The effect of music in gynaecological office procedures on pain, anxiety and satisfaction: a randomized controlled trial
Mak et al. Gynecological Surgery
The effect of music in gynaecological office procedures on pain, anxiety and satisfaction: a randomized controlled trial
N. Mak 0 1 4
I. M. A. Reinders 1 3 5
S. A. Slockers 0 1 4
E. H. M. N. Westen 1 2
J. W. M. Maas 0 1 4
M. Y. Bongers 0 1 4 5
0 Department of Obstetrics and Gynaecology, Máxima Medical Centre , Veldhoven , The Netherlands
1 Trial registration: Dutch Trial Register , NTR4924
2 Department of Obstetrics and Gynaecology, Rode Kruis Hospital , Beverwijk , The Netherlands
3 Department of Obstetrics and Gynaecology, VieCuri Medical Centre , Venlo , The Netherlands
4 Department of Obstetrics and Gynaecology, Máxima Medical Centre , Veldhoven , The Netherlands
5 Department of Obstetrics and Gynaecology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre , Maastricht , The Netherlands
Background: Pain can interfere with office procedures in gynaecology. The aim of this study is to measure the positive effect of music in gynaecological office procedures. Methods: A randomized controlled trial was performed between October 2014 and January 2016. Women scheduled for an office hysteroscopy or colposcopy were eligible for randomization in the music group or control group. Stratification for hysteroscopy and colposcopy took place. The primary outcome is patients' level of pain during the procedure measured by the visual analogue scale (VAS). Secondary outcomes include patients' level of pain after the procedure, anxiety and satisfaction of patient and doctor. Results: No positive effect of music on patients' perception of pain during the procedure was measured, neither for the hysteroscopy group (57 mm vs. 52 mm) nor for the colposcopy group (32 mm vs. 32 mm). Secondary outcomes were also similar for both groups. Conclusions: This study showed no positive effect of music on patients' level of pain, anxiety or satisfaction of patient or doctor for office hysteroscopy and colposcopy. We believe a multimodal approach has to be used to decrease patient distress in terms of pain and anxiety, with or without music.
Pain; Anxiety; Music; Office procedures; Hysteroscopy; Colposcopy
Background
Today, office procedures in gynaecology are widely used
to diagnose and directly treat gynaecological abnormalities
[
1–3
]. However, pain and anxiety remain problems that
may impede the procedure and can contribute to a
negative experience for the patient [
4–8
].
Listening to music could be an easy and non-invasive
way to decrease pain and anxiety. However, the
literature is not clear about the efficacy of music therapy.
Music for pain relief of any type was previously
examined in a review including 31 studies. The studies
showed a high variation in the results. Pooled data
demonstrated a significant reduction of 0.4 points on a
0–10 scale, which is of doubtful clinical importance [
9
].
Research on this topic in gynaecology is also not
conclusive. The meta-analysis of Wang et al. suggested a positive
effect of music regarding pain, anxiety and satisfaction for
patients undergoing endoscopic surgery. For patients
undergoing colposcopy, no effect was found [
10
]. This
result is the sum of two randomized controlled trials
with contradictory results regarding the impact of
music in office colposcopy, with no effect versus an
almost 2 point decrease in pain measured by the VAS
(0–10) in favour of music therapy [
7, 11, 12
]. Only
one article could be found on the effect of music
during office hysteroscopy. Angioli et al. showed a
positive effect of the use of music with a reduction of
pain and anxiety [
13
].
The effect of music in gynaecological office procedures
on satisfaction of patients is less frequently examined.
Danhauer et al. found no effect [
11
]. Other studies in
office gynaecology did not examine the efficacy of music on
satisfaction of patients [
12, 13
]. The satisfaction of the
doctor is not described in any of these articles [
11–13
].
However, music can have a negative influence on task
performance and level of irritation of the surgeon in
laparoscopic surgery [
14, 15
]. Therefore, this satisfaction of
the doctor should not be ignored.
Previous research on the effect of music in
gynaecological office procedures was not blinded for patients
or doctors, meaning there was a risk of bias [
11–13
].
Moreover, other interventions to decrease the patient’s
discomfort, such as verbal communication between
patient and doctor or nurse, are not mentioned or are
excluded in previous studies [
11–13
]. Positive
interactions between patient and doctor or nurse may
interact with pain and anxiety and such interaction is often
used in daily practice. The use of local anaesthetics,
the use of information leaflets and the use of
videoscopy are all methods used to improve patients’
experience [
3, 6, 7, 16
].
We can conclude from previous research that a large
discrepancy exists in the efficacy of music in the
reduction o (...truncated)