Feasibility of a music intervention protocol for patients receiving mechanical ventilatory support

Context • Music has been found to be an effective nonpharmacologic adjunct for managing anxiety and promoting relaxation in limited trials of critically ill patients receiving mechanical ventilation. No data are available to determine the effect of the intervention over repeated trials or to determine whether patients or staff will use music intervention independently. Objective • To test the feasibility of a patient-initiated music intervention protocol over a 3-day trial and to discern the associated barriers to adherence by study participants and nursing staff. Design • descriptive pilot study. Setting • two adult critical care units contained in 1 university-affiliated tertiary care center in the urban Midwest. Patients • Five alert, critically ill adults receiving mechanical ventilatory support. Intervention • Patient-selected music listening via audiotapes and headphones with frequency and length of session determined by each patient. Main Outcome Measures • Anxiety, heart rate, respiratory rate, blood pressure, and identified barriers to protocol adherence. Results • Subjects averaged 2 self-initiated music interventions (mode=3; range = 1-5) and listened for an average of 67.8 minutes per session (SD 34.3; mode = 50; range=25-120 minutes). Barriers to this intervention included inaccessibility of the equipment and lack of knowledge and experience of the nursing staff. Due to missing data, physiological measures were not interpretable. Conclusions • Patient-initiated music is a feasible intervention protocol: subjects were able to request music independently and nursing staff were cooperative. Findings will be used in future studies to refine the protocol and attendant measures to implement music intervention in the critical care setting and to develop detailed staff education materials.