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CompletedNCT04170842Updated Nov 20, 2019

Music During Paediatric Outpatient Wound Dressing Changes: Impact on Anxiety, Pain and Patient Satisfaction

An interventional study of Music intervention in Wound Heal, sponsored by KK Women's and Children's Hospital. Completed. Open to participants aged 9 Years to 21 Years. Per ClinicalTrials.gov, last updated 2019-11-20.

Sponsored by KK Women's and Children's Hospital · Not applicable, Interventional, and Supportive care

From the registry’s dates

  • Registered 2 years 10 months after the study started (first participant enrolled Dec 2016, registered Nov 2019).
Phase
Not applicable
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
9 Years to 21 Years
Sex
All
01

Study summary

Background: Wound dressing changes can be painful and distressing for children and the consequences of poorly managed pain and anxiety can be lifelong. Multiple sessions are usually required, and recurrent painful episodes can trigger significant anxiety and behavioural changes with subsequent escalation on re-exposure. Music has been shown to improve relaxation and reduce autonomic activity in paediatric oncology outpatients and have significant positive effect on postoperative pain, anxiety and distress.

Aims: The investigators propose using music listening as a complement to alleviate anxiety, reduce pain and improve the experience of surgical outpatients undergoing wound dressing changes. Investigators will also evaluate the impact on physiological parameters, such as heart rate and blood pressure.

Hypothesis: That pain and anxiety are significantly reduced and patient satisfaction is significantly improved when wound dressings are accompanied by music intervention.

Methodology: A prospective crossover randomised controlled trial recruiting 88 surgical outpatients aged 9 years and above undergoing multiple wound dressing changes. Patients will be randomised to receive music intervention either during the first or subsequent dressing change, with the alternate dressing change not accompanied by music. Patient selected music will be chosen with the input of a trained music therapist. Participants will complete post session self-assessment questionnaires on pain, anxiety and satisfaction. Physiological parameters will be measured pre and post session.

Importance: If proven feasible and effective, this intervention may improve patient experience by reducing pain and anxiety associated with outpatient wound dressing changes, improve patient satisfaction by taking advantage of the relaxing and calming effects of music listening, and improve clinical efficiency by using a cost-effective method for alleviating pain and anxiety

Risks/benefits: There is minimal risk as usual standard treatment protocols for wound management continues. Patients may benefit from the soothing effects of music.

Read the detailed description

Music intervention - The music intervention used in the study will be a patient selected list of songs or other music delivered to the participant by passive listening via in-ear or on-ear headphones. They will be given the choice of using their own personal headphones or use a pair provided by the hospital. If choosing to use a hospital device, the earphones provided will be disposable to minimise infection risk from re-use.

Patient preferred music has shown to be more effective than preselected, or prescriptive music. Prescriptive music, if not of the patient's preference, could cause further discomfort, distress or anxiety. Therefore, investigators will use streaming services to provide a bank of music containing a wide range of music and genres to suit the majority of music preferences. Music will also be curated based on feedback from age-appropriate sources to identify common and popular music in the target participant age group.

Participants will work with the music therapist to make their selections. Music therapists will provide input on how best to synchronise type, tempo and genre of music to the wound dressing procedure. As musical preference is very personal, the choice of music provided will try to strike a balance of providing what is acceptable to patients while not exposing them to music with known stimulatory effects.

Patients will be given the opportunity to look to music therapists for support in choosing or creating a playlist to accompany their procedure.Through a brief questionnaire the music therapists will gather pertinent information such as favourite styles, experience playing instruments, favourite artists/songs as well as the challenges related to their first experience. The music therapist will help to identify possible song choices/playlists for various parts of the procedure that may decrease their perception of pain by refocusing their attention.

Randomisation - This will be a randomised crossover study. Patients will be randomised into 2 groups:

Group 1: One dressing change or procedure after recruitment will be accompanied by music intervention. Subsequent dressing change or procedure will NOT be accompanied by music intervention.

Group 2: One dressing change or procedure after recruitment will NOT be accompanied by music intervention. Subsequent dressing change or procedure will be accompanied by music intervention.

With this crossover design, all recruited participants will have the opportunity to experience the music intervention.

02

Conditions studied

  • Wound Heal

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Keywords

  • Wound dressing
03

In context

Wounds and Injuries

5,056 studies on the registry are indexed under Wounds and Injuries; 861 are open to participants now.

This study's enrollment of 48 is close to the median of 52 across 3,239 interventional studies indexed under Wounds and Injuries.

Browse Wounds and Injuries studies →

Lead sponsor

KK Women's and Children's Hospital is the lead sponsor of 136 studies on the registry; 33 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
9 Years to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Aged 9 years and above, male or female
  2. Anticipated to require at least 2 further wound dressing changes or outpatient painful procedures (e.g. cryotherapy for skin lesions)
  3. Already had at least one outpatient dressing change or painful outpatient procedure prior to recruitment
  4. Able to communicate clearly, navigate simple technical software, be awake and alert
  5. Not hearing impaired
  6. Willing to use headphones
  7. Able to read and communicate in English

Exclusion criteria

Exclusion Criteria:

  1. Hearing impaired
  2. Abnormal anatomy of external ear (unable to use headphones)
  3. Wound site prevents use of headphones - for example, on the ear
05

Study design

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

Study arms

  • Experimental
    Music intervention

    The music intervention used in the study will be a patient selected list of songs or other music delivered to the participant by passive listening via in-ear or on-ear headphones. They will be given the choice of using their own personal headphones or use a pair provided by the hospital. If choosing to use a hospital device, the earphones provided will be disposable to minimise infection risk from re-use. Patient preferred music has shown to be more effective than preselected, or prescriptive music. Prescriptive music, if not of the patient's preference, could cause further discomfort, distress or anxiety. Therefore, investigators will use streaming services to provide a bank of music containing a wide range of music and genres to suit the majority of music preferences. Music will also be curated based on feedback from age-appropriate sources to identify common and popular music in the target participant age group.

    Other: Music intervention

  • No intervention
    Control

    Wound dressing procedure conducted according to clinical practice

Interventions

  • OtherMusic intervention

    Participants will work with the music therapist to make their selections. Music therapists will provide input on how best to synchronise type, tempo and genre of music to the wound dressing procedure. As musical preference is very personal, the choice of music provided will try to strike a balance of providing what is acceptable to patients while not exposing them to music with known stimulatory effects.

06

What researchers measure

Primary outcomes

  1. Self-assessment of pain

    Using the numeric rating score, which is standard pain score used in the institution ranging from 0-10 where a score of 10 indicates 'worst possible pain' and 0 indicates 'no pain'.

    Time frame: Immediately after intervention

  2. Anxiety score

    Spielberger State-Trait Anxiety Inventory Score for Children (STAIC) which is a validated anxiety score in children, or the Spielberger STAI Score which is a validated anxiety score in adolescents and adults. This score allows adjustment for the different scores that may be produced for a given situation in individuals who may vary in baseline anxiety levels.

    Time frame: Immediately after intervention

  3. Satisfaction survey

    A modified version of the patient satisfaction survey currently used by KK Hospital to assess patient satisfaction with outpatient services

    Time frame: Immediately after intervention

Secondary outcomes

  1. Heart rate

    Physiological observations before and after dressing changes

    Time frame: Before and immediately after intervention

  2. Blood pressure readings

    Physiological observations before and after dressing changes

    Time frame: Before and immediately after intervention

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Stinson J, Yamada J, Dickson A, Lamba J, Stevens B. Review of systematic reviews on acute procedural pain in children in the hospital setting. Pain Res Manag. 2008 Jan-Feb;13(1):51-7. doi: 10.1155/2008/465891. PubMed 18301816 ↗
  • Hyland EJ, D'Cruz R, Harvey JG, Moir J, Parkinson C, Holland AJA. An assessment of early Child Life Therapy pain and anxiety management: A prospective randomised controlled trial. Burns. 2015 Dec;41(8):1642-1652. doi: 10.1016/j.burns.2015.05.017. Epub 2015 Oct 6. PubMed 26452308 ↗
  • Wilson-Smith EM. Procedural Pain Management in Neonates, Infants and Children. Rev Pain. 2011 Sep;5(3):4-12. doi: 10.1177/204946371100500303. PubMed 26526331 ↗
  • Stouffer JW, Shirk BJ, Polomano RC. Practice guidelines for music interventions with hospitalized pediatric patients. J Pediatr Nurs. 2007 Dec;22(6):448-56. doi: 10.1016/j.pedn.2007.04.011. PubMed 18036465 ↗
  • George S, Ahmed S, Mammen KJ, John GM. Influence of music on operation theatre staff. J Anaesthesiol Clin Pharmacol. 2011 Jul;27(3):354-7. doi: 10.4103/0970-9185.83681. PubMed 21897507 ↗
  • Moris DN, Linos D. Music meets surgery: two sides to the art of "healing". Surg Endosc. 2013 Mar;27(3):719-23. doi: 10.1007/s00464-012-2525-8. Epub 2012 Oct 6. PubMed 23052506 ↗
  • Tan X, Yowler CJ, Super DM, Fratianne RB. The efficacy of music therapy protocols for decreasing pain, anxiety, and muscle tension levels during burn dressing changes: a prospective randomized crossover trial. J Burn Care Res. 2010 Jul-Aug;31(4):590-7. doi: 10.1097/BCR.0b013e3181e4d71b. PubMed 20498613 ↗
  • Protacio J. Patient-directed music therapy as an adjunct during burn wound care. Crit Care Nurse. 2010 Apr;30(2):74-6. doi: 10.4037/ccn2010250. No abstract available. PubMed 20360454 ↗
  • van der Heijden MJ, Oliai Araghi S, van Dijk M, Jeekel J, Hunink MG. The Effects of Perioperative Music Interventions in Pediatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One. 2015 Aug 6;10(8):e0133608. doi: 10.1371/journal.pone.0133608. eCollection 2015. PubMed 26247769 ↗
  • DeLoach Walworth D. Procedural-support music therapy in the healthcare setting: a cost-effectiveness analysis. J Pediatr Nurs. 2005 Aug;20(4):276-84. doi: 10.1016/j.pedn.2005.02.016. PubMed 16030507 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 20, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04170842
Lead sponsor
KK Women's and Children's Hospital
Responsible party
Sponsor
First posted
Nov 20, 2019
Start date
Dec 23, 2016
Primary completion
Mar 25, 2019
Completion
Mar 28, 2019
Last update
Nov 20, 2019

Oversight

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

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