| 摘要: | 背景及目的：靜脈注射是兒童住院期間最害怕的侵入性治療之一，也造成兒童疼痛的主要來源，如何協助兒童緩解靜脈注射之疼痛與焦慮非常重要，聆聽音樂常被用於緩解兒童疼痛，本研究旨在探討聆聽音樂對兒童靜脈處置之疼痛及焦慮改善成效。
研究方法：以系統性文獻回顧及統合分析研究設計，探討聆聽音樂對兒童靜脈處置疼痛及焦慮之成效分析，針對七個中英文資料庫進行文獻檢索。研究對象為接受靜脈處置之兒童，年齡小於十八歲，介入措施為聆聽音樂，成效指標包含疼痛及焦慮，並依據考科藍的誤差風險評估工具(Cochran risk of bias tool, Rob 2.0)進行文獻品質評估，以Comprehensive Meta-Analysis V.3 (CMA) 統計軟體進行統合分析。
研究結果：共10篇隨機對照研究納入分析，結果顯示，聆聽音樂可降低兒童靜脈處置之疼痛，整體標準化平均數差值(SMD)為-0.686 (95% CI = -1.130 ~ -0.242，p <0.05)；而聆聽音樂對兒童靜脈處置之焦慮無顯著改善成效(SMD= -0.132,95% CI=-0.355~ 0.091, p=0.247)。由於各研究結果對疼痛之改善存在高度異質性(Q=57.961, I2 =86.198%)，故進行次族群分析。結果顯示，足跟穿刺之靜脈注射、對象為新生兒、使用揚聲器播放、選擇搖籃曲、聆聽音樂大於10分鐘、量表經觀察者填寫及使用0-10分量表者(FACES、VAS、FPS-R)，在疼痛改善成效顯著優於其它的次族群成效。
結論：聆聽音樂對兒童靜脈處置之疼痛具改善成效，但異質性高；另外，聆聽音樂雖然可降低焦慮分數，但未達顯著性統計差異。
Background: Intravenous injection is one of the most feared invasive treatments in children during hospitalization. It is also the main source of children’s pain. How to help children relieve pain and anxiety caused by intravenous injection is very important. Listening to music is often used to relieve children’s pain.
Purpose: The aims to explore the effects of Music listening on Pain and Anxiety in Children during Intravenous Treatment: A Systematic Review and Meta-Analysis.
Research Methods: The study used systematic review and Meta-analysis to analyze the effects of music listening on pain and anxiety in children during intravenous treatment. b Seven, database were searched. Subjects under 18 years old who received intravenous treatment were included. The intervention consisted of listening to music, and the outcome measures were improvement in pain and anxiety. Cochran Risk of Bias Tool (Rob 2.0) was used to evaluate literature quality, and statistical Analysis software Comprehensive Meta-analysis V.3 (CMA).
Result: A total of 10 randomized controlled studies were included. In terms of pain, the results show that listening to music can reduce the pain of intravenous treatment in children. The overall standardized mean difference (SMD) is -0.686 (95% CI = -1.130 ~ -0.242, p <0.05). Treatment of anxiety did not show a significant improvement effect (SMD= -0.132, 95% CI=-0.355~0.091, p=0.247). Since the results of each study have a high degree of heterogeneity in the improvement of pain (Q=57.961, I2 =86.198%), a sub-ethnic analysis was performed. The results showed that those who were at the heel puncture site, the subject was a newborn, used loudspeaker to play, selected lullaby, listened to music for more than 10 minutes, and the scale was filled out by the observer and used the 0-10 subscale (FACES、VAS、FPS-R), the pain improvement effect was significantly better than others The effectiveness of the sub-ethnic group. The effect of listening to music on children's heartbeat changes during intravenous treatment, standardized mean difference (SMD) -0.672 (95% CI= -1.314 ~ -0.030, p <0.05), showing that listening to music has statistically significant effect on children's heartbeat changes during intravenous treatment difference.
Conclusion: Listening to music can effectively improve the pain of children's intravenous treatment, But the heterogeneity is high, Although listening to music can reduce the anxiety score, it does not reach a statistically significant difference. |
