School of Nursing - University of Minnesota

nursing.umn.edu

School of Nursing - University of Minnesota

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Linda Chlan

• Outcomes and effectiveness of nursing interventions; symptom management

• Testing non-pharmacologic relaxation and anxiety-management techniques with

critically ill patients receiving mechanical ventilatory support

• Music intervention; complementary therapies

Every day in intensive care units (ICUs) across the

globe, mechanical ventilators perform the heroic:

They save and prolong the lives of critically ill

people by “breathing” oxygen into their lungs.

a stressful experience

For all the good they do, it’s too bad the machines are not better

loved. Any goodwill they may enjoy too often vanishes with the

stress they cause. Patients coming off mechanical ventilators

describe feelings of anxiety, fear, loneliness, even terror, as well as

physical pain and difficulty breathing.

Linda Chlan, PhD, RN, associate professor in the School of

Nursing, cared for ICU patients at several Twin Cities hospitals

before and during her graduate studies at the U of M. Too often,

she saw patient anxiety rise as the ventilator tube was passed

through the mouth and over the vocal cords to the trachea.

Once intubated, patients could not talk, eat, or swallow. “The

machine really causes a lot of distress,” she says.

Sedatives were the medical response to calm anxious patients

on ventilators. While Chlan (pronounced kline) recognized that

sedatives had an important place in managing patients on

ventilators, she also saw their unpleasant side effects. She began to

ask: Might there be other ways to alleviate the stress of patients on

ventilators? The question stayed with Chlan—through graduate,

PhD, and post-doctoral training. Today, it is at the core of her

growing body of research.

restoring control

In Chlan’s most recent study, she is testing the effectiveness of

music as a way for ICU patients on ventilators to alleviate stress.

Specifically, she and her multi-disciplinary team are exploring

whether patients who are able to listen to music of their own

choice whenever they wish have less stress and anxiety and are

able to leave the ICU sooner than patients on ventilators who do

not listen to music.

“The ICU takes control away from patients,” Chlan says.

”By allowing study participants to choose the music and then

decide when and how long to listen to it, we are giving them back

some control. This helps lower anxiety and stress.”

Funded in 2006 by the National Institute of Nursing Research,

National Institutes of Health, Chlan’s study aims to enroll 260 ICU

patients who are on mechanical ventilation. Participants must be

alert and willing and able to provide consent.

study design

Participants, who are being recruited in 12 ICUs at five hospitals in

Minneapolis and St. Paul, are assigned randomly to one of three

groups:

• Those who listen through headphones to music they prefer and

decide how often and how long to listen throughout the day

• Those who wear noise-canceling headphones and do not

hear music

• Those who receive usual ICU care

Study participants and their families say

that music has a positive effect.

The latter two groups are the study controls. Participants remain

in the study while they are on a ventilator, or up to 30 days.

Participants assigned to listen to music work with a professional

music therapist to determine their music preferences.

14 minnesota nursing

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