December 2018

PATIENT STUDY OF MUSIC IN THE OPERATING ROOM

This purpose of this study is to evaluate the perception of patients regarding the influence and effect of
music on patients and operating room staff prior to and during surgical procedures. .

General Questions (please circle all that apply)

Type of surgery performed: ______________________________________________________________________

Type of anesthesia (circle): general (unconscious) or local/conscious sedation (partially/fully awake)

Age: 18-30 31-40 41-50 51-60 61-70 71-80 81-90

Sex: Male Female Gender Neutral

Which, if any, caused you anxiety during your surgical experience: IV insertion local/general anesthesia
being in the operating room surgical staff conversations surgical staff movement surgical equipment sounds

NOT  
Pre-operative Musical Experience (please circle all that apply)
YES   NO     APPLICABLE  
Was music played prior to the administration of anesthesia?            
Was music played through a speaker in the room?            
Were you given headphones to listen to music?            
If you were not given headphones would you have preferred to use them?            
Did you enjoy listening to music?            
Were you given the opportunity to select the music genre played?            
Did you like the music genre that was selected?            
Music helped to relieve any anxiety you may have been experiencing            
Listening to music distracted me from the sounds of the pre-operative
room            

NOT  
Operative Musical Experience (please circle all that apply)
YES   NO     APPLICABLE  
Was music played during surgery?            
Was music played through a speaker in the room?            
Were you given headphones to listen to music?            
If you were not given headphones would you have preferred to use them?            
Did you enjoy listening to music?            
Were you given the opportunity to select the music genre played?            
Did you like the music genre that was selected?            
Music helped to relieve any anxiety you may have been experiencing            
Listening to music distracted me from the sounds of the operating room
           

Music genre was selected by: surgeon anesthesiologist patient group consensus unknown not applicable

Music genre played: (circle all that apply) Broadway Classical Country Instrumental Jazz Metal Pop Rap
Reggae Rhythm & Blues Rock None
Pre-Operative and Operative Music Opinion
Music should be played pre-operatively prior to the administration of anesthesia

Strongly disagree       strongly agree not sure

Music should be played during surgical procedures under general anesthesia (patient unconscious)

Strongly disagree       strongly agree not sure

Music should be played during surgical procedures under local anesthesia (patient awake/partially awake)

Strongly disagree       strongly agree not sure

If music is played, at what level should it be played

very loud       very soft not sure

Music helps relieve patient anxiety prior to being administered anesthesia

strongly disagree strongly agree not sure

Music helps relieve patient anxiety during surgical procedures

strongly disagree strongly agree not sure

Music helps a patient relax during surgical procedures

strongly disagree strongly agree not sure

Patients should select the type of music played

strongly disagree strongly agree not sure

Patients should be offered the opportunity to listen to music through headphones during surgical procedures

strongly disagree strongly agree not sure

Music interferes with communication between operating room personnel

strongly disagree strongly agree not sure

Music interferes with communication between surgical staff and patients during awake procedures

strongly disagree strongly agree not sure

Music is distracting to the surgical staff during surgical procedures

strongly disagree strongly agree not sure

Operating Room Music Genre & Selection

Select your preferred music genre for surgical procedures (up to 3 may be selected)
Broadway Classical Country Instrumental Jazz Metal Pop Rap Reggae Rhythm & Blues Rock None
Music should be selected by: (circle one) surgeon anesthesiologist entire surgical team patient consensus

Thank you for taking the time to complete this survey. All surveys should be returned to

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