A qualitative exploration of the perceptions of music use by healthcare professionals in the operating theatre (the BACH study)

Background music is commonly played in operating theatres and is perceived by many health care professionals (HCP) to reduce stress and fatigue. However, objective psychological and physiological evidence supporting these benefits remains limited, leaving a gap between HCPs’ perceptions and the measured experience. The Background Auditory Conditions in Healthcare (BACH) study aims to qualitatively explore HCPs’ experiences, beliefs and perspectives regarding the use of background music in the operating theatre. Semi-structured interviews were conducted with seven HCPs including surgeons, anaesthetists, and theatre nurses recruited via purposive and snowball sampling between February and November 2024. Data were analysed using qualitative content analysis, with themes developed through open coding, collaborative review, and iterative refinement using a critical realist epistemology. Three surgeons, two anaesthetists, and two nurses from general, vascular, and ENT specialties participated in interviews. Five major themes were identified: (1) Team cohesion reflected in music (2) Music contributes to therapeutic space, (3) Music is not a panacea, (4) Power and protection play out through music and (5) Music as an environmental cue, encompassing nine subthemes. This study highlights the multifaceted role of music in the operating theatre, as perceived by HCPs. While music promoted team cohesion, elevated shared mood and was identified to have therapeutic value for patients and staff, it was also perceived to create or exacerbate interpersonal tension, reinforce hierarchy and disproportionately impact some individuals negatively. Background music also functioned as a situational cue, helping HCPs interpret the immediate OT environment.