Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


Objective stated as follows: The objective of this selective EBM review is to determine whether or not music therapy decreases anxiety levels in pre-operative cesarean section patients.

Study Design: A systematic review of 3 randomized controlled trials (RCT) published in 2012, 2012, and 2018; all in the English language.

Data sources: All three RCT’s were from peer-reviewed journals, found on the PubMed database. These articles were chosen based on their relevance to the chosen topic and included patient-oriented outcomes.

Outcome(s) Measured: Patient outcomes were measured using a Visual Analog scale (VAS), Mood State Scale, and the Zung Self Rating Anxiety Scale (SAS). All of the aforementioned are patient reported.

Results: All three RCTs showed statistically significant improvement in anxiety levels in the experimental group after interventional music therapy. This was based on the patient reported scales with Kushnir et. Al showing a p-value <0.01, Eren et al. with a p-value of <0.002, and Li et al. with a p-value <0.01 (Birth, vol. 39, no. 2, 2012, pp. 121–127., doi:10.1111/j.1523-536x.2012.00532.x.) (Journal of the College of Physicians and Surgeons Pakistan, vol. 28, no. 3, 2018, pp. 247–249., doi:10.29271/jcpsp.2018.03.247.) ( Obstetric Anesthesia Digest, vol. 33, no. 4, 2013, pp. 221–222. PubMed, doi:10.1097/01.aoa.0000436341.61510.7e.) The control groups in all three trials showed no real change in anxiety levels in the absence of musical intervention.

Conclusions: This systemic review has concluded based on evidence from various studies that music therapy administered to cesarean section patients pre-operatively can effectively reduce anxiety levels. Based on its efficacy and ease of accessibility it should be further studied and considered as an acceptable first line conservative method or adjunct therapy to ease anxiety in these patients.