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| BRIEF REPORT |
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| Year : 2023 | Volume
: 37
| Issue : 1 | Page : 53-55 |
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A 10-minute music therapy decreases prework anxiety level in nurses during SARS-CoV- 2 omicron pandemic
You Sian Lee R.N., M.S 1, Chia-Chun Wu OT., Ph.D 2, Chia-Jung Li R.N, M.S 3, Chien-Hua Tseng M.D., Ph.D 4, Yi-Nuo Shih OT., Ph.D 5
1 Department of Nursing, Wan Fang Hospital, Taipei Medical University, New Taipei City, Taiwan
2 Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University; Division of Psychiatry, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
3 Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
4 Division of Critical Care Medicine, Department of Emergency and Critical Care Medicine, Taipei Medical University-Shuang Ho Hospital; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan
5 Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, New Taipei City, Taiwan
| Date of Submission | 05-Jan-2023 |
| Date of Decision | 08-Feb-2023 |
| Date of Acceptance | 09-Feb-2023 |
| Date of Web Publication | 28-Mar-2023 |
Correspondence Address:
Yi-Nuo Shih
510 Chung Cheng Road, Hsinchuang, New Taipei City 24205
Taiwan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/TPSY.TPSY_6_23
Objectives: Many nurses feel anxious before starting to work during SARS-CoV- 2 omicron pandemic. How to reduce prework anxiety level in nurses is an important issue. In this study, we intended to explore the effect of a 10-minute music intervention on prework anxiety in nurses during the Omicron COVID-19 pandemic. Methods: A randomized controlled trial was conducted to measure the anxiety level of 60 nurse participants at a hospital before starting to work. We randomized 60 study participating nurses into three groups who listened to no music, fast-tempo music, and slow-tempo music for 10 min each day before going to work. Results: Nurses who listened to 10-min music, whether fast or slow, before work had significantly lower anxiety level than those who experienced no music in this study (p < 0.05). Conclusion: This 10-min music intervention designed for nurses is a feasible and time-saving method during the omicron COVID-19 epidemic.
Keywords: occupational therapy, omicron COVID-19, State-Trait Anxiety Inventory State Anxiety, work efficiency
How to cite this article:
Lee YS, Wu CC, Li CJ, Tseng CH, Shih YN. A 10-minute music therapy decreases prework anxiety level in nurses during SARS-CoV- 2 omicron pandemic. Taiwan J Psychiatry 2023;37:53-5 |
How to cite this URL:
Lee YS, Wu CC, Li CJ, Tseng CH, Shih YN. A 10-minute music therapy decreases prework anxiety level in nurses during SARS-CoV- 2 omicron pandemic. Taiwan J Psychiatry [serial online] 2023 [cited 2023 May 28];37:53-5. Available from: http://www.e-tjp.org/text.asp?2023/37/1/53/372643 |
| Introduction | |  |
Dangerous and fast-paced clinical work often makes nursing staff anxious about going to work. Therefore, how to reduce work anxiety level is an important issue for clinical administration. On November 26, 2021, the World Health Organization designated a new strain of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV- 2 or COVID-19) as a variant of concern and named it omicron variant which has a higher transmission rate and higher hospitalization load than previous variants, and thus, may cause higher patient loading and anxiety level for many nurses [1]. Besides physical harm, SARS-CoV- 2 omicron pandemic effects on mental health, including anxiety level, are also of concern [2]. Many nurses feel anxious because they worry about contracting the virus or passing it on to family members, and anxiety may affect professional performance and increase staff turnover. How to reduce prework anxiety level in nurses is an important topic during the SARS-CoV-2 omicron pandemic.
Many studies' investigations have pointed out that music therapy can reduce anxiety level [3],[4],[5]. An investigation has indicated that the interventions of music could reduce the anxiety of nurses. Therefore, the use of music is recommended to lower the anxiety level of nurses in the clinical setting [3]. A study of 60 medical staff examined the effect of “mode of internet plus music therapy” on reducing anxiety level, and demonstrated that music can relieve anxiety and depression, and ensure the mental health of frontline medical staff during the epidemic [4]. Another study showed that music without lyrics is less likely to affect people's work attention [6].
Why listening to music may affect the anxiety level of workers is a key question. In occupational therapy, music in the clinical setting can be attributed to a certain occupational form using the frame of reference related to occupational form and occupational performance [6],[7]. This model states that occupational performance changes with occupational form, providing a theoretical explanation for the effect of changes in music on human behavior. Music likely affects the listener's behavior and emotions. Background music can be seen as a part of the occupational form, and can affect emotion [8].
Whether the work anxiety level of frontline nurses can be relieved will be an important issue facing this epidemic. Although past research has pointed out that music can reduce work anxiety level, in the face of such a serious challenge of omicron virus, whether listening to music before going to work can effectively relieve stress is an issue worth exploring. Due to the busy work schedules of nurses during the epidemic, we in this study intended to examine the effect of intervening in music 10 min before starting to work on reducing their work anxiety in the hospital.
| Methods | | |
This investigation adopted a randomized controlled trial (RCT) design to study the influence of music listening before work in decreasing anxiety level in nurses during the SARS-CoV-2 omicron, pandemic. The trial was run under three conditions, nonmusic, fast tempo, and slow tempo. The experiment had three steps and was undertaken with three groups of participants (n = 20, 20, 20). The study was approved by the institutional review board of the Taipei Medical University (IRB protocol number = N202110050, and the date of approval = August 09, 2022) with the need of obtaining signed informed consents from study participants before the study.
Study participants
This study involved 60 staff nurses from a hospital in New Taipei City who may care for omicron COVID-19 patients, cases, and who did not have any communication disorders or diseases related to listening. The subjects were divided into three 20-person groups: nonmusic, fast-tempo music, and slow-tempo music.
Study procedures
Step 1: Sixty nurses, who were voluntary participants, were randomly divided into three groups by simple random sampling.
Step 2: The two anxiety tests were administered to the three groups before work, with Group 1 in a quiet environment, Group 2 listening to music with fast tempo, and Group 3 listening to music with slow tempo.
Step 3: The differences in anxiety test results were calculated O between each pair of conditions (quiet environment/fast tempo/slow tempo).
Study tools
State-trait anxiety inventory state anxiety
The test has 20 questions in total. The scoring method of the scale is computed by a Likert four-point scale, with scores from 1 point to 4 points [9].
Visual analog scale for pressure
Each participant was asked to mark between 0 mm on the far left and 100 mm on the far right, where 0 mm means no pressure at all, 100 mm means extreme pressure, and higher scores indicate greater levels of pressure [10].
Background music
Three pairs of conditions were selected: nonmusic, Pachelbel's Canon for 10 minutes with fast tempo (beats per minute (BPM = 100), and Pachelbel's Canon for 10 min with slow tempo (BPM = 60).
Statistical analysis
All statistics were analyzed using Statistical Package for the Social Science (SPSS) software 25.0 (SPSS Japan, Tokyo, Japan) with p < 0.05 considered to be statistically significant. However, the original statistical software is from International Business Machine SPSS (IBM Inc., Armonk, New York, USA).
| Results | | |
Analysis of variance analysis for all three groups in state-trait anxiety inventory state anxiety
Group 1 (nonmusic) reported the highest anxiety level score, followed by Group 3 (slow tempo), and Group 2 (fast tempo) with the lowest anxiety level score in the State-Trait Anxiety Inventory State Anxiety test. The differences in the scores of the three groups were statistically significant, as shown in [Table 1] (p < 0.05). | Table 1: Analysis of variance analysis of the anxiety score for nurse before work in state-trait anxiety inventory state anxiety for all three groups (n = 60)
Click here to view |
Analysis of variance analysis for all three groups in Visual analog scale for pressure
Group 1 (nonmusic) reported the highest anxiety level score, followed by Group 2 (fast tempo), and Group 3 (slow tempo) with the lowest anxiety score in the visual analog scale for pressure test. The differences in the scores of the three groups were statistically significant, as shown in [Table 2] (p < 0.001). | Table 2: Analysis of variance analysis of the anxiety score for nurse before work in visual analog scale for pressure for all three groups (n = 60)
Click here to view |
| Discussion | | |
Many studies have been done on the preventive measures that medical staff should take before work from the perspective of physical health, but few studies have examined how to reduce the anxiety level of medical staff before work from the perspective of mental health during the SARS-CoV-2 omicron pandemic.
Music can reduce anxiety level during COVID-19 [11],[12]. To reduce the anxiety level of nurses before they start to work, listening to music can be a treatment option [13]. In occupational form and occupational performance theory, music is an attribute of the occupational form. The theory states that occupational performance changes with occupational form, theoretically explaining the impact of changes in background noise and music on emotion before work [6],[7],[8]. However, because nurses are busy and have limited time during the SARS-CoV-2 omicron pandemic, this study could only adopt musical intervention 10 min before work. Accordingly, this investigation studied the influence of listening to music for 10 min before work on reducing anxiety level before work.
This investigation found that compared with a quiet environment before work, allowing nurses to listen to music for 10 min before work can decrease their anxiety scores, but found no consistent answer in the two tests on whether fast-paced music or slow-paced music is more effective. However, both tests indicated that listening to music before work can relieve anxiety. Previous studies have also pointed out that listening to music for a few minutes before facing unknown pressure can help decrease anxiety [14]. That study finding is consistent with the findings of this study.
Study limitations
The readers are warned not to overinterpret the study findings because this study still has two major limitations:
- Due to the heavy workload of nurses during the COVID-19 epidemic and their willingness to be tested, only 60 nurses were enrolled as study participants in this study. The validity of the results of this three-arm RCT is still doubtful due to the limited study participants.
- The music used in this study is only Pachelbel's Canon at 100 or 60 BPM, and no other tracks or rhythms were used. We are not sure whether the study results are still valid if music with other kinds of BPM is used.
Summary
Compared with a quiet prework environment, allowing nurses to listen to music for 10 min before starting to work decreased their anxiety level before starting to work, and has low time and costs of intervention. For future studies, we suggest adopting different music as study material to examine the effect of listening to music on reducing the anxiety level of nurses before starting to work, and increasing the number of study participants to strengthen the study results.
| Financial Support and Sponsorship | | |
None.
| Conflicts of Interest | | |
The authors declare no potential conflicts of interest in writing this report. Yi-Nuo Shih who is a multidisciplinary advisory board of the editorial board member at the Taiwanese Journal of Psychiatry (Taipei), had no rôle in the peer review process or decision to publish this article.
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[Table 1], [Table 2]
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