The Use of Patient-Preferred Music to Improve Patient Experience during Interfacility Ambulance ...

56 Pages·2015·4.31 MB·English

by  Katie Louise Myers

Florida State University Libraries
Electronic Theses, Treatises and Dissertations The Graduate School
2013
The Use of Patient-Preferred Music
to Improve Patient Experience during
Interfacility Ambulance Transport
Katie L. Myers
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FLORIDA STATE UNIVERSITY

COLLEGE OF MUSIC

THE USE OF PATIENT-PREFERRED MUSIC TO IMPROVE PATIENT EXPERIENCE
DURING INTERFACILITY AMBULANCE TRANSPORT

By

KATIE L. MYERS

A Thesis submitted to the
Department of Music Therapy
in partial fulfillment of the
requirements for the degree of
Master of Music

Degree Awarded:
Fall Semester, 2013
Katie Myers defended this thesis on September 16, 2013.
The members of the supervisory committee were:

Jayne Standley
Professor Directing Thesis

Dianne Gregory
Committee Member

Kimberly VanWeelden
Committee Member

The Graduate School has verified and approved the above-named committee members, and
certifies that the thesis has been approved in accordance with university requirements.
ii
This thesis is dedicated to opening new avenues for the field of music therapy, and to improving
the lives of many new clients through music therapy.

iii
ACKNOWLEDGMENTS
I would like to thank these people, whose support made this thesis possible:
Leon County Emergency Medical Services, for being willing to take a risk in allowing me to
incorporate music therapy services into an area of emergency medicine that has never provided
music therapy services before.

The emergency medical technicians and paramedics of Leon County, for their dedication to their
patients, and for willing to become more informed about music therapy in order to help improve
patient care.

The patients who were willing to participate in this study, without whom, this study would not
have been possible.

Dr. Standley, who was so patient with me, and always able to provide an answer to my every
question throughout the research process.

Dr. VanWeelden for making research fun and exciting, and for serving on my thesis committee.

Professor Gregory, for her caring spirit and dedication to improving the field of music therapy,
and for serving on my thesis committee.

My fellow music therapy grads, who inspire me to be better every day, and continue to be so
eager to collaborate in order to make the field of music therapy the best that it can be.

Elaine, Emily, and Ellyn, for being incredibly supportive and reassuring throughout the thesis
process, and for helping me navigate the most difficult parts of graduate school.

My sister Rachel, for being my best friend, and always giving me the encouragement I need to
navigate the obstacles in life.

My family, for their constant love and support, and for taking an interest in my journey as a
music therapist.

My parents, whose love and support has provided me with countless opportunities to do
whatever I set my mind to, and who are the reason for everything I have accomplished.

iv
TABLE OF CONTENTS
List of Tables ................................................................................................................................. vi
List of Figures .............................................................................................................................. vii
Abstract ........................................................................................................................................ viii
INTRODUCTION ...........................................................................................................................1
REVIEW OF LITERATURE ..........................................................................................................3
Interfacility Transport ......................................................................................................................3
Transport Demographics ............................................................................................................3
Patient Experience During Interfacility Transport .....................................................................4
Ambulance Environment ...........................................................................................................5
Music Therapy .................................................................................................................................6
Beneficial Qualities of Music ....................................................................................................6
Effectiveness of Music Therapy in Emergency Medicine .........................................................8
METHODS ....................................................................................................................................13
Case Study Approach .....................................................................................................................13
Setting ......................................................................................................................................13
Design ......................................................................................................................................13
Case Study Participants............................................................................................................13
Case Study Procedure ..............................................................................................................14
RESULTS AND DISCUSSION ....................................................................................................16
Case Study Results .........................................................................................................................16
Participant Case Studies ...........................................................................................................16
Summary Results .....................................................................................................................18
Case Study Discussion .............................................................................................................23
Clinical Recommendations ......................................................................................................27
APPENDICES ...............................................................................................................................29
A. HUMAN SUBJECTS APPROVAL FROM FLORIDA STATE UNIVERSITY .................29
B. EMT CONSENT TO PARTICIPATION ..............................................................................30
C. CONSENT TO PARTICPATION ........................................................................................31
D. PATIENT SURVEY .............................................................................................................33
E. MUSICAL GENRE SELECTIONS ......................................................................................36
REFEERENCES ............................................................................................................................43
BIOGRAPHICAL SKETCH .........................................................................................................47

v
LIST OF TABLES
1 Table 1: Participant Demographics ....................................................................................14

2 Table 2: Negative Mood Scale Changes ............................................................................20

3 Table 3: Positive Mood Scale Changes .............................................................................20
4 Table 4: Pain Scale Changes .............................................................................................20

vi
LIST OF FIGURES
1 Figure 1: Pulse ...................................................................................................................21

2 Figure 2: Oxygen Saturation ..............................................................................................21

3 Figure 3: Systolic Blood Pressure ......................................................................................22

4 Figure 4: Diastolic Blood Pressure ....................................................................................22

vii
ABSTRACT
The aim of this study is to determine whether there is a significant difference between self-
reported scores of anxiety, mood state, and pain levels and the physiological comparison of vital
signs when patients are allowed to listen to preferred music during interfacility ambulance
transport. The music therapist administered a mood scale prior to and following interfacility
ambulance transport, and measured vital signs prior to, during, and following transport for all
participants (N=5). In addition, the music therapy intervention of listening to self-selected music
on an iPad was provided to the participants in the music condition (n=2). Results determined that
music therapy was effective in increasing relaxation and comfort, and in positively impacting the
experience of interfacility ambulance transport. Participant feedback on the study questionnaire
indicated that 100% patients would prefer listening to their selected genre of music during
ambulance transport.

viii
INTRODUCTION
There is limited research regarding interfacility ground transports, however, the number
of interfacility transports has been rapidly increasing in recent years. The cause of recent
increases is due to a decrease in the number of hospitals and an increase in the centralization of
specialists in high-level hospitals (Koppenberg & Taeger, 2002). Additionally, changes in
reimbursement for medical treatment may necessitate transfer to a designated facility that can
provide services for payers (National Highway Traffic Safety Administration, 2006).
The National Highway Traffic Safety Administration (2006) defines interfacility transfer
as “any transfer, after initial assessment and stabilization, from and to a health care facility.”
Transports may occur from hospital to hospital, clinic to hospital, hospital to rehabilitation
facility, and hospital to long-term care facility (NHSTA, 2006). A wide variety of facilities use
interfacility transport services for transfer of patient care, including skilled nursing facilities,
physician offices, clinics, custodial care centers, acute care hospitals, home and hospice care
facilities, board and care facilities, and urgent care centers (County of Santa Clara County
Emergency Medical Services System, 2013).
The interfacility transport experience may cause or increase patient stress and anxiety due
to separation from family, lack of patient control in decision-making, and other unknown factors,
such as an unfamiliar hospital, city, and length of transport (Brown, Tompkins, Chaney, &
Donovan, 1998). In addition, patients may be critically ill and have underlying disease stressors
(Stuhlmiller, Lamba, Rooney, Chait, & Dolan, 2009). These added disease stressors may
manifest as anxiety, which is comprised of a physiological response in the arousal of the
autonomic nervous system, in addition to the psychological component involving feelings of
powerlessness, apprehension, and impending doom (Stuhlmiller et al., 2009). While there has
been such an increase in numbers of interfacility transports, there is still little research about
anxiety due to transport, and whether anti-anxiety interventions are successful (Stuhlmiller et al.,
2009).
The American Music Therapy Association (2013) defines music therapy as “the clinical
and evidence-based use of music interventions to accomplish individualized goals within a
therapeutic relationship by a credentialed professional who has completed an approved music
therapy program”. Berry (2013) provides a rationale for the necessity of having a music therapist
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