Friday, November 2, 2007

Research: Chapter 3: The Effect of Preferred Sedative Music on the Anxiety of Patients During Pacemaker Implant Surgery and Heart Catheterization

Chapter III

Methods and Procedures


Twenty-two patients ranging in age from 44 to 88 years were selected from patients admitted for pacemaker implant surgery or heart catheterization to one mid-sized hospital in the southwestern United States. The researcher alternately assigned subjects to the control group or experimental group in a sequential manner as they were admitted to the hospital. There were 11 subjects in the control group whose ages ranged from 56 years to 88 years, with a mean age of 70.2 years. There were 11 subjects in the experimental group whose ages ranged from 44 years to 77 years, with a mean age of 62.8 years. All subjects were told that they might listen to sedative music during surgery if they chose to participate in the study, although, the patients were unaware of their assigned group. Informed consent was obtained from the patients prior to the experiment (see Appendix A).


Necessary equipment included medical apparatus for the pacemaker implant or heart catheterization. Other equipment included a portable auto-reverse tape player, stereo headphones, a questionnaire and a clipboard.


The researcher measured the dependent variable of state anxiety through interview format with the State-Trait Anxiety Inventory (STAI) developed by Spielberger (1983). The STAI has high reliability as indicated in test-retest scores for samples of working adults, students and military recruits under stressful conditions. Alpha coefficients for these populations ranged from .92 to .94 which indicated very high reliability for the instrument. The STAI also provides evidence of high construct and concurrent validity in tests using military recruits and college students (Spielberger, 1977).


Recordings consisted of sedative classical, new-age, and easy-listening adult music. Sedative music was defined as music that had a constant underlying rhythm, a tempo between 60 and 80 beats per minute, a repeating melodic pattern, and little or no change in dynamics, articulation, or tempo.


Twenty-two male subjects between the ages of 44 and 88 years were alternately assigned to one of two groups as they were admitted for pacemaker implant surgery or heart catheterization, (a) an experimental group that listened to music during surgery, and (b) a control group that listened to only whatever naturally occurred in the operating room environment. The researcher obtained consent from each patient prior to the procedures.

The researcher met with each patient in the patient’s room or in the preoperative holding area. Experimental subjects were told that they may choose to listen to one of several different types of music during surgery. After verbally offering the choices, the researcher asked the patient to choose one type of music. The researcher placed the headphones that would be used in the experiment on the patient and began playing the selected style of music.

The researcher told all patients that they were going to practice listening to the music like they would do in the operating room. The researcher instructed the patient to begin taking slow and relaxed breaths. The researcher told the patients to think about the music as they took in each breath and to think of the tension flowing out of their bodies as they exhaled. The researcher allowed each patient to practice this protocol for approximately one minute. Patients in the control group were left to the medical staff after consent was obtained.

Patients were taken from their rooms to either the operating room holding area or directly to the operating room. After the patient had arrived at one of these locations, the researcher asked the patient to answer the STAI questions. The researcher asked each question verbally and recorded the subject’s responses on a form. This took approximately five minutes for each subject. Control subjects were left in the care of the medical staff after answering the STAI questions. Patients in both groups were told that they would be asked to answer several more questions immediately after the surgery.

The music for the experimental group began after the patients were lying immobile on the operating table. The headphones were placed flush against each patient’s head. The tape player was secured by double sided foam tape to the table next to the patient’s pillow. The researcher set the loudness of the music to a level comfortable for the patient so that the patient could still hear the researcher and the medical staff when they spoke to him. The researcher asked all of the patients to answer the STAI questions immediately after all of the post-operative nursing protocols were completed in the operating room.

Data Analysis

Individual scores from the STAI pre and post test were recorded for each patient in the control and experimental groups. The change in scores between pre and post tests for the control group were compared to the change in scores for the experimental group using a one-way ANOVA test for two groups.

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