ÖZET
Amaç:
Mekanik ventilasyon desteği uygulanan hastalarda müzik terapi ve ses izolasyonunun konfora olan etkisini incelemek amacıyla deneysel olarak yapılmıştır.
Gereç ve Yöntem:
Araştırma, Kasım 2019-Ocak 2020 tarihleri arasında bir üniversite hastanesinin anesteziyoloji ve reanimasyon yoğun bakım ünitesinde yürütülmüştür. Araştırmanın örneklemini oluşturan n=24 hastaya üç farklı girişim uygulanmıştır. Her bir hastaya Klasik Batı Müziği ve Nihavent makamında olan Klasik Türk Müziği hastalara ayrı ayrı 60 dakika (dk) boyunca dinlettirilmiş ve özel bir kulaklık aracılığıyla 60 dk boyunca hastalara ses izolasyonu uygulanmıştır.
Bulgular:
Araştırmaya katılan hastaların yaş ortalaması 64,88±14,05, %66,7’sinin erkek, %79,2’sinin evli, %45,8’inin okur-yazar olmadığı saptanmıştır. Hastaların sistolik, diyastolik kan basıncı, nabız hızı, solunum hızı, Yoğun Bakım Ağrı Gözlem Aracı puanları ve Amerikan Yoğun Bakım Hemşireleri Birliği Sedasyon Değerlendirme ölçeği ajitasyon ve anksiyete alt boyutu puanları Klasik Batı Müziği, nihavent makamında olan Klasik Türk Müziği ve ses izolasyonu doğrultusunda etkilemiştir. Araştırmada uygulanan Klasik Batı müziği, nihavent makamında Klasik Türk müziği ve ses izolasyonu uygulamaları arasında fark saptanmamıştır.
Sonuç:
Mekanik ventilasyon desteğinde olan hastalara uygulanan müzik terapi ve ses izolasyonunun hastaların hemodinamik parametrelerini olumlu yönde etkilediği, hastaların algıladığı ağrı şiddetini ve sedasyon ihtiyacını azalttığı saptanmıştır. Bu bağlamda; çalışmanın en önemli bulgusu mekanik ventilasyon desteğinde olan hastalarda yoğun bakım ortamına ilişkin seslerin arındırıldığı bir girişimin hastaların konfor düzeyini artırdığıdır. Dolayısıyla müzik terapinin de sese bağlı uyaranlardan arındırılmış bir girişim olarak belki de etki ettiği de diğer araştırmanın önemli ve kritik bir sonucudur.
References
1
Olsen BF, Rustøen T, Valeberg BT. Nurse’s Evaluation of a Pain Management Algorithm in Intensive Care Units. Pain Manag Nurs 2020;21:543-8.
2
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;24:290-8.
3
Saadatmand V, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Zayeri F, Vaismoradi M, et alEffect of nature-based sounds’ intervention on agitation, anxiety, and stress in patients under mechanical ventilator support: a randomised controlled trial. Int J Nurs Stud 2013;50:895-904.
4
Kim T, Kim JS, Choi EY, Chang Y, Choi W Il, Hwang JJ, et al. Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: A multi-center prospective observational study. Acute Crit Care 2020;35:255-62.
5
Uyar M, Korhan EA. Yoğun bakim hastalarinda müzik terapinin ağri ve anksiyete üzerine etkisi. Agri 2011;23:139-46.
6
Efstathiou N, Vanderspank-Wright B, Vandyk A, Al-Janabi M, Daham Z, Sarti A, et al. Terminal withdrawal of mechanical ventilation in adult intensive care units: A systematic review and narrative synthesis of perceptions, experiences and practices. Palliat Med 2020;34:1140-64.
7
Stein-Parbury J, McKinley S. Patients’ experiences of being in an intensive care unit: a select literature review. Am J Crit Care 2000;9:20-7.
8
Adamson H, Murgo M, Boyle M, Kerr S, Crawford M, Elliott D. Memories of intensive care and experiences of survivors of a critical illness: an interview study. Intensive Crit Care Nurs 2004;20:257-63.
9
Hofhuis JGM, Spronk PE, van Stel HF, Schrijvers AJP, Rommes JH, Bakker J. Experiences of critically ill patients in the ICU. Intensive Crit Care Nurs 2008;24:300-13.
10
Kolcaba K, Dimarco MA. Comfort Theory and its application to pediatric nursing “The Relationship between Comfort and Adherence in Hemodialysis Patients” View project. Pediatr Nurs 2005:187-94.
11
Kolcaba K, Tilton C, Drouin C. Comfort theory: A unifying framework to enhance the practice environment. J Nurs Adm 2006;36:538-44.
12
Juang DF, Lee CH, Yang T, Chang MC. Noise pollution and its effects on medical care workers and patients in hospitals. Int J Environ Sci Technol 2010;7:705-16.
13
Pugh RJ, Jones C, Griffiths RD. The impact of noise in the intensive care unit. In: Intensive Care Medicine: Annual Update 2007. Springer New York 2007:942-9.
14
Topf M. Hospital noise pollution: an environmental stress model to guide research and clinical interventions. J Adv Nurs 2000;31:520-8.
15
Xue CCL, Zhang AL, Lin V, Da Costa C, Story DF. Complementary and alternative medicine use in Australia: A national population-based survey. J Altern Complement Med 2007;13:643-50.
16
Bodeker G, Kronenberg F. A public health agenda for traditional, complementary, and alternative medicine. Am J Public Health 2002;92:1582-91.
17
Yom YH, Lee KE. A comparison of the knowledge of, experience with and attitudes towards complementary and alternative medicine between nurses and patients in Korea. J Clin Nurs 2008;17:2565-72.
18
Quinn F, Hughes CM, Baxter GD. Reflexology in the management of low back pain: A pilot randomised controlled trial. Complement Ther Med 2008;16:3-8.
19
Morey JH. Integrative Reflexology: A Therapy Within a Naturopathic Nursing Practice. Explor J Sci Heal 2005;1:400-1.
20
National Center for Complementary and Integrative Health. Available from: URL: https://www.nccih.nih.gov/. Accessed: 2021, Feb 18.
21
World Federation of Music Therapy (WFMT). Available from: URL: https://wfmt.info/. Accessed: 2021, Feb 18.
22
Almerud S, Petersson K. Music therapy - A complementary treatment for mechanically ventilated intensive care patients. Intensive Crit Care Nurs 2003;19:21-30.
23
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;14;13:e0207174.
24
Chen YY. Single-session improvisational group music therapy in adult inpatient psychiatry: a pilot study of the therapist’s experience. Nordic Journal of Music Therapy 2019:151-68.
25
Nussberger R. Short-term music therapy with in-patient high-risk pregnant women and their unborn child in the obstetric unit. Nord J Music Ther 2016;25:142.
26
Giordano F, Zanchi B, De Leonardis F, Rutigliano C, Esposito F, Brienza N, et al. The influence of music therapy on preoperative anxiety in pediatric oncology patients undergoing invasive procedures. Arts Psychother 2020:68.
27
Reimnitz L, Silverman MJ. A randomized pilot study of music therapy in the form of patient-preferred live music on fatigue, energy and pain in hospitalized adult oncology patients on a blood and marrow transplant unit. Arts Heal 2020;12:154-68.
28
Alcântara-Silva TR, de Freitas-Junior R, Freitas NMA, de Paula Junior W, da Silva DJ, Machado GDP, et al. Music Therapy Reduces Radiotherapy-Induced Fatigue in Patients With Breast or Gynecological Cancer: A Randomized Trial. Integr Cancer Ther 2018;17:628-35.
29
Wong HLC, Lopez-Nahas V, Molassiotis A. Effects of music therapy on anxiety in ventilator-dependent patients. Hear Lung J Acute Crit Care 2001;30:376-87.
30
Clark M, Isaacks-Downton G, Wells N, Redlin-Frazier S, Eck C, Hepworth JT, et al. Use of preferred music to reduce emotional distress and symptom activity during radiation therapy. J Music Ther 2006;43:247-65.
31
Hamel MB, Phillips RS, Davis RB, Teno J, Connors AF, Desbiens N, et al. Outcomes and cost-effectiveness of ventilator support and aggressive care for patients with acute respiratory failure due to pneumonia or acute respiratory distress syndrome. Am J Med 2000;109:614-20.
32
Chlan L. Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. Hear Lung J Acute Crit Care 1998;27:169–76.
33
McCaffrey RG, Good M. The Lived Experience of Listening to Music While Recovering from Surgery. J Holist Nurs 2000;18:378-90.
34
Marfil AH, Castro MM, Moline LG, Jaime SC, Guardado JL. 61 The Use of Music Therapy to Control Anxiety and Increase the Comfort of the Patient During the Treatment of Chemotherapy. Eur J Oncol Nurs 2012;16:S22-3.
35
Lu Y, Liu M, Shi S, Jiang H, Yang L, Liu X, et al. Effects of stress in early life on immune functions in rats with asthma and the effects of music therapy. J Asthma 2010;47:526-31.
36
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;20:1026-34.
37
Loomba RS, Shah PH, Chandrasekar S, Arora R, Molnar J. Effects of music on systolic blood pressure, diastolic blood pressure, and heart rate: A meta-analysis. Indian Heart J 2012;64:309-13.
38
Han L, Li JP, Sit JWH, 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;19:978-87.
39
Liu Y, Petrini MA. Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery. Complement Ther Med 2015;23:714-8.
40
Lee CH, Liu JT, Lin SC, Hsu TY, Lin CY, Lin LY. Effects of Educational Intervention on State Anxiety and Pain in People Undergoing Spinal Surgery: A Randomized Controlled Trial. Pain Manag Nurs 2018;19:163-71.
41
Yaman Aktaş Y, Karabulut N. The effects of music therapy in endotracheal suctioning of mechanically ventilated patients. Nurs Crit Care 2016;21:44-52.
42
Dijkstra BM, Gamel C, van der Bijl JJ, Bots ML, Kesecioglu J. The effects of music on physiological responses and sedation scores in sedated, mechanically ventilated patients. J Clin Nurs 2010;19:1030-9.
43
Aktaş YY, Karabulut N. Relief of Procedural Pain in Critically Ill Patients by Music Therapy: A Randomized Controlled Trial. Complement Med Res 2019;26:156-64.
44
Tan X, Yowler CJ, Super DM, Fratianne RB. The efficacy of music therapy protocols for decreasing pain, anxiety, and muscle tension levels during burn dressing changes: A prospective randomized crossover trial. J Burn Care Res 2010;31:590-7.
45
Gutgsell KJ, Schluchter M, Margevicius S, Degolia PA, McLaughlin B, Harris M, et al. Music therapy reduces pain in palliative care patients: A randomized controlled trial. J Pain Symptom Manage 2013;45:822-31.
