Effect Of Music Therapy And Accompanying Of Family Members On Emotion,sleep And Delirium Of ICU Patients

Objective:In this study,patients in ICU were given music therapy and accompanied by family members,the changes of anxiety score,depression score,sleep score,incidence of delirium,time of initial delirium,duration of delirium and severity of delirium in ICU patients were investigated.To provide reference and guidance for the prevention and nursing of delirium in ICU.Methods:This study was a quasi-experimental study,in which patients from January to June 2019 were assigned to one or two wards of the Grade Ⅲ,Class A hospital in a city.51 patients in Ward 1 from January to March 2019 were in control group,51 patients in Ward 2 were in Intervention Group 1,and 51 patients in Ward 1 from April to June 2019 were in intervention group 2,at the same time,51 patients in the second ward were in the 3 intervention groups.Control Group,the implementation of Routine Care Model;Intervention Group 1,the implementation of routine care model and music therapy;Intervention Group 2,the implementation of routine care model and Family Care;Intervention Group 3,the implementation of routine care model,music therapy and family care.Self-rating anxiety scale(SAS),self-rating depression scale(SDS),Chinese version of Richards-Campbell sleep scale(RCSQ),ICU patients’ CAM-ICU and simple version of CAM-S were used to evaluate the effect of intervention before and 48h,72h and 96h after intervention.All collected data were analyzed by SPSS 23.0.Results:(1)The scores of anxiety(SAS)and depression(SDS)in the control group increased with time(P<0.05),and the scores of sleep(RCSQ)decreased(P<0.01).(2)There was no significant difference in anxiety score(SAS)between Intervention Group 1 and Control Group at 48h of admission(P>0.05),but at 72h and 96h of admission(P<0.01);There was no significant difference between Intervention Group 1 and Control Group in Depression Score(SDS)at 48h and 72h after admission(P>0.05),but at 96h after admission(P<0.01);There was no significant difference in sleep score(RCSQ)between Intervention Group 1 and Control Group at 48h of admission(P>0.05),but there was significant difference at 72h and 96h of admission(P<0.01).(3)There was no significant difference in anxiety score(SAS)between intervention 2 group and Control Group at 48h of admission(P>0.05),but at 72h and 96h of admission(P<0.01);There was no significant difference in depression score(SDS)between Intervention Group 2 and Control Group at 48h and 72h after admission(P>0.05),but at 96h after admission(P<0.01);There was no significant difference in sleep score(RCSQ)between intervention group and Control Group at 48h of admission(P>0.05),but at 72h and 96h of admission(P<0.01).(4)There was no significant difference in anxiety score(SAS)and sleep score(RCSQ)between the intervention group and the Control Group at 48h of admission(P>0.05),the other time point anxiety score(SAS),depression score(SDS),sleep score(RCSQ)and the control group were significantly different(P<0.05).(5)The incidence,duration and severity of delirium in ICU patients of Intervention Group 3 were significantly different from those of the other three groups(P<0.01),there was no significant difference in the first occurrence time of delirium between the two groups(P>0.05).Conclusions:(1)With the length of stay in ICU,the level of anxiety and depression gradually increased,and the sleep quality gradually decreased.(2)Music therapy and family accompanying can reduce the level of anxiety and depression and improve the quality of sleep,but the combination of the two can reduce the level of anxiety and depression,improve the quality of sleep shorter time,better effect.(3)Music therapy and Family Care Program can reduce the incidence of delirium in ICU patients,reduce the duration of delirium,reduce the severity of delirium.The effect of music therapy alone and family accompanying program on incidence rate of delirium,duration of delirium and severity of delirium in ICU was weak.(4)ICU clinical care workers can try to reduce the incidence of delirium,the duration of delirium,and the severity of delirium by reducing the level of anxiety,depression,and improving the quality of sleep in patients.