Effect of Nature Sounds on Stress, Anxiety, Depression, and Sleep Quality in Type II Diabetes

Introduction: Type II diabetic patients experience various physical and mental problems, such as stress, anxiety, depression, and sleep quality disorders, that require necessary interventions. So far, few studies have evaluated the effectiveness of nature sounds on mood and sleep disorders in patients. Therefore, this study was conducted to determine the effect of nature sounds on stress, anxiety, depression, and sleep quality among type II diabetic patients.Materials and Methods: In this study, 40 patients with type II diabetes were evaluated in the intervention and control groups (n=20 each). The required data were collected using the Anxiety, Stress, and Depression Scale21 and Pittsburgh Sleep Quality Index at the baseline and 1 week after the nature sounds intervention. The participants in the intervention group listened to an audio file containing the sounds of nature twice a day, once in the morning and once at night before going to bed, for 20 min at each stage. The control group received the usual nursing care program. The gathered data were analyzed using descriptive and inferential statistics.Results: The independent ttest did not show a significant difference between the mean scores of stress (11.70 ±3.14 vs 9.60 ±3.57), anxiety (9.05 ±3.32 vs 8.05 ±3.31), depression (9.25 ±3.77) vs 9.30 ±4.07), and sleep quality (9.22 ±3.61 vs 9.44 ±4/06) of diabetic patients in the intervention and control groups. However, the ANCOVA with Bonferroni post hoc test by controlling pretest scores significantly reduced the difference between the mean scores of stress in the intervention and control groups, accounting for 9.58 (95% confidence interval [CI] 8.10, 11.07) and 11.71 (95% CI 10.22, 13.20), respectively.Conclusion: The sound of nature reduced stress in diabetic patients; nevertheless, it did not have a significant effect on their anxiety, depression, and sleep quality.