Amaç: Bu çalışmanın amacı, yoğun bakımda uygulanan müzik müdahalesinin hastalar üzerindeki etkisi ve uygulama yöntemlerine dair çalışmaların incelenmesidir. Gereç ve Yöntemler: Bu çalışma, sistematik derleme ve metaanaliz çalışma rehberi PRISMA-P'ye göre hazırlanmıştır. Ulusal ve uluslararası elektronik veri tabanları kullanılarak (Pubmed, Cochrane Library, Embase, Science Direct, Ovid, CINAHL ve ULAKBİM Türk Tıp Dizini) son 10 yılda yapılan çalışmalar dil sınırlaması olmaksızın taranmıştır. Tarama yaparken Türkçe veri tabanları için 'müzik', 'müzik terapisi', 'yoğun bakım', 'kritik bakım', 'yoğun bakım ünitesi' ve uluslararası veri tabanları için 'music', 'music therapy', 'music listening', 'music medicine', 'intensive care', 'critical care', 'intensive care unit', 'adult intensive care unit' anahtar kelimeleri kullanılmıştır. Dâhil edilme ve dışlanma kriterleri, PICOS ölçütleri göz önünde bulundurularak oluşturulmuştur. Çalışmalar, metodolojik kalite açısından PEDro ölçeği ile değerlendirilmiştir. Bulgular: Dâhil edilme kriterlerine uygun 18 çalışma incelemeye alınmıştır. Çalışmalarda, en çok randomize kontrollü çalışma desenine rastlanmıştır. Müziğin yoğun bakım hastalarında (mekanik ventilatöre bağlı veya değil); ağrı, anksiyete, deliryum, sedasyon ihtiyacı, uyku kalitesi, yaşamsal parametreler ve bazı ağrılı girişimler üzerine olumlu etkisi olduğu belirlenmiştir. İncelemeye alınan çalışmalar örneklem büyüklüğü, müzik süresi, tipi, değerlendirme araçları açısından farklılıklar göstermiştir. Çalışmalardaki, müzik uygulama süresinin ortalama 40,6 dk olduğu ve çoğunun 60-80 vuruşluk tempoda gerçekleştirildiği, daha çok rahatlatıcı ve klasik müzik tipinden yararlanıldığı gösterilmiştir. Sonuç: Bu sistematik inceleme ile müziğin yoğun bakım ortamında uygulaması kolay, invaziv olmayan ve maliyeti düşük bir yöntem olarak hastaların yaşadığı birçok olumsuz deneyimi kontrol altına alabileceği gösterilmiştir.
Anahtar Kelimeler: Müzik; yoğun bakım; hemşirelik
Objective: The aim of this study is to examine the effects of music intervention in intensive care unit on patients and its application methods. Material and Methods: The protocol of this systematic review was prepared according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. Studies conducted in the last 10 years have been searched without language limitations by using national and international electronic databases (Pubmed, Cochrane Library, Embase, Science Direct, Ovid, CINAHL and ULAKBİM Turkish Medical Database). The databases searched using the keywords 'music', 'music therapy', 'music listening', 'music medicine', 'intensive care', 'critical care', 'intensive care unit', 'adult intensive care unit' (for Turkish database; 'müzik', 'müzik terapisi', 'yoğun bakım', 'kritik bakım', 'yoğun bakım ünitesi'). The PICOS criteria were used for inclusion and exclusion criteria. Studies were evaluated with the PEDro scale in terms of methodological quality. Results: Eighteen studies that met the inclusion criteria were reviewed. Studies mostly have a randomized controlled study design. It has been determined that music has a positive effect on pain, anxiety, delirium, sedation needs, sleep quality, vital parameters and some painful interventions in intensive care patients (whether connected to a mechanical ventilator or not). The studies examined differed in terms of sample size, duration and type of music and assessment tools. It has been shown that the music practice time in the studies is 40.6 minutes on average, most of them are performed at a tempo of 60-80 beats and relaxing and classical music types are used. Conclusion: This systematic review shown that music can be used as an easy to apply, non-invasive and low cost method in the intensive care setting, and can control many negative experiences of patients.
Keywords: Music; intensive care; nursing
- Mangoulia P, Ouzounidou A. The role of music to promote relaxation in intensive care unit patients. Hospital Chronicles 2013;8(2):78-85. [Link]
- Samuelson KA, Lundberg D, Fridlund B. Stressful memories and psychological distress in adult mechanically ventilated intensive care patients - a 2-month follow-up study. Acta Anaesthesiol Scand. 2007;51(6):671-8. [PubMed]
- Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, et al; American College of Critical Care Medicine. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41(1):263-306. [PubMed]
- Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJC, Pandharipande PP, et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med. 2018;46(9):e825-e873. [PubMed]
- Foster J. Complications of Sedation in Critical Illness: An Update. Crit Care Nurs Clin North Am. 2016;28(2):227-39. [PubMed]
- Barbateskovic M, Krauss SR, Collet MO, Larsen LK, Jakobsen JC, Perner A, et al. Pharmacological interventions for prevention and management of delirium in intensive care patients: a systematic overview of reviews and meta-analyses. BMJ Open. 2019;9(2):e024562. [PubMed] [PMC]
- de Witte M, Spruit A, van Hooren S, Moonen X, Stams GJ. Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses. Health Psychol Rev. 2020;14(2):294-324. [PubMed]
- Stegemann T, Geretsegger M, Phan Quoc E, Riedl H, Smetana M. Music Therapy and Other Music-Based Interventions in Pediatric Health Care: An Overview. Medicines (Basel). 2019;6(1):25. [PubMed] [PMC]
- Torun Ş. [Sağlık alanında müzik temelli uygulamalar: Müzik terapi, müzik tıbbı ve diğerleri]. Torun Ş, editör. Müzik Terapi, Müzik Tıbbı ve Müzik Temelli Diğer Uygulamalar. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.9-19.
- Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al; PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. [PubMed] [PMC]
- de Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother. 2009;55(2):129-33. [PubMed]
- Cooke M, Chaboyer W, Schluter P, Foster M, Harris D, Teakle R. The effect of music on discomfort experienced by intensive care unit patients during turning: a randomized cross-over study. Int J Nurs Pract. 2010;16(2):125-31. [PubMed]
- Han L, Li JP, Sit JW, Chung L, Jiao ZY, Ma WG. Effects of music intervention on physiological stress response and anxiety level of mechanically ventilated patients in China: a randomised controlled trial. J Clin Nurs. 2010;19(7-8):978-87. [PubMed]
- Korhan EA, Khorshid L, Uyar M. The effect of music therapy on physiological signs of anxiety in patients receiving mechanical ventilatory support. J Clin Nurs. 2011;20(7-8):1026-34. [PubMed]
- Jafari H, Emami Zeydi A, Khani S, Esmaeili R, Soleimani A. The effects of listening to preferred music on pain intensity after open heart surgery. Iran J Nurs Midwifery Res. 2012;17(1):1-6. [PubMed] [PMC]
- Su CP, Lai HL, Chang ET, Yiin LM, Perng SJ, Chen PW. A randomized controlled trial of the effects of listening to non-commercial music on quality of nocturnal sleep and relaxation indices in patients in medical intensive care unit. J Adv Nurs. 2013;69(6):1377-89. [PubMed]
- Chiasson AM, Linda Baldwin A, McLaughlin C, Cook P, Sethi G. The effect of live spontaneous harp music on patients in the intensive care unit. Evid Based Complement Alternat Med. 2013;2013:428731. [PubMed] [PMC]
- Chlan LL, Weinert CR, Heiderscheit A, Tracy MF, Skaar DJ, Guttormson JL, et al. Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical ventilatory support: a randomized clinical trial. JAMA. 2013;309(22):2335-44. [PubMed] [PMC]
- Sanjuán Naváis M, Via Clavero G, Vázquez Guillamet B, Moreno Duran AM, Martínez Estalella G. Efecto de la música sobre la ansiedad y el dolor en pacientes con ventilación mecánica [Effect of music on anxiety and pain in patients with mechanical ventilation]. Enferm Intensiva. 2013;24(2):63-71. Spanish. [PubMed]
- Saadatmand V, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M, Jordan S. Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support. Pain Manag Nurs. 2015;16(4):483-92. [PubMed]
- Ciğerci Y, Özbayır T. [The effects of music therapy on anxiety, pain and the amount of analgesics following coronary artery surgery]. Turkish Journal of Thoracic and Cardiovascular Surgery. 2016;24(1):44-50. [Link]
- Yaman Aktaş Y, Karabulut N. The effects of music therapy in endotracheal suctioning of mechanically ventilated patients. Nurs Crit Care. 2016;21(1):44-52. [PubMed]
- Ames N, Shuford R, Yang L, Moriyama B, Frey M, Wilson F, et al. Music Listening Among Postoperative Patients in the Intensive Care Unit: A Randomized Controlled Trial with Mixed-Methods Analysis. Integr Med Insights. 2017;12:1178633717716455. [PubMed] [PMC]
- Hansen IP, Langhorn L, Dreyer P. Effects of music during daytime rest in the intensive care unit. Nurs Crit Care. 2018;23(4):207-213. [PubMed]
- Mateu-Capell M, Arnau A, Juvinyà D, Montesinos J, Fernandez R. Sound isolation and music on the comfort of mechanically ventilated critical patients. Nurs Crit Care. 2019;24(5):290-98. [PubMed]
- Johnson K, Fleury J, McClain D. Music intervention to prevent delirium among older patients admitted to a trauma intensive care unit and a trauma orthopaedic unit. Intensive Crit Care Nurs. 2018;47:7-14. [PubMed]
- Jacq G, Melot K, Bezou M, Foucault L, Courau-Courtois J, Cavelot S, et al. Music for pain relief during bed bathing of mechanically ventilated patients: A pilot study. PLoS One. 2018;13(11):e0207174. [PubMed] [PMC]
- Golino AJ, Leone R, Gollenberg A, Christopher C, Stanger D, Davis TM, et al. Impact of an Active Music Therapy Intervention on Intensive Care Patients. Am J Crit Care. 2019;28(1):48-55. [PubMed]
- Khan SH, Xu C, Purpura R, Durrani S, Lindroth H, Wang S, et al. Decreasing Delirium Through Music: A Randomized Pilot Trial. Am J Crit Care. 2020;29(2):e31-e38. [PubMed] [PMC]
- Umbrello M, Sorrenti T, Mistraletti G, Formenti P, Chiumello D, Terzoni S. Music therapy reduces stress and anxiety in critically ill patients: a systematic review of randomized clinical trials. Minerva Anestesiol. 2019;85(8):886-98. [PubMed]
- Aslan FE, Badir A, Arli SK, Cakmakci H. Patients' experience of pain after cardiac surgery. Contemp Nurse. 2009-2010;34(1):48-54. [PubMed]
- Siffleet J, Young J, Nikoletti S, Shaw T. Patients' self-report of procedural pain in the intensive care unit. J Clin Nurs. 2007;16(11):2142-8. [PubMed]
- Akinci IÖ, Basel A. [Sedation and analgesia in burn]. J Turk Soc Intens Care. 2011;9(1):26-30.
- Ersoy EO, Demir AU, Topeli A. [Sleep in intensive care: is there or not?]. Journal of Medical and Surgical Intensive Care Medicine 2016;7(1):28-33. [Link]
- Lat I, McMillian W, Taylor S, Janzen JM, Papadopoulos S, Korth L, et al. The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients. Crit Care Med. 2009;37(6):1898-905. [PubMed]
- Nilsson U. Music: a nursing intervention. Eur J Cardiovasc Nurs. 2011;10(2):73-4. [PubMed]
- Messika J, Kalfon P, Ricard JD. Adjuvant therapies in critical care: music therapy. Intensive Care Med. 2018;44(11):1929-31. [PubMed]
.: İşlem Listesi