title: Low degree of formal education and musical experience predict degree of music-induced stress reduction in relatives and friends of patients: a single-center, randomized controlled trial.
abstract: OBJECTIVE
  To determine the factors that may predict music-induced relaxation in friends and family of patients in the emergency department.
  
  
  BACKGROUND
  It remains unclear to date which demographic and experiential factors predict the effectiveness of music-induced relaxation. Furthermore, in-hospital stressors for friends and family of patients rather than patients themselves are underresearched and deserve in-depth investigation to improve this group's experience in health care environments.
  
  
  METHODS
  A total of 169 relatives and friends of patients in the emergency department-waiting area completed a series of questionnaires, including the Spielberger State-Trait Anxiety Inventory (STAI), the Music Experience Questionnaire (MEQ), and a demographic survey. They were then randomly assigned to either Case Group (1 hour in the waiting area with classical music in the background) or Control Group (1 hour with no music) before completing a second, identical copy of the STAI to measure change from baseline. Data were analyzed for associations between music intervention, change in STAI scores, MEQ scores, and demographic characteristics.
  
  
  RESULTS
  Participants who underwent the music intervention experienced a 9.8% decrease in overall mean State Anxiety, whereas those in the Control Group experienced no change over time (P = 0.001). Higher education significantly inversely correlated with the effectiveness of music intervention: participants with no formal education beyond high school showed a greater overall mean decrease in State Anxiety than those with a college education or beyond in response to classical music (P = 0.006). Furthermore, MEQ scores indicated that the Social Uplift scale (a measure of one's tendency to be uplifted in a group-oriented manner by music) was highly predictive of the effectiveness of music intervention.
  
  
  CONCLUSIONS
  Music is an effective and inexpensive means of reducing anxiety in friends and family of patients, who are underresearched in medicine. Moreover, low educational attainment and tendency to respond positively to music in a group setting can predict the effectiveness of music-induced relaxation.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, MA 021114, USA.
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: Tilt
authors.forename: Paul D
authors.initials: PD
authors.lastname: Werner
authors.forename: David F
authors.initials: DF
authors.lastname: Brown
authors.forename: Hassan B
authors.initials: HB
authors.lastname: Alam
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Warshaw
authors.forename: Blair A
authors.initials: BA
authors.lastname: Parry
authors.forename: Brigita
authors.initials: B
authors.lastname: Jazbar
authors.forename: Abigail
authors.initials: A
authors.lastname: Booker
authors.forename: Lars
authors.initials: L
authors.lastname: Stangenberg
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Fricchione
authors.forename: Herbert
authors.initials: H
authors.lastname: Benson
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lillemoe
authors.forename: Claudius
authors.initials: C
authors.lastname: Conrad
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D004311:Double-Blind Method; D004522:Educational Status; D004636:Emergency Service, Hospital; D005190:Family / Q000523:psychology*; D005260:Female; D033062:Friends / Q000523:psychology*; D006801:Humans; D008297:Male; D009147:Music Therapy / Q000379:methods; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome