音乐对重症患者心身不良应激改善作用的Meta分析  

Effects of music on improving psychosomatic distress in severe patients：a Meta-analysis

作　　者：朱佳清 戴菲菲[1] 吕苏珍[1] 赖美红[1] 

机构地区：[1]杭州市中医院ICU,310007

出　　处：《中华现代护理杂志》2016年第5期617-623,共7页Chinese Journal of Modern Nursing

摘　　要：目的：评价音乐对重症患者不良情绪的改善作用。方法由2位研究人员独立检索年文献资料,数据库包括中国知网（1979年1月—2014年12月）、维普数据库（1989年1月—2014年12月）及万方数据库（1982年1月—2014年12月）,检索主题为音乐对重症患者焦虑、抑郁等的干预作用；对纳入文献提取数据,进行Meta分析。检索策略由第一作者确定,文献检索、Meta分析中产生的分歧,由第三方予以裁定。结果共纳入11篇文献进行定量,研究性质均为随机对照试验。 Meta分析结果显示,焦虑3个量表的合并加权均数差分别为,SAS：-10.13（95%CI：-14.56,-5.69）,VAS：-0.73（95%CI：-1.21,-0.24）,TAI：-3.71（95%CI：-5.18,-2.25）,均提示音乐对焦虑情绪具有保护作用；抑郁量表SDS的合并加权均数差为-0.05（95%CI：-0.08,-0.03）,提示音乐对抑郁情绪具有保护作用；孤独量表UCLA的合并加权均数差为：-6.24（95%CI：-8.62,-3.87）,提示音乐对孤独情绪具有保护作用；睡眠时间的合并加权均数差为：1.09（95%CI：0.72,1.45）,提示音乐可显著延长睡眠时间；觉醒时间的合并加权均数差为：-0.93（95%CI：-1.49,-0.36）,提示音乐可显著缩短觉醒时间；血压的合并加权均数差为：-5.41（95%CI：-20.08,9.27）,效应值区间跨越正反区位,提示音乐对血压影响不确定；心率的合并加权均数差为：-12.35（95%CI：-14.68,-10.01）,提示音乐可显著减慢心率。结论音乐对重症患者的焦虑、抑郁、孤独、睡眠不足等不良应激均有明显的保护作用,值得推广应用。Objective To evaluate the effects of music on improving psychosomatic distress in severe patients. Methods The data were collected via China national knowledge infrastructure （ From January 1979 to December 2014）, Vip journal integration platform （From January 1989 to December 2014） and Wanfang data （ From January 1982 to December 2014 ） , conducted by two researchers separately. The inclusive literatures were related to the intervention effects of music on anxiety and depression in severe patients, and the data were analyzed by Meta-analysis. The searching strategies determined by the first author; the third party would be involved into the determination in case of the divergence emerged. Results The researchers invited 11 literatures into the study and randomly compared them. Meta-analysis demonstrated that music had protective function on anxiety and the WMD（weighted mean difference）values for SAS, VAS and TAI were： -10. 13 （95%CI：-14. 56, -5. 69）,-0. 73 （95%CI： -1. 21, -0. 24） and -3. 71 （95%CI： -5. 18, -2. 25）;the WMD values for SDS and for UCLA were -0. 05 （95%CI： -0. 08, -0. 03） and -6. 24 （95%CI： -8. 62,-3. 87）, suggested that music had protective effects on depression and on loneliness;the WMD values for sleeping time and awakening time were 1. 09 （95%CI：0. 72, 1. 45） and -0. 93 （95%CI： -1. 49,-0. 36）, suggested that music could significantly increase the sleeping time and reduce the awakening time in order to cope with sleep disorder;the WMD value for blood pressure was -5. 41 （95%CI： -20. 08, 9. 27）, suggested that the protective effects of music on blood pressure was uncertain;the WMD value for heart rate was -12. 35 （95%CI：-14. 68,-10. 01）, suggested that music could protectively reduce the heart rate. Conclusions Music should be highly recommended for it plays a significant role in dealing with psychosomatic distress such as anxiety, depression, lonely and sleep insufficiency.

关 键 词：ICU 心身不良刺激 音乐干预 META分析 

分 类 号：R473[医药卫生—护理学]