***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: 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 Pre‐operative anxiety is common and often significant . Ambulatory surgery challenges our pre‐operative goal of an anxiety‐free patient by requiring people to be ‘ street ready ’ within a brief period of time after surgery . Recently , it has been demonstrated that music can be used successfully to relieve patient anxiety before operations , and that audio embedded with tones that create binaural beats within the brain of the listener decreases subjective levels of anxiety in patients with chronic anxiety states . We measured anxiety with the  State‐Trait Anxiety Inventory question naire and compared binaural beat audio ( Binaural Group ) with an identical soundtrack but without these added tones ( Audio Group ) and with a third group who received no specific intervention ( No Intervention Group ) . Mean [ 95 % confidence intervals ] decreases in anxiety scores were 26.3%[19–33 % ] in the Binaural Group ( p = 0.001 vs. Audio Group , p < 0.0001 vs. No Intervention Group ) , 11.1%[6–16 % ] in the Audio Group ( p = 0.15 vs. No Intervention Group ) and 3.8%[0–7 % ] in the No Intervention Group . Binaural beat audio has the potential to decrease acute pre‐operative anxiety significantly Many patients in the Surgical Holding Area become stressed and anxious . In a hospital setting music reduces patients '  anxiety . This study determined that music can reduce the anxiety and stress of patients in the Surgical Holding Area . In this study , one group of subjects listed to music while a second group did not . Subjects who listened to music while in the Surgical Holding Area had significantly less stress and anxiety than did those who did not listen to music . Both groups spent similar lengths of time in the Surgical Holding Area . The results strongly suggest that if music were available to all patients in the Surgical Holding Area , most would select this option , and they would experience less anxiety UNLABELLED The purpose of this study was to determine whether larger doses of anesthetics are required in the anxious patient to establish and maintain a clinical ly sufficient hypnotic component of the anesthetic state . Fifty-seven women undergoing bilateral laparoscopic tubal ligation with a propofol-based anesthetic regimen  were enrolled in this cross-sectional study . Trait ( baseline ) and state ( situational ) anxiety were assessed in all patients immediately before surgery , and the propofol doses required for the induction and maintenance of anesthesia were recorded . A  bispectral index monitor was used to assure that the hypnotic component of the anesthetic state was the same in all patients . We found that patients with high trait anxiety required more propofol for both the induction ( 2.1+/-0.4 vs 1.8+/-0.3 mg/kg ; P = 0.01 ) and maintenance of anesthesia ( 170+/-70 vs 110+/-20 microg x kg(-1 ) x min(-1 ) ; P = 0.02 ) , compared with patients with low trait anxiety . State anxiety , however , was not found to affect the propofol doses required for the induction or maintenance of anesthesia . Multiple regression models confirmed that Trait anxiety is an independent predictor for intraoperative propofol requirements ( P = 0.02 ) . We conclude that increased baseline ( i.e. , trait ) anxiety is associated with increased intraoperative anesthetic requirements . Thus , we suggest that the initial dose of anesthetic administered by an anesthesiologist should be modified based on the anxiety level exhibited by the patient . IMPLICATION S The goal of this study was to assess the relationship between preoperative anxiety and intraoperative anesthetic requirements . We found that high baseline anxiety predicts increased intraoperative anesthetic requirements . We suggest that anesthesiologists should modify the initial induction dose based on the anxiety level exhibited by the patient The anticipation of surgery has been recognized as a stressful event that produces anxiety for most patients ( Kapnoullas 1988 ) . Even minor surgical procedures can produce anxiety in patients ; this in turn can affect their postoperative recovery and lead to a risk of physiological complications ( Swindale 1989 ) . Thus , preoperative anxiety is identified as one of the common nursing diagnoses or problems for surgical patients The ambient noise of monitors , other patients , and staff in the postanesthesia care unit/operating room may elevate levels of anxiety . The purpose of our study was to determine the effect of music versus noise-blocking headphones on the level of anxiety in women undergoing gynecologic same-day surgery . Institutional Review Board approval was obtained . The women were approached for consent and r and omized to usual care , music with headphones , or headphones only . Preoperative and postoperative anxiety was rated on a scale of 0 to 10 . Music/headphones were continued throughout surgery and removed when Aldrete level of consciousness equaled 2 . The 119 women had a mean age of 38.8 ( st and ard deviation=2.2 ) years . Of interest , 51 ( 45 % ) reported very low preoperative anxiety  ( 0 - 3/10 ) and were excluded . All groups experienced a drop in anxiety from pre- to postoperative status , but the usual care group had the least improvement ( P<.05 ) . The music group experienced the lowest postoperative anxiety scores ; the headphone group had a greater change overall . Music is a relatively inexpensive intervention , easy to administer , and noninvasive The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . AIMS AND OBJECTIVES To identify the effect of music on preprocedure anxiety levels of Hong Kong Chinese patients undergoing day procedures in a local community based hospital . DESIGN Pre and post-test quasi experimental design with non-r and om assignment . METHOD A total of 113 participants were assigned to the control group or intervention group depending on the day of their procedure . Participants ' anxiety levels were measured objective ly by comparing their vital signs and subjectively by the Spielberger State Trait Anxiety Scale . Participants ' physiological parameters ( blood pressure , pulse and respiration ) and State Trait Anxiety Scale were measured at two time periods . The control group undertook the usual relaxing activities provided in the waiting room compared with the intervention group who listened to music of their own choice in reclining chairs while waiting for the procedure . RESULTS The physiological parameters for both the control and intervention groups dropped significantly during the waiting period , however , only the intervention group had a significant reduction in reported anxiety levels . CONCLUSIONS These results suggest that providing self-selected music to day procedure patients in the preprocedure period assists in the reduction of physiological parameters and anxiety , yet , a relaxing environment can assist in the reduction of physiological parameters . RELEVANCE TO CLINICAL PRACTICE The administration of self-selected music to day procedure patients in the preprocedure period can be effective in the reduction of physiological parameters and anxiety The purpose of this r and omized controlled trial was to investigate the influences of music during kangaroo care ( KC ) on  maternal anxiety and preterm infants ' responses .  There are no experimental studies that explore the influences of combination of music and KC on psychophysiological responses in mother-infant dyads . Purposive sampling was used to recruit 30 hospitalized preterm infants body weight 1500 gm and over , gestational age 37 weeks and lower from two NICUs . Mother-infant dyads were r and omly assigned to the treatment and the control group using permuted block r and omization stratified on gender . There were 15 mother-infant dyads in each group . Subjects in the treatment dyads listened to their choice of a lullaby music during KC for 60 min/section/day for three consecutive days . Control dyads received routine incubator care . Using a repeated measures design with a pretest and three posttests , the responses of treatment dyads including maternal anxiety and infants ' physiologic responses ( heart rate , respiratory rate , and O2 saturation ) as well as behavioural state were measured . The results revealed that there were no significant differences between the two groups on infants ' physiologic responses and the values were all in the normal range . However , infants in the treatment group had more occurrence of quiet sleep states and less crying ( p<0.05 - 0.01 ) . Music during KC also result ed in significantly lower maternal anxiety in the treatment group ( p<0.01 ) . Maternal state anxiety improved daily , indicating a cumulative dose effect . The findings provide evidence for the use of music during KC as an empirically-based intervention for bahavioural state stability and maternal anxiety in mother-infant dyads This study aim ed to provide an objective view of the relationship between the giving of information , anxiety and  hospital admission .  Previous research has suggested that patients are already anxious on admission to hospital and that any information given at this time may be forgotten easily or misunderstood . Forty patients listed for simple elective surgery participated in this study . Using an experimental design , subjects in the experimental group were interviewed and information given to them in their own home before admission and again on their first day in hospital . A  state-trait anxiety question naire was used to compare both groups . The result ant difference in the anxiety level shown between both groups on admission was found to be significant Pre‐operative anxiety is associated with many unwanted effects such as increased analgesic and anaesthetic requirement , postoperative pain and prolonged hospital stay . In the present study , we investigated the effects of acupressure on pre‐operative anxiety and bispectral index ( BIS ) values . Seventy‐six adults , ASA grade I and II , undergoing elective surgery , were r and omly assigned to two equal groups . Group 1 ( control ) received acupressure at an inappropriate site and group 2 ( acupressure ) received acupressure at extra 1 point . The study was conducted during the pre‐operative period and the duration of the study was 40 min ( acupressure was applied for 10 min and thereafter patients were observed for another 30 min ) . Anxiety was recorded on a visual stress scale ( VSS ) at the start of the study and thereafter at 10 and 40 min . BIS was recorded at 0 , 2 , 5 , 10 , 12 , 15 , 30 and 40 min . The VSS decreased in both groups following pressure application for 10 min : median VSS ( interquartile range ) were 5 ( 1 ) vs. 8 ( 1 ) in the acupressure and 7 ( 0 ) vs. 8 ( 1 ) in the control groups ( p < 0.001 ) . Both pre‐operative anxiety and BIS decreased significantly during acupressure application at extra 1 point ( p < 0.001 ) . Acupressure is effective in decreasing both pre‐operative anxiety and BIS ; however , these effects are not sustained 30 min following release of acupressure . Further studies are needed to eluci date the duration for which acupressure is effective BACKGROUND While waiting 
    Output:
    
The results suggested that music listening may have a beneficial effect on preoperative anxiety .
The results also suggested a small effect on heart rate and diastolic blood pressure , but no support was found for reductions in systolic blood pressure , respiratory rate , and skin temperature .
One large study found that music listening was more effective than the sedative midazolam in reducing preoperative anxiety and equally effective in reducing physiological responses .
This systematic review indicates that music listening may have a beneficial effect on preoperative anxiety .
Therefore , we conclude that music interventions may provide a viable alternative to sedatives and anti-anxiety drugs for reducing preoperative anxiety