Ergin, E., Midilli, T.S., & Baysal, E. (2018). The effect of music on dyspnea severity, anxiety, and hemodynamic parameters in patients with dyspnea. Journal of Hospice and Palliative Nursing, 20, 81–87.

To examine the effects of music therapy in patients with dyspnea on the severity of dyspnea, state anxiety, and hemodynamic parameters such as heart rate, diastolic, systolic blood pressure, respiratory rate, and oxygen saturation.

Random assignment occurred by having patients who were hospitalized for dyspnea draw groups (A or B) from a bag for intervention or control groups. Intervention group patients were to rest supine in their hospital rooms for five minutes; patients were given earphones for music listening to 30 minutes of prepared music with instructions to listen with eyes closed and to concentrate on the music. Volume was adjusted by the researcher according to facial expressions of the participant. 

Control group patients were to rest in bed for 30 minutes with eyes closed and headphones connected to a CD player but with no music playing, creating a quiet environment. 

Testing via face-to-face interviews took place before and after the 30 minute period took place in both groups to measure dyspnea severity, respiratory rate, state anxiety, and hemodynamic parameters such as heart rate and diastolic and systolic blood pressure.

• N = 60 (30 in each group) with 81% power; effect size = 0.519, 0.05 one-side significant level   
• AGE: Range - 60-62.43 years; mean age = 61.21 years
• MALES: 50% in control group; 70% in intervention group  
• FEMALES: 50% in control group; 30% in intervention group
• CURRENT TREATMENT: Not applicable
• KEY DISEASE CHARACTERISTICS: Severe dyspnea
• OTHER KEY SAMPLE CHARACTERISTICS: Control group: 50% had unnamed chronic illness(es); intervention group: 33.3% had unnamed chronic illness(es). Overall, 41.7% had a chronic illness; most frequent was hypertension (48%).

• SITE: Single site   
• SETTING TYPE: Inpatient    
• LOCATION: Chest Diseases Service of Manisa Public Hospitals Association Government Hospital (western Turkey)

PHASE OF CARE: Seems not applicable in the current study

Randomized controlled study with pre-/post-test intervention and control group

• Patient identification form: Six items for sociodemographic data: age, sex, education level, diagnosis, chronic illness, chest tube presence.
• Effect of music on hemodynamic data: Respiratory rate, heart rate, systolic and diastolic blood pressure, oxygen saturation.
• Dyspnea visual analog scale: 100 mm vertical line where self-report of 0 mm means no dyspnea and 100 mm means the most severe dyspnea.
• State-Trait Anxiety Inventory (Turkish adaptation): State and trait items were read aloud to the patients; patients indicated answers by holding up 1 to 4 fingers or by pointing to corresponding answers on signs. State and trait scored separately and then combined for total score of 20-80. Scores of 20-39 indicate slight; 40-59 indicate medium; 60 and greater indicate severe dyspnea, profess help needed.
• Patient satisfaction: Single question to rate the music

Effect size: 0.519; significant at p = 0.05. The demographic and clinical characteristics of the intervention and control group were similar. There were no differences between groups before or after on hemodynamic measures. However, a simple paired t test of post-test scores revealed a significant between-groups difference in the decrease in diastolic blood pressure (p = 0.05) and state anxiety (p = 0.01) scores on post test, but no significant diff in systolic blood pressure, heart rate, respiratory rate, or oxygen saturation.

Music therapy has no significant effect on severity of dyspnea or on hemodynamic measures named, but showed an effective or significant change in state anxiety (p = 0.01) and a significance for decrease in diastolic blood pressure (p = 0.05) only for post-test between-groups scores.

• Small sample (< 100)
• Selective outcomes reporting
• Findings not generalizable
• Other limitations/explanation: Selective outcomes: the change in diastolic blood pressure measurements from pre- to post-test seemed to be reported inconsistently in the table and in the text. Findings are not generalizable beyond small test group use of classical Turkish music.

Increased awareness that music of a patient’s choice may decrease anxiety: data needs to be collected before and after to determine effectiveness of music categories or genres. Patient choice may vary (according to cultural and spiritual and regional circumstances).