FEATURESEffectiveness of Music to Improve Anxiety in Hemodialysis Patients A Systematic Review and Meta-analysisBurrai, Francesco PhD, RN; Forton Magavern, Emma MD; Micheluzzi, Valentina MSN, RN; Magnaghi, Cristiano RMN, RN; Apuzzo, Luigi MSC, RN; Brioni, Elena RMN, RNAuthor Information Education, Research and Organization Change, ATS Sardegna, Sassari, Italy (Dr Burrai); Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England (Dr Forton Magavern); AOU of Sassari, Sassari, Italy (Ms Micheluzzi); San Raffaele Hospital, Milan, Italy (Mr Magnaghi); Intensive Care Unit, Sant'Anna e San Sebastiano Hospital, Caserta, Italy (Mr Apuzzo); and San Raffaele Hospital, Milan, Italy (Ms Brioni). Correspondence: Francesco Burrai, PhD, RN, Education and Research, ATS Sardegna, Via San Camillo, Sassari, Italy (email@example.com). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Holistic Nursing Practice: November/December 2020 - Volume 34 - Issue 6 - p 324-333 doi: 10.1097/HNP.0000000000000411 Buy Metrics Abstract Anxiety affects many hemodialysis patients. The response to treatment varies and often requires patients to take therapeutics for long periods; thus, many patients look for complementary approaches. There have been reports of music alleviating anxiety in hemodialysis patients. However, the efficacy of music needs to be evaluated. The objective of this study was to conduct a systematic review and meta-analysis to compare the effects of participation in standard care combined with music with standard care alone. This was a systematic review and meta-analysis of randomized controlled trials to determine the efficacy of music to lower anxiety in hemodialysis patients. Five studies were included in the review (290 patients). Listening to music resulted, on average, in an anxiety reduction that was −0.52 standard deviation units greater (95% confidence interval, −1.02 to −0.03 lower, P = .003) than in the standard care group. No adverse events were identified. All trials contained a risk of bias due to lack of blinding. The heterogeneity showed an I2 = 75%. The strength of evidence was very low. No adverse events were identified. Few trials were available for inclusion, with small sample sizes and significant heterogeneity. Within these considerable limitations there was a demonstrated decrease in anxiety for hemodialysis patients receiving standard care augmented with music. The effect size was moderate. Results were inconsistent across studies. We are uncertain about the estimate. The likelihood that effect will be substantially different is very high. Further research has a large potential for reducing uncertainty about the effects of the music interventions. © 2020 Wolters Kluwer Health, Inc. All rights reserved.