Date of this Version

11-9-2024

Document Type

DNP Project

Abstract

Background: Although surgical practices have evolved significantly, anxiety remains a concern among the adult population during the perioperative period. Anxiety is characterized by emotional discomfort, apprehension, or dread, with autonomic and somatic manifestations that impair functioning. It is essential to recognize that emotional aspects of anxiety are often overlooked by surgical teams, potentially leading to physiological, psychological, and economic consequences. Traditionally, Midazolam is administered to manage preoperative anxiety. While Midazolam effectively ensures hemodynamic stability during the preoperative and intraoperative stages, its short half-life limits its efficacy in alleviating postoperative anxiety. Additionally, numerous studies have conflicting findings regarding the correlation between preoperative Midazolam use and adverse outcomes such as delirium. Recent research underscores the importance of implementing non-pharmacological therapies, such as Music Therapy (MT), during the perioperative period to enhance anxiety management and improve patient outcomes.

Method: This quality improvement project (QI) aimed to assess the impact of MT on preoperative anxiety among adults at a prominent hospital. Eighteen healthcare professionals, including Certified Registered Nurse Anesthetists (CRNAs) and Anesthesiologists, were invited to participate in a survey, and 11 responded, forming the sample size. A pre/post-test design was utilized to measure knowledge and attitudes towards preoperative anxiety management before and after an educational PowerPoint presentation (PPT). Data were collected via anonymous online surveys using Qualtrics. Descriptive statistics summarized demographic features, and paired-sample t-tests compared pre- and post-test scores to assess changes in knowledge and attitudes. The project adhered to ethical guidelines with IRB approval, informed consent, and stringent data security measures.

Results: The educational PPT markedly improved healthcare providers' acceptance and understanding of MT for preoperative anxiety. Pre-test results showed limited awareness, with only 55% (n=6) recognizing the limited postoperative efficacy of Midazolam. Post-intervention, 100% (n=11) accurately understood MT benefits, emphasizing Classical Turkish music's effectiveness, which all participants agreed surpasses Midazolam in reducing anxiety. Notably, willingness to implement MT surged from 27% (n=3) to 64% (n=7) among participants. The significant shift from initial skepticism to favorable acceptance highlights the educational impact on MT integration in clinical settings.

Discussion: The QI demonstrated the effectiveness of an educational PPT on enhancing knowledge and acceptance of MT for managing preoperative anxiety. Despite the limitations of a small sample size and the study’s confinement to a single hospital, the findings reveal significant improvements in healthcare providers' readiness to implement MT, indicating a shift towards patient-centered care. Future implications include the potential for integrating MT into routine clinical practice, enhancing professional development, and fostering quality improvement initiatives. The QI underscores the necessity of ongoing research to explore long-term effects and optimize nonpharmacological interventions. Challenges such as participant availability and the reliance on digital educational tools highlight areas for improvement in study design and engagement strategies. The efficacy of Classical Turkish music highlights the need for further research in nonpharmacological anxiety management to improve patient outcomes.

Keywords: Music Therapy, Preoperative Anxiety, Invasive Procedures, Anxiety Reduction

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