{"id":28985,"date":"2018-02-20T23:50:30","date_gmt":"2018-02-20T23:50:30","guid":{"rendered":"https:\/\/writemyessayfree.com\/validity-of-research-methodology"},"modified":"2017-08-12T07:41:34","modified_gmt":"2017-08-12T07:41:34","slug":"validity-of-research-methodology","status":"publish","type":"post","link":"https:\/\/www.benedictsol.com\/blogs\/validity-of-research-methodology\/","title":{"rendered":"validity of research methodology"},"content":{"rendered":"<div class=\"mkdf-post-text-inner clearfix\">\n &#8216;<br \/>\n  &#8216;<br \/>\n   <PROFFESIONALS COURSEWORK ASSISTANCE2017-03-20\">March 20, 2017<\/time>\n  <\/div>\n<p>  <'\"><br \/>\n   <a =\"#\" class=\"mkdf-like\" id=\"mkdf-like-16663-992\" title=\"Like this\"><i class=\"icon_heart\"><\/i><span>0<\/span><\/a>\n  <\/div>\n<div class=\"mkdf-post-info-comments-holder mkdf-post-info-item\">\n   <a class=\"mkdf-post-info-comments\" =\"\/validity-of-research-methodology\/#respond\"> <span class=\"mkdf-post-info-comments-icon\"> <span aria-hidden=\"true\" class=\"mkdf-icon-font-elegant icon_comment \"><\/span> <\/span> <span itemprop=\"commentCount\">0<\/span> <\/a>\n  <\/div>\n<div class=\"mkdf-post-info-category mkdf-post-info-item\">\n   <span aria-hidden=\"true\" class=\"icon_tags\"><\/span><br \/>\n   <a =\"\/category\/Services\/\" rel=\"category tag\">Services<\/a>\n  <\/div>\n<\/p><\/div>\n<h2 itemprop=\"headline\" class=\"mkdf-post-title\"> validity of research methodology<\/h2>\n<p>validity of research methodology<br \/> Selection of the appropriate sample is critical to the reliability and validity of research methodology. The sample must be representative of the population that is being studied. Researchers often report both the inclusion and exclusion criteria for the sample. There are many different methods for selecting a sample and random sampling provides the high control of outside variables but is often difficult to utilize in many studies.<\/p>\n<p>For this Discussion, please review the following:<\/p>\n<p>For this assignment, read the article by Labrague, L. &amp; McEnroe-Petitte, D. (2016). Influence of music on preoperative anxiety and physiological parameters in women undergoing gynecologic surgery. Clinical Nursing Research, 25(2), 157-173, listed in the resource section for this week.<br \/> By Day 3<\/p>\n<p>Prepare a 250-300-word post discussing the strengths and weaknesses of the sampling method used in this study and if the sampling method promoted reliable and valid results. Include in the discussion if there is anything the researcher could have done to improve the sampling process.<\/p>\n<p>Note: Post a three paragraph (at least 250\u2013350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames.<\/p>\n<p>File #1<br \/> validity of research methodology<br \/> Selection of the appropriate sample is critical to the reliability and validity of research methodology. The sample must be representative of the population that is being studied. Researchers often report both the inclusion and exclusion criteria for the sample. There are many different methods for selecting a sample and random sampling provides the high control of outside variables but is often difficult to utilize in many studies.<\/p>\n<p>For this Discussion, please review the following:<\/p>\n<p>For this assignment, read the article by Labrague, L. &amp; McEnroe-Petitte, D. (2016). Influence of music on preoperative anxiety and physiological parameters in women undergoing gynecologic surgery. Clinical Nursing Research, 25(2), 157-173, listed in the resource section for this week.<br \/> By Day 3<\/p>\n<p>Prepare a 250-300-word post discussing the strengths and weaknesses of the sampling method used in this study and if the sampling method promoted reliable and valid results. Include in the discussion if there is anything the researcher could have done to improve the sampling process.<\/p>\n<p>Note: Post a three paragraph (at least 250\u2013350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames.<\/p>\n<p>File #1<\/p>\n<p>Clinical Nursing Research<br \/> 2016, Vol. 25(2) 157\u2013173<br \/> \u00a9 The Author(s) 2014<br \/> Reprints and permissions:<br \/> sagepub.com\/journalsPermissions.nav<br \/> DOI: 10.1177\/1054773814544168<br \/> cnr.sagepub.com<br \/> Article<br \/> Influence of Music on<br \/> Preoperative Anxiety<br \/> and Physiologic<br \/> Parameters in Women<br \/> Undergoing Gynecologic<br \/> Surgery<br \/> Leodoro J. Labrague, MAN, BSN, RN1 and<br \/> Denise M. McEnroe-Petitte, PhD, MSN, BSN, RN2<br \/> Abstract<br \/> The aim of this study was to determine the influence of music on anxiety levels<br \/> and physiologic parameters in women undergoing gynecologic surgery. This<br \/> study employed a pre- and posttest experimental design with nonrandom<br \/> assignment. Ninety-seven women undergoing gynecologic surgery were<br \/> included in the study, where 49 were allocated to the control group<br \/> (nonmusic group) and 48 were assigned to the experimental group (music<br \/> group). Preoperative anxiety was measured using the State Trait Anxiety<br \/> Inventory (STAI) while noninvasive instruments were used in measuring<br \/> the patients\u2019 physiologic parameters (blood pressure [BP], pulse [P], and<br \/> respiration [R]) at two time periods. Women allocated in the experimental<br \/> group had lower STAI scores (t = 17.41, p &lt; .05), systolic (t = 6.45, p &lt; .05)<br \/> and diastolic (t = 2.80, p &lt; .006) BP, and P rate (PR; t = 7.32, p &lt; .05) than<br \/> in the control group. This study provides empirical evidence to support<br \/> the use of music during the preoperative period in reducing anxiety and<br \/> unpleasant symptoms in women undergoing gynecologic surgery.<br \/> 1Samar State University, Catbalogan City, Philippines<br \/> 2Kent State University Tuscarawas, New Philadelphia, OH, USA<br \/> Corresponding Author:<br \/> Leodoro J. Labrague, Associate Dean, College of Nursing and Health Sciences, Samar State<br \/> University, Brgy. Guindapunan, Catbalogan, Samar, 6700, Philippines.<br \/> Email: Leo7_ci@yahoo.com<br \/> 544168 CNRXXX10.1177\/1054773814544168Clinical Nursing ResearchLabrague and McEnroe-Petitte<br \/> research-article2014<br \/> 158 Clinical Nursing Research 25(2)<br \/> Keywords<br \/> anxiety, gynecologic surgery, music therapy, physiologic parameters, State<br \/> Trait Anxiety Inventory<br \/> Introduction<br \/> Patients generally experience high levels of anxiety when hospitalized to<br \/> undergo surgery and other invasive procedures. Anxiety is an emotional state<br \/> consisting of a set of behavioral manifestations, which occurs in 11% to 80%<br \/> of adult surgical clients prior to surgery regardless of the scope and extent of<br \/> surgery (Caumo et al., 2001; Starkweather, Witek-Janusek, Nockels, Peterson,<br \/> &amp; Mathews, 2006). Women, in particular, experience high levels of anxiety<br \/> during surgery when compared with men (Caumo et al., 2001; Mitchell,<br \/> 2003). Many factors are thought to contribute to surgical patients\u2019 anxiety:<br \/> preoperative waiting time, fear of postoperative pain, disfigurement, disruptions<br \/> of their personal and professional lives, and even financial burdens<br \/> (D. Lee, Henderson, &amp; Shum, 2004; Mitchell, 2003; Poleshuck et al., 2006;<br \/> Shelby, Taylor, Kerner, Coleman, &amp; Blum, 2002). Although considered as a<br \/> common phenomenon and accepted as a normal response in anticipation of a<br \/> surgical event, high levels of anxiety affects patients\u2019 postoperative outcome<br \/> and overall well-being (Hook, Songwathana, &amp; Petpichetchian, 2008;<br \/> McCance &amp; Huether, 2006; Starkweather et al., 2006). Therefore, the challenge<br \/> for perioperative nurses is to maintain physiological and psychological<br \/> well-being of patients by reducing anxiety and fear.<br \/> Background<br \/> Anxiety is defined as a state of uneasiness or apprehension resulting from the<br \/> anticipation of a real or perceived threatening event or situation. This state<br \/> commonly occurs among preoperative patients and ranges from low to high<br \/> in intensity depending on the individual\u2019s perception of the event (Arslan,<br \/> Ozer, &amp; Ozyurt, 2008; Pritchard, 2009). Anxiety related to surgery is thought<br \/> to be related to fear of the outcome of the surgery, separation from friends and<br \/> family, fear of death and disfigurement, coping with postoperative pain and<br \/> treatment regimens, fear of losing independence, and surgical recovery time<br \/> from surgery burdens (D. Lee et al., 2004; Mitchell, 2003; Poleshuck et al.,<br \/> 2006; Shelby et al., 2002). It usually appears during the planning phase<br \/> including scheduling of the surgical procedure and peaks during the day of<br \/> admission. (Carr, Brockbank, Allen, &amp; Strike, 2006; Pritchard, 2009).<br \/> Women, in particular, experience high levels of anxiety during surgery when<br \/> Labrague and McEnroe-Petitte 159<br \/> compared with men (Caumo et al., 2001; Mitchell, 2003). Although studies<br \/> on prevalence of anxiety in women undergoing gynecologic surgery are<br \/> scarce, Carr et al. (2006) found that rates reach 67%; 45% during the night<br \/> before surgery, 53% in the morning of surgery, and 67% just prior to administration<br \/> of anesthetic agents.<br \/> Although considered a normal phenomenon and highly anticipated during<br \/> the preoperative period, anxiety that exceeds an individual\u2019s tolerance may<br \/> have harmful physiological and psychological effects to the human body.<br \/> During the preoperative period, surgery-related anxiety affects the functioning<br \/> of the sympathetic nervous system and hypothalamic\u2013pituitary\u2013adrenal<br \/> axis. This in turn triggers the release of biological substances that cause physiological<br \/> and psychological manifestations of anxiety (McCance &amp; Huether,<br \/> 2006; Pritchard, 2009), which can affect surgical outcomes. High levels of<br \/> anxiety are attributed to poor surgical outcomes. This will additionally affect<br \/> the immune system by significantly decreasing cellular immunity, which can<br \/> subsequently prolong the time for healing (McCance &amp; Huether, 2006;<br \/> Starkweather et al., 2006). It will alter the individual\u2019s postoperative pain<br \/> response by decreasing pain tolerance and threshold, which will lead to prolonged<br \/> recovery time and hospital discharge (Hook et al., 2008). In response<br \/> to the various adverse effects of anxiety, it is imperative that interventions for<br \/> managing anxiety be explored to reduce postoperative complications.<br \/> Substantial research had been undertaken to identify anxiety-reduction interventions<br \/> and strategies such as therapeutic relationships and providing surgicalspecific<br \/> preoperative information and education (Erci, Sezgin, &amp; Kacmaz, 2008;<br \/> Kain et al., 2007; Ng, Chau, &amp; Leung, 2004; Spaulding, 2003; Stirling, 2006).<br \/> Other interventions such as application of essential oils, relaxation techniques,<br \/> and parental presence were also found to be effective in reducing anxiety (Kain<br \/> et al., 2007; Stirling, 2006). However, it can be noted that most of the strategies<br \/> and interventions available provide limited evidence for managing preoperative<br \/> anxiety and stabilizing vital signs among preoperative patients. Given this constraint,<br \/> evidence-based, nonpharmacological approaches in managing preoperative<br \/> anxiety during the immediate preoperative period is essential. One<br \/> innovative approach is the use of music intervention.<br \/> Music intervention, which is defined as utilization of music for restoration,<br \/> maintenance, and improvement of diseases and defects (Kemper &amp; Danhauer,<br \/> 2005) has been studied and used in a variety of populations and settings primarily<br \/> to reduce pain and anxiety and induce relaxation (Bringman, Giesecke,<br \/> Th\u00f6rne, &amp; Bringman, 2009; Cooke, Chaboyer, Schluter, &amp; Hiratos, 2005;<br \/> Kemper &amp; Danhauer, 2005; Labrague, Rosales, Rosales, &amp; Fiel, 2013; D. Lee<br \/> et al., 2004; K. C. Lee, Chao, Yiin, Chiang, &amp; Chao, 2011; K. C. Lee et al.,<br \/> 2012; Ni, Tsai, Lee, Kao, &amp; Chen, 2012; Sendelbach, Halm, Doran, Miller, &amp;<br \/> 160 Clinical Nursing Research 25(2)<br \/> Gaillard, 2006; Twiss, Seaver, &amp; McCaffrey, 2006). The act of listening to<br \/> music has been proven to be effective in reducing anxiety and pain. Music<br \/> additionally induces relaxation and plays an important role in the provision of<br \/> comfort for patients by decreasing activity in the sympathetic nervous system<br \/> (Arslan et al., 2008; Boso, Politi, Barale, &amp; Emanuele, 2006; Cooke et al.,<br \/> 2005; Gillen, Biley, &amp; Allen, 2008). In a randomized controlled study conducted<br \/> by Ni et al. (2012) in a group of patients undergoing minor surgery,<br \/> those patients who were provided with musical interventions reported a significantly<br \/> lower level of anxiety on the State Trait Anxiety Inventory (STAI) compared<br \/> with the nonmusical group. Cooke et al. (2005) introduced music into a<br \/> group of adult surgery patients in Australia. The study\u2019s findings supported the<br \/> hypothesis that listening to music prior to surgery is associated with a decrease<br \/> in preoperative anxiety. Music also showed a significant reduction in anxiety in<br \/> the immediate preoperative period when having procedures performed in the<br \/> daytime hours (D. Lee et al., 2004). Music listening also decreases preoperative<br \/> anxiety in a preoperative setting to a greater extent when compared with the use<br \/> of preoperative midazolam (Bringman et al., 2009).<br \/> Music can also have positive effects on vital signs of preoperative patients<br \/> (Buffum et al., 2006; Hamel, 2001; D. Lee et al., 2004; Wang, Kulkarni,<br \/> Dolev, &amp; Kain, 2002; Wong, Lopez-Nahas, &amp; Molassiotis, 2001; Yung, ChuiKam,<br \/> French, &amp; Chan, 2002). In a quasi-experimental study conducted by<br \/> Hamel (2001) with 101 subjects prior to cardiac catheterization, music significantly<br \/> reduced physiologic parameters. After listening to music, systolic<br \/> blood pressure (BP) was lower than baseline measurements and the mean<br \/> heart rate decreased after 20 min in the music group. Yung et al. (2002) also<br \/> found significant reduction in systolic and diastolic BP and mean heart rate<br \/> following music interventions. Similarly, a significant reduction in heart rate<br \/> and respiratory rate (RR) was also observed by Wong et al. (2001) in their<br \/> study using crossover repeated measures design with random assignment.<br \/> However, in other studies conducted, music provided no significant changes<br \/> in vital signs (Buffum et al., 2006; D. Lee et al., 2004).<br \/> For centuries, music has been used as a modality in health care and as an<br \/> adjunct in treating varied health problems (Bringman et al., 2009; Buffum et al.,<br \/> 2006; Cooke et al., 2005; Hamel, 2001; Kemper &amp; Danhauer, 2005; Labrague<br \/> et al., 2013; D. Lee et al., 2004; Yung et al., 2002). However, little is known in<br \/> the literature highlighting the use of music in alleviating anxiety among women<br \/> who are known to experience high levels of anxiety prior to a surgical procedure.<br \/> Furthermore, a thorough review of the literature identified that this topic<br \/> has never been previously researched in the Philippines. For this current study,<br \/> the researchers are interested in identifying influence of music on the anxiety<br \/> level and vital signs among women undergoing gynecologic surgery.<br \/> Labrague and McEnroe-Petitte 161<br \/> Aim of the Study<br \/> The aim of this study was to determine the influence of music on anxiety<br \/> levels and vital signs of women undergoing gynecologic surgery. More specifically,<br \/> this study aimed<br \/> 1. to compare the anxiety levels of the control and experimental group<br \/> after exposure to music and<br \/> 2. to compare the physiologic parameters (RR, BP, pulse rate [PR]) of<br \/> the control and experimental group after exposure to music.<br \/> Method<br \/> Research Design<br \/> This study utilized a pre- and posttest experimental design with nonrandom<br \/> assignment to determine whether music decreases anxiety levels in women<br \/> undergoing gynecologic surgery and to examine whether it has effects on<br \/> their physiologic parameters.<br \/> Study Subjects<br \/> Subjects in this study were recruited from a 150-bed capacity government<br \/> hospital in Samar Province, Philippines during the months of September to<br \/> November 2013. This study used a purposive sampling of women who were<br \/> undergoing gynecologic procedures. To be eligible to participate in the study,<br \/> subjects were required to (a) have no hearing difficulties, (b) be at least 18<br \/> years old, (c) have no presurgical morbidities, (d) be informed and have<br \/> signed consent form, and (e) be undergoing gynecologic surgery.<br \/> In this study, gynecologic surgery refers to surgery that involves the<br \/> female reproductive system to include minor and major operative procedures.<br \/> One hundred five subjects were originally recruited to participate in<br \/> the study. However, eight women withdrew for the following reasons: Four<br \/> were referred to highly specialized facility, three revealed having hearing<br \/> difficulties, and one refused to wear the required headset. Finally, 97 women<br \/> were included in the study. Forty-nine women were allocated to the control<br \/> group (nonmusic group) and 48 women were assigned in the experimental<br \/> group (music group). The number of subjects both in the control and experimental<br \/> group were equivalent to the number of subjects in previous studies<br \/> conducted (Arslan et al., 2008; Hamel, 2001; D. Lee et al., 2004; K. C. Lee<br \/> et al., 2012).<br \/> 162 Clinical Nursing Research 25(2)<br \/> Music<br \/> Three types of prerecorded music were used in this study consisting of classical,<br \/> country, and nature sounds with slow and flowing tempos. The music<br \/> tempo was primarily chosen (with the help of a music expert) to mimic the<br \/> human heart beat. This would be considered appropriate in reducing anxiety<br \/> as it has a slow tempo, a middle low pitch, low volume, and has a simple and<br \/> steady melody. In a systematic review of recent studies describing the clinical<br \/> effects of music intervention preoperatively, it has been suggested that music<br \/> used therapeutically should have the following characteristics: (a) slow and<br \/> flowing music, (b) approximately 60 to 80 beats per minute, (c) is nonlyrical,<br \/> (d) consists predominantly of low notes, (e) is comprised mostly of strings<br \/> with minimal brass or percussion, and (f) has a maximum volume level at 60<br \/> decibels (dB; Cepeda, Carr, Lau, &amp; Alvarez, 2006; Nilsson, 2008). Preselected<br \/> music was recorded in four multimedia players (MP3s) with the utilization of<br \/> accompanying headphones.<br \/> Measurement<br \/> Anxiety<br \/> Preoperative anxiety was measured using the STAI. It is a 20-item report<br \/> instrument developed by Spielberger (2010) and was designed to evaluate<br \/> patients\u2019 feeling of apprehension, tension, nervousness, and worry. Patients<br \/> rated their responses on the scale of 1 (not at all) to 4 (very much so), the<br \/> intensity of the feelings being asked about. The instrument has been extensively<br \/> utilized with a high level of reliability and validity. The state anxiety<br \/> score can range from 20 to 80 with higher scores indicating higher levels of<br \/> anxiety. The STAI was translated into the individual country\u2019s language using<br \/> the American English version, using a forward and back translation process.<br \/> The translated version was discussed with a group of experts to determine<br \/> content validity.<br \/> The Cronbach\u2019s alpha of the STAI was calculated. The 20-item inventory<br \/> scale yielded a Cronbach\u2019s alpha of .92, which is comparable with previous<br \/> studies (Arslan et al., 2008; Buffum et al., 2006; Spielberger, 2010).<br \/> Physiologic Parameters<br \/> Noninvasive instruments were used in measuring patients\u2019 vital signs. BP and<br \/> heart rate were measured with an automatic BP monitor (Japan, OMRON<br \/> HEM 7111). The RR was obtained by the researchers counting one full<br \/> Labrague and McEnroe-Petitte 163<br \/> minute the number of times the chest rose and fell. To ensure an accurate<br \/> measurement of physiologic measures, the researcher underwent intensive<br \/> training in vital signs monitoring.<br \/> Music Intervention Protocol<br \/> After seeking an informed, signed consent from the participants, eligible<br \/> women who agreed to participate were assigned to the control and experimental<br \/> group. The music intervention took place in the preoperative waiting<br \/> room. Both groups did not receive anxiety medications during the course of<br \/> the study. The experimental group received and was exposed to music intervention<br \/> for 20 min prior to admission to the operating room, whereas the<br \/> control group only received standard nursing care. In most studies conducted,<br \/> listening durations ranged from 15 min to 40 min, however, a minimum of 15<br \/> to 20 min of listening to music was shown to be effective in minimizing preoperative<br \/> anxiety (Pittman &amp; Kridli, 2011). Measures of anxiety with the use<br \/> of the STAI and physiologic parameters (RR, BP, PR) were obtained before<br \/> and after 20 min of exposure to music in the experimental group and 20 min<br \/> after taking physiologic parameters (RR, BP, PR) in the control group. To<br \/> block environmental noise that may heighten anxiety or may distract participants,<br \/> headphones were used to deliver the music. In most studies conducted,<br \/> headphones were used to provide music to the subjects (Arslan et al., 2008;<br \/> Cooke et al., 2005; D. Lee et al., 2004; Nilsson, 2008). Subjects were also<br \/> given the freedom to adjust and readjust the volume of music during the<br \/> entire listening experience. In addition, to avoid unnecessary disturbances in<br \/> the preoperative waiting rooms, subjects were assigned by group either into<br \/> the control group or experimental group on a weekly basis. For instance,<br \/> patients who were scheduled for surgery on the first week were assigned in<br \/> the control group and those who were assigned in the following week were<br \/> assigned in the experimental group. See Figure 1 for the flow diagram through<br \/> the phases of the trial.<br \/> Statistical Analysis<br \/> The data were coded and entered into a computerized database and analyzed<br \/> using the SPSS (version 19). Descriptive statistics such as the mean, frequency,<br \/> and standard deviation were used to quantify the participants\u2019 demographic<br \/> profile. To test for the homogeneity and normality of the two groups,<br \/> chi-square and Fisher\u2019s exact test were used. Paired t tests were utilized to<br \/> examine any significant difference between the pre- and posttest STAI, and<br \/> physiologic parameters for each group. To compare the control and<br \/> 164 Clinical Nursing Research 25(2)<br \/> experimental group, the unpaired t test was used. The level of significance<br \/> was set at p &lt; .05.<br \/> Ethical Considerations<br \/> Approval for the study was granted by the Ethical Committee of Samar State<br \/> University prior to the actual study. The principal researcher sought the permission<br \/> of the hospital director and chief nurse of the hospital prior to conduction<br \/> of the study. Consent forms from the subjects were also secured upon<br \/> approval to participate in the study.<br \/> Results<br \/> Ninety-seven women were recruited in this study. Forty-nine women were<br \/> allocated in the control group, and 48 women were assigned in the music<br \/> group. The mean age was 42.10 years (SD = 5.02) and 42.31 years (SD =<br \/> 4.89) in the control group and experimental group, respectively. When compared,<br \/> no significant differences were identified between the two groups in<br \/> their demographic characteristics such as civil status, education, history of<br \/> previous surgery, and type of surgery. The majority of the subjects chose classical<br \/> music (53.61%, n = 52) whereas the rest chose nature (26.80%, n = 26)<br \/> and country music (19.59%, n = 19; Table 1).<br \/> Baseline scores of the two groups on the STAI and physiologic measures<br \/> were compared using inferential statistics. Results of five independent t tests<br \/> indicate that the two groups were not significantly different on STAI scores<br \/> Women undergoing<br \/> gynecologic procedures<br \/> (105)<br \/> 4 were referred to highly specialized;<br \/> 3 revealed having hearing difficulties;<br \/> 1 refused to wear the required<br \/> headset<br \/> Allocated to<br \/> experimental Group<br \/> (n = 48)<br \/> Allocated to control<br \/> Group<br \/> (n = 49)<br \/> Analyzed (n = 49) Analyzed (n = 48)<br \/> Figure 1. Flow diagram of the trial.<br \/> Labrague and McEnroe-Petitte 165<br \/> (t = 1.02, p = .3085), systolic BP (t = 1.48, p = .1407), diastolic BP (t =<br \/> 0.99, p = .3202), PR (t = 0.61, p = .5445), and RR (t = 1.33, p = .1877). The<br \/> result showed that there is normality and homogeneity of samples on both<br \/> groups.<br \/> With the use of the dependent t test (one-tailed test), STAI scores and<br \/> physiologic measures of both groups were examined separately for any<br \/> changes at Period 1 and Period 2 (Table 2). Statistically significant decreases<br \/> in the STAI scores (t = 11.89, p &lt; .05), systolic BP (t = 7.99, p = &lt; .05), diastolic<br \/> BP (t = 4.16, p = &lt; .05), and PR (t = 5.33, p &lt; .05) were observed except<br \/> for the RR (t = 0.17, p = .8579) in the experimental group. For the control<br \/> group, there were no significant changes noted on the systolic BP (t = \u20130.37,<br \/> p = .7130), diastolic BP (t = 1.28, p = .2041), and RR (t = 0.25, p = .7991).<br \/> However, significant increases in the STAI scores (t = \u20138.78, p &lt; .05) and PR<br \/> (t = \u20136.01, p &lt; .05) were noted.<br \/> Table 1. Characteristics of the Subjects in Two Groups.<br \/> Variable<br \/> Control group<br \/> (n = 49)<br \/> M (SD)\/n (%)<br \/> Experimental<br \/> group (n = 48)<br \/> M (SD)\/n (%) t\/?2 p<br \/> Age<br \/> Mean age (year) 42.10 (5.02) 42.31 (4.89) 0.208 .835<br \/> Civil status<br \/> Single 8 (16.32) 5 (10.42) 3.078 .214<br \/> Married 38 (77.55) 35 (72.92)<br \/> Separated 3 (6.12) 8 (16.67)<br \/> Education<br \/> Primary 10 (20.41) 8 (16.67) 0.560 .755<br \/> Secondary 16 (32.65) 19 (39.58)<br \/> Tertiary 23 (46.94) 21 (43.75)<br \/> History of previous surgery<br \/> No 42 (85.71) 40 (83.33) 0.105 .745<br \/> Yes 7 (12.28) 8 (16.67)<br \/> Types of surgery<br \/> Partial Hysterectomy 3 (6.12) 2(4.17) 1.333 .987<br \/> Dilatation and curettage 5 (10.20) 4 (8.33)<br \/> Completion curettage 9 (18.37) 12 (25)<br \/> Tubal ligation 12 (24.49) 10 (20.83)<br \/> Total Hysterectomy 4 (8.16) 3 (6.25)<br \/> Breast mastectomy 5 (10.20) 6 (12.5)<br \/> Breast lumpectomy 6 (12.24) 7 (14.83)<br \/> 166<br \/> Table 2. Means, Standard Deviations, t Values, and p Values After Music Intervention.<br \/> Experimental group (n = 48) Control group (n = 49)<br \/> Scale\/parameter Before M\/SD After M\/SD t value p value Before M\/SD After M\/SD t value p value<br \/> STAI 40.75 \u00b1 1.97 36.43 \u00b1 1.86 11.89 &lt;.05* 41.18 \u00b1 2.16 43.30 \u00b1 2.02 -8.78 &lt;.05*<br \/> Systolic BP 127.60 \u00b1 5.20 123.04 \u00b1 4.25 7.99 &lt;.05* 129.30 \u00b1 6.03 129.48 \u00b1 5.49 -0.37 .7130<br \/> Diastolic BP 75.93 \u00b1 5.15 73.81 \u00b1 4.91 4.16 &lt;.05* 77.08 \u00b1 6.13 76.67 \u00b1 5.11 1.28 .2041<br \/> Pulse rate 75.39 \u00b1 4.87 71.39 \u00b1 4.28 5.33 &lt;.05* 74.82 \u00b1 4.35 77.51 \u00b1 3.95 -6.01 &lt;.05*<br \/> Respiratory rate 18.39 \u00b1 1.51 18.35 \u00b1 1.56 0.17 .8579 18.75 \u00b1 1.14 18.73 \u00b1 1.15 0.25 .7991<br \/> Note. STAI = State Trait Anxiety Inventory; BP = blood pressure.<br \/> *p &lt; .05.<br \/> Labrague and McEnroe-Petitte 167<br \/> An important finding focused on whether the experimental group had significantly<br \/> lower STAI scores and physiologic parameters (Table 3). Five<br \/> independent t test analyses were conducted to compare the two groups after<br \/> ensuring homogeneity of the samples used. Women in the experimental group<br \/> had lower STAI scores (t = 17.41, p &lt; .05) than the control group. No significant<br \/> difference in the RR (t = 1.36, p = .17) was noted in both groups.<br \/> Discussion<br \/> Patients during the preoperative period may have stress and anxiety heightened<br \/> due to the unknown environment and unfamiliar staff. During this<br \/> period, the sympathetic nervous system is aroused resulting in increased<br \/> body processes leading to undesirable surgical outcomes (Hook et al., 2008;<br \/> McCance &amp; Huether, 2006; Pritchard, 2009; Starkweather et al., 2006).<br \/> Developing effective anxiety-reduction interventions based on empirical evidence<br \/> is essential to optimize nursing care. Music intervention may be particularly<br \/> effective for patients experiencing physical and psychological<br \/> distress. With that, this study determined the influence of music on the anxiety<br \/> level and physiologic parameters in women who will undergo gynecologic<br \/> surgery.<br \/> Key finding of this study indicated that exposure to music intervention<br \/> during the immediate preoperative period was effective in reducing anxiety<br \/> levels in women undergoing gynecological surgery. Subjects in the experimental<br \/> group (allocated to music group), after listening to music, reported<br \/> significant reduction in their anxiety level compared with those women allocated<br \/> in the control group. This result further supports previous findings of<br \/> Table 3. Difference on the Posttest Scores of the Control and Experimental<br \/> Group After Music Intervention.<br \/> Scale\/parameter<br \/> Experimental<br \/> (n = 48)<br \/> M\/SD<br \/> Control<br \/> (n = 49)<br \/> M\/SD 95% CI t value p value<br \/> STAI 36.43 \u00b1 1.86 43.30 \u00b1 2.02 [-7.65, -6.08] 17.41 &lt;.05*<br \/> Systolic BP 123.04 \u00b1 4.25 129.48 \u00b1 5.49 [-8.42, -0.83] 6.45 &lt;.05*<br \/> Diastolic BP 73.81 \u00b1 4.91 76.67 \u00b1 5.11 [-4. 88, -0.83] 2.80 .0060*<br \/> Pulse rate 71.39 \u00b1 4.28 77.51 \u00b1 3.95 [-7.78, -4.46] 7.32 &lt;.05*<br \/> Respiratory rate 18.35 \u00b1 1.56 18.73 \u00b1 1.15 [-0.93, 0.17] 1.36 .1747<br \/> Note. CI = confidence interval; STAI = State Trait Anxiety Inventory; BP = blood pressure.<br \/> *p &lt; .05.<br \/> 168 Clinical Nursing Research 25(2)<br \/> the use of music in the reduction of anxiety during the immediate preoperative<br \/> period. For instance, in a recent systematic review conducted by Bradt,<br \/> Dileo, and Shim (2013), results indicated that listening to music may help<br \/> reduce anxiety in patients awaiting surgery. Similarly, Hamel (2001) and<br \/> El-Hassan, McKeown, and Muller (2009) also concluded that listening to<br \/> music, regardless of age and type of procedures, may be an effective intervention<br \/> for decreasing preoperative anxiety. The same result was obtained in<br \/> randomized controlled studies of previous authors (Arslan et al., 2008;<br \/> Bringman et al., 2009; Cooke et al., 2005; D. Lee et al., 2004; K. C. Lee et al.,<br \/> 2012; Wang et al., 2002). Preoperative STAI scores in patients undergoing<br \/> day surgery such as orthopedic, cystoscopy, biopsy, urology, and endoscopy<br \/> had significantly lower scores with posttest than in the control group.<br \/> Significant reductions in the anxiety levels were also obtained in the experimental<br \/> studies conducted by Twiss et al. (2006) and Sendelbach et al. (2006)<br \/> among a wide range of surgical patients. Interestingly, subjects in the control<br \/> group reported increased STAI scores and PRs during the posttest. This suggests<br \/> that as the surgical schedule time approaches, preoperative anxiety<br \/> increases. With the proven anxiety-reducing effects of music, perioperative<br \/> nurses may consider this intervention as part of their routine nursing care for<br \/> surgical patients during the immediate preoperative period as anxiety and<br \/> stress is heightened in this period (Hamel, 2001).<br \/> Findings also revealed significant changes in the physiologic parameters.<br \/> Women in the experimental group demonstrated a significant reduction in<br \/> their BPs (systolic and diastolic BPs) and heart rates but not the RR. This is<br \/> in keeping with the previous studies conducted in a variety of populations<br \/> and settings. For instance, Hamel (2001) provided music intervention to cardiac<br \/> patients prior to surgery. After exposure to music, systolic BP and heart<br \/> rate lowered significantly in the music group. Similarly, Yung et al. (2002)<br \/> proved that music notably reduced BP and heart rate in patients undergoing<br \/> transurethral resection of the prostate. In a systematic review conducted by<br \/> Nilsson (2008) concerning the effects of music intervention on anxiety and<br \/> pain reduction, it was indicated that music has both physiological (changes in<br \/> heart rate, BP, and RR) and psychological (reduction in anxiety and pain)<br \/> benefits. However, Wang et al. (2002) and Buffum et al. (2006) observed no<br \/> significant changes in the heart rate and respiratory pattern in the music group<br \/> when compared with nonmusic group.<br \/> The majority of the studies conducted utilizing music as<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8216; &#8216; 0 0 Services validity of research methodology validity of research methodology Selection of the appropriate sample is critical to the reliability and validity of research methodology. 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