Patients' Perceptions of Virtual Live Music in the Intensive Care Unit.

BACKGROUND: Implementing music in the intensive care unit has increased in popularity because the environment can be stressful and anxiety inducing for many patients. In hospital settings, therapeutic music can be beneficial for patients' well-being and recovery. Although live music typically involves a face-to-face encounter between the musician and patient, the COVID-19 pandemic has prompted a change to virtual live therapeutic music, using technology to present music in real time (eg, with a tablet computer). OBJECTIVE: To generate novel findings regarding patients' perceptions of virtual live therapeutic music, which has been little studied compared with live or recorded music.. METHODS: Fifty patients in Vanderbilt University Medical Center intensive care units listened to virtual live music played by a volunteer musician via an online video communication platform. Patients' responses to 5 survey questions were transcribed and analyzed qualitatively and quantitatively using data analysis software. RESULTS: Seven major themes describing the familiarity and significance of music for patients were identified. Forty-seven patients (94%) experienced positive emotions from the music, 46 (92%) indicated that music was a significant part of their lives, 28 (56%) accessed a cherished memory, and 45 (90%) indicated that they would not change anything. CONCLUSIONS: Therapeutic virtual music was well received and provided tangible benefits to patients. Additional research would provide information on patients' outcomes and differences between live and virtual live music.

The Influence of Audible Alarm Loudness and Type on Clinical Multitasking.

In high-consequence industries such as health care, auditory alarms are an important aspect of an informatics system that monitors patients and alerts providers attending to multiple concurrent tasks. Alarms levels are unnecessarily high and alarm signals are uninformative. In a laboratory-based task setting, we studied 25 anesthesiology residents' responses to auditory alarms in a multitasking paradigm comprised of three tasks: patient monitoring, speech perception/intelligibility, and visual vigilance. These tasks were in the presence of background noise plus/minus music, which served as an attention-diverting stimulus. Alarms signified clinical decompensation and were either conventional alarms or a novel informative auditory icon alarm. Both alarms were presented at four different levels. Task performance (accuracy and response times) were analyzed using logistic and linear mixed-effects regression. Salient findings were 1), the icon alarm had similar performance to the conventional alarm at a +2 dB signal-to-noise-ratio (SNR) (accuracy: OR 1.21 (95% CI 0.88, 1.67), response time: 0.04 s at 2 dB (95% CI: -0.16, 0.24), which is a much lower level than current clinical environments; 2) the icon alarm was associated with 27% greater odds (95% CI: 18%, 37%) of correctly addressing the vigilance task, regardless of alarm SNR, suggesting crossmodal/multisensory multitasking benefits; and 3) compared to the conventional alarm, the icon alarm was associated with an absolute improvement in speech perception of 4% in the presence of an attention-diverting auditory stimulus (p = 0.031). These findings suggest that auditory icons can provide multitasking benefits in cognitively demanding clinical environments.