Published online Apr 29, 2020. doi: 10.5500/wjt.v10.i4.79
Peer-review started: December 2, 2019
First decision: February 20, 2020
Revised: March 9, 2020
Accepted: March 26, 2020
Article in press: March 26, 2020
Published online: April 29, 2020
Both end-stage renal disease and being wait-listed for a kidney transplant are anxiety-causing situations. Wait-listed patients usually require arteriovenous fistula surgery for dialysis access. This procedure is performed under local anesthesia. We investigated the effects of music on the anxiety, perceived pain and satisfaction levels of patients who underwent fistula surgery.
To investigate the effect of music therapy on anxiety levels and perceived pain of patients undergoing fistula surgery.
Patients who were on a waiting list for kidney transplants and scheduled for fistula surgery were randomized to control and music groups. The music group patients listened to music throughout the fistula surgery. The State-Trait Anxiety Inventory was performed to assess anxiety, additionally visual analog scale was used to evaluate perceived pain, willingness to repeat the procedure and patient satisfaction. Demographic features, comorbidities, surgical history, basic surgical data (location of fistula creation, duration of surgery, incision length) and intra-operative hemodynamic parameters were recorded by an investigator blinded to the study group. An additional trait anxiety assessment was performed following the surgery.
There was a total of 55 patients included in the study. However, 14 patients did not fulfill the criteria due to requirement of sedation during surgery or uncompleted questionnaires. The remaining 41 patients were included in the analysis. There were 26 males and 15 females. The control and music groups consisted of 20 and 21 patients, respectively. With regard to basic surgical and demographic data, there was no difference between the groups. Overall patient satisfaction was significantly higher and intra-operative heart rate and blood pressure were significantly lower in the music group (P < 0.05). Postoperative state anxiety levels were significantly lower in the music group.
Music therapy can be a complimentary treatment for patients undergoing fistula surgery. It can reduce anxiety and perceived pain, improve intraoperative hemodynamic parameters and enhance treatment satisfaction, thus may contribute to better compliance of the patients.
Core tip: Being successful in managing patients undergoing kidney transplantation goes beyond passing on best medical advice and performing operations with cutting edge technology. It requires building rapport and informing them about the procedures awaiting, like transplantation and arteriovenous fistula creation. However, having to go through these procedures may cause anxiety and feeling powerless. One of our important duty as a physician should be to keep our patients on task and help them manage their anxiety. This article conceptualizes music therapy as an effective tool to relieve patient anxiety during fistula creation surgery by providing randomized, single-blind clinical trial data.