Research Proposal. The effect of Music on relieving anxiety perioperatively in patients undergoing ambulatory surgery service

Authors Avatar by vvtang61 (student)

                        MSc Intake N14 Group B

                        SSN 09036

The effect of Music on relieving anxiety perioperatively in patients undergoing ambulatory surgery service

Abstract – Anxiety is unpleasant sensations, and can also adversely influence the surgical procedure as well as affect the patient’s recovery (Jamison et al, 1987). Reports indicated that a significant number of adult patients undergoing surgical procedures experienced high levels of anxiety before surgery (Badner et al, 1990). It means patients scheduled to have surgery induces their feeling of fear and anxiety in all phases of surgery: preoperative, intraoperative and postoperative.  Music is a method of treatment that humankind has relied on for many centuries.  Research has also supported the effectiveness of music therapy as a treatment modality for many clinical issues (Lehrer, 2007).  By providing music as nursing intervention to patient perioperatively, it hopes that the patient’s anxiety level could be reduced.

Aim – The aim of this study is to investigate the effect of music on perioperative levels of anxiety in the operative patients. To investigate the effectiveness of this nursing intervention, we are going to study in the surgical patient at Ambulatory Surgery Centre in Hong Kong Hospital.

Background and Significance

Ambulatory Day Surgery Centre in Hong Kong, Hospital Authority (HA) provides ambulatory care for people. Its goal is provide an effective form of surgery with a high level of quality care for both pre and post operative cares on an ambulatory basis.  To attain this goal, nursing care has as its aim to provide high quality care through knowledge and good nursing.  Increasing numbers of surgical procedures are being performed in ambulatory surgery centre due to new technology and, demand for cost-effectiveness. Extending service in ambulatory day centre is also one of very important agenda in HA in coming year.

The outcomes of surgery can engender emotions such as stress and anxiety. Anxiety is present in most patients prior to surgery.  Anxiety is frequently defined as an emotional response to a threatening situation (Johnston, 1980 cited in Spielberger, 1972), and it is generally agreed that surgery and associated hospitalization produce various threats, including possible disability or fear of death, coping with new social situations and loss of control. Numerous studies and relevant clinical literature document the presence of raised anxiety levels in surgical patients (Johnston, 1980).

Anxiety not only affects the psychological aspect of patients undergoing surgical procedures but also physical aspect which will prolong wound healing and increase complication of anesthesia.  Broadbent et al (2003) investigated the relationship between psychological stress and wound repair in patients – the psychological stress impairs the inflammatory response and matrix degradation processes in the wound immediately following surgery.  This finding generalizes previous laboratory research to surgical patients and expands the known influence of stress to connective tissue matrix remodeling processes. These results suggest that in clinical practice, interventions to reduce patients’ psychological stress levels may improve surgical wound healing and recovery following surgery.

Daoud and Hasan (1999) showed that higher anxiety was associated with increased time for the jaw to relax during intubation, a higher incidence of coughing and thereby more anesthetic interventions during insertion of laryngeal airway.  Anxiety and pain are also closely related.  Ozalp et al (2003) result in study was that the pain intensity, total analgesic consumption and dose ration were significantly related to preoperative anxiety and depression. Degree of dissatisfaction with patients control anaesthesia (PCA) was significantly correlated with preoperative anxiety and depression. It is found that the patients with a higher anxiety and depression levels preoperatively had higher postoperative pain and analgesic requirements. Reduction of patients’ pre-operative anxiety can decrease dosage in using of anesthesia and their postoperative pain, vomiting, surgical complications and recovery time.

Conceptual framework

Almost everyone has used music at one time or another for relaxation purpose or perhaps to get energized.  Music is a natural source of distraction.  Chakib et al (2005) found that intraoperative music decrease sedative requirements in patients who undergo surgery under spinal anesthesia while controlling for operating theatre ambient noise.

Join now!

Music therapy is an evidence-based practice that can affect changes in physical, psychological, social and cognitive domains. Many scientists and researchers have examined music treatment and its ability to reduce anxiety in a variety health care settings and patients. The soothing effects of music have been demonstrated in patients undergoing chemotherapy or elective surgery under local or regional anesthesia.  These effects also have been found in preoperative and postoperative patients, patients receiving assistance from a ventilator or undergoing flexible sigmoidoscopy, and women in labor (Standley, 1992, Marley, 1984, Mckinney, 1990 and Barnason et al, 1995 cited in Mok and ...

This is a preview of the whole essay