Music intervention to prevent delirium among older patients admitted to a trauma intensive care unit and a trauma orthopaedic unit

Abstract

Purpose: Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli.

Methods: Randomised controlled trial, 40 patients aged 55 and older.

Intervention: Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses.

Outcomes: Heart rate, respiratory rate, systolic and diastolic blood pressure, confusion assessment method.

Results: Repeated measures ANOVA, F(4, 134) = 4.75, p = .001, suggested statistically significant differences in heart rate pre/post music listening, and F(1, 37) = 10.44, p = .003 in systolic blood pressure pre/post music listening. Post-hoc analysis reported changes at three time periods of statistical significance; (p = .010), (p = .005) and (p = .039) and a change in systolic blood pressure pre/post music listening; (p = .001) of statistical significance. All participants screened negative for delirium.

Conclusion: Music addresses pathophysiologic mechanisms that contribute to delirium; neurotransmitter imbalance, inflammation and acute physiologic stressors. Music to prevent delirium is one of few that provide support in a critical care setting.

Keywords: Delirium; Diastolic pressure; Heart rate; Music listening; Neuroscience of music; Non-pharmacologic approach; Pharmacologic approach; Roy Adaptation Model; Systolic blood pressure.