Today, endoscopic evaluation of digestive system is an important diagnostic approach in gastrointestinal

diseases. As it is an invasive method, it causes fear and anxiety in patients. The current study was fulfilled to evaluate

the effect of music therapy during endoscopy on the anxiety of patients by measuring blood pressure.

 This is an experimental study of single blind clinical trial type. The participants were patients in the endoscopy

unit in the age range of 30 to 60, undergoing endoscopy or colonoscopy for the first time with negative history of

cardiovascular diseases or hypertension. Cases were randomly placed in two groups: the experiment group who listened

to music during the procedure and the control group who did not listen to music during the procedure. The patients’

blood pressures, arterial blood oxygen saturation during the procedure as well as their demographic information were

recorded. Finally, the data was analyzed using t- test and analysis of variance by SPSS software.

 Our results demonstrated that patients of the experiment group had lower systolic and diastolic blood pressure

and higher arterial blood oxygen saturation comparing to control group, but the difference was not statistically significant.

Also it was showed that the blood pressure altered more in the patients underwent colonoscopy comparing

those underwent endoscopy. The difference was statistically significant. (p= 0.034) Mean duration of endoscopy procedure

in control group was higher than that of the experiment group.

 Light music has useful effects on cooperation and tolerance of patients during the procedure by regulating

blood pressure and oxygen saturation of blood and reducing the duration of the procedure

امانی, فیروز

تذکری, زهرا

کریم اللهی, منصوره

English

ArUMS Digital Repository (سامانه اطلاعات زیست پزشکی و سلامت)

Received: 8 Nov. 2006 Accepted: 27 May 2006 
Original Article 
* MSc, Department of Nursing, School of Nursing and Midwifery, Ardebil University of Medical Sciences, Ardebil, Iran. 
** MSc, Department of Nursing, School of Nursing and Midwifery, Ardebil University of Medical Sciences, Ardebil, Iran. 
*** MSc, Department of Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. 
Correspondence to: Zahra Tazakori MSc. 
E-mail: tazakorri@yahoo.com 
Research Article of Vice Chancellor of Ardebil University of Medical Sciences, No: 102. 
10 Iranian Journal of Nursing and Midwifery Research Winter 2007; Vol 12, No 1. 
The Effect of Music Therapy on Patients' Blood Pressure in Endoscopy Unit in 
Bou-Ali hospital, Ardebil 
Z. Tazakori*, F. Amani**, M. Karimollahi*** 
Abstract 
BACKGROUND: Today, endoscopic evaluation of digestive system is an important diagnostic approach in gastrointesti-
nal diseases. As it is an invasive method, it causes fear and anxiety in patients. The current study was fulfilled to evalu-
ate the effect of music therapy during endoscopy on the anxiety of patients by measuring blood pressure. 
METHODS: This is an experimental study of single blind clinical trial type. The participants were patients in the endo-
scopy unit in the age range of 30 to 60, undergoing endoscopy or colonoscopy for the first time with negative history of 
cardiovascular diseases or hypertension. Cases were randomly placed in two groups: the experiment group who listened 
to music during the procedure and the control group who did not listen to music during the procedure. The patients’ 
blood pressures, arterial blood oxygen saturation during the procedure as well as their demographic information were 
recorded. Finally, the data was analyzed using t- test and analysis of variance by SPSS software. 
RESULTS: Our results demonstrated that patients of the experiment group had lower systolic and diastolic blood pres-
sure and higher arterial blood oxygen saturation comparing to control group, but the difference was not statistically sig-
nificant. Also it was showed that the blood pressure altered more in the patients underwent colonoscopy comparing 
those underwent endoscopy. The difference was statistically significant. (p= 0.034) Mean duration of endoscopy proce-
dure in control group was higher than that of the experiment group. 
CONCLUSIONS: Light music has useful effects on cooperation and tolerance of patients during the procedure by regulat-
ing blood pressure and oxygen saturation of blood and reducing the duration of the procedure. 
KEY WORDS: Music, endoscopy, blood pressure, anxiety 
 
 
IJNMR 2007; 12(1): 10-12 
 
oday, endoscopic evaluation of diges-
tive system is an important diagnostic 
approach in gastrointestinal diseases. 
As it is an invasive method, it causes fear and 
anxiety, hemodynamic changes and decrease 
in blood oxygen saturation (1). In recent years, 
researchers seek effective non-pharmacological 
and non-invasive methods to reduce anxiety. 
In this regard, several studies were carried out 
to evaluate the effect of music therapy and 
different types of music on anxiety control (2). 
Different types of music such as classical 
and relaxing music would increase patients’ 
tolerance during endoscopy procedure and 
help them get relaxed due to its neuro-
logical effects (3). Michigan University studies 
revealed that some types of music have effect 
on heart rate, respiratory rate and also endor-
phin release (4). As clinical indications of diag-
nostic endoscopy and colonoscopy increase, it 
is necessary to find appropriate non-invasive 
and non-pharmacological relaxing methods to 
reduce the procedure induced anxiety. Music 
therapy is a non-invasive method to reduce 
the anxiety caused by the procedure. As there 
were not any similar studies, the current 
study was carried out to evaluate the effect of 
music therapy on blood pressure (BP) as the 
index of anxiety in patients undergoing endo-
scopy or colonoscopy. It was supposed that 
T 
The Effect of Music Therapy on Patients' Blood Pressure… Tazakori et al 
Iranian Journal of Nursing and Midwifery Research Winter 2007; Vol 12, No 1. 11 
music therapy would affect BP and blood 
oxygen saturation. 
Methods 
This is an experimental study of single blind 
clinical trial type, carried out on the patients 
admitted at the endoscopy unit of Bou-Ali 
hospital, Ardebil, in year 2004. 
Among the admitted patients for endo-
scopy and colonoscopy, ninety patients were 
randomly selected and divided into experi-
ment and control groups. Before starting the 
project, the protocols of the study was pre-
sented to the research academics and consid-
ering the ethical aspects, music therapy proto-
col was approved. As music therapy was used 
every other day and no intervention was 
done, no consent was needed. It was a single 
blind study as the patient was unaware of the 
group he/ she was placed in, but the nurse 
recording BP and pulse oximetry results was 
aware of the category. Inclusion criteria were 
being candidate of endoscopy or colonoscopy, 
negative history of hypertension, no previous 
history of endoscopy or colonoscopy, being in 
the age range of 30-60, not having taken seda-
tive drugs before the procedure and having 
no serious hearing problems. The data was 
collected using a questionnaire which con-
tained demographic data, age, sex, BP and ar-
terial blood oxygen saturation. BP and arterial 
blood oxygen saturation was measured using 
portable barometer (ALPK2, Japan) and pulse 
oximeter (Nellcore, Germany). In pilot phase, 
classical Azeri music was used and it was 
shown to have no conflict with the cultural 
background of the patients. The data was ana-
lyzed using SPSS software.Using descriptive 
analysis methods, the data was tabulated ac-
cording to frequency and percentage. Analyti-
cal methods of t- test and variance analysis 
were, then, utilized. 
Results 
In the study, 66.7% cases were female. Com-
parison of mean systolic and diastolic BP on 
admission and during procedure (at 1st and 5th 
minute) using t-test did not reveal significant 
statistical differences between the two groups. 
Mean systolic BP was 121.3 and 125.3 mmHg 
at 1st minute and 115.3 and 119.6 mmHg at 5th 
minute in music therapy and control groups, 
respectively.  In addition, mean diastolic BP 
was 66.3 and 77.1 mmHg at 1st minute and 
64.4 and 60.2 mmHg at 5th minute and 60.2 
and 80.4 at the end of the procedure in music 
therapy and control groups, respectively. 
Findings demonstrated that mean arterial 
blood oxygen saturation was 97.4% and 97.5% 
at 1st minute and 97.4% and 96% at 5th minute 
in music therapy group and control group, 
respectively. Mean duration of procedure was 
respectively 10.7 and 12.4 minutes in the ex-
periment and control group. 
Table 1.  Results of variance analysis of variables in experi-
ment and control group 
Variables Experiment group Mean 
Control 
group 
Mean 
F quantity 
for 
variance 
analysis 
test 
Sig.  
SBP* on 
admission 123.8 121.3 0.52 0.5 
DBP** on 
admission 66.7 63.8 1.46 0.2 
SBP at 1st min. 121.3 125.3 1.36 0.2 
DBP at 1st min. 66.2 77.1 0.6 0.5 
SBP at 5th min. 119.9 123.4 0.81 0.4 
DBP at 5th min. 64.4 65.3 0.1 0.7 
Final SBP 115.3 119.6 1.6  0.2 
Final DBP 60.2 80.4 1.3 0.3 
Final blood 
oxygen 
saturation 
96 95.8 0.06 0.8 
Duration of the 
procedure 10.7 12.4 1.6 0.2 
* SBP: Systolic Blood Pressure 
**DBP: Diastolic Blood Pressure 
Finally, there was significant statistical dif-
ference between the mean systolic and dia-
stolic BP in the two groups regarding the type 
of procedure. (p= 0.034) (Table 1). 
Discussion 
Various studies demonstrated that stress-
inducing therapeutic procedures cause an in-
crease in BP by catecholamine release. Results 
of the study showed that, although BP in-
creased on admission and at the 1st and 5th 
minutes of the procedure in control group, 
systolic and diastolic BP in the music therapy 
and control group were not significantly dif-
The Effect of Music Therapy on Patients' Blood Pressure… Tazakori et al 
12 Iranian Journal of Nursing and Midwifery Research Winter 2007; Vol 12, No 1. 
ferent. Various studies revealed that music 
therapy reduces the anxiety of patients and 
causes BP and heart rate reduction (1). A study 
on 45 myocardial infarction patients showed 
that music therapy decreased the heart and 
respiratory rate and also anxiety of the pa-
tients (5). 
Another study on seventeen post surgical 
patients indicated that music could lead to 
decrease in vital signs (6). Also, another study 
on patients receiving mechanical ventilation 
support showed that music would lessen 
heart rate, BP and anxiety of patients (7). 
In current study, it was showed that the ar-
terial blood oxygen saturation during the pro-
cedure (at 1st and 5th minutes) and also at the 
end of the procedure decreased in both 
groups, but the changes at the 1st and 5th min-
utes in control group was significant. It is 
compatible with the results of another study 
carried out in Iran; which indicated that arte-
rial blood oxygen saturation differs signifi-
cantly before and after endoscopy (8). 
As well, it was demonstrated that BP 
changes in patients underwent colonoscopy 
was more than those underwent endoscopy. 
Regarding systolic BP, the difference of 
changes was significant between endoscopy  
and colonoscopy patients. In another study on 
63 patients, it was showed that mean BP 
was higher in patients undergoing endo-
scopy than those undergoing colonoscopy (9). 
In addition, finding of the study showed 
that mean duration of the procedure in music 
therapy group was less than the control group 
which possibly indicates better cooperation 
and tolerance of the patients received music 
therapy.  Hearing relaxing music, medical 
staff also feels relaxed which can affect the 
anxiety of patients. As only three patients of 
the study received midazolam for sedation, 
effects of the drug in combination with music 
therapy was not evaluated. Generally, our 
findings demonstrate that relaxing music 
could have useful effects on BP, arterial blood 
oxygen saturation and anxiety of patients un-
dergoing endoscopy and relaxes them.  It is 
recommended to use light music in all wards 
and waiting rooms of the hospitals to reduce 
the anxiety of patients and also medical staff 
to some extent. 
 
Acknowledgement 
We would like to express our thanks towards 
staff of endoscopy unit of Bou-Ali hospital, 
especially Mrs. F. Alizadeh. 
 
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Effect of holy Quran's sound in decreasing stress before and after diagnosis and treatment affairs.

Effect of Relaxing Music on Cardiac Autonomic Balance and Anxiety After acute myocardial.

Farda publication;

Feasibility of a Music Intervention Protocol for patient’s Receiving Mechanical ventilator support. Altern Ther Health Med

Musa Nasab A.. Changes in oxygen saturation of arterial blood during upper gastrointestinal endoscopy. Pajuhande journal.

Neurobiology of The Effect of Relaxation Music on Patient Tolerance of Gastrointestinal Endoscopic Procedures.

Stethoscope: Now Hear This. Current Health Stanford

The Effect of Preprocedure Teaching, Relaxation Instruction, and Music on Anxiety as Measured by Blood Pressures in an Outpatient Gastrointestinal Endoscopy Laboratory. Gastroenterology Nursing

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The Effect of Music Therapy on Patients' Blood Pressure in Endoscopy Unit in Bou-Ali hospital, Ardebil

http://eprints.arums.ac.ir/562/1/Music-Therapy.pdf

The Effect of Music Therapy on Patients' Blood Pressure in Endoscopy Unit in Bou-Ali hospital, Ardebil

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