音樂聆聽對燒傷病人換藥疼痛與焦慮之成效―南部某醫學中心燒傷加護病房

Effects of music therapy during wound care on pain and anxiety in burn patients: A single-centered study in Southern Taiwan

背景及目的：燒傷病人每天換藥過程，身體與心理承受了極大的痛楚，而這些不適可能會影響生理及心理層面之負向感受，此研究為探討音樂治療對燒傷病人換藥前後之疼痛與焦慮變化。材料及方法：採類實驗設計法，於病人入院時，隨機分配將燒傷病人分為實驗組及控制組，並於入院後第4天進行音樂治療計畫，實驗組換藥前後提供音樂治療，控制組病人接受一般常規措施。共收集20位燒傷病人換藥前、後之生命徵象、疼痛、焦慮資料，以單因子變異數分析、t檢定及無母數分析比較音樂治療措施之成效。結果：音樂治療措施介入後，有效降低燒傷病人換藥疼痛分數2.43分（p<0.01）及焦慮分數15.1分（p<0.05）。實驗組之脈搏、呼吸、疼痛改善均高於控制組，脈搏p=0.02，呼吸次數p=0.04，疼痛分數p=0.00，顯示音樂治療可緩解燒傷病人換藥疼痛、焦慮不適之感受。結論：音樂治療可減少燒傷換藥過程疼痛、焦慮之感受，臨床可推廣音樂療法並彰顯護理師獨特性及人性化關懷之照護。

Background and purpose: During wound care, burn patients feel considerable physical andpsychological discomfort. This study explored the effects of music therapy during dressing changeon pain and anxiety in burn patients.Materials and Methods: A quasiexperimental design was used; 20 burn patients wererandomly assigned to either the experimental or the control group (n=10 per group). Theexperimental group received music therapy during dressing change, but the control group receivedonly routine care. Vital signs and pain and anxiety perception scale scores were collected beforeand after dressing change. One-way analysis of variance, the t test, and nonparametric analysiswere used for data analysis.Results: Music therapy significantly reduced pain and anxiety scores by 2.43 (p<0.01) and15.1 (p<0.05) points, respectively; moreover, the experimental group demonstrated significantlyimproved pulse, respiratory, and pain relief outcomes than did the control group (p=0.02, 0.04,and 0.00, respectively).Conclusion: Music therapy during dressing change effectively relieved pain and anxiety inburn patients. This modality thus may promote the uniqueness and humanistic nursing care ofburn patients.