• First such programme in Singapore
  
• With music-based intervention, anxiety related to Caesarean section surgery was halved; pain magnification¹ scores were reduced by 35 per cent

"Most expectant mothers are given spinal anaesthesia during elective Caesarean sections. During the procedure, they would be awake, may feel anxious and think about possible negative pain experience. In the study we conducted on KKH patients, we found that anxiety was prevalent in seven out of 10 of the patients . However, with music-based intervention, their states improved significantly," said Associate Professor Sng Ban Leong, Senior Author of the study, and Head and Senior Consultant, Department of Women's Anaesthesia, KKH.

In a study of 108 women at KKH, patients who had music-based intervention when undergoing elective Caesarean sections, anxiety scores were halved, and pain magnification (when an individual thinks of the pain in the worst possible outcome, and feels helpless or hopeless, making it difficult to cope) scores were reduced by 35 per cent².

"It is important to manage anxiety in the patient's journey - before, during and after surgery. Anxiety is often associated with increased blood pressure, heart and breathing rates, adding stress on the patient's body during surgery. Patients with pre-existing anxiety also tend to have higher pain scores after Caesarean delivery, which may lead to an increased risk of developing persistent pain and postnatal depression. Addressing anxiety places our patients in the optimal state for their surgery and recover" added Associate Professor Sng.

Conventionally, anxiety related to surgery is treated with medications. However, in recent times, music-based intervention has emerged as an effective tool to ease anxiety.

Ms Kayla Wong, Senior Music Therapist, Child Life, Art and Music Therapy Programmes (CHAMPs) said, "Evidence shows that music-based interventions can be effective for reducing anxiety, which in turn can make the Caesarean surgery experience less daunting. Listening to music that the patient prefers has the effect of increasing relaxation, bringing on the associated benefit of alleviating anxiety."

All patients undergoing elective Caesarean section at the hospital will be offered this music-based intervention as part of the KKH birthing journey. Ms Shen Haiying, Senior Nurse Manager, Operating Theatres, KKH, said, "Patients are encouraged to choose their preferred tunes from a selection of songs that spans genres, to cater to their diverse preferences. They then create a playlist based on the selection and listen to them before, during and after surgery. Patients are also encouraged to include their preferred tunes, should they not be on the selection. Nine out of 10 pregnant patients have taken up the music-based intervention since its implementation a month ago."

There are plans to gradually expand the music-based intervention programme to benefit more patients who require other types of surgeries. Healing Tunes is part of KKH's continuous efforts to enhance the patient experience to ensure that it is as comfortable and stress-free as possible. It is led by a team of nurses and doctors across various disciplines and departments.

For more details on the patient journey of Healing Tunes, please refer to Annex A.

¹This refers to an individual thinking of the pain in the worst possible outcome, and feeling helpless or hopeless, making it difficult to cope.
²Kakde A, Lim MJ, Shen H, Tan HS, Tan CW, Sultana R, Sng BL. Effect of music listening on perioperative anxiety, acute pain and pain catastrophizing in women undergoing elective cesarean delivery: a randomized controlled trial. BMC Anesthesiol. 2023 Apr 3;23(1):109. doi: 10.1186/s12871-023-02060-w. PMID: 37013499; PMCID: PMC10069065.