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Effects of Duration of Selected Music As an Intervention on Postoperative Eastern Michigan University DigitalCommons@EMU Master's Theses, and Doctoral Dissertations, and Master's Theses and Doctoral Dissertations Graduate Capstone Projects 2010 Effects of duration of selected music as an intervention on postoperative pain in open-heart surgery patients during chair rest on the first postoperative day Tzu-Ting Shu Follow this and additional works at: http://commons.emich.edu/theses Part of the Music Therapy Commons, and the Rehabilitation and Therapy Commons Recommended Citation Shu, Tzu-Ting, "Effects of duration of selected music as an intervention on postoperative pain in open-heart surgery patients during chair rest on the first postoperative day" (2010). Master's Theses and Doctoral Dissertations. 321. http://commons.emich.edu/theses/321 This Open Access Thesis is brought to you for free and open access by the Master's Theses, and Doctoral Dissertations, and Graduate Capstone Projects at DigitalCommons@EMU. It has been accepted for inclusion in Master's Theses and Doctoral Dissertations by an authorized administrator of DigitalCommons@EMU. For more information, please contact [email protected]. EFFECTS OF DURATION OF SELECTED MUSIC AS AN INTERVENTION ON POSTOPERATIVE PAIN IN OPEN-HEART SURGERY PATIENTS DURING CHAIR REST ON THE FIRST POSTOPERATIVE DAY By Tzu-Ting Shu, BSN, RN Thesis Submitted to the School of Nursing College of Health and Human Services Eastern Michigan University In partial fulfillment of the requirement for the degree of: MASTER OF SCIENCE IN NURSING Thesis Committee: Lorraine M. Wilson, PhD, RN: Chair Tsu-Yin Wu, PhD, RN: Committee Member December 16, 2010 Ypsilanti, Michigan i THESIS APPROVAL Effects of Duration of Selected Music as an Intervention on Postoperative Pain in Open-heart Surgery Patients during Chair Rest on the First Postoperative Day Tzu-Ting Shu APPROVED: _________________________________ _______________________ Lorraine M. Wilson, PhD, RN Date Thesis Chair _________________________________ _______________________ Tsu-Yin Wu, PhD, RN Date Committee Member _________________________________ _______________________ Betty Beard, PhD, RN Date Director, School of Nursing _________________________________ _______________________ Deb DeLaski, PhD Date Interim Dean, Graduate School ii Dedication This study is dedicated to God, first of all. Without him, I would not have been able to finish this. This study is also dedicated to my dad, who encouraged me to pursue nursing as my career and had taught me to persevere but cannot share this joy with me, and my mom, who supports me in many ways to complete advanced nursing degree. I would like to dedicate this study to my church, King of Love. They have encouraged me and been walking with me through difficult times with grace and love. iii Acknowledgement I would like to express my sincere gratefulness to several people. This study would not have been possible without their help. First of all, I would like to give thanks to Dr. Ruth Moore at St. John Providence IRB; Administrative Nursing Director, Julie Gorczyca; Clinical Practice Manager of SICU, Brooke Johnson; and all staff members of SICU at St. John Providence. Many thanks and appreciation to my advisors: Dr. Lorraine Wilson and Dr. Tsu-Yin Wu, who have supported me and given me guidance throughout my years at Eastern Michigan University. iv Abstract The purpose of this study was to test the effects of selected music on reducing postoperative pain and use of pain relief medications in open-heart surgery patients during chair rest on the first postoperative day. This study was conducted using a pretest-posttest experimental design. A convenience sample of 13 open-heart surgery patients from a metropolitan hospital in southeastern Michigan were randomly assigned to the music group (n = 6) and the control group (n = 7). T-test analysis showed that pain scores (numeric rating scale, NRS = 0-10) were lower in the music group than the control group after 30, 45, and 60 minutes of chair rest, and sense of well- being rated by using the visual analog scale (VAS = 0-100) was also higher in the music group at 60 minutes than the control group although the difference was not statistically significant. Optimal duration of music to reduce postoperative pain and the frequency of the use of pain medication could not be determined due to the small sample size. A replication study with a larger study group is recommended to ensure greater statistical power to test the usefulness of music as an adjuvant therapy in reducing postoperative pain. v TABLE OF CONTENTS Dedication………………………………………………………………………………………...iii Acknowledgement..........................................................................................................................iv Abstract……………………………………………………………………………………………v List of Tables……………………………………………………………………………………..ix List of Figures……………………………………………………………………………………..x Chapter I: Introduction……………………………….……………………………………………1 Background and Significance of the Study……………………………………………….1 Research Purpose…………………………………………………………………………2 Research Questions……………………………………………………………………….3 Chapter II: Review of Literature………………………………………………………………….4 Theoretical Research Literature…………………………………………………………..4 Empirical Research Literature………………………………………………….………...6 Summary………………………………………………………………………………….8 Chapter III: Framework…………………………………………………………………………...9 Framework Development…………………………………………………………………9 Definitions……………………………………………………………………………….10 Formulation of Hypotheses……………………………………………………………...11 Chapter IV: Method and Procedures……………………………………………………………..12 Research Design…………………………………………………………………………12 Rationale for Research Design…………………………………………………………..13 Sampling Design and Setting……………………………………………………………14 Rationale for Sampling Design………………………………………………………….14 vi Ethical Consideration……………………………………………………………………15 Measurement Method…………………………………………………………………...16 Data Collection………………………………………………………………………….17 Data Analysis...………………………………………………………………………….19 Chapter V: Results……………………………………………………………………………….21 Description of the Sample………………………………………………………………21 Possible confounding Variables…………………………………………………………21 The effect of Music as an Intervention on Pain and Well-being of First Day Post Open- heart Surgery Patients.…………………………………………………………...27 The Effect of the Duration of Music as an Intervention on Pain of First Day Post Open- heart Surgery Patients…………….……………………………………………...32 The Use of Pain Medications during Chair Rest………………………………………..34 Chapter VI: Discussion…………………………………………………………………………..35 Sample Profile………………………………………………………………………......35 The Effect of Music as an Intervention on Pain and Well-being on First Postoperative Day in Open-heart Surgery Patients…………………………………...…35 The Effect of the Duration of Music as an Intervention on Pain of First Day Post Open- heart Surgery Patients……..…………………………………………………......36 The Use of Pain Medications during Chair Rest………………………………………..38 Study Limitation………………………………………………………………………...38 Implications for Research and Clinical Use of Music Therapy…………………………39 Conclusion………………………………………………………………………………39 References………………………………………………………………………………………..41 vii Appendices……………………………………………………………………………………….44 Appendix A: Letters……………………………………………………………………..44 Appendix B: The Pain Numeric Rating Scale and Visual Analog Scale…………….....49 Appendix C: Oral Explanation of the Study to Potential Participants…………………..51 Appendix D: Consent to Participate in a Clinical Research Study and Authorization to Use or Disclose Protected Health Information for Research……………..52 Appendix E: Data Collection Sheet……………………………………………………..57 viii LIST OF TABLES Table Page 1 Characteristics of the Sample……………………………………………………………...23 2 Between Groups Comparison on Use of Cardiovascular Medications 8 hours prior to Chair Rest………………………………………………………………………………..25 3 Between Groups Comparison on Use of Pain Medications 4 hours prior to and during Chair Rest………………………………………………………………………………..26 4 Comparison of the Mean Pain Scores for the Music and Control Groups during 0 (pre- test), 15, 30, 45, and 60 minutes of Chair Rest………………………………………….28 5 Comparison of the Mean Pretest and Posttest Scores on the VAS for the Music and Control Groups…………………………………………………………………………...29 6 Comparison of the Mean Difference of Pain Scores between Pretests and Posttests and in each 15-Minute Period…………………………………………………………………...33 ix LIST OF FIGURES Figure Page 3-1 Conceptual Map…………………………………………………………........................10 4-1 The Intervention of the Control Group and the Experimental Group..…………………12 4-2 The Study Procedure……………………………………………..……………………..19 5-1 Comparison of the Mean Pain Scores on a Numeric Rating Scale (NRS) for the Music and Control Groups……………………………………………………………………...30 5-2 Comparison of the Mean Pretest and Posttest Scores for Well-being on a 100 mm Visual Analog Scale (VAS) for the Music and Control Groups………………………………..31 x 1 CHAPTER І Introduction Pain, the most common problem for patients after coronary artery bypass grafting or valve replacement, is caused by the stimulation of peripheral nerve endings in the muscles and tissue that have been cut and traumatized during surgery (Complementary and alternative medicine, 2005). The effective management of acute postoperative pain primarily relies on pharmacologic interventions, such as patient-controlled analgesic devices and spinal analgesics (Miaskowski, 1996). However, the use of nonpharmacologic strategies is considered as an adjuvant intervention for acute postoperative pain management (Miaskowski). Music therapy has
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