AMBI ENT MUSI C I N THE EMERGENCY SERVI CES: THE PROFESSI ONALS’ PERCEPTI ON
Mar ia Fer nanda Zor zi Gat t i1
Mar ia Júlia Paes da Silva2
Gat t i MFZ, Silva MJP. Am bient m usic in t he em er gency ser v ices: t he pr ofessionals’ per cept ion. Rev Lat ino- am En fer m agem 2 0 0 7 m aio- j u n h o; 1 5 ( 3 ) : 3 7 7 - 8 3 .
Du e t o t h e assist an t ch ar act er ist ic of t h e em er g en cy ser v ice, t h e h ealt h p r of ession al ex p er ien ces
count less sit uat ions t hat gener at e anx iet y . This st udy aim ed t o lear n t he pr ofessionals’ per cept ion about t he
pr esence of classical m usic in t he w or king env ir onm ent . The sam ple w as com posed of 49 pr ofessionals of t he
adult em er gency depar t m ent of a m edium sized pr ivat e hospit al. The dat a w er e collect ed t hr ough a quest ionnair e
t o ev aluat e t he pr ofessional’s per cept ion. The r esult s show ed t hat 78% of t he pr ofessionals not iced alt er at ion
in t he at m ospher e w hen t he m usic w as pr esent , 41% believed t hat t he m usic alt er ed t heir per sonal per for m ance;
85% believed it alt er ed t heir per for m ance in a posit ive w ay and 15% in a negat ive w ay. Regar ding t he m usical
r eper t oir e, 61% of t he indiv iduals affir m ed t hey enj oy ed t he select ion, 96% believ ed t hat t he am bient m usic
should be k ept , w hile 76% of t he int er v iew ees suggest ed ot her m usical genr es.
DESCRI PTORS: an x iet y ; em er gen cies; m u sic; com plem en t ar y t h er apies
MÚSI CA AMBI ENTAL EN EL SERVI CI O DE EMERGENCI A: PERCEPCI ÓN
DE LOS PROFESI ON ALES
Consider ando que el ser v icio de em er gencia t iene una función asist encial, el pr ofesional de salud se
expone a diver sas sit uaciones que le gener an ansiedad. El obj et ivo del pr esent e est udio fue conocer la per cepción
de los pr ofesionales sobr e la audición de m úsica er udit a en el am bient e de t r abaj o. La m uest r a est uvo confor m ada
por 4 9 pr ofesion ales del ser v icio de em er gen cia adu lt o de u n h ospit al pr iv ado de m edian a com plej idad. Los
dat os fuer on r ecolect ados ut ilizando un cuest ionar io que evaluó la per cepción de los pr ofesionales. Fue obser vado
q u e la p r esen cia d e m ú sica p r ov ocó alt er acion es en el am b ien t e seg ú n 7 8 % d e los p r of esion ales, 4 1 %
con sider ó qu e la m ú sica alt er ó su desem peñ o per son al, de los cu ales 8 5 % m en cion ar on qu e f u e de f or m a
posit iv a y 15% de for m a negat iv a. En r elación al r eper t or io m usical, 61% de los indiv iduos afir m ar on haber se
sent ido a gust o con la selección m usical, 96% m encionar on que debe cont inuar se con la m úsica am bient al y
76% sugir ió la int r oducción de ot r os géner os m usicales.
DESCRI PTORES: an siedad; em er gen cias; m ú sica; t er apias com plem en t ar ias
MÚSI CA AMBI ENTE EM SERVI ÇO DE EMERGÊNCI A: PERCEPÇÃO DOS PROFI SSI ONAI S
Em f u n ção da car act er íst ica assist en cial do ser v iço de em er gên cia, o pr of ission al de saú de v iv en cia
inúm er as sit uações ger ador as de ansiedade. O obj et ivo dest e est udo foi conhecer a per cepção dos pr ofissionais
sobr e a au dição de m ú sica er u dit a n o am bien t e de t r abalh o. A am ost r a con st it u iu - se de 4 9 pr ofission ais do
pr ont o- socor r o adult o de um hospit al pr ivado de m édio por t e. Os dados for am colet ados ut ilizando- se quest ionár io
de avaliação da per cepção do pr ofissional. Foi obser vado que, com a pr esença da m úsica, 78% dos pr ofissionais
p er ceb eu alt er ação n o am b ien t e, 4 1 % acr ed it ou q u e a m ú sica alt er ou seu d esem p en h o p essoal, d e f or m a
posit iv a par a 8 5 % e n egat iv a par a 1 5 % . Em r elação ao r eper t ór io m u sical, 6 1 % dos in div ídu os afir m ou t er
gost ado da seleção, 9 6 % acr edit a qu e se dev e con t in u ar com a m ú sica am bien t e com su gest ão de ou t r os
gêner os m usicais por 7 6 % dos ent r ev ist ados.
DESCRI TORES: an siedade; em er gên cias; m ú sica; t er apias com plem en t ar es
1 M.Sc in Nur sing, Specialist in I nt ensive Ther apy and Em er gency Medical Ser vices, Nur sing Chief of t he Adult Em er gency Medical Ser vices in t he Hospit al
Sam ar it ano, Brazil, e- m ail: m ar ia.gat t i@sam ar it ano.com .br ; 2 Full Pr ofessor, Univer sit y of São Paulo, College of Nur sing, Brazil, e- m ail: j uliaps@usp.com .br
I NTRODUCTI ON
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u r si n g i s co n si d e r e d a p r o f e ssi o n t h a t suffers t he t ot al and im m ediat e im pact of st r ess, w hich st em s f r o m t h e co n st a n t ca r e o f si ck p e o p l e , u n p r e d i ct a b l e si t u a t i o n s, e x e cu t i o n o f so m e t i m e s r epulsive and agonizing t asks, char act er izing t he w or k it self as a focus of st ress( 1).Anot her appr oach ev aluat es t hat t he psy chic loads, due t o physical condit ions ( noise, t em per at ur e, v ib r at ion s) , b iolog ical con d it ion s ( v ir u ses, b act er ia, f u n g i ) a n d w o r k o r g a n i za t i o n ( d i v i si o n o f t a sk s, h ierar chy, com m an d, su bm ission ) can dir ect ly affect t h e w o r k e r s ’ r e l a t i o n s h i p s . I n r e s p o n s e t o t h e o r g a n i za t i o n a l p r e ssu r e , p sy ch o so m a t i c d i se a se s em er gence, w hich ar e descr ibed as st r ess( 2).
Her e, w e consider t hat bot h t he w or k obj ect ( a n d t h e a c t i v i t i e s t h a t s t e m f r o m i t ) a n d i t s or ganizat ion cont r ibut e t o highlight nur sing in t er m s of st r ess. St udies hav e t r ied t o ident ify w het her t he focus of st r ess lies in t he char act er ist ic of t he unit s w h er e t h e act iv it ies ar e d ev elop ed , com p ar in g t h e div er se hospit al unit s and r ev ealing a r ealit y t hat is not equal in differ ent inst it ut ions.
Wh ile on e st u dy iden t if ied t h at n u r ses w h o w or k in open unit s ( det er m ined by t he flow of pat ient s a n d r e l a t i v e s) p r e se n t h i g h e r l e v e l s o f st r e ss i n co m p a r i so n w i t h t h o se i n cl o sed u n i t s( 3 ). An o t h er r esear ch ident ified a higher lev el of st r ess in cr it ical unit s lik e sur gical w ar ds ( SW) and em er gency r oom s ( ER) , i n d e p e n d e n t l y o f t h e f l o w o f p a t i e n t s a n d r el at i v es( 4 ), w h i ch su g g est s t h at i t i s n o t t h e u n i t c h a r a c t e r i s t i c , b u t t h e p r o f e s s i o n a l a c t i v i t y char act er ist ic per se w hich leads t o st r ess.
St u dies in gen er al h av e t en ded t o con sider st r ess on ly in t h e w or k of n u r ses an d n ot of ot h er healt h pr ofessionals, per haps because m ost r esear ch is conduct ed by t his pr ofessional cat egor y. How ev er, c o n s i d e r i n g t h a t t h e a c t i v i t y o f s e c o n d a r y - l e v e l p r of ession als r eq u ir es d ed icat ion , com m it m en t an d r esponsibilit y in an equal pr opor t ion t o t heir act iv it y, i t can b e i n f er r ed t h at t h ese p r o f essi o n al s’ st r ess should be analy zed in t he sam e w ay.
Al t h o u g h h o sp i t al i n st i t u t i o n s ar e act u al l y co n cer n ed w i t h r el at i n g sat i sf act i o n , t u r n o v er an d ab sen t eeism in d ices w it h w or k con d it ion s, ef f ect iv e m e a su r e s t o i m p r o v e t h i s p r o ce ss a r e st i l l b e i n g discussed in a ver y isolat ed way, so t hat a cult ur e of int er v ent ion, or ev en pr ev ent ion of suffer ing at w or k is far fr om being im plem ent ed.
I n t e r p e r so n a l r e l a t i o n sh i p s r e p r e se n t t h e m ain difficult y, not only for t he nur sing t eam but for all professionals in t he sect or. The environm ent , oft en d isr u p t ed d u e t o ex cessiv e p at ien t d em an d s, car e
n eed s w it h in an ap p r op r iat e t im e, lim it ed p h y sical st r uct ur e, r equest s by pat ient s and fam ilies, w ho ar e se n si t i v e a n d n e e d i n f o r m a t i o n a t t h i s m o m e n t , fr equent ly gener at e anx iet y and ex pect at ion, also in t he t eam s, t o solv e pr oblem s.
Sev er al st r ess f act or s h av e b een id en t if ied w h i c h c a n a f f e c t t h e e m e r g e n c y s e r v i c e t e a m , including personal problem s of em ot ional order, w hich dir ect ly affect t h e pr ofession al’s com m u n icat ion an d pr of ession al, t h e an x iet y cau sed by t h e ex pect at ion of adequat e per form ance, et hical issues, t he pat ient ’s a n d t h e f a m i l y ’ s st r e ss, a g g r a v a t e d b y t h e h i g h d e m a n d , r e q u i r i n g b e t t e r a b i l i t i e s f r o m t h e p r o f e ssi o n a l t o co n t r o l t h e si t u a t i o n , i n a d e q u a t e w o r k i n g c o n d i t i o n s r e l a t e d t o t h e e n v i r o n m e n t , m at er ial and t echnological r esour ces( 5 - 6 ).
Ther efor e, w e conclude t hat inv est ing in t he pr ofessional’s phy sical and m ent al healt h is essent ial f o r t h e q u a l i t y o f t h e d e l i v e r e d c a r e , a n d t h a t con t r ollin g t h e w or k en v ir on m en t an d r elat ion sh ip s can sign if ican t ly con t r ibu t e t o t h e w ell- bein g of t h e t eam .
St udies in t he em er gency ar ea t hat pr esent co m p l e m e n t a r y t h e r a p i e s a i m i n g t o i m p r o v e t h e pat ient ’s t her apeut ic appr oach ar e lim it ed. As for t he healt h t eam , despit e r ealizing t he ext r em e im por t ance o f t h e b e h a v i o r a l a r e a a n d r e l a t i o n s h i p s f o r i t s dev elopm en t , lit t le r esear ch h as been dev eloped in order t o int ervene in favor of t he nursing professional, w h e t h e r i n t h e f i e l d o f co m p l e m e n t a r y t h e r a p y, com m unicat ion or ev en qualit y of life.
Ad op t in g t h e p er sp ect iv e of t ak in g car e of car egiver s and consider ing t he evidence t hat r esearch has dem onst r at ed over t he year s, t hat m usic r elieves p at i en t s’ p ai n( 7 ) an d h as so m an y o t h er f av o r ab l e ef f ect s, su ch as d im in ish ed an x iet y an d r elax at ion , alr eady used in ot her hospit al ar eas, w e believ e t hat m u sic cou ld also be im plem en t ed in t h e em er gen cy sect or. Th e ar gu m en t is t h at it can posit iv ely affect sev er al aspect s of t h e en v ir onm ent , dim inishing n ot only t he pat ient s but also t he healt h t eam ’s st r ess.
Ma r t h a Ro g e r s, a n o t h e r n u r si n g t h e o r i st , m ak es us t hink of t he hum an being as an indiv idual in t eg r it y w h o is con st an t ly ex ch an g in g en er g y w it h t h e en v ir on m en t , ir r ev er sibly ev olv in g in space an d t i m e – t h e p r i n ci p l e o f i n t e g r a l i t y. Ba se d o n t h i s assum pt ion is t he energy field, a unifying concept for bot h anim at ed and unanim at ed env ir onm ent s, w hich h a v e n o l i m i t s , a r e i n d i v i s i b l e a n d d y n a m i c , m an if est in g dif f er en t bu t in t egr at in g ch ar act er ist ics, of t h e p er son – p r in cip le of r eson an ce. Th e au t h or defines nursing as a science in t he st udy of t he hum an and env ir onm ent al fields, dir ect ed at t he descr ipt ion o f h u m a n i t y ’ s l i f e p r o ce sse s, g u i d e s p r o f e ssi o n a l N u r s i n g p r a c t i c e i n t h e s e a r c h f o r h a r m o n i o u s int egr at ion of t he hum an being w it h t he envir onm ent , d i r e c t s t h e s t a n d a r d i z a t i o n o f t h e h u m a n a n d en v ir on m en t al ar eas, w it h a v iew t o t h e m ax im u m r ealizat ion of healt h( 8).
A c c o r d i n g t o t h e r e s o n a n c e p r i n c i p l e , descr ibed befor e, t he change in t he pat t er n of hum an beings and envir onm ent s is pr opagat ed by w aves t hat m ov e bet w een lon g low - f r equ en cy w av es an d sh or t high- frequency w av es. The sound, like light and color, is also t r an sm it t ed t h r ou gh v ibr at ion s, per ceiv ed by t h e h u m an bein g in t h e f r equ en cy bet w een 2 0 an d 20,000 Hz( 9).
Get t ing t o k now am bient m usic t hr ough t he pr inciples of int egr alit y and r esonance allow s for t he im pr ov em en t of t h e en v ir on m en t at t h e em er gen cy ser v ice an d can g r eat ly con t r ib u t e t o t h e h ealt h ier dev elopm ent of w or k at t his ser v ice.
Th r o u g h t h e r h y t h m i c v i b r a t i o n o f so u n d w aves, m usic per m it s t he cr eat ion of a r ecept ive st at e, t hrough t he relaxat ion of t he hum an senses, especially r egar din g em ot ion s, allow in g f or t h e assim ilat ion of t he cont ent t r ansm it t ed by m usic or any ot her elem ent close t o it at t he m om ent t he m usic is heard( 10).
I t pr om pt s t he induct ion phenom enon, w hich is a t echnique t hat can be used t o program life it self, con t r ol en v ir on m en t s or r eg u lat e act ion s, t h ou g h t s and em ot ions. Music can help t o elim inat e pain, w orking as an im aginar y sanct uar y – a safe r efuge – against pain. I t helps t o reduce st ress and t ension and induces r e l a x a t i o n . I t a l s o a c t i v a t e s t h e p r o d u c t i o n o f e n d o r p h i n a n d h e l p s t h e m i n d t o cr e a t e i m a g e s, allow ing t he hum an being t o t em por ar ily escape t o a “ painless w orld”, shelt ered by im aginat ion. Music act s a s a n “ i n t e r p r e t e r ” , t r a n s l a t i n g “ w a v e s ” o f p a i n ( sensat ions) in ener gy or healt hy vibr at ion, sound. I t h elp s t o r ein f or ce sp at ial t h in k in g , t h e cap acit y t o per ceive obj ect s w it h precision, t o develop im aginat ion an d t o d i st i n g u i sh am on g av ai l ab l e op t i on s. Si n ce an x iet y u su ally in t er f er es in t h e clar it y of t h in k in g, t h e u se o f m u si c t o r e d u ce t e n si o n i s e x t r e m e l y
ef f ect iv e, im p r ov in g con cen t r at ion an d r et en t ion of t h e m a t er i a l l ea r n ed . Ho w ev er, i t i s n ecessa r y t o ch oose an ap p r op r iat e r ep er t oir e. Th e p r in cip le of in du ct ion is closely lin k ed t o t h e “ iso” ( isom or ph ic) pr inciple, w hich suggest s t hat a per son’s m ood adj ust s t o t he m ood of t he m usic and is gr adually m ov ed t o t he desir ed dir ect ion( 11).
Mu sic w as in it ially u sed in h osp it als in t h e n i n e t e e n ce n t u r y, a s a r e cr e a t i o n a l r e so u r ce f o r psy chiat r ic pat ient s. At t he t im e, r hy t hm s t hat could hav e a fav or able or har m ful effect had alr eady been dist inguished and it w as obser v ed t hat soft m elodies calm ed d ow n ag it at ed p at ien t s. Th e m u sic f ocu sed on t o im p r ov e w or k cap acit y w as id en t if ied on t h e occasion of World War I I , in Brit ish and Nort h Am erican plant s pr oducing w ar w eapons, in or der t o r aise t he w o r k e r s ’ d i s p o s i t i o n a n d m a k e t h e m m o r e ef f icien t( 1 2 ).” Like good illu m in at ion , m u sic sh ou ld go by alm ost unnot iced t o t he w or ker s. Funct ional m usic, m u sic at t h e ser v ice of t h e im pr ov em en t of h u m an act iv it ies m u st n ot be h ear d, bu t on ly sen sed”. Th e r h y t h m s get t o t h e u n con sciou s, cr eat e a feelin g of w ell- being and elim inat e t he t ension of t he spirit . The gener al r ule is t o use m usic dur ing shor t per iods, up t o 2 hour s and half, avoiding pr olonged per iods( 12).
I n t he beginning of t he t w ent iet h cent ury, t he use of m usic as a t her apeut ic r esour ce st ar t ed t o gain pow er and, in 1941, t he Nat ional Foundat ion of Musical Ther apy w as cr eat ed t o expand st udies in t his ar ea( 12), t h ou g h t h e t h er ap eu t ic u se of m u sic b ecam e m or e d issem in at ed an d d if f er en t iat ed on ly at t h e en d of t he cent ury. Like art , m usic involves t he environm ent and t he person as a w hole, t he m usical for m act s on t he hum an sensit ivit y and t he cont ent is t he m essage t hat w ill be t r ansm it t ed, for m and cont ent ar e m ix ed in an indivisible w hole( 10).
Er u d i t e m u si c p r esen t s t h i s co n t en t i n an ar t ist ic f or m t h r ou gh t h e r hy t h m , m elody, h ar m on y a n d t i m b r e o f t h e i n s t r u m e n t s , a n d r e a c h e s a n elevat ed level of art , w hose aim is not only t he est het ic s e n s e , b u t a l s o t h e t r a n s m i s s i o n o f s o m e t h i n g significant and t r ue, using t he sensor ial r elat ion w it h t he list ener( 10).
I n g e n e r a l , r e l a x i n g m u s i c m u s t h a v e r h y t h m i c s y n c h r o n i c i t y , a n d b a r o q u e m u s i c , i f co m p a r ed t o o t h er m u si ca l f o r m s, i s si g n i f i ca n t l y effect iv e in t he induct ion of “ alpha st at es”, t hat is, a st at e of r elaxed aler t ness accom panied by t he feeling of w ell- being in t he list ener( 11).
presents itself by its im posing sound and, hence, the great developm ent of the technique and m usical construction. Johann Sebastian Bach is a perfect exam ple of baroque art in m usic history; the developm ent of the concert style, t he colorful and ornam ent al decorat ion of t he im posing sound are eloquent t est im onies of t he baroque spirit of Bach’s work( 13).
Ex pect in g t h at t h e er u dit e m u sic of Joh an n Seb ast ian Bach cou ld p osit iv ely in f lu en ce t h e w or k en v ir on m en t , w e p r op osed t o w or k w it h a m u sical select ion of t h is com poser as am bien t m u sic f or an em er g en cy ser v ice.
Th er efor e, t h is st u dy aim ed t o get t o k n ow t h e p er cep t ion of p r of ession als f r om an em er g en cy ser v ice r egar ding t he use of er udit e am bient m usic.
METHOD
Th e s t u d y w a s d e v e l o p e d a t a n a d u l t em er gency m edical ser vice of a m edium - sized pr ivat e h o sp i t a l i n t h e ci t y o f Sã o Pa u l o , Br a zi l . On t h e av er age, t he 24- hour ser v ice at t ends 5,800 pat ient s/ m ont h in all specialt ies.
A t ot al of 49 pr ofessionals, am ong physicians, nur ses, adm inist r at iv e aids, phar m acy aids, cleaning aids and nur sing aids and t echnicians w ho w or k ed in t h e m or n in g an d af t er n oon sh if t s in t h e em er gen cy sect or w er e included in t he st udy. The m or ning and aft er noon shift s w er e chosen because t hey r epr esent t h e h ig h est p er cen t ag e of car e d eliv er ed in t h e 2 4 hours, hence, w it h t he heavier w or k load. I n addit ion, t he night period is w hen, physiologically, rest is m ost needed and am bient m usic is not adequat e. Ther efor e, t he fir st six hour s of w or k w er e consider ed for dat a collect ion .
Aft er t he appr oval by t he inst it ut ional r eview b o a r d , d a t a co l l ect i o n w a s i n i t i a t ed i n t h e p er i o d b et w een Ap r il an d May, 2 0 0 5 . A q u est ion n air e w as u sed, elabor at ed by t h e r esear ch er s, w it h t en open a n d cl o sed q u est i o n s. Th i s q u est i o n n a i r e w a s n o t subm it t ed t o a pilot t est as t he quest ions w er e shor t a n d d i r e ct . Qu e st i o n s 1 a n d 2 ch a r a ct e r i ze d t h e populat ion accor ding t o t he pr ofession ( t im e of w or k and w or k load/ day ) . Quest ions 3 and 4 inv est igat ed t h e m u sical pr efer en ce an d t h e h abit of list en in g t o m u si c, w h i l e q u est i o n s 5 t o 7 i n q u i r ed a b o u t t h e per ceiv ed effect s of m usic on t he w or k env ir onm ent an d on per son al per for m an ce an d, fin ally, qu est ion s 8 t o 1 0 a s k e d i f t h e p r o f e s s i o n a l a p p r o v e d t h e in t er v en t ion an d w ou ld lik e t o su ggest an ot h er k in d of m u sic. I n or d er t o d ef in e t h e m u sical select ion , t h r ee CDs of Joh an n Sebast ian Back w er e u sed: 1 ) BACH for RELAXat ion, 2) Royal Philhar m onic Or chest r a
BACH, 3) Cr azy for BACH, and 24 songs w er e select ed w it h a t ot al dur at ion of 1 hour and 28 m inut es.
Dat a w er e collect ed by one of t he r esear cher s at t he em er gency sect or and dur ing t he par t icipant s’ shift . First , t he subj ect received individual explanat ion r egar ding t he r esear ch, in a r eser v ed r oom , and t he fr ee and infor m ed consent t er m w as r ead.
I n t he fir st w eek, t he am bient m usic w as kept for 1 hour and 28 m inut es, w it h int er v als of 1 hour a n d 3 0 m i n u t e s w i t h o u t m u s i c , s o t h a t t h e pr ofessionals hear d t he sam e m usical sequence t w ice d u r in g t h eir w or k sh if t . Sof t in st r u m en t al son g s b y Johann Sebast ian Bach w er e chosen random ly, t aking car e t o avoid a sequence of songs of t he sam e m usical f or m , so as n ot t o b or e t h e list en er s, in t er calat in g adagios, sonat as, cant at as, suit es and concer t s in t he t r ack s. I n t he second w eek , t he subj ect s w er e ask ed t o fill out a quest ionnair e w hile t ak ing a br eak fr om t heir act ivit ies and, aft er doing so, t o hand it personally t o t he r esear cher. Descr ipt ive st at ist ics was used for dat a an aly sis.
RESULTS
Char act er izat ion of t he populat ion accor ding t o sociodem ogr aph ic v ar iables
Ta b l e 1 – D i s t r i b u t i o n o f s o c i o d e m o g r a p h i c a n d p r o f e s s i o n / a c t i v i t y v a r i a b l e s o f e m e r g e n c y pr ofession als. São Pau lo, 2 0 0 5
s e l b a i r a
V Frequency Percentage
r e d n e G e l a
M 25 51
e l a m e
F 24 49
e g A d l o s r a e y 9 2 o t 8
1 17 34.7
d l o s r a e y 1 4 o t 0
3 21 42.9
d l o s r a e y 3 5 o t 2
4 9 18.4
d l o s r a e y 5 6 o t 4
5 2 4
n o i s s e f o r P n a i c i s y h
P 14 28.6
n a i c i n h c e T g n i s r u
N 12 24.5
d i A e v i t a r t s i n i m d
A 12 24.5
e s r u
N 6 12.2
d i A g n i s r u
N 3 6.1
d i A y c a m r a h
P 1 2
d i A g n i n a e l
C 1 2
a e r a e h t n i e c n e i r e p x E r a e y 1 n a h t s s e
L 6 12.3
s r a e y 5 o t
1 7 14.3
s r a e y 7 1 o t
6 26 53
s r a e y 9 2 o t 8
1 9 18.4
e r o m r o s r a e y 0
3 1 2
y a d / d a o l k r o W s r u o h 8 o t
6 20 40.9
s r u o h 2 1 o t 0
1 26 53
s r u o h 2 1 n a h t e r o
d e r r e f e r P
s e l y t S l a c i s u
M NursingPhysicianAdministrative / g n i n a e l C
y c a m r a h
P Total (%)
B P
M 17 7 11 1 36 38
l a c i s s a l
C 6 6 - - 12 13
k c o
R 6 8 3 - 17 18
s e u l b / z z a
J 6 10 2 - 18 19
y r t n u o
C 4 - - 1 5 5
, a r e p o ( s r e h t O
) l u o s , c it l e
c 2 2 1 - 5 5
e d o g a p / a b m a
S 1 - 1 - 2 2
l a t o
T 42 33 18 2 95* 100
I n Table 1, w e can obser ve t hat t he fr equency of m en an d w om en p ar t icip at in g in t h e st u d y w as pr opor t ional, w it h a higher per cent age of indiv iduals, 21 ( 42.9% ) , bet w een 30 and 41 year s old. Regar ding e x p e r i e n c e i n t h e e m e r g e n c y a r e a , 2 6 ( 5 3 % ) pr ofessionals hav e w or k ed in t he ar ea for bet w een 6 and 17 y ear s. The par t icipat ion of t he nur sing gr oup st ands out w hen t he t hree pr ofessional cat egor ies w er e g r o u p e d t o g e t h e r, w i t h 2 1 i n d i v i d u a l s ( 4 2 . 8 % ) . Exper ience in t he em er gency ar ea cor r esponds t o t he pr edom in an t r an ge of age, w h ich in dicat es t h at t h e gr ou p is com posed of ex per ien ced pr of ession als.
The w or k load per day is 10 t o 12 hour s for 26 individuals ( 53% ) and m or e t han 12 hour s for t hr ee pr of ession als ( 6 % ) .
Ch a r a c t e r i z a t i o n o f t h e p r o f e s s i o n a l ’ s m u s i c a l p r ef er en ce
A s o b s e r v e d i n Ta b l e 2 , t h e r e w a s a pr edom inance of Br azilian Popular Music ( MPB) ( 38% ) as t h e m u sical pr ef er en ce. Alt h ou gh classical m u sic ( 1 3 % ) , w h ich w as u sed in t h is st u dy, h as n ot been indicat ed as t he pr edom inant pr efer r ed st y le, it does n ot seem t o h av e in f lu en ced t h e r esu lt s p r esen t ed below , indicat ing t hat t he pr efer r ed st yle is not a sine qua non condit ion t o t he achiev em ent of t he m usical
ef f ect s.
Table 2 – Mu sical Pr ef er en ce of pr of ession als at an em er gen cy ser v ice. São Pau lo, 2 0 0 5
* The num ber of m usical st yles exceeds t he n of t he st udy because t he par t icipant s indicat ed m or e t han one st yle.
Accor ding t o t he pr ofessional’s per cept ion, t he ef f ect s pr odu ced in t h e en v ir on m en t w er e classif ied as posit ive ( 76% ) , such as: har m ony, r elaxat ion, calm , t ranquilit y, at t ent ion, light ness, dim inished st r ess and h appin ess – in t h eir w or ds; an d n egat iv e ( 1 0 . 5 % ) , such as: ir r it abilit y and anx iet y.
Regar ding t he per cept ion of alt er at ion in t he act iv it y, 41% of t he pr ofessionals believ ed t he m usic
w a s r e s p o n s i b l e f o r a l t e r i n g t h e i r p e r s o n a l p er f or m an ce, r ep or t in g h ig h er con cen t r at ion , g ood m o o d , en t h u si a sm , o r d er, st r ess r el i ef, ca l m n ess, r el a x a t i o n a n d j o y a s p o si t i v e ef f ect s ( 8 5 % ) a n d ir r it abilit y and sleepiness as negat iv e effect s ( 15% ) . Reg a r d i n g t h e p a t i en t s’ m a n i f est a t i o n , 2 6 ( 5 3 % ) p r o f essi o n a l s r ep o r t ed h a v i n g h ea r d so m e spont aneous com m ent , of appr oval w it h 15 m ent ions, d i sa p p r o v a l w i t h si x m en t i o n s a n d b o t h w i t h f i v e m ent ions, t hat is, a lar ge par t of t he pat ient s did not ex pr ess w h et h er t h ey per ceiv ed t h e am bien t m u sic, w hich w as ex pect ed t o som e ext ent , since t her e w as no act iv e sear ch for t his infor m at ion.
Regar ding t he m usical select ion, 61% of t he professionals appreciat ed t he select ion and m ent ioned ch ar act er ist ics lik e sof t n ess, t r an q u ilit y, r elax at ion , lig h t n ess, ap p r op r iat e m u sic an d u n iv er sal; on t h e opposit e, 39% did not like it , ar guing it w as a bor ing, r epet it iv e, gloom y and sad select ion.
Ot her k inds of m usic w er e suggest ed by 37 ( 76% ) pr ofessionals, w it h em phasis on MPB, chosen by 1 2 ( 2 4 % ) pr of ession als. Am on g t h e su ggest ion s ar e r adio st at ion s, j azz, blu es, n ew age, celt ic an d n at u r e sou n ds. Keepin g t h e am bien t m u sic w as t h e opinion of 4 7 ( 9 6 % ) pr ofessionals, w hich show s t he gr oup’s appr ov al of t he int er v ent ion.
DI SCUSSI ON
Th e pr of ession als’ w illin gn ess t o par t icipat e i n t h e r e s e a r c h w a s a v e r y s t i m u l a t i n g f a c t o r, esp ecially in t h e n u r sin g an d ad m in ist r at iv e ar eas. Th er e w as on ly on e r ef u sal b y on e m em b er of t h e m ed ical t eam . I t is im p or t an t t o t ak e in t o accou n t t h at on e of t h e r esear ch er s is h ead of t h e n u r sin g d e p a r t m e n t , w h i c h m a y h a v e i n f l u e n c e d t h e accept ance t o par t icipat e in dat a collect ion, alt hough t h e r e w e r e c o u n t l e s s e n t h u s i a s t i c a n d a n x i o u s com m ent s for t he am bient m usic t o st ar t .
pat ien t s, r esu lt in g in an u n sat isf act or y sit u at ion f or bot h sides( 14).
I n v i e w o f a n i n e v i t a b l e s i t u a t i o n , t h e inst it ut ions only hav e one w ay t o int er v ene, so t hat car e qualit y is not com pr om ised.
Th e ch o i ce o f t h e m u si ca l sel ect i o n i s a n ex t r em ely r elev an t f act or w h en t h e aim is t o cau se an effect besides t he est het ic sense t he m usic offers. I n t his st udy, w e only w or ked w it h one m usical st yle an d o n e sp eci f i c co m p o ser, j u st i f y i n g t h e n eed t o dev elop fur t her r esear ch and use ot her com poser s in order t o expand t he repert oire possibilit ies. I n addit ion, t h e e v a l u a t i o n o f t h e p a t i e n t s ’ p e r c e p t i o n i n a ch ar act er ist ic em er g en cy sit u at ion is su g g est ed in or der t o find out about how m usic influences t hem .
The person’s preferred m usical st yle does not seem t o be det er m inant for obt aining posit ive r esult s in t he decr ease of an x iet y or r elax at ion . I n a st u dy t h at u sed t h r ee d if f er en t m u sical g en r es ( classical, p op u lar an d n ew ag e) t o ev alu at e t h e r ed u ct ion of s t r e s s , r e g a r d i n g t h e m u s i c a l p r e f e r e n c e o f t h e list eners, popular m usic, like in our sam ple, was chosen by 45% of t he list eners as t he preferred st yle ( n= 58) , a fact or t hat can be relat ed t o t he habit of list ening t o popular m usic on t he radio m ore frequent ly. Aft er t he st at ist ical analysis of t he result s, it was observed t hat c l a s s i c a l a n d n e w a g e m u s i c e x e r t e d a p o s i t i v e significant effect on t he reduct ion of st ress, as opposed t o t he preferred m usic, which did not exert t his effect( 15). List ening t o Bach’s classical m usic and r ock w as also ev alu at ed in or d er t o clar if y w h et h er t h e p r ef er r ed m u sical st y le in t er f er es w it h t h e b en ef ic ef f ect of m u sic t o m in im ize an x iet y. Tw o g r ou p s of m u sic st u den t s pr ef er r ed t h e classical m u sic gen r e; t h e f ir st g r ou p list en ed t o Bach an d t h e secon d t o r o c k . Th e g r o u p t h a t h a d l i s t e n e d t o r o c k g o t uncom for t able, dispir it ed and t her e w as no alt er at ion of pr essur e levels; on t he ot her hand, t he gr oup t hat had list ened t o Bach got r elaxed and ar t er ial pr essur e significant ly dim inished( 1 6 ).
We consider ed t hat m usical st y le adopt ed in t his st udy ( r ock) t o oppose t he pr efer r ed m usic ( Bach) w as not indicat ed t o pr ovide r elaxat ion and t o dim inish anxiet y. Thus, it is quest ionable w hat t he result w ould if t he second gr oup had list ened r elaxing m usic, even if not t he pr efer r ed one.
I n t his st udy, m ost pr ofessionals enj oyed t he m u s i c a l s e l e c t i o n a n d , c u r i o u s l y, o n l y 2 4 % h a d r epor t ed t he habit of list ening t o classical m usic. For 3 9 % of t h ose w h o d id n ot , t h e f act or s m en t ion ed , such as t he t ir esom e and r epet it iv e select ion, m ak e us t hink t hat it m ight be r elat ed t o t he w ay t hey w er e exposed t o t he m usic and not t o t he select ion per se. Alt h ou g h t h e p r ef er en ce f or MPB h as b een h i g h l i g h t ed , w e i d en t i f i ed t h at , at t h e m o m en t o f su ggest in g an ot h er r eper t oir e, t h e st y les w er e v er y d i v er se.
Thr ough t he differ ent appr oaches, t he st udy of m u sic h as ben ef it ed t h e dev elopm en t of a m or e h olist ic an d h u m an ized n u r sin g car e, im p lem en t in g alt er nat iv es of car e t hat com plem ent t he biom edical m o d el . Th e car e w i t h t h e h eal t h p r o f essi o n al i s a r esp o n si b i l i t y al l o f u s sh o u l d assu m e i n o r d er t o pr ovide for a bet t er w or k envir onm ent , com pensat ing for t he inev it able r equir em ent s of t he pr ofession. I n t his cont ext , m usic can be an ally.
CONCLUSI ONS
We can conclude t hr ough t his st udy t hat t he pr ofessionals’ per cept ion r egar ding t he effect of m usic, b o t h o n t h e e n v i r o n m e n t a n d o n h i s ( e r ) o w n per for m an ce, is v er y posit iv e. Th e m aj or it y en j oy ed t he m usical select ion ( 61% ) , per ceiv ed t he effect on t he env ir onm ent ( 77.5% ) and per ceiv ed alt er at ion in individual act ivit y ( 41% ) . This kind of int er vent ion can cont r ibut e t o t he or ganizat ion of em er gency ser vices, im pr oving t he envir onm ent and m inim izing t he effect s of t he st ress at w ork.
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