FAR EASTERN UNIVERSITY

Institute of Nursing
Nicanor Reyes Street, Sampaloc, Manila

Deogracias, Andrea Patrish M. November 08, 2019

BSN 207 – Group 2 Ms. Cherry Tuprio

EVIDENCE BASED NURSING

GENERAL QUESTION
Are live music has an effect on the distress of pediatric patients receiving intravenous starts,
venipunctures, injections, and heel sticks
Reconstruction of General Question related to client’s problem identified in the RLE?
Will the live music has an effect on the distress of pediatric patients receiving
intravenous starts, venipunctures, injections, and heel sticks?

Patient Focus Intervention Comparison Outcome

Population

- The inclusion For those patients in The music The study revealed
criteria were an the experimental intervention consisted statistically
experimental group, the researcher of age-appropriate significant
group of 20 positioned herself as children's songs led differences between
patients age 7 and closely to the patient by the researcher age groups with less
under received as possible and began with guitar behavioral distress
live music as they singing age- accompaniment. This exhibited in the
experienced a appropriate songs group was compared music group for
variety of needle accompanied by a to a control group of children 1 year old
insertions in a steel string guitar as 20 pediatric patients and younger.
treatment room soon as the children who did not receive The addition of music
and emergency were placed on the music. Groups were as distraction during
room setting at a table. matched on the basis invasive procedures
local hospital. - Children who of age, site of with pediatric patients
were at an procedure (floor or appears to be
appropriate ER), and type of beneficial for all age
age were needle insertion. groups during the pre-
encouraged to needle and post-
sing and were needle stages. This is
also given the consistent with other
opportunity to studies resulting in the
request same conclusion
 favorite (Pfaff, Smith, &
songs. If the Gowan, 1989; Chetta,
child was not 1981). It appears that
verbal, music, when
parents compared with no
provided intervention, is
suggestions of effective in
familiar distracting children
songs. Many before and after the
requested the actual needle
“Barney insertion. Analysis of
Song”. “Hush the time-sampling
Little Baby” observation form,
and “Twinkle, which attempts to
Twinkle Little record duration of
Star” were pain, revealed that
used for ages children receiving
one to three music exhibited
years. shorter periods of
- For those distress than children
children who did not
above three,
the same
songs were
employed as
well as an
original song
by the
researcher
entitled,
“Sparky, My
Friend the
Dragon”. The
purpose of
this song as
well as “Old
MacDonald”
was to
encourage
interaction
with the
therapist and
to provide
opportunities
for children to
make choices
in order to
increase their
sense of
control.
Patients were
asked to name
animals and
make up
sounds in
“Old
MacDonald”
and were
asked to name
the dragon in
the dragon
song. This
song also
incorporated
taking deep
breaths with
the dragon for
further
distraction
purposes. For
pre-verbal
patients and
for those who
chose not to
communicate
or interact,
songs were
selected
primarily
based on
familiarity
and
preference.
Music was
provided for
each patient
throughout
the entire
procedure.
Music was not
provided for
 those in the
control group.
- The
researcher
remained as
inconspicuous
as possible
and the needle
insertion
proceeded as
normal.
Nurses and IV
therapists
were
encouraged to
maintain their
normal modes
of consolation
or distraction
in the control
group. If the
parents were
present during
the procedure
they
completed the
questionnaire
on their
child’s history
of pain.
- After the
procedure was
complete,
other patient
information
was obtained
from medical
charts and a
checklist was
completed
about the
procedure for
future
analysis.
 Abstract
Currently there is a growing interest in non-invasive methods of pain management with pediatric
patients. Needle insertions are a major source of distress for children. The term “needle insertions”
includes intravenous starts, venipunctures, injections, and infant heel sticks. Distraction has proven
effective in helping children to cope and adding music as a non-invasive method of pain
management is a unique way to achieve this technique of distraction. To assess the benefits of live
music on the behavioral distress levels of pediatric patients, an experimental group of 20 patients
age 7 and under received live music as they experienced a variety of needle insertions in a
treatment room and emergency room setting at a local hospital. The music intervention consisted
of age-appropriate children's songs led by the researcher with guitar accompaniment. This group
was compared to a control group of 20 pediatric patients who did not receive music. Groups were
matched on the basis of age, site of procedure (floor or ER), and type of needle insertion. Two-
way analysis of variance (ANOVA) revealed a statistically significant difference between groups
for the pre-needle and post-needle stages (F = 9.6, p < .05) with the music group exhibiting less
behavioral distress. A Mann-Whitney U test revealed statistically significant differences between
age groups with less behavioral distress exhibited in the music group for children 1 year old and
younger (U = 14, crit. value = 15).
SOURCE:
Journal of Music Therapy, Volume 33, Issue 1, Spring 1996, Pages 19–
33, https://doi.org/10.1093/jmt/33.1.19