1280: SELF-SELECTED RECORDED MUSIC LISTENING FOR COGNITIVE AND PSYCHOLOGICAL HOMEOSTASIS IN CRITICAL CARE

Introduction: Patients experience significant symptom burden during critical care hospitalization and mechanical ventilation. Medications are of limited effectiveness and are associated with increased morbidity such as delirium and long-term cognitive and psychological impairments. Recorded music listening (RML) has been used for pain and anxiety management in critical care but remains understudied in terms of music selection, and range of symptoms. This study aimed to describe the ways in which a diverse sample of adults used self-selected RML in critical care, and their perceptions of the effects of self-selected RML on symptom experience after critical injury. Methods: Semi-structured interviews (N =14) of patients and family members of adults who used self-selected RML in an urban, academic, neurotrauma and surgical intensive care unit (ICU) were collected and analyzed with grounded theory methodology. Open coding of transcripts, field notes and memos was performed using Atlas.ti.9.1. Recruitment and data collection were deemed complete once thematic saturation was achieved. Results: We identified 6 novel uses of self-selected RML in ICU: 1) Restoring consciousness; 2) Maintaining cognition; 3) Humanizing the hospital experience; 4) Providing a source of connection; 5) Improving psychological wellbeing; and 6) Resolving the problems of silence. Few patients described the use of RML for pain or anxiety. Instead, patients used RML to address psychological experiences of loneliness, fear, confusion, threats to identity and loss of control. Self-selected RML helped patients regain their sense of self and start to process their trauma and grief. Additional benefits of RML included experiencing joy, pleasure, hope, resilience, and feelings of normalcy. Patients identified an aversion to being sedated, preferring to be awake and aware; RML facilitated this state. Findings also highlighted the problems patients experienced with silence and lack of meaningful stimulation in critical care. Conclusions: Critically injured adults used self-selected RML to achieve psychological and cognitive homeostasis during ICU hospitalization. These results can inform future studies designed to explore the use of RML to prevent and treat the cognitive and emotional morbidity of ICU hospitalization.