The effects of five-element music therapy on alleviating negative emotions in clinical nurses: A randomized controlled pilot trial

Objective: This study aimed to compare the efficacy of Traditional Chinese Medicine (TCM) Five-Element Music Therapy (FEMT) versus Western Art Music Therapy (WAMT) in reducing negative emotions and improving sleep quality among clinical nurses and to inform future psychological support strategies. Methods: This randomized controlled trial was conducted at the Department of Nursing, Xiyuan Hospital Jining Branch. Sixty nurses were randomized to receive either personalized FEMT based on TCM pattern differentiation or standardized WAMT. The intervention lasted 4 weeks. The outcomes were measured using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI) at baseline, postintervention, and at 1-week follow-up. Results: Fifty-seven participants completed the study, 29 in the FEMT group and 28 in the WAMT group. At the 4 th week, both groups showed significant within-group improvements in HADS scores (FEMT: P = 0.002; WAMT: P < 0.001). The reduction in HADS scores was significantly greater in the FEMT group than in the WAMT group (mean difference: −2.1 points; t = 2.25; P = 0.030). For PSQI scores, both groups showed improvement, but the between-group difference was not statistically significant ( P > 0.05). The WAMT group reported significantly higher scores on music acceptability and familiarity than the FEMT group (mean acceptability: 9.39 vs. 8.28, P = 0.013; mean familiarity: 9.29 vs. 8.10, P < 0.001). Conclusion: Both FEMT and WAMT were effective. FEMT was more effective than WAMT in reducing anxiety and depression symptoms, while WAMT was more familiar and acceptable. Music therapy is a viable intervention for improving nurses’ well-being.