音樂介入對早產兒生理指標的影響：系統性文獻回顧與統合分析

The Effects of Music Interventions on Physiological Indicators in Premature Infants: A Systematic Review and Meta-analysis

背景：許多文獻證實音樂能對神經傳導產生直接的影響，進而適當調節心率、呼吸和降低血壓等作用。本文旨在透過全面性、系統性文獻搜尋與研究成果整合，探討音樂介入對於早產兒生理指標之影響。方法：採系統性回顧法，關鍵字為：「早產（Premature Birth [MeSH]）」、「早產兒（Infant, Premature [MeSH]）」、「音樂（Music [MeSH]）」與「音樂治療（Music Therapy [MeSH]）」，搜尋Cochrane Library、Cumulative Index toNursing and Allied Health Literature（CINAHL）、Embase、PubMed、Web of Science與華藝線上圖書館等資料庫，文章出版日期至2016年12月的論文。運用“Cochrane Handbook for Systematic Reviews of Intervention-tool forassess the risk of bias＂評價研究品質，以RevMan 5.3統計軟體進行統合分析。結果：共納入8篇的研究進行統合分析，結果顯示音樂介入對早產兒生理指標的影響，心跳速率是唯一呈現顯著差異的生理指標（MD=-2.94, CI: -5.62~-0.27）。另二項指標呼吸速率（MD=-1.8, CI: -4.39~0.80）與血氧飽和濃度（MD=0.97, CI: -0.26~2.20）皆未呈現顯著差異。結論：音樂介入對早產兒的心率降低有顯著的效果，而在呼吸速率減少與血氧飽和濃度增加的效果雖然不顯著，仍可看出結果偏向於音樂介入的趨勢。但目前關於早產兒運用音樂介入的研究，由於音樂形式與種類的選擇差異很大，且執行時間長短不一，因此很難有一具體穩健的成果能加以推論，建議學者專家盡早建立臨床操作指引。

Background: Previous studies have revealed that music interventions can regulate heart rate, respiration and blood pressure through affecting nerve conduction. This study aimed to explore the effects of music interventions on physiological indicators in premature infants by conducting a comprehensive systematic review and meta-analysis. Methods: We searched literature systematically by using keywords: ”premature (Premature Birth [MeSH])”, “premature infant (Infant, Premature [MeSH])”, “music (Music [MeSH])” and “music therapy (Music Therapy [MeSH])” on electronic database, including Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed, Web of Science, and Airiti Library from their first available date until December 2016. We assessed the quality of studies using the Cochrane Handbook for Systematic Reviews of Intervention-tool for assessing the risk of bias. We also performed a meta-analysis using the RevMan 5.3 software. Results: A total of 8 studies were included in quantitative analyses. The results revealed significant effects favoring music interventions on premature infants’ heart rate (MD=-2.94, CI: -5.62~-0.27), but no significant effects on respiratory rate (MD=-1.8, CI: -4.39~0.80) and oxygen saturation (MD=0.97, CI: -0.26~2.20). Conclusion: Music interventions had a significant effect on heart rate reduction but not on respiratory rate reduction and oxygen saturation increase in premature infants. The effects of music interventions on physiologic indicators in premature infants remain inconclusive due to variations in the music type and duration employed in existing studies.