Effect of Music Therapy with Emotional-Approach Coping on Pre-Procedural Anxiety in Cardiac Catheterization

Abstract

Individuals undergoing cardiac catheterization, and related procedures such as electrophysiological studies involving cardiac catheter placement, are likely to experience elevated anxiety periprocedurally, with highest anxiety levels occurring in the waiting period immediately prior to the procedure. Elevated anxiety has the potential to negatively impact these individuals psychologically and physiologically in ways that may interfere with the procedure itself. Pre-medication via various common anxiolytics does not always adequately lower patients' level of perceived anxiety, and at high dosages such medication may interfere with patient compliance during the procedure itself. This study evaluated the use of music therapy, with a specific emphasis on emotional-approach coping, immediately prior to cardiac catheterization in order to impact periprocedural outcomes. The randomized, pre-test/post-test control group design consisted of two experimental groups--the Music Therapy with Emotional-Approach Coping group (n = 13), and a talk-based Emotional-Approach Coping group (n = 14), compared with a standard care Control group (n = 10). Results support the use of music therapy with an emphasis on emotional-approach coping to improve positive affective states in adults awaiting elective cardiac catheterization and electrophysiological study. Statistically significant improvements in positive affect were seen after a single session of music therapy lasting 30-minutes in length. Conversely, participants who received a talk-based emphasis on emotional-approach coping or standard care did not demonstrate improvements in positive affect. There was a significant overall decrease in negative affect for all participants in the study, regardless of group membership. Heart rate, respiratory rate, and oxygen saturation levels did not differ significantly between groups. The MT/EAC group demonstrated a statistically significant increase in systolic blood pressure from pre-test to end of study intervention while the EAC group demonstrated a significant increase in diastolic blood pressure from pre-test to post-test. The observed mean increase in systolic blood pressure was less than 10% over baseline, and thus likely reflects a benign increase in sympathetic nervous system arousal due to engagement in active music making. Though group means display a trend toward the MT/EAC group having shortest procedure length and least amount of anxiolytic required during the procedure, while the EAC group had least amount of analgesic required during the procedure, none of these differences was statistically significant.