3. Discussion: Music’s Effect
inner-city, anxiety/depression, pain
ADVERSE EFFECT
While the question of the influence of noise and unwanted sound on patients and staff in hospitals is receiving growing attention in the search for environments that are conducive to healing and well-being, there are presently few studies examining the effects of environmental music therapy [A prime focus of the current study was to ascertain whether or not participants were able to spontaneously differentiate and recognize the presence of noise in the units and its possible effects on their state and other conditions, and also to contrast that with the identification and possible response to music in that same environment. We made no assumptions that music would improve the environment. This pilot study does not just examine music, but measures the impact of patient preferred music provided by a music therapist in contrast with the usual and customary sounds in busy inner-city ICUs of a hospital system.An important first step in analyzing how sound interventions are established is an effective strategy for constructively modulating perception through addressing hospital soundscapes. To that end, our study focused on whether the patients, caregivers and staff were actively distinguishing discreet elements of the sound environment, and whether they were, on the one hand, aware of and able to differentiate patient preferred music vs. noise and/or unwanted sounds in the SICU and PICU, and secondly, to what degree those acoustic elements influenced sleep and the experience of pain. We also measured music and noise’s effect on Apache scores, and anxiety/depression on the HADS. We found a statistically significant reduction in Apache scores in the music condition, which may suggest an overall change in state and observable patient signs with exposure to music, though further rigorous study is needed to confirm the outcomes. Interestingly, the data also showed that there was a statistically significant change (While all three groups found a moderate negative influence of noise on sleep, with staff members’ belief that noise had a higher adverse effect on patients’ sleep and complaints about noise on the unit than patients and caregivers, there was a greater diversity in outcomes regarding environmental music therapy’s effect. The median values show that all three groups believed that music had a strong positive effect on sleep, perception of general quality of care, and comfort. There was a statistical significance between the comparisons of each group’s perception of music’s benefits, with staff holding the highest valuation, followed by patients, and lastly caregivers. Patients and caregivers’ responses showed EMT had a greater positive effect on sleep compared to no music and/or noise on mediating pain. The effect of both noise and music on pain perception was less than their effect on sleep. Music therapists’ inquiry into patients’ preferred music styles found them identifying 26 separate genres, with 90% requesting more than one genre, and 10% one individual genre. The most requested style was “Classical”, with 15.2% of patients identifying it as their preferred genre for the interventions, followed by “Jazz” at 13.39%. A number of culturally diverse styles were requested, attesting to the diversity of the patient cohort (