Music intervention to prevent delirium among older patients admitted to a trauma intensive care unit and a trauma orthopaedic unit

Kari Johnson, Julie Fleury, Darya McClain

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Purpose: Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli. Methods: Randomised controlled trial, 40 patients aged 55 and older. Intervention: Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses. Outcomes: Heart rate, respiratory rate, systolic and diastolic blood pressure, confusion assessment method. Results: Repeated measures ANOVA, F(4, 134) = 4.75, p =.001, suggested statistically significant differences in heart rate pre/post music listening, and F(1, 37) = 10.44, p =.003 in systolic blood pressure pre/post music listening. Post-hoc analysis reported changes at three time periods of statistical significance; (p =.010), (p =.005) and (p =.039) and a change in systolic blood pressure pre/post music listening; (p =.001) of statistical significance. All participants screened negative for delirium. Conclusion: Music addresses pathophysiologic mechanisms that contribute to delirium; neurotransmitter imbalance, inflammation and acute physiologic stressors. Music to prevent delirium is one of few that provide support in a critical care setting.

Original languageEnglish (US)
JournalIntensive and Critical Care Nursing
DOIs
StateAccepted/In press - Jan 1 2018

Keywords

  • Delirium
  • Diastolic pressure
  • Heart rate
  • Music listening
  • Neuroscience of music
  • Non-pharmacologic approach
  • Pharmacologic approach
  • Roy Adaptation Model
  • Systolic blood pressure

ASJC Scopus subject areas

  • Critical Care

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