INTRODUCTION:

Music therapy is the use of music to improve health or functional outcomes. Music therapy is a creative arts therapy, consisting of a process in which a music therapist uses music and all of its facets physical, emotional, mental, social, aesthetic, and spiritual to help clients improve their physical and mental health.

Music therapists primarily help clients improve their health in several domains, such as cognitive functioning, motor skills, emotional development, communication, sensory, social skills, and quality of life by using both active and receptive music experiences such as improvisation, re-creation, composition, and listening and discussion of music to achieve treatment goals¹.

More than 2.7 million cardiac catheterizations are done every year in the United States. In India 4.06 million people underwent cardiac catheterization between the years 2008-2014²

Angiography is a complex procedure that involves insertion of a catheter in to the heart and surrounding vessels to obtain detailed information about the structure and performance of the heart, valves and the circulatory system. Cardiac catheterization is usually performed in the laboratory. Anticipation of an invasive procedure in hospital is likely to provoke feelings of anxiety and stress in patients. An unfamiliar environment, loss of control, separation from family are all factors that can contribute to the development of such feelings. Recently, there has been considerable interest in potential of music listening in a variety of clinical settings, yet thus far little is known about the impact of music listening on the pre-procedural patient population³.

NEED FOR STUDY:

Now a days Angiography is a common diagnostic procedure in heart related problems. During clinical postings researcher observed that many patients undergoing procedure have anxiety related to it and leads to change in physiological parameters. Therefore, researcher is interested to assess effect of Music therapy on level of anxiety and selected physiological parameters. To analyse the existing literature for the use of music therapy during cerebral, coronary, and peripheral angiography to determine whether it improves patient anxiety levels, heart rate, and blood pressure during the procedure.

OBJECTIVE:

1. To assess the physiological parameters before providing music therapy among patients undergoing angiography at selected hospitals of city.

2. To assess the effectiveness of music therapy on selected physiological parameters among the patients undergoing angiography at selected hospitals of city.

3. To find association of study findings with selected demographic variables.

HYPOTHESIS:

H₀₁-There is no significant effect of music therapy on pre procedure selected physiological parameters among patients undergoing Angiography at selected hospitals of city (at p =0.05)

H₁_-There is significant effect of music therapy on pre procedure selected physiological parameters among patients undergoing Angiography at selected hospitals of city (at p=0.05)

METHODOLOGY:

Research Approach/Design:

Research design adopted for the present study was Quasi experimental Non Randomize Control group design.

Quasi experimental research design involves the manipulation of independent variable to observe the effect on dependent variable; but it lacks at least one of the two characteristics of the true experimental design: randomized or a control group

Group

Pre test

Treatment

Post test

Experimental group

Measurement anxiety and physiological parameters

(O1)

Music Therapy

(X)

Measurement of Anxiety and physiological parameters (O2)

Control

Group

Measurement anxiety and physiological parameters (O1)

Measurement of Anxiety and physiological parameters (O2)

KEY:

O₁ (pre-test) = An assessment of the physiological parameters and anxiety level before music therapy.

X= intervention of the music therapy.

O2 (post-test) = An assessment of physiological parameters and anxiety level.

Variables:

1. Independent variable - Music therapy.

2. Dependent variable - the selected physiological parameters

3. Demographic variables - age, gender, marital status, type of family, education, economic status, type of. Occupation

Setting of the Study:

The study is conducted in selected hospitals of city. Total 60 samples patient undergoing angiography at selected hospitals of city.

Population:

Target population:

Target populations for the present study were patients undergoing angiography at selected hospitals from all over Maharashtra

Accessible population:

Accessible population selected for this study consist of all the angiography patients from selected hospitals of city.

Sample and Sampling:

In the present study, the sample selected for the study where the patients undergoing angiography at selected hospitals city.

Sampling Technique:

The sampling technique used in this study is non-probability convenient sampling. This entails the use of the sample purposefully in the study, until the desired samples are reached. Everyday list of patients undergoing angiography at selected hospitals city and checked patients who met the criteria were selected.

Sampling Criteria:

Inclusion Criteria: Patient who are

1. Undergoing angiography within the age group of 30 -70 years

2. Willing to participate in the study.

3. Undergoing planned angiography for first time.

4. Admitted at the pre-operative care unit of selected hospitals of city

5. Able to understand Marathi and/or English

Exclusion criteria: Patients who are:

i. Critically ill.

ii. Unconscious, Disoriented, Sedated.

iii. Having hearing impairment.

RESULTS:

Result

Analysis of data related to the physiological parameters before providing music therapy among patients undergoing angiography

Table 1.1: Physiological parameters before providing music therapy among patients undergoing angiography N= E-30, C-30

Parameter	Experimental		Control
Parameter	Mean	SD	Mean	SD
Pulse rate	92.3	8.3	84.9	7.6
Respiration Rate	24.1	3.5	21.5	3.5

In experimental group, average pulse rate was 92.3 with standard deviation of 8.3 and average respiratory rate was 24.1 with standard deviation 3.5.

In control group, average pulse rate was 84.9 with standard deviation of 7.6 and average respiratory rate was 21.5 with standard deviation 3.5.

Analysis of data related to the effectiveness of music therapy on selected physiological parameters among the patients undergoing angiography

Table 1.2: Paired t-test for the effectiveness of music therapy on selected physiological parameters among the patients undergoing angiography N= E-30, C-30

Parameter		Mean	SD	t	df	p-value
Pulse rate	Pre-test	92.3	8.3	11.5	29	0.000
	Post-test	77.7	5.0
Respiration Rate	Pre-test	24.1	3.5	13.3	29	0.000
	Post-test	17.7	1.6

Researcher applied paired t-test for the effectiveness of music therapy on pulse rate and respiratory rate among patients undergoing angiography.

Average pulse rate in pre-test was 92.3 which reduced to 77.7 in post-test. T-value for this test was 11.5 with 29 degrees of freedom. Corresponding p-value was small (less than 0.05), the null hypothesis is rejected. It is evident that the music therapy significantly reduced the pulse rate among patients undergoing angiography.

Average respiration rate in pre-test was 24.1 which reduced to 17.7 in post-test. T-value for this test was 13.3 with 29 degrees of freedom. Corresponding p-value was small (less than 0.05), the null hypothesis is rejected. It is evident that the music therapy significantly reduced the respiration rate among patients undergoing angiography.

Table 1.3: Two sample t-test for the effectiveness of music therapy on selected physiological parameters among the patients undergoing angiography N= E-30, C-30

Parameter	Group	Mean	SD	t	df	p-value
Pulse rate	Experimental	14.6	6.9	9.9	58	0.000
	Control	0.1	4.1
Respiration Rate	Experimental	6.5	2.7	9.6	58	0.000
	Control	-0.4	2.8

Researcher applied paired t-test for the comparison of change in pulse rate and respiratory rate among patients undergoing angiography in experimental and control group.

Average change in pulse rate in experimental group was 14.6 which was 0.1 in post-test. T-value for this test was 9.9 with 58 degrees of freedom. Corresponding p-value was small (less than 0.05), the null hypothesis is rejected. It is evident that the music therapy is significantly effective in improving the pulse rate among patients undergoing angiography.

Average respiration rate in experimental group was 6.5 which was -0.4 in post-test. T-value for this test was 9.6 with 58 degrees of freedom. Corresponding p-value was small (less than 0.05), the null hypothesis is rejected.It is evident that the music therapy is significantly effective in improving the respiration rate among patients undergoing angiography.

LIMITATIONS:

A study period was limited for one month.

This study was limited to selected hospitals of city.

True experimental study could not be conducted due to practical difficulty.

RECOMMENDATIONS:

On the basis of the present study, the investigator suggested the following recommendation for further study.

A study to assess the effectiveness of music therapy on physiological parameters of Patient undergoing cardiac surgery.

Effectiveness of music therapy to reduce physiological parameters subjects posted for surgical interventions.

Effectiveness of music therapy on selected Bio-physiological parameters among hypertensive patients in selected hospitals.

The same study can be conducted on larger samples for better generalization.

The similar study can be conducted with one group pre-test post-test.

The similar study could be replicated in different settings.

CONCLUSION:

Thus, music therapy is significantly effective on pre procedure selected physiological parameters (heart rate and respiration rate) among patients undergoing Angiography at selected hospitals of city.

ETHICAL CLEARANCE:

Obtained from the Ethical Clearance Committee of SCON college of Nursing, Narhe Pune.

CONFLICT OF INTEREST:

Nil.

REFERENCES:

1. American Music Therapy Association, About Music Therapy and AMTA. November 9, 2011.

2. American Heart Association. AHA Guidelines for Prevention of Cardiovascular Disease and Stroke (2014). Retrieved from website: https://my.americanheart.org.documents on 14.12.2014.

3. Black J.M. Medical-Surgical Nursing: Clinical Management for Positive Outcomes, 2-Volume Set, 8e

4. White JM A Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction. 3-group repeated measures experimental design was used [2008] available from https://www.ncbi.nlm.nih.gov/pubmed/10392221

5. Lieber AC, Bose J, (2018) Effects of music therapy on anxiety and physiologic parameters in angiography available from J Neurointerv Surg. 2019 Apr;11(4):416-423. doi: 10.1136/neurintsurg-2018-014313. Epub 2018 Nov 10.https://www.ncbi.nlm.nih.gov/pubmed/30415224

Received on 14.01.2023 Modified on 10.02.2023

A and V Pub J. of Nursing and Medical Res. 2023; 2(3):59-62.

DOI: 10.52711/jnmr.2023.15