Music for emotional well-being in paediatric nurses: a work-related stress study Open Access

Effective communication in healthcare—particularly empathic, emotionally attuned communication—is essential for quality care in both physical and psychological domains. Beyond technical competencies, professionals must integrate emotional awareness into patient interactions, fostering therapeutic relationships based on listening, understanding and mutual trust (Gamberoni, 1998; Benenzon, 2007).

However, the high emotional demands of healthcare—especially in paediatrics—expose professionals to continuous stress, potentially leading to anxiety, emotional fatigue and burnout. This risk is exacerbated when no structured space exists for emotional reflection and processing (Yıldırım and Çiriş Yıldız, 2022; Happell et al., 2013). Without appropriate support, healthcare professionals may resort to defensive mechanisms that can hinder relational quality and professional well-being.

Within this context, music has gained recognition as a unique channel for managing stress and expressing emotion. As a vibratory phenomenon, music affects individuals on multiple levels—physical, neurological, psychological, and communicative—facilitating emotional release and intersubjective connection (Thoma et al., 2013; Iyendo, 2016; Kim et al., 2024). On a pre-verbal level, it bypasses cognitive defences and supports non-verbal self-expression (Benenzon, 2007).

Empirical research supports the use of music interventions for improving the well-being of healthcare workers. Finnerty et al. (2022) and Phillips et al. (2020, 2021) found that music fosters resilience, emotional clarity and workplace satisfaction. Beck et al. (2015), Kacem et al. (2020) and Raglio et al. (2020) showed how music reduces occupational stress and burnout in high-pressure environments. Moreover, studies on expressive arts interventions, such as those by Phillips and Becker (2019) and Ledger et al. (2013), highlight music’s ability to promote emotional regulation and improve group dynamics in interdisciplinary teams.

Despite these findings, limited research focuses specifically on paediatric nurses—professionals uniquely vulnerable to emotional strain due to the sensitive nature of their work. There remains a gap in understanding how structured music listening can support this population in coping with work-related stress.

This study addresses that gap by examining whether guided music listening sessions can enhance emotional well-being, interpersonal communication, and self-awareness among paediatric nurses. By offering a non-verbal, creative outlet for emotional processing, the intervention aims to reduce stress and promote sustainable, compassionate caregiving.

The study is grounded in evidence suggesting that musical engagement:

1. Promotes self-awareness and reflective capacity (Dos Santos and Lotter, 2016),

2. Enhances psychophysical balance (Guo et al., 2015),

3. Improves emotional expression and empathy (Linnemann et al., 2017; Ploukou and Panagopoulou, 2018),

4. Fosters group cohesion and shared meaning (Brooke et al., 2020).

The objectives are:

1. To investigate whether guided music listening can help paediatric nurses manage work-related stress more effectively;

2. To assess whether such interventions enhance emotional intelligence, self-awareness, and interpersonal communication;

3. To contribute practical insights for designing institutional well-being policies in paediatric care settings.

This research employs a descriptive approach and utilises a retrospective design to analyse a project conducted in the years 2016–2018, before the Covid-19 pandemic, at the Maternal and Child Department of the University Hospital.

This project caters to healthcare professionals interested in delving into personal experiences and the relational dynamics that unfold during of their profession. The sessions are meticulously structured to stimulate interactive group work, amplifying the contributions of individual participants and fostering an experiential journey in the creative pursuit of solutions.

The follow-up group context provides a privileged and secure space for participants to share their experiences.

A total of 26 paediatric nurses took part in the project. The group was demographically and professionally diverse:

1. Age Range: 20–60 years

2. Years of Experience: Less than 10 to over 40 years

3. Work Shifts: 8 participants worked rotating shifts (day, evening, night)

4. Educational Background: 15 held a university degree; 11 held a diploma

5. Professional Roles: 20 paediatric nurses; 6 head nurses

6. Departmental Roles: 16 in inpatient wards; 10 in day hospital settings

7. Parental Status: 4 had adult children, 10 had underage children, and 12 had no children

8. Previous Exposure to Music Interventions: None of the participants had previously engaged in structured music-based workplace interventions.

This diverse group provided a comprehensive overview of the potential impact of the music intervention across different demographics and levels of experience within the paediatric nursing field.

Participants, lacking prior group experiences, joined with the intention of having a protected space where they could openly share work-related problems and emotions. The project, conducted in sessions lasting approximately 90 min once a month in a small group. These sessions aim to facilitate connections among participants, stimulating greater self-awareness.

Each session follows a structured format, commencing with a briefing on the participant’s current state of mind regarding the experienced workday. This is followed by a guided relaxation period, the listening of instrumental music pieces chosen based on the material discussed in the previous colloquial phase, and, finally, a moment of sharing.

The selected classical music pieces for each session are as follows in the Table 1 (insert here).

This methodology is designed to facilitate a comprehensive exploration of experiences, offering a blend of psychological and sensory stimuli to promote well-being among healthcare professionals. This table captures the essence of each piece, its composer, and its characteristics, making it easier to understand the emotional and psychological journey intended by the selection and order of the music.

The sequence of pieces is designed to guide listeners through an emotional journey that begins with serene and reassuring tones, passes through meditative reflections, and culminates with energy and physical well-being. This order allows for a natural progression that promotes the psychological well-being and emotional resilience of healthcare professionals, supporting their ability to manage stress in their challenging daily work.

Upon completion of the course, participants, as per the administered questionnaires, reported an enhanced ability to recognise and manage their emotions. They also noted heightened awareness of both their own roles and the emotions of their colleagues. The sessions provided a unique opportunity for participants to engage in a level of communication that seldom occurs during their regular work activities, fostering a deeper and more intimate connection among them.

The acquisition of improved emotional and relational competencies by health operators has far-reaching implications. It facilitates a more gratifying approach to patient care, prioritising relationship-building, active listening, and responsiveness to individual needs over mere intervention and prescription. This transformative process nurtures a special sensitivity, diminishing tension in the patient-professional relationship and fostering a collaborative alliance. Health operators, thus equipped, gain a greater awareness of their emotional responses to patient behaviour, enhancing their ability to manage anxiety effectively (Ploukou and Panagopoulou, 2018; Phillips et al., 2021).

Crucially, the development of these competencies acts as a deterrent to counterproductive defence mechanisms, paving the way for the establishment of more efficient, effective, and gratifying therapeutic relationships for both parties involved. Furthermore, this enhanced emotional intelligence contributes to a clearer understanding of group processes, organisational dynamics and network relationships, all of which significantly influence the professional well-being of health operators.

In essence, the study illuminates the multifaceted benefits derived from integrating music-based interventions into the professional development of healthcare providers. Beyond stress reduction, these interventions contribute to the holistic enhancement of emotional intelligence, relational skills and overall job satisfaction among health operators.

Table 2 (insert here) summarises the main outcomes achieved through the musical intervention aimed at enhancing the well-being and performance of nurses.

1. “The music sessions provided a much-needed break from the stress of the job and allowed me to reconnect with my emotions.”

2. “I found that listening to classical music helped me to reflect on my experiences and approach my work with a calmer mindset.”

3. “The variety of music kept the sessions interesting and engaging. I particularly enjoyed the pieces by Debussy and Satie.”

This study highlights the positive influence of music as a complementary strategy for managing work-related stress in paediatric nurses. Music listening, particularly within a structured and reflective group setting, offered a powerful means of emotional expression and psychological relief (Matoso et al., 2021). Through guided sessions, nurses explored their emotional responses to work-related experiences, enhancing their capacity for self-awareness, communication, and relational engagement (Hayakawa et al., 2022).

A key implication is the importance of providing protected, emotionally safe spaces for healthcare professionals to express, share, and process their experiences. The music-based approach helped reduce emotional overload, improved interpersonal understanding, and supported resilience in high-stress clinical environments. These findings align with a broader vision of holistic and integrated care, where staff well-being is recognised as essential to quality patient outcomes (Phillips and Becker, 2019).

Nevertheless, the study has limitations. The sample was small and restricted to one hospital department, reducing the generalisability of results. The absence of a control group and the reliance on self-reported data also limit the strength of causal inferences. Furthermore, the retrospective nature of the study means that some experiential data may be subject to recall bias.

Future research should aim to expand on these findings by adopting longitudinal and comparative designs, with larger and more diverse samples. Incorporating quantitative outcome measures, alongside qualitative data, would strengthen the evidence base. There is also potential for exploring the effects of other musical genres, as well as the role of individual musical preferences in modulating outcomes.

Despite its exploratory nature, the study underscores the feasibility and effectiveness of integrating music into structured support programmes for healthcare staff. With appropriate institutional support, these interventions could become a valuable component of workforce well-being strategies, particularly in emotionally demanding care settings.

Based on the theoretical foundation provided, a practical development plan can be designed to directly involve healthcare professionals, aiming to enhance their emotional and physical well-being within the workplace context. Here is a possible practical development plan:

Objective: Implement a professional development programme Table 3 (insert here) that integrates emotional and physical management strategies to enhance the well-being of healthcare professionals within the context of interpersonal relationships in the healthcare sector.

By implementing a practical programme based on these principles, it is possible to create a healthier and more sustainable work environment for healthcare professionals, thereby enhancing the quality of care provided to patients.

This study suggests that music-based interventions, when embedded in reflective and supportive group settings, can significantly enhance the emotional well-being and relational competence of paediatric nurses. By fostering emotional resilience and improving stress management, these interventions contribute to more empathetic, collaborative, and patient-centred care.

The findings support the integration of music as a practical tool within professional development programmes aimed at improving healthcare staff well-being. Such initiatives align with the principles of integrated care, recognising staff mental health as a key determinant of quality service delivery and continuity of care.

Embedding music listening sessions into routine workplace practice may be a cost-effective, scalable strategy to address burnout and strengthen team cohesion. Institutional policies that prioritise staff well-being through creative and evidence-informed approaches can ultimately lead to better outcomes for both healthcare professionals and patients.

Future implementations should consider adapting the intervention to different clinical contexts, monitoring long-term outcomes, and exploring the interplay between musical preferences and therapeutic effects.

All the authors have provided:

Substantial contributions to the conception, design of the work; the acquisition, analysis, interpretation of data for the work.

Drafting the work and reviewing it critically for important intellectual content.

Final approval of the version to be published.

Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Furthermore, Prof. BRAVACCIO handled the English translation, Dr CONTINISIO and Dr STORACE led the research project, Dr D’ONOFRIO and Dr TOSCANO conducted the literature review. Dr STORACE also oversaw the final drafting of the article.

All the authors saw and approved this manuscript.

The study only analyses anonymous data and is retrospective; therefore, ethical approval was waived because of the retrospective nature of the study.

The study is limited to the analysis of anonymised data and does not involve interviews, questionnaires, or other types of direct interactions with participants.

This study did not involve direct participation or contribution from patients or the public in any phase of the research process.