ESSAI

BAHASA INGGRIS KEPERAWATAN 1

“ The Effect of Music Theraphy on Anxiety Hospitalized in Children”

Disusun oleh kelompok 5

Ayu Dita Aprillia 1710913320007

Deta indrayanti 1710913320008
Erlina Haliza Hazmi 1710913220010
Fitri Rohaina 1710913120003
Muhammad Refly Sa'dillah 1710913310021
Nor Assyifa Badaliyah 1710913220001
Oca Aprilyani 1710913120006
Rizky Aulia Ramadhan 1710913320035

PROGRAM STUDI ILMU KEPERAWATAN

FAKULTAS KEDOKTERAN

UNIVERSITAS LAMBUNG MANGKURAT

BANJARBARU

2019
 “The Effect Of Music Therapy On Anxiety Hospitalized in Children”

Introduction:

From one study, about 30% of children about once in their childhood had
successfully been hospitalized and about 5% never understood by the hospital.
Inpatient consider one of the factors that make children stress because of the
environment, the pain they experienced, hospital procedures such as blood tests and
medical examinations conducted (1). Children treated in hospitals are completing
negative talks and logs related to health issues and managing unknown hospitals.
During stressful periods, cortisol increases and can affect the body's immune and
recovery (2). For children, hospitalization can irritate them. These experiences can
influence physiological and psychosocial aspects that affect their physical and mental
health. In physiological aspects there is an increase in heart rate, an increase in blood
pressure, and a decrease in oxygen saturation which can produce anxious responses.
Children who are treated in hospitals also have coping strategies to accept this anxiety
(3).

Coping strategies in children can be found in children who always avoid

difficult situations and non-compliance with treatment. In addition, children can also
express their feelings about hospitalization, always ask for information on the
procedure of action, and seek support from others (parents or close relatives). Children
who are active in the environment tend to be faster in overcoming trauma. Therefore,
to overcome anxiety reduction can be done with music therapy measures (3).

Music therapy is a therapy used in nursing care as a complementary therapy to

promote relaxation, emotional and spiritual comfort, disturbances, health sensations
and pain relief (4).

Main body:
 Anxiety disorders are one of the most common disorders and can affect
children. This anxiety can interfere with social, academic and personal functions in
children. Children who are hospitalized tend to feel anxious because of the care
measures taken there and the environment that is foreign to them (5). Anxiety disorders
can affect children in adulthood which cause tremendous suffering every year for
treatment. Anxiety in children can cause sleep disorders, decreased appetite,
developmental disorders and can delay the child's recovery process (6). Stress and
anxiety can affect the immune system and behavior of children. Stress causes pituitary-
adrenocortical activity (to restore physiological and psychological adaptations to
stress) (7). Actions that can be taken to reduce anxiety in hospitalized children are with
music therapy (6).

Music therapy is a cheap nonpharmacological treatment. Music therapy can be

used as a non-invasive tool that can relieve pain and anxiety, increase comfort and
immunity, lower blood pressure and pulse and respiratory rate in humans. Listening to
music can affect endorphins secretion which can regulate emotions and relieve pain
that can increase comfort in children (1). Music therapy can also be used in cancer
patients because it can reduce nausea during chemotherapy. Music therapy is more
significant than drawing therapy in decreasing pain perception in children hospitalized
(3). Music therapy in pain management helps patients to control themselves and be
active in managing their pain. Types of musical therapy interventions performed on
patients such as singing, listening to music, and writing songs can increase relaxation,
provide opportunities to express, facilitate communication with loved ones and to bring
happiness to sufferers. This helps to alleviate anxiety and fear (8). In doing music
therapy, keep in mind the type of music used. Music must make children relax and
calm (9).

In one study, music therapy was performed using genres of classical music,
rock music and music chosen by the patients themselves. The results show that patients
who listen to music of their own choice experience decreased anxiety and anger
compared to patients who listen to rock music (10). Lullabies can be used as music
therapy because they can relax and encourage children to sleep. Soft music has a
positive impact on a child's sleep quality. Lullabies have a calming, comforting, and
relaxing nature. A slow and soothing lullaby can relax a child's body and encourage the
child to sleep by stimulating parasympathetic nerves that reduce anxiety, relax muscles,
divert individual attention, lower blood pressure, pulse and breathing rate (9). The type
of music used for music therapy is soothing music and is loved by children, soft music
and easy to hear (11). The type of music used to reduce pain depends on the choice of
music, the time and duration of music varies. In this case, the researchers revealed that
interpersonal cultural differences greatly influenced the decrease in pain scale on each
person. For example, jazz music reduces pain in adult patients in the United States,
while soft music reduces pain in adult patients in China. Local music is related to pain
reduction in Turkey, while music chosen by patients reduces pain in patients in Tunisia.
Letting the patient decide what music to listen to may be the most flexible way to
increase the use of music interventions. It is important to note that music has different
meanings in different age groups (12). In essence, the genre of music used in music
therapy is music that is slow, gentle, relaxed and depends on the patient's preference.
The application of music therapy can be done in various ways. The application of music
therapy is carried out in different ways and each has a positive effect (13).

In one study, music therapy was carried out by inserting a CD into the iPod.
Each patient is given the opportunity to choose his preferred music from a set of CDs
that are loaded into the iPod. List of music is provided in various categories, namely
children's music, hip hop, rock, and pop music). After the patient chooses the song he
likes, he is given time to relax for 45 minutes to listen to music. Each patient is invited
to listen to various types of music during the allotted time. As long as the patient listens
to music, the therapist stays in the room and maintains contact with the patient and asks
why they are choosing the music. This study found that there was a decrease in pain
levels in children (3). In other studies, music played in a clinical environment with a
frequency of 40 dB is better than using headphones individually (10). When a child is
hospitalized it usually upsets the child's psychic. Fear behaviors that may arise in
children and painful treatment procedures make nurses act as givers of security and
protection. In music therapy this can be a powerful tool in strengthening ties between
children and nurses to eliminate fear. There are two ways to approach a music therapist,
namely first by using songs that access a child's ability to manage interpersonal
relationships from their caregivers directly and the second by focusing on reducing
caregiver anxiety and building positive things on children (14). Music therapy is also
done at the right time and situation so that more leverage.

In one study, music therapy can help minimize the distress experienced by
patients during infusion and IV injection. In addition, music therapy can reduce
difficulties for children during general medical procedures. When a child is given an
intravenous injection procedure that involves a needle, it is the most stressful
experience in the hospital. A child's response to the hospital environment is largely
determined by his ability to cope with stress. Therefore, some families of patients have
an increased interest in using music therapy methods to eliminate anxiety in their
children. Child specialists and child therapists have a role to provide psychosocial care
to pediatric patients and their families. These professionals are trained to provide
clinical interventions that support treatment, help normalize patient experience and
reduce the potential for experiencing psychological distress. Music therapy can be
applied before a medical procedure is performed. Child specialists function to assess
temperament, level of development, and overcome resources to develop individuals to
manage patient stress and anxiety. Whereas the therapist functions to reduce the
patient's pain perception, increase endurance, and provide emotional support with a
variety of techniques, one of which is music therapy (15). Empirically, music therapy
influences heart rate variability, stress and anxiety. Music therapy reduces stress and
anxiety levels more than just resting. Listening to soothing music for half an hour every
day significantly reduces stress, anxiety, and depression after a period of 2 weeks (16).
 The results of several studies with music therapy found the application of music
therapy in children is very effective. The study was conducted for 6 weeks in pediatric
patients who experienced pain between 4-7 showing a decrease in pain intensity and
increased patient satisfaction with pain management treatments. From these results it
can be said that music therapy is very well used to manage pain with pain intensity that
can be given with music therapy on a scale of 0-7, with 0 equivalent to "no pain" and
7 is already quite heavy (17). From other studies also said that the scale of pain in
children will be significantly reduced if the child uses music therapy using his own
choice of songs. In this case the researchers revealed that with music therapy in
pediatric patients who have congenital heart disease will reduce the severity of the
disease (12). Music therapy can be done in a hospital or patient's clinic in care.

Not all patients can have the opportunity to bring their favorite music device to
the hospital. Considering this, the clinic can realize music therapy to patients by
providing facilities directly from the hospital for the music devices that the patient
likes. In postoperative pain management, nurses must be more active in giving patients
the opportunity to listen to music in order to recover from postoperative pain. Music
can help patients relax, but does not interfere with the work of the medical team. There
are patients who prefer to listen to silence through headphones and also patients who
want to listen to their favorite music without using headphones. At present, modern
electronic technology, such as remote guidance, instructions provided by e-hospital
websites and mobile applications, can be used to inform and guide patients to be
prepared for musical intervention as a reference for painkillers during their stay in
hospital. postoperatively (12).

Conclusion:

Hospitalization is considered as one of the factors that makes children stress

due to the environment, the pain they experience, hospital procedures such as blood
tests and medical examinations carried out. Children who are treated in hospitals tend
to feel anxious because of the care measures taken there environment that is foreign to
him. Music therapy can be used as a non-invasive tool that can eliminate pain and
anxiety, increase comfort and immune, lower blood pressure and pulse and breathing
rate in humans. Music therapy in pain management helps patients in control yourself
and be active in managing the pain. Types of musical therapy interventions performed
on patients such as singing, listening to music, and writing songs can increase
relaxation, provide opportunities to express, facilitate communication with loved ones
and to bring happiness to sufferers. Music therapy is carried out using the genre of
classical music, rock music and music chosen by the patient himself.

Anxiety is an emotional experience that is felt by individuals as an

unpleasant one. Music therapy is an intrapersonal process carried out by a therapist
using music to assist in the process of patient care. Music therapy also provides music
as a therapeutic tool to improve, maintain and improve one's physical, mental and
emotional health. This therapy is one of the easy and beneficial ways for health,
intelligence and social interaction. Listening to music regularly is very beneficial for
health because it can eliminate stress and make the body relaxed and able to improve
mood. With the presence of music, it is hoped that it can be a medicine or be a
consolation for patients who suffer from mental problems, by being handled by me by
a professional party, music therapy can be right on target for those who need it.
Classical music therapy and murotal therapy have the same benefits in terms of
reducing stress levels. However, if classical music is more effective than murotal
therapy in terms of.
Therefore, some families of patients have an increased interest in using music
therapy methods to eliminate anxiety in their children. Music therapy can be applied
before a medical procedure is performed. Child specialists function to assess
temperament, level of development, and overcome resources to develop individuals to
manage patient stress and anxiety. The study was conducted for 6 weeks in pediatric
patients who experienced pain between 4-7 showing a decrease in pain intensity and
increased patient satisfaction with pain management treatments. From these results it
can be said that music therapy is very well used to manage pain with pain intensity that
can be given with music therapy on a scale of 0-7, with 0 equivalent to "no pain" and
7 is already quite heavy. Stress causes pituitary-adrenocortical activity (to restore
physiological and psychological adaptations to stress).

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