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The effect of soothing music on neonatal behavioural states in the hospital newborn nursery Kaminski, June L.

Abstract

This study was designed to test the effect of soothing music on the number of high arousal neonatal behavioural states and the frequency of behavioural state change within the hospital newborn nursery. The theoretical framework for this study was drawn from theories related to newborn behavioural states, environmental influences on newborns, psychophysiologic effects of music and music as a health intervention. This study used a quasi-experimental, one sample, pretest, posttest design in which the subjects served as their own controls. The results were then analyzed using a one-tailed, McNemar's test (alpha < .05) specific for related small samples when nominal scale data are gathered. The sample consisted of twenty subjects observed in a large tertiary care hospital in Western Canada. The subjects ranged in age from 24 to 57 hours old, were 36 to 42 weeks gestational age, weighed 2860 to 4160 grams at birth, and had Apgar scores ranging from 9 to 10 at five minutes postbirth. There were 8 females and 12 males. All were Caucasian and all were born vaginally without complications. All but two were breastfed. The subjects were observed for a total of four hours each, two hours in the normal nursery environment and another two hours with the addition of selected soothing music. All observations took place between 2400 and 0600hours. There was a significant difference at the alpha < .05level in the number of high arousal states (Nonalert Waking and Crying) between the control and experimental observations. The control group exhibited significantly more high arousal states than the experimental group did. The score obtained from comparing the proportion of high arousal states between the two observations was 2.36, p < .01, significantly higher than the score of 1.65 needed to be significant at alpha < .05. There was also a statistically significant difference in the number of state changes and in the z score of 2.93, p < .001 for state lability. The control group demonstrated significantly more state changes than the experimental group did. With a sample size of twenty, conclusions are tentative. The findings suggest that music may be useful to newborns adapting to extra uterine existence within a nursery setting. Interventions intended to reduce the frequency of high arousal states in newborns while in the nursery are the responsibility of nurses. Nursing and patient education should also address the possible use of music with babies exhibiting high arousal behavioural states. The results of this study suggest areas for replication and further study.

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