Eckhouse, D.R., Hurd, M., Cotter-Schaufele, S., Sulo, S., Sokolowski, M., & Barbour, L. (2014). A randomized controlled trial to determine the effects of music and relaxation interventions on perceived anxiety in hospitalized patients receiving orthopaedic or cancer treatment. Orthopaedic Nursing, 33, 342–351. 

To explore effects of music and relaxation interventions on anxiety among patients with cancer and orthopedic interventions

Patients were randomly assigned to the music group, relaxation group or usual care control. Participants in the music group listened to a 20 minute CD of music composed by the hospital’s music therapist. The CD used harp and vocal music with spoken relaxation instructions. Patients in the relaxation group listened to and viewed a music video for 20 minutes that featured nature scenes and instrumental music. The control group were allowed 20 minutes of unstructured free time and were not allowed to listen to music during that time. The intervention was provided once during the first 48 hours of hospital admission. Study data were obtained immediately before and after the intervention.

• N = 112
• MEAN AGE = 60.6 years (range = 24-87 years)
• MALES: 37%, FEMALES:  63%
• KEY DISEASE CHARACTERISTICS: 49% were patients with cancer
• OTHER KEY SAMPLE CHARACTERISTICS: 59% were receiving anti-anxiety medications

• SITE: Single site  
• SETTING TYPE: Inpatient  
• LOCATION: Illinois

• PHASE OF CARE: Active antitumor treatment

• Randomized, controlled trial

• Spielberger State Trait Anxiety scale
• Blood pressure and heart rate

Although there were some differences among groups in single items on the anxiety measurement tool, there were no differences across groups for total anxiety scores. Anxiety scores declined in all on average (p < 0.001)

Results did not show effectiveness of the music and relaxation interventions used here, although anxiety did decline somewhat more in both intervention groups.

• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Unintended interventions or applicable interventions not described that would influence results
• Other limitations/explanation: Interventions were delivered via the hospital TV system, so could only be viewed at certain times. There is no description of the reason for hospitalization, so the degree to which some patients may have been in more anxiety-producing situations is unknown. There was no subgroup analysis to account for the potential impact of anti-anxiety drugs administered.

This study did not provide strong evidence supporting effectiveness of music and relaxation interventions for anxiety among the hospitalized patients involved. At the same time, there have been some studies showing benefits of music for various symptoms, and although not significant, this study did show greater reduction in anxiety with the intervention. This type of intervention is low risk and low cost, and may be beneficial to some patients. Here, the intervention was provided via the hospital television system, which can provide a very practical approach to delivery of the intervention.