pain, music, orthopedic, pain management


Objective: The objective of this study was to add to the body of knowledge about the impact of music on postoperative pain and anxiety. The specific purpose of this research study was to determine if listening to music and/or having a quiet rest period just prior to and just after the first ambulation on postoperative day 1 can reduce pain and/or anxiety, or impact mean arterial pressure, heart rate, respiratory rate, and/or oxygen saturation in patients following a total knee arthroplasty. Methods: An experimental repeated measures design was used. Setting: A postoperative orthopedic unit in a 300-bed community hospital in the southeastern United States. Sample: Fifty-six patients having a total knee arthroplasty, randomly assigned to either a music intervention group or a quiet rest group. Measures: A visual analog scale was used to measure pain and anxiety. Physiological measures, including blood pressure, heart rate, oxygen saturation, and respiratory rate, were also obtained. Results: A repeated measures analysis of variance between and within groups was conducted for pain and anxiety. Statistical findings between groups indicated the music group's decrease in pain or anxiety was not significantly different from the comparison rest group's decrease in pain (F = 1.120, p = .337) or anxiety (F = 1.566, p = .206) at any measurement point. However, statistical findings within groups indicated that when the groups were combined, the sample had a statistically significant decrease in pain (F = 6.699, p = .001) and anxiety (F = 4.08, p = .013) over time. Post hoc analyses showed the significant decrease in pain was from time 1 (just prior to the initiation of music or rest) to time 2 (just after 20 minutes of music or rest) (t(55) = 4.751, p = .000). Post hoc analyses showed the significant decrease in anxiety was from time 1 (just prior to the initiation of music or rest) to time 2 (just after 20 minutes of music or rest) (t(55) = 2.86, p = .006). Additionally, anxiety decreased significantly from time 3 (just after physical therapy) and time 4 (after second period of 20 minutes of music or rest period) (t(55) = 2.222, p = .030). Implications: Results of this research provides evidence to support the use of music and/or a quiet rest period to decrease pain and anxiety when initiated just before and just after ambulation on postoperative day 1 following a total joint arthroplasty of the knee. The interventions pose no risks, and have the benefits of improved pain reports and decreased anxiety. It potentially could be opioid sparing in some individuals, limiting the negative effects from opioids. Nurses can offer music as an intervention to decrease pain and anxiety in this patient population with confidence, knowing there is evidence to support its efficacy.


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Graduation Date





Byers, Jacqueline


Doctor of Philosophy (Ph.D.)


College of Health and Public Affairs



Degree Program









Release Date

May 2007

Length of Campus-only Access


Access Status

Doctoral Dissertation (Open Access)

Included in

Nursing Commons