Music versus distraction for procedural pain and anxiety in patients with cancer

Oncol NuPURPOSE/OBJECTIVES: To test the hypotheses that the effects of a music intervention are greater than those of simple distraction and that either intervention is better at controlling procedural pain and anxiety than treatment as usual. DESIGN: Randomized, controlled experiment. SETTING: A midwestern comprehensive cancer center. SAMPLE: 60 people with cancer having noxious medical procedures such as tissue biopsy or port placement or removal; 58 provided usable data. METHODS: Participants completed measures of pain and anxiety before and after their medical procedures and provided a rating of perceived control over pain and anxiety after the procedure. MAIN RESEARCH VARIABLES: Procedural pain, state anxiety, and perceived control over pain and anxiety. FINDINGS: Contrary to hypotheses, outcomes achieved with music did not differ from those achieved with simple distraction. Moreover, outcomes achieved under treatment as usual were not significantly different from those obtained with music or distraction interventions. Some patients found that the interventions were bothersome and reported that they wanted to attend to the activities of the surgeon and the medical procedure itself. CONCLUSIONS: The effects of music, distraction, and treatment as usual are equivocal. In addition, patients have individual preferences for use of distraction during painful or anxiety-provoking procedures. IMPLICATIONS FOR NURSING: Patients having noxious medical procedures should be asked about their desire to be distracted before and during the procedure and offered a strategy that is consistent with their preferences.