Abstract
Introduction: Urolithiasis is one of the most common urinary tract disorders with high prevalence in developing countries, including Iran. Extracorporeal shock wave lithotripsy (ESWL) is a standard non-invasive treatment, but it often causes moderate to severe pain and anxiety. Non-pharmacological interventions, such as music therapy, have gained attention as safe and low-cost alternatives. This study aimed to evaluate the effect of preferred permissible music on pain and anxiety in patients undergoing ESWL.
Methods: This randomized controlled trial involved 80 adult patients undergoing ESWL at Alborz Hospital in Karaj from September to October 2025. Participants were selected consecutively and randomly assigned to intervention or control groups. The intervention group received preferred permissible music via noise-cancelling headphones during ESWL, while the control group received routine care. Pain was measured using the Visual Analog Scale (VAS), and anxiety was examined using the State-Trait Anxiety Inventory (STAI-State). Data were analyzed using SPSS version 26 with repeated measures ANOVA, ANCOVA, and Chi-square tests (P<0.05).
Results: No significant differences were found in baseline demographic and clinical characteristics between groups (P>0.05). Mean pain scores during ESWL were significantly lower in the intervention group (4.38±1.98) compared to controls (5.62±1.82; P=0.003; Cohen’s d=-0.55). Similarly, anxiety scores during ESWL were lower in the intervention group (37.15±15.78) than in controls (44.92±15.65; P=0.021; Cohen’s d=-0.52). No significant differences were observed between the groups pre- or post-procedure.
Conclusion: Preferred permissible music during ESWL effectively reduces pain and anxiety during the procedure. As a non-invasive cost-effective intervention, it can be integrated into nursing care protocols in Iranian ESWL centers to enhance patient experience.