音樂治療對膽結石病人膽囊切除術後疼痛緩解之成效

Effects of Music Therapy on Pain Relief Following Cholecystectomy

楊淑溫(Shu-Wen Yang) ； 周少鈞(Shao-Jiun Chou) ； 陳梓泓(Tzu-Hung Chen) ； 鍾玉珠(Yu-Chu Chung) ； 劉介宇(Chieh-Yu Liu) ； 王雅蕙(Ya-Hui Wang)

《北市醫學雜誌》 Volume 18 Issue 1 (2021/03) Pp. 52-64

https://doi.org/10.6200/TCMJ.202103_18(1).0006

Abstracts

目的：本研究旨在探討音樂治療對膽結石患者接受腹腔鏡膽囊切除手術後24小時內疼痛緩解之成效。方法：採隨機對照研究設計，以台灣北部某區域教學醫院膽結石患者接受腹腔鏡膽囊切除手術患者為研究對象，隨機分派至實驗組與控制組，實驗組接受術後常規照護合併音樂治療介入方案；控制組接受術後常規照護。符合收案條件之受試者在隨機分派之後，使用視覺疼痛量表及簡易版麥克吉爾疼痛量表（Short Form McGill Pain Questionnaire；簡稱SF-MPQ）在術後24小時內進行前測及後測疼痛測量，同時收集止痛藥物使用情形。資料分析採用一般線型模型（General Linear Model, GLM），並考慮統計顯著之交互作用項，進行Johnson-Neyman演算法分析。結果：本研究共計收案89人，實驗組46人、對照組43人，男性48人（54%）、女性41人（46%）。採用一般線型模型進行分析，在控制了年齡、性別、SF-MPQ之前測分數、住院日數以及過去手術次數後，組別與SP-MPQ前測交互作用項呈現統計顯著，進一步採用Johnson-Neyman演算法，得到在前測分數超過8.719分後，前測SF-MPQ每增加一分，音樂治療組比控治組在SP-MPQ疼痛後測分數顯著低0.249分（p = 0.046）。結論：本研究顯示膽結石患者行腹腔鏡膽囊切除術後合併使用常規照護及音樂治療能達到良好的術後24小時疼痛緩解效果。建議未來臨床護理人員可以學習音樂治療之技巧，並且考慮合併術後照護，將可有助於接受外科手術病患術後疼痛之緩解。

Keywords

音樂治療 ； 膽結石 ； 腹腔鏡膽囊切除術 ； 疼痛

Parallel abstracts

Objectives: This trial aimed to investigate the effects of music therapy on pain relief within 24 hours after laparoscopic cholecystectomy in patients with gallstones. Methods: This trial adopted a randomized-controlled design. Patients with gallstones receiving laparoscopic cholecystectomy in one regional teaching hospital in northern Taiwan were recruited. Eligible participants were randomized into music therapy group who received music therapy besides routine postoperative care and control group who received routine postoperative care only. The Visual Analogue Pain Scale (VAS-pain) and Short-Form McGill Pain Questionnaire (SF-MPQ) were used to measure the pain levels. General Linear Model (GLM) considering interaction term was used for data analysis. The Johnson-Neyman algorithm was further used to estimate the confidence interval if the interaction term was statistically significant. Results: The current trial recruited 89 participants; 46 of the participants were allocated to the music therapy group and 43 were allocated to the control group. The sample consisted 48 (54%) males and 41 females (46%). The GLM demonstrated a significant interaction between SF-MPQ pre-test score and group after adjusting for age, gender, SF-MPQ pre-test score, length of hospital stay, and time of surgery. Further analysis using the Johnson-Neyman algorithm showed that for every 1 unit increment in the SF-MPQ pre-test score, the pain level in music therapy group would reduce by 0.249 compared with the control group among participants whose SFMPQ pre-test score ＞ 8.719 (p=0.046). Conclusion: Our results showed that routine postoperative care combining with music therapy significantly relieve the pain levels among patients with gallstones receiving laparoscopic cholecystectomy. We recommend nurses to learn music therapy skills and consider incorporating music therapy in post-operative care for the patients undergone laparoscopic cholecystectomy.

Parallel keywords

music therapy ； gallstones ； laparoscopic cholecystectomy ； pain