| Summary: | 碩士 === 國防醫學院 === 護理學研究所 === 86 === Anxiety is a common phenomena among patients facing weaning
from ventilator. It was reflected by their syndrome of increasing heart rate, respiration rate as well as higher blood pressure. These symptoms not only have negative impact on their recovery from open-heart surgery, but also cause problems in respiration due to energy exhaustion. This exhaustion cause by over-functioning of respiratory system, in turn, increases the degree of difficultness in administrating weaning ventilator.
To help patients reduce their anxiety facing weaning wentilator and smooth its procedures become a important issue for health care. In recent years, Music Therapy has been applied to patients in various fields and the results were encouraging. Our research work was based on an experimental program aiming at evaluating the efficiency of Music Therapy in reducing patients* anxiety and other related factors when facing weaning ventilator.
The qualified subject patients were selected from ICU of Cardiology Surgery in a medical center near Taipei, and were assigned to either Control Group or the Experimental Group by Block Randomization. Each group consists of 30 patients. Using Single Blind Design on both group patients, we let them wear ear-phones during the testing period. The control group patients only hear selected music after collection of data
while experimental group were giving 30 minutes of selected music through ear-phones prior to data collection. Physiological signs, including heart rate, respiration rate, finger temperature and blood pressure , and emotional reactions- Anxiety （Anxiety Scale）were carefully recorded
on both groups of patients as our pre-test information for comparison.
Post-test were done 30 minutes after the administration of weaning ventilator. Same sets of data were collected for Post-test. We analyze these data to evaluation the efficiency of Music Therapy.
After data has been processed and analyzed, the following
conclusions were drawn:
(1) All Open Heart Surgery patients showed moderate level of anxiety when weaning from ventilator. Their degrees of anxiety varies as patients* basic characteristics such as age group, diagnosis group and operating methods differs.
(2) Providing Music Therapy significantly improved patients physiological reaction when weaning from ventilator. Their average heart rate were reduced by 4.3 p.m., respiration rate were reduced by 2.5 p.m., finger temperature raised 1℃., systolic blood pressure reduced by 11. 8mmHg and diastolic blood pressure fell down by 5.4mmHg, mean arterial pressure reduced by 7.8mmHg. We believe Music Therapy has effectively achieve its goal. The controlled group showed no improvement on patients* physiological signs: to the contrary, their average heart rate increased by 0.97 p.m., respiration rate increased by 0.87 p.m., finger temperature fell down by 0.4℃, systolic blood pressure raised by 1.8mmHg while diastolic blood pressure increased by 1.3mmHg, their mean arterial pressure raised by 1.5mmHg, in average.
(3) The provision of Music Therapy significantly reduced patients degree of anxiety when weaning from ventilator. In average, patients* anxiety index were lowered by 12.67points on the Anxiety Scale. This proves that Music Therapy is effective. As regards to the control group, the anxiety index only lowered by 1.4points. In comparing each individualsets of point under different contents of the anxiety scale, we found the 5 most significant changes, after Music Treatment, are ranked as "I am
very nervous" "I feel calm" "I fell easy" "I feel pleasant" "I feel happy". In other words, Music Therapy has achieved its goal, eased patients anxiety mainly by reducing their nervousness, increasing their calmness, and obviously making patients feel easy, pleasant and happy.
(4) During the evaluation of the effectiveness of Music Therapy, we found that the change of anxiety index is positive correlated with the change of physical indicators : Heart rate, Respiratory rate, Systolic Blood Pressure,
Diastolic Blood Pressure and Mean Arterial pressure. Their correlation coefficient are 0.55, 0.53, 0.59, 0.60 and 0.65 respectively. We also found a negative correlation between the Anxiety index and the Finger Temperature, the correlation coefficient is -0.74.
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