The healing power of music: a mixed-methods study on stress reduction in paediatric hospitalisation

Abstract

Background and objectives: Hospitalisation is a potentially distressing experience for children and their families, often accompanied by emotional, psychological, and physical discomfort. Humanised care through complementary and integrative health practices (CIHP), such as music-based interventions (MBIs), has demonstrated beneficial effects in specific paediatric populations. However, evidence in general paediatric hospital settings remains limited. This study aimed to assess the impact of an MBI on perceived stress and the subjective experience of hospitalisation among paediatric patients and their caregivers.

Methods: It was a quasi-experimental study, cross-sectional, with a mixed-methods approach, conducted in a paediatric ward of a teaching hospital affiliated with the University of São Paulo. The study carried out in two phases: (I) a quantitative evaluation of perceived stress using a visual analogue scale (VAS) before and after the intervention; and (II) a qualitative analysis of caregivers’ perceptions through semi-structured interviews. The intervention included 20–40 min of live music using string instruments (kantele or lyre), complemented by age-appropriate singing and spoken word. Quantitative data were analysed using the Wilcoxon test; qualitative data underwent content analysis and lexical analysis via IRAMUTEQ software.

Results: A total of 125 children (mean age: 30.6 months) and their caregivers participated in Phase I. On a scale from 0 to 10, the mean stress score decreased by 2.18 points among children/adolescents and by 1.45 points among caregivers, with the reduction being significant for both (p < 0.001), with a large effect size (Cohen’s d = 1.0). All participants approved the intervention, and 74.4% reported behavioural improvements in the children. Phase II included 30 interviews, which revealed overwhelmingly positive perceptions of the intervention. Caregivers described the hospital environment as stressful and isolating but reported that the MBI provided relaxation, comfort, and emotional relief for both children and themselves.

Conclusions: The findings highlight the potential of MBIs as an effective, safe and non-pharmacological strategy to reduce stress and improve emotional well-being for paediatric patients and their families. Incorporating music-based practices into routine paediatric care may foster more welcoming, humanised environments that address the emotional needs of children and caregivers.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12906-025-05098-0.

Keywords: Complementary and integrative health practices; Humanised care; Music-based interventions; Paediatric hospital care.

Fig. 1

Characteristics of study phases

Fig. 2

Variations in stress scores of children/adolescents and caregivers, pre- and post-intervention – phase I (N = 125)

Fig. 3

Categories of descending hierarchical classification – phase II (N = 30) Note: The DHC presents the most frequent words (%) within each of the identified themes, represented by different colours. Words were grouped based on their lexical similarities, reflecting shared meanings in the formulation of the discussed content. Through the chi-square test (χ²), it was possible to identify the terms with the highest frequency and statistical significance (p), contributing to the construction and delimitation of each thematic class

Fig. 4

Similarity tree – Phase II (N = 30) Note: The similitude tree illustrates the words that appeared most frequently in each theme, separated by colours, allowing the identification of their connections within the participants’ narratives. Each line drawn represents the integration and relationship between terms, highlighting how these elements were interconnected in the construction of the discourse