音樂治療緩解呼吸器使用患者焦慮之心理及生理反應成效

The Effectiveness of Music Therapy in Reducing Physiological and Psychological Anxiety in Mechanically Ventilated Patients

焦慮是病患於接受呼吸器治療中常見的反應，但焦慮對病患的疾病復原，具相當負向的影響。音樂治療為非侵入性的措施，極易被病患所接受，國外已廣泛運用於住院病患的焦慮緩解，效果頗受肯定。本研究之目的是探討音樂治療對於使用呼吸器病患緩解生心理焦慮之成效，以實驗性研究設計，於南部某醫學中心進行收案。實驗組病患接受一次30分鐘的音樂治療，而控制組則予30分鐘休息。研究工具包括簡式焦慮量表及視覺焦慮量表，並以非侵入性的生理儀器監測血壓、心跳、呼吸、血氧濃度及指溫。本研究結果顯示，音樂治療能顯著改善病患焦慮感受（簡式焦慮量表, t29 = -4.80, p < .001；視覺焦慮量表, t29 = -3.38, p = .002）、舒張壓（t29 = -2.74, p = .010）、平均動脈壓（t29 = -2.26, p = .031）及呼吸（t29 = -4.84, p < .001）。比較兩組改變量之結果，實驗組病患接受音樂治療處置後，焦慮感受（簡式焦慮量表, t58 = -3.21, p = .002；視覺焦慮量表, t58 = -2.90, p = .005），及呼吸（t58 = -3.20, p = .002）能顯著下降。本研究結果，可提供臨床護理人員運用音樂治療的方式緩解病患焦慮之參考，以達到人性化護理之目標。

Anxiety, a common reaction in patients receiving ventilation therapy, often impacts negatively on patient recovery. Music therapy, a non-invasion intervention, is readily accepted by patients and has been used to relieve patient anxiety with encouraging results. The purpose of this study was to investigate the effectiveness of music therapy on reducing anxiety in patients on mechanical ventilators. An experimental design was used and all cases were collected from a medical center in southern Taiwan. While the experimental group patients took a 30-minute music therapy session, control group patients were asked to rest. Both facility anxiety and anxiety visual scales were used as research tools, with other non-invasive medical instruments employed to measure heartbeat and breathing, blood pressure and blood oxygen saturation in both patient groups. When compared with the control group, patients in the experimental group showed significant improvement in sense of anxiety (Brief Anxiety Scale, BAS, t29 = -4.80, p < .001; Visual Analogue Anxiety Scales, VAAS, t29 = -3.38, p = .002), diastolic pressure (t29 = -2.74, p = .002), mean arterial pressure(t29 = -2.26, p = .031) and breathing rate (t29 = -4.84, p < .001). In analyzing data from the two groups, we found that the sense of anxiety (BAS, t58 = -3.21, p = .002; VAAS, t58 = -2.90, p = .005) and breathing rate (t58 = -3.20, p = .002) in the experimental group decreased significantly following music therapy. Study results are hoped to serve as an important reference for clinical nursing staff. Also, it is hoped that the music therapy method may help facilitate achievement of broader humanized nursing goals.