AudioTherapy & Hemodialysis
Abstracts about music
therapy in hemodialysis
1. Music therapy-induced changes in salivary cortisol level are predictive of cardiovascular mortality in patients under maintenance hemodialysis

BACKGROUND: Music therapy has been applied in hemodialysis (HD) patients for relieving mental stress. Whether the stress-relieving effect by music therapy is predictive of clinical outcome in HD patients is still unclear.

METHODS: We recruited a convenience sample of 99 patients on maintenance HD and randomly assigned them to the experimental (n=49) or control (n=50) group. The experimental group received relaxing music therapy for 1 week, whereas the control group received no music therapy. In the experimental group, we compared cardiovascular mortality in the patients with and without cortisol changes.

RESULTS: The salivary cortisol level was lowered after 1 week of music therapy in the experimental group (-2.41±3.08 vs 1.66±2.11 pg/mL, P<0.05), as well as the frequency of the adverse reaction score (-3.35±5.76 vs -0.81±4.59, P<0.05), the severity of adverse reactions score (-1.93±2.73 vs 0.33±2.71, P<0.05), and hemodialysis stressor scale (HSS) score (-6.00±4.68 vs -0.877±7.08, P<0.05). The difference in salivary cortisol correlated positively with HD stress score scales (r=0.231, P<0.05), systolic blood pressure (r=0.264, P<0.05), and respiratory rates (r=0.369, P<0.05) and negatively with finger temperature (r=-0.235, P<0.05) in the total study population. The 5-year cardiovascular survival in the experimental group was higher in patients whose salivary cortisol lowered by <0.6 pg/mL than that in patients whose salivary cortisol lowered by >0.6 pg/mL (83.8% vs 63.6%, P<0.05).

CONCLUSION: Providing music during HD is an effective complementary therapy to relieve the frequency and severity of adverse reactions, as well as to lower salivary cortisol levels. Differences in salivary cortisol after music therapy may predict cardiovascular mortality in patients under maintenance HD. 260 913
2. Anxiolytic Effects of Music Interventions in Patients Receiving Incenter Hemodialysis: A Systematic Review and Meta-Analysis

Music interventions are effectively used to reduce anxiety in patients on maintenance hemodialysis (HD). The purpose of this review was to identify the methodological quality and examine the effectiveness of music interventions on anxiety in patients requiring maintenance HD. Articles were searched through 10 electronic databases, and relevant articles were systematically reviewed. Seven studies were analyzed for this study, and the combined seven studies revealed a medium effect size (pooled standardized mean differences [SMD] = 0.76; 95% CI: 0.55, 0.98). This study found that music interventions effectively reduce anxiety in patients on maintenance HD. 462 307
3. Effects of live saxophone music on physiological parameters, pain, mood and itching levels in patients undergoing hemodialysis

BACKGROUND: Few studies have focused on the effect of music in patients undergoing hemodialysis.

OBJECTIVES: To determine the effects of live saxophone music on various physiological parameters and pain, mood and itching levels.

DESIGN: A randomised controlled study with 114 patients undergoing hemodialysis with a control group (n = 57) and an experimental group (n = 57) who received 30 minutes of live saxophone music therapy.

MEASUREMENTS: Systolic and diastolic blood pressure, pulse rate, glycaemia, oxygen saturation, pain, mood and itching levels were measured before and after the live music performance, resulting in baseline and post-test values for the patients in the experimental group.

RESULTS: The experimental group showed a statistically significant reduction in pain level, and an improvement in mood and itching levels and in the oxygen saturation.

CONCLUSION: Live saxophone music could be introduced to improve clinical and quality-of-life measures in patients undergoing hemodialysis. 980 265
4. Chronic renal failure patients

The study was planned as a case-control study to examine the effects of music on some of the complications experienced by chronic renalfailure (CRF) patients during hemodialysis. A total of 60 patients (30 intervention and 30 control) diagnosed with end-stage renal failure undergoing hemodialysis treatment participated in this study. The study was conducted in Manisa Merkez Efendi State Hospital HemodialysisUnit and Manisa Özel Anemon Hemodialysis between April 2012 and July 2012. The intervention group listened 30 minutes in each session (12 total sessions) Turkish art music at the beginning of the third hour of their hemodialysis sessions. Patient Information Form and visual analog scale to assess pain, nausea, vomiting, and cramps during hemodialysis session were used. For the analysis of data, the number, percentage, chi-square test, and significance test of independent group differences between two averages were conducted. According to the findings of the study, the average of the intervention and control group ages, respectively, was 50.86 ± 11.3 and 55.13 ± 9.68. The primary duration of hemodialysis treatment for both intervention and control groups was "1 year and above" (70.0%). The intervention group’s pain and nausea scores were lower than the control group for all 12 sessions. The difference between the intervention and the control group’s pain scores was significant (P < 0.05). However, in pain scores from the first session to 12th session, continuous decreasing trend was not observed. According to the results, music can be used as an independent nursing practice for reduction of complications for CRF patients receiving hemodialysis treatment.
5. The influence of music therapy on perceived stressors and anxiety levels of hemodialysis patients

BACKGROUND: This study was designed as a pretest-posttest control group experiment. The aim was to identify the influence of music therapy on the perceived stressors and anxiety levels of hemodialysis (HD) patients.

METHODS: The data were collected in HD Units of Ataturk University Yakutiye Research Hospital and Regional Education, Application and Research Hospital between February and March. The study population consisted of 104 patients who received dialysis. Since four patients refused to participate, the study was completed with 100 patients. While one-half of the patients formed a control group, the other half consisted of an experimental group. Patient introduction form, hemodialysis stressor scale, and state-trait anxiety inventory (STAI) forms were used to collect the data. HSS was used to identify the stressors perceived by the patients, and STAI form was used to classify anxiety levels. Data were analyzed by using t-test and chi-square test.

RESULTS: It was found that differences between average pretest and posttest scores of perceived psychosocial, physiological, and total stressors were statistically significant. It was also found that differences between average pretherapy and posttherapy test scores of state and trait anxiety were statistically significant.

CONCLUSIONS: Music therapy was influential in reducing anxiety levels and perceived stressors of HD patients. It is concluded that music therapy-as an independent nursing initiative-can be used to help in fulfilling the physical, emotional, and psychological requirements of patients. 151 089
6. The influence of musical rhythms on the perception of subjective states of adult patients on dialysis

Being submitted to dialysis four hours a day, three times a week can mean experiencing boredom, besides discomfort. Patients often report that the time seems to take longer to go by. The purpose of this study was to explore the influence of two different musical rhythms in the states of mind and perception of adult patients undergoing dialysis, since the literature on this subject is scarce. The study was performed at a private hospital with 43 patients, who participated in two sessions of musical improvisation with a keyboard. The subjective states and perception were evaluated before and after the intervention. Over 80% of the patients felt that time went by faster after the interventions in both rhythms. However, the pace was a decisive factor in the kind of emotional experience that the patients had. 085 165

7. An investigation of the effects of music on anxiety and pain perception in patients undergoing hemodialysis treatment

This study aimed to investigate the effects of preferred music listening on anxiety and pain perception in patients undergoing hemodialysis. A two group experimental design was used. Sixty people diagnosed with end stage renal failure undergoing hemodialysis treatment participated in this study. Preferred music listening was applied as an intervention. Anxiety and pain were measured pretest and post-test. The control group scored significantly higher in state anxiety than the experimental group and experienced significantly higher pain intensity in post-test phase. Findings provide experimental evidence to support the effectiveness of preferred music listening in medical settings. 809 642

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