Electroconvulsive Therapy-Related Anxiety Relief: An Implementation and Evaluation of a Non-Pharmacological Care

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Date

2024-05

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The Ohio State University

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Abstract

Background: Patients receiving ECT experience procedure anxiety, which causes a delay in or discontinuation of treatment and affects quality of life. Research provides evidence that listening to music before a procedure lowered self-reported procedure anxiety. Objective: To relieve procedure anxiety, the project leader aimed to implement an EBP change for patients to listen to music before ECT. Design: Evidence-based practice change utilizing The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care. Method: The project leader surveyed patients on treatment visits in a two-phase initiative. In phase one, patients rated their ECT anxiety using a verbal numerical rating scale before the procedure. In phase two, the patients were offered a music device and headphones while waiting and then asked to rate their ECT anxiety before the procedure. Results: No visits used a device in phase one (n = 128). In phase two visits (n = 129), 48% used a device. The mean anxiety score for not using a device in phase one was 23% higher (M = 3.98, SD = 3.829) than using a device in phase two (M = 3.05, SD = 2.595). The independent t-test indicated a significant difference (t(167.831) = 1.981, p = 0.049, d = 0.269, 95% CI [-0.036, 0.573]). Within phase two, the mean anxiety score for no device was 28% higher (M = 4.25, SD = 3.386) than for using a device. The independent t-test indicated a significant difference (t(122.835) = 2.279, p = 0.024, d = 0.398, 95% CI [0.048, 0.746]). Conclusion: Music devices reduced ECT anxiety, and the effect was small. This implementation can expand to similar clinical areas. Implications for Nursing: Nursing staff may implement an EBP initiative to reduce ECT-related anxiety.

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electroconvulsive therapy, anxiety, evidence-based practice, music, mental health, non-pharmacological

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