The Effect of Music Therapy on Perceived Pain, Mental Health, Vital Signs, and Medication Usage of Burn Patients Hospitalized in the Intensive Care Unit: A Randomized Controlled Feasibility Study Protocol

Abstract

Background: Burn patients experience major physiological and psychological stressors during treatment and rehabilitation, including elevated levels of pain, anxiety, stress, or depression. Music interventions inclusive of music therapy (MT) have been shown to improve such symptoms, but rigorous clinical trials investigating specific music therapy methods in adult burn patients are scarce.Methods: This is a single center Randomized Controlled Trial (RCT) protocol with two parallel arms. Participants are 81 adult burn patients admitted to the Intensive Care Unit (ICU) of the University Hospital Fundación Santa Fe de Bogotá in Colombia. The intervention consists of a Music Assisted Relaxation (MAR) protocol, a music therapy technique composed of entrained live music combined with a guided relaxation and/or the use of imagery. The effects of the MAR will be compared to a control group (treatment as usual) over a period of maximum 2 weeks or six interventions. The primary outcome measure is perceived background pain, as measured with a Visual Analog Scale (VAS) before and after each intervention. Secondary outcomes are anxiety and depression levels; vital signs; and the use of pain medication. Additionally, some patients in the intervention group will be invited to participate in electroencephalography, electromyography, and electrocardiography recordings during the MAR.Discussion: This study protocol follows the SPIRIT guidelines for defining items of clinical trials and is the first study in Colombia to evaluate the effects of music therapy for adult burn patients. With this RCT it is hoped to gather new knowledge about the potential of music therapy to help critical care patients cope and recover from their injuries during the hospitalization in the ICU.Trial registration:www.clinicaltrials.gov, Identifier: NCT04571255.Protocol version: V1.0, May 24th 2021

The Effect of Music as a Non-Pharmacological Intervention on the Physiological, Psychological, and Social Response of Patients in an Intensive Care Unit

“…"Therapeutic music listening should not be confused with music therapy". The first form of music used in the form of music therapy can only be conducted by a certified music therapist, while therapeutic music listening is conducted by nurses, among others, through patients listening to music on headphones or volunteers playing live music [21]. Golino et al, 2019, in their publication, present a juxtaposition of the terms music therapy and music listening [3].…”

“…The authors also found that playing music to patients from a player is far less expensive than using individual headsets for each patient [29,33]. [21,23,24], as well as reduce sleep disturbances [21,25] and have a relaxing effect and regulate breathing [22]. Studies by Dallı et al, Browning et al, and Jawaharani et al emphasize that music therapy reduces the incidence of delirium [25,29,30], and Yekefallah et al pointed out that it can improve cognitive function [32]; in addition, it can result in reduced costs of drug treatment [26].…”

Underlying Music Mechanisms Influencing the Neurology of Pain: An Integrative Model

“…Areas of study in music therapy for pain in adults occur most frequently in palliative care and in debridement [ 33 , 34 , 35 ]. Surprisingly, it is common for studies to leave out patient culture in the assessment of how to treat pain.…”

Mechanistic research approaches in music therapy for pain: Humanizing and contextualized options for clinician-researchers

“…Approaches permitting treatment individualization within a standard protocol are perhaps highest in the medical EBP hierarchy. Few such studies involve music therapy targeting pain in individuals, though these do not report outcomes on pain measures ( 19 , 20 ) or the results are not yet published ( 21 ). Examples in other contexts include clinical improvisation for depression ( 22 , 23 ) and autism ( 24 ) and customized songs for pre-term infants and their caregivers ( 25 ).…”