The Effect of Music Therapy on Anxiety and Physiological Indicators in Patients Undergoing Colonoscopy: A Meta-analysis
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Keywords

Music therapy
Colonoscopy
Randomized controlled trial
Meta-analysis
Anxiety

DOI

10.26689/jcnr.v10i5.14767

Submitted : 2026-05-31
Accepted : 2026-06-15
Published : 2026-06-30

Abstract

Purpose: To evaluate the effect of music therapy on anxiety, physiological indicators and successful colon intubation rate in patients undergoing colonoscopy. Methods: Randomized controlled trials (RCTs) on music therapy during colonoscopy published up to December 2025 were retrieved from 8 databases. Study quality was assessed using the Cochrane risk-of-bias tool (ROB 2.0), and meta-analysis was performed with R software. Results: 25 RCTs involving 4,525 patients were included. Music therapy significantly reduced anxiety (SMD = -0.61; 95% CI [-0.84, -0.38]; p < 0.0001), systolic blood pressure (MD = -8.63; p = 0.015), diastolic blood pressure (MD = -0.92; p = 0.034), mean arterial pressure (MD = -7.77; p = 0.005) and heart rate (MD = -11.65; p < 0.0001), and improved intubation success rate (RR = 1.04; p = 0.002). No significant effect on respiratory rate was observed. Results were robust, but study quality was generally low. Conclusions: Music therapy is safe and effective for alleviating anxiety and improving physiological indicators in colonoscopy patients, warranting clinical promotion. More high-quality RCTs are needed.

References

Al-Shamali M, Kalaoui M, Hasan F, et al., 2001, Colonoscopy: Evaluating Indications and Diagnostic Yield. Ann Saudi Med, 21(5–6): 304–307.

Hoffman A, Teubner D, Kiesslich R, 2014, Competition in Colon Cancer Screening? What Is the Role of Colonoscopy? Visceral Medicine, 30(1): 18–25.

Deng Y, Chen X, Li X, et al., 2007, Study on Individualised Music Intervention to Relieve Pain in Patients Undergoing Colonoscopy. Nursing Practice and Research, 4(13): 3–6.

Demirci S, Sezer S, Pirincci S, 2025, Effect of Binaural Beats on Pain, Anxiety, and Procedure Tolerance in Patients Undergoing Colonoscopy Without Sedation: A Randomised Controlled Trial. European Research Journal, 11(2): 270–278.

Sun D, You Y, He X, et al., 2022, Effects of Light Music Played by Piano Intervention on Satisfaction, Anxiety, and Pain in Patients Undergoing Colonoscopy: A Randomised Controlled Trial. Medicine, 101(52): e32339.

Martindale F, Mikocka-Walus A, Walus B, et al., 2014, The Effects of a Designer Music Intervention on Patients’ Anxiety, Pain, and Experience of Colonoscopy: A Short Report on a Pilot Study. Gastroenterology Nursing, 37(5): 338–342.

Nagata K, Iida N, Kanazawa H, et al., 2014, Effect of Listening to Music and Essential Oil Inhalation on Patients Undergoing Screening CT Colonography: A Randomised Controlled Trial. European Journal of Radiology, 83(12): 2172–2176.

Ko S, Leung D, Wong E, 2019, Effects of Easy Listening Music Intervention on Satisfaction, Anxiety, and Pain in Patients Undergoing Colonoscopy: A Pilot Randomised Controlled Trial. Clinical Interventions in Aging, 14: 977–986.

Hirani A, Ismail F, Abdulaziz F, et al., 2024, The Effects of Music Therapy on Patients Undergoing Colonoscopy in a Tertiary Care Hospital at Karachi, Pakistan: A Comparative Study. Journal of Pain & Palliative Care Pharmacotherapy, 38(3): 233–243.

Costa A, Montalbano L, Orlando A, et al., 2010, Music for Colonoscopy: A Single-Blind Randomised Controlled Trial. Digestive and Liver Disease, 42(12): 871–876.

Bashiri M, Akçali D, Coşkun D, et al., 2018, Evaluation of Pain and Patient Satisfaction by Music Therapy in Patients with Endoscopy/Colonoscopy. Turkish Journal of Gastroenterology, 29(5): 574–579.

Cakir S, Evirgen S, 2023, Three Distraction Methods for Pain Reduction During Colonoscopy: A Randomised Controlled Trial Evaluating the Effects on Pain and Anxiety. Journal of Perianesthesia Nursing, 38(5): e1–e7.

Li L, Shu W, Li Z, et al., 2019, Using Yoga Nidra Recordings for Pain Management in Patients Undergoing Colonoscopy. Pain Management Nursing, 20(1): 39–46.

Çelebi D, Yılmaz E, Şahin S, et al., 2020, The Effect of Music Therapy During Colonoscopy on Pain, Anxiety and Patient Comfort: A Randomised Controlled Trial. Complementary Therapies in Clinical Practice, 38: 101084.

Brix L, Pedersen A, 2022, Effect of Music Intervention in Colonoscopy-Naïve Adults: A Randomised Controlled Trial. British Journal of Nursing, 31(10): 526–532.

López-Cepero Andrada J, Amaya Vidal A, Castro Aguilar-Tablada T, et al., 2004, Anxiety During the Performance of Colonoscopies: Modification Using Music Therapy. European Journal of Gastroenterology & Hepatology, 16(12): 1381–1386.

Hayes A, Buffum M, Lanier E, et al., 2003, A Music Intervention to Reduce Anxiety Prior to Gastrointestinal Procedures. Gastroenterology Nursing, 26(4): 145–149.

De Silva A, Niriella M, Nandamuni Y, et al., 2016, Effect of Audio and Visual Distraction on Patients Undergoing Colonoscopy: A Randomised Controlled Study. Endoscopy International Open, 4(11): E1211–E1214.

Zhou G, Luo Y, 2014, Application of Background Music in Electronic Colonoscopy in Primary Hospitals. Guide of China Medicine, 12(29): 176–177.

Wang J, Yue Q, Yuan J, et al., 2010, The Role of Background Music in Colonoscopy. Journal of Hunan University of Chinese Medicine, 30(2): 30–31 + 36.

Zhang Y, Yang F, Zhao J, et al., 2022, Effects of Attention Distraction Methods on Pain and Anxiety in Patients Undergoing Colonoscopy. Jilin Medical Journal, 43(8): 2065–2070.

Wang H, 2010, Effect of Music Therapy on Preoperative Anxiety and Vital Signs in Patients Undergoing Colonoscopy. Modern Medicine & Health, 26(1): 68–69.

Luo Y, 2016, Effect of Background Music Intervention on Patients Undergoing Colonoscopy. Medical Information, 29(15): 375.

Wang P, Cai X, Xu J, et al., 2009, Application of Background Music in Ordinary Colonoscopy. China Journal of Endoscopy, 15(6): 630–632 + 635.

Luo J, Man L, 2010, Effect of Music Therapy Intervention on Patients Undergoing Colonoscopy. Chinese Journal of Modern Nursing, 16(6): 670–671.

Huang C, Lü L, Tan Y, et al., 2010, Nursing Application of Light Music in Colonoscopy. Medical Innovation of China, 7(33): 92–93.

Li X, Yang L, Yin Y, 2008, Study on the Effect of Relaxing Music on Pain in Patients Undergoing Colonoscopy. Chinese Journal of Practical Nursing, 24(8C): 15–17.

Ko C, Chen Y, Wu K, et al., 2017, Effect of Music on Level of Anxiety in Patients Undergoing Colonoscopy Without Sedation. Journal of the Chinese Medical Association, 80: 154–160.

Smolen D, Topp R, Singer L, 2002, The Effect of Self-Selected Music During Colonoscopy on Anxiety, Heart Rate, and Blood Pressure. Applied Nursing Research, 16(2): 126–136.

Tonnesen H, Puggaard L, Braagaard J, et al., 1999, Stress Response to Endoscopy. Scandinavian Journal of Gastroenterology, 34(6): 629–631.

Zhang Y, Basnet D, Zhao Y, et al., 2025, One-Hour Music Intervention to Improve the Quality of Recovery in Female Patients Undergoing Elective Surgery After General Anaesthesia: A Single-Centre Randomised Clinical Study. Journal of Clinical Anaesthesia, 106: 111955.