Case Study: Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice
Introduction. Unrelieved postoperative pain remains a common problem despite advances in pain management. Complementary music has been suggested as an adjuvant to the standard of care treatment for postoperative pain.
Purpose. The purpose of this study was to determine if music therapy was an effective adjunct to decrease state anxiety, and increase pain management and environmental noise satisfaction in the postoperative patient.
Method.A quasi-experimental nonequivalent control group design was used in this study with participants assigned based on room assignment rather than randomly. The control group, which consisted of participants admitted to the A hallway, received the standard of care. The intervention group, which consisted of participants admitted to the B hallway, received complementary music therapy in the form of preprogrammed MP3 players, in addition to the standard of care. Neither analgesia type nor route was controlled. Each participant was enrolled for a total of 3 days or until discharge, whichever came first. Outcome measures were collected upon enrollment (Time One) and for the next 2 consecutive days (Time Two and Time Three). Participants in the intervention group were encouraged to listen to a selection of nonlyrical low decibel (less than 60 db) preprogrammed music, for at least 30 minutes via an MP3 player after their prescribed analgesia was administered. State trait anxiety, as well as pain and environmental noise satisfaction, were assessed using the State-Trait Anxiety Inventory and two standardized questions from the Press Ganey survey.
Findings.Before the intervention was implemented, both groups were the same related to their average level of state and trait anxiety, pain, and noise perception. The patient’s state anxiety, pain perception, and noise perception were measured 1 day after the intervention was in place. A significant difference was found from Time One to Time Two in pain management (t = 3.938, p < .001 ) and environmental noise satisfaction (t = 3.457, p = .001), while there was no change in state anxiety (t = 0.373, p = .711 ). The intervention group experienced improved pain management (t = 7.385, p < .01) and environmental noise satisfaction over time (t = 4.371; p < .001); however, there was no improvement in state anxiety (t = l .47; p = .159). The findings suggest music therapy decreases pain and environmental noise perception, although there was no effect on state anxiety.
Conclusions.Use of music therapy improves patients’ postoperative experience by increasing their pain management and white noise satisfaction. This intervention was inexpensive and easy to implement in the clinical setting, and therefore recommended to improve postoperative outcomes in other facilities.
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