Many ICU patients require mechanical ventilation (MV) which can cause consistent high levels of anxiety and increase the risk of complications, as well as lead to longer lengths of hospital stays and higher rates of morbidity and mortality. Generally, as patients recover from acute illness, they can be """"""""weaned"""""""" off of the ventilator. Weaning is a gradual decrease in ventilator settings that leads to liberation from mechanical ventilatory support. Anxiety is a major psychological issue experienced during MV and during the MV weaning process. Music intervention is one integrative therapy shown to decrease pain and anxiety during MV. Incorporating music into the care of the mechanically ventilated patient has strong potential to alleviate the symptom burden and the high cost of conventional treatments, as well as increase patient satisfaction and promote efficient weaning. Little research has been conducted to evaluate the impact of music on ventilator weaning trials. While music has been studied previously in MV patients, a large knowledge gap exists regarding music's influence during ventilator weaning trials. Further evaluation of music intervention during weaning trials is essential to determine if this adjunctive therapy can reduce anxiety during weaning trials and promote efficient ventilator liberation. Incorporating music during ventilator weaning trials is an innovative idea that warrants more thorough investigation. The proposed research is a secondary analysis of data from the primary sponsor's R01-NR009295 (L.Chlan, PI) using exploratory survival analysis, a proportional hazards regression, and linear regression. This project is significant because of the potential clinical benefit to ventilated patients. It wil provide an in-depth analysis of the influence of anxiety on ventilator weaning trials as well as th effect of music on anxiety during mechanical ventilator weaning trials by evaluating objective data originally obtained through a large randomized controlled clinical trial. The knowledge gained from this study will advance current practices of anxiety management during weaning trials in mechanically ventilated patients. This study is consistent with NINR's 2011 Strategic Plan to advance the quality of life through symptom management during acute illness. The findings will provide new information regarding the influence of anxiety during weaning from MV and the potential impact of music on anxiety during weaning from MV. The knowledge obtained through activities proposed in this training plan has the potential to lead to innovative perspectives and strategies for medical management of the mechanically ventilated patient, as well as build the evidence base supporting the use of integrative therapies as viable adjuncts in the care of the estimated 5 million patients who experience acute critical illness each year.

Public Health Relevance

More than 750,000 people undergo mechanical ventilation each year, and this expensive treatment can lead to severe anxiety which can delay weaning from the ventilator. Failure to wean from mechanical ventilation can increase patient morbidity and mortality. This study will provide a more comprehensive understanding of the influence of anxiety on ventilator weaning trials and the impact music may have on anxiety and weaning trials.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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Nursing Science Review Committee (NRRC)
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Banks, David
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University of Minnesota Twin Cities
Schools of Nursing
United States
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Hetland, Breanna; Lindquist, Ruth; Weinert, Craig R et al. (2017) Predictive Associations of Music, Anxiety, and Sedative Exposure on Mechanical Ventilation Weaning Trials. Am J Crit Care 26:210-220
Hetland, Breanna; Lindquist, Ruth; Chlan, Linda L (2015) The influence of music during mechanical ventilation and weaning from mechanical ventilation: A review. Heart Lung 44:416-25