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Classical 101

Ohio State Researchers Find Music Helps Anxiety In ICU Patients

Dr. Linda Chlan is distinguished professor of Symptom Management Research at Ohio State University's College of Nursing. One of Dr. Chlan's current projects was discussed in the June 13 issue of onCampus, in an article by Emily Caldwell. Persons on ventilators are being supplied with music of their choice, delivered on noise cancelling headphones. The goal is to reduce anxiety and increase a sense of well-being for the critically ill. Dr. Chlan spoke to me recently. CP: It was always my understanding that patients on ventilators were immobile and unconscious. LC: Some critically patients in the ICU are, but once patients start to recover from critical illness or injury, they are awake. That's becoming more and more common practice. Years ago, the thought was it was best for patients to sleep through critical illness, because we have patients sleep through surgery. You think, people are so sick they're unconscious. But we have found over the years that psychologically and physically, it is better for patients to be more awake, unless there's a pressing physiological need for them to be unconscious, or if there's a medical reason due to stroke etc. The patients we enrolled in this study were on ventilators, but these were patients that were getting better, but yet they couldn't yet breathe on their own. CP: You are providing the patients with headphones and providing them with music of their choice. Would you ever do this for someone unconscious and critically ill if you thought music would help, but you didn't know their taste in music? LC: We haven't done studies in that area. We would have to be very certain that a certain type or piece of music as selected the patient would find comforting and soothing. That information would have to come from a family member. CP: Do you have specific titles or types of music known to be effective? LC: No. I work very closely with a music therapy colleague. Our intervention is to offer individually tailored music that that patient finds comforting and familiar to them. CP: What kind of response are you looking for? LC: We're looking for a reduction in anxiety, calmer, more relaxed. CP: Would you envision this sometimes taking the place of drugs? LC: I do not. This is an adjunctive or integrated intervention which is added to the medical plan of care. CP: What is the link in the use of music with critically ill patients to speed up their recovery? LC: One size doesn't fit all. That's why we have the paitents self initiate when ever they wanted to listen to music for as long as they wanted to listen to music. It's similar to ways we deliver pain medications, with a patient controlled device. The music was used in a similar manner for patients when they were feeling anxious, or needed quiet time and the preferences are highly individual. That's why I say one size does not fit all. We're working on a publication right now on the choices the patients randomized to the group. We do 60 to 80 beats per minute. To mirror the heartbeat and breathing as a way to increase relaxation. CP: Is this treatment available now to anyone on a ventilator, as standard practice? LC: No. That's the next piece we're working on, as to how to take a highly controlled research study and implement it into practice. And still have the intervention be effective. That's always the challenge translating research finding into practise. It is important for people to understand that this is part of the care for clinically ill patients and is integrated to the full medical plan. See also OSU's onCampus, June 13, 2013, Music Lowers Anxiety in ICU Patients,  by Emily Caldwell. It is reported that in this study the option to listen to music lowered anxiety, on average, by 36.5 percent and reduced the number of sedated doses by 38 percent and the intensity of sedation by 36 percent compared to ventilated ICU patients who did not receive the music intervention. The effects were seen, on average, five days into the study--Emily Caldwell, onCampus.