@2024 Afarand., IRAN

---

ISSN: 2252-0805    The Horizon of Medical Sciences 2014;20(1):63-68

Background
Dressing and daily treatment after burn are very painful [2], and theses painful processes may affect pain understanding and other side effects caused by burn; and if it is possible to decrease pain feeling, burn suffering will decrease [3-5].‏ The use of narcotics results in many side effects [8], while non-medication interventions for pain relief have little side effects [9]. From ancient times, it has been believed that music is a wonderful tool in treating the diseases [11]. Using music is a safe and easy method in pain controlling, which can be included in the daily care programs of the hospitals [12, 13].
Previous Studies
First scientific researches about impact of music on the diseases were conducted in the 19th century; and, nowadays, music therapy is a popular method to reach relaxation [14, 15]. Music is suggested as an improved method for distraction concerning pain decrease in painful operations [16, 17]. There are many conducted researches about the impact of music on pain, showing decrease in pain via music therapy [18, 19]. According to a research, hearing a selected music during dressing change has a massive impact on pain and anxiety, decreasing them in the patients [24].
Aim(s)
The aim of the study was to investigate the effect of music (selective and non-selective) in reducing pain, anxiety, and behavioral reactions, and changes of hemodynamic parameters in the burned patients during the daily dressing change
Research type
The research type is clinical trial.
Research society, place and time
The research society was the population of patients hospitalized in Burn Unit of Shahid Rajaei Hospital affiliated with the Qazvin University of Medical Sciences, Iran. The study was performed during 2013.
Sampling method and number
Entry conditions were as the followings: Willingness to participate-age between 15 and 6o years old-no addiction-lack of mental disease or specific disease (like cancer, notch, and thyroid diseases which result in pain or anxiety)-20% to 40% burn of degrees 2 or 3. According to similar studies, 80% test power, and 5% confidence coefficient, 90 patients were selected by the use of purposive sampling method. These patients were randomly divided into three “selective music”, “non-selective music” and “control” groups.
Used devices&materials
Data were collected through interview, self-reporting, and document observing. To this aim, the following questionnaires were used: Demographic questionnaire (patients’ personal characteristics and the disease’s characteristics)- Spielberger questionnaire (containing 20 questions to evaluate patients’ situational anxiety during dressing change at “mild” level with 20 to 40 scores, “mean” level with 40 to 60 scores, and “severe” level with60 to 80 scores)- pain intensity recording sheet (by the use of Johnson numerical scale at “mild” level with 1 to 3 scores, “mean” level with 4 to 6 scores, and “severe” level 7 to 10 scores)-pain behavioral questionnaire (containing 15 questions evaluating stress through studying persons’ behavioral reactions to pain at “mild” level with 1 to 2 scores, “mean” with 3 to 4 scores, and “severe” with 5 to 6 scores) The hemodynamic status (heart rate, blood pressure, and respiratory rate) of the patient was measured and recorded during dressing change. For reliability evaluation, 10 burned patients (5 case studies and 5 control persons), who had the entry conditions of the study, were evaluated by the use of checklists. The reliability coefficient was computed 0.83, using Split-half method and Spearman-Brown statistical test. The samples were divided into experiment and control groups, based on odd and even days. No music was played for control group. The played music for non-selective group was gentle classical music. For the selective group, any favorite music was played according to the patient’s preferences. Data were analyzed using One-way Variance Analysis (average difference between groups) and Tukey’s Post Hoc (to evaluate intergroup differences) tests, as well as the use of SPSS 21 software.
Findings by Text
57 patients (63.3%) were male and 33 patients (36.7%) were female. The patients’ mean age was 40.1±5.3 yaers. 75 samples (83.3%) had a high school degree. In the three groups, the patients’ burn degree was homogeneous and had no significant relation with music impact on the study indices. Average pain intensities in “control”, “non-selective”, and “selective” groups were 8.6±2.1, 5.3±0.9, and 4.7±1.9, respectively, in which the difference between “control” and “non-selective” groups was significant, as well as the difference between “control” and “selective” groups. There was no significant difference between “non-selective” and “selective” groups. Average anxiety intensities in “control”, “non-selective”, and “selective” groups were 63.7±12.1, 34.1±5.9, and 26.3±10.9, respectively, in which the differences between “control” and “non-selective” groups, and between “control” and “selective” groups were significant, as well as the difference between “selective” and “non-selective” groups. Average intensities of behavioral reactions to pain in “control”, “non-selective”, and “selective” groups were 3.5±0.8, 1.8±0.5, and 1.2±0.3, respectively, in which the difference between “control” and “selective” groups was significant. There was no significant difference between “control” and “non-selective” groups, as well as between “selective” and “non-selective” groups (Table 1). Concerning average of the mean arterial pressure (mmHg), there was no significant difference between “control”(86.9±4.6), “selective”(83.8±4.6), and “non-selective”(85.4±5.6) groups. In addition, concerning average respiratory rate, there was no significant difference between “control”(15.2±0.9), “selective”(14.9±0.2), and “non-selective”(15.1±0.3) groups. However, selected music (72.1±1.6) and non-selected music (79.9±1.2) resulted in significant moderation of average heart rate, than “control” group (89.1±1.7)do. In addition, heart rate average difference was significant in “selective” and “non-selective” groups; and the selected music had more impact on heart rate decrease.
Main comparison to the similar studies
Results of a conducted study show that music therapy decreases some parameters such as pain and anxiety [25]. According to the results of the present study, music playing results in pain decrease. There are various results about selected kinds of music, and some results, in contrast to the results of the present study, show that kind of the selected music has a little influence on anxiety and relaxation [28], while some other results confirm the patients’ interest in music selection [29].
Suggestions
It is suggested that, while playing music to patient’s relaxation, her favorite music to be played, in order to take better results.
Limitations
Non-declared
Conclusions
Music, especially the familiar kind, can have positive effects in reducing anxiety, pain, and control of some vital sings of burned patients during dressing change.
Acknowledgments
The researchers feel grateful to all the personnel of Burn Unit of Shahid Rajaei Hospital, Qazvin, Iran.
Conflict of interest
Non-declared
Ethical Permissions
Ethical confirmation has been registered with Code No. “Medsab.res.92.31”. All the participants filled the consent for participation in the study.
Funding Sources
Sabzevar University of Medical Sciences (Iran) funded the study.

TABLES and CHARTS

Show attach file