Limited Impact of Music Therapy on Patient Anxiety with the Large Loop Excision of Transformation Zone Procedure - a Randomized Controlled Trial

  • Kongsawatvorakul, Chompunoot (Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University) ;
  • Charakorn, Chuenkamon (Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University) ;
  • Paiwattananupant, Krissada (Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University) ;
  • Lekskul, Navamol (Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University) ;
  • Rattanasiri, Sasivimol (Department of Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University) ;
  • Lertkhachonsuk, Arb-Aroon (Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University)
  • 발행 : 2016.06.01

초록

Background: Many studies have pointed to strategies to cope with patient anxiety in colposcopy. Evidence shows that patients experienced considerable distress with the large loop excision of transformation zone (LLETZ) procedure and suitable interventions should be introduced to reduce anxiety. This study aimed to investigate the effects of music therapy in patients undergoing LLETZ. Materials and Methods: A randomized controlled trial was conducted with patients undergoing LLETZ performed under local anesthesia in an out patient setting at Ramathibodi Hospital, Bangkok, Thailand, from February 2015 to January 2016. After informed consent and demographic data were obtained, we assessed the anxiety level using State Anxiety Inventory pre and post procedures. Music group patients listened to classical songs through headphones, while the control group received the standard care. Pain score was evaluated with a visual analog scale (VAS). Statistical analysis was conducted using Pearson Chi-square, Fisher's Exact test and T-Test and p-values less than 0.05 were considered statistically significant. Results: A total of 73 patients were enrolled and randomized, resulting in 36 women in the music group and 37 women in the non-music control group. The preoperative mean anxiety score was higher in the music group (46.8 VS 45.8 points). The postoperative mean anxiety scores in the music and the non-music groups were 38.7 and 41.3 points, respectively. VAS was lower in music group (2.55 VS 3.33). The percent change of anxiety was greater in the music group, although there was no significant difference between two groups. Conclusions: Music therapy did not significantly reduce anxiety in patients undergoing the LLETZ procedure. However, different interventions should be developed to ease the patients' apprehension during this procedure.

키워드

참고문헌

  1. Bosgraaf RP, de Jager WC, Servaes P, et al (2013). Qualitative insights into the psychological stress before and during colposcopy: a focus group study. J Psychosom Obstet Gynaecol, 34, 150-6. https://doi.org/10.3109/0167482X.2013.849688
  2. Burns JL, Labbe E, Arke B, et al (2002). The effects of different types of music on perceived and physiological measures of stress. J Music Ther, 39, 101-6. https://doi.org/10.1093/jmt/39.2.101
  3. Carwile JL, Feldman S, Johnson NR (2014). Use of a simple visual distraction to reduce pain and anxiety in patients undergoing colposcopy. J Low Genit Tract Dis, 18, 317-21. https://doi.org/10.1097/LGT.0000000000000024
  4. Chan YM, Lee PW, Ng TY, et al (2003). The use of music to reduce anxiety for patients undergoing colposcopy: a randomized trial. Gynecol Oncol, 91, 213-7. https://doi.org/10.1016/S0090-8258(03)00412-8
  5. Dalton M, Dangel A, Strohsnitter W, et al (2014). The impact of gentle language on pain perception during colposcopy: a randomized controlled trial. J Low Genit Tract Dis, 18, 314-6. https://doi.org/10.1097/LGT.0000000000000013
  6. Danhauer SC, Marler B, Rutherford CA, et al (2007). Music or guided imagery for women undergoing colposcopy: a randomized controlled study of effects on anxiety, perceived pain, and patient satisfaction. J Low Genit Tract Dis, 11, 39-45. https://doi.org/10.1097/01.lgt.0000230206.50495.4c
  7. Galaal K, Bryant A, Deane KH, et al (2011). Interventions for reducing anxiety in women undergoing colposcopy. Cochrane Database Syst Rev, 12, 6013.
  8. Heinonen A, Tapper A, Leminen A, et al (2013). Health-related quality of life and perception of anxiety in women with abnormal cervical cytology referred for colposcopy: an observational study. Eur J Obstet Gynecol Reprod Biol, 169, 387-91. https://doi.org/10.1016/j.ejogrb.2013.03.033
  9. Idestrom M, Milsom I, Andersson-Ellstrom A (2003). Women's experience of coping with a positive Pap smear: A registerbased study of women with two consecutive Pap smears reported as CIN 1. Acta Obstet Gynecol Scand, 82, 756-61. https://doi.org/10.1034/j.1600-0412.2003.00165.x
  10. Jerachotechueantaveechai T, Charoenkwan K, Wongpakaran N (2015). Prevalence and predicting factors for anxiety in thai women with abnormal cervical cytology undergoing colposcopy. Asian Pac J Cancer Prev, 16, 1427-30. https://doi.org/10.7314/APJCP.2015.16.4.1427
  11. Kola S, Walsh JC (2009). Patients' psychological reactions to colposcopy and LLETZ treatment for cervical intraepithelial neoplasia. Eur J Obstet Gynecol Reprod Biol, 146, 96-9. https://doi.org/10.1016/j.ejogrb.2009.05.005
  12. Kola-Palmer S, Walsh JC, Rogers M (2016). Patients' perceptions of colposcopy pain. Eur J Cancer Care (Engl), 25, 49-56. https://doi.org/10.1111/ecc.12343
  13. Labbe E, Schmidt N, Babin J, et al (2007). Coping with stress: the effectiveness of different types of music. Appl Psychophysiol Biofeedback, 32, 163-8. https://doi.org/10.1007/s10484-007-9043-9
  14. Mao C (2002). Teaching residents humanistic skills in a colposcopy clinic. Acad Med, 77, 742.
  15. Marteau TM, Kidd J, Cuddeford L, et al (1996). Reducing anxiety in women referred for colposcopy using an information booklet. Br J Health Psychol, 1, 181-9 https://doi.org/10.1111/j.2044-8287.1996.tb00501.x
  16. McDonald TW, Neutens JJ, Fischer LM, et al (1989). Impact of cervical intraepithelial neoplasia diagnosis and treatment on self-esteem and body image. Gynecol Oncol, 34, 345-9. https://doi.org/10.1016/0090-8258(89)90170-4
  17. O'Connor M, Waller J, Gallagher P, et al (2015). Understanding women's differing experiences of distress after colposcopy: a qualitative interview study. Womens Health Issues, 25, 528-34. https://doi.org/10.1016/j.whi.2015.05.009
  18. Phahuwatanakorn W (2004), The relationship between social support, maternal employment, postpartum anxiety, and maternal role competencies in Thai primiparous mothers, PhD thesis. Washington, DC: The Catholic University of America.
  19. Ratanasiripong P (2012), Mental health of muslim nursing students in Thailand. International Scholarly Research Network - Nursing, 2012, 463471
  20. Spielberger C, Gorsuch R, Lushene R (1970). Manual for state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologist Press.
  21. Tanriverdi O, Aydemir NF (2013). Perspectives of medical oncologists regarding music therapy for patients with cancer in Turkey - can musicology be integrated into psychooncology? Asian Pac J Cancer Prev, 14, 6537-40. https://doi.org/10.7314/APJCP.2013.14.11.6537
  22. Wang MC, Zhang L, Y.Zhang YL, et al (2014). Effect of music in endoscopy procedures: systematic review and meta-analysis of randomized controlled trials. Pain Med, 15, 1786-94. https://doi.org/10.1111/pme.12514
  23. Wilkinson C, Jones J, M.McBride J (1990). Anxiety caused by abnormal result of cervical smear test: a controlled trial. BMJ, 300, 440. https://doi.org/10.1136/bmj.300.6722.440