title: The impact of listening to pleasant natural sounds on anxiety and physiologic parameters in patients undergoing coronary angiography: A pragmatic quasi-randomized-controlled trial.
abstract: OBJECTIVE
  This study aimed to investigate the impact of listening to pleasant natural sounds on anxiety and physiological parameters in patients undergoing coronary angiography.
  
  
  METHODS
  The present pragmatic quasi-randomized controlled clinical trial was conducted on 130 patients undergone elective angiography. The participants were randomly divided into two groups, including a pleasant natural sounds group, and a control group (n1/2 65 per group). Spielberger's state/trait anxiety inventory was used to assess levels of anxiety. The patients' anxiety level and physiological parameters were measured at baseline, before, during, immediately after, and 20 min after coronary angiography.
  
  
  RESULTS
  The mean level of anxiety was similar in both arms at baseline (t = 1.317, df = 128, p = 0.190). The intervention arm displayed significantly lower anxiety levels than the control arm during the intervention (Wilks' lambda 0.11, Pillai's trace 0.89, P 0.001, F 2.05). The physiological parameters (systolic and diastolic blood pressure, mean arterial pressure, heart rate, and oxygen saturation) of both groups showed statistically significant differences (p < 0.05) over time and in group-by time interactions.
  
  
  CONCLUSIONS
  As an effective nursing intervention presenting no side-effects, listening to pleasant natural sounds can be helpful in the management of anxiety.
authors.affiliation: Elderly Care Research Center, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran. Electronic address: reje@shahed.ac.ir.
authors.forename: Nahid
authors.initials: N
authors.lastname: Rejeh
authors.affiliation: Elderly Care Research Center, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran. Electronic address: heraev@shahed.ac.ir.
authors.forename: Majideh
authors.initials: M
authors.lastname: Heravi-Karimooi
authors.affiliation: Faculty of Nursing, Baqiyatallah University of Medical Science, Tehran, Iran. Electronic address: sdt1344@hotmail.com.
authors.forename: Seyed Davood
authors.initials: SD
authors.lastname: Tadrisi
authors.affiliation: Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran. Electronic address: Jahni@gmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Jahani
authors.affiliation: Faculty of Professional Studies, Nord University, Bodø, Norway. Electronic address: mojtaba.vaismoradi@nord.no.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Vaismoradi
authors.affiliation: College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, United Kingdom. Electronic address: s.e.jordan@swansea.ac.uk.
authors.forename: Sue
authors.initials: S
authors.lastname: Jordan
mesh_terms: D000368:Aged; D001007:Anxiety / Q000628:therapy*; D001794:Blood Pressure / Q000502:physiology; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009147:Music Therapy; D013315:Stress, Psychological / Q000628:therapy*
keywords: Anxiety; Coronary angiography; Music therapy; Physiologic parameters