatric symptoms and depression in patient with schizophrenia. Comparison between Massage and Music Therapies to Relieve the Severity of Labor Pain The effect of a music programme during lunchtime on the problem behaviour of the older residents with dementia at an institution in Taiwan. Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical ventilatory support: a randomized clinical trial. The effect of music therapy on physiological signs of anxiety in patients receiving mechanical ventilatory support. The effect of complementary music therapy on the patient's postoperative state anxiety, pain control, and environmental noise satisfaction. Music Therapy in Palliative Care. Coping-Infused Dialogue through Patient-Preferred Live Music: A Medical Music Therapy Protocol and Randomized Pilot Study for Hospitalized Organ Transplant Patients. Not All Sounds Have Negative Effects on Children Undergoing Cardiac Surgery. Music to reduce pain and distress in the pediatric emergency department: a randomized clinical trial. The effect of singing training on voice quality for people with quadriplegia. Effect of Active Music Therapy and Individualized Listening to Music on Dementia: A Multicenter Randomized Controlled Trial. Sonas: a pilot study investigating the effectiveness of an intervention for people with moderate to severe dementia. Effects on Postoperative Salivary Cortisol of Relaxation/Music and Patient Teaching About Pain Management The effects of music on physiological responses and sedation scores in sedated, mechanically ventilated patients. A Home-Based Walking Program Using Rhythmic Auditory Stimulation Improves Gait Performance in Patients With Multiple Sclerosis: A Pilot Study Music versus lifestyle on the autonomic nervous system of prehypertensives and hypertensives--a randomized control trial. Music therapy as an adjunctive treatment in the management of stress for patients being weaned from mechanical ventilation. Effects of a live educational music therapy intervention on acute psychiatric inpatients' perceived social support and trust in the therapist: a four-group randomized effectiveness study. Effects of music therapy on pain and anxiety in patients undergoing bone marrow biopsy and aspiration. The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: a mixed methods study The impact of kangaroo care and music on maternal state anxiety.
OBJECTIVE Idiopathic chronic fatigue ( ICF ) , defined as medically unexplained chronic fatigue , is common these days . To date , there is no definite cure for ICF , and alternative therapies are being investigated . Oriental medicine music therapy ( OMMT ) , a novel music therapy that occurs through an active behavioral process , has been applied to various chronic diseases , including ICF . In the present study , we aim ed to evaluate the effect of OMMT on ICF . DESIGN R and omized controlled trial of OMMT compared with the waitlist control ( 6 sessions each ) during a 2-week period . PARTICIPANTS Thirty participants who had had ICF for at least 6 months before the experiments were recruited . OUTCOME MEASURES We evaluated fatigue severity scale ( FSS ) , visual analog scale ( VAS ) for overall fatigue , revised Chalder fatigue scale ( RCFS ) , World Health Organization quality of life scale abbreviated version ( WHOQOL-BREF ) , Buzhongyiqi-Tang question naire ( BZTQ ) , and salivary cortisol level at baseline ( week 0 ) and at the end of the study ( week 2 ) in the two groups . RESULTS FSS , VAS , and RCFS scores were significantly lower , and WHOQOL-BREF scores were significantly higher in the OMMT group than in the waitlist group ( p=0.006 , p=0.004 , p=0.002 , and p=0.002 , respectively ) . In contrast , salivary cortisol level and BZTQ scores were not significantly different between the OMMT group and the waitlist group . CONCLUSIONS The present study suggests that OMMT may be an alternative treatment for ICF . Based on this result , further studies including possible mechanisms are needed Colonoscopy is a procedure often experienced as uncomfortable and worrying . Music has been reported to reduce discomfort during colonoscopy ; however , no study in a Swedish setting has been found . The purpose of this r and omized controlled trial was to analyze the effects of sedative music on patients ' experience of anxiety , pain , relaxation , and well-being during colonoscopy . Prior to colonoscopy , adult patients ( n = 120 ) , aged 18–80 years , were r and omly assigned to either an intervention group ( n = 60 ) who listened to sedative instrumental music with 60–80 beats per minute during the colonoscopy or a control group . After the colonoscopy , both groups completed a question naire on anxiety , the State Trait Anxiety Inventory  , and an anxiety Visual Analogue Scale . Pain , relaxation , and well-being were also measured with Visual Analogue Scales . Women in the intervention group had a lower level of anxiety during the colonoscopy than those in the control group ( p = .007 ) and well-being was significantly higher in the intervention group , especially among men , than in the controls ( p = .006 and p = .025 , respectively ) . Men in the intervention group were more relaxed during the colonoscopy than those in the control group ( p = .065 ) . Listening to sedative music  decreased anxiety among women and increased well-being among men during colonoscopy AIM AND OBJECTIVE The study compared the effect of earplug-delivered sleep-inducing music on sleep in persons with percutaneous transluminal coronary angiography in the cardiac care unit . BACKGROUND Diverse types of music have been cl aim ed to improve sleeping elsewhere , but relatively little is known in South Korea . Most studies investigating the effect of sleep-inducing music on sleep have involved persons with insomnia , even though many persons with cardiovascular disease in the intensive care unit suffer from sleeping problems . There is a need to investigate the effect of sleep-inducing music on sleep disorders in persons with percutaneous transluminal coronary angiography in the cardiac care unit . DESIGN An experimental research design was used . METHODS Data collection was conducted in the cardiac care unit of K University Hospital in D city , from 3 September-4 October 2010 . Fifty-eight subjects participated and were r and omly assigned to the experimental group ( earplug-delivered sleep-inducing music for 52 min beginning at 10:00 pm , while wearing an eyeshield , n = 29 ) and the control group ( no music , but earplugs and eyeshield worn , n = 29 ) . The quantity and quality of sleep were measured using question naires at 7 am the next morning for each group . RESULTS Participants in the experimental group reported that the sleeping quantity and quality were significantly higher than control group ( t = 3·181 , p = 0·002 , t = 5·269 , p < 0·001 , respectively ) . CONCLUSION Sleep-inducing music significantly improved sleep in patients with percutaneous transluminal coronary angiography at a cardiac care unit . Offering earplugs and playing sleep-inducing music may be a meaningful and easily enacted nursing intervention to improve sleep for intensive care unit patients . RELEVANCE TO CLINICAL PRACTICE Nurses working at cardiac care unit can use music to improve sleeping in clients with percutaneous transluminal coronary angiography BACKGROUND Music therapy has previously been found to be effective in the treatment of depression but the studies have been method ologically insufficient and lacking in clarity about the clinical model employed . Aims To determine the efficacy of music therapy added to st and ard care compared with st and ard care only in the treatment of  depression among working-age people . METHOD Participants ( n = 79 ) with an ICD-10 diagnosis of depression were r and omised to receive individual music therapy plus st and ard care ( 20 bi-weekly sessions ) or st and ard care only , and followed up at baseline , at 3 months ( after intervention ) and at 6 months . Clinical measures included depression , anxiety , general functioning , quality of life and alexithymia . TRIAL REGISTRATION IS RCT N84185937 . RESULTS Participants receiving music therapy plus st and ard care showed greater improvement than those receiving st and ard care only in depression symptoms ( mean difference 4.65 , 95 % CI 0.59 to 8.70 ) , anxiety symptoms ( 1.82 , 95 % CI 0.09 to 3.55 ) and general functioning ( -4.58 , 95 % CI -8.93 to -0.24 ) at 3-month follow-up . The response rate was significantly higher for the music therapy plus st and ard care group than for the st and ard care only group ( odds ratio 2.96 , 95 % CI 1.01 to 9.02 ) . CONCLUSIONS Individual music therapy combined with st and ard care is effective for depression among working-age people with depression . The results of this study along with the previous research indicate that music therapy with its specific qualities is a valuable enhancement to established treatment practice OBJECTIVE To determine whether emergency department ( ED ) patients ' self-rated levels of anxiety are affected by exposure to purpose - design ed music or sound compositions with and without the audio frequencies of embedded binaural beat . DESIGN , SETTING AND PARTICIPANTS R and omised controlled trial in an ED between 1 February 2010 and 14 April 2010 among a convenience sample of adult patients who were rated as category 3 on the Australasian Triage Scale . INTERVENTIONS All interventions involved listening to soundtracks of 20 minutes ' duration that were purpose - design ed by composers and sound-recording artists . Participants were allocated at r and om to one of five groups : headphones and iPod only , no soundtrack ( control group ) ; reconstructed ambient noise simulating an ED but free of clear verbalisations ; electroacoustic musical composition ; composed non-musical soundtracks derived from audio field recordings obtained from natural and constructed setting s ; sound composition of audio field recordings with embedded binaural beat . All soundtracks were presented on an iPod through headphones . Patients and research ers were blinded to allocation until interventions were administered . State-trait anxiety was self-assessed before the intervention and state anxiety was self-assessed again 20 minutes after the provision of the soundtrack . MAIN OUTCOME MEASURE Spielberger State-Trait Anxiety Inventory . RESULTS Of 291 patients assessed for eligibility , 170 patients completed the pre-intervention anxiety self- assessment and 169 completed the post-intervention assessment . Significant decreases ( all P < 0.001 ) in anxiety level were observed among patients exposed to the electroacoustic musical composition ( pre-intervention mean , 39 ; post-intervention mean , 34 ) , audio field recordings ( 42 ; 35 ) or audio field recordings with embedded bianaural beats ( 43 ; 37 ) when compared with those allocated to receive simulated ED ambient noise ( 40 ; 41 ) or headphones only ( 44 ; 44 ) . CONCLUSION In moderately anxious ED patients , state anxiety was reduced by 10%-15 % following exposure to purpose - design ed sound interventions . TRIAL REGISTRATION Australian New Zeal and Clinical Trials Registry ACTRN 12608000444381 Purpose To test the effect of a music intervention on procedural anxiety , stress response and medication requirements in participants with a cerebral aneurysm or arteriovenous malformation ( AVM ) undergoing cerebral angiography . Method and material s A prospect i ve pilot study was conducted using an experimental two group pre-test , post-test design . 48 participants were r and omly assigned to a control group ( st and ard care ) or experimental group ( st and ard care plus self-selected music via overhead stereo system ) . The stress response was measured by heart rate ( HR ) and systolic blood pressure ( SBP ) at baseline , and during and following the procedure . Anxiety was measured by the State Trait Anxiety Inventory for Adults ( STAI ) before and after the procedure , and total medications administered periprocedurally were recorded . Results 24 participants in each group were enrolled . R-ANCOVA revealed non-significant findings for HR ( F=1.4 ; p=0.27 ; power=0.38 ) and SBP ( F=2.1 ; p=0.10 ; power=0.57 ) . The ANCOVA for anxiety revealed significantly lower STAI scores in the control group ( F=3.8 ; p=0.003 ) compared with the experimental group . Independent t test analysis for the total doses of fentanyl and midazolam were found to be F=0.08 , p=0.78 and F=0.38 , p=0.54 , respectively . Conclusion A music intervention on participants with a brain aneurysm or AVM undergoing cerebral angiography did not have a statistically significant impact on reducing the stress response , anxiety or medication requirements . Interestingly , participants in the control group had significantly less anxiety after their angiogram than did participants in the experimental group . This pilot study sets the stage for future research to further examine these findings OBJECTIVES Tinnitus is a very common symptom , yet the quest for an effective treatment is challenging . Results from several clinical trials support the notion that neuro-music therapy is an effective means to reduce tinnitus distress with short duration and long lasting effect . However , until now , the effectiveness has not been tested in a controlled trial against an active comparator . METHODS The trial was design ed as two-center , parallel intervention group controlled study with two intervention groups : Counseling ( 50minute individualized personal instruction ) or neuro-music therapy ( counseling plus eight 50-minute sessions of individualized music therapy ) .  Data of n=290 patients suffering from chronic tinnitus were analyzed . Outcome measure was the change in Tinnitus Question naire Total Scores ( TQ ) from baseline ( admission ) to end of treatment . RESULTS Both treatment groups achieved a statistically relevant reduction in TQ scores , though 66 % of patients in the music therapy group attained a clinical ly meaningful improvement compared to 33 % in the counseling group . A binary logistic regression revealed two variables significantly influencing therapy outcome : initial tinnitus score and type of therapy with an OR for the music therapy compared to the counseling of 4.34 ( CI 2.33 - 8.09 ) . CONCLUSIONS Counseling is an appropriate treatment option with well above chance of improvement . The neuro-music therapy outperformed the counseling . This treatment targets the tinnitus sound itself , is short in duration , intrinsically motivating and easy to operate and thus presents a possible complement to the therapeutic spectrum in chronic tinnitus . The trial was registered at the Clinical Trials.gov registry ( ID : NCT01845155 ) OBJECTIVES : Recorded music risks overstimulation in NICUs . The live elements of music such as rhythm , breath , and parent-preferred lullabies may affect physiologic function ( eg , heart and respiratory rates , O2 saturation levels , and activity levels ) and developmental function ( eg , sleep , feeding behavior , and weight gain ) in premature infants . METHODS : A r and omized clinical multisite trial of 272 premature infants aged ≥32 weeks with respiratory distress syndrome , clinical sepsis , and /or SGA ( small for gestational age ) served as their own controls in 11 NICUs . Infants received 3 interventions per week within a 2-week period , when data of physiologic and developmental domains were collected before , during , and after the interventions or no interventions and daily during a 2-week period . RESULTS : Three live music interventions showed changes in heart rate interactive with time . Lower heart rates occurred during the lullaby ( P < .001 ) and rhythm intervention ( P = .04 ) . Sucking behavior showed differences with rhythm sound interventions ( P = .03 ) . Entrained breath sounds rendered lower heart rates after the intervention ( P = .04 ) and differences in sleep patterns ( P < .001 ) . Caloric intake ( P = .01 ) and sucking behavior ( P = .02 ) were higher with parent-preferred lullabies . Music decreased parental stress perception ( P < .001 ) . CONCLUSIONS : The informed , intentional therapeutic use of live sound and parent-preferred lullabies applied by a certified music therapist can influence cardiac and respiratory function . Entrained with a premature infant ’s observed vital signs , sound and lullaby may improve feeding behaviors and sucking patterns and may increase prolonged periods of quiet – alert states . Parent-preferred lullabies , sung live , can enhance bonding , thus decreasing the stress parents associate with premature infant care BACKGROUND Postoperative pain and anxiety are common in cardiac surgery patients . Studies have suggested that music can decrease anxiety in hospitalized patients . Primary Study Objective This study focused on the efficacy and feasibility of special music , which included nature sounds , for pain and anxiety . METHODS / DESIGN In this r and omized controlled trial , postoperative cardiovascular surgery patients were r and omly assigned to a music group to receive 20 minutes of st and ard postoperative care and music twice daily on postoperative days 2 through 4 or to a control group to receive 20 minutes of st and ard care with a quiet resting period twice daily on postoperative days 2 through 4 . SETTING Cardiovascular surgical unit of Saint Marys Hospital , Rochester , Minnesota . PARTICIPANTS One hundred patients completed the study ( music group , n = 49 ; control group , n = 51 ) . Intervention The music was delivered through CD players in the patients ' rooms . PRIMARY OUTCOME MEASURES Pain , anxiety , satisfaction , and relaxation were evaluated from visual analog scales . RESULTS Data showed a significant decrease in mean ( SD ) pain scores after the second session of day 2 for the music group ( change , ? 1.4 [ 1.4 ] ) compared with the control group ( change , ? 0.4 [ 1.4 ] ) ( P = .001 ) . Mean relaxation scores improved more at the first session of day 2 for the music group ( change , 1.9 [ 2.7 ] ) compared with the control group ( change , 0.3 [ 2.9 ] ) ( P = .03 ) . The music group also showed lower anxiety and increased satisfaction overall , but these differences were not statistically significant . No major barriers to using the therapy were identified . CONCLUSION Recorded music and nature sounds can be integrated into the postoperative care of cardiovascular surgery patients . The recordings may provide an additional means for addressing common symptoms of pain and anxiety while providing a means of relaxation for these patients Background : The instability of cardiovascular indices and anxiety disorders are common among patients undergoing coronary artery bypass graft ( CABG )  and could interfere with their recovery . Therefore , improving the cardiovascular indices and anxiety is essential . Objectives : This study aim ed to investigate the effect of music therapy on anxiety and cardiovascular indices in patients undergoing CABG .  Patients and Methods : In this r and omized controlled trial , 60 patients hospitalized in the cardiovascular surgical intensive care unit of Shahid Beheshti Hospital in Qom city , Iran , in 2013 were selected using a consecutive sampling method and r and omly allocated into the experimental and control groups . In the experimental group , patients received 30 minutes of light music , whereas in the control group , patients had 30 minutes of rest in bed . The cardiovascular indices and anxiety were measured immediately before , immediately after and half an hour after the study . Data were analyzed using the chi-square test and repeated measures analysis of variance . Results : Compared to the immediately before intervention , the mean anxiety scores immediately after and 30 minutes after the intervention were significantly lower in the experimental group ( P < 0.037 ) while it did not significantly change in the control group . However , there were no significant differences regarding the cardiovascular indices in the three consecutive measurements ( P > 0.05 ) . Conclusions : Music therapy is effective in decreasing anxiety among patients undergoing CABG . However , the intervention was not effective on cardiovascular indices . Music can effectively be used as a non-pharmacological method to manage anxiety after CABG Background Several recently developed therapies targeting motor disabilities in stroke sufferers have shown to be more effective than st and ard neurorehabilitation approaches . In this context , several basic studies demonstrated that music training produces rapid neuroplastic changes in motor-related brain areas . Music-supported therapy has been recently developed as a new motor rehabilitation intervention . Methods and Results In order to explore the plasticity effects of music-supported therapy , this therapeutic intervention was applied to twenty chronic stroke patients . Before and after the music-supported therapy , transcranial magnetic stimulation was applied for the assessment of excitability changes in the motor cortex and a 3D movement analyzer was used for the assessment of motor performance parameters such as velocity , acceleration and smoothness in a set of diadochokinetic movement tasks . Our results suggest that the music-supported therapy produces changes in cortical plasticity leading the improvement of the subjects ' motor performance . Conclusion Our findings represent the first evidence of the neurophysiological changes induced by this therapy in chronic stroke patients , and their link with the amelioration of motor performance . Further studies are needed to confirm our observations Background : Individuals with dementia often experience poor quality of life ( QOL ) due to behavioral and psychological symptoms of dementia ( BPSD ) . Music therapy can reduce BPSD , but most studies have focused on patients with mild to moderate dementia . We hypothesized that music intervention would have beneficial effects compared with a no-music control condition , and that interactive music intervention would have stronger effects than passive music intervention . Methods : Thirty-nine individuals with severe Alzheimer 's disease were r and omly and blindly assigned to two music intervention groups ( passive or interactive ) and a no-music Control group . Music intervention involved individualized music . Short-term effects were evaluated via emotional response and stress levels measured with the autonomic nerve index and the Faces Scale . Long-term effects were evaluated by BPSD changes using the Behavioral Pathology in Alzheimer 's Disease ( BEHAVE-AD ) Rating Scale . Results : Passive and interactive music interventions caused short-term parasympathetic dominance . Interactive intervention caused the greatest improvement in emotional state . Greater long-term reduction in BPSD was observed following interactive intervention , compared with passive music intervention and a no-music control condition . Conclusion : Music intervention can reduce stress in individuals with severe dementia , with interactive interventions exhibiting the strongest beneficial effects . Since interactive music intervention can restore residual cognitive and emotional function , this approach may be useful for aiding severe dementia patients ’ relationships with others and improving QOL . The registration number of the trial and the name of the trial registry are UMIN000008801 and “ Examination of Effective Nursing Intervention for Music Therapy for Severe Dementia Elderly Person ” respectively OBJECTIVES Not all patients with post-traumatic stress disorder ( PTSD ) respond to cognitive behavioural therapy ( CBT ) . Literature suggests group music therapy might be beneficial in treating PTSD . However , feasibility and effectiveness have not been assessed . The study objectives were to assess whether group music therapy was feasible for patients who did not respond to CBT  , and whether it has an effect on PTSD symptoms and depression . DESIGN The study employed mixed methods comprising of an exploratory r and omized controlled trial , qualitative content analysis of therapy , and patient interviews . METHOD Patients with significant PTSD symptoms ( n = 17 ) following completion of CBT were r and omly assigned to treatment ( n = 9 ) or control groups ( n = 8) . The treatment group received 10 weeks of group music therapy after which exit interviews were conducted . Control group patients were offered the intervention at the end of the study . Symptoms were assessed on the Impact of Events Scale-Revised and Beck Depression Inventory II at the beginning and end of treatment . RESULTS Treatment-group patients experienced a significant reduction in severity of PTSD symptoms ( -20.18 ; 95 % confidence interval [ CI ] : [ -31.23 , -9.12 ] ) and a marginally significant reduction in depression ( -11.92 ; 95%CI : [ -24.05 , 0.21 ] ) at 10 weeks from baseline compared to the control . Patients viewed music therapy as helpful and reported experiences concur with current literature . CONCLUSIONS Group music therapy appears feasible and effective for PTSD patients who have not sufficiently responded to CBT . Limitations include the small sample size and lack of blinding . Further research should address these limitations , test sustainability , and identify specific factors that address symptoms in treatment OBJECTIVES Mechanically ventilated patients experience profound stress . Interventions are needed to ameliorate stress that does not cause adverse effects . The purpose of this study was to explore the influence of music on stress in a sample of patients over the duration of ventilatory support . RESEARCH METHODOLOGY / DESIGN R and omised controlled trial ; r and omised patients ( 56.8 + 16.9 years , 61 % male , APACHE III 57.2 + 18.3 ) receiving ventilatory support to : ( 1 ) patient-directed music ( PDM ) where patients self-initiated music listening whenever desired from a preferred collection , ( 2 ) headphones only to block ICU noise , or ( 3 ) usual ICU care . Twenty-four hour urinary cortisol sample s were collected from a sub-set of subjects with intact renal function and not receiving medications known to influence cortisol levels ( n=65 ) . SETTING 12 ICUs in the Midwestern United States . MAIN OUTCOME MEASURES Urinary free cortisol ( UFC ) , an integrative biomarker of stress . RESULTS Controlling for illness severity , gender , and baseline UFC ( 29 - 45 mg/day ) , mixed models analysis revealed no significant differences among groups in UFC over the course of ventilatory support . CONCLUSION While music did not significantly reduce cortisol , less profound spikes in UFC levels were observed but that , given the limitations of the research , this observation could have occurred merely by chance OBJECTIVES To examine effects of sedative music on  cancer pain .  DESIGN A r and omized controlled trial . SETTING S Two large medical centers in Kaoshiung City , in southern Taiwan . PARTICIPANTS 126 hospitalized persons with cancer pain . METHODS Participants were r and omly assigned to an experimental ( n=62 ) or a control group ( n=64 ) , with computerized minimization , stratifying on gender , pain , and hospital unit . Music choices included folk songs , Buddhist hymns ( Taiwanese music ) , plus harp , and piano ( American ) . The experimental group listened to music for 30 min ; the control group rested in bed .  Sensation and distress of pain were rated on 100 mm VAS before and after the 30-min test . RESULTS Using MANCOVA , there was significantly less posttest pain in the music versus the control group , p<.001 . Effect sizes were large , Cohen 's d=.64 , sensation , d=.70 , distress , indicating that music was very helpful for pain . Thirty minutes of music provided 50 % relief in 42 % of the music group compared to 8 % of the controls . The number needed to treat ( NNT ) to find one with 50 % sensation relief was three patients . More patients chose Taiwanese music ( 71 % ) than American music ( 29 % ) , but both were liked and effective . CONCLUSIONS Offering a choice of familiar , culturally appropriate music was a key element of the intervention . Findings extend the Good and Moore theory ( 1996 ) to cancer pain . Soft music was safe , effective , and liked by participants . It provided greater relief of cancer pain than analgesics alone . Thus nurses should offer calming , familiar music to supplement analgesic medication for persons with cancer pain Background Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia . Music therapy has shown potential effects , but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients ’ care . This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes . Methods 17 care home residents and 10 care staff were r and omised to the  music therapy intervention group or st and ard care control group . The cluster r and omised , controlled trial included baseline , 3-month , 5-month and post-intervention 7-month measures of residents ’ symptoms and well-being . Carer-resident interactions were also assessed . Feasibility was based on carers ’ feedback through semi-structured interviews , programme evaluations and track records of the study . Results The music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms . Recruitment and retention data indicated feasibility but also challenges . Preliminary outcomes indicated differences in symptoms ( 13.42 , 95 % CI : [ 4.78 to 22.07 ; p = 0.006 ] ) and in levels of wellbeing ( −0.74 , 95 % CI : [ −1.15 to −0.33 ; p = 0.003 ] ) between the two groups , indicating that residents receiving music therapy improved . Staff in the intervention group reported enhanced caregiving techniques as a result of the programme . Conclusion The data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication . The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size . Trial registration Clinical trials.gov , number NCT01744600 A mixed methods research design was used to investigate the effects of a music therapy CD ( MTCD ) creation intervention on pediatric oncology patients ' distress and coping during their first radiation therapy treatment .  The music therapy method involved children creating a music CD using interactive computer-based music software , which was " remixed " by the music therapist- research er to extend the musical material . Eleven pediatric radiation therapy out patients aged 6 to 13 years were r and omly assigned to either an experimental group , in which they could create a music CD prior to their initial treatment to listen to during radiation therapy , or to a st and ard care group . Quantitative and qualitative analyses generated multiple perceptions from the pediatric patients , parents , radiation therapy staff , and music therapist- research er . Ratings of distress during initial radiation therapy treatment were low for all children . The comparison between the two groups found that 67 % of the children in the st and ard care group used social withdrawal as a coping strategy , compared to 0 % of the children in the music therapy group ; this trend approached significance ( p = 0.076 ) . MTCD creation was a fun , engaging , and developmentally appropriate intervention for pediatric patients , which offered a positive experience and aided their use of effective coping strategies to meet the dem and s of their initial radiation therapy treatment The ambient noise of monitors , other patients , and staff in the postanesthesia care unit/operating room may elevate levels of anxiety . The purpose of our study was to determine the effect of music versus noise-blocking headphones on the level of anxiety in women undergoing gynecologic same-day surgery . Institutional Review Board approval was obtained . The women were approached for consent and r and omized to usual care , music with headphones , or headphones only . Preoperative and postoperative anxiety was rated on a scale of 0 to 10 . Music/headphones were continued throughout surgery and removed when Aldrete level of consciousness equaled 2 . The 119 women had a mean age of 38.8 ( st and ard deviation=2.2 ) years . Of interest , 51 ( 45 % ) reported very low preoperative anxiety  ( 0 - 3/10 ) and were excluded . All groups experienced a drop in anxiety from pre- to postoperative status , but the usual care group had the least improvement ( P<.05 ) . The music group experienced the lowest postoperative anxiety scores ; the headphone group had a greater change overall . Music is a relatively inexpensive intervention , easy to administer , and noninvasive The main objective of this paper is to examine the impact of familiar music on self-consciousness ( SC ) in patients with Alzheimer 's disease ( AD ) . For this purpose , two AD groups of 20 patients matched by age , educational level , gender , illness duration , and cognitive state were assessed using an SC question naire before and after music intervention . The SC question naire measured several aspects : personal identity , anosognosia , affective state , body representation , prospect i ve memory , introspection and moral judgments . One AD group received familiar music stimulation and another AD group unfamiliar music stimulation over three months . The AD patients who received a familiar music intervention showed a stabilization or improvement in aspects of SC . By contrast , control AD group showed a deterioration of most of the SC aspects after unfamiliar music stimulation , except the SC aspects of body representation and affective state .  Familiar music stimulation could be considered as an enhancer of SC in patients with Alzheimer 's disease BACKGROUND Falls occur mainly while walking or performing concurrent tasks . We determined whether a music-based multitask exercise program improves gait and balance and reduces fall risk  in elderly individuals . METHODS We conducted a 12-month r and omized controlled trial involving 134 community-dwelling individuals older than 65 years , who are at increased risk of falling . They were r and omly assigned to an intervention group ( n = 66 ) or a delayed intervention control group scheduled to start the program 6 months later ( n = 68 ) . The intervention was a 6-month multitask exercise program performed to the rhythm of piano music .  Change in gait variability under dual-task condition from baseline to 6 months was the primary end point . Secondary outcomes included changes in balance , functional performances , and fall risk . RESULTS At 6 months , there was a reduction in stride length variability ( adjusted mean difference , -1.4 % ; P < .002 ) under dual-task condition in the intervention group , compared with the delayed intervention control group . Balance and functional tests improved compared with the control group . There were fewer falls in the intervention group ( incidence rate ratio , 0.46 ; 95 % confidence interval , 0.27 - 0.79 ) and a lower risk of falling ( relative risk , 0.61 ; 95 % confidence interval , 0.39 - 0.96 ) . Similar changes occurred in the delayed intervention control group during the second 6-month period with intervention . The benefit of the intervention on gait variability persisted 6 months later . CONCLUSION In community-dwelling older people at increased risk of falling , a 6-month music-based multitask exercise program improved gait under dual-task condition , improved balance , and reduced both the rate of falls and the risk of falling . Trial Registration clinical trials.gov Identifier : NCT01107288 PURPOSE To investigate the effects of music therapy on anxiety , perceived pain , and satisfaction in patients undergoing intravitreal injections in the outpatient setting . METHODS This is a r and omized clinical trial . Seventy-three patients were recruited from the retina clinic at 1 institution and r and omized into a music therapy  ( n=37 ) or control ( n=36 ) group . Prior to injection , patients completed the state portion of the Spielberger State Trait Anxiety Inventory ( STAI-S ) . The music therapy group listened to classical music through computer speakers while waiting for and during the injection . The control group underwent the injection in the same setting without music . Afterward , all patients completed another STAI-S and a satisfaction and pain  question naire . The main outcome measures were objective anxiety derived from STAI-S scores and subjective pain and anxiety from the post procedure question naire . RESULTS The music therapy group had a greater decrease in anxiety than the control group ( P=0.0480 ) . Overall , 73 % of all patients requested music for future injections ( P=0.0001 ) . The music therapy group ( 84 % ) requested music in future injections more frequently than the control group ( 61 % ) ( P=0.0377 ) . Both groups reported similar levels of pain ( P=0.5879 ) . CONCLUSIONS Classical music before and during intravitreal injections decreases anxiety in patients without decreasing pain . Most patients desire to have music during future injections . Music therapy is a low-cost , easy , safe intervention that reduces anxiety during intravitreal injections in the outpatient setting Objective : A music intervention method in the management of pain was recently developed while taking account of recommendations in the scientific literature . The objective of this study was to assess the usefulness of this music intervention to the management of patients with chronic pain .  Methods : A controlled , single-blind , r and omized trial was used . Eighty-seven patients presenting with lumbar pain , fibromyalgia , inflammatory disease , or neurological disease were included in the study . During their hospitalization , the intervention arm ( n=44 ) received at least 2 daily sessions of music listening between D0 and D10 , associated with their st and ard treatment , and then pursued the music intervention at home until D60 using a multimedia player in which the music listening software program had been installed . The control arm received st and ard treatment only ( n=43 ) . The end points measured at D0 , D10 , D60 , and D90 were : pain ( VAS ) , anxiety-depression ( HAD ) and the consumption of medication . Results : At D60 in the music intervention arm , this technique enabled a more significant reduction ( P<0.001 ) in pain ( 6.3±1.7 at D0 vs. 3±1.7 at D60 ) when compared with the arm without music intervention ( 6.2±1.5 at D0 vs. 4.6±1.7 at D60 ) . In addition , music intervention contributed to significantly reducing both anxiety/depression and the consumption of anxiolytic agents . Discussion : These results confirm the value of music intervention to the management of chronic pain and anxiety/depression . This music intervention method appears to be useful in managing chronic pain as it enables a significant reduction in the consumption of medication BACKGROUND Parkinson 's disease ( PD ) is a progressive neurodegenerative disorder where patients exhibit impairments in speech production . Few studies have investigated the influence of music interventions on vocal abilities of individuals with PD . OBJECTIVES To evaluate the influence of a group voice and singing intervention on speech , singing , and depressive symptoms in individuals with PD . METHODS Ten patients diagnosed with PD participated in this one-group , repeated measures design study . Participants received the sixty-minute intervention , in a small group setting once a week for 20 consecutive weeks . Speech and singing quality were acoustically analyzed using a  KayPentax Multi-Dimensional Voice Program  , voice ability using the Voice H and icap Index ( VHI ) , and depressive symptoms using the Montgomery and Asberg Depression rating scale ( MADRS ) . Measures were taken at baseline ( Time 1 ) , after 10 weeks of weekly sessions ( Time 2 ) , and after 20 weeks of weekly sessions ( Time 3 ) . RESULTS Significant changes were observed for five of the six singing quality outcomes at Time 2 and 3 , as well as voice range and the VHI physical subscale at Time 3 . No significant changes were found for speaking quality or depressive symptom outcomes ; however , there was an absence of decline on speaking quality outcomes over the intervention period . CONCLUSIONS Significant improvements in singing quality and voice range , coupled with the absence of decline in speaking quality support group singing as a promising intervention for persons with PD . A two-group r and omized control study is needed to determine whether the intervention contributes to maintenance of speaking quality in persons with PD AIM To examine the effects of music intervention on the physiological stress response and the anxiety level among mechanically ventilated patients in intensive care unit . BACKGROUND Despite the fact that previous studies have found music interventions to be effective in stress and anxiety reduction , effects of music on the Chinese population are inconclusive and warranted systematic study to evaluate its effect fully for a different Asian culture . DESIGN A r and omised placebo-controlled trial . METHODS A total of 137 patients receiving mechanical ventilation were r and omly assigned to either music listening group , headphone group or control group . Outcome measures included the Chinese version of Spielberger State-Trait Anxiety Scale and physiological parameters ( heart rate , respiratory rate , saturation of oxygen and blood pressure ) . RESULTS Comparison of mean differences ( pretest score-posttest score ) showed significant differences in heart rate , respiratory rate , systolic blood pressure and diastolic blood pressure as well as the Chinese version of Spielberger State-Trait Anxiety Scale , but not in SaO(2 ) among the three groups ( ranging from p < 0.001 to p = 0.007 ) , of which greater mean differences were found in music listening group . A significant reduction in physiological stress response ( heart rate and respiratory rate ) over time was found in music listening group ( p < 0.001 for both variables ) and a significant increase in heart rate and respiratory rate over time in control group ( p < 0.001 and p = 0.032 ) , with no significant change over time in headphone group . Within group pretest-posttest comparison of the Chinese version of Spielberger State-Trait Anxiety Scale demonstrated a significant reduction in anxiety for the music listening group ( p < 0.001 ) and headphone group ( p < 0.001 ) but not the control group . CONCLUSIONS Our findings confirm that short-term therapeutic effects of music listening results in substantial reduction in physiological stress responses arising from anxiety in mechanically ventilated patients . RELEVANCE TO CLINICAL PRACTICE Music as a non-pharmacological nursing intervention can be used as complementary adjunct in the care of patients with low-energy states who tire easily , such as those requiring mechanical ventilator support OBJECTIVES : We conducted a r and omized trial to test the hypothesis that mother ’s voice played through a pacifier-activated music player ( PAM ) during nonnutritive sucking would improve the development of sucking ability and promote more effective oral feeding in preterm infants . METHODS : Preterm infants between 34 0/7 and 35 6/7 weeks ’ postmenstrual age , including those with brain injury , who were taking at least half their feedings enterally and less than half orally , were r and omly assigned to receive 5 daily 15-minute sessions of either PAM with mother ’s recorded voice or no PAM , along with routine nonnutritive sucking and maternal care in both groups . Assignment was masked to the clinical team . RESULTS : Ninety-four infants ( 46 and 48 in the PAM intervention and control groups , respectively ) completed the study . The intervention group had significantly increased oral feeding rate ( 2.0 vs 0.9 mL/min , P < .001 ) , oral volume intake ( 91.1 vs 48.1 mL/kg/d , P = .001 ) , oral feeds/day ( 6.5 vs 4.0 , P < .001 ) , and faster time-to-full oral feedings ( 31 vs 38 d , P = .04 ) compared with controls . Weight gain and cortisol levels during the 5-day protocol were not different between groups . Average hospital stays were 20 % shorter in the PAM group , but the difference was not significant ( P = .07 ) . CONCLUSIONS : A PAM using mother ’s voice improves oral feeding skills in preterm infants without adverse effects on hormonal stress or growth There is increasing interest in evaluating the use of nonpharmacologic interventions such as music to minimize potential adverse effects of anxiety-reducing medications . This study used a quasi-experimental design to evaluate the effects of a perioperative music intervention ( provided continuously throughout the preoperative , intraoperative , and postoperative periods ) on changes in mean arterial pressure ( MAP ) , heart rate , anxiety , and pain in women with a diagnosis of breast cancer undergoing mastectomy . A total of 30 women were assigned r and omly to a control group or to the music intervention group . Findings indicated that women in the intervention group had a greater decrease in MAP and anxiety with less pain from the preoperative period to the time of discharge from the recovery room compared with women in the control group . Music is a noninvasive and low-cost intervention that can be easily implemented in the perioperative setting , and these findings suggest that perioperative music can reduce MAP , anxiety , and pain among women undergoing mastectomy for breast cancer UNLABELLED Migraine and tension-type headache have a high prevalence in children and adolescents . In addition to common pharmacologic and nonpharmacologic interventions , music therapy has been shown to be efficient in the prophylaxis of pediatric migraine . This study aim ed to assess the efficacy of specific music therapy techniques in the treatment of adolescents with primary headache ( tension-type headache and migraine ) . A prospect i ve , r and omized , attention-placebo-controlled parallel group trial was conducted . Following an 8-week baseline , patients were r and omized to either music therapy  ( n = 40 ) or a rhythm pedagogic program  ( n = 38 ) design ed as an " attention placebo " over 6 sessions within 8 weeks . Reduction of both headache frequency and intensity after treatment ( 8-week postline ) as well as 6 months after treatment were taken as the efficacy variables . Treatments were delivered in equal dose and frequency by the same group of therapists . Data analysis of subjects completing the protocol showed that neither treatment was superior to the other at any point of measurement ( posttreatment and follow-up ) . Intention-to-treat analysis revealed no impact of drop-out on these results . Both groups showed a moderate mean reduction of headache frequency posttreatment of about 20 % , but only small numbers of responders ( 50 % frequency reduction ) . Follow-up data showed no significant deteriorations or improvements . PERSPECTIVE This article presents a r and omized placebo-controlled trial on music therapy in the treatment of adolescents with frequent primary headache .  Music therapy is not superior to an attention placebo within this study . These results draw attention to the need of providing adequate controls within therapeutic trials in the treatment of pain OBJECTIVE Positive results have been reported with melodic intonation therapy ( MIT ) in nonfluent aphasia patients with damage to their left-brain speech processes , using the patient 's intact ability to sing to promote functional language . This pilot study sought to determine the immediate effects of introducing modified melodic intonation therapy ( MMIT ) , a modification of MIT , as an early intervention in stroke patients presenting with Broca 's aphasia . METHOD After a r and omized controlled single-blind design , 30 acute stroke survivors with nonfluent aphasia were r and omly assigned to receive MIT treatment or no treatment . A pre/post test , based on the responsive and repetition subsections of the Western Aphasia Battery , was developed for this study . RESULTS After 1 session , a significant within-subject change was observed for the treatment group 's adjusted total score ( p = .02 ) , and a significant difference between groups was found for adjusted total score ( p = .02 ) favoring the treatment group . The treatment group also showed a significant change in their responsive subsection scores ( p = .01 ) when their pre-tests from Visit 1 to Visit 2 were compared , whereas the control group showed no change , suggesting a possible carry-over effect of MIT treatment . CONCLUSION This study provides preliminary data supporting the possible benefits of utilizing MMIT treatment early in the recovery of nonfluent aphasia patients Primary fibromyalgia , a poorly understood chronic pain syndrome , is a disorder of uncertain etiology . The ultimate goal of fibromyalgia treatment is to develop a multimodal therapy . In recent years , the use of music as an intervention for the pain management and other symptoms has increased . The purpose of this study was to investigate the effects of music on pain and depression for people diagnosed with fibromyalgia using Rogers ' theory of the unitary human being as the theoretical framework . An experimental 4-week longitudinal trial design was undertaken . Sixty patients diagnosed with fibromyalgia were r and omly assigned to either a music intervention group or a control group . Music interventions consisted of listening to music once a day for 4 consecutive weeks using two types of CDs .  Pain was measured with the McGill Pain Question naire Long Form and depression with the Beck inventory ; a 100-mm visual analog scale was used to measure pain and depression . The treatment group reported a significant reduction in pain and depression at week 4 compared with the control group . Members of the control group reported no differences in pain . The findings of this pilot study suggest the importance of music therapy as a nursing intervention and justify further investigation into music as a self-management intervention to reduce pain and depression BACKGROUND Pregnant women who are placed on hospitalized bed rest experience increased antepartum-related distress . We sought to examine the efficacy of a single session music or recreation therapy intervention to reduce antepartum-related distress among women with high-risk pregnancies experiencing extended antepartum hospitalizations . METHODS In a r and omized , single-blinded study , participants ( n = 80 ) received 1 hour of music or recreation therapy or were placed in an attention-control group . Antepartum-related distress was measured by the Antepartum Bedrest Emotional Impact Inventory , which was administered before and after the intervention and at a follow-up period between 48 and 72 hours . RESULTS Significant associations were found between the delivery of music and recreation therapy and the reduction of antepartum-related distress in women hospitalized with high-risk pregnancies . These statistically significant reductions in distress persisted over a period of up to 48 - 72 hours . CONCLUSIONS Single session music and recreation therapy interventions effectively alleviate antepartum-related distress among high-risk women experiencing antepartum hospitalization and should be considered as valuable additions to any comprehensive antepartum program INTRODUCTION Despite persuasive theories about the beneficial effects of music and singing in developmental care for premature infants , few small studies are available in this regard . We conducted this study to investigate the physiological and behavioral responses of premature infants to recorded lullaby music and silence . METHODS In a r and omized controlled trial , 90 premature infants in the neonatal care unit of a hospital in Qom ( Iran ) were r and omly allocated to intervention ( lullaby and silence ) or control groups . Lullaby music was played via headphones at a volume of 50 - 60 dB. In the silence group , headphones were placed on the infants ' ears while no music was played . The three groups were surveyed for physiological responses including oxygen saturation , respiratory and heart rates , and behavioral states every five minutes before , during , and after the intervention . RESULTS The three groups were not significantly different in terms of mean values of respiratory and heart rates , oxygen saturation , and behavioral states of infants . Similarly , no significant within group differences in respiratory and heart rates , oxygen saturation , and behavioral states were observed at different times . CONCLUSION Our findings did not support the beneficial effects of music for premature infants . However , music is a noninvasive , non-pharmaceutical , and relatively low-cost intervention that can be implemented at infants ' bedside . Thus further research is warranted to determine whether the effects noted in previous studies can be consistently replicated in diverse setting s and with diverse groups of preterm infants BACKGROUND Music is considered a subset of developmental supportive care . It may act as a suitable auditory stimulant in preterm infants . Also , it may reduce stress responses in autonomic , motor and state systems . OBJECTIVE To assess and compare the influence of lullaby and classical music on physiologic parameters . METHOD This is a r and omized clinical trial with cross-over design . A total of 25 stable preterm infants with birth weight of 1000 - 2500 grams were studied for six consecutive days . Each infant was exposed to three phases : lullaby music , classical music , and no music ( control ) for two days each . The sequence of these phases was assigned r and omly to each subject . Babies were continuously monitored for heart rate , respiratory rate , and oxygen saturation and changes between phases were analyzed . RESULT Lullaby reduced heart rate ( p < 0.001 ) and respiratory rate ( p = 0.004 ) . These effects extended in the period after the exposure ( p < .001 and p = 0.001 , respectively ) . Classical music reduced heart rate ( p = 0.018 ) . The effects of classical music disappeared once the music stopped . Oxygen saturation did not change during intervention . CONCLUSION Music can affect vital signs of preterm infants ; this effect can possibly be related to the reduction of stress during hospitalization . The implication s of these findings on clinical and developmental outcomes need further study Background and Objectives : Cardiovascular diseases are the number 1 cause of death globally . Cardiac catheterization is a key step in the diagnosis and management of cardiovascular diseases . Decreasing the stress of cardiac catheterization is a key factor in improving patients ' well-being . The aim of the study was to explore the effect of music on psychophysiological indices in patients awaiting cardiac catheterization examination . Methods : Using a 2-group repeated- measures design , 54 subjects aged 47 to 70 years and scheduled for cardiac catheterization examination were recruited . The subjects were r and omly assigned to either the music group ( 27 subjects ) or the usual-care group ( 27 subjects ) . Subjects in the music group listened to 30 minutes of music , whereas the usual-care group rested quietly , as in routine care . The heart rate ( HR ) , HR variability , and skin temperature ( ST ) were measured at 7 time points and were recorded by the MP150 recording system ( BIOPAC Systems , Inc , Goleta , California ) . Heart rate variability was analyzed by power spectral analysis : low frequency , high frequency , and ratio of low frequency to high frequency . The state of anxiety was measured at baseline and at time 7 . At the end of the study , the subjects ' music preference was evaluated using a visual analog scale . Results and Conclusions : Listening to music result ed in a significantly reduced state of anxiety ( P = .003 ) . Both the music and quiet rest groups noted the beneficial effects of decreased HR and increased ST ( all P < .001 ) . The treatment effects of both interventions on HR variability were inconclusive . Moreover , we also found that the higher the scores of the music preference , the lower the subjects ' perceived anxiety level ( P = .05 ) . Our findings provide the necessary scientific support for the use of sedative music and quiet rest as safe and effective interventions against anxiety , as manifested in the subjects ' anxiety state , HR , and ST Depression and anxiety are associated with increased risk of postoperative cardiac events and death in patients who have undergone coronary artery bypass graft surgery . These risks persist even several months after the procedure . Guided imagery has been used with cardiac surgery patients for some time and with numerous anecdotal reports of considerable benefit . In addition , this therapy is low-cost and easy to implement , and the literature holds ample evidence for its efficacy in symptom reduction in various patient population s. It was thus hypothesized that preoperative use of guided imagery would reduce postoperative distress in patients undergoing coronary artery bypass graft . Fifty-six patients scheduled to undergo coronary artery bypass graft at Columbia University Medical Center were r and omized into 3 groups : guided imagery , music therapy , and st and ard care control . Patients in the imagery and music groups listened to audiotapes preoperatively and intraoperatively . All patients completed  psychological , complementary medicine therapies use , and other assessment s preoperatively and at 1 week and 6 months postoperatively . Only preoperative distress was predictive of postoperative distress at follow-up . Use of complementary medicine therapies was high in all groups and this fact , in addition to the small sample size , may have accounted for the lack of significant relationship between imagery and postoperative distress . Regardless , this complementary and alternative medicine therapy remains palatable to patients . Given its efficacy in other patient population s , it is worth exploring its potential utility for this population with a larger sample AIMS To determine the effect of music therapy and verbal relaxation on state anxiety and anxiety-induced physiological manifestations among patients with cancer before and after chemotherapy . BACKGROUND Cancer and its treatment provoke a series of changes in the emotional sphere of the patient 's anxiety . Music therapy and verbal relaxation had reported the anxiety reduction effect on patients with cancer receiving chemotherapy . Few studies have been undertaken comparing music therapy and verbal relaxation in differentiating high-normal state anxiety sub sample . DESIGN A r and omised controlled trial and permuted block design were used . Outpatient chemotherapy clinic operated by a University medical centre in southern Taiwan . METHODS Ninety-eight patients were r and omised into three groups : the music therapy group received one-hour single music session ; the verbal relaxation group received 30 minutes of guided relaxation ; the control group received usual care .  Spielberger State-Trait Anxiety Instrument , Emotional Visual Analog Scale , three biobehavioural indicators : skin temperature , heart rate and consciousness level were measured during and after chemotherapy . RESULT Music therapy had a greater positive effect on postchemotherapy anxiety than verbal relaxation and control groups and a significantly increase in skin temperature .  Patients with high state anxiety receiving music therapy had a greater drop in postchemotherapy anxiety than did the normal state anxiety sub sample . CONCLUSIONS Both music and verbal relaxation therapy are effective in reducing chemotherapy-induced anxiety . Thirty minutes of intervention initiates anxiety reduction .  Patients with high state anxiety receiving chemotherapy obtain the most benefit from music or verbal relaxation . RELEVANCE TO CLINICAL PRACTICE Prior to chemotherapy , patients with high state anxiety must be sorted from all patients as they are more responsive to interventions . Oncology nurses can offer music and verbal relaxation as adjuvant interventions to reduce chemotherapy-induced anxiety and enhance the quality of care The purpose of this study was to determine the effect of a music intervention ( MI ) on physiological parameters , pain and mood states in the neuroscience patient . This study enrolled and r and omized subjects to 1 of 2 groups , usual care ( UC ) group ( n=29 ) or UC plus MI ( n=24 ) . Data collected were physiologic parameters , pain and mood states pre and post a 30 min MI with UC compared to UC .  The sample was 16 males/37 females , mean age of 55.8 years , with similar baseline characteristics . There were significant reductions in heart rate ( t=-2.1 , p<0.04 ) , respirations ( t=-3.4 , p<0.001 ) , perceived anxiety ( t=-4.1 , p<0.000 ) , depression ( t=-4.3 , p<0.000 ) , and total mood score ( t=-4.1 , p<0.000 ) in subjects who received UC plus MI compared to UC . The inclusion of MI as a therapeutic intervention for neuroscience patients appears to decrease the emotional burden of hospitalization BACKGROUND Stress and anxiety during pregnancy have been associated with premature and low birth weight babies , presumably through fetus over exposion to glucocorticoids . Antenatal stress also seems to have long-term effects upon infant development and adult health . However , medication for stress may carry risks to the expectant mother , therefore the efficacy of non-pharmacological interventions should be investigated . METHODS Pregnant women ( n=154 ) awaiting amniocentesis , were r and omly assigned in the morning and the afternoon to three groups for 30 min : ( 1 ) listening to relaxing music , ( 2 ) sitting and reading magazines , and ( 3 ) sitting in the waiting-room . Before and after that period , they completed the  Spielberger 's State and Trait anxiety inventory  and provided blood sample s for cortisol . The groups were then compared regarding change in cortisol levels and anxiety . RESULTS Maternal cortisol and state anxiety were correlated ( r=0.25 , p=0.04 ) in the afternoon , but not in the morning . The larger decreases in cortisol occurred in the music group ( -61.8 nmol/L , ANOVA : p=0.01 ) , followed by magazine , being differences among groups more pronounced in the morning . Women in the music group also exhibited the greater decreases in state anxiety ( p<0.001 ) . Younger mothers with less gestational age were on average the most anxious , and also the ones with greater decreases in cortisol and anxiety levels after relaxation . CONCLUSION A relaxing intervention as short as 30 min , especially listening to music , decreases plasma cortisol and self-reported state anxiety score .  Pregnant women might benefit from the routine practice of relaxation in the imminence of clinical stressful events BACKGROUND Songwriting is a commonly utilized music therapy technique for clients in substance abuse rehabilitation . For these patients , motivation and readiness for treatment remain two key treatment areas . Moreover , there is a lack of r and omized and controlled music therapy studies systematic ally investigating how group songwrit-ing can affect patients on a detoxification unit . OBJECTIVE The purpose s of this study were to measure the effects of a single group songwriting session on motivation and readiness for treatment and determine emerging themes from patient-composed songs with patients on a detoxification unit . METHODS Participants ( N = 99 ) were r and omized to experimental ( posttest only ) or wait-list control ( pretest only ) conditions to provide treatment to all participants in an inclusive single-session design . RESULTS There were significant between-group differences in motivation and readiness for treatment , with experimental participants having higher means than control participants . Code categorizations from patients ' composed song lyrics concerned " action , " " emotions and feelings , " " change , " " reflection , " " admission , " and " responsibility . " CONCLUSION From the results of this study , it seems that a single group songwriting session can be an effective intervention concerning motivation and readiness for treatment in patients on a detoxification unit . Implication s for clinical practice , suggestions for future research , and limitations are provided The aim of this r and omized control study is to examine the effect of a multimodal psycho-music therapy intervention on respiratory symptoms , psychological well-being and quality of life of patients with Chronic Obstructive Pulmonary Disease and other lung diseases as adjunct to Pulmonary Rehabilitation with a design of music therapy plus PR compared to Pulmonary Rehabilitation alone . Music therapy group treatment including music visualization , wind playing and singing was provided weekly . This was compared with st and ard care treatment .  Adults ages 48 to 88 ( mean 70.1 ) with moderate to severe GOLD stage II-IV lung disease as well as other diseases processes that lead to chronic airflow limitations were included ( n = 98 ) . Participants in both conditions were followed from baseline enrollment to six weeks post control/treatment . Outcome measures included the Beck Depression Inventory Scale 2nd edition-Fast Screen ( BDI-FS ) , Chronic Respiratory Question naire Self-Reported ( CRQ-SR ) , and Dyspnea Visual Analog Scale ( VAS ) . Results showed improvement in symptoms of depression ( LS mean -0.2 ) in the music therapy group with statistical divergence between groups ( p = 0.007 ) . The CRQ-SR demonstrated improvement in dyspnea ( p = 0.01 LS mean 0.5 ) and mastery ( p = 0.06 LS mean 0.5 ) in the music therapy group and fatigue ( p = 0.01 LS mean 0.3 ) . VAS demonstrated highly significant effect in the music therapy group between weeks 5 and 6 ( p < 0.001 ) . The findings of this study suggest that music therapy combined with st and ard PR may prove to be an effective modality in the management of pulmonary disease The purpose of this study was to determine the effect of a " rockumentary " music therapy intervention on readiness to change and craving in patients on a detoxification unit utilizing psychometric instruments in a r and omized three-group design . Participants ( N = 141 ) were r and omized by group to a rockumentary music therapy intervention , verbal therapy , or recreational music therapy condition . All interventions were scripted and manualized in a posttest only design . Concerning readiness to change , results indicated there were significant between-group differences in Contemplation and Action subscales , with participants in the rockumentary and recreational music therapy conditions having higher means than participants in the verbal therapy condition . There were no differences between the two music therapy conditions concerning readiness to change variables . Although not significant , participants in both music therapy conditions tended to have lower mean craving scores than participants in the verbal therapy condition . Concerning Likert-type ratings of motivation to change , perception of helpfulness , and perception of enjoyment , participants in both music therapy conditions tended to have slightly higher mean scores than participants in the verbal therapy conditions . Participants ' posttest written comments were positive , regardless of condition . Limitations of the study , suggestions for the future inquiry , and implication s for clinical practice are provided OBJECTIVE The purpose of this study was to investigate the music therapy ( MT ) effect in levels of intraoperative anxiety in patients undergoing crossectomy with stripping of the great saphenous vein and to assess the efficacy , safety , and feasibility of this alternative therapy as a complement of st and ard intraoperative care . MATERIAL AND METHODS The study is a simple blind , controlled , parallel groups , prospect i ve r and omized clinical trial . Patients were allocated by means of r and omized controlled sampling . The study was performed in the surgery room of Getafe University Hospital in Madrid . The study was carried out in 40 patients , 20 r and omized to the experimental group and 20 r and omized to the control group , with an age range from 27 to 70 years . The control group was given intraoperative routine attention , and the experimental group was given an MT passive intervention that consisted of audition of musical fragments during varicose veins surgery . These pieces previously showed relaxing actions on the cardiovascular system . The anxiety levels were measured by means of pre- and postsurgical question naires by a blinded investigator for the study arm to which the patients had been r and omized . Heart rate and systolic and diastolic blood pressures were determined during the intervention , and adrenaline and noradrenaline plasma levels were determined before and after the surgical procedure . RESULTS The majority of the patients in the MT group ( 95 % ) and st and ard care group ( 90 % ) completed the study . There were no statistical differences between the control and experimental groups in heart rate gradient or systolic and diastolic blood pressures measured after the intervention . The anxiety state and the stress feeling scale score after surgery were significantly inferior in the MT group ( 94.7 % vs 57.9 % decrease in anxiety levels , P < .05 , and stress score of 1.31 vs 2.36 , P < .05 , respectively ) . The adverse events ratio was low and occurred with similar frequency in both groups . CONCLUSIONS The MT intervention was easily implemented in the context of nursing care received during varicose vein surgery and was positively accepted and valued by the majority of the patients . MT is a safe procedure that is proved to reduce anxiety and stress in the study patients Background : Most postoperative patients have unrelieved pain despite the use of patient-controlled analgesia . Nurses need additional effective modalities . Relaxation and music ( RM ) , in addition to analgesics , have been shown to reduce pain more than do analgesics alone . Objectives : The objectives of the study were to test an intervention of patient teaching for pain management ( PT ) and compare it with RM for immediate and general effects on postoperative pain . Methods : Patients having abdominal surgery and receiving patient-controlled analgesia aged 18 - 75 years ( n = 517 ) were r and omized to four groups : PT , RM , a combination ( PTRM ) , and a control . A 2 × 2 factorial design was used to assess PT-Effects and RM-Effects . Immediate effects on pain were measured on visual analogue sensation and distress scales before and after five 20-min tests in the first 2 days . Because participants also listened independently , general nonimmediate effects were examined at eight other times . Results : Using multivariate analysis of covariance with contrasts and pretest control , immediate RM-Effects on pain were found at Day 1 a.m. ( p < .001 ) , Day 1 p.m. ( p = .04 ) , and Day 2 a.m. ( p = .04 ) . No PT-Effects or nonimmediate RM-Effects were found . Discussion : Patient teaching did not result in less pain and did not support the theoretical proposition that PT reduces pain . However , the immediate RM-Effects supported the proposition that nonpharmacological adjuvants to analgesics can ease pain without adding side effects OBJECTIVES To examine the effects of music listening on sleep quality amongst older community-dwelling adults in Singapore . METHODS In a r and omized controlled study , a cohort of older adults ( N=60 ) age 55 years or above were recruited in one community centre . Sleep quality , as measured by the Pittsburgh Sleep Quality Index ( PSQI ) , was the primary outcome . Participants ' demographic variables including age , gender , religion , education level , marital and financial status , any chronic illness , previous experiences of music intervention as well as depression levels were collected . Participants were asked to listen to soft , instrumental slow sedative music without lyrics , of approximately 60 - 80 beats per minute , and 40 min in duration , for 6 weeks . Generalized estimating equations were used to examine the effects of the intervention on the elders ' sleep quality . RESULTS Significant reductions in PSQI scores were found in the intervention group ( n=28 ) from baseline ( mean±SD , 10.2±2.5 ) to week 6 ( 5.9±2.4 , p<0.001 ) , while there were no changes in the control group ( n=32 ) from baseline ( 9.0±2.4 ) to week 6 ( 9.5±2.6 ) . At week 6 , the intervention group showed a better sleep quality than the control ( χ(2)=61.84 , p<0.001 ) . CONCLUSIONS Notwithst and ing the placebo effect , this study supports music listening as an effective intervention for older adults  to improve sleep quality . Not only does this process improve their sleeping quality at old age , it also individualizes and enhances the quality of care provided by the healthcare provider as the therapeutic relationship between provider and client is being established . Contemporary gerontology is progressively characterized by collaboration between several approaches with the intent to comprehend the mental aspects of the multifarious process of ageing . Music listening is one such avenue to enhance sleep quality amongst older adults and make an essential contribution to healthy ageing Music therapy has been used in multiple health care setting s to reduce patient pain , anxiety , and stress . However , few available studies have investigated its effect on  pain among breast cancer patients after radical mastectomy . The aim of this study was to explore the effects of music therapy on pain reduction in patients with breast cancer after radical mastectomy . This r and omized controlled trial was conducted at the Surgical Department of Oncology Center , First Affiliated Hospital of Xi’an Jiaotong University from March to November 2009 . A total of 120 breast cancer patients who received Personal Controlled Analgesia ( PCA ) following surgery ( mastectomy )  were r and omly allocated to two groups , an intervention group and a control group ( 60 patients in each group ) . The intervention group accepted music therapy from the first day after radical mastectomy to the third admission to hospital for chemotherapy in addition to the routine nursing care , while the control group received only routine nursing care .  Pain scores were measured at baseline and three post-tests using the General Question naire and Chinese version of Short-Form of McGill Pain Question naire . The primary endpoint was the change in the Pain Rating Index ( PRI-total ) score from baseline . Music therapy was found to reduce the PRI-total score in the intervention group significantly compared with the control group with a mean difference ( 95 % CI ) of −2.38 ( −2.80 , −1.95 ) , −2.41 ( −2.85 , −1.96 ) , and −1.87 ( −2.33 , −1.42 ) for the 1st , 2nd , and 3rd post-tests , respectively . Similar results were found for Visual Analogue Scale ( VAS ) and Present Pain Intensity ( PPI ) scores . The findings of the study provide some evidence that music therapy has both short- and long-term positive effects on alleviating pain in breast cancer patients following radical mastectomy Organ transplant recipients characteristically experience low levels of relaxation and high levels of anxiety , pain , and nausea . Although music therapy has demonstrated effectiveness in ameliorating these types of conditions with patients in other areas of medical hospitals , no studies have evaluated the effects of music therapy on solid organ transplant patients . The purpose of this study was to assess the impact of music therapy on anxiety , relaxation , pain , and nausea levels in recovering patients on the adult transplant unit of the hospital utilizing a pre-posttest design . Participants ( N = 58 ) received an individual 15 - 35 minute music therapy session consisting of live patient-preferred music and therapeutic social interaction . To remain consistent with the hospital 's evaluative instruments during this pilot study , participants ' self-reported levels of anxiety , relaxation , pain , and nausea , were based on separate 10-point Likert-type scales . The principal investigator observed affect and verbalizations at pre and posttest . Results indicated there were significant improvements in self-reported levels of relaxation , anxiety ( both p < .001 ) , pain ( p < .01 ) , and nausea ( p < .05 ) . Although there was no reliability measure , there were significant increases in positive verbalizations and positive affect ( p < .001 ) . All participants reported that they would desire music therapy again during a future long-term hospital stay . From the results of this exploratory study , it seems that music therapy can be a viable psychosocial intervention for hospitalized postoperative solid transplant patients . Implication s for clinical practice and suggestions for future research are provided PURPOSE : Maternal breast milk is considered the nutritional “ gold st and ard ” for all infants , especially premature infants . However , preterm mothers are at risk of not producing adequate milk . Multiple factors affect the production of milk , including stress , fatigue , and the separation of the breastfeeding dyad — for example , when mother or infant is hospitalized . The purpose of this study was to examine the effects of listening and visual interventions on the quantity and quality of breast milk produced by mothers using a double electric breast pump . SUBJECTS : Mothers of 162 preterm infants were r and omly assigned to 1 of 4 groups . METHODS : The control group received st and ard nursing care , whereas mothers in the 3 experimental groups additionally listened to a recording of 1 of 3 music-based listening interventions while using the pump . RESULTS : Mothers in the experimental groups produced significantly more milk ( P < .0012 ) . Mothers in these groups also produced milk with significantly higher fat content during the first 6 days of the study OBJECTIVE The purpose of this study is to examine the feasibility and prospect i ve success associated with implementing and evaluating a six-week live music intervention on an inpatient neurorehabilitation ward . PATIENTS AND METHODS In total 26 patients were included in this study . Out of which , 15 were patients and 11 were staff members . Staff participants completed wellbeing measures at before and after music . Patients completed an assortment of vali date d measures at five consecutive time points from baseline to follow-up . Staff participants experienced a minor decrease in wellbeing over time . RESULTS The majority of the data collected from patients illustrated positive trends , with improvements in wellbeing , pain , cognition functioning , independent functioning , and mobility . The feasibility indicates that with modifications that this project is a viable venture . CONCLUSIONS We found that live music appears to be promising new addition to neurorehabilitation PURPOSE To evaluate the impact of slow-tempo music listening periods in mechanically ventilated intensive care unit patients . METHODS A r and omized crossover study was performed in a 16-bed , adult critical care unit at a tertiary care hospital . Still-se date d patients , m and ating at least 3 more days of mechanical ventilation , were included . The intervention consisted in two 1-hour daily periods of music-vs-sham-MP3 listening which were performed on Day 1 or 3 post- inclusion , with a Day 2 wash-out . " Before-after " collection of vital signs , recording of daily sedative drug consumption and measurement of stress and inflammatory blood markers were performed . RESULTS Of 55 r and omized patients , 49 were included in the final analyses . Along with music listening , ( i ) vital signs did not consistently change , whereas narcotic consumption tended to decrease to a similar sedation ( P = .06 vs sham-MP3 ) ; ( ii ) cortisol and prolactin blood concentrations decreased , whereas Adreno Cortico Trophic Hormone (ACTH)/cortisol ratio increased ( P = .02 ; P = .038 ; and P = .015 vs sham-MP3 , respectively ) , ( iii ) cortisol responders exhibited reversed associated changes in blood mehionine (MET)-enkephalin content ( P = .01 ) . CONCLUSIONS In the present trial , music listening is a more sensitive stress-reliever in terms of biological vs clinical response . The hypothalamus-pituitary adrenal axis stress axis is a quick sensor of music listening in responding mechanically ventilated intensive care unit patients , through a rapid reduction in blood cortisol Although musical interventions have recently gained popularity as a non-pharmacological treatment in dementia , there is still insufficient evidence of their effectiveness . To investigate this issue , a single-center r and omized controlled trial was conducted with forty-eight patients with Alzheimer 's disease or mixed dementia to compare the effects of music versus cooking interventions in the emotional , cognitive , and behavioral domain , as well as on professional caregiver distress . Each intervention lasted four weeks ( two one-hour sessions a week ) . Multi-component evaluations ( with blind assessors ) were conducted before , during , and after the interventions to assess their short and long-term effects ( up to four weeks post interventions ) . Analyses revealed that both music and cooking interventions led to positive changes in the patients ' emotional state and decreased the severity of their behavioral disorders , as well as reduced caregiver distress . However , no benefit on the cognitive status of the patients was seen . While results did not demonstrate a specific benefit of music on any of the considered measures , the present study suggests the efficacy of two pleasant non-pharmacological treatments in patients with moderate to severe dementia . Our findings highlight the potential of such interventions in improving the well-being of patients living in residential care  , as well as reducing caregiver distress The purpose of this study was to determine the effects of a songwriting intervention on  psychiatric patients '  knowledge of coping skills and working alliance .  Participants were r and omly assigned to  scripted and manualized experimental ( n=48 ) or control ( n=41 ) conditions . The experimental condition was a group psychoeducational music therapy songwriting session concerning coping skills while the control condition was a group psychoeducational session concerning coping skills . Both conditions were single-session therapy with patients on an acute adult psychiatric unit . Results indicated no significant between group differences in measures of knowledge of coping skills , consumer working alliance , or perception of enjoyment ( p>.05 ) , although the experimental condition tended to have slightly higher mean scores than the control group for these measures . There was a significant between group difference in measures of therapist working alliance ( p<.001 ) , with the therapist scoring the experimental group higher than the control group . Although the music therapy group had a higher mean rate of previous psychiatric hospitalizations , their perception of enjoyment scores were still higher than those of the control condition , a finding incongruent in the literature . Furthermore , despite the increased number of previous hospitalizations , the music therapy condition had higher attendance rates than the control condition , thus possibly providing incentives for funding . It seems that group songwriting about coping skills can be as effective a psychosocial intervention as traditional talk-based psychoeducation to teach psychiatric in patients how to proactively manage their illness . Additionally , music therapy can be as effective as talk-based psychoeducation in establishing working alliance . Implication s for clinical practice , limitations , and suggestions for future research are provided OBJECTIVE To assess the effects of playing patient-selected music during interventional procedures on ( 1 ) the doses of sedation and analgesia and ( 2 ) anxiety levels . METHODS Patients undergoing interventional radiological procedures were r and omised to either the intervention ( music ) or the control ( no music ) group . Patients in the intervention group had music of their choice played via headphones during the procedure . The primary outcomes were reductions in the doses of drugs for sedation ( midazolam ) and analgesia ( fentanyl ) . Anxiety levels were assessed both before and after the procedure using the vali date d State Anxiety Inventory . Mean pulse rate and average of mean blood pressures were also recorded before and during the procedures as surrogate indicators of anxiety levels . RESULTS 100 patients were r and omised in a 1:1 ratio . There were 58 males and 42 females , with a mean age of 58 years .  Sedation was required in 21 ( 42 % ) patients in the music group compared with 30 ( 60 % ) patients in the control group ( p=0.046 ) . The mean [ st and ard deviation ( SD ) ] midazolam dose was 2.1 mg ( 2.3 mg ) in the control group and 1.3 mg ( 2.2 mg ) in the music group ( p=0.027 ) . The mean ( SD ) fentanyl dose was 29 mg ( 40 mg ) in the control group and 18 mg ( 34 mg ) in the music group ( p=0.055 ) . There was no significant effect of music on the change from baseline in anxiety levels ( p=0.74 ) , pulse rate ( p=0.56 ) or blood pressure ( p=0.34 ) . CONCLUSION Sedation requirements are significantly reduced by playing self-selected music to the patient during interventional radiology procedures . By lowering sedation during interventional radiology , music makes the procedure safer . It also contributes favourably to the overall patient experience AIMS AND OBJECTIVES The objective of this study was to evaluate the effects of musical intervention on preoperative anxiety and vital signs in patients undergoing day surgery . BACKGROUND Studies and systematic meta-analyses have shown inconclusive results of the efficacy of music in reducing preoperative anxiety . We design ed a study to provide additional evidence for its use in preoperative nursing care . DESIGN R and omised , controlled study . METHOD Patients ( n = 183 ) aged 18 - 65 admitted to our outpatient surgery department were r and omly assigned to either the experimental group ( music delivered by earphones ) or control group ( no music ) for 20 minutes before surgery . Anxiety , measured by the State-Trait Anxiety Inventory , and vital signs were measured before and after the experimental protocol . RESULTS A total of 172 patients ( 60 men and 112 women ) with a mean age of 40·90 ( SD 11·80 ) completed the study . The largest number ( 35·7 % ) was undergoing elective plastic surgery and 76·7 % of the total reported previous experience with surgery . Even though there was only a low-moderate level of anxiety at the beginning of the study , both groups showed reduced anxiety and improved vital signs compared with baseline values ; however , the intervention group reported significantly lower anxiety [ mean change : -5·83 ( SD 0·75 ) vs. -1·72 ( SD 0·65 ) , p < 0·001 ] on the State-Trait Anxiety Inventory compared with the control group . CONCLUSIONS Patients undergoing day surgery may benefit significantly from musical intervention to reduce preoperative anxiety and improve physiological parameters . RELEVANCE TO CLINICAL PRACTICE Finding multimodal approaches to ease discomfort and anxiety from unfamiliar unit surroundings and perceived risks of morbidity ( e.g. disfigurement and long-term sequelae ) is necessary to reduce preoperative anxiety and subsequent physiological complications . This is especially true in the day surgery setting , where surgical admission times are often subject to change and patients may have to accommo date on short notice or too long a wait that may provoke anxiety . Our results provide additional evidence that musical intervention may be incorporated into routine nursing care for patients undergoing minor surgery The aim of this study was to investigate the effect of relaxing music on pain intensity in patients with neuropathic pain . A quasi-experimental study , repeated measures design was used . Thirty patients , aged 18 - 70 years , with neuropathic pain and hospitalized in an Algology clinic were identified as a convenience sample . Participants received 60 minutes of music therapy . Classical Turkish music was played to patients using a media player ( MP3 ) and headphones . Participants had pain scores taken immediately before the intervention and at the 30th and 60th minutes of the intervention . Data were collected over a 6-month period in 2012 . The patients ' mean pain intensity scores were reduced by music , and that decrease was progressive over the 30th and 60th minutes of the intervention , indicating a cumulative dose effect . The results of this study implied that the inclusion of music therapy in the routine care of patients with neuropathic pain could provide nurses with an effective practice for reducing patients ' pain intensity There is a controversy on whether listening to music before or during colonoscopy reduces anxiety and pain and improves satisfaction and compliance with the procedure . This study aim ed to establish whether specifically design ed music significantly affects anxiety , pain , and experience associated with colonoscopy . In this semir and omized controlled study , 34 patients undergoing a colonoscopy were provided with either muted headphones ( n = 17 ) or headphones playing the investigator-selected music ( n = 17 ) for 10 minutes before and during colonoscopy . Anxiety , pain , sedation dose , and overall experience were measured using quantitative measures and scales . Participants ' state anxiety decreased over time ( P < .001 ) . However , music did not significantly reduce anxiety ( P = .441 ) , pain scores ( P = .313 ) , or midazolam ( P = .327 ) or fentanyl doses ( P = .295 ) . Despite these findings , 100 % of the music group indicated that they would want music if they were to repeat the procedure , as compared with only 50 % of those in the nonmusic group wanting to wear muted headphones . Although no significant effects of music on pain , anxiety , and sedation were found , a clear preference for music was expressed , therefore warranting further research on this subject OBJECTIVE To prospect ively evaluate the effect of listening to music and inhaling aroma oil on patients undergoing screening computed tomography colonography . MATERIAL S AND METHODS Two hundred and twenty four participants were r and omly allocated to one of the four groups including : ( 1 ) combined music and aroma , ( 2 ) music alone , ( 3 ) aroma alone , and (4)control . The visual analog scale for pain and a question naire were used for subjective outcomes . We also used a pre-test – post-test design to compare the differences in blood pressure and heart rate as objective outcomes . RESULTS There were no statistical differences between the control group and other groups in the visual analog scale or changes in heart rate . Changes in blood pressure were similar . Participants reported good overall experiences . There were no differences in terms of overall satisfaction , pain rating , willingness to repeat the computed tomography colonography procedure in the future , or preference between colonoscopy and computed tomography colonography . More participants using music and /or aroma requested music and /or aroma during the next computed tomography colonography ( P < 0.0001 ) . CONCLUSION Although audio and olfactory intervention had little effect on perceived pain or discomfort and vital signs , participants who listened to music and inhaled aroma during the computed tomography colonography preferred music and aroma during the next computed tomography colonography AIMS The purpose of the study was to investigate the effects of music on pain reaction and anxiety during labour .  BACKGROUND Music therapy has been used on clinical medicine . Only few scientific studies vali date the value on labour women . DESIGN R and omised controlled trial . METHODS Sixty primiparas expected to have a normal spontaneous delivery were r and omly assigned to either the experimental group ( n = 30 ) or the control group ( n = 30 ) . The experimental group received routine care and music therapy , whereas the control group received routine care only . A self-report visual analogue scale for pain and a nurse-rated present behavioural intensity were used to measure labour pain . Anxiety was measured with a visual analogue scale for anxiety and finger temperature . Pain and anxiety between groups were compared during the latent phase ( 2 - 4 cm cervical dilation ) and active phase ( 5 - 7 cm ) separately . RESULTS Our results revealed that compared with the control group , the experimental group had significantly lower pain , anxiety and a higher finger temperature during the latent phase of labour . However , no significant differences were found between the two groups on all outcome measures during the active phase . CONCLUSIONS This study provides evidence for the use of music as an empirically based intervention of women for labour pain and anxiety during the latent phase of labour . RELEVANCE TO CLINICAL PRACTICE The findings support that music listening is an acceptable and non-medical coping strategy for labouring women . Especially , apply in reducing the pain and anxiety for women who are at the early phase of labour Abstract Self-efficacy is a component of B and ura ’s social cognitive theory and can lead to abstinence and a reduction of relapse potential for people who have substance abuse disorders . To date , no music therapy research er has utilized this theoretical model to address abstinence and reduce the likelihood of relapse in people who have addictions . The purpose of this study was to determine the effects of music therapy on drug avoidance self-efficacy in a r and omized three-group wait-list control design with patients on a detoxification unit . Participants ( N = 131 ) were cluster r and omized to one of three single-session conditions : music therapy , verbal therapy , or wait-list control . Music therapy participants received a group lyric analysis intervention , verbal therapy participants received a group talk therapy session , and wait-list control participants eventually received a group recreational music therapy intervention . Although there was no significant between-group difference in drug avoidance self-efficacy , participants in the music therapy condition tended to have the highest mean drug avoidance self-efficacy scores . Posttest written comments supported the use of both music therapy and verbal therapy sessions . Two music therapy participants specifically noted that their initial skepticism had dissipated after receiving music therapy . Despite a lack of significant differences , the theoretical support of self-efficacy for substance abuse rehabilitation suggests that this may be an area of continued clinical focus and empirical investigation . Clinical anecdotes , limitations of the study , and suggestions for future research are provided OBJECTIVE This experimental study aim ed to evaluate the effects of a group music intervention on anxiety and agitation of institutionalized older adults with dementia . METHODS A total of 60 participants were r and omly assigned to an experimental or a control group . The experimental group received a 30-min music intervention using percussion instruments with familiar music in a group setting in mid afternoon twice weekly for 6 weeks , whereas the control group received usual care with no music intervention . The Rating of Anxiety in Dementia scale was used to assess anxiety , and Cohen-Mansfield Agitation Inventory was used to assess agitation at baseline , week 4 and week 6 . RESULTS Repeated measures analysis of covariance indicated that older adults who received a group music intervention had a significantly lower anxiety score than those in the control group while controlling for pre-test score and cognitive level ( F = 8.98 , p = 0.004 ) . However , the reduction of agitation between two groups was not significantly different . CONCLUSIONS Anxiety and agitation are common in older adults with dementia and have been reported by caregivers as challenging care problems . An innovative group music intervention using percussion instruments with familiar music as a cost-effective approach has the potential to reduce anxiety and improve psychological well-being of those with dementia Objective : The aims of this study were to determine the effectiveness of group music therapy for improving depression and delaying the deterioration of cognitive functions in elderly persons with dementia . Method : The study had a prospect i ve , parallel-group design with permuted-block r and omization . Older persons with dementia ( N = 104 ) were r and omly assigned to the experimental or control group . The experimental group received 12 sessions of group music therapy ( two 30-min sessions per week for 6 weeks ) , and the control group received usual care . Data were collected 4 times : ( 1 ) 1 week before the intervention , ( 2 ) the 6th session of the intervention , ( 3 ) the 12th session of the intervention , and ( 4 ) 1 month after the final session . Results : Group music therapy reduced depression in persons with dementia . Improvements in depression occurred immediately after music therapy and were apparent throughout the course of therapy . The cortisol level did not significantly decrease after the group music therapy .  Cognitive function significantly improved slightly at the 6th session , the 12th session , and 1 month after the sessions ended ; in particular , short-term recall function improved . The group music therapy intervention had the greatest impact in subjects with mild and moderate dementia . Conclusion : The group music intervention is a noninvasive and inexpensive therapy that appeared to reduce  elders  ’ depression . It also delayed the deterioration of cognitive functions , particularly short-term recall function .  Group music therapy may be an appropriate intervention among elderly persons with mild and moderate dementia Background : Patients often exhibit preoperative fear and anxiety that may influence the process of induction and recovery from anesthesia . Music is thought to be an alternative to medication for relief of fear and anxiety . Objectives : The purpose of the present study was to explore the feasibility of using heart rate ( HR ) variability ( HRV ) for evaluating the efficacy of music listening to relieve the patients ’ anxiety during their stay in the operation room waiting area and to compare the HRV measures with subjective Visual Analogue Scale ( VAS ) scores . Methods : In total , 140 patients were r and omly assigned to the experimental ( n = 64 ) or control group ( n = 76 ) . The intervention consisted of a 10-min period of exposure to relaxing music delivered through headphones .  Anxiety levels were measured by VAS ( a 10-point scale ) and 5 min of HRV monitoring before and after the music intervention . Results : The music group demonstrated significant reductions in VAS scores , mean HR , low-frequency HRV , and low- to high-frequency ratio and an increase in high-frequency HRV , while patients in the control group showed no changes . The subjective results of patients ’ VAS anxiety scores were consistent with the objective results of HRV parameters . Conclusions : Listening to music can significantly lower the anxiety levels of patients before surgery . The frequency-domain parameters of HRV can be indicators for monitoring the change in anxiety level of preoperative patients BACKGROUND & AIM Pain is a common experience for women during labor . In the present study , we compared the effect of two types of non-pharmacological pain relief methods " music therapy " and " Hoku point ice massage " on the severity of labor pain . METHODS This prospect i ve , r and omized , controlled trial was conducted in Shahrekord , Iran , from September 2013 to June 2014 . We r and omly assigned 90 primiparous women who expected a normal childbirth into three groups : group " A " received music therapy , group " B " received Hoku point ice massage , and group " C " received usual labor care . At the beginning of the active phase ( 4 cm cervical dilation ) and before and after each intervention ( at dilations 4 , 6 , and 8 cm ) , the intensities of labor pain were measured using Visual Analogue Scale ( VAS ) . RESULTS At the beginning of the active phase , the mean VAS scores were 5.58 ± 1.29 , 5.42 ± 1.31 , and 6.13 ± 1.37 in the women in groups " A , " " B , " and " C , " respectively ( P > 0.05 ) . After the intervention , the mean pain scores were significantly lower at all of the time points in groups " A " and " B " than in group " C " women ( P < 0.05 ) . Although the pain scores showed a more decreasing trend after the intervention in group " A " than that in group " B , " the difference between the two groups was not statistically significant ( P > 0.05 ) . CONCLUSIONS Music therapy and Hoku point ice massage are easily available and inexpensive methods and have a similar effect in relieving labor pain The purpose of this study was to determine if listening to music or having a quiet rest period just before and just after the first ambulation on postoperative day 1 can reduce pain and /or anxiety or affect mean arterial pressure , heart rate , respiratory rate , and /or oxygen saturation in patients who underwent a total knee arthroplasty . Fifty-six patients having a total knee arthroplasty were r and omly assigned to either a music intervention group or a quiet rest group . A visual analog scale was used to measure pain and anxiety . Physiologic measures , including blood pressure , heart rate , oxygen saturation , and respiratory rate , were also obtained . Statistical findings between groups indicated that the music group 's decrease in pain and anxiety was not significantly different from the comparison rest group 's decrease in pain ( F = 1.120 ; p = .337 ) or anxiety ( F = 1.566 ; p = .206 ) at any measurement point . However , statistical findings within groups indicated that the sample had a statistically significant decrease in pain ( F = 6.699 ; p = .001 ) and anxiety ( F = 4.08 ; p = .013 ) over time . Results of this research provide evidence to support the use of music and /or a quiet rest period to decrease pain and anxiety . The interventions pose no risks and have the benefits of improved pain reports and decreased anxiety . It potentially could be opioid sparing in some individuals , limiting the negative effects from opioids . Nurses can offer music as an intervention to decrease pain and anxiety in this patient population with confidence , knowing there is evidence to support its efficacy OBJECTIVES to test the effectiveness of breast feeding ( BF ) , music therapy ( MT ) , and combined breast feeding and music therapy ( BF+MT ) on pain relief in healthy-term neonates during heel lance . DESIGN r and omised controlled trial . SETTING in the postpartum unit of one university-affiliated hospital in China from August 2013 to February 2014 . PARTICIPANTS among 288 healthy-term neonates recruited , 250 completed the trial . All neonates were undergoing heel lancing for metabolic screening , were breast fed , and had not been fed for the previous 30 minutes . INTERVENTIONS all participants were r and omly assigned into four groups - BF , MT , BF+MT , and no intervention - with 72 neonates in each group . Neonates in the control group received routine care . Neonates in the other three intervention groups received corresponding interventions five minutes before the heel lancing and throughout the whole procedure . MEASUREMENTS Neonatal Infant Pain Scale ( NIPS ) , latency to first cry , and duration of first crying . FINDINGS mean changes in NIPS scores from baseline over time was dependent on the interventions given . Neonates in the BF and combined BF+MT groups had significantly longer latency to first cry , shorter duration of first crying , and lower pain mean score during and one minute after heel lance , compared to the other two groups . No significant difference in pain response was found between BF groups with or without music therapy . The MT group did not achieve a significantly reduced pain response in all outcome measures . CONCLUSIONS BF could significantly reduce pain response in healthy-term neonates during heel lance . MT did not enhance the effect of pain relief of BF . IMPLICATION S FOR PRACTICE healthy-term neonates should be breast fed to alleviate pain during heel lance . There is no need for the additional input of classical music on breast feeding in clinic to relieve procedural pain . Nurses should encourage breast feeding to relieve pain during heel lance PURPOSE To examine effects of music therapy and progressive muscle relaxation training on depression , anxiety and length of hospital stay in Chinese female breast cancer patients after radical mastectomy . METHODS A total of 170 patients were r and omly allocated to the intervention group ( n = 85 ) receiving music therapy and progressive muscle relaxation training plus routine nursing care and the control group ( n = 85 ) receiving routine nursing care . Music therapy and progressive muscle relaxation training were performed twice a day within 48 h after radical mastectomy , once in the early morning ( 6a.m.-8a.m . ) and once in the evening ( 9p.m.-11p.m . ) , for 30 min per session until discharged from the hospital . RESULTS A general linear model with univariate analysis showed that the intervention group patients had significant improvement in depression and anxiety in the effects of group ( F = 20.31 , P < 0.001 ; F = 5.41 , P = 0.017 ) , time ( F = 56.64 , P < 0.001 ; F = 155.17 , P < 0.001 ) and group*time interaction ( F = 6.91 , P = 0.009 ; F = 5.56 , P = 0.019 ) . The intervention group patients had shorter length of hospital stay ( 12.56 ± 1.03 ) than that of the control group ( 17.01 ± 2.46 ) with statistical significance ( F = 13.36 , P < 0.001 ) . CONCLUSION Music therapy and progressive muscle relaxation training  can reduce depression , anxiety and length of hospital stay in female breast cancer patients after radical mastectomy OBJECTIVE To evaluate the effects of music played preoperatively in women undergoing elective cesarean delivery . METHODS Sixty women undergoing elective cesarean delivery were r and omized to a study group or a control group . Those in the study group listened to music for 30 minutes before surgery . All women underwent heart rate variability analysis and scored their anxiety and pain levels using the Self-Rating Anxiety Scale and a visual analog pain scale . RESULTS In the study group the mean HRV , as measured by the low frequency power ( LF ) value and the LF to high frequency power ( LF/HF ) ratio during Holter assessment , was significantly less after the music intervention but was not significantly changed in the control group . Moreover , the mean HF value was significantly increased and the mean anxiety score was significantly decreased after the music intervention but not in the control group . Finally , the mean pain score obtained 6 hours after surgery was significantly lower in the study than in the control group . CONCLUSION A preoperative music intervention can reduce anxiety and pain in women undergoing cesarean delivery The purpose was to investigate if women with high pre-procedural anxiety reported higher degree of relaxation and comfort if listening to music during coronary angiographic procedures . A prospect i ve r and omized controlled trial was used included 68 patients undergoing coronary angiography and /or PCI . The women were allocated to receive calming music and st and ard care or st and ard care only .  Relaxation , environmental sound and discomfort associated with lying still were assessed . There was significantly more positive impression of the sound environment and less discomfort associated with lying still in women listening to music in comparison to women who received only st and ard care . No effect in relaxation was found Objectives : This study , as part of a larger programme of research , sought to investigate the effect that participation in a 40-min live group music programme , involving facilitated engagement with song-singing and listening , three times a week for eight weeks , had on agitation and anxiety in older people with dementia . Methods : A r and omized cross-over design , with music and reading control groups , was employed . Forty-seven participants with mild – moderate dementia , from two aged care facilities in Queensl and , Australia , were recruited . Participants were assessed three times on the Cohen-Mansfield Agitation Inventory – Short Form ( CMAI-SF ) and the Rating Anxiety in Dementia Scale ( RAID ) . Results : A sub- analysis of 24 participants attending ≥50 % of music sessions found a significant increase in the frequency of verbal aggression over time , regardless of group ( F(2,46 ) = 3.534 , p < 0.05 ) . A series of multiple regressions found cognitive impairment , length of time living in the facility and gender to be predictors of agitation overall and by subtype . Conclusion : Participation in the music programme did not significantly affect agitation and anxiety in older people with dementia . Both the music and reading group activities , however , gave some participants a ‘ voice ’ and increased their verbalization behaviour . Agitation was found to be predicted by a number of background factors ( namely level of cognitive impairment , length of time in the facility and gender ) . Future studies would benefit more from in-depth participant assessment prior to study commencement , helping to moderate the influence of low scores , and by undertaking interventions at times when assessed symptoms are most prevalent Purpose The purpose of the feasibility study was to compare the effects of music-assisted relaxation and imagery , administered via compact disc recording ( MARI CD ) without therapeutic intervention , to the effects of music therapy ( MT ) , facilitated by a board-certified music therapist , on selected health outcomes of patients enrolled in diabetes self-management education/training ( DSME/T ) . Methods A 3-group , parallel , r and omized controlled trial with 199 patients , aged 30 to 85 years with type 1 , type 2 , or prediabetes was employed . Patients were enrolled in a study from 2 hospital sites and r and omly assigned to : DSME/T alone , DSME/T plus MARI CD , or DSME/T plus MT . The MARI CD included research er-selected music and spoken suggestions , while MT included therapeutic experiences with personally preferred relaxing and energizing music . Outcome measures included blood pressure , glycosylated hemoglobin ( A1C ) , body mass index ( BMI ) , trait anxiety , state anxiety , and stress . Results There were no statistically significant differences among the 3 conditions in blood pressure , A1C , BMI , trait anxiety , or stress . Significant changes over time were evident in the MT condition from pre- to post-each session in systolic blood pressure , state anxiety , and stress . Blood pressure changes were compared pre- to postprogram for those patients with a comorbidity of hypertension between DSME/T alone and a combined music intervention group ( MT and MARI CD ) . It was found that the music intervention group had a significantly larger decrease in systolic blood pressure . Themes derived from patient narratives further informed the data . Conclusions The study results support the relationship between DSME/T and improvement on all measured outcomes except blood pressure . Results suggest the feasibility of integrating MARI and MT with DSME/T to potentially lower systolic blood pressure of patients with diabetes and a comorbidity of hypertension . Collaboration between diabetes educators and board-certified music therapists is recommended BACKGROUND Treatment motivation is a key component in the early rehabilitative stages for people with substance use disorders . To date , no music therapy research er has studied how lyric analysis interventions might affect motivation in a r and omized controlled design . OBJECTIVES The primary purpose of this study was to determine the effect of lyric analysis interventions on treatment motivation in patients on a detoxification unit using a single-session wait-list control design . A secondary purpose was to determine if there were between-group differences concerning two contrasting songs used for the lyric analyses . METHODS Participants ( N=104 ) were cluster r and omized to a  group lyric analysis condition or a wait-list control condition . Participants received either a " Hurt " or a " How to Save a Life " lyric analysis treatment . The Texas Christian University Treatment Motivation Scale-Client Evaluation of Self at Intake ( CESI ) ( Simpson , 2008[2005 ] ) was used to measure aspects of treatment motivation : problem recognition , desire for help , treatment readiness , pressures for treatment , and total motivation . RESULTS Results indicated significant between-group differences in measures of problem recognition , desire for help , treatment readiness , and total motivation , with experimental participants having higher treatment motivation means than control participants . There was no difference between the two lyric analysis interventions . CONCLUSIONS Although the song used for lyric analysis interventions did not affect outcome , a single group-based music therapy lyric analysis session can be an effective psychosocial treatment intervention to enhance treatment motivation in patients on a detoxification unit . Limitations , implication s for clinical practice , and suggestions for future research are provided BACKGROUND : Nonpharmacological interventions , including combinations of music , education , coping skills , and relaxation techniques , have been found to have a positive effect on patients ' perceived anxiety in many setting s. However , few research studies have assessed and compared the effectiveness of music and relaxation interventions in reducing the anxiety levels of orthopaedic and oncology patients . PURPOSE : We conducted a prospect i ve , r and omized , controlled study to examine the effectiveness of music and relaxation interventions on perceived anxiety during initial hospitalization for patients receiving orthopaedic or cancer care treatment at a Midwestern teaching hospital . METHOD : This was a pre-test/post-test study design utilizing the State-Trait Anxiety Inventory . One hundred twelve patients were r and omized into 3 study groups . Thirty-eight subjects ( 34 % ) were r and omized in the music-focused relaxation group , 35 subjects ( 31 % ) in the music and video group , and 39 ( 35 % ) subjects in the control group . Fifty-seven ( 51 % ) were orthopaedic patients and 55 ( 49 % ) were oncology patients . RESULTS : Comparison of the 3 study groups showed no statistically significant differences with regard to patients ' demographics . Although reduced anxiety levels were reported for all 3 groups postintervention , the differences were not statistically significant ( p > .05 ) . Also , there was no significant difference found between the perceived anxiety levels of patients admitted to the orthopaedic and oncology care units ( p > .05 ) . Finally , the results of the intragroup comparisons ( regardless of the group assignment ) showed a significant decrease in anxiety levels reported by all patients postintervention ( p < .001 ) . CONCLUSIONS : Music and relaxation interventions could be an additional tool in assisting patients to become less anxious during their hospital stay . Music focused relaxation and music and video are both valuable and cost-effective strategies that can assist the orthopaedic and oncology patient population . Identifying opportunities to make these interventions easily accessible to healthcare professionals can assist in the management of patient anxiety during hospitalization BACKGROUND Patients scheduled to invasive medical procedures experience high levels of anxiety , which may lead to increased perceptions of pain and vital sign instability throughout . AIMS To examine the effect of a music intervention ( MI ) on stress hormones , physiologic parameters , pain , and anxiety state before and during port catheter placement procedures ( PCPPs ) . METHODS We conducted a prospect i ve , r and omized , controlled study in 100 oncology patients , who were r and omly assigned to an  MI group ( n=50 ) or a control group ( n=50 ) . The effects of music were assessed by determination of serum cortisol and adrenocorticotropic hormone ( ACTH ) levels , heart and respiratory rate ( HR , RR ) and systolic and diastolic blood pressure ( SBP , DBP ) , on arrival in the surgical intervention room , as well as immediately prior to and immediately after the PCPP , in both groups . Furthermore , pain and anxiety levels were identified using visual analogue scale and state-trait anxiety inventory scales . RESULTS On arrival , there were no differences between the patients in terms of serum cortisol and ACTH levels , HR , RR , SBP , DBP and anxiety levels . There were significant reductions in hormone levels ( p<0.05 for all ) , HR ( p<0.001 ) , RR ( p<0.001 ) , SBP ( p<0.05 ) and DBP ( p<0.05 ) , immediately prior to and immediately after the PCPP in participants in the MI group compared to those in the control group . Furthermore , music led to a significant reduction in pain ( p<0.05 ) and anxiety scores ( p<0.05 ) in the MI group compared to control group . CONCLUSION During invasive medical procedures , MI significantly decreases stress hormone levels , physiological parameters , acute procedural pain and anxiety AIM The purpose was to examine the effects of non-commercial music on quality of sleep and relaxation indices , including heart rate , mean arterial pressure , and respiratory rate in patients in intensive care units . BACKGROUND There is currently insufficient scientific knowledge for the effects of music on quality of sleep in critically ill patients . DESIGN A r and omized controlled trial . METHODS Between January-December 2010 , 28 patients aged 39 - 78 years were r and omly assigned to music and control groups . Participants in the music groups listened to non-commercial music for 45 minutes at nocturnal sleep time . In the control group , participants slept with no music . Participants were assessed using vital signs monitors , st and ardized question naire , and polysomnography . Polysomnography sleep was recorded for the first 2 hours of the nocturnal sleep . General estimating equation was applied to analyse data . FINDINGS Participants in the music group had shorter stage N2 sleep and longer stage N3 sleep in the first 2 hours of the nocturnal sleep and improved self-reported sleep quality , compared with those in the control group . The music group patients also had significantly lower heart rates than those in the control group . The intensive care units patients experienced fragmented sleep with a high frequency of awakenings and severe reduction in r and om eye movement sleep during the first 2 hours of the nocturnal sleep . CONCLUSION The findings provided evidence for nurses to use soothing music as a research -based nursing intervention for intensive care unit patients ' sleep improvement BACKGROUND Music has served as an auxiliary analgesic in perioperative setting s. This study evaluates the impact of intraoperative music added to routine pain control measures during first trimester surgical abortion . STUDY DESIGN We analyzed data from 101 women r and omized to undergo abortion with routine pain control measures only ( ibuprofen and paracervical block ) or with the addition of intraoperative music via headphones .  The primary outcome was the change in preoperative and postoperative pain scores on a 100-mm visual analog scale . Secondary outcomes included change in anxiety and vital signs , and satisfaction . RESULTS Baseline characteristics were similar between groups . The magnitude of increase in pain scores was greater in the intervention than in the control group ( + 51.0 mm versus + 39.3 mm , p=.045 ) . Overall pain control was rated as good or very good by 70 % of the intervention and 75 % of the control group ( p=.65 ) . CONCLUSIONS Intraoperative music added to routine pain control measures increases pain reported during abortion Background : A cardiac catheterization laboratory can be a frightening environment and music can be a supportive source of environmental sound that stimulates and maintains relaxation . Aim : To test the effects of patient focused music versus loudspeaker music versus st and ard sound on patient 's experiences of anxiety and well-being during coronary angiographic procedures . Methods : A prospect i ve , r and omized , controlled trial of 98 subjects undergoing elective coronary angiogram and /or percutaneous coronary intervention . The subjects were r and omly allocated to three different groups of sound environments : a control group ( the usual sound environment ) , a patient focused music group ( audio pillow ) or to a loudspeaker music group . Results : Anxiety decreased significantly and well-being increased significantly in the two music groups compared to the control group . There was a significantly more positive impression of the sound environment in the patient focused music group compared to the two other groups . Conclusion : This study showed that the use of a specially design ed music reduced anxiety and increased well-being in patients during coronary angiographic procedures . However , patient focused music seemed to be more preferable . The sound environment was rated more positively by the subjects listening to music via audio pillow . The music delivered via loudspeakers seemed to distract the staff during the examination at the cardiac catheterization laboratory CONTEXT Anesthesiologists use various medications to provide surgical patients with pain relief in the postoperative period . Other modalities , such as music , could be used in conjunction with opioids and nonsteroidal anti-inflammatory drugs ( NSAIDs ) to decrease pain and lower heart rate and blood pressure . Our hypothesis was that patients listening to jazz in a postanesthesia care unit ( PACU ) would have lower heart rates and blood pressures and reduced pain and anxiety . OBJECTIVE The study objective was to determine if listening to jazz music in the PACU , when compared to wearing noise-canceling headphones with no music playing , would decrease heart rate , blood pressure , pain , or anxiety in patients undergoing a hysterectomy . DESIGN The research design was a prospect i ve , r and omized study . SETTING The study was conducted in the PACU at the Penn State Hershey Medical Center in Hershey , PA , USA . PARTICIPANTS A total of 56 patients , aged 18 - 75 y , who were categorized as status 1 or 2 according to the American Society of Anesthesiologists ( ASA ) Physical Status Classification System , and who were undergoing elective laparoscopic or abdominal hysterectomies , were enrolled in the study . INTERVENTION Patients were r and omly assigned either to listen to jazz music where the beats per min ( BPM ) was < 100 ( experimental group , n = 28 ) or to wear noise-canceling headphones ( control group , n = 28 ) for 30 min while in the PACU after their surgery . OUTCOME MEASURES Heart rate was the primary outcome , and secondary outcomes included systolic and diastolic blood pressure , an anxiety score , and a pain score . All outcome measures were initially recorded at baseline upon the patient 's arrival in the PACU . Heart rate and blood pressure were recorded postoperatively every 5 min for the initial 30 min that a patient was in the PACU . Pain was checked every 10 min during the 30-min period ; anxiety was checked at 30 min . RESULTS Heart rates of patients in the noise-cancellation group were significantly lower when compared with baseline ( P < .05 ) , at all time points . For patients in the jazz group , heart rates were significantly lower at 15 , 20 , 25 , and 30 min when compared with baseline . The pain scores were significantly lower ( P < .05 ) in the noise-cancellation group compared with the jazz group at 10 min into the recovery period . CONCLUSION Overall , the results showed that patients responded not only to music but also to silence in the PACU . Using music and /or noise reduction could decrease opioid administration , promote relaxation , and improve patient satisfaction AIMS To evaluate the effects of music listening on pain intensity and pain distress on the first and second postoperative days in abdominal surgery patients and the long-term effects of music on the third postoperative day . BACKGROUND Music has been found to relieve pain intensity in surgery patients . There are only a few studies on music intervention in abdominal surgery . Music intervention studies assessing multidimensional pain such as pain intensity and pain distress are also scarce . DESIGN Prospect i ve clinical study with two parallel groups . METHODS Patients undergoing elective abdominal surgery ( n = 168 ) were divided into either a music group ( n = 83 ) or a control group ( n = 85 ) . Patients assessed pain intensity and pain distress in bed rest , during deep breathing and in shifting position once in the evening of the operation day and on the first and second postoperative days in the morning , at noon and in the evening . On the third postoperative day , the patients assessed their pain intensity and pain distress only once . RESULTS In the music group , the patients ' pain intensity and pain distress in bed rest , during deep breathing and in shifting position were significantly lower on the second postoperative day compared with control group of patients . On the third postoperative day , when long-term effects of music on pain intensity and pain distress were assessed , there were no significant differences between music and control groups . CONCLUSION This study demonstrates that the use of music alleviates pain intensity and pain distress in bed rest , during deep breathing and in shifting position after abdominal surgery on the second postoperative day . Music intervention is safe , inexpensive and easily used to improve the healing environment for abdominal surgery patients . RELEVANCE TO CLINICAL PRACTICE Music intervention should be offered as an adjunct alternative to pharmacological pain relief after abdominal surgery in nursing practice OBJECTIVE To examine the effectiveness of music listening on pain , anxiety , and vital signs among patients after thoracic surgery in China . DESIGN AND SETTING A r and omized controlled clinical trial was conducted in the thoracic surgery department of two tertiary hospitals in Wuhan , China . 112 patients were recruited and r and omly assigned to either experimental ( n=56 ) or control ( n=56 ) group respectively . INTERVENTION The experimental group received st and ard care and a 30-min soft music intervention for 3 days , while the control group received only st and ard care . Measures include pain , anxiety , vital signs ( blood pressure , heart rate and respiratory rate ) , patient controlled analgesia , and diclofenac sodium suppository use . RESULTS The experimental group showed statistically significant decrease in pain , anxiety , systolic blood pressure and heart rate over time compared to the control group , but no significant difference were identified in diastolic blood pressure , respiratory rate , patient controlled analgesia and diclofenac sodium suppository use . CONCLUSION The findings provide further evidence to support the practice of music therapy to reduce postoperative pain and anxiety , and lower systolic blood pressure and heart rate in patients after thoracic surgery in China INTRODUCTION Listening to music is a low-cost intervention that has demonstrated ability to reduce pain and anxiety levels in various medical procedures . METHODS Subjects undergoing electrophysiological examinations were r and omized into a music-listening group and a control group .  Visual analog scales were used to measure anxiety and pain levels during the procedure . RESULTS Thirty subjects were r and omized to each group . No statistically significant difference was found in anxiety or pain levels during the procedure between groups . However , most subjects in the music-listening group reported anxiety and pain reduction and would prefer to hear music in a future examination . CONCLUSIONS Although listening to music during electrophysiological examinations did not reduce anxiety or pain significantly , most subjects felt a positive effect and would prefer to hear music ; therefore , we suggest that music may be offered optionally in the electromyography laboratory setting OBJECTIVE To explore the effects of singing training on respiratory function , voice , mood , and quality of life for people with quadriplegia . DESIGN R and omized controlled trial . SETTING Large , university-affiliated public hospital , Victoria , Australia . PARTICIPANTS Participants ( N=24 ) with chronic quadriplegia ( C4 - 8 , American Spinal Injury Association grade s A and B ) . INTERVENTIONS The experimental group ( n=13 ) received group singing training 3 times weekly for 12 weeks . The control group ( n=11 ) received group music appreciation and relaxation for 12 weeks . Assessment s were conducted pre , mid- , immediately post- , and 6-months postintervention . MAIN OUTCOME MEASURES St and ard respiratory function testing , surface electromyographic activity from accessory respiratory muscles , sound pressure levels during vocal tasks , assessment s of voice quality ( Perceptual Voice Profile , Multidimensional Voice Profile ) , and Voice H and icap Index , Profile of Mood States , and Assessment of Quality of Life instruments . RESULTS The singing group increased projected speech intensity ( P=.028 ) and maximum phonation length ( P=.007 ) significantly more than the control group . Trends for improvements in respiratory function , muscle strength , and recruitment were also evident for the singing group . These effects were limited by small sample sizes with large intersubject variability . Both groups demonstrated an improvement in mood ( P=.002 ) , which was maintained in the music appreciation and relaxation group after 6 months ( P=.017 ) . CONCLUSIONS Group music therapy can have a positive effect on not only physical outcomes , but also can improve mood , energy , social participation , and quality of life for an at-risk population , such as those with quadriplegia . Specific singing therapy can augment these general improvements by improving vocal intensity Stigma is a major social barrier that can restrict access to and willingness to seek psychiatric care . Psychiatric consumers may use secrecy and withdrawal in an attempt to cope with stigma . The purpose of this study was to determine the effects of music therapy on self- and experienced stigma in acute care psychiatric in patients using a r and omized design with wait-list control . Participants ( N=83 ) were r and omly assigned by cluster to one of three single-session group-based conditions : music therapy , education , or wait-list control . Participants in the music therapy and education conditions completed only posttests while participants in the wait-list control condition completed only pretests . The music therapy condition was a group songwriting intervention wherein participants composed lyrics for " the stigma blues . " Results indicated significant differences in measures of discrimination ( experienced stigma ) , disclosure ( self-stigma ) , and total stigma between participants in the music therapy condition and participants in the wait-list control condition . From the results of this r and omized controlled investigation , music therapy may be an engaging and effective psychosocial technique to treat stigma . Limitations , suggestions for future research , and implication s for clinical practice and psychiatric music therapy research are provided In this r and omized , controlled multi-site study , the pacifier-activated-lullaby system ( PAL ) was used with 68 premature infants . Dependent variables were ( a ) total number of days prior to nipple feeding , ( b ) days of nipple feeding , ( c ) discharge weight , and ( d ) overall weight gain . Independent variables included contingent music reinforcement for non-nutritive sucking for PAL intervention at 32 vs. 34 vs. 36 weeks adjusted gestational age ( AGA ) , with each age group subdivided into three trial conditions : control consisting of no PAL used vs. one 15-minute PAL trial vs. three 15-minute PAL trials . At 34 weeks , PAL trials significantly shortened gavage feeding length , and three trials were significantly better than one trial . At 32 weeks , PAL trials lengthened gavage feeding . Female infants learned to nipple feed significantly faster than male infants . It was noted that PAL babies went home sooner after beginning to nipple feed , a trend that was not statistically significant BACKGROUND Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to st and ard care , in a variety of psychiatric ailments including mood and anxiety disorders . However , the role of music in the treatment of obsessive-compulsive disorder ( OCD ) have not been investigated to date . METHODS In a single-center , parallel-group , r and omized clinical trial ( NCT02314195 ) 30 patients with OCD were r and omly assigned to st and ard treatment ( pharmacotherapy and cognitive-behavior therapy ) plus 12 sessions of individual music therapy ( n = 15 ) or st and ard treatment only ( n = 15 ) for one month . Maudsley Obsessive-Compulsive Inventory , Beck Anxiety Inventory , and Beck Depression Inventory-Short Form were administered baseline and after one month . RESULTS Thirty patients completed the study .  Music therapy result ed in a greater decrease in total obsessive score ( post-intervention score : music therapy+st and ard treatment : 12.4 ± 1.9 vs st and ard treatment only : 15.1 ± 1.7 , p < 0.001 , effect size = 56.7 % ) . For subtypes , significant between-group differences were identified for checking ( p = 0.004 ) , and slowness ( p = 0.019 ) , but not for washing or responsibility . Music therapy was significantly more effective in reducing anxiety ( post-intervention score : music therapy + st and ard treatment : 16.9 ± 7.4 vs st and ard treatment only : 22.9 ± 4.6 , p < 0.001 , effect size = 47.0 % ) , and depressive symptoms ( post-intervention score : music therapy + st and ard treatment : 10.8 ± 3.8 vs st and ard treatment : 17.1 ± 3.7 , p < 0.001 , effect size = 47.0 % ) . LIMITATIONS Inclusion of a small sample size , lack of blinding due to the nature of the intervention , short duration of follow-up . CONCLUSION In patients with OCD  , music therapy , as an adjunct to st and ard care , seems to be effective in reducing obsessions , as well as co-morbid anxiety and depressive symptoms CONTEXT Treatment of  pain in palliative care patients is challenging . Adjunctive methods of pain management are desirable . Music therapy offers a nonpharmacologic and safe alternative . OBJECTIVES To determine the efficacy of a single music therapy session to reduce  pain in palliative care patients . METHODS Two hundred in patients at University Hospitals Case Medical Center were enrolled in the study from 2009 to 2011 . Patients were r and omly assigned to one of two groups : st and ard care alone ( medical and nursing care that included scheduled analgesics ) or st and ard care with music therapy . A clinical nurse specialist administered pre- and post-tests to assess the level of pain using a numeric rating scale as the primary outcome , and the Face , Legs , Activity , Cry , Consolability Scale and the Functional Pain Scale as secondary outcomes . The intervention incorporated music therapist-guided autogenic relaxation and live music . RESULTS A significantly greater decrease in numeric rating scale pain scores was seen in the music therapy group ( difference in means [ 95 % CI ] -1.4 [ -2.0 , -0.8 ] ; P<0.0001 ) . Mean changes in Face , Legs , Activity , Cry , Consolability scores did not differ between study groups ( mean difference -0.3 , [ 95 % CI ] -0.8 , 0.1 ; P>0.05 ) . Mean change in Functional Pain Scale scores was significantly greater in the music therapy group ( difference in means -0.5 [ 95 % CI ] -0.8 , 0.3 ; P<0.0001 ) [ corrected ] : A single music therapy intervention incorporating therapist-guided autogenic relaxation and live music was effective in lowering pain in palliative care patients OBJECTIVES To examine the effects of a group music therapy on psychiatric symptoms and depression for patient with schizophrenia in a psychiatric nursing home . SUBJECTS AND METHODS Eighty patients with schizophrenia were r and omly assigned to a music intervention group ( MIG ) or usual care group ( UCG ) . Both groups received similar medical and routine care . The MIG received a 60-min group music therapy twice a week , a total of ten sessions . The UAG only received the usual care with no music therapy .  Psychiatric symptoms and depression assessment s were conducted using the positive and negative syndrome scale and the depression scale for schizophrenia at baseline , the posttest , and at a 3-month follow-up . RESULTS Thirty-eight patients in the MIG and 42 in the UCG completed the study . After 10 sessions of group music therapy , the groups showed statistically significant differences in psychiatric symptoms ( p<.05 ) and depression status ( p<.05 ) . CONCLUSION Group music therapy is an economical and easily implemented method of improving depression and psychiatric symptoms in patients with schizophrenia Background : During labor , women experience a high level of intense , stressful and steady pain that may negatively affect both mothers and neonates . Painkillers have previously been used for childbearing women , but nowadays , owing to some well-known limitations and serious side effects , nonpharmacologic methods such as massage and music therapies are being broadly recommended . The present clinical trial was conducted to compare the effects of massage and music therapies on the severity of  labor pain  in the Ilam province of western Iran . Material s & Methods : Overall , 101 primigravidae who were hospitalized for vaginal delivery were recruited and r and omly stratified into two groups of either massage ( n = 51 ) or music ( n = 50 ) therapies .  Pain was measured using the visual analog scale and the two groups were compared in terms of pain severity before and after the interventions . Results : Mothers in the massage therapy group had a lower level of pain compared with those in the music therapy group ( p = 0.009 ) . A significant difference was observed between the two groups in terms of pain severity after intervention ( p = 0.01 ) . Agonizing , or most severe , labor pain was significantly relieved after massage therapy ( p = 0.001 ) . Conclusion : Massage therapy was an effective method for reducing and relieving labor pain compared with music therapy and can be clinical ly recommended as an alternative , safe and affordable method of pain relief where using either pharmacological or nonpharmacological methods are optional AIMS To study the effect of a music programme during lunchtime on problem behaviour among institutionalised older residents with dementia . BACKGROUND Symptoms of dementia among older people include depression , problems with memory , insomnia and problem behaviours . Problem behaviour has been identified by families and nurses as the greatest challenge that needs to be addressed . Several studies have found that music therapy can reduce problem behaviours among dementia sufferers and , based on this finding , music has been recommended for incorporation as part of dementia management . DESIGN This study used a quasi-experimental design with an eight-week time series follow-up . The intervention was background music when residents had their lunch meal . METHODS A purposive sampling technique was used . Forty-one participants were selected from an institution housing residents with dementia located in a city in Taiwan . RESULTS The mean age of participants was 81.68 ( SD 6.39 ) years old . The mean score for Mini-Mental State Examination ( MMSE ) was 10.66 ( SD 6.85 ) . The mean of Barthel Activity of Daily Living score was 56.83 ( SD 38.12 ) . The results showed that the music programme reduced , significantly , physical and verbal aggressive behaviour among the older residents with dementia . The study identified that there was a one-week time lag between the implementation of the music programme and a significant effect on the residents . CONCLUSIONS The results from this study suggested that music is able to reduce the degree of problem behaviours among the older residents with dementia and this helps to ease work-load of nurse aides and nurses during meal times . RELEVANCE TO CLINICAL PRACTICE The results may serve as a reference for the future treatment of problem behaviour among the older with dementia IMPORTANCE Alternatives to sedative medications , such as music , may alleviate the anxiety associated with ventilatory support . OBJECTIVE To test whether listening to self-initiated patient-directed music ( PDM ) can reduce anxiety and sedative exposure during ventilatory support in critically ill patients . DESIGN , SETTING , AND PATIENTS R and omized clinical trial that enrolled 373 patients from 12 intensive care units ( ICUs ) at 5 hospitals in the Minneapolis-St Paul , Minnesota , area receiving acute mechanical ventilatory support for respiratory failure between September 2006 and March 2011 . Of the patients included in the study , 86 % were white , 52 % were female , and the mean ( SD ) age was 59 ( 14 ) years . The patients had a mean ( SD ) Acute Physiology , Age and Chronic Health Evaluation III score of 63 ( 21.6 ) and a mean ( SD ) of 5.7 ( 6.4 ) study days . INTERVENTIONS Self-initiated PDM ( n = 126 ) with preferred selection s tailored by a music therapist whenever desired while receiving ventilatory support , self-initiated use of noise-canceling headphones ( NCH ; n = 122 ) , or usual care ( n = 125 ) . MAIN OUTCOMES AND MEASURES Daily assessment s of anxiety ( on 100-mm visual analog scale ) and 2 aggregate measures of sedative exposure ( intensity and frequency ) . RESULTS Patients in the PDM group listened to music for a mean ( SD ) of 79.8 ( 126 ) ( median [ range ] , 12 [ 0 - 796 ] ) minutes/day . Patients in the NCH group wore the noise-abating headphones for a mean ( SD ) of 34.0 ( 89.6 ) ( median [ range ] , 0 [ 0 - 916 ] ) minutes/day . The mixed-models analysis showed that at any time point , patients in the PDM group had an anxiety score that was 19.5 points lower ( 95 % CI , -32.2 to -6.8 ) than patients in the usual care group ( P = .003 ) . By the fifth study day , anxiety was reduced by 36.5 % in PDM patients . The treatment × time interaction showed that PDM significantly reduced both measures of sedative exposure . Compared with usual care , the PDM group had reduced sedation intensity by -0.18 ( 95 % CI , -0.36 to -0.004 ) points/day ( P = .05 ) and had reduced frequency by -0.21 ( 95 % CI , -0.37 to -0.05 ) points/day ( P = .01 ) . The PDM group had reduced sedation frequency by -0.18 ( 95 % CI , -0.36 to -0.004 ) points/day vs the NCH group ( P = .04 ) . By the fifth study day , the PDM patients received 2 fewer  sedative doses ( reduction of 38 % ) and had a reduction of 36 % in sedation intensity . CONCLUSIONS AND RELEVANCE Among ICU patients receiving acute ventilatory support for respiratory failure , PDM result ed in greater reduction in anxiety compared with usual care , but not compared with NCH . Concurrently , PDM result ed in greater reduction in sedation frequency compared with usual care or NCH , and greater reduction in sedation intensity compared with usual care , but not compared with NCH . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00440700 AIMS The aim of this study was to investigate if relaxing music is an effective method of reducing the physiological signs of anxiety in patients receiving mechanical ventilatory support . BACKGROUND Few studies have focused on the effect of music on physiological signs of anxiety in patients receiving mechanical ventilatory support . DESIGN A study -case-control , experimental repeated measures design was used . METHOD Sixty patients aged 18 - 70 years , receiving mechanical ventilatory support and hospitalised in the intensive care unit , were taken as a convenience sample . Participants were r and omised to a control group or intervention group , who received 60 minutes of music therapy . Classical music was played to patients using media player ( MP3 ) and headphones . Subjects had physiological signs taken immediately before the intervention and at the 30th , 60th and 90th minutes of the intervention . Physiological signs of anxiety assessed in this study were mean systolic and diastolic blood pressure , pulse rate , respiratory rate and oxygen saturation in blood measured by pulse oxymetry . Data were collected over eight months in 2006 - 2007 . RESULTS The music group had significantly lower respiratory rates , and systolic and diastolic blood pressure , than the control group . This decrease improved progressively in the 30th , 60th and 90th minutes of the intervention , indicating a cumulative dose effect . CONCLUSION Music can provide an effective method of reducing potentially harmful physiological responses arising from anxiety . RELEVANCE TO CLINICAL PRACTICE As indicated by the results of this study , music therapy can be supplied to allay anxiety in patients receiving mechanical ventilation . Nurses may include music therapy in the routine care of patients receiving mechanical ventilation Postoperative pain is difficult to manage with analgesia alone . Complementary interventions such as music therapy provide a level of distraction , thus promoting comfort . In this study , decreased pain and environmental noise were demonstrated , without diminishing state anxiety , in a group of postoperative patients BACKGROUND Music therapy has been used successfully for over 30 years as part of palliative care programs for severely ill patients . There is nonetheless a lack of high- quality studies that would enable an evidence -based evaluation of its psychological and physiological effects . METHODS In a r and omized controlled trial , 84 hospitalized patients in palliative care were assigned to one of two treatment arms -- music therapy and control . The music therapy intervention consisted of two sessions of live music-based relaxation exercises ; the patients in the control group listened to a verbal relaxation exercise . The primary endpoints were self-ratings of relaxation , well-being , and acute pain , assessed using visual analog scales . Heart rate variability and health-related quality of life were considered as secondary outcomes . The primary data analysis was performed according to the intention-to-treat principle . RESULTS Analyses of covariance revealed that music therapy was more effective than the control treatment at promoting relaxation ( F = 13.7 ; p < 0.001 ) and well-being ( F = 6.41 ; p = 0.01 ) . This effect was supported by a significantly greater increase in high-frequency oscillations of the heart rate ( F = 8.13 ; p = 0.01 ) . Music therapy did not differ from control treatment with respect to pain reduction ( F = 0.4 ; p = 0.53 ) , but it led to a significantly greater reduction in the fatigue score on the quality -of-life scale ( F = 4.74 ; p = 0.03 ) . CONCLUSION Music therapy is an effective treatment with a low dropout rate for the promotion of relaxation and well-being in terminally ill persons undergoing palliative care BACKGROUND Solid organ transplant patients often experience a variety of psychosocial stressors that can lead to distress and may hinder successful recovery . Using coping-infused dialogue ( CID ) through patient- preferred live music ( PPLM ) music therapy sessions may improve mood and decrease pain while also imparting psychoeducational knowledge concerning the identification of local and global problems and coping skills . OBJECTIVE The purpose of this pilot study was to develop a coping-based medical music therapy protocol that combines coping-infused dialogue ( CID ) with patient-preferred live music ( PPLM ) and measure the effects of the result ing CID-PPLM protocol on mood ( positive and negative affect ) and pain in hospitalized transplant patients . METHODS Our study used a pre-/posttest single-session wait-list control design . Participants ( N=25 ) were r and omly assigned to experimental ( CID-PPLM ) or control ( usual care ) conditions . Participants in the CID-PPLM condition received a single 30-minute session that integrated stressor identification and knowledge of coping skills ( CID ) with patient-preferred live music ( PPLM ) . RESULTS Results indicated no between-group differences at pretest and significant correlations between pre- and posttest measures . Concerning posttest ANCOVA analyses , there were significant between-group differences in positive affect , negative affect , and pain , with experimental participants having more favorable posttest scores than control participants . Effect sizes were in the medium-to-large range for positive affect ( η2=.198 ) , negative affect ( η2=.422 ) , and pain ( η2=.303 ) . CONCLUSIONS CID through receptive PPLM may be an effective protocol for improving mood and decreasing pain in organ transplant recipients . MT interventions can be an important tool to develop rapport and enhance outcomes with patients . As greater engagement during interventions may have stronger treatment effects , we recommend future research examining patient engagement as a potential mediator of intervention effects , as well as the number of sessions required to maximize clinical outcomes OBJECTIVE This study was design ed to evaluate the role of music therapy on the level of stress in children undergoing repair of congenital heart disease . DESIGN Prospect i ve , r and omized , double-blind , controlled clinical trial . SETTING Children 's university hospital . PARTICIPANTS Fifty children aged 4 to 12 years undergoing repair of congenital heart disease . INTERVENTIONS Patients were r and omized into 2 equal groups ( control group and music group ) ; in the control group , patients listened to a blank CD , and in the music group , patients listened to a recorded CD of music and songs preferred by the child .  Demographic data , clinical data , and preoperative vital signs were recorded . Baseline stress markers ( blood glucose and cortisol levels ) were sample d. Patients were assessed intraoperatively until extubation for vital signs and stress markers and after extubation for pain and sedation scales . An interview was conducted within the first postoperative week with the patients and their parents for assessment of post-traumatic stress disorder and negative postoperative behavior changes . MEASUREMENTS AND MAIN RESULTS There were no significant differences in demographic characteristics , clinical data , vital signs , preoperative and at-extubation blood glucose levels , and preoperative blood cortisol levels between groups . Significant differences were found between groups in blood glucose levels and cortisol levels at all intraoperative times , but only in cortisol blood levels at extubation . Significant differences were found in pain score , sedation score , occurrence of child post-traumatic stress disorder , and occurrence of negative postoperative behavior . CONCLUSION Listening to favorable music by children undergoing repair for congenital heart disease result ed in less stress and more relaxation IMPORTANCE Many medical procedures aim ed at helping children cause them pain and distress , which can have long-lasting negative effects . Music is a form of distraction that may alleviate some of the pain and distress experienced by children while undergoing medical procedures . OBJECTIVE To compare music with st and ard care to manage pain and distress . DESIGN , SETTING , AND PARTICIPANTS R and omized clinical trial conducted in a pediatric emergency department with appropriate sequence generation and adequate allocation concealment from January 1 , 2009 , to March 31 , 2010 . Individuals assessing the primary outcome were blind to treatment allocation . A total of 42 children aged 3 to 11 years undergoing intravenous placement were included . INTERVENTIONS Music ( recordings selected by a music therapist via ambient speakers ) vs st and ard care . MAIN OUTCOMES AND MEASURES The primary outcome was behavioral distress assessed blinded using the Observational Scale of Behavioral Distress-Revised  . The secondary outcomes included child-reported pain , heart rate , parent and health care provider satisfaction , ease of performing the procedure , and parental anxiety . RESULTS With or without controlling for potential confounders , we found no significant difference in the change in behavioral distress from before the procedure to immediately after the procedure . When children who had no distress during the procedure were removed from the analysis , there was a significantly less increase in distress for the music group ( st and ard care group = 2.2 vs music group = 1.1 , P < .05 ) . Pain scores among children in the st and ard care group increased by 2 points , while they remained the same in the music group ( P = .04 ) ; the difference was considered clinical ly important . The pattern of parent satisfaction with the management of children 's pain was different between groups , although not statistically significant ( P = .07 ) . Health care providers reported that it was easier to perform the procedure for children in the music group ( 76 % very easy ) vs the st and ard care group ( 38 % very easy ) ( P = .03 ) . Health care providers were more satisfied with the intravenous placement in the music group ( 86 % very satisfied ) compared with the st and ard care group ( 48 % ) ( P = .02 ) . CONCLUSIONS AND RELEVANCE Music may have a positive impact on pain and distress for children undergoing intravenous placement . Benefits were also observed for the parents and health care providers . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00761033 OBJECTIVES Despite anecdotal reports of voice impairment in quadriplegia , the exact nature of these impairments is not well described in the literature . This article details objective and subjective voice assessment s for people with quadriplegia at baseline and after a respiratory-targeted singing intervention .  STUDY DESIGN R and omized controlled trial . METHODS Twenty-four participants with quadriplegia were r and omly assigned to a 12-week program of either a singing intervention or active music therapy control . Recordings of singing and speech were made at baseline , 6 weeks , 12 weeks , and 6 months postintervention . These deidentified recordings were used to measure sound pressure levels and assess voice quality using the Multidimensional Voice Profile and the Perceptual Voice Profile . RESULTS Baseline voice quality data indicated deviation from normality in the areas of breathiness , strain , and roughness . A greater percentage of intervention participants moved toward more normal voice quality in terms of jitter , shimmer , and noise-to-harmonic ratio ; however , the improvements failed to achieve statistical significance . CONCLUSIONS Subjective and objective assessment s of voice quality indicate that quadriplegia may have a detrimental effect on voice quality ; in particular , causing a perception of roughness and breathiness in the voice . The results of this study suggest that singing training may have a role in ameliorating these voice impairments OBJECTIVES To assess the effects of active music therapy ( MT ) and individualized listening to music ( LtM ) on behavioral and psychological symptoms of dementia ( BPSDs ) in persons with dementia ( PWDs ) . DESIGN R and omized controlled trial . SETTING Nine Italian institutions . PARTICIPANTS Persons with moderate to severe dementia and BPSDs ( N = 120 ) were r and omized to one of three treatments . INTERVENTIONS All groups received st and ard care ( SC ) , and two groups attended 20 individualized MT or LtM sessions , twice a week , in addition to SC . MEASUREMENTS The Neuropsychiatric Inventory ( NPI ) , Cornell Scale for Depression in Dementia ( CSDD ) , and Cornell-Brown Scale for Quality of Life in Dementia ( CBS-QoL ) were administered before treatment , after treatment , and at follow-up to evaluate behavioral and psychological outcomes . A specific coding scheme ( Music Therapy Check List-Dementia ) was used to evaluate the MT process . RESULTS Behavioral assessment did not show significant differences between groups . All groups showed a reduction over time in NPI global score ( P ≤ .001 ) , CSDD ( P = .001 ) , and CBS-QoL ( P = .01 ) . The NPI global score fell 28 % in the MT group , 12 % in the LtM group , and 21 % in the SC group at the end of treatment . An exploratory post hoc analysis showed similar within-group improvements for the NPI Delusion , Anxiety , and Disinhibition subscales . In the MT group , communication and relationships between the music therapists and PWDs showed a positive albeit nonsignificant trend during treatment . CONCLUSION The addition of MT or LtM to st and ard care did not have a significant effect on BPSDs in PWDs . Further studies on the effects of the integration of st and ard care with different types of music interventions on BPSD in PWD are warranted OBJECTIVE To investigate the feasibility and effectiveness of Sonas , a group intervention involving multisensory stimulation , reminiscence , and light physical activity . METHODS A total of 39 participants with moderate to severe dementia were r and omized to receive either 14 sessions of Sonas or treatment as usual . Measures such as quality of life ( QoL ) , communication , depression , anxiety , and behavioral disturbance were administered at baseline and follow-up . RESULTS No statistically significant results were found . However , participant attendance to sessions was good ( mean = 12.4 sessions of 14 offered ) . CONCLUSIONS Sonas sessions did not lead to improvements in QoL and behavioral and psychological symptoms of dementia The physiological and psychological stress of surgery and postoperative pain can leave patients more susceptible to infection and complications . The present study was design ed to determine whether two interventions , patient teaching ( PT ) for pain management and relaxation/music ( RM ) , reduced cortisol levels , an indicator of stress , following abdominal surgery . Patients ( 18–75 years ) were r and omly assigned to receive PT , RM , a combination of the two  ,  or usual care ; the 205 patients with both pre- and posttest cortisol values were analyzed . A 2 × 2 factorial design was used to compare groups for PT effects and RM effects . Stress was measured by salivary cortisol before and after 20-min tests of the interventions in the morning and afternoon of postoperative Day 2 . Saliva was stimulated with lemon juice and analyzed with high-sensitivity salivary cortisol enzyme immunoassay . Comparisons using analysis of covariance ( ANCOVA ) , controlling for baseline levels , showed no PT effect or RM effect on cortisol in the morning or afternoon . Post hoc ANCOVA showed no significant effects when intervention groups were compared to the control group . Although in previous studies , RM reduced pain and music reduced cortisol on Day 1 , in the present study the cortisol response to surgery was not attenuated by PT or RM on Day 2 . The RM intervention can be used for pain but needs to be further tested for effects on plasma cortisol in abdominal surgery patients on their first postoperative day AIMS AND OBJECTIVES A pilot study design ed as future r and omised controlled trial was carried out to determine the effects of music on physiological responses and sedation scores in se date d , mechanically ventilated patients . BACKGROUND Mechanically ventilated ICU patients , even when receiving intravenous sedatives , may experience stress and anxiety . One possible intervention to reduce stress and anxiety is listening to music . DESIGN A r and omised controlled trial design with repeated measures was used . METHODS Data were collected over a six-month period in 2006 . Twenty subjects were r and omly assigned to either the experimental or control group . Subjects in the experimental group listened to music three times for 30 minutes over two days ; subjects in the control group undertook three 30 minute rest periods .  Physiological effects of music on systolic , diastolic and mean arterial blood pressure and heart and respiratory rate were assessed . Sedation scores were also measured . RESULTS Physiological parameters did not show a significant difference between the groups . Patients in the experimental group showed significantly higher Ramsay ( sedation ) scores than patients in the control group after the first session . The higher scores indicate that patients were less responsive to external stimuli . CONCLUSION Our results suggest that listening to music leads to higher sedation scores in se date d , mechanically ventilated ICU patients . No significant decreases in physiological parameters were observed . Listening to music showed no negative changes in the condition of these patients . Future research should focus on the use of other measures , such as stress hormones , to assess stress in se date d , mechanically ventilated ICU patients . RELEVANCE TO CLINICAL PRACTICE For the se date d , mechanically ventilated ICU patient , the benefit of music may lie in the associated ( deeper ) level of sedation that is achieved , which in turn may make the patient less susceptible to stress and anxiety Background . Few interventions have been successful in improving gait dysfunction in patients with multiple sclerosis ( MS ) .  Rhythmic auditory stimulation ( RAS ) has demonstrated positive results on gait performance in other neurologically impaired population s. Objective . To measure the effects of RAS on quantitative walking parameters in ambulatory patients with MS . Methods . Ten MS patients with gait disturbance were r and omly assigned to receive RAS versus no intervention for 2 weeks . All participants received RAS for another 2 weeks . Between weekly clinic visits , they were provided with MP3 players containing songs whose tempo was 10 % above the participant ’s spontaneous cadence and were instructed to walk to the music 20 minutes daily .  Quantitative gait parameters were measured using the GAITRite system . Results . A statistically significant decrease between groups was found for change in double-support time ( left , P = .0176 ; right , P = .0247 ) , whereas trends with medium to high effect sizes were found for other gait parameters , including walking speed . A pooled within-group analysis showed significant improvement of cadence , stride length , step length , velocity , and normalized velocity after 1 week of treatment . Satisfaction level with RAS was high . Conclusions . These results in a convenience sample of MS patients demonstrate the feasibility and safety of RAS when used at home and suggest a potential benefit on gait parameters OBJECTIVES Ragas of Indian music are said to be beneficial in normalizing blood pressure ( BP ) . The objective of this study was to evaluate the effect of passive listening to relaxing raga on the autonomic functions of hypertensives and prehypertensives and provide scientific evidence . METHODS Ethical clearance was obtained from the institutional review board . A prospect i ve , r and omized controlled trial was done on hundred prehypertensives/stage I hypertensives , r and omly divided into two groups ( n=50 in each ) . Group 1 received music intervention along with lifestyle modifications while Group 2 received only lifestyle modifications ( according to Joint national committee VII guidelines ) . Group 1 listened to raga bhimpalas played on flute for 15min daily for at least 5 days/week for 3 months . The main outcome measures were heart rate variability ( HRV ) ( Power lab 15 T , AD Instruments ) , BP and stress levels ( State Trait anxiety inventory score ) . All HRV variables were log transformed for analysis . Statistical analysis was done using SPSS version 18.0 with P<0.05 being considered statistically significant . RESULTS Group 1 exhibited significant reduction in stress levels , diastolic BP and systolic BP decreased in Group 2 after intervention . Insignificant rise in parasympathetic parameters of HRV ( SDNN , RMSSD , HF ms(2 ) , HF nu ) was seen after intervention in both the groups . We found significantly increased parasympathetic and lower sympathetic parameters ( LF ms(2 ) , LF nu , LF/HF ) in Group 1 and 2 males and females of Group 2 . The results suggest that females of Group 1 were least compliant with the given intervention . CONCLUSIONS Passive listening to Indian music along with conventional lifestyle modifications has a role in normalizing BP through autonomic function modification and thus can be used as a complementary therapy along with other lifestyle modifications This project investigated music therapy ( MT ) in managing  anxiety  associated with weaning from mechanical ventilation . The use of sedation to treat anxiety during weaning is problematic because side effects ( e.g. , respiratory depression ) are precisely the symptoms that cause the weaning process to be interrupted and consequently prolonged . Study goals were to determine the feasibility of incorporating MT into the weaning process and to evaluate the efficacy of the intervention , based on levels of anxiety , Days to Wean ( DTW ) , and patient/nurse satisfaction .  Adult patients received multiple MT sessions per week while undergoing weaning trials from mechanical ventilation .  Feasibility was determined by successful enrollment in the study and nurse survey . Efficacy was evaluated through anxiety , as measured by heart rate , respiratory rate , and patient/nurse survey ; DTW ; and patient/nurse satisfaction . Nurse surveys reported that MT was successfully incorporated into the milieu and 61 subjects were enrolled . Significant differences in heart rate and respiratory rate were found from the beginning to the end of MT sessions ( p < .05 and p < .0001 , respectively ) , indicating a more relaxed state . No significant difference in mean DTW was found between study and control subjects . Patient/nurse satisfaction was high . Music therapy can be used successfully to treat anxiety associated with weaning from mechanical ventilation . Limitations and suggestions for further research are discussed BACKGROUND Social support is associated with enhanced illness management and recovery in persons with mental illness , making it an important topic addressed through acute inpatient psychoeducational programs . In addition , trust in the therapist may mediate clinical outcomes in this patient population . To date , few studies have examined the effect of music-based psychoeducational programs on these variables . PURPOSE The purpose of this study was to isolate and examine the component parts of a live educational music therapy intervention , and its effect on acute psychiatric in patients ' perceived social support from significant others , family , and friends and trust in the therapist . This study also explored whether trust in therapist varied across conditions , but did not examine it as a mediator for social support . METHOD Participants ( N = 96 ) were cluster-r and omized in a single-session posttest-only design to one of four conditions : live educational music therapy , recorded educational music therapy , education without music , or recreational music therapy without education . Conditions were design ed to isolate the following intervention components : live vs. recorded music , educational vs. non-educational content , and music vs. nonmusic modality . Dependent measures were assessed post intervention via established self-report instruments evaluating perceived social support and trust in the therapist . RESULTS There were no significant between-group differences for social support or trust in therapist total scores . However , subscale score analyses revealed two significant between-group differences : ( a ) participants in the Live Educational Music Therapy condition reported significantly higher perceived therapist competence compared with the Recorded Educational Music Therapy condition ; ( b ) participants in the Live Educational Music Therapy condition reported significantly higher perceived support from friends compared with the Recreational Music Therapy condition . CONCLUSIONS Live educational music therapy may be a way to heighten psychiatric in patients ' perceived social support concerning friends and perceptions of the therapist 's competence . The current results demonstrated differences between live and recorded music therapy in psychiatric music therapy and provide empirical support for competent musicianship . Implication s for clinical practice , limitations , and suggestions for future research are included Bone marrow biopsy and aspiration are commonly used for diagnosing , treating , and following up after treatment for blood disorders and solid tumors . For adults , the infiltration of local anesthesia at the biopsy site has been used as the principal form of analgesia for bone marrow biopsy and aspiration .  Pain relief during these procedures is often incomplete , especially during aspiration of the bone marrow , and pain is likely to contribute to patient anxiety . Research ers at the Tabriz Hematology and Oncology Center in Iran conducted a study to quantify and evaluate the effectiveness of music therapy interventions on pain and anxiety control for 100 patients undergoing bone marrow biopsy and aspiration .  Participants in the study were r and omly assigned to one of two groups : one group listened to music during the procedure , and the other did not . Patients completed the  Spielberger State-Trait Anxiety Inventory  both before and after the procedure and reported pain severity by using a visual analog scale . Results showed that participants who listened to music had lower state anxiety and pain levels than those who did not listen to music Purpose The purpose of this study was to compare the impact of music therapy ( MT ) versus music medicine ( MM ) interventions on psychological outcomes and pain in cancer patients and to enhance underst and ing of patients ’ experiences of these two types of music interventions . Methods This study employed a mixed methods intervention design in which qualitative data were embedded within a r and omized cross-over trial . Thirty-one adult cancer patients participated in two sessions that involved interactive music making with a music therapist ( MT ) and two sessions in which they listened to pre-recorded music without the presence of a therapist ( MM ) . Before and after each session , participants reported on their mood , anxiety , relaxation , and pain by means of visual analogue and numeric rating scales . Thirty participants completed an exit interview . Results The quantitative data suggest that both interventions were equally effective in enhancing target outcomes . However , 77.4 % of participants expressed a preference for MT sessions . The qualitative data indicate that music improves symptom management , embodies hope for survival , and helps connect to a pre-illness self , but may also access memories of loss and trauma . MT sessions helped participants tap into inner re sources such as playfulness and creativity . Interactive music making also allowed for emotional expression . Some participants preferred the familiarity and predictability of listening to pre-recorded music . Conclusions The findings of this study advocate for the use of music in cancer care . Treatment benefits may depend on patient characteristics such as outlook on life and readiness to explore emotions related to the cancer experience OBJECTIVE The effect of kangaroo care ( KC ) has not been adequately studied in mothers . This present study was undertaken to determine if music during KC has a greater effect than KC alone , on  maternal state anxiety ( MSA ) in the early postpartum period . DESIGN AND SETTING In a r and omized controlled trial , 90 Iranian women who were scheduled for a repeat Cesarean-section , were r and omized into three groups : KC , music during KC , and a control group . Mothers ' pain scores were evaluated using a visual analog scale ( VAS ) . If the VAS score was ≤3 , then MSA was measured by using the State-Trait Anxiety Inventory ( STAI ) Scale ( Spielberg ) . Interventions were 30 min KC for mother-infant dyads , or playing music for the mothers during KC . Six hours later , in cases where the VAS was ≤3 , the MSA was re-measured using Spielberg 's scale for all mothers . RESULTS Six hours post intervention , there was no significant difference in the overall mean scores of MSA between the groups , but the severity of MSA in the two experimental groups was less than in the control group ( P=0.02 ) , although not between the two experimental groups . CONCLUSIONS The findings of this study provide evidence that KC has an effect on the severity of MSA in mothers who were delivered by C-section , however , music during KC had no more effect than KC alone . More research is needed to document the effectiveness of selected or familiar music during KC on state anxiety in early postpartum
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