Paper
Wednesday, July 11, 2007
This presentation is part of : Critical Care Initiatives
Use of Relaxing Music during Acute Recovery from Myocardial Infarction: Evidence-Based Implementation Guidelines
Jill M. Winters, PhD, RN, College of Nursing, Marquette University, Milwaukee, WI, USA and Susan E. Cashin, PhD, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Learning Objective #1: The learner will be able to describe psychophysiological benefits of using relaxing music during acute recovery from mycardial infarction.
Learning Objective #2: The learner will be able to identify optimal timing and frequency for implementing relaxing music sessions during acute recovery from myocardial infarction.

Background and Significance:  Acute myocardial infarction (AMI) remains the leading cause of death worldwide.  Important predictors of morbidity and mortality in this population include diminished heart rate variability (HRV) and the extent of myocardial damage, and they are influenced by factors impacting myocardial oxygen (MVO2) supply and demand.  The purpose of this randomized six-group experimental design study was to compare effectiveness of relaxing music, rest, and treatment as usual, for improving indicators of cardiac autonomic nervous system function and reducing anxiety, and to determine optimal timing and frequency for implementing relaxing music sessions.

 Methods:  One hundred eighty AMI patients were randomly assigned to one of six groups.  The six comparison groups included (1) music once per day (morning); (2 & 3) music twice per day (morning & afternoon; morning & evening); (4) music three times per day (morning, afternoon, & evening); (5) attention (rest); and (6) control (usual treatment).  It was hypothesized that when compared with participants in the control and attention groups, individuals who listened to relaxing music would experience greater reductions in heart rate (HR), respiratory rate (RR), blood pressure (BP), MVO2 demand, and state anxiety, with concomitant increases in HRV.

 Results:  Repeated measures analysis of variance was used to test differences in dependent variables after intervention sessions.  Individuals who listened to relaxing music showed greater reductions in HR, RR, BP, MVO2 demand, and anxiety, with greater increases in HRV.  Repeated measures general linear modeling was used to determine optimal timing and frequency of relaxing music sessions.  Delivering relaxing music sessions two or three times per day was more beneficial than once per day, quiet rest, or treatment as usual.

 Conclusions: Relaxing music sessions promote both physiological and psychological relaxation responses during AMI recovery.  These changes may potentially reduce the extent of ongoing myocardial injury and damage.