Jurnal Kesehatan Ibu dan Anak Vol.
No.
November 2024, pp.
: 10.
29238/kia.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
Flute instrumental music relaxation effectively reduces anxiety in premenopausal women Witri Nuraeni1.
Nunung Mulyani2.
Laila Putri Suptiani3 Department of Midwifery.
Poltekkes Kemenkes Tasikmalaya.
Indonesia, witrinuraeni2121@gmail.
Department of Midwifery.
Poltekkes Kemenkes Tasikmalaya.
Indonesia, nunung.
mulyani@dosen.
Department of Midwifery.
Poltekkes Kemenkes Tasikmalaya.
Indonesia, laila.
putri@dosen.
ARTICLE INFO
Article history:
Received: July 10th 2025 Revised : July 24th 2025 Accepted: July 29th 2025 Keyword:
Music therapy.
Nonpharmacological Hamilton anxiety rating Pre-experimental design.
ABSTRACT
Premenopausal women often experience heightened anxiety due to hormonal fluctuations and psychosocial stressors related to the menopausal transition.
Non-pharmacological interventions, particularly music therapy, have been recognized as an effective complementary approach to promote emotional well-being.
However, limited empirical evidence exists on the specific effect of flute instrumental music relaxation among premenopausal women in community health settings.
This study aimed to determine the effectiveness of flute instrumental music relaxation therapy in reducing anxiety levels among premenopausal women.
A quasi-experimental pretestAeposttest design was applied involving 51 premenopausal participants selected through purposive sampling in the Mangkubumi Public Health Center service area.
Tasikmalaya City.
Indonesia in 2025.
Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS) before and after seven consecutive days of flute instrumental music relaxation therapy.
Data were analyzed using the Wilcoxon signed-rank test after confirming non-normal distribution via the KolmogorovAe Smirnov test.
Respondents were predominantly aged 40Ae45 years .
9%).
The mean anxiety score before the intervention was 16.
25 (SD = 2.
categorized as mild anxiety, and decreased to 12.
43 (SD = 1.
postintervention, indicating no anxiety.
The Wilcoxon test revealed a statistically significant reduction in anxiety levels (Z = Ae3.
82, p < 0.
The mean reduction of 3.
82 points demonstrates a meaningful therapeutic effect of the flute music intervention.
These findings align with prior studies reporting musicAos role in regulating stress responses, modulating neuroendocrine pathways, and improving emotional stability among menopausal and perimenopausal women.
The result emphasizes the cultural appropriateness and accessibility of flute music as a relaxation medium within IndonesiaAos maternal and reproductive health services.
Flute instrumental music relaxation effectively reduces anxiety among premenopausal women and represents a feasible, low-cost intervention for community-based midwifery and womenAos health programs.
Future research should utilize randomized controlled designs, explore long-term outcomes, and compare different musical modalities to enhance evidence-based integration into reproductive health This is an open access article under the CCAeBY-SA license.
Corresponding Author:
Witri Nuraeni Department of Midwifery.
Poltekkes Kemenkes Tasikmalaya Babakan Siliwangi Street No.
Kahuripan.
Tawang.
Tasikmalaya.
Indonesia 46115.
Phone:
Email: witrinuraeni2121@gmail.
INTRODUCTION
Menopause refers to a natural phase experienced by every woman, marked by the cessation of the menstrual cycle for 12 consecutive months due to decreased ovarian function and reduced production of the hormone estrogen.
Before menopause, women go through a premenopause period marked by reproductive, hormonal, physical, and http://e-journal.
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Jurnal Kesehatan Ibu dan Anak Vol.
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November 2024, pp.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
psychological changes.
The climacteric phase is divided into premenopause, perimenopause, menopause, and postmenopause, with premenopause usually occurring at the age of 40-49 years.
During premenopause, many women experience complaints such as hot flashes, night sweats, sleep disturbances, fatigue, anxiety, and mood swings that can reduce quality of life.
In Tasikmalaya City, the number of women aged 40-49 years continues to increase, and this increase has the potential to become a public health Anxiety in premenopausal mothers can interfere with daily activities, productivity, and social relationships.
Anxiety is a psychological condition characterized by feelings of discomfort, often accompanied by physical symptoms such as heart palpitations and excessive sweating.
During the premenopausal phase, declining levels of the hormone progesterone contribute to emotional instability and increased anxiety.
This condition is further influenced by factors such as age, overall health status, psychological resilience, and social environment.
With appropriate support and interventions, anxiety in premenopausal women can be effectively .
The population of women aged 40Ae49 in many regions of Indonesia shows an increasing trend, which has implications for public reproductive and mental health .
Furthermore, the prevalence of anxiety symptoms in women entering menopause is reported to be quite high.
Observational studies indicate a significant proportion of menopausal/perimenopausal women experience anxiety disorders.
According to data from the Tasikmalaya City Health Department, a notable number of anxiety cases were recorded among women aged 40Ae49 years, indicating a growing public health concern that warrants serious attention.
However, primary care providers are often unable to adequately manage these psychological complaints due to treatment gaps: limited access, stigma, and low levels of professional care for mental health issues at the community level.
Therefore, the increasing number of women aged 40Ae49, coupled with limited management in primary care and the still-inadequate evidence of interventions, makes testing simple, affordable, and contextual solutions an urgent research need.
Anxiety management strategies can include both pharmacological and nonpharmacological approaches.
Although pharmacological interventions, such as hormone therapy and non-hormonal medications, remain the primary options for managing the psychological symptoms of perimenopause and menopause, numerous studies have shown that side effects .
, cardiovascular disorders, increased risk of thrombosis, metabolic change.
, high costs, and limited access make these approaches not always acceptable or safe for all women.
For example, a recent review of non-hormonal therapies for menopausal symptoms noted that some medications, such as clonidine and pregabalin, are now less recommended due to side effects and poor tolerability.
Meanwhile, nonpharmacological interventions .
ncluding music therapy, psychosocial therapy, physical exercise, and lifestyle intervention.
have emerged as promising alternatives.
The RCT study reported that listening to music twice daily for five weeks reduced menopausal symptoms, depression, and improved sleep quality compared to controls receiving only routine care.
Similarly, the study by Kim et al.
showed that music psychotherapy was more effective than cognitive behavioral therapy in reducing psychological scores and improving psychological quality of life.
However, despite strong evidence of non-pharmacological efficacy in research contexts, the implementation of these interventions in primary healthcare is still limited.
Many studies use RCT designs in clinical facilities or large institutions, rather than in community settings or community health centers.
Therefore, accessibility, cost, practicality, and cultural adaptation are often not a primary focus.
For example, studies of music and psychosocial therapy take place in clinics or research laboratories and require resources .
herapists, dedicated spac.
, which are not necessarily available in community health Nuraeni.
Mulyani.
Suptiani (Flute instrumental music relaxation effectively reduces anxiety inA) Jurnal Kesehatan Ibu dan Anak Vol.
No.
November 2024, pp.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
A meta-analysis of non-pharmacological interventions for insomnia and sleep quality in perimenopausal/postmenopausal women also noted that most studies were not conducted in primary or limited community settings.
In this situation, instrumental music interventions, especially those using simple instruments such as the flute, in community/community health center settings, emerge as the most appropriate solution.
Instrumental music is easily accessible, relatively inexpensive, has minimal side effects, and can be implemented without the need for complex clinical infrastructure.
Music has been shown to reduce psychological symptoms in perimenopausal studies, as mentioned Therefore, instrumental flute interventions in primary care have the potential to be a practical and effective approach to reducing premenopausal anxiety, closing the gap between scientific effectiveness and practical application.
Preliminary evidence in the Indonesian context also indicates the effectiveness of a combination of nature music/flute or instrumental music in reducing anxiety in laboring mothers and other populations, so adapting a flute-based program in Public Health Centers (PHC/ Puskesma.
merits further testing.
Based on data and surveys in the Mangkubumi PHC work area, many premenopausal women experience symptoms of anxiety and sleep Flute instrumental music therapy is considered suitable for reducing anxiety in this group because it is easy to implement, cost-effective, and effective.
Therefore, a study examining how flute instrumental music relaxation impacts anxiety levels.
This study was conducted to determine the effectiveness of relaxation with flute instrumental music in reducing anxiety levels in premenopausal women .
ged 40Ae.
in the Community setting and to evaluate the feasibility of implementing this intervention in primary health care.
METHOD
This study employed a pre-experimental one-group pretest-posttest design to evaluate the effect of flute instrumental music relaxation on anxiety levels among premenopausal The research was conducted in the working area of Mangkubumi PHC.
Tasikmalaya in 2025.
The target population comprised premenopausal women aged 40Ae49 years residing in the health center's service area, with a total population of 1,022 individuals.
A sample of 51 participants was selected using purposive sampling, based on the following inclusion criteria: women in the premenopausal phase .
ased on age and clinical histor.
, experiencing symptoms of anxiety, able to communicate effectively, and willing to Exclusion criteria included those currently undergoing pharmacological treatment for anxiety, having a diagnosed psychiatric disorder, or experiencing hearing Five participants dropped out during the intervention, resulting in a final sample of 46 respondents.
The intervention applied in this study was flute instrumental music relaxation, a structured non-pharmacological relaxation method designed to reduce anxiety among premenopausal women.
Participants were exposed to recorded instrumental flute music with a tempo of 60Ae80 beats per minute .
, selected for its calming rhythm and smooth tonal qualities.
Each participant attended five sessions per week for four consecutive weeks, resulting in a total of 20 sessions.
Each session lasted 25 minutes, conducted individually or in small groups .
aximum of five participant.
in a quiet room at the PHC to minimize environmental distractions.
Before the session began, participants were seated or reclined comfortably, and the facilitator provided a brief orientation about breathing awareness.
During the session, participants listened passively to the flute music through speakers or headphones at a comfortable volume .
pproximately 50Ae60 dB).
They were instructed to focus on their breathing rhythm, inhaling slowly through the nose for four counts and exhaling gently through the mouth for six counts, allowing the music to guide Each session followed a consistent instructional script to maintain fidelity and A trained health worker or research assistant supervised the session, monitored participant comfort, and documented attendance and session duration using a Nuraeni.
Mulyani.
Suptiani (Flute instrumental music relaxation effectively reduces anxiety inA) Jurnal Kesehatan Ibu dan Anak Vol.
No.
November 2024, pp.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
standardized checklist.
Participants who missed more than 25% of sessions were categorized as non-compliant.
No adverse effects were reported during the intervention.
This protocol was adapted to suit the primary healthcare context, emphasizing accessibility, cost-effectiveness, and cultural suitability for community-based implementation.
Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS), a validated instrument consisting of 14 items assessing both somatic and psychic symptoms.
Each item is rated on a scale from 0 .
ot presen.
to 4 .
ery sever.
, with total scores ranging from 0 Higher scores indicate greater anxiety severity.
The HARS has been widely used in clinical and community settings and has demonstrated good reliability and validity.
The instrument was administered by trained research assistants through structured interviews before .
and after .
the intervention.
Descriptive statistics were used to summarize participant characteristics and anxiety levels.
To compare pretest and posttest scores, the Wilcoxon signed-rank test was applied due to the non-normal distribution of the Statistical analysis was performed using SPSS version 25, with a significance level set at p < 0.
RESULTS
A total of 51 premenopausal women participated in this study.
Table 1 presents the respondentsAo age distribution, showing that the majority .
9%) were between 40 and 45 years old, while 45.
1% were aged 46 to 49 years.
These findings indicate that most participants were in the early phase of premenopause, a period typically associated with emerging hormonal fluctuations and increased vulnerability to anxiety symptoms.
Table 1.
Respondent Characteristics by Age (N = .
Age Group .
40Ae45 46Ae49 Total Frequency .
Percentage (%) Table 2 present the intervention, the mean anxiety score of respondents was 16.
(SD = 2.
, with a minimum score of 14 and a maximum of 23.
This score falls within the mild anxiety category according to the Hamilton Anxiety Rating Scale (HARS).
After receiving the flute instrumental music relaxation intervention, the mean anxiety score decreased to 12.
43 (SD = 1.
, with a range of 10Ae17, corresponding to the no anxiety This descriptive finding indicates a reduction in anxiety symptoms among premenopausal women following the intervention.
Table 2.
Descriptive Statistics of Anxiety Scores Before and After Flute Instrumental Music Relaxation (N = .
Variable Mean Standard Deviation Minimum Maximum Anxiety Category Pretest Mild anxiety Posttest No anxiety The data normality test using the KolmogorovAeSmirnov method showed that both pretest and posttest scores were not normally distributed .
= 0.
008 and p = 0.
Table .
Consequently, a non-parametric statistical test (Wilcoxon signedrank tes.
was applied to evaluate the difference in anxiety levels before and after the Nuraeni.
Mulyani.
Suptiani (Flute instrumental music relaxation effectively reduces anxiety inA) Jurnal Kesehatan Ibu dan Anak Vol.
No.
November 2024, pp.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
Table 3.
Normality Test of Anxiety Scores (KolmogorovAeSmirnov Tes.
Variable Statistic Sig.
Normality Assumption Pretest Not normal Posttest 037 Not normal Note.
The KolmogorovAeSmirnov test indicated non-normal data distribution .
< 0.
, justifying the use of non-parametric analysis (Wilcoxon signed-rank tes.
The results of the Wilcoxon signed-rank test revealed a statistically significant difference between the pretest and posttest anxiety scores (Z = Ae3.
82, p < 0.
Table .
The null hypothesis (HCA), which assumed no difference in anxiety levels before and after the intervention, was therefore rejected.
This finding supports the alternative hypothesis (HCA), indicating that flute instrumental music relaxation effectively reduces anxiety levels among premenopausal women in the Mangkubumi PHC service area.
Table 4.
Effect of Flute Instrumental Music Relaxation on Anxiety Levels (Wilcoxon Signed-Rank Tes.
Variable N Mean Z-value p-value Interpretation Pretest Ae3.
Significant Posttest Note.
The Wilcoxon signed-rank test revealed a significant decrease in anxiety levels after the intervention .
< 0.
indicating the effectiveness of flute instrumental music relaxation.
Overall, the data demonstrated a meaningful reduction in anxiety scores after the intervention, with the average HARS score declining by 3.
82 points.
The results provide empirical evidence that the use of flute instrumental music relaxation is an effective nonpharmacological approach for managing anxiety symptoms in premenopausal women within a community health setting.
DISCUSSION
This study demonstrated that most premenopausal women were aged 40Ae45 years .
n = .
, while 45.
1% .
= .
were aged 46Ae49 years.
Before the flute instrumental music relaxation intervention, the mean anxiety score measured by the Hamilton Anxiety Rating Scale (HARS) was 16.
25 (SD = 2.
, categorized as mild anxiety.
After the intervention, the mean score decreased to 12.
43 (SD = 1.
, falling into the no anxiety category.
This significant reduction of 3.
82 points .
< 0.
Wilcoxon tes.
indicates that flute instrumental music relaxation effectively reduced anxiety levels among premenopausal women in the Mangkubumi PHC area.
The anxiolytic effect observed in the present study aligns with several recent investigations of music interventions in midlife and related female populations.
Ugurlu et Aos randomized trial .
reported significant between-group improvements in menopausal symptoms, depression, and sleep quality after a 5-week music program .
osttest differences: MRS p = 0.
BDI p = 0.
PSQI p = 0.
and the authors powered the study assuming a large effect .
nticipated d = 0.
, indicating a clinically meaningful effect size for structured music exposure.
Kim et al.
directly compared music psychotherapy with CBT in perimenopausal women and reported substantially larger mean reductions in Menopause Rating Scale scores for the music group versus CBT .
otal MRS change over time: 9.
2 vs 3.
5 points, p = 0.
, and in the psychology subscale .
5 vs 0.
9 points, p = 0.
, demonstrating sizeable clinical improvements with musicbased therapy.
A large cross-sectional survey by Balasubramanian et al.
found Nuraeni.
Mulyani.
Suptiani (Flute instrumental music relaxation effectively reduces anxiety inA) Jurnal Kesehatan Ibu dan Anak Vol.
No.
November 2024, pp.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
that 90% of surveyed menopausal women reported using music to relax when stressed and that many perceived benefit for mood regulation and pain this high uptake supports ecological validity for community-delivered music interventions, even though survey designs do not yield effect-size estimates.
In a preAepost interventional study by Shah et al.
that paired music with biofeedback measures, music produced statistically significant improvements in biofeedback indices and hemodynamic parameters .
improvement in biofeedback bars p = 0.
GSR increase p = 0.
after brief sessions, indicating rapid physiological correlates of relaxation even when clinical anxiety scores were not the sole endpoint.
Earlier fertility-setting trials (Vaithianathan et al.
, 2021.
summarized in Fertility & Sterilit.
and subsequent systematic reviews report consistent reductions in pre-procedure anxiety with music interventions.
meta-analytic syntheses in reproductive contexts conclude moderate quality evidence for anxiety reduction.
Collectively, these studies show a recurrent pattern: structured, repeated music exposure .
ulti-session protocols of 2Ae6 weeks or multiple sessions per da.
tends to yield clinically meaningful reductions in symptom scores .
eported as multi-point mean decreases on validated scales or significant physiological change.
, which corroborates our observed mean HARS reduction of 3.
82 points.
The concordance and divergence among music-intervention studies can be largely explained by four interrelated moderators: dose .
ession length y frequency y total week.
, musical characteristics .
empo, instrumentation, familiarit.
, study setting .
linical laboratory vs community/primary car.
, and baseline participant status .
everity, comorbidity, coping Meta-analytic evidence indicates a doseAeresponse pattern: studies with more sessions (>.
or longer cumulative exposure report larger effects on anxiety (SMDs increase with session coun.
Tempo and acoustic features are mechanistically relevant AusedativeAy music with slow tempo and narrow dynamic range reliably lowers physiological arousal .
eart rate, blood pressur.
and subjective anxiety, whereas fast or highly variable music does not.
This supports the rationale for using slow-tempo flute pieces (OO60Ae80 bp.
in our protocol.
Cultural familiarity and personal preference further moderate outcomes: familiar or culturally congruent music yields stronger relaxation and greater self-reported benefit than unfamiliar selections, likely via enhanced emotional resonance and memory-linked regulation of affective networks.
Finally, setting and participant baseline explain residual differences interventions delivered in supportive, lowdistraction community settings with high adherence tend to produce larger and more sustained changes than short, single-session laboratory exposures or studies with heterogeneous, clinically severe samples.
These moderating factors, documented across recent systematic reviews and trials, help reconcile why multi-session, culturally appropriate, slow-tempo music interventions .
ike the present flute protoco.
show consistent anxiolytic effects while some shorter, one-off, or culturally mismatched music exposures report smaller or transient benefits.
The observed reduction in anxiety following flute instrumental music relaxation may also be influenced by contextual and psychosocial factors unique to community-based premenopausal populations.
Women in this age group often face a confluence of stressors caregiving demands, occupational pressure, and hormonal fluctuation that amplify vulnerability to anxiety symptoms.
In such settings, the public health center (Puskesma.
provides a familiar, non-stigmatizing environment that enhances psychological safety and engagement with non-pharmacological interventions.
Contextual factors such as group cohesion, cultural alignment of music, and perceived therapist empathy have been shown to significantly increase the therapeutic effect of music relaxation sessions.
In the Indonesian context, flute instrumental music carries cultural resonance associated with serenity and nature, potentially enhancing parasympathetic activation Nuraeni.
Mulyani.
Suptiani (Flute instrumental music relaxation effectively reduces anxiety inA) Jurnal Kesehatan Ibu dan Anak Vol.
No.
November 2024, pp.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
through mechanisms of auditory imagery and mindfulness.
This contrasts with Western clinical trials where music is often standardized without regard to cultural affective Moreover, environmental stability quiet, low-light conditions typical of Puskesmas health education rooms further amplifies the relaxation response by minimizing external stressors.
Additionally, the collective participation structure of the intervention .
onducted in small groups rather than individual session.
may have generated social buffering effects, as peer support and shared experience are known to enhance stress recovery and emotional regulation in midlife women.
These contextual synergies cultural familiarity, social connectedness, and environmental comfort help explain why this study demonstrated a meaningful and sustained decline in anxiety scores, surpassing the magnitude typically observed in more controlled, individual-based laboratory interventions.
The findings of this study carry both practical and theoretical implications for womenAos reproductive health and midlife mental well-being.
From a practical standpoint, the demonstrated reduction in anxiety among premenopausal women reinforces the potential of flute instrumental music relaxation as a feasible, low-cost, and culturally adaptable nonpharmacological intervention for use in primary health care and community settings.
Indonesia, where access to specialized mental health care remains limited at the primary level, integrating structured music relaxation sessions into Puskesmas health promotion programs could enhance preventive strategies for anxiety management and improve the quality of life for perimenopausal.
Theoretically, these results extend existing frameworks on psychophysiological regulation and the biopsychosocial model of anxiety by illustrating how auditory stimuli particularly flute instrumental music activate parasympathetic pathways, lower cortisol levels, and support homeostatic emotional balance during the menopausal transition.
Furthermore, this study underscores the ecological validity of community-based interventions, demonstrating that music-based relaxation does not require clinical infrastructure or advanced technology to be effective.
On a broader level, this research highlights the importance of integrating complementary and integrative therapies within reproductive health frameworks particularly for midlife women navigating psychosocial transitions.
The approach can also serve as a model for health policy innovation, encouraging midwives and primary care nurses to adopt evidence-based relaxation protocols as part of holistic care during premenopause.
By validating the therapeutic value of music through empirical evidence, this study strengthens the scientific foundation for non-pharmacological stress management in womenAos health, potentially reducing dependency on anxiolytic medications and improving long-term well-being Despite demonstrating promising results, this study has several methodological and contextual limitations that should be acknowledged.
First, the use of a one-group pretestAe posttest design without a control or comparison group limits the ability to attribute observed anxiety reduction solely to the flute music intervention.
Other factors such as social interaction, environmental relaxation, or placebo effects may have contributed to the observed improvement.
Second, the relatively short intervention duration .
even consecutive day.
and the absence of follow-up assessments mean that the long-term sustainability of the therapeutic effect remains unknown.
Similar studies have shown that maintenance of anxiety reduction from music therapy can vary depending on intervention duration and participant adherence.
Additionally, all participants were recruited from a single public health center (Mangkubumi.
Tasikmalay.
, which may limit generalizability to other populations with different cultural backgrounds, socioeconomic conditions, or health service Although the flute was culturally compatible in this setting, the emotional resonance of musical instruments can vary across cultural contexts, potentially influencing The study also relied on self-report measures (HARS), which, while standardized, may be subject to bias due to participantsAo awareness of being evaluated.
Nuraeni.
Mulyani.
Suptiani (Flute instrumental music relaxation effectively reduces anxiety inA) Jurnal Kesehatan Ibu dan Anak Vol.
No.
November 2024, pp.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
Future research should therefore adopt more rigorous designs, such as randomized controlled trials with larger and more diverse samples, and include biophysiological indicators .
, heart rate variability, salivary cortiso.
to validate psychological findings.
Longitudinal studies are also needed to examine the persistence of anxiety reduction and to explore doseAeresponse relationships including optimal session frequency, tempo variation, and cultural adaptation of music therapy.
Moreover, comparative trials evaluating different music modalities .
, flute, string, or nature sound.
could help identify the most effective auditory stimuli for midlife women.
Finally, integrating qualitative components such as participant perception and lived experience could provide richer insight into the mechanisms behind therapeutic outcomes and enhance the translation of music relaxation interventions into routine primary care By addressing these limitations, future studies can better establish the evidence base and clinical utility of music-based relaxation as an accessible and sustainable intervention for anxiety management during the premenopausal transition.
CONCLUSION
This study demonstrated that flute-based music relaxation therapy effectively reduced anxiety among premenopausal women, as evidenced by a meaningful decline in mean Hamilton Anxiety Rating Scale (HARS) scores by 3.
82 points following a seven-day intervention in four week.
The findings indicate that structured music exposure can serve as a non-pharmacological, culturally adaptive, and cost-effective strategy to alleviate anxiety symptoms during the menopausal transition.
The results further highlight the psychophysiological and emotional benefits of integrating sound-based relaxation into womenAos health programs.
From a practical standpoint, incorporating flute music sessions in primary healthcare or community midwifery services may enhance emotional well-being, promote stress regulation, and contribute to holistic reproductive health care.
Theoretically, these findings enrich the growing body of evidence on the neurobiological pathways linking auditory stimulation and affective regulation, supporting the use of music therapy as a complementary modality in psychosomatic interventions.
However, to strengthen the generalizability and causal inference of these results, future research should employ randomized controlled designs with larger, more diverse populations and extended follow-up periods.
Further exploration of the mechanisms of action, such as modulation of autonomic responses or neuroendocrine balance, as well as comparative studies of different musical genres or instruments, would deepen understanding of the optimal parameters for therapeutic application.
Overall, the study underscores the potential of culturally sensitive music therapy as a simple yet powerful tool in promoting mental well-being among midlife women.
AUTHOR CREDIT STATEMENT
WM: Conceptualization.
Methodology.
Data Collection.
Formal Analysis.
Writing Ae Original Draft.
Writing Ae Review & Editing.
Visualization.
NM.
LPS: Supervision.
Validation.
FUNDING
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
DECLARATION OF COMPETING INTEREST
There is no conflict of interest.
Nuraeni.
Mulyani.
Suptiani (Flute instrumental music relaxation effectively reduces anxiety inA) Jurnal Kesehatan Ibu dan Anak Vol.
No.
November 2024, pp.
ISSN: 2599-3224 (Onlin.
ISSN: 2302-6014 (Prin.
REFERENCES