The Effectiveness of Music Interventions on Anxiety Level, Pain Level and Satisfaction for Chinese Adult Patients Undergoing Colonoscopy

• Other Authors: Ko, Shuk Yee (author.)
• Format: Others
• Language: English; Chinese
• Published: 2016
• Online Access: http://repository.lib.cuhk.edu.hk/en/item/cuhk-1292161

研究背景:結腸內視鏡是內視鏡檢查室常見的檢查，但在檢查過程中,病人常會經歷焦慮和疼痛。音樂干預對減輕結腸內視鏡檢查患者焦慮和疼痛的成效已被廣泛研究，但其成效仍然存疑。因此，一個兩階段的研究便被進行，以評估音樂干預對成人結腸內視鏡檢查患者的生理、心理和麻醉藥及止痛藥需求的成效。第一階段，是進行系統化綜述, 緊接著，一個隨機對照臨床試驗便在第二階段進行。第二階段的研究的資料是根據第一階段的系統化綜述結果。 === 系統化綜述(第一階段) === 方法:從主要中文及英文電子資料庫中，搜尋所有關於比較音樂干預和標準護理對成人結腸內視鏡檢查患者的隨機對照文獻，然後由二位獨立評審員進行文獻選取及研究質量評審。 === 結果:薈萃分析在於十篇隨機對照文獻(包括七篇英文及三篇中文)結果顯示,音樂干預能減低患者的疼痛程度(SMD-0.77,95%CI-1.25to-0.29,P=0.002)、心率(MD-7.85,95%CI-10.41to-5.29,P<0.00001)、及舒張壓(MD-5.59,95%CI-10.13to-1.06,P=0.02)，差異是有統計學意義，但對於患者的焦慮指數、麻醉藥及止痛藥的需求、收縮壓及治療滿意度，差異是無統計學意義。次組分析顯示古典音樂、或其他類型的音樂，或放鬆音樂，或耳機音樂、或背景音樂，或病人可選擇音樂、或病人不可選擇音樂，都有顯著的成效在焦慮、疼痛及治療滿意度方面。 === 試驗研究 (第二階段) === 旨意: 是在香港探討音樂干預對中國成年人結腸內視鏡檢查患者的焦慮，痛楚程度，麻醉藥及止痛藥的需求，生理參數和滿意度的成效。 === 方法:本研究是一個前瞻性隨機對照試驗。八十名便利抽樣法的結腸內視鏡檢查成人患者，被隨機分配到實驗組接受標準治療及在檢查前二十分鐘透過耳機聽流行金曲直到檢查結束，而對照組則接受標準治療。資料收集會在T0(簽署研究同意書後)，T1(內視鏡進入結腸後五分鐘)，及T2(結腸內視鏡檢查後30分鐘)進行。焦慮指數則用狀態-特質焦慮量表-Y(中文版本)來測量在T0和T2，麻醉藥及止痛藥的需求則在T1監察，疼痛指數、治療滿意度和痛楚處理的滿意度則用視覺模拟评分表來測量在T2，心率及血壓則在T0, T1和T2監察。 === 結果:音樂干預可改善病人對治療的滿意度(p=0.043)和痛楚處理的滿意度(p=0.045)。此外大多數參與者都表示他們會再次選擇用聽音樂方法去減低他們的焦慮如將來再需要進行結腸內視鏡檢查(p=0.001)。除此之外，在本該研究中亦没有觀察到有任何不利的影响。可是，音樂干預並無改善對患者的焦慮指數、疼痛程度，麻醉藥及止痛藥的需求、心率、收縮壓、及舒張壓, 差異亦無統計學意義。 === 結論: 透過耳機聽流行金曲在結腸內視鏡檢查程序中是可行的，亦可提升病人對於治療和痛楚處理的滿意度。然而，評估這種干預的成效在將來的研究，建議應使用較大的樣本。 === Background: Colonoscopy is the most commonly performed procedure in an endoscopy unit, but patients often experience anxiety and pain. The effects of music intervention in reducing anxiety and pain levels during colonoscopy have been widely studied, but the results are inconclusive. Therefore, a study comprising two-phase was carried out to examine the effects of the music intervention on physiological and psychological outcomes, and sedative and analgesic medication requirements among adult patients undergoing colonoscopy. In phase I, a systematic review was performed, and then a pilot randomized controlled trial was conducted in phase II. The details of the phase two study were guided by the findings of the systematic review. === Systematic Review (Phase I) === Methods: Randomized controlled trials from major Chinese and English electronic databases that compared music interventions with standard care for adult patients undergoing colonoscopy were searched to extract. Data extraction and a quality appraisal of the studies were performed independently by two reviewers. === Key results: The meta-analysis of 10 randomized controlled trials (seven in English and three in Chinese) showed that music interventions resulted in a statistically significant reduction in pain (SMD -0.77, 95%CI -1.25 to - 0.29, P = 0.002), heart rate (MD -7.85, 95%CI -10.41 to -5.29, P<0.00001) and diastolic blood pressure (MD -5.59, 95% CI -10.13 to -1.06, P = 0.02), but no significant effects were observed for anxiety, requirement for sedative and analgesic medications, systolic blood pressure and procedure satisfaction. Results of the subgroup analysis revealed significant effects on anxiety, pain and procedure satisfaction regarding whether the patients were offered classical music, or other types of music, or relaxation music, or listening through headphones or listening to background music, or allowing patients to choice or no choice of music. === Pilot Study (Phase II) === Aim of pilot study: This phase of the study was performed to examine the effects of a music intervention on anxiety, pain, sedative and analgesic medication requirements, physiological parameters, and satisfaction in Chinese adult patients undergoing === Key results: Listening to music had a statistically significant improvement in procedure satisfaction (p = 0.043) and satisfaction with pain management (p = 0.045). Moreover, most participants indicated that they would choose listening to music to red === Conclusion: Music intervention in the form of easy listening music via earphones is feasible and can be incorporated into the colonoscopy procedure in Hong Kong to enhance patients’ satisfaction with the procedure and with pain management. However, fu === Ko, Shuk Yee. === Thesis D.Nurs. Chinese University of Hong Kong 2016. === Includes bibliographical references (leaves ). === Abstracts also in Chinese. === Title from PDF title page (viewed on …). === Detailed summary in vernacular field only. === Detailed summary in vernacular field only. === Detailed summary in vernacular field only. === Detailed summary in vernacular field only. === Detailed summary in vernacular field only. === Detailed summary in vernacular field only. === Detailed summary in vernacular field only. === Detailed summary in vernacular field only. === Detailed summary in vernacular field only.