Sound Tools May Reduce Anxiety in Gynecologic Oncology Settings

Simple sound machines appear to effectively mitigate anxiety among patients attending outpatient gynecology appointments, according to findings from a study conducted at the University of Arkansas for Medical Sciences (UAMS) presented at the 51st Annual Oncology Nursing Society (ONS) Congress.

The burden of exam room anxiety

Patients with cancer are at a significantly higher risk for anxiety, a condition often triggered or intensified by the clinical setting. While previous evidence has supported the use of sound-based interventions, particularly music therapy, to reduce stress, research into non-musical sound interventions remains sparse.

Led by Desiree Brown, BSN, RN, CRS, and her team at the Winthrop P. Rockefeller Cancer Institute, the study sought to determine if exam room sound machines could serve as a worthwhile and cost-effective tool for reducing the specific anxiety felt while patients wait for their providers.

Study design and intervention

The researchers utilized an auxiliary grant to outfit seven exam rooms in the UAMS Gynecology Oncology clinic with small, user-friendly sound machines. The protocol was designed to be minimally disruptive to the clinical workflow, a critical consideration for busy oncology nursing staff.

New patients arriving for their appointments were invited to participate in a pre-visit survey in the waiting room to rate their current anxiety levels. Once moved to an exam room, nursing or clinical staff turned on the sound machine. Patients were given autonomy over their environment, allowing them to select their preferred non-musical sound, such as white noise or nature sounds, and adjust the volume to their comfort level. Following the consultation, patients completed a five-question post-visit survey to assess the impact of the intervention.

Significant reductions in patient distress

The results of the evaluation were statistically significant. Data was collected from 35 cases where both pre- and post-visit anxiety scores were available. Of those participants, 15 patients reported lower levels of anxiety after being exposed to the sound machines compared to their initial ratings in the waiting room.

The researchers utilized an exact sign test, which revealed a statistically significant reduction in anxiety (z = -2.835, p = 0.005). Furthermore, 61.8% of the surveyed patients explicitly stated that they found the sound machine beneficial to their experience.

Nursing implications and implementation

For oncology nurses, the study’s discussion points are particularly relevant. The UAMS team highlighted that the integration of sound machines is a high-yield, low-effort intervention. The machines are inexpensive and require minimal training for staff, making them a viable option for healthcare facilities facing budget constraints or staffing shortages.

However, the study also noted that the intervention is not a universal solution. Five participants chose to turn the machines off, and feedback from others suggested areas for improvement. One patient proposed that sounds should emanate from ceiling speakers rather than a standalone device; however, the researchers noted that such an implementation would be "financially prohibitive for many institutions." Additionally, while the study focused on non-musical sounds to maintain consistency across a diverse patient population, one participant expressed a preference for musical options.

The UAMS study suggests that the simple addition of ambient, non-musical sound can significantly improve the patient experience in the gynecology oncology setting. By providing a low-cost, user-friendly method to reduce distress, oncology clinics can foster a more positive environment, potentially leading to higher patient satisfaction and better emotional outcomes during a difficult point in the continuum of care.

Reference

Brown D, Dooley R, Williams HR, Faulkner JL, Johnson D. Evaluating the use of sound machines as an anxiety reduction tool during gynecology oncology appointments. Presented at the 51st Annual Oncology Nursing Society (ONS) Congress; May 13-17, 2026; San Antonio, TX.