Sequential Allocation Study of Music Duration
Study Details
Study Description
Brief Summary
The investigators are interested in studying the effects of varying lengths of musical exposure on patient anxiety and stress levels.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
Studies have shown that musical intervention has had an effect on hemodynamic variability, postoperative pain and the amount of sedative and analgesic medication needed during post-operative periods. These effects extend to beyond post-operative care as musical intervention has played a role in pain management for cancer and for the side-effects of cancer treatment. However, little information is known whether or not the duration of musical exposure plays a direct role in the efficacy of reducing pain, sedative use and other unwanted side effects during post-operative recovery. Similarly, it is not known if "under-exposure" and "over-exposure" states exist in musical intervention when it comes specifically to patient anxiety before and after operations.
The investigators believe there to be an optimal duration of music exposure (ED50) that will have the highest probability of achieving the desired effects of reduced anxiety. In understanding the ED50 of musical exposure, there could be various applications that work in tandem with other therapies to reduce patient pain and anxiety in medical settings. While the investigators do not expect music to be as effective as medical intervention, it holds a promising position as a form of supportive therapy.
The study will utilize a sequential allocation approach where subsequent parameters of the study are adjusted based on the accrued data. The sequential allocation method minimizes the necessary sample size while still providing accurate effective dose (ED50) measurements. Our allocation methods will follow an up-and-down sequential allocation model. Our targeted population will be patients awaiting scheduled cesarean sections. This patient population was chosen based on a previous study done on patient satisfaction in response to musical exposure. Patient accessibility was also a considered factor. Scheduled cesarean section patients will usually have access to their own room during pre-operative preparation, lending an ideal environment to conduct the musical exposure in.
Specifically, the study team will start at a musical exposure of 15 minutes for the first study subject. The second study subject will have their exposure time "stepped up" by 5 minutes if the first study subject results in a success, defined as a greater than one point reduction in anxiety before and after musical exposure. If there was no change or worsening of anxiety in the first study subject, then the second subject will have their exposure time reduced by 5 minutes. This will continue until the first 5 minute exposure is achieved. At that point, success and failures will increase and decrease the exposure time by increments of 1 minute. The minimal musical exposure time will be set at 1 minute and if the effective dose is achieved at 1 minute, the study team will start each subsequent patient at 1 minute of musical exposure. The patients will all listen to Mozart music played for them from some type of music player. The study will terminate once the data shows 6 "cross overs" between up and down steps or if 30 participants have been recruited-whichever comes first. Statistical analysis and final ED50 determination will be done using methods described by Dixon and Massey.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Music Exposure Patient will listen to a specified duration of music. |
Other: Music Exposure
Music will be played for participants.
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Outcome Measures
Primary Outcome Measures
- Change in anxiety through a questionnaire rating anxiety levels on a scale of 0-10 [baseline and up to 60 minutes after exposure.]
Investigators will measure the patient's anxiety pre exposure on a scale of 0-10, with 0 being no anxiety and 10 being extreme anxiety. Anxiety will be assessed again on the same scale post musical exposure.
Secondary Outcome Measures
- General Musical Experience [Up to 60 minutes after musical exposure]
The investigators will ask questions inquiring about the general musical experience for the patient in both the research context and their lives. The questions will include: Overall, how would you rate your experience listening to music pre-operation on a scale of 0-10, with 1 being the worst experience and 10 being the best experience? If you were to have another C-section, would you want to listen to music before hand? Definitely Not Maybe Not Maybe Yes Definitely Yes Would you recommend listening to music before a C-section to friends and family? Definitely Not Maybe Not Maybe Yes Definitely Yes Would you consider yourself as someone who listens to music regularly for enjoyment? Yes No What musical experience, if any, do you have? What level of education do you have in music? Are you currently active in music?
- Change in Heart Rate between baseline and at end of exposure [baseline and up to 60 minutes after exposure.]
The investigators will measure the patient's heart rate before and after musical exposure
- Change in Blood Pressure between baseline and at the end of exposure [baseline and up to 60 minutes after exposure.]
The investigators will measure the patient's blood pressure before and after musical exposure
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age 18-50
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Elective scheduled cesarean delivery
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Able to provide informed consent
Exclusion Criteria:
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Patient refusal
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Impaired hearing
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Patient taking at least one anti-anxiolytic medication on a daily basis at baseline
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No anxiety (a score of 0, on a scale of 0-10 of pre-music exposure anxiety) after consent is given.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Tufts Medical Center | Boston | Massachusetts | United States | 02111 |
Sponsors and Collaborators
- Tufts Medical Center
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Conrad C. Music for healing: from magic to medicine. Lancet. 2010 Dec 11;376(9757):1980-1.
- Drzymalski DM, Lumbreras-Marquez MI, Tsen LC, Camann WR, Farber MK. The effect of patient-selected or preselected music on anxiety during cesarean delivery: a randomized controlled trial. J Matern Fetal Neonatal Med. 2020 Dec;33(24):4062-4068. doi: 10.1080/14767058.2019.1594766. Epub 2019 Mar 27.
- Görges M, Zhou G, Brant R, Ansermino JM. Sequential allocation trial design in anesthesia: an introduction to methods, modeling, and clinical applications. Paediatr Anaesth. 2017 Mar;27(3):240-247. doi: 10.1111/pan.13088. Epub 2017 Feb 17. Review.
- Huang ST, Good M, Zauszniewski JA. The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Int J Nurs Stud. 2010 Nov;47(11):1354-62. doi: 10.1016/j.ijnurstu.2010.03.008. Epub 2010 Apr 18.
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