用音乐疗法控制创伤术后患者的疼痛和焦虑

Elizabeth R. Moryc
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摘要

目的:急性疼痛是创伤术后患者中一个常见而复杂的问题,90% 以上的患者都有此困扰。尽管药物干预仍是住院患者疼痛治疗的主要手段,但非药物干预正在成为合法的辅助手段。音乐疗法这种非药物干预措施已被证明能显著且持续地降低疼痛和焦虑水平。本质量改进项目旨在美国东南部的一家一级创伤中心试点为术后创伤患者整合音乐疗法,并评估其对疼痛和焦虑水平的影响:方法:在该机构进行了为期 10 周的干预前后研究。对病房注册护士进行了关于患者纳入标准的教育,并据此下达了音乐治疗咨询单。一名经过委员会认证的音乐治疗师为接受咨询的患者提供循证音乐治疗干预。干预前后进行了一项调查,内容包括状态-特质焦虑量表State-5和疼痛数字评分量表。通过配对样本 t 检验来评估音乐疗法对疼痛和焦虑影响的统计学意义:结果:在接受音乐治疗的患者(28 人)中,测试前国家-特质焦虑量表 State-5 的平均得分为 8.43(sd = 3.46),测试后为 5.64(sd = 1.10)。结果发现,患者的焦虑程度明显降低(t (27) = 5.227,p < .001)。测试前疼痛数字评分量表的平均值为 6.36(sd = 2.59),测试后为 4.57(sd = 2.66)。疼痛明显减轻(t (4.90) = 4.892,p < .001):结论:接受音乐疗法辅助干预的患者,其疼痛和焦虑程度在统计学上有明显下降。该质量改进项目验证了当前的研究,并加强了循证实践建议,将音乐疗法作为药物疼痛和焦虑治疗方案的合理辅助手段。
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Music therapy for pain and anxiety management in postoperative trauma patients
Objective: Acute pain is a common and complex problem among postoperative trauma patients, burdening over 90% of the population. Although pharmacological interventions remain the mainstay of pain management in the inpatient setting, non-pharmacological interventions are emerging as legitimate adjuncts. The non-pharmacological intervention of music therapy has been shown to significantly and consistently lower pain and anxiety levels. This quality improvement project aimed to pilot the integration of music therapy for postoperative trauma patients at a Level I Trauma Center in the Southeast United States and evaluate its effects on pain and anxiety levels.Methods: A before and after intervention study was conducted at the organization over a 10-week period. Unit registered nurses were educated on patient inclusion criteria and placed music therapy consultation orders accordingly. A board-certified music therapist provided evidence-based music therapy intervention for consulted patients. A survey consisting of the State-Trait Anxiety Inventory State-5 and the numeric rating scale for pain was administered pre- and post-intervention. A paired-sample t-test was run to evaluate the statistical significance of music therapy’s effect on pain and anxiety.Results: The mean pre-test State-Trait Anxiety Inventory State-5 score was 8.43 (sd = 3.46), and the post-test was 5.64 (sd = 1.10) among patients who received music therapy (n = 28). A significant decrease in anxiety was found (t (27) = 5.227, p < .001). The mean pre-test numeric rating scale for pain score was 6.36 (sd = 2.59), and the post-test was 4.57 (sd = 2.66). A significant decrease in pain was found (t (4.90) = 4.892, p < .001).Conclusions: Patients who received music therapy as an adjunct intervention achieved a statistically significant decrease in pain and anxiety levels. This quality improvement project validates current research and bolsters evidence-based practice recommendations that reference music therapy as a legitimate adjunct to pharmacological pain and anxiety treatment regimens.
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