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Low Degree of Formal Education and Musical Experience Predict Degree of Music-Induced Stress Reduction in Relatives and Friends of Patients: A Single-Center, Randomized Controlled Trial

Tilt, Alexandra C. BA*; Werner, Paul D. PhD§; Brown, David F. MD; Alam, Hassan B. MD*; Warshaw, Andrew L. MD*; Parry, Blair A. CCRC; Jazbar, Brigita MD*; Booker, Abigail BA*; Stangenberg, Lars MD*; Fricchione, Gregory L. MD; Benson, Herbert MD; Lillemoe, Keith D. MD*; Conrad, Claudius MD, PhD*

doi: 10.1097/SLA.0b013e31828ee1da
Randomized Controlled TrialS

Objective: To determine the factors that may predict music-induced relaxation in friends and family of patients in the emergency department.

Background: It remains unclear to date which demographic and experiential factors predict the effectiveness of music-induced relaxation. Furthermore, in-hospital stressors for friends and family of patients rather than patients themselves are underresearched and deserve in-depth investigation to improve this group's experience in health care environments.

Methods: A total of 169 relatives and friends of patients in the emergency department–waiting area completed a series of questionnaires, including the Spielberger State-Trait Anxiety Inventory (STAI), the Music Experience Questionnaire (MEQ), and a demographic survey. They were then randomly assigned to either Case Group (1 hour in the waiting area with classical music in the background) or Control Group (1 hour with no music) before completing a second, identical copy of the STAI to measure change from baseline. Data were analyzed for associations between music intervention, change in STAI scores, MEQ scores, and demographic characteristics.

Results: Participants who underwent the music intervention experienced a 9.8% decrease in overall mean State Anxiety, whereas those in the Control Group experienced no change over time (P = 0.001). Higher education significantly inversely correlated with the effectiveness of music intervention: participants with no formal education beyond high school showed a greater overall mean decrease in State Anxiety than those with a college education or beyond in response to classical music (P = 0.006). Furthermore, MEQ scores indicated that the Social Uplift scale (a measure of one's tendency to be uplifted in a group-oriented manner by music) was highly predictive of the effectiveness of music intervention.

Conclusions: Music is an effective and inexpensive means of reducing anxiety in friends and family of patients, who are underresearched in medicine. Moreover, low educational attainment and tendency to respond positively to music in a group setting can predict the effectiveness of music-induced relaxation.

Music intervention was shown to effectively reduce anxiety in friends and family of patients in the emergency department–waiting area. Moreover, it was found that level of formal education and musical experience, among other factors, may predict the extent of music-induced relaxation in this cohort.

*Departments of Surgery

Emergency Medicine

Psychiatry, Massachusetts General Hospital, Boston, Massachusetts

§PhD Program in Clinical Psychology, California School of Professional Psychology, Alliant International University, San Francisco, California.

Reprints: Claudius Conrad, MD, PhD, Harvard Medical School and Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 021114. E-mail:

Disclosure: The authors declare no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins.