Published online May 16, 2017. doi: 10.4253/wjge.v9.i5.228
Peer-review started: December 26, 2016
First decision: February 4, 2017
Revised: February 24, 2017
Accepted: March 23, 2017
Article in press: March 24, 2017
Published online: May 16, 2017
To investigate the role of music in reducing anxiety and discomfort during flexible sigmoidoscopy.
A systematic review of all comparative studies up to November 2016, without language restriction that were identified from MEDLINE and the Cochrane Controlled Trials Register (1960-2016), and EMBASE (1991-2016). Further searches were performed using the bibliographies of articles and abstracts from major conferences such as the ESCP, NCRI, ASGBI and ASCRS. MeSH and text word terms used included “sigmoidoscopy”, “music” and “endoscopy” and “anxiety”. All comparative studies reporting on the effect of music on anxiety or pain during flexible sigmoidoscopy, in adults, were included. Outcome data was extracted by 2 authors independently using outcome measures defined a priori. Quality assessment was performed.
A total of 4 articles published between 1994 and 2010, fulfilled the selection criteria. Data were extracted and analysed using OpenMetaAnalyst. Patients who listened to music during their flexible sigmoidoscopy had less anxiety compared to control groups [Random effects; SMD: 0.851 (0.467, 1.235), S.E = 0.196, P < 0.001]. There was no statistically significant heterogeneity (Q = 0.085, df = 1, P = 0.77, I2 = 0). Patients who listened to music during their flexible sigmoidoscopy had less pain compared to those who did not, but this difference did not reach statistical significance [Random effects; SMD: 0.345 (-0.014, 0.705), S.E = 0.183, P = 0.06]. Patients who listened to music during their flexible sigmoidoscopy felt it was a useful intervention, compared to those who did not (P < 0.001). There was no statistically significant heterogeneity (P = 0.528, I2 = 0).
Music appeared to benefit patients undergoing flexible sigmoidoscopies in relation to anxiety and was deemed a helpful intervention. Pain may also be reduced however further investigation is required to ascertain this.
Core tip: The use of flexible sigmoidoscopy is becoming more prevalent particularly in the context of bowel cancer screening; however uptake remains low and patients are often anxious when attending about discomfort and embarrassment. We conduct a systematic review and meta-analysis of studies investigating the role of music in reducing anxiety and discomfort in patients undergoing screening flexible sigmoidoscopy. In our review, music reduced anxiety and was deemed a helpful intervention by the patients. It may also reduce discomfort but further studies are required to confirm this. Music may potentially improve patient experience and have a positive effect on the test uptake.