Randomized single-blinded clinical trial on effects of nursery songs for infants and young children’s anxiety before and during head computed tomography

Abstract

ObjectiveThe objective of this clinical trial was to determine if an intervention of listening to nursery songs with integrated heartbeat sounds resulted in changes in anxiety levels in infants and children younger than 4 years in an emergent setting. MethodsThis is a randomized single-blinded controlled trial. The study included 62 children younger than 4 years who were deemed by the emergency physician to need a computed tomographic (CT) scan. The experimental group (Exp) (n = 30) listened to recorded children’s songs with integrated heartbeat sounds (Baby Go To Sleep compact disc) before and during the head CT. The controls (Con) (n = 32) had no music. Two scales to measure agitation were completed by a trained research associate: (1) a 10-cm visual analog scale (VAS) and (2) the Modified Ramsay Sedation Scale (MRSS). The research associate wore headphones blocking out all music. The research associate recorded agitation levels preintervention and postintervention on the 2 scales, whether there was successful completion of the head CT without pharmacologic intervention, and the frequency of medication use. Mann-Whitney U, t test, and logistic regression were used for analysis, and P < .05 was considered significant. ResultsThere were no differences between groups in the age, sex, initial vital signs, diagnostic category, ethnicity, insurance status, rate of completion of head CT, rate of medication use, hospital admissions, or initial VAS or MRSS score. There was improvement on the VAS score in 53% of the Exp group subjects and 25% of the Con group subjects. The VAS score in the Exp group improved by 1.6 cm, whereas the Con group worsened by 0.8 cm after the intervention (difference = 2.4 cm, P = .03). There were no significant changes in MRSS scores. Accounting for age, sex, and admission status, the adjusted odds of having an improved sedation score were 3.2 (1.0-9.7) in the Exp group. ConclusionMeasured on a VAS, there was a significant decrease in agitation in children undergoing a head CT when children’s songs with integrated heartbeat sounds were played before and during the procedure.