Rapid realist review: Anxiolytic effects of music therapy on mechanically ventilated patients

AimsTo review the literature focusing on anxiety and music therapy as a non-pharmacological anxiolytic for patients receiving mechanical ventilation and to determine the contexts, mechanisms and outcomes of what works for whom and under what circumstances. BackgroundMechanical ventilation is one of the numerous processes that a critically ill patient requiring single or multi organ support may experience. This is often frightening and perplexing for the patient, particularly when mechanically ventilated. The abundance of interventions, monitoring and unfamiliar noises can precipitate feelings of stress and anxiety which is common within this population of patients leading to prolonged hospital stay and increases in mortality and morbidity. MethodsA rapid realist review (Abrahamson et al. 2020) was undertaken applying the realist methodology to a search of the literature using CINHAL, MEDLINE and Cochrane library, PsycIFNO, PubMed and EMBASE along with searching for the grey literature using an experience library technician, Google Scholar, Google, OpenGrey and the British Library ETHOS. ResultsTwenty-one studies were included in the review. From the heterogeneity amongst the literature and the poor quality of evidence it was ascertained what worked for whom and under what circumstances. No negative outcomes for patients were noted in the review thus suggesting that music may have a place within critical care to help reduce anxiety. Given the heterogeneity of the evidence there is scope to review this topic further. ConclusionThe overarching conclusion was that music could help reduce anxiety in the critically ill mechanically ventilated patient. Thematic analysis helped identify what quantifies the markers of anxiety; furthermore, it noted alternative themes that could be explored through more research. Theories could be developed and implemented into a protocol for practice; however, it would be based on the researchers own experience due to the poor-quality heterogeneous evidence.