Academic journal article Australian Journal of Music Therapy

The Use of Music to Relieve Pre-Operational Anxiety in Children Attending Day Surgery

Academic journal article Australian Journal of Music Therapy

The Use of Music to Relieve Pre-Operational Anxiety in Children Attending Day Surgery

Article excerpt


A music therapy program was provided .for children, aged 18 months to eleven years, awaiting elective surgery in the Day Surgery ward of a large paediatric hospital. The program aimed to relieve symptoms of pre-operational anxiety. Thirty-minute music therapy sessions provided opportunities for self-expression and choice, and aimed to glue children feelings of familiarity and security. A checklist was used to record children's behaviour before and after the sessions, while a questionnaire asked parents for comments on the atmosphere of the ward and their own child's anxiety before and after the music. Children were observed by the therapist to be less anxious following music therapy. Information gathered from the questionnaires showed that parents considered the atmosphere of the ward less tense and their own children to be less anxious after the session. It was recommended that music therapy be included as preparation for children of this age group attending Day Surgery.


The music therapy program described in this report took place in the Day Surgery section of a large paediatric hospital. "Day Surgery" describes the unit where children enter the hospital for elective surgery without the requirement of an overnight stay. Children arrive at the hospital early on the morning of their surgery and return home later in the day after a short recovery time. As an overnight stay is not necessary, treatment in Day Surgery takes less time, is less costly and minimizes the length of time children are separated from their parents. In other hospitals Day Surgery wards are also known as "Surgical Day Units', "Short-Stay Surgery", "One-Day Surgery", "Ambulatory Surgery" "Outpatient Surgery" or "Same-Day Surgery"

In Day Surgery a wide range of minor surgeries are performed, including: general surgery (e.g. the removal of hernias: circumcisions); optical (e.g. the correction of squints); ear, nose and throat (e.g. the insertion of drainage tubes; repair of fractured noses); orthopedic (e.g. the removal of wires or pins from joints: changing plasters); rheumatology, (e.g. administering injections to joints); treatment of bums (e.g. injections for scars); and plastic surgery (e.g. the removal of birthmarks, moles, scars; skin grafts).

Literature Review

Anxiety is commonly experienced by those facing hospitalization and surgery. Anticipation of the actual procedure of surgery may be accompanied by fears of the unknown, loss of control over one's body, pain, mutilation, separation from loved ones or death (Cowan, 1991; Froehlich, 1984; Marley, 1984). Changes in the patient's normal routine and exposure to the unfamiliar hospital environment also contribute to a generally stressful experience.

Symptoms of anxiety can manifest in behaviour as restlessness, trembling, shortness of breath, fearful facial expressions, muscular tension or fatigue. Physiological changes may include increases in heart rate, blood pressure and respiration, fluctuatons in body temperature, sweaty palms, urinary urgency, dry mouth, enlarged pupils and loss of appetite (Moss, 1987, cit. Cowan, 1991; Hanser, 1985).

The amount of anxiety experienced varies between individuals. Writers on the causes of anxiety place importance on the individual's perception of danger and the perceived ability to cope with stressful situations (Knight et al., 1979; Lazarus, 1966 and Mechanic, 1970, cit. in Hanser, 1985).

Gove (1985) includes in a definition of anxiety:

   An abnormal and overwhelming sense of apprehension and fear often
   marked by physiological signs (as sweating, tension, and increased
   pulse), doubt concerning the reality and nature of the threat, and
   by self-doubt regarding one's capacity to cope with it (p. 93).

For a child attending a Day Surgery ward. it appears that neither the short stay in hospital nor the type of surgery received determines the amount of anxiety experienced. …

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