Music to Decrease Pain and Anxiety During Head CTs Performed at the PEds ED
Condition: Anxiety Disorder of Childhood or Adolescence
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      A single blinded controlled trial to determine if an intervention of listening to nursery
      songs with integrated heart beat sounds results in changes in anxiety level in infants and
      young children less than four years of age in an emergent setting.
    

Detailed description: 
      This study is a prospective cohort with a randomized single-blinded intervention with
      convenience sampling design. Our pediatric emergency medicine department (PED) treats nearly
      2,500 patients between 1 and 3 years of age annually in 2008-10 and is a regional referral
      center for specialty care for our state. All data is collected in the PED between May 2008
      and July 2010.

      One PED examination room is designated as the study room. The music was stored on an ipod
      played in a portable speaker. The music is from the Compact Disk(CD), "Baby Go to Sleep."
      This is a commercially available CD.23 The "Baby Go to Sleep" Compact Disk played a
      combination of the sound of an actual human heartbeat and children's songs. Tempo changes
      occurred between each song. During the study, the initial three nursery rhymes were played.

      The principal investigator's research associates recruit all patients up to 3 years of age
      presenting to the PED during the hours they were available. Once situated in the room,
      children both in the control and experimental group received the usual medical care including
      the evaluation by attending physician to determine if head CT would be performed or not.
      After subjects were determined to need a head CT by the attending physicians, they were
      randomly assigned to either the Control(Con) or experimental(Exp) group. Children in the Con
      group received the usual medical care while children in the Exp group received the usual
      medical care in combination with the intervention. The intervention was started by the
      patients nurse without the knowledge of the research associate. In the intervention group,
      music was played until the CT scan was completed. Research associates rated children's
      anxiety levels using a visual analogue scale(VAS) and Modified Ramsay Sedation Scale(MRSS)
      before children were transferred to radiology department for head CT then after children was
      laid down to go through head CT. Researchers associates were blinded to group by wearing
      headphones that were tested to ensure that they could not hear whether or not music was
      playing during the intervention phase.
    

Intervention name(s): Use of music for anxiety in children
Intervention type(s): Other
Intervention description(s): The "Baby Go to Sleep" CD played a combination of the sound of an actual human heartbeat and children's songs. The concept behind the "Baby Go to Sleep" CD is to blend heart beat sounds, which are known to be calming to infants and children, with children's music. The basic principles of relaxation were incorporated in the arrangements of heartbeat and children's songs, ie: simplicity, repetition, predictability, and simple symmetry (short repeated patterns). The adult human heart in the "Baby Go to Sleep" CD was recorded from the chest and set in consistent tempos for each song ranging from 62 to 78 beats per minute(BPM). The sound of the heartbeat continued between and during songs. Tempo changes occurred between each song.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Single (Investigator)
Primary purpose: Treatment