Effect of Music Therapy on Reducing Stress for Post-Open Heart Surgery Patients in Intensive Care Unit

心臟手術對病人的身體與心理產生極大的威脅與壓力，本研究目的在探討心臟手術後 病於加護期間，接受音樂治療對生理反應、疼痛程度、及心理感受的壓力反應成效及 其影響因素。研究採實驗設計法，選取心臟術62位病患，實驗組於術後加護期間給予 音樂治療。研究結果發現，音樂對病患能夠減少呼吸次數和提升指溫，減輕疼痛，改 善緊張和「具有可怕念頭或影象」心理感受。另外，音樂治療的效果受年齡、手術次 數和依變項改變量的影響。音樂治療壓力處置兼具科學、藝術及符合人性，值得臨床 上廣為宣傳與應用。 　　The purpose of this study was to investigate the effectiveness of music therapy on pain, physiological parameters and psychological perceptions of post-heart surgery patients in Intensive Care Unit (ICU). A quaxi- experimental design was used in the study. Data were collected in a 1750-bed medical center in northern Taiwan. Sixty-two patients were recruited for this study, patients were randomly assigned to either treatment or control group. The treatment group patients listened to the relaxing or religious music in ICU while control group patients received only routine care without music therapy. 　　Music therapy was conducted each time for 20 minutes, three times a day, within forty-eight hours of post heart surgery while patient was awake in ICU. Stress management data were collected before and after each music therapy. The physiological indicators of the patients, including heart rate, systolic pressure, diastolic pressure, mean arterial pressure, respiratory rate and finger temperature, as well as the patients' level of pain and psychological perception of anxiety, depression, anger and tension were collected. 　　 The results indicated that music therapy reduced respiration rate, pain and tension levels, increase finger temperature, and improved the psychological perception of " terrifying ideas or images" of the patients. Patients with first heart surgery had more decreased systolic pressure during music therapy than patients with second or third heart surgery. Patients with forty-five to sixty years old had more pain relief than those age greater than sixty during music therapy. The study also found that forty-five to sixty years old patients had more tension relieved than patients younger than age forty-five with music therapy. 　Music therapy successfully reduced stress as reflected in pain and other physiological parameters. Frequency of surgery and age influenced the effects of music therapy. The use of this intervention will improve the quality of care received by the heart surgery patients. Medical personnel can use music therapy to improve the quality of care to the heart surgery patients as well as other patients in pain and stresses.痛程度、及心理感受 的壓力反應成效及其影響因素。研究採實驗設計