WHAT The relationship between live music and the reduction of stress levels and other cardiovascular risk factors in workers at a tertiary care hospital in the autonomous community of Madrid.
WHO Principal investigator, Dr. Carmen Muñoz Ruiperez, head of the Occupational Medicine and Occupational Risk Prevention Department at Hospital Universitario 12 de Octubre.
WHY With a view to reducing the level of stress and other cardiovascular risk factors (CVRF), the study sought to expose healthcare staff at Hospital 12 de Octubre to music sessions with Musicians In Residence and compare their effects in relation to other techniques such as relaxation, to implement a project aimed at reducing these risk factors within the health promotion programme for professionals at Hospital Universitario 12 de Octubre, called “They take care of me too” (A mí también me cuidan in Spanish).
WHAT The change in the level of general stress and prevalence of other CVRFs, especially blood pressure, was estimated in a comparative study after random assignment to the three study groups (randomised experimental design). Additionally, the efficiency of the response to live music was established according to professional category, age and sex. The participants understood and signed the informed consent in accordance with the provisions established in Organic Law 15/1999 on the Protection of Personal Data.
WHEN The study was carried out between October 2018 and February 2020.
Situation of the patients
Hospital Universitario 12 de Octubre has approximately 7,000 workers. According to internal studies carried out by the Occupational Risk Prevention Department, the prevalence of cardiovascular risk factors was as follows: hypertension, 12.3%; smoking, 24.7%; sedentary lifestyle, 40.9%; overweight, 33.8%; obesity, 10.8%; hypercholesterolemia, 17.3%; diabetes mellitus, 0.9%. The prevalence of work-related stress (distress) in residents is 11% 6 months after the beginning of their residency. According to the 6th National Survey of Working Conditions in Spain (2015 EWCS), stress at work “always or almost always” affects 30% of workers, and its magnitude has increased in the last five years.
The estimated mean cardiovascular score in our working population is 4.18 (SD+/4.7) in men and 1.38 (SD+-1.4) in women.
For this study, the study population comprised healthcare personnel who presented cardiovascular risk factors, the most important of which were arterial hypertension and stress.
After the necessary agreements had been obtained, the place chosen to hold the live music sessions was the chapel on the 10th floor of the Maternity and Children’s Hospital, since this space was available to professionals 3 days a week, 1 hour each day: 30 minutes were dedicated to the group exposed to live music and 30 minutes to the group exposed to relaxation techniques. On Mondays, the group exposed to live music carried out the intervention in the auditorium of the Maternity and Children’s Hospital, since the instrument used was the piano and that is the where the instrument is located.
The timetable of the group exposed to the music-based intervention was 11:30-12:00 h and the timetable of the group exposed to relaxation techniques was 11:00-11:30. The control group was not exposed to any intervention.
The study in Occupational Medicine concludes that there is no statistically significant evidence to determine that music is better than relaxation techniques for reducing the level of stress and other cardiovascular risk factors in healthcare workers at Hospital 12 de Octubre, although certain aspects of the use of music in terms of its effect on certain variables could be highlighted and published.
After applying the exclusion criteria, a sample of 48 healthcare workers was obtained, with an average age of 55 years, of whom 75% were women. The predominant professional category was nursing staff (n 30). The sample was distributed into groups as follows: music-based intervention group, n 13; relaxation group, n 14; and control group, n 21. There was greater participation in the relaxation group. Significant differences of more than 5 mmHg were observed in initial and final SBP in the music-based intervention group, as well as changes in other CVRFs after different interventions.
As regards stress, both intervention groups presented reductions in the level of stress, with the decrease in the maximum total score being greater in the live music group. All participants scored below the established cut-off value. No statistically significant differences were observed.
With respect to other CVRFs, no significant differences were found at the end of the sessions. However, the pre- intervention MBP/post-intervention MBP values measured in the relaxation group were statistically significant (p = 0.008).
The 40-50 and 50-60 age groups exposed to live music evidenced decreases in Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Blood Pressure (MAP), which in the case of SBP were greater than 5 mmHg, with significant differences in the 40-50 age group (p = 0.022).
It is recommended that the study be broadened to include a larger sample and longer exposure time.