A randomised pilot study evaluating music therapy and virtual reality mindfulness sessions for reducing anxiety and stress in patients undergoing first-time elective cardiac surgery.
Bhuvaneswari Krishnamoorthy, Moslem Abdelghafar, Rick Air and 8 others
PMID 41045170WHAT IT FOUND
Both music and VR reduced preoperative anxiety scores by similar amounts, but neither lowered stress hormone levels.
Because there was no untreated control group, it is impossible to know if the interventions themselves caused the improvement.
Key findings
01Preoperative anxiety scores dropped significantly in both the music and VR groups, but the change was not different between the two treatments.
02Salivary cortisol levels did not change in either group, meaning the reported reduction in anxiety was not matched by a change in this physiological stress marker.
03The study lacked a standard care control group, so any observed reduction in anxiety could be due to the passage of time, regression to the mean, or the placebo effect rather than the specific interventions.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The absence of a standard care control group means it is impossible to determine if the interventions caused the anxiety reduction or if it would have happened anyway. The study was a pilot with a small sample size (36 participants), limiting the certainty of the findings. Postoperative assessments on day 3 were compromised by patient fatigue, confusion, and strong analgesia, leading to high dropout rates and incomplete data. Cortisol analysis showed no change, contradicting the subjective anxiety scores and raising questions about the physiological impact of the interventions.
Declared interests
The study was funded by The University of Salford. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that the reduction in anxiety scores proves the music or VR caused it. Without a control group, the improvement could be due to the natural course of preoperative care or regression to the mean. Furthermore, the lack of change in cortisol levels suggests the physiological stress response was not altered by these interventions.