The Influence of Music and Anxiety on Weaning from Mechanical Ventilation

Abstract

Objectives: Weaning from mechanical ventilation (MV) requires increased respiratory effort which heightens anxiety and prolongs MV. The purpose of this paper was to examine the relationship among music, anxiety, and ventilator weaning to better understand factors that facilitate successful weaning. Design: A descriptive, correlational design was used to address the primary aims for this secondary data analysis project. Methods: Music intervention was defined as self-initiated, patient directed-music via headphones. Anxiety was measured daily using a self-report visual analogue scale. Analyses consisted of descriptive statistics, graphing, survival analysis, Cox proportional hazards regression, and linear regression. Results: Subjects (N=307) were 52% female, 86% white. Mean age was 59.3 � 14.4 years; APACHE III scores were 62.9 � 21.6. Length of ventilation was 8 days (range, 1-52). Length of ICU stay was 18 days (range, 2-71). Subjects with higher illness severity had shorter times to first weaning trial after study enrollment. For each day from study admission, weaning trials increased in duration. If a subject had a tracheostomy on the day of the weaning trial, weaning trials increased in duration for that day. Conclusions: Music intervention and self-reported anxiety were not found to influence time to first weaning trial or duration of weaning trials, but clinical practice factors of illness severity, days of weaning trials, and tracheostomy placement influenced weaning patterns in this sample of ventilated subjects. Further examination of music intervention and other psychophysiological factors during weaning from MV with prospective primary studies is recommended to better understand factors that facilitate successful weaning.