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Music may help distressed children in pediatric ED

Music intervention eased distressed children and assisted health care providers during intravenous placement, although overall outcomes including children without distress were not statistically significant, according to the results of a study conducted at the Stollery Children’s Hospital in Edmonton, Canada.

The parallel, randomized trial included 42 children aged 3 to 11 years who underwent IV placement in a pediatric ED. An equal number of children were randomly assigned to the standard care group and the music intervention group. Those in the intervention group listened to music throughout the procedure to assess for management of pain and distress.

Using the Observational Scale of Behavior Distress-Revised, researchers found no difference in primary outcome of patient distress before, during and after the procedure. After adjusting for ethnic minorities, who researchers observed to have less distress (P=.06), the reduction of an increase in distress was of borderline significance between the two groups (P=.05).

When researchers removed the 10 children without distress from the analysis, the median change in distress scores was 2.2 (interquartile range, 1.7-8.7; P<.05) in the standard care group and 1.1 (interquartile range, 0.1-2.4; P<.05) in the music group. The regression analysis indicated that music significantly reduced the increase in distress (coefficient, –3.19; 95% CI, –5.75 to –0.63).

Secondary outcome was change in self-reported pain from before to after the procedure, measured with the Faces Pain Scale-Revised. In the standard care group, the pain score increased from before to immediately after the procedure (median, 2; interquartile range, 0-4; P=.04), whereas it remained the same in the music group (median, 0; interquartile range, –4.1 to 0.5; P=.04).

Health care providers found it easier to perform the IV procedure (76% vs. 38%; P=.03) and were more satisfied with the IV start (86% vs. 48%; P=.02) in the music group. 

Researchers also measured heart rate and parent satisfaction, and found no statistical significances between the groups.

“Any easy-to-implement and low-cost intervention that also contributed to efficiency of care and provider job satisfaction may have some important but as-of-yet largely unmeasured benefits,” researchers wrote.

Disclosure: Study researchers Lisa Hartling, PhD, and Amanda S. Newton, PhD, are supported by New Investigator Salary Awards from the Canadian Institutes of Health Research.