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CompletedNCT03412019Updated Mar 3, 2020Results posted

Music vs. No Music During Cesarean Delivery on Patient Satisfaction

An interventional study of Music in Patient Satisfaction, sponsored by Tufts Medical Center. Completed at 1 site in United States. Open to female participants aged 18 Years to 50 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-03-03.

Sponsored by Tufts Medical Center · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
22
Allocation
Randomized
Ages
18 Years to 50 Years
Sex
Female
01

Study summary

Several studies have demonstrated that music can improve various outcomes during labor and delivery. However, many of these studies didn't measure satisfaction rate accurately. This study aim to assess patient satisfaction in the setting of music or no music during the cesarean delivery. The study will be conducted in the labor and delivery unit and the expected number to enroll and complete the study is 22.

Read the detailed description

Background:

Several studies have demonstrated that music can improve various outcomes during labor and delivery. In particular, patient satisfaction is often measured on a simple VAS scale, where 0 is no satisfaction and 10 is the highest satisfaction. However, patient satisfaction is a complex parameter to measure, and may be affected by a number of different factors. This study will be performed on the labor and delivery unit to assess patient satisfaction with a validated, reliable, 22-question survey in the setting of music or no music during the cesarean delivery.

Although "music" is an all-encompassing term that describes sound with different pitches and rhythms that comes together as a harmonious whole, not all music is the same. Using "music" for therapeutic purposes would be the equivalent of using "antibiotics" to cure an infection; it is too general of a term, and unlikely that such a general use of music would show a valid therapeutic benefit. However, a study demonstrated that specific selections of Mozart piano sonatas, which have a specific rhythm and mode, improve patient anxiety through a biochemical mechanism (changing the plasma levels of IL-6 and epinephrine). Therefore, in this study, the term "music" will specifically means the same Mozart sonatas as described in the prior study.

Objectives:

The objective of this study is to determine the effect of music on patient satisfaction and anxiety during cesarean delivery.

The hypothesis is that parturients exposed to music during cesarean delivery will have greater overall satisfaction and less anxiety.

Study Timelines:

  • Participation begins at the time of consultation for cesarean delivery on the day of surgery, where the co-investigator Dr. Dahlawi will approach the participants and ask them to sign the ICF, and it ends after the post-anesthesia check on postoperative day 1. After recruitment and consent, patients will be randomized using a computer-generated randomization scheme will be used to allocate patients to one of the arms of the study.
  • The two arms of the study are as follows:

    • Control group: baseline hemodynamics and anxiety screen; no music
    • Intervention group - Mozart: A study investigator will turn on a playlist of pre-selected Mozart music.
02

Conditions studied

  • Patient Satisfaction

Keywords

  • Music
  • Patient Satisfaction
03

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Age: 18-50 years old
  • Scheduled for elective cesarean delivery
  • Nulliparity
  • Singleton pregnancy
  • Full term fetus (≥37.0 weeks gestational age)
  • Healthy fetus (no known congenital diseases at the time of surgery)
  • Requesting neuraxial anesthesia for the procedure
  • Able to provide informed consent

Exclusion criteria

Exclusion Criteria:

  • Patient refusal
  • Prior history of extensive abdominal surgery
  • Active labor
  • Contraindication to neuraxial anesthesia
  • Uncorrected coagulopathy
  • Infection at the skin site of epidural placement
  • Increased intracranial pressure
  • Untreated hemodynamic instability
  • Known hypersensitivity to local anesthetics (a.k.a. amide or ester allergy)
  • Patients with impaired hearing
  • Patient on anti-anxiolytic medication
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
22 participants (actual)

Study arms

  • No intervention
    Control group

    baseline hemodynamics and anxiety screen; no music. Satisfaction will be measured.

  • Experimental
    Intervention group - Mozart

    A study investigator will turn on a playlist of pre-selected Mozart music. Hemodynamics and anxiety screen. Satisfaction will be measured.

    Other: Music

Interventions

  • OtherMusic

    Selections of Mozart piano sonatas

05

What researchers measure

Primary outcomes

  1. Patient Satisfaction

    This outcome will be measured using Morgan's "Maternal Satisfaction Scale for Cesarean Section" (MSSCS). It is a 22-item questionnaire, each item have a Likert scale from 1-7 (1 =strongly disagree, 7=strongly agree), yielding a composite (total) score ranging 22-154, representing lowest to highest satisfaction. The questionnaire will be given to participants on post-operative day one during the hours of 8am-1pm.

    Time frame: 1 Day

Secondary outcomes

  1. Patient Anxiety

    Change in anxiety before and after surgery using a numeric rating scale from 0 (no anxiety at all) to 10 (greatest anxiety)

    Time frame: Perioperatively

  2. Hemodynamic Parameter (Mean Arterial Pressure, MAP)

    This is the post-procedure mean arterial pressure of the patients.

    Time frame: post procedure

06

Results

Posted Mar 3, 2020

Participant flow

Participant flow — Overall Study
MilestoneControl GroupIntervention Group
Started1111
Completed1010
Not completed11
Withdrew: Withdrawal by subject11

Outcome measures

PrimaryPatient Satisfaction

This outcome will be measured using Morgan's "Maternal Satisfaction Scale for Cesarean Section" (MSSCS). It is a 22-item questionnaire, each item have a Likert scale from 1-7 (1 =strongly disagree, 7=strongly agree), yielding a composite (total) score ranging 22-154, representing lowest to highest satisfaction. The questionnaire will be given to participants on post-operative day one during the hours of 8am-1pm.

Time frame:
1 Day
Reported as:
Mean · units on a scale
Patient Satisfaction
units on a scaleControl GroupIntervention Group
Patient Satisfaction120 ± 22.3116 ± 16.4
SecondaryPatient Anxiety

Change in anxiety before and after surgery using a numeric rating scale from 0 (no anxiety at all) to 10 (greatest anxiety)

Time frame:
Perioperatively
Reported as:
Mean · NRS scale (0-10)
Patient Anxiety
NRS scale (0-10)Control GroupIntervention Group
Patient Anxiety2.5 ± 2.62.7 ± 2.7
SecondaryHemodynamic Parameter (Mean Arterial Pressure, MAP)

This is the post-procedure mean arterial pressure of the patients.

Time frame:
post procedure
Reported as:
Mean · mmHg
Hemodynamic Parameter (Mean Arterial Pressure, MAP)
mmHgControl GroupIntervention Group
Hemodynamic Parameter (Mean Arterial Pressure, MAP)82.2 ± 24.880.4 ± 8.4

Adverse events

Collected over 24 hours. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Control Group0/11 (0%)0/11 (0%)0/11 (0%)
Intervention Group0/11 (0%)0/11 (0%)0/11 (0%)

Baseline characteristics

Parturients scheduled for cesarean delivery

Age, Continuous
Age, Continuous(years)Control GroupIntervention GroupTotal
Mean36.2 ± 4.232.1 ± 6.134.2 ± 5.5
Sex: Female, Male
Sex: Female, Male(Participants)Control GroupIntervention GroupTotal
Female101020
Male000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Control GroupIntervention GroupTotal
American Indian or Alaska Native000
Asian011
Native Hawaiian or Other Pacific Islander000
Black or African American000
White6612
More than one race000
Unknown or Not Reported437
07

Study locations

1 site
  • Tufts Medical Center
    Boston, Massachusetts 02111, United States
08

References and documents

Publications

  • Morgan PJ, Halpern S, Lo J. The development of a maternal satisfaction scale for caesarean section. Int J Obstet Anesth. 1999 Jul;8(3):165-70. doi: 10.1016/s0959-289x(99)80132-0. PubMed 15321139 ↗
  • Conrad C, Niess H, Jauch KW, Bruns CJ, Hartl W, Welker L. Overture for growth hormone: requiem for interleukin-6? Crit Care Med. 2007 Dec;35(12):2709-13. doi: 10.1097/01.ccm.0000291648.99043.b9. PubMed 18074473 ↗

Study documents

  • Protocol and statistical analysis plan · Oct 16, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Will be shared upon reasonable request.

Supporting information: Study protocol

09

Registry details

Key details

Study ID
NCT03412019
Lead sponsor
Tufts Medical Center
Responsible party
Sponsor
First posted
Jan 26, 2018
Start date
Feb 21, 2018
Primary completion
Aug 6, 2019
Completion
Aug 6, 2019
Results posted
Mar 3, 2020
Last update
Mar 3, 2020

Study contacts

Dan Drzymalski, MD
principal investigator · Tufts Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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