Abstract P4-10-18: The effects of preoperative personalized music therapy associated with the patient-doctor relationship and surgical experience of patients with breast cancer (MARS)
Authors: Joo Yohan , Chung Seockhoon , Kim Seonok , Lee Saebyeol , Ahn Sei-Hyun , Lee Jongwon , Ko BeomSeok , Kim Jisun , Chung Il Yong , Son Byung Ho , Kim Hee Jeong 
Published: March 2022

Background. It is well known through several studies that listening to music can reduce the anxiety of patients. However, most of the previous studies focused only on the psychological effects of patients and some physiological effects such as blood pressure, pain. Moreover, previous studies played music that is not related to personal preferences. The purpose of this study is to investigate whether reducing the patient's anxiety through music selected by patients can improve the patient's surgical experience and the relationship between the patient and doctor. Methods. We randomly assigned 304 breast cancer patients who underwent surgery between September 2020 to April 2021 into a music therapy group(MG) and a control group(CG). Among them, 290 people completed the study. MG (n = 150) listened to the patient's chosen music after entering the operating room until induction of anesthesia, while CG (n = 140) wore earmuffs for noise block in the operating room instead of music. All patients measured anxiety scores over time by numeric rating scale. Treatment satisfaction and patient-doctor depth of relationship scale(PDDRS) were also assessed after surgery. In addition, surgical satisfaction and intimacy with patients were evaluated in the surgeon. Result. The anxiety scores immediately after entering the operating room were not significantly different between the two groups(MG: 4.62 ± 2.44, CG: 4.61 ± 2.45, p = .984). However, the anxiety levels before anesthesia induction of MG patients was 3.36 ± 2.32, which was significantly lower than that of CG patients (3.90 ± 2.26) (p = .047). There was no difference between the groups in PDDRS evaluated for patients after surgery (MG: 26.25 ± 5.529, CG: 25.56 ± 5.918, p = .338) while the degree of intimacy with the patient stated by the surgeon was significantly higher in MG (MG: 7.59 ± 0.89, CG: 7.30 ± 1.05, p = .013). Satisfaction with treatment experience of patients was 18.01 ± 1.78 in MG, which was significantly higher than 17.65 ± 1.59 in CG (p = .040). Especially among the detailed items, the experience in the operating room was evaluated more positively in MG as 4.21 ± 0.79 than 3.91 ± 0.78 in CG (p = .001). The difference in the anxiety-reducing effect of music therapy in the subgroup without surgery history was larger than with a history of surgery, but there was no statistical significance. Similarly, the difference in the anxiety reduction effect in the subgroup with low preoperative anxiety level was greater than that in the subgroup with high anxiety, but this was also not statistically significant (Table 1). People evaluated the experience of surgery more positively as the degree of anxiety reduction in the operating room was greater (Spearman's correlation coefficients = -0.124, p = .035). Conclusion. Personalized selected music in the operating room before anesthesia can effectively lower the patient's anxiety and has the potential to positively change the patient’s satisfaction with surgery. Patients with no surgical history, low pre-operative anxiety can more benefit from personalized music therapy. It is expected to create an opportunity for the patient with breast cancer who anticipate receiving surgery to improve their compliance to treatment by strengthening intimacy with the surgeon.

Table 1.Subgroup analysis for anxiety-reducing effect of music in operating roomGroupNMean ± SDDifference between groupP value between groupP value for interactionOverallCG140-0.71±1.560.55.005MG150-1.26±1.68Surgical historyNoCG53-0.38 ± 1.690.75.012.428MG67-1.13 ± 1.49YesCG87-0.92 ± 1.450.44.076MG83-1.36 ± 1.83Pre-Op. GAD-7&lt; 5 pointsCG85-0.55 ± 1.470.73.003.215MG91-1.28 ± 1.57≥5 pointsCG55-0.97 ± 1.670.25.416MG59-1.22 ± 1.86

Citation Format: Yohan Joo, Seockhoon Chung, Seonok Kim, Saebyeol Lee, Sei-Hyun Ahn, Jongwon Lee, BeomSeok Ko, Jisun Kim, Il Yong Chung, Byung Ho Son, Hee Jeong Kim. The effects of preoperative personalized music therapy associated with the patient-doctor relationship and surgical experience of patients with breast cancer (MARS) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-18.