Purpose To investigate the effect of live and recorded perioperative music therapy on anesthesia requirements, anxiety levels, recovery time, and patient satisfaction in women experiencing surgery for diagnosis or treatment of breast cancer. Patients and Methods Between 2012 and 2014, 207 female patients undergoing surgery for potential or known breast cancer were randomly assigned to receive either patient-selected live music (LM) preoperatively with therapist-selected recorded music intraoperatively (n = 69), patient-selected recorded music (RM) preoperatively with therapist-selected recorded music intraoperatively (n = 70), or usual care (UC) preoperatively with noise-blocking earmuffs intraoperatively (n = 68). Results The LM and the RM groups did not differ significantly from the UC group in the amount of propofol required to reach moderate sedation. Compared with the UC group, both the LM and the RM groups had greater reductions (P < .001) in anxiety scores preoperatively (mean changes [and standard deviation: −30.9 [36.3], −26.8 [29.3], and 0.0 [22.7]), respectively. The LM and RM groups did not differ from the UC group with respect to recovery time; however, the LM group had a shorter recovery time compared with the RM group (a difference of 12.4 minutes; 95% CI, 2.2 to 22.5; P = .018). Satisfaction scores for the LM and RM groups did not differ from those of the UC group. Conclusion Including music therapy as a complementary modality with cancer surgery may help manage preoperative anxiety in a way that is safe, effective, time-efficient, and enjoyable.

We all write excellent consent forms to be presented to prospective participants in clinical research studies. That is, we think that they are excellent. But many times consent forms are written from our jaded perspective and contain terms of clinical research jargon, common to us, but foreign to a participant. These terms slip through unnoticed because of their familiarity in our everyday language. In a recent study 1 a computer analysis (Flesh-Fry scoring) 2-4 of 71 consent forms at a midwest university showed that a mean U.S. school grade for 70 percent comprehension was about 15. In simple terms this means that you would have had to complete your junior year in college to understand 70 percent of the language in the consent forms, which implies about 37 percent of the U.S. adult population could read them. Similar analyses were done with columns of Ann Landers, articles from Reader's Digest, and columns from the New Yorker. Analysis of Ann Landers columns showed readability by a median seventh grader and by 75 percent of the U.S. adult population. Reader's Digest articles yielded data showing a readability by a 10th grader or about 60 percent. Lastly, analysis of the New Yorker columns revealed they were readable by only about 43 percent of the U.S. population. In short, these three widely published columns and articles all were more easily read than the analyzed consent forms. It was the authors' opinion that in their case IRB review did little to improve readability. In the above study 64 of the 71 consent forms received final IRB approval. Eighty percent of the forms were revised according to the IRBs' wishes. No forms improved by more than a grade reading level and eight of the forms actually worsened. Prior studies have also shown that most consent forms are not readable by the general population. 5-9 In our IRB meetings we often question some of the terms that appear in the text. The clinical research jargon runs rampant in many cases and would appear to confuse the lay reader. In an effort to answer some of these questions we designed a questionnaire to quiz a cross-section of the population on their understanding of many of these terms. In the spring and summer of 1992 the survey was conducted in person by the interviewer on an individual basis. Many of the answers were predictable. Some were surprising! The questionnaire was on standard 81/2 x 11 plain bond with demographic information on top of the first page, such as gender, place of interview, occupation, and maximum educational level.

Collaboration between perioperative nurses and music therapists can be beneficial in providing a safe, cost-effective means of managing patients' anxiety and pain and reducing the need for pharmacologic intervention in the perioperative setting. The use of a board-certified music therapist may help to improve patient outcomes, ease nurse workload, and serve as an adjunct therapeutic modality that is enjoyable for both patients and staff members. We conducted a two-year, randomized controlled trial to determine how to best implement a music therapy program, navigate its challenges, and collaborate with nurse colleagues to bring its benefits to surgical patients. This article offers suggestions for alliances between perioperative nursing and music therapy staff members and describes the potential of music therapists to help provide optimal patient care.