Nonpharmacological

Methods to Lower Anxiety

in Patients
Sylvia Kim
Azusa Pacific University
Overview

❖  Problem
❖  Key Findings
❖  Clinical Implications & Nursing Practice
❖  Barriers to Implementation
❖  Next steps
❖  Conclusion
Problem/Issue

❖  Anxiety (Lee et al., 2012)

■  Physiological alterations
■  Emotional alterations
❖  Interventions (Zengin et al., 2013)
■  Pharmacological Image from www.drgaglioti.com/chiropractic-anxiety-panic-disorder/

■  Nonpharmacological
Key Findings
❖  Music therapy
■  General anesthesia (Bae, Lim, Hur, & Lee, 2014)
■  Waiting room (Lee et al., 2012)
■  Port catheter placement (Zengin et al., 2013)
❖  Guided visual imagery + music therapy
■  Chemotherapy (Karagozoglu, Tekyasar, & Yilmax, 2012)
❖  Play distraction
■  Pediatric surgery (Al-Yateem, Brenner, Shorrab, & Docherty, 2016)
Clinical Implications & Nursing Practice

❖  Play music before, during, and

after invasive procedures or
prolonged treatments (Bae et al., 2014; Lee et
al., 2012; Zengin et al., 2013; Karagozoglu et al., 2012)

❖  Implement in surgical, oncology, Image from www.jordantimes.com/

and pediatric units (Bae et al., 2014; Karagozoglu

et al., 2012; Al-Yateem et al., 2016)
Barriers to Implementation
❖  Involvement of family members
(Al-Yateem et al., 2016)

❖  Nursing burnout (Henry, 2014) Image from www.gizmodo.com/

❖  Sterile field is compromised

with headphones
❖  Patients with hearing or visual
disabilities Image from www.cnn.com/
Next steps

❖  Cost effective, convenient, and easy to apply (Karagozoglu et al.,

2012)

❖  Need for further research

■  Types of music (Bae et al., 2014)
■  Headphones vs. speakers (Bae et al., 2014)
■  Western culture (Bae et al., 2014; Lee et al., 2012; Zengin et al., 2013; Karagozoglu et
al., 2012; Al-Yateem et al., 2016)

■  Larger sample size (Karagozoglu et al., 2012)

Conclusion

Nonpharmacological
interventions are effective
methods to lower anxiety
levels in patients.

Image from www.medicalxpress.com/

References
Al-Yateem, N., Brenner, M., Shorrab, A., & Docherty, C. (2016). Play distraction versus pharmacological
treatment to reduce anxiety levels in children undergoing day surgery: A randomized controlled
non-inferiority trial. Child: Care, Health and Development, 42(4), 572-581. doi: 10.1111/cch.12343
Bae, I., Lim, H., Hur, M.-H., & Lee, M. (2014). Intra-operative music listening for anxiety,the BIS index, and the
vital signs of patients undergoing regional anesthesia. Complementary Therapies in Medicine, 22, 251-257.
doi: 10.1016/j.ctim.2014.02.002
Henry, B. (2014). Nursing burnout interventions: What is being done? Clinical Journal of Oncology Nursing,
18(2), 211-214. doi: 10.1188/14.CJON.211-214
Karagozoglu, S., Tekyasar, F., & Yilmaz, F. (2012). Effects of music therapy and guided visual imagery on
chemotherapy-induced anxiety and nausea-vomiting. Journal of Clinical Nursing, 22, 39-50. doi:
10.1111/jocn.12030
Lee, K.-C., Chao, Y.-H., Yiin, J.-J., Hsieh, H.-Y., Dai, W.-J., & Chao, Y.-F. (2012). Evidence that music listening
reduces preoperative patients’ anxiety. Biological Research for Nursing, 14(1), 78-84. doi:
10.1177/1099800410396704
Zengin, S., Kabul, S., Behcet, A., Sarcan, E., Dogan, M., & Yildirim, C. (2013). Effects of music therapy on pain
and anxiety in patients undergoing port catheter placement procedure. Complementary Therapies in
Medicine, 21, 689-696. doi: 10.1016/j.ctim.2013.08.017