基于音乐的干预在术后肺移植护理中的应用：一项可行性研究。
完整摘要 · 中文译文
基于音乐的干预措施可能有助于内外科环境中的康复；然而，其在肺移植术后即刻恢复期的实施仍未得到充分研究。这项单中心随机可行性研究考察了由委员会认证的音乐治疗师提供的结构化音乐干预措施是否可在具有临床意义的术后恢复里程碑节点实施，并初步探讨了疼痛、焦虑、用药、睡眠和住院时长的趋势。2021年9月至2023年9月期间，共纳入29名成年肺移植受者（实验组 n = 17，对照组 n = 12）。干预组参与者在自主苏醒试验期间、拔管后24-48小时以及从重症监护病房转至过渡病房后72小时内接受音乐干预治疗。干预内容包括患者偏好的现场音乐、音乐辅助放松，以及根据患者状态定制的可选接受性或主动性音乐参与。干预措施在所有三个术后里程碑节点的实施均可行，但发现与招募、保留、睡眠测量和干预标准化相关的挑战。探索性分析提示，与标准护理相比，干预组观察到的疼痛评分较低且对乙酰氨基酚中位使用量较低；然而，所有结局均未达到统计学显著性。焦虑结局在两组之间无差异，且使用消费级可穿戴设备进行睡眠测量并不可行。这些结果为在肺移植术后环境中进一步优化音乐干预措施及其评估方法提供了依据。 这些发现支持了在肺移植术后恢复期间实施基于音乐的干预措施的可行性，并为未来采用精细化结局指标、基于里程碑的干预实施方式及改进实施策略的充分把握度的试验设计提供了指导。
完整摘要 · 英文原文
Music-based interventions may support recovery in medical and surgical settings; however, their implementation during the immediate postoperative period following lung transplantation remains understudied. This single-center randomized feasibility study examined whether a structured music-based intervention delivered by board-certified music therapists could be implemented at clinically meaningful postoperative recovery milestones and explored preliminary trends in pain, anxiety, medication use, sleep, and length of stay. Twenty-nine adult lung transplant recipients (experimental n = 17, control n = 12) were enrolled between September 2021 and September 2023. Participants in the intervention group received music-based intervention sessions during spontaneous awakening trials, 24-48 hr following extubation, and within 72 hr of transfer from the intensive care unit to a step-down unit. Intervention components included patient-preferred live music, music-assisted relaxation, and optional receptive or active music engagement tailored to patient status. Intervention delivery was feasible across all three postoperative milestones, although challenges related to recruitment, retention, sleep measurement, and intervention standardization were identified. Exploratory analyses suggested lower observed pain scores and lower median acetaminophen use in the intervention group compared to standard care; however, no outcomes reached statistical significance. Anxiety outcomes did not differ between groups, and sleep measurement using consumer-grade wearable devices was not feasible. These findings support the feasibility of music-based interventions during postoperative lung transplant recovery and provide guidance for the design of future adequately powered trials using refined outcome measures, milestone-based intervention delivery, and improved implementation strategies.