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Music is common in the GPs' waiting room despite conflicting evidence of its effect on patients' anxiety,1,2 and stress.3 In primary care Zalewsky,4 reports that 88% of patients find music improves their mood. Additionally, Kabler reports that in the UK 83% find it relaxing.5 ‘Muzak’, can provoke strong feelings.6 These studies report small numbers and have no comparator, and none of them report views of healthcare staff. We aimed to explore the perceptions held by patients and staff of the effect music has on health and anxiety. A block controlled study was conducted in a London GPs' waiting room (2004) having gained ethics committee approval.
A pre-piloted questionnaire using an ill-health scale,7 and anxiety levels, was administered to:
Participants received an information sheet and questionnaire before their consultation. Children were excluded.
The sample size assumed the absence of music increases anxiety by 0.33 of a standard deviation, requiring 380 patients (90% power, 5% significance).
The response rate was 71% (370/523) participants and 97% (28/29) for staff with no significant differences in responders (% male, age, or response rate between weeks).
Music had no impact on health status (IG 65/100 versus CG 67/100, P = 0.21) or anxiety state (CG 72/100 versus IG 73/100, P = 0.79), where zero indicates very poor health or high levels of anxiety and 100 indicates good health or minimal anxiety. The majority of participants (61%) and half of staff (52%) were in favour of music; more so in the intervention group (IG 76% [116/153] versus CG 48% [92/190] P<0.001). Volume control was important for two-thirds. Four per cent of patients found it more difficult to talk to staff when music was playing compared to 7% (P = 0.44) with no music. Classical music was preferred (56% [110/166] participants, 67% [19/28] staff). Written comments from participants and staff were overwhelmingly negative:
‘Sensory overload. Airport mentality’.
‘I would not want to sit in the waiting room with music playing; I would rather wait in the street.’
There were also concerns for and by hearing impaired patients about hearing aids.
In summary, the playing of music had no significant effect on self-reported anxiety or health status. The majority of patients were, however, in favour of music in the waiting room and preferred classical music. Staff opinions were divided. A significant minority of staff and participants were strongly opposed.