Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support

Chlan, Linda L.; Weinert, Craig R.; Heiderscheit, Annie; Tracy, Mary Fran; Skaar, Debra J.; Guttormson, Jill; Savik, Kay

doi:10.1001/jama.2013.5670

Cited by 246 publications

(268 citation statements)

References 29 publications

(25 reference statements)

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“…Although one randomized controlled trial (RCT) examining musical interventions for patients under mechanical ventilation has been conducted,243 as there are currently no musical therapists currently practicing at medical institutions in Japan, introducing this type of intervention at this time is believed to be difficult. Medical interventions using music require assessing together with related medical staff which types of music and sound quality are likely to produce the desired clinical effects, methods for reducing noise and other interferences, the selection of suitable speaker devices, among various other potential factors.…”

Section: Cq11: Management Of Analgesia Sedation and Deliriummentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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Section: Cq11: Management Of Analgesia Sedation and Deliriummentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

View full text Add to dashboard Cite

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“…PDM patients' anxiety levels decreased significantly over time by 36% and those patients received 36% less intense sedative regimens with 38% less frequent sedative administration compared with the control group over the course of mechanical ventilatory support. 22 That study was the first to show that music as a nonpharmacological intervention could reduce anxiety while also reducing exposure to potent sedative medications. Moreover, that study was the first to show that MVPs could self-manage their anxiety with the PDM intervention.…”

Section: Patient-directed Music Listening To Reduce Anxiety and Sedatmentioning

confidence: 99%

“…We carefully recorded anecdotal comments from study participants and their family members throughout our clinical trial. 22 General themes derived from content analysis revealed that patients reported relaxation and improved sleep from less environmental noise, particularly at night. 45 Patients also reported enjoyment and comfort from listening to preferred music while in the ICU.…”

Section: Patients' Music Preferences and Benefits Of Research Study Pmentioning

confidence: 99%

“…19 When music is used to induce relaxation through entrainment, it should have a tempo at or below a resting heart rate (60-80 beats per minute), predictable dynamics, fluid melodic movement, pleasing harmonies, a regular rhythm without sudden changes, and the tonal qualities of strings, flute, piano, or specially synthesized tones. 20 A substantial body of evidence indicates that music reduces anxiety, 6,[21][22][23] which is a common, distressful symptom for MVPs and a frequent indication for sedative administration. [24][25][26][27][28] Music perceived as pleasant and relaxing enhances tension reduction because relaxation is incompatible with anxiety.…”

Section: Music: More Than Something Nice To Listen Tomentioning

confidence: 99%

“…We next designed a randomized clinical trial to test the efficacy of patient self-initiated music listening on anxiety and sedative exposure (sedation intensity and sedation frequency 43 ) over the course of mechanical ventilatory support in critically ill patients. 22 A total of 373 patients were enrolled from 12 participating ICUs in the urban Midwest. Patients were randomly assigned to 1 of 3 conditions: (1) patient-directed music (PDM), which consisted of patients self-initiating music listening whenever desired for as long as desired using noise-canceling headphones with relaxing music selections individually tailored by a music therapist, (2) active control condition of wearing noise-canceling headphones whenever desired to block out ICU noise, or (3) usual-care control condition.…”

Section: Patient-directed Music Listening To Reduce Anxiety and Sedatmentioning

confidence: 99%

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Engaging Critically Ill Patients in Symptom Management: Thinking Outside the Box!

Chlan

2016

American Journal of Critical Care

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Caring for critically ill patients receiving mechanical ventilation in the intensive care unit (ICU) is an immense challenge for clinicians. Interventions to maintain physiological stability and life itself can cause a number of adverse effects that have a marked impact on patients beyond the period of critical illness or injury. These ICU-acquired conditions include but are not limited to weakness, depression, and post–intensive care syndrome, all of which markedly affect patients’ quality of life after they leave the unit. How best to manage the many symptoms experienced by patients undergoing mechanical ventilation without contributing to adverse ICU-acquired sequelae remains a daunting charge for clinicians and requires innovative “out of the box” approaches to address these complex issues. Systematic, cutting-edge research is needed to challenge the “usual” way of managing ICU patients in order to provide the best available evidence for practice integration that minimizes adverse, ICU-acquired sequelae and improves outcomes for the most vulnerable patients. This article highlights a program of research focused on interventions for managing symptoms in critically ill patients receiving mechanical ventilatory support, including the appropriate empowerment of symptom self-management by patients undergoing mechanical ventilation. Development and testing of innovative, nontraditional interventions specifically tailored for ICU patients receiving mechanical ventilatory support are presented. Music listening is highlighted as a nonpharmacological, adjunctive intervention to reduce anxiety associated with mechanical ventilation. Patient-controlled sedation is discussed as an alternative method to meet patients’ highly individual needs for sedative therapy to promote comfort.

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Music Therapy for Reducing Anxiety in Critically Ill Patients

Azoulay¹,

Chaize²,

Kentish-Barnes³

2013

JAMA

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Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support

Cited by 246 publications

References 29 publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Engaging Critically Ill Patients in Symptom Management: Thinking Outside the Box!

Music Therapy for Reducing Anxiety in Critically Ill Patients

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