Implementation of music in colorectal perioperative standard care - barriers and facilitators among patients and healthcare professionals

Ellaha Kakar*, Oddeke van Ruler, Bram van Straten, Bas Hoogteijling, Eelco J R de Graaf, Erwin Ista, Johan F Lange, Johannes Jeekel, Markus Klimek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
115 Downloads (Pure)


Aim: Perioperative anxiety and pain are still prevalent among patients undergoing surgery. Inflammatory bowel disease and colorectal cancer patients are known to have higher anxiety rates than the general population. Perioperatively applied music intervention has been proven to be effective in reducing perioperative anxiety and pain, resulting in a decrease of intra-operative sedative use, postoperative opioid requirement and neurohormonal stress response. IMPROVE evaluates the adherence to music intervention in colorectal perioperative standard care during systematic implementation. Method: The Consolidated Framework for Implementation Research (CFIR) was used for implementation in three steps. This study addresses the first step in which barriers and facilitators for implementing perioperative music were identified by surveying patients who underwent colorectal surgery and healthcare professionals involved in perioperative care. Also, perioperative anxiety scores were assessed and data on perioperative pain was collected from the patients’ medical records. Results: Fifty patients and 69 professionals (response rate 68.3%) were surveyed. For patients, all domains of the CFIR were facilitating implementation. The median reported preoperative and postoperative anxiety scores were 4.5 (1.0–7.0) and 3.0 (1.0–5.75) respectively. The median postoperative pain score on the first postoperative day was 2.8 (2.0–3.7). Also, for professionals most domains were facilitating, except for some factors related to work climate and culture among nurses. Conclusions: In this study it was identified that facilitating factors for implementing music in standard perioperative care were more prominent in both patients and healthcare professionals and therefore successful implementation is probable. Also, this study provides a guideline for assessing facilitators and barriers in other settings.

Original languageEnglish
Pages (from-to)868-875
Number of pages8
JournalColorectal Disease
Issue number7
Early online date23 Feb 2022
Publication statusPublished - Jul 2022

Bibliographical note

Funding Information:
This research was funded by the Music as Medicine Foundation, Erasmus MC, Rotterdam, The Netherlands, grant number N/A, and partly by the Van Cappellen Foundation, Rotterdam, The Netherlands, grant number N/A.

Publisher Copyright:
© 2022 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.


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