Research has shown that music therapy can help restore emotional balance, calm neural activity, reduce pain, and bolster positive immune response. Studies in patients undergoing bone marrow biopsies have shown that such advantages include decreased anxiety and pain.1 Additional studies in hospice patients show that music helps meet those patients' physical, emotional, and spiritual needs.2 There is also evidence that preoperative music therapy decreases stress, improving patients' postoperative outcomes.
As part of the effort to adopt the Jean Watson model of human caring-a more holistic approach that emphasizes the concept of caring and a positive healing environment to create positive patient outcomes-as our nursing theory here at the Atlanta VA Medical Center, music therapy has been integrated into certain clinics, including the Chemotherapy/Biotherapy Infusion Center in the Hematology/Oncology clinic.
One project uses music as a mechanism to lower blood pressure in patients whose blood pressures are out of range according to performance measures issued by the Department of Veterans Affairs. The relaxing music and imagery has also been found to decrease anxiety related to the procedures, suggesting that the method can be used as an adjunct for pain control in addition to decreasing blood pressures.
Testing the Intervention
The music therapy program was tested in 30 post-infusion-treatment patients whose blood pressure measurements were above the benchmark of 140/90 mmHg after treatment. Patients' vital signs are evaluated routinely at the conclusion of infusion treatments, and patients with blood pressure readings above this benchmark are routinely rechecked.
The hypertensive patients who participated in testing this intervention were given compact disc players with headphones, positioned in recliners, and asked to close their eyes. The patients listened to soft instrumental music for 15 to 30 minutes, and vital signs were then rechecked. Patients who did not respond to the music therapy were treated with anti-hypertensive medication or referred to their primary care physician for further evaluation.
The Outcomes
We defined positive outcomes for this intervention as: a decrease in blood pressure readings to an acceptable range at re-evaluation (140/90 mmHg or lower) and/or positive feedback based on anecdotal comments from the patients that showed decreased anxiety. The findings were:
* From this sample 90 percent of the patients had a decrease in blood pressure of 5 to 20 mmHg in either systolic, diastolic, or both; and
* Subjective responses to the music experience demonstrating decreased anxiety were: "This is wonderful," "I like this music," and "I want to take this home." Another comment was: "Thank you for letting me listen to that. May I have a copy of this CD?" One patient stated, "It made me feel better about everything."
The comments were consistent with the same type of comments made after relief of the anxiety that many oncology patients associate with anticipating treatment or medication side effects.
Nursing Implications/Takeaways
Music therapy is now available at the Medical Center's Hematology/Oncology Infusion Clinic for patients with elevated blood pressure after infusion. And, as with all therapeutic modalities, music therapy is individualized for each patient's needs.
This holistic approach to reducing anxiety and blood pressure is non-invasive and cost-effective, and involves the patient in his or her care. The outcomes of this project suggest that adopting music therapy interventions and other non-pharmacologic therapies (such as guided imagery, laughter therapy, and others) should be considered as a means of reducing anxiety and blood pressure. Additional education for staff nurses on how to use such alternative therapies may be required.
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