Running Head: CONNECTIONS AND RECOMMENDATIONS: ANTI-ANXIETY Connections and Recommendations: Alternative or Pharmaceutical Therapy for Anti-Anxiety Juliette Langit University of San Francisco, School of Nursing and Health Professions
Connections and Recommendations: Alternative or Pharmaceutical Therapy for Anti-Anxiety Many patients look for alternative therapy in replacement of pharmaceutical therapy for any medical condition. Our group decided to focus this phenomenon on patients who experience anxiety during their hospital stay and formed the following clinical question: For surgical patients, how does alternative therapy compared to pharmaceutical care or no care relieve anxiety symptoms during their hospital stay? After critiquing several scholarly articles we found multiple connections between alternative relaxation therapies and prescription medications. It is important that these connections are brought to our attention to fully summarize the literature and make further recommendations to improve how healthcare professional can approach this possible change in care. Summary of Studies Strategies for Decreasing Patient Anxiety in the Perioperative Setting. This systematic review by Laila Bailey, RN, MSN, CNOR, was developed to address factors that affect perioperative patients. Literature on how education and music therapy helps with perioperative anxiety was explored. Perioperative Music or Headsets to Decrease Anxiety. This study conducted by Brenda Johnson, BSN, RN, CPAN, Shirley Raymond, BSN, RN, CPAN, and Judith Goss, BSN, RN, was done to test the effectiveness of noise-cancelling headphones versus music on patient s anxiety levels. The study found that music therapy is a cheap alternative that is easy to use and noninvasive compared to other anti-anxiety treatments pre- or post-operatively. The Role of a Prescription in Anxiety Medication Use, Abuse, and Dependence. This study conducted by Miriam C. Fenton, M.P.H. Katherine M. Keyes, Ph.D. Silvia S. Martins, M.D., Ph.D. and Deborah S. Hasin, Ph.D. used a national survey to explore the factors that make a
patient more prone to medication use, abuse, and/or dependence. This study is helpful to our clinical question because it explores a reason why alternative therapies may be more beneficial than pharmacological methods. A Systematic Review of Yoga for State Anxiety: Considerations for Occupational Therapy. This systematic review by Neha Chugh-Gupta, Fulvia G. Baldassarre, and Brenda H. Vrkljan was conducted to explore how different life situations can induce anxiety and what alternative treatments best fit those experiencing anxiety. After searching through six databases and gathering 25 studies they found that yoga was the most successful alternative therapy to treat anxiety. Effect of Acupressure on Preoperative Anxiety: A Clinical Trial. This study done by Sina Valiee, MSc, Shiva Sadat Bassampour, MSc, Alireza Nikbakht Nasrabadi, PhD, Zahra Pouresmaeil, PhD, and Abbas Mehran, MSc was conducted to find out how acupressure would affect anxiety in patients before they had surgery. They found that acupressure, if used on the right pressure points, could significantly reduce anxiety. Meditative Therapies for Reducing Anxiety. This systematic review done by Kevin W. Chen, MPH, Ph.D., Christine C. Berger, Ph.D., Eric Manheimer, M.S., Darlene Forde, M.A., Jessica Magidson, M.S., Laya Dachman, B.A., and C. W. Lejuez, Ph.D compiles multiple studies into a review that focuses on the efficacy of meditative therapy on anxiety symptoms. They found that meditative therapy somewhat reduces anxiety symptoms but the studies focused on symptoms, not disorders. Effectiveness of Different Music-playing Devices for Reducing Preoperative Anxiety. In this study by Kwo-Chen Lee, Yuh-Huey Chao, Jia-Jean Yiin, Pei-Yi Chiang, and Yann-Fen Chao patients waiting for surgery in Taiwan were randomly assigned to groups to test the effectiveness
of broadcast music or individual headphones. They found a significant decrease in anxiety for both headphones and broadcasted music. Reducing Anxiety in Preoperative Patients. This systematic review by Alaa Ayyadhah Alanazi explored the various ways of delivering preoperative education. The author used different methods of delivering the education such as audiovisual, visual, and multimedia supported education; they found that any education reduces pre-operative anxiety. Discussion After reviewing all 8 of these studies and systematic reviews, our group has come to a conclusion that the best alternative therapy is music therapy. Music therapy was examined in three of our articles that we researched and critiqued. All three of those studies expressed that music therapy significantly reduced pre- and post-op anxiety. This addresses our clinical question in providing an alternative therapy to pharmaceutical care that is affective and can be widely used. Recommendations Our group recommends that there should be changes made with the delivery of this music therapy whether it be through individual handsets or broadcasted. This depends on the hospitals financial ability and infection control policies. For further research we recommend narrowing down the research to music therapy to find more statistics and studies to see the effectiveness and if it is worth using universally in each healthcare setting.
References Alanazi, A. A. (2014). Reducing anxiety in preoperative patients: a systematic review. British Journal Of Nursing, 23(7), 387-393. Retrieved October 26, 2014, from CINAHL Bailey, L. (n.d.). Strategies For Decreasing Patient Anxiety In The Perioperative Setting.AORN, 445-460. Chen, K., Berger, C., Manheimer, E., Forde, D., Magidson, J., Dachman, L., & Lejuez, C. (n.d.). Meditative Therapies For Reducing Anxiety: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials. Depression and Anxiety, 545-562. Chugh-Gupta, N., Baldassarre, F., & Vrkljan, B. (2013). A systematic review of yoga for state anxiety: Considerations for occupational therapy / Revue systematique sur l'efficacite du yoga pour traiter l'anxiete reactionnelle : Facteurs a considerer en ergotherapie. Canadian Journal of Occupational Therapy, 150-170. Fenton, M., Keyes, K., Martins, S., & Hasin, D. (n.d.). The Role of a Prescription in Anxiety Medication Use, Abuse, and Dependence. American Journal of Psychiatry, 1247-1253. Johnson, B., Raymond, S., & Goss, J. (n.d.). Perioperative Music or Headsets to Decrease Anxiety. Journal of Perianesthesia Nursing, 146-154. Lee, K., Chao, Y., Yiin, J., Chiang, P., & Chao, Y. (n.d.). Effectiveness of different music playing devices for reducing preoperative anxiety: A clinical control study. International Journal of Nursing Studies, 1180-1187. Valiee, S., Bassampour, S., Nasrabadi, A., Pouresmaeil, Z., & Mehran, A. (n.d.). Effect of Acupressure on Preoperative Anxiety: A Clinical Trial. Journal of Perianesthesia Nursing,259-266.