***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM AND OBJECTIVE The study compared the effect of earplug-delivered sleep-inducing music on sleep in persons with percutaneous transluminal coronary angiography in the cardiac care unit . BACKGROUND Diverse types of music have been cl aim ed to improve sleeping elsewhere , but relatively little is known in South Korea . Most studies investigating the effect of sleep-inducing music on sleep have involved persons with insomnia , even though many persons with cardiovascular disease in the intensive care unit suffer from sleeping problems . There is a need to investigate the effect of sleep-inducing music on sleep disorders in persons with percutaneous transluminal coronary angiography in the cardiac care unit . DESIGN An experimental research design was used . METHODS Data collection was conducted in the cardiac care unit of K University Hospital in D city , from 3 September-4 October 2010 . Fifty-eight subjects participated and were r and omly assigned to the experimental group ( earplug-delivered sleep-inducing music for 52 min beginning at 10:00 pm , while wearing an eyeshield , n = 29 ) and the control group ( no music , but earplugs and eyeshield worn , n = 29 ) . The quantity and quality of sleep were measured using question naires at 7 am the next morning for each group . RESULTS Participants in the experimental group reported that the sleeping quantity and quality were significantly higher than control group ( t = 3·181 , p = 0·002 , t = 5·269 , p < 0·001 , respectively ) . CONCLUSION Sleep-inducing music significantly improved sleep in patients with percutaneous transluminal coronary angiography at a cardiac care unit . Offering earplugs and playing sleep-inducing music may be a meaningful and easily enacted nursing intervention to improve sleep for intensive care unit patients . RELEVANCE TO CLINICAL PRACTICE Nurses working at cardiac care unit can use music to improve sleeping in clients with percutaneous transluminal coronary angiography CONTEXT Music has been used in the acute clinical care setting as an adjunct to current treatment modalities . Previous studies have indicated that some types of music may benefit patients by reducing  pain and anxiety , and may have an effect on physiological measures . OBJECTIVE To evaluate the scientific foundation for the implementation of a complementary therapy , harp playing . The research questions for this pilot study were : Does live harp playing have an effect on patient perception of anxiety , pain , and satisfaction ? Does live harp playing produce statistically and clinical ly significant differences in physiological measures of heart rate , systolic and diastolic blood pressure , respiratory rate , and oxygen saturation ? DESIGN A prospect i ve , quasiexperimental , repeated measures design was used with a convenience sampling . SETTING Orl and o Regional Medical Center , Orl and o Fla. PATIENTS Subjects wer eligible for the study if they were postoperative and admitted to a hard-wired-bedside-monitored room of the Vascular Thoracic Unit within the 3 days of the study period . INTERVENTION A singl e20-minute live harp playing session . MAIN OUTCOME MEASURES Visual analog scales ( VAS ) were used to measure patient anxiety and pain . Patient satisfaction was measured with a 4-item question naire . Physiological measures ( heart rate , systolic and diastolic blood pressure , respiratory rate , and oxygen saturation ) were recorded from the bedside monitor . METHODS Visual analog scales ( VAS ) were completed just before harp playing , 20 minutes after harp playing was started , and 10 minutes after completion . Patient satisfaction with the experience was measured with a 4-item question naire . Physiological measures ( heart rate , systolic and diastolic blood pressure , respiratory rate , and oxygen saturation ) were recorded from the bedside monitor at baseline ( 5 minutes before study setup ) , at zero , 5 , 10 , 15 , and 20 minutes after harp playing began , and at 5 and 10 minutes after harp playing stopped . RESULTS Seventeen patients were used in this study , with a retrospective power of .91 . Results indicate that listening to live harp music has a positive effect on patient perception of anxiety ( P=.000 ) , pain ( P=.000 ) and satisfaction . Live harp playing also produced statistically significant differences in physiological measures of systolic blood pressure ( P=.046 ) , and oxygen saturation ( P=.011 ) . Although all values over time trended downward , the changes of other variables were not adequate to achieve statistical or clinical significance . CONCLUSION Subjects in this study experienced decreased pain and anxiety with the harp intervention , and slight reductions in physiologic variable values . It is not possible in this study to determine if the results were due to the harp music , the presence of the harpist and data collector , or both . Future research is recommended using a control group and comparison of live versus recorded harp music with a wider variety of diagnoses and procedures Purpose To test the effect of a music intervention on procedural anxiety , stress response and medication requirements in participants with a cerebral aneurysm or arteriovenous malformation ( AVM ) undergoing cerebral angiography . Method and material s A prospect i ve pilot study was conducted using an experimental two group pre-test , post-test design . 48 participants were r and omly assigned to a control group ( st and ard care ) or experimental group ( st and ard care plus self-selected music via overhead stereo system ) . The stress response was measured by heart rate ( HR ) and systolic blood pressure ( SBP ) at baseline , and during and following the procedure . Anxiety was measured by the State Trait Anxiety Inventory for Adults ( STAI ) before and after the procedure , and total medications administered periprocedurally were recorded . Results 24 participants in each group were enrolled . R-ANCOVA revealed non-significant findings for HR ( F=1.4 ; p=0.27 ; power=0.38 ) and SBP ( F=2.1 ; p=0.10 ; power=0.57 ) . The ANCOVA for anxiety revealed significantly lower STAI scores in the control group ( F=3.8 ; p=0.003 ) compared with the experimental group . Independent t test analysis for the total doses of fentanyl and midazolam were found to be F=0.08 , p=0.78 and F=0.38 , p=0.54 , respectively . Conclusion A music intervention on participants with a brain aneurysm or AVM undergoing cerebral angiography did not have a statistically significant impact on reducing the stress response , anxiety or medication requirements . Interestingly , participants in the control group had significantly less anxiety after their angiogram than did participants in the experimental group . This pilot study sets the stage for future research to further examine these findings BACKGROUND Postoperative pain and anxiety are common in cardiac surgery patients . Studies have suggested that music can decrease anxiety in hospitalized patients . Primary Study Objective This study focused on the efficacy and feasibility of special music , which included nature sounds , for pain and anxiety . METHODS / DESIGN In this r and omized controlled trial , postoperative cardiovascular surgery patients were r and omly assigned to a music group to receive 20 minutes of st and ard postoperative care and music twice daily on postoperative days 2 through 4 or to a control group to receive 20 minutes of st and ard care with a quiet resting period twice daily on postoperative days 2 through 4 . SETTING Cardiovascular surgical unit of Saint Marys Hospital , Rochester , Minnesota . PARTICIPANTS One hundred patients completed the study ( music group , n = 49 ; control group , n = 51 ) . Intervention The music was delivered through CD players in the patients ' rooms . PRIMARY OUTCOME MEASURES Pain , anxiety , satisfaction , and relaxation were evaluated from visual analog scales . RESULTS Data showed a significant decrease in mean ( SD ) pain scores after the second session of day 2 for the music group ( change , ? 1.4 [ 1.4 ] ) compared with the control group ( change , ? 0.4 [ 1.4 ] ) ( P = .001 ) . Mean relaxation scores improved more at the first session of day 2 for the music group ( change , 1.9 [ 2.7 ] ) compared with the control group ( change , 0.3 [ 2.9 ] ) ( P = .03 ) . The music group also showed lower anxiety and increased satisfaction overall , but these differences were not statistically significant . No major barriers to using the therapy were identified . CONCLUSION Recorded music and nature sounds can be integrated into the postoperative care of cardiovascular surgery patients . The recordings may provide an additional means for addressing common symptoms of pain and anxiety while providing a means of relaxation for these patients OBJECTIVE To test the efficacy of music and muscle relaxation techniques in reducing the anxiety of patients admitted to a coronary care unit with ischemic heart disease . DESIGN R and omized , controlled trial . SETTING Seven-bed coronary care unit of an Australian tertiary care hospital . PATIENTS Fifty-six patients admitted to a coronary care unit with unstable angina pectoris or acute myocardial infa rct ion . OUTCOME MEASURES Psychologic ( State Trait Anxiety Inventory , Hospital Anxiety and Depression Scale , Linear Analogue Anxiety Scale ) and physiologic ( systolic and diastolic blood pressure and heart rate ) variables were measured as indicators of anxiety . INTERVENTION Two or three 30-minute sessions of audiotape interventions were conducted with portable tape players with headphones . The two intervention tapes consisted of light classical music and verbal instructions for muscle relaxation . RESULTS With analysis of variance procedures , the null hypotheses were supported . No significant differences ( p < 0.05 ) between groups were demonstrated for the psychologic or physiologic variables ; that is , no significant reductions in anxiety were achieved for patients using music or muscle relaxation interventions when compared with the control group . The effect size of the interventions on the outcome measures was 0.19 to 0.22 , indicating a small effect . Result ant power was at a low level . CONCLUSIONS These results differ from those of similar studies but may be related to the high probability of a type II error . Further investigation with longer intervention sessions and larger sample sizes is indicated . Similar studies should incorporate power analysis when reporting their results AIM To evaluate the effect of bed rest with music on relaxation for patients who have undergone heart surgery on postoperative day one . BACKGROUND Music intervention has been evaluated as an appropriate nursing intervention to reduce patients ' pain , stress and anxiety levels in several clinical setting s , but its effectiveness in increasing patients ' subjective and objective relaxation levels has not been examined . DESIGN A r and omised controlled trial . METHOD Forty patients undergoing open coronary artery bypass grafting and /or aortic valve replacement surgery were r and omly allocated to either music listening during bed rest ( n = 20 ) or bed rest only ( n = 20 ) .  Relaxation  was assessed during bed rest the day after surgery by determining the plasma oxytocin , heart rate , mean arterial blood pressure , PaO2 SaO2 and subjective relaxation levels . RESULTS In the music group , levels of oxytocin increased significantly in contrast to the control group for which the trend over time was negative i.e. , decreasing values . Subjective relaxation levels increased significantly more and there were also a significant higher levels of PaO2 in the music group compared to the control group . There was no difference in mean arterial blood pressure , heart rate and SaO2 between the groups . CONCLUSION Listening to music during bed rest after open-heart surgery has some effects on the relaxation system as regards s-oxytocin and subjective relaxations levels . This effect seems to have a causal relation from the psychological ( music makes patients relaxed ) to the physical ( oxytocin release ) . RELEVANCE TO CLINICAL PRACTICE Music intervention should be offered as an integral part of the multimodal regime administered to the patients that have undergone cardiovascular surgery . It is a supportive source that increases relaxation Background : Pain is a common phenomenon after surgery . Cardiac surgeries are no exception and patients generally experience acute pain after these surgeries . Inadequate pain management after cardiac surgery predisposes patients to many complications . Therefore , the aim of this study was to determine the effects of listening to preferred music on pain intensity after open heart surgery . Material s and Methods : This study was a r and omized clinical trial ( RCT ) conducted in open heart intensive care unit ( ICU ) of a university hospital in Sari , Iran . A total of 60 patients who were scheduled to undergo open heart surgery were r and omly allocated in two groups . Patients in the intervention group ( n = 30 ) listened to their preferred music by headphones for 30 minutes , whereas those in the control group ( n = 30 ) did not listen to music . Using a Numerical Rating Scale ( NRS ) , pain intensity was measured among the patients before the intervention , and immediately , 30 minutes and one hour after the intervention . Data was analyzed by Chi-square test , student 's t-test and repeated measures analysis of variance ( ANOVA ) . Findings : Mean pain intensity in the intervention group before , immediately after , 30 minutes and one hour after the intervention were 5.8 , 3.1 , 2.5 and 2.4 , respectively . Corresponding numbers in the control group were 4.7 , 4.7 , 4.8 and 4.9 , respectively . Repeated measures ANOVA showed music to significantly reduce pain intensity ( p = 0.0001 ) Conclusions : Music can be effective as a non-pharmacological , inexpensive , non-invasive and side effect free method for pain management after open heart surgery The purpose of this study was to examine the effects of relaxing music on elevated state anxiety in patients with a confirmed medical diagnosis of acute myocardial infa rct ion . In addition , the relationship between trait anxiety and state anxiety was analyzed . A purposive sample of 40 myocardial infa rct ion patients was r 
    Output:
    
The results also suggest that listening to music may improve patients ' quality of sleep following a cardiac procedure or surgery ( SMD = 0.91 , 95 % CI 0.03 to 1.79 , P = 0.04).We found no strong evidence for heart rate variability and depression .
This systematic review indicates that listening to music may have a beneficial effect on anxiety in persons with CHD , especially those with a myocardial infa rct ion .
Anxiety-reducing effects appear to be greatest when people are given a choice of which music to listen to .
Furthermore , listening to music may have a beneficial effect on systolic blood pressure , heart rate , respiratory rate , quality of sleep and pain in persons with CHD .