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音樂治療是否能有效降低呼吸器使用患者的焦慮程度

Can music therapy reduce anxiety of mechanically ventilated patients?

摘要


呼吸器常使用於急性呼吸衰竭、重大術後臨時呼吸道支持等情形,但氣管內管及氣切套管留置之不適、限制臥床、身處於陌生環境、因探病時間受限導致與家人或朋友分離的孤獨感、無法有效溝通等,對於呼吸器使用患者來說容易出現焦慮的情緒,引起呼吸作功和心肌需氧量的增加,影響患者的疾病復原與呼吸器脫離訓練。此篇文章透過實證醫學之手法,形成PICO問題,探討音樂治療對於呼吸器使用患者的焦慮程度是否可以有效改善。在各電子期刊資料庫中篩選出3篇隨機對照試驗研究文獻及1篇系統性回顧文獻進行評讀。結果證實,音樂治療確實可以作為呼吸器使用患者焦慮時的輔助替代方案,且無明顯副作用,但需注意患者個別性之需求,及早發現患者焦慮及介入音樂治療,降低發生因焦慮帶來的不良影響。

並列摘要


Ventilators are always used on acute respiratory failure, airway management after operation... etc. But mechanically ventilated patients may have anxiety because uncomfortable by endotracheal tube or tracheostomy tube, bed rest only, unfamiliar environment, loneliness, unable to communicate effectively. The anxiety may increase the work of breathing and myocardial oxygen demand, then affect mechanically ventilated patients' disease recovery and ventilator weaning. This article make a PICO question and talk about "Can music therapy reduce anxiety of mechanically ventilated patients?" by evidence-based medicine. We select a systematic review article and three randomized controlled trial article from online library to read. In the end, we find what music therapy can reduce anxiety of mechanically ventilated patients and have no obvious side effect. But Health care providers must pay attention to patients' personal need, find patients' anxiety and use music therapy early. In this way, it can reduce the adverse effect about anxiety.

參考文獻


武香君、周汎澔(2008)‧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‧護理雜誌,55(5),35-44。https://doi.org/10.6224/JN.55.5.35
張于娟、陳玉如(2017)‧以護理人員為主導的實證照護措施於呼吸器脫離之運用‧台灣醫學,21(2),208-217。https://doi.org/10.6320/FJM.2017.21(2).12
李秋香、張淑華、王素美、賴慶祥、賴美玉(2015)‧音樂介入對使用呼吸器患者之焦慮成效探討-前驅性研究‧澄清醫護管理雜誌,11(1),31-38。https://doi.org/10.30156/CCMJ
Bradt, J., & Dileo, C. (2014). Music interventions for mechanically ventilated patients. Cochrane Database System Review. 12, 1-66. https://doi.org/10.1002/14651858. CD006902.pub3
Chlan, L., & Savik, K. (2011). Patterns of anxiety in critically ill patients receiving mechanical ventilatory support. Nursing Research ,60(3), 50-57. https://doi.org/ 10.1097/NNR.0b013e318216009c.

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