A music-based intervention programme proves to be effective in lowering anxiety and pain magnification among patients undergoing Caesarean section surgery.

Music can set the mood in a room to alter one’s state of mind.

There is no doubt that music has its benefits, but is it relevant in a medical setting? According to patients who participated in KK Women’s and Children’s Hospital (KKH)’s music-based intervention programme, Healing Tunes, the answer is a resounding “yes”.

A soundtrack for giving birth

Launched last May, and the first of its kind in Singapore, Healing Tunes allows patients undergoing Caesarean section to select songs and create a playlist to accompany their experience. By listening to their music selection before, during and after the surgery, the programme aims to reduce anxiety and pain magnification.

Associate Professor Sng Ban Leong (below), Head and Senior Consultant, Department of Women’s Anaesthesia, KKH, and his team found in a study that, with musicbased intervention, their patients’ state of mind improved significantly. “In the study published in 2023, among the group of patients who had the music-based intervention when undergoing elective Caesarean sections, their anxiety scores were halved, and pain magnification scores were reduced by 35 per cent,” said Assoc Prof Sng. The research paper on that study, ‘Effect of music listening on perioperative anxiety, acute pain and pain catastrophising in women undergoing elective Caesarean delivery’, was published in BMC Anaesthesiology.

Ms Kayla Wong (below), Senior Music Therapist, Child Life, Art and Music Therapy Programmes, KKH, explained that patients listening to their preferred music enjoy “the effect of increasing relaxation, bringing on the associated benefit of alleviating anxiety”. She added: “Evidence shows that music-based interventions can be effective in reducing anxiety, which in turn can make the Caesarean surgery experience less daunting.”

Pregnant with worry

Typically, pregnant patients are given spinal anaesthesia during Caesarean sections but remain awake throughout. As such, they feel anxious and may focus on the pain. Increased blood pressure, heart and breathing rates are the physical effects of anxiety that add to the stress on a patient’s body during surgery

Besides having higher pain scores, the effects of anxiety extend beyond surgery, with patients developing an increased risk of persistent pain and postnatal depression. “In the study, which involved 108 KKH patients, we found that anxiety was prevalent in seven out of 10 patients, while pain magnification was prevalent in around three out of 10 patients,” shared Assoc Prof Sng.

Conventionally, medications are used to treat anxiety related to surgery. But such medications carry side effects that are transferred from the pregnant patient to her baby. Such risks do not apply with Healing Tunes.

Goodbye anxiety

Besides easing the anxiety levels of pregnant patients undergoing Caesarean sections, Healing Tunes offers other benefits. “Our memories are embedded within music that is meaningful to us. Choosing familiar and personalised favourite music to accompany their delivery experience can create stronger familial bonds between parents and the baby,” said Ms Wong.

By curating their delivery experience soundtrack, patients “play a part in their care while sharing a part of who they are through their musical identity with the team”, added Ms Wong. This in turn enables patients to create meaningful connections with the medical staff, allowing them to offer better support.

Since the nurses in the Operating Theatres led its implementation, Healing Tunes has enjoyed a high adoption rate among all pregnant patients undergoing Caesarean sections, with almost all opting for the music-based intervention programme. Reactions from the patients have been overwhelmingly positive. Ms Shen Haiying (below), Senior Nurse Manager, Operating Theatres, KKH, pointed out: “From the feedback that we have gathered, the satisfaction and recommendation rates were 92 per cent and 93 per cent respectively.”

Since late 2023, patients undergoing embryo transfer at the KKIVF Centre have been able to adopt music-based intervention to reduce their anxiety. “The KKH team continues to improve the Healing Tunes workflow and patient satisfaction, and plans to offer it to other types of patients,” shared Ms Shen.

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