Effects of music therapy in patients with diabetic retinopathy undergoing pan‑retinal photocoagulation

Pan-retinal photocoagulation is a common outpatient procedure for diabetic retinopathy that often causes procedural pain and anxiety. Nonpharmacologic interventions such as music therapy may provide relief but are underexplored in this population. This study aimed to evaluate the effectiveness of a three-phase music therapy intervention in reducing pain, anxiety, and physiological responses during pan-retinal photocoagulation, and to explore its potential as a supportive outpatient strategy.

Quasi-experimental study.

Ophthalmology Outpatient Department, The First Affiliated Hospital of Soochow University.

Participants were non-randomly allocated. This experimental study allocated participants to groups based on clinic visiting time. Patients attending on Tuesday and Wednesday mornings were assigned to the intervention group, while those attending on Tuesday afternoons formed the control group receiving usual care. This time-based allocation minimized cross-contamination and facilitated implementation in routine practice. 116 patients with diabetes were assigned to experimental or control groups, out of which 59 patients completed the intervention.

The intervention consisted of listening to pre-recorded three-phase classical music combined with audiovisual education. The control group only received the audiovisual education.

Primary outcome was pain, measured by the Visual Analog Scale, it was taken during treatment and 5 minutes after treatment; secondary outcomes included state anxiety (Spielberger State-Trait Anxiety Inventory), heart rate and blood pressure (Omron electronic sphygmomanometer). Theses measurements were taken 15 minutes before and 5 minutes after treatment. Post-treatment satisfaction was evaluated using a study-specific, self-developed questionnaire comprising six items rated on a 5-point Likert scale.

Pain, anxiety, systolic blood pressure and diastolic blood pressure were lower in the intervention group compared with control group (p < 0.05). No significant differences in heart rate were observed between groups. There were none adverse events occurred during intervention. Satisfaction was high in both groups, the intervention group rated staff education content and service attitude higher (p < 0.05), with no other between-group differences, and music acceptability was favorable.

A three-phase music therapy intervention is a safe and effective approach for reducing procedural pain, anxiety, and blood pressure in patients undergoing PRP. These results support its integration as a nonpharmacologic option in outpatient ophthalmologic care. Trial registration number: ChiCTR2500106330.