Music for stress and anxiety reduction in coronary heart disease patients.
BACKGROUND
Individuals with coronary heart disease (CHD) often suffer from severe distress putting them at greater risk for complications. Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients, however its efficacy for CHD patients needs to be evaluated.


OBJECTIVE
To examine the effects of music interventions with standard care versus standard care alone on psychological and physiological responses in persons with CHD.


METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, PSYCINFO, LILACS, Science Citation Index, www.musictherapyworld.net, CAIRSS for Music, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, and the National Research Register (all to May 2008). We handsearched music therapy journals and reference lists, and contacted relevant experts to identify unpublished manuscripts. There was no language restriction.


METHODS
We included all randomized controlled trials that compared music interventions and standard care with standard care alone for persons with CHD.


METHODS
Data were extracted, and methodological quality was assessed, independently by the two reviewers. Additional information was sought from the trial researchers when necessary. Results are presented using weighted mean differences for outcomes measured by the same scale and standardized mean differences for outcomes measured by different scales. Posttest scores were used. In cases of significant baseline difference, we used change scores.


RESULTS
Twenty-three trials (1461 participants) were included. Music listening was the main intervention used, and 21 of the studies did not include a trained music therapist.Results indicated that music listening has a moderate effect on anxiety in patients with CHD, however results were inconsistent across studies. This review did not find strong evidence for reduction of psychological distress. Findings indicated that listening to music reduces heart rate, respiratory rate and blood pressure. Studies that included two or more music sessions led to a small and consistent pain-reducing effect.No strong evidence was found for peripheral skin temperature. None of the studies considered hormone levels and only one study considered quality of life as an outcome variable.


CONCLUSIONS
Music listening may have a beneficial effect on blood pressure, heart rate, respiratory rate, anxiety, and pain in persons with CHD. However, the quality of the evidence is not strong and the clinical significance unclear.Most studies examined the effects of listening to pre-recorded music. More research is needed on the effects of music offered by a trained music therapist.
Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, Presser Hall, 2001 North 13 Street, Philadelphia, USA. jbradt@temple.edu
Joke
J
Bradt
Cheryl
C
Dileo
D001007:Anxiety / Q000628:therapy*; D001794:Blood Pressure / Q000502:physiology; D003327:Coronary Disease / Q000523:psychology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D009147:Music Therapy; D016032:Randomized Controlled Trials as Topic; D015656:Respiratory Mechanics / Q000502:physiology; D013315:Stress, Psychological / Q000628:therapy*