This study investigates the influence of ambient scent and music, and their combination, on patients' anxiety in a waiting room of a plastic surgeon.
BACKGROUND:
Waiting for an appointment with a plastic surgeon can increase a patient's anxiety. It is important to make the waiting time before an appointment with the surgeon more pleasant and to reduce the patient's anxiety. Ambient environmental stimuli can influence people's mood, cognition, and behavior. This experimental study was performed to test whether ambient scent and music can help to reduce patients' anxiety.
METHODS:
Two pre-studies (n = 21) were conducted to measure the subjective pleasantness and arousal of various scents and music styles. Scent and music that scored high on pleasantness and low on arousal were selected for the main study. The field experiment (n = 117) was conducted in the waiting room of a German plastic surgeon. The patients' levels of anxiety were measured in four conditions: (1) without scent and music, (2) with lavender scent; (3) with instrumental music; (4) with both scent and music.
RESULTS:
When used separately, each of the environmental factors, music and scent, significantly reduced the level of patient's anxiety compared to the control condition. However, the combination of scent and music was not effective in reducing anxiety.
CONCLUSIONS:
Our results suggest that ambient scent and music can help to reduce patients' anxiety, but they should be used with caution. Adding more ambient elements to environment could raise patients' level of arousal and thus increase their anxiety.
ApterM. J. (1982). The experience of motivation: The theory of psychological reversals. London, England: Academic Press.
2.
ApterM. J. (1984). Reversal theory and personality: A review. Journal of Research in Personality, 18, 265–288.
3.
ArneillA. B., & DevlinA. S. (2002). Perceived quality of care: The influence of the waiting room environment. Journal of Environmental Psychology, 22, 345–360.
4.
BakerJ., & CameronM. (1996). The effects of the service environment on affect and consumer perception of waiting time: An integrative review and research propositions. Journal of the Academy of Marketing Science, 24, 338–349.
5.
BeckerF., & DouglassS. J. (2008). The ecology of the patient visit: Physical attractiveness, waiting times, and perceived quality of care. Journal of Ambulatory Care Management, 31(2), 124–137.
6.
BeckerF.SweeneyB., & ParsonsK. (2008). Ambulatory facility design and patients' perceptions of healthcare quality. Health Environments Research & Design Journal, 1(4), 35–54.
7.
BerlyneD. E. (1960). Conflict, arousal, and curiosity. New York, NY: McGraw-Hill.
8.
BernardiL.PortaC., & SleightP. (2006). Cardiovascular, cerebrovascular, and respiratory changes induced by different types of music in musicians and non-musicians: The importance of silence. Heart, 92, 445–452.
9.
BerscheidE., & GangestadS. (1982). The social and psychological implications of facial physical attractiveness. Clinics in Plastic Surgery, 9, 289–296.
10.
BitnerM. J. (1992). Servicescapes: The impact of physical surroundings on customers and employees. Journal of Marketing, 56, 57–71.
11.
BoltonM. A.PruzinskyT.CashT. F., & PersingJ. A. (2003). Measuring outcomes in plastic surgery: Body image and quality of life in abdominoplasty patients. Plastic and Reconstructive Surgery, 112, 619.
12.
BoneP. F., & EllenP. S. (1999). Scents in the marketplace: Explaining a fraction of olfaction. Journal of Retailing, 75(2), 243–262.
13.
BradleyI. L. (1971). Repetition as a factor in the development of musical preferences. Journal of Research in Music Education, 19, 295–298.
14.
BrentarJ. E.NeuendorfK. A., & ArmstrongG. B. (1994). Exposure effects and affective responses to music. Communication Monographs, 61, 161–181.
15.
BrickmanP., & D'AmatoB. (1975). Exposure effects in a free-choice situation. Journal of Personality and Social Psychology, 32, 415–420.
16.
DeatonA. V., & LangmanM. I. (1986). The contribution of psychologists to the treatment of plastic surgery patients. Professional Psychology: Research and Practice, 17(3), 179–184.
17.
DelinskyS. S. (2005). Cosmetic surgery: A common and accepted form of self-improvement?Journal of Applied Social Psychology, 35, 2012–2028.
18.
EdgertonM. T.LangmanM. W.SchmidtJ. S., & SheppeW. (1982). Psychological considerations of gender reassignment surgery. Clinics in Plastic Surgery, 9, 355–366.
19.
EhrlichmanH., & HalpernJ. N. (1988). Affect and memory: Effects of pleasant and unpleasant odors on retrieval of happy and unhappy memories. Journal of Personality and Social Psychology, 55, 769–779.
20.
FergusonE.SinghA. P., & Cunningham-SnellN. (1997). Stress and blood donation: Effects of music and previous donation experience. British Journal of Psychology, 88, 277–294.
21.
FieldT.DiegoM.Hernandez-ReifM.CisnerosW.FeijoL.VeraY., & GilK. (2004). Lavender fragrance cleansing gel effects on relaxation. International Journal of Neuroscience, 115, 207–222.
22.
FosterE., & GambleE. A. (1906). The effects of music on thoratic breathing. The American Journal of Psychology, 17(3), 406–414.
23.
FrederickD. A.LeverJ., & PeplauL. A. (2007). Interest in cosmetic surgery and body image: Views of men and women across the lifespan. Plastic and Reconstructive Surgery, 120, 1407–1415.
24.
GoodM.AndersonG. C.AhnS.CongX., & Stanton-HicksM. (2005). Relaxation and music reduce pain following intestinal surgery. Research in Nursing and Health, 28, 240–251.
25.
GroverR., & SandersR. (1998). Recent advances. Plastic surgery. British Medical Journal, 317 (7155), 397–400.
26.
GueguenN., & PetrC. (2006). Odors and consumer behavior in a restaurant. Hospitality Management, 25, 335–339.
27.
HargreavesD. J. (1984). The effects of repetition on liking for music. Journal of Research in Music Education, 32, 35–47.
28.
HarrisD. L. (1981). The symptomathology of abnormal appearance: An anecdotal survey. British Journal of Plastic Surgery, 25, 312–323.
29.
HarrisP. B.RossC.McBrideG., & CurtisL. (2002). A place to heal: Environmental sources of satisfaction among hospital patients. Journal of Applied Social Psychology, 32(6), 1276–1299.
30.
HaunM.MainousR. O., & LooneyS. W. (2001). Effect of music on anxiety of women awaiting breast biopsy. Behavioral Medicine, 27(3), 127–132.
31.
Henderson-KingD., & Henderson-KingE. (2005). Acceptance of cosmetic surgery: Scale development and validation. Body Image, 2, 137–149.
32.
HerzR. (2010). The emotional, cognitive, and biological basis of olfaction: Implications and considerations for scent marketing. In KrishnaA. (Ed.), Sensory marketing: Research on the sensuality of products (pp. 87–108). New York, NY: Taylor and Francis Group.
33.
HeydukB. J. (1975). A descriptive study of the two-dimensional and the three-dimensional forming strategies of seventh grade students. Dissertation Abstracts International, 35, 7527–7528.
34.
HirschA. R. (1995). Effects of ambient odors on slot-machine usage in a Las Vegas casino. Psychology and Marketing, 12, 585–594.
35.
HornikJ. (1984). Subjective vs. objective time measures: A note on the perception of time in consumer behaviour. Journal of Consumer Research, 11, 614–618.
36.
HydeR.BrydenF., & AsburyA. J. (1998). How would patients prefer to spend the waiting time before their operations?Anaesthesia, 53(2), 192–195.
37.
IkonomidouE.RehnstromA., & NaeshO. (2004). Effect of music on vital signs and postoperative pain. AORN Journal, 80, 269–278.
38.
KettererJ. (2008). Zusammenhang zwischen klinischen, psychosozialen und soziodemog-raphischen Faktoren und Angst und Depressivität gemessen in der Hospital Anxiety and Depression Scale – Deutsche Version (HADS-D) – zu einem definierten postoperativen Zeitpunkt bei Patientinnen mit Brustkrebs. Charité Universität, Berlin.
39.
Kirk-SmithM. D., & BoothD. (1987). Chemoreception in human behavior: Experimental analysis of the social effects of fragrances. Chemical Senses, 12(1), 159–166.
40.
KnaskoS. C. (1992). Ambient odor's effect on creativity, mood, and perceived health. Chemical Senses, 17, 27–35.
41.
KorhanE. A.KhorshidL., & KyarM. (2010). The effect of music therapy on physiological signs of anxiety in patients receiving mechanical ventilator support. Journal of Clinical Nursing, 20(7), 1026–1034.
42.
KrishnaA. (2012). An integrative review of sensory marketing: Engaging the senses to affect perception, judgment and behavior. Journal of Consumer Psychology, 22(3), 332–351.
43.
LauxL.GlanzmannP.SchaffnerP., & SpielbergerC. D. (1981). Das State-Trait-Angstinventar: Theoretische Grundlagen und Handanweisung. Weinheim, Germany: Beltz.
44.
LeeK. C.ChaoY. H.YiinJ. J.ChiangP. Y., & ChaoY. F. (2011). Effectiveness of different music-playing devices for reducing pre-operative anxiety: A clinical control study. International Journal of Nursing Studies, 48, 1180–1187.
45.
LehrnerJ.EckersbergerC.WallaP.PötschG., & DeeckeL. (2000). Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients. Physiology & Behavior, 71, 83–86.
46.
MacGregorF. C. (1982). Social and psychological studies of plastic surgery: Past, present and future. Clinics in Plastic Surgery, 9, 283–288.
47.
MattilaA., & WirtzJ. (2001). Congruency of scent and music as a driver of in-store evaluations and behavior. Journal of Retailing, 77(2), 273–90.
48.
MoolaS.PearsonA., & HaggerC. (2011) Effectiveness of music interventions on dental anxiety in paediatric and adult patients: A systematic review. JBI Library of Systematic Reviews, 9(18), 588–630.
49.
MorrinM., & ChebatJ. C. (2005). Person–place congruency: The interactive effects of shopper style and atmospherics on consumer expenditures. Journal of Service Research, 8(2), 181–91.
50.
MorrisonM.GanS.DubelaarC., & OppewalH. (2011). In-store music and aroma influences on shopper behavior and satisfaction. Journal of Business Research, 64, 558–564.
NorthA. C.HargreavesD. J., & McKendrickJ. (1999). The influence of in-store music on wine selections. Journal of Applied Psychology, 84(2), 271–276.
53.
O'DeaJ. A. (2008). Gender, ethnicity, culture and social class influences on childhood obesity among Australian schoolchildren: Implications for treatment, prevention and community education. Health and Social Care in the Community, 16, 282–290.
54.
PertschukM. J., & WhitakerL. A. (1982). Social and psychological effects of craniofacial deformity and surgical reconstruction. Clinics in Plastic Surgery, 9, 297–306.
55.
PruynA., & SmidtsA. (1998). Effects of waiting on the satisfaction with the service: Beyond objective time measures. International Journal of Research in Marketing, 15, 321–334.
56.
PruynA., & SmidtsA. (1993). Customers' evaluations of queues: Three exploratory studies. In van RaaijW. F. & BamossyG. (Eds.), European advances in consumer research (Vol. 1) (pp. 371–382). Provo, UT: Association of Consumer Research.
57.
RaudenbushB.GrayhemR.SearsT., & WilsonI. (2009). Effects of peppermint and cinnamon odor administration on simulated driving alertness, mood and workload. North American Journal of Psychology, 11, 245–256.
58.
SarwerD. B.CashT. F.MageeL.WilliamsE. F.ThompsonJ. K.RoehrigM.RomanofskiM. (2005). Female college students and cosmetic surgery: An investigation of experiences, attitudes, and body image. Plastic and Reconstructive Surgery, 115, 931–938.
59.
SarwerD. B.ZanvilleH. A.LaRossaD.BartlettS. P.ChangB.LowD. W., & WhitakerL. A. (2004). Mental health histories and psychiatric medication usage among persons who sought cosmetic surgery. Plastic and Reconstructive Surgery, 114, 1927–1933.
60.
SnaithR. P.BaughS. J.ClaydenA. D.HusainA., & SippleM. A. (1982). The Clinical Anxiety Scale: An instrument derived from the Hamilton Anxiety Scale. The British Journal of Psychiatry, 141, 518–523.
61.
SpangenbergE. R.GrohmannB., & SprottD. E. (2005). It's beginning to smell (and sound) a lot like Christmas: The interactive effects of ambient scent and music in a retail setting. Journal of Business Research, 58(11), 1583–1589.
62.
SpangenbergE. R., & YalchR. F. (2000). The effects of music in a retail setting on real and perceived shopping times. Journal of Business Research, 49, 139–147.
63.
SwamiV.Chamorro-PremuzicT.BridgesS., & FurnhamA. (2009). Acceptance of cosmetic surgery: Personality and individual difference predictors. Body Image, 6, 7–13.
64.
ThorgaardB.HenriksenB. B.PedersbaekG., & ThomsenI. (2004). Specially selected music in the cardiac laboratory—An important tool for improvement of wellbeing of patients. European Journal of Cardiovascular Nursing, 3, 21–26.
65.
ThorgaardP.ErtmannE.HansenV.NoerregaardA.HansenV., & SpanggaardL. (2005). Designed sound and music environment in postanaesthesia care units—A multicenter study of patients and staff. Intensive Critical Care Nursing, 21(4), 220–225.
66.
TurleyL. W., & MillimanR. E. (2000). Atmospheric effects on shopping behavior: A review of the experimental evidence. Journal of Business Research, 49(2), 193–211.
67.
UlrichR. S. (1991). Effects of interior design on wellness: Theory and recent scientific research. Journal of Health Care Interior Design, 3, 97–109.
68.
Van RompayT. L., & Tanja-DijkstraK. (2010). Directions in healthcare research: Pointers from retailing and services marketing. Health Environments Research & Design Journal, 3(3), 87–100.
VoorheesC. M.BakerJ.BourdeauB. L.BrocatoE. D., & CroninJ. J. (2009). It depends: Moderating the relationships among perceived waiting time, anger, and regret. Journal of Service Research, 12(2), 138–155.
71.
WaltersJ.ApterM. J., & SvebakS. (1982). Color preference, arousal and the theory of psychological reversals. Motivation and Emotion, 6(3), 193–215.
72.
WitvlietC. V. O., & VranaS. R. (2007) Play it again Sam: Repeated exposure to emotionally evocative music polarises liking and smiling responses, and influences other affective reports, facial EMG, and heart rate. Cognition & Emotion, 21(1), 3–25.
73.
WongH. L.Lopez-NahasV., & MolassiotisA. (2001). Effects of music therapy on anxiety in ventilator dependent patients. Heart and Lung, 30, 376–387.
74.
ZigmondA. S., & SnaithR. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.
75.
FenkoA. & LoockC. (2014). The influence of ambient scent and music on patients' anxiety in a waiting room of a plastic surgeon. Health Environments Research & Design Journal, 7(3), 38–59.
