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The role of music therapy in the treatment of children with cancer: A systematic review of literature
Abstract
Background
and purpose: Music Therapy has become a consolidated strategy to relief stress in children during hospitalization, and previous research demonstrated its efficacy on individuals’ health. This is a systematic review of literature on the application of music therapy with children and adolescent with cancer, with the aim of evaluating its feasibility and its benefits, in terms of physical and mental health.
Methods
Database search was carried out via PubMed, PsycINFO and SCOPUS, using an age restriction of 0–24 years and the following keywords: (cancer OR oncology) AND music. Search was conducted from inception to June 2020.
Results
From 462 studies retrieved, 19 were selected and included in this research, with 596 participants. They received three different types of music therapy: receptive music therapy (n = 4), active music therapy (n = 9) and the combined method of receptive and active interventions (n = 6). These studies indicated a significant reduction of psychological distress (n = 9) and an increase in well-being (n = 8). 8 articles evaluated the effects on subjective pain and other biological parameters, with inconclusive results.
Conclusion
Music therapy, in paediatric oncology, seems to have a good feasibility and positive effects on mental and physical health. Nevertheless, some critical issues have emerged, such as the heterogeneity of interventions and study designs, which make generalizability still difficult. These and other clinical implications are discussed.
... Pediatric cancer patients often have psychological and emotional burdens that may be overlooked during and following invasive treatments (Facchini & Ruini, 2021). Music therapy interventions may be beneficial as they are shown to have positive emotional and mood regulatory effects. ...
... Results found that musical training is effective in reducing depressive symptoms and enhancing self-esteem in pediatric oncology patients (Cheung et al., 2021). Despite various forms of musical interventions such as receptive music therapy, active music therapy, and combined methods of receptive and active interventions, there are psychological benefits that can enhance the quality of life in pediatric patients undergoing painful treatment procedures (Facchini & Ruini, 2021). Children undergoing different oncologic treatments may have specific goals and needs. ...
... Reports indicated that patients reported a decreased rating in self-reported pain with the addition of music and a reduction in both resting heart rate and respiratory rate during chemotherapy (Thrane, 2013). Additional studies noted improvements in heart rate, respiratory rate, blood pressure, and oxygen saturation following the implementation of music therapy (Facchini & Ruini, 2021). One study reported a reduced value in the high frequency parameter used to establish physiological relaxation measurement (Kemper & McLean, 2008). ...
Aim: This study aimed to analyze articles that discussed the effect of music as adjunctive therapy to traditional treatments of pediatric cancer patients compared to a control of no music therapy. Background: Cancer is a leading cause of death in children, with over 400,000 children diagnosed annually. During standard oncologic treatments, children often experience psychological and physical adverse effects. The use of music therapy can provide numerous supportive benefits to pediatric patients as adjunctive treatment in reducing psychological and physical burdens. Design: This was a systematic review of English-language articles from PubMed. Methods: Nine outcome articles were utilized in this systematic review, including quantitative and qualitative reviews of case studies, interviews, historical accounts, randomized control trials, and other systematic reviews. Results: The study found increased quality of life (QOL) involving dimensions of mood, cognition, relaxation, self-esteem, vitality, and a sense of community involving interpersonal relationships. The implementation of music therapy in pediatric oncology patients decreased stress/distress and pain. Qualitative data suggests QOL dimensions of localization and control of feelings, sense of community involving social roles and ecological health, stress, distress, and pain, improved in pediatric oncology patients receiving music therapy. Conclusion: The literature supports music therapy as a complementary treatment during traditional therapies to help decrease stress and pain in children and improve quality of life and sense of community. Therefore, music therapy as an adjunctive therapy should be implemented into standard practice.
... Music therapy is considered one of the appropriate ways to promote public health. However, the people who are not motivated to get health facilities appropriately, are required to have health facilities in a significant way [9]. The relatable health facilities are appropriate for the public to improve their health standard accordingly. ...
... The public's cultural awareness can be promoted by the knowledge that is relevant to them, and they can develop more effective strategies for practicing sustainability behavior. According to [9], music plays a crucial function in promoting understanding of cultures, and people must concentrate on the cultural objectives that are essential for their improved working methods. Every culture uses music therapy as a therapeutic method frequently, and people appear to enjoy it. ...
Background
Psychological problems are common among the people of every community. These psychological issues are leading people to mental health issues. Human well-being is required to be improved appropriately for the better health of the public. The objective of this research is to determine the influence of music therapy on the sustainable psychological well-being of the Chinese community. Furthermore, this research determines that moderating role of health awareness and strategic health management between music therapy and sustainable psychological well-being.
Method
The research used a sample of 384 collected with a random sampling method. For data collection, a cross-sectional method was adopted to collect data on a Likert scale questionnaire. The Health Awareness Scale, Music Therapy Scale, Sustainable Health Management Scale and Sustainable Psychological Wellbeing Scale was used in this research.
Results
The findings of the research highlighted that there is a significant and positive influence of music therapy on the sustainable psychological well-being of the Chinese community. This research also concluded that there is a significant and positive moderating role of health awareness and strategic health management between music therapy and sustainable psychological well-being. The findings of this research are new and novel in the literature on psychological well-being.
Conclusion
This research has some theoretical and practical implications to advance the literature and practice for sustainable psychological well-being respectively. In clinical practice, music therapy can be effectively used to improve the psychological well-being of individuals with sustainability. The information related to health awareness and practice for strategic health management is also necessary for the clinical patients to improve their psychological well-being.
... A cancer diagnosis has significant physical and psychological consequences and presents an existential challenge for patients, their families, and the healthcare professionals involved [1][2][3][4][5]. This is especially true for pediatric cancers whose diagnosis at a young age often evokes profound emotional and psychological responses, potentially resulting in the development of trauma and psychosomatic symptoms [6]. ...
... Among them, Music Therapy (MT) represents a non-pharmacological, art-based approach that uses music experiences within a therapeutic relationship to address clients' physical, emotional, cognitive, and social needs [7]. An essential element of all types of MT intervention is the sound-music synergy, which aims at enhancing the expressive abilities and resources of each patient [2,3,5]. This approach has been shown to have a profound impact on patients' well-being, offering relief from physical and psychological symptoms [8,9]. ...
Background: Musicotherapy (MT) is a non-pharmacological, art-based intervention that employs music experiences within a therapeutic alliance to attend to clients’ physical, emotional, cognitive, and social requirements. This is the first study aiming at investigating the impact of MT on the psychological facets of children suffering from cancer. Methods: The study, combining the AQR and m-YPAS assessment tools, evaluated behavioral, sound–musical, and interactive parameters in pediatric oncology patients undergoing MT sessions during hospitalization. Fifty patients admitted to the Paediatric Oncology and Haematology Unit at Policlinico S. Orsola Hospital in Bologna, Italy, were enrolled, irrespective of their treatment regimen. Data collection occurred on the first day of the MT session between 3 p.m. and 5 p.m., with observations conducted by independent observers. In addition to traditional statistical analysis, network analysis was used to explore the combined interactions of all parameters, effectively discerning the distinctive roles played by each one during therapy sessions and their influence on all others. Results: Network analysis highlighted distinct patterns of interactions among parameters during the various sessions, emphasizing the role of positive emotions and a calm setting, the child’s ability to take the initiative in sessions, their sense of agency, and the parent’s role in guiding them. Significant differences were recorded at each time point between all variables considered. Conclusions: The results of this innovative study may pave the way for future multicenter studies aimed at further exploring the role of MT in children undergoing both curative and palliative treatments for cancer.
... Some scientific studies with children and adolescents in the field of oncology have also confirmed that the application of MT benefits patient quality of life (Fedhila et al., 2023;González-Martín-Moreno et al., 2021). For example, publications examining its effect on clinical factors have shown that, among other benefits, it can increase patient relaxation (Facchini & Ruini, 2021;Sepúlveda-Vildósola et al., 2014) and reduce preoperative anxiety (Giordano et al., 2020) and pain, with MT even being useful as a means of support for painful tests such as lumbar puncture and biopsies. Other studies have revealed that MT can improve physiological outcomes in these same patients. ...
... Thus, MT could help generate positive emotions, and could constructively impact their wellbeing and state of mind (Uggla et al., 2018;Wong et al., 2021). This aspect has also been considered by some recent reviews on this topic (Facchini & Ruini, 2021;Rodríguez-Rodríguez et al., 2022) which argue that MT is an important component in critical health situations such as the care of children and adolescents with cancer. These authors reported that MT allowed their patients to express their emotions, thereby helping to improve their personal autonomy and promote self-knowledge. ...
... For example, functional neuroimaging studies of music and emotion have shown that music can modulate activity in brain structures known to be crucially involved in emotion such as the amygdala, hypothalamus, hippocampus, insula, nucleus accumbens, orbitofrontal cortex, and cingulate cortex [13]. Given the efectiveness of MT, other studies have shown how it helps reduce anxiety in children with cancer, both when undergoing painful procedures and during the process of their disease [14][15][16][17], as well as during radiotherapy [18] and chemotherapy treatments [19,20]. ...
... In addition, research that evaluated physiological parameters showed a reduction in heart rate [27]. Nonetheless, still very few studies have addressed the efects of MT on the expression of emotions in children with cancer [14,17]. ...
Background. Children with cancer are subjected to aggressive tests and treatments that can affect their emotional states. Studies available in the academic literature analyse the effect of music therapy on the emotions of these patients are scarce. Objectives. The objective of this study was to explore and transform the emotional responses that may arise with the application of music therapy (MT) in children with oncological pathology. Methods. The methodology of this study was based on the participatory action research approach. Semistructured interviews were conducted with 27 children with cancer who participated in 65MT sessions. Interviews were also conducted with their families. Results. We conducted a thematic analysis using MAXQDA software. Three main categories emerged from this process as follows: (1) expression: children with cancer stated that MT made it easier for them to express their emotions, with indirect benefits to families; (2) participation: patients showed interest in the sessions; and (3) experiences: MT was valued and created a positive environment. The results of this research demonstrate the positive transformative power MT had on children with cancer in terms of their emotions. Conclusions. Positive results were achieved through MT that encouraged the expression of emotions by children with cancer and favoured and improved their moods. In addition, it also encouraged social interactions in the hospital and helped the children to better cope with their illness through self-awareness. Their families also benefited. Therefore, we encourage healthcare professionals to support the use of MT in paediatric oncology settings.
... Standard medical care is increasingly supplemented by the use of different psychological and psychosocial complementary interventions, with the aim of alleviating the negative effect of cancer and its treatment process [3][4][5]. ...
... Music therapy (MT), differently by other music-based approaches used in health ( Fig. 1), has received increasing attention in the last few years [3]. ...
Unlabelled:
Music therapy (MT) is a complementary therapy offered to children, young adults, and their families in pediatric oncology and palliative care. We performed a survey to collect information about MT in pediatric oncology in Italy. The outbreak of COVID-19 unavoidably changed the scenario of MT, suggesting some considerations presented in this survey. 27/32 (84.4%) centers belonging to the Infections and Supportive Therapy Working Group of Association of Pediatric Hematology and Oncology (AEIOP) completed in 2 different time points (T1 and T2) an online survey on MT, before and after COVID-19 pandemia. Different kinds of music approach were used taking care of patients in 21/27 centers, while in 14/21 (66%), a specific project of MT conducted by a music therapist was present. In 6/14 centers, MT activities were delivered for < 3 h/week, in 3 centers for > 3 and < 10 h/week, and in the remaining 5 for > 3 h/week. MT sessions were in different areas, day hospital, or ward (patient rooms, operating rooms, waiting rooms), on an individual basis or by groups. Patients were invited to MT by psychologists, caring physician, or nurse, or on equipé decision. MT was evaluated with tools self-made by music therapist in 11/14 centers. After COVID-19, MT has been withdrawn in 3 centers, sessions in the waiting rooms were reduced, individual sessions were preferred, and enrollment by multidisciplinary teams increased.
Conclusion:
This survey represents the starting platform to compare and discuss different experience of MT in AIEOP centers, to implement MT in pediatric oncology for a more qualified assistance to patients, and to improve quality of care.
What is known:
• Music therapy in pediatric oncology and palliative care can be used for the management and prevention of various somatic and psychological symptoms of patients and often is provided to children together with their families. • In Italy the application of Music therapy in the AIEOP pediatric oncology centers is constantly increasing, but due to the outbreak of Covid-19 Pandemic, Italian pediatric oncology departments were obliged to adopt restrictive measures.
What is new:
• Although the majority of Centres did not abrogate MT interventions, judgment about limitation should be carefully taken since MT helps children and even more adolescents in their fight against cancer. • The best practice of Music therapy in pediatric oncology requires communication and collaboration among qualified music therapists and multidisciplinary care team, using a model of family-centered care that actively involves parents/ caregivers in assessment, treatment planning, and care delivery.
... MT interventions can also help the families of paediatric oncology patients [30,32]. Indeed, recent systematic reviews on the use of MT with children and adolescents with cancer [33][34][35] have shown that most studies have had positive effects on physiological, psychological, social, and physical parameters in these patients, which in turn has improved their wellbeing. However, these reviews also refer to the heterogeneity and flaws in the study designs of the MT interventions completed to date. ...
... As indicated by previous systematic reviews [33,34], our review showed that, due to the wide range of methodological designs used, and the heterogeneity of the MT sessions employed and patient ages, etc., it is not easy to reach general, overall conclusions about the effect of MT. However, several studies have shown that MT can significantly reduce anxiety [46,47,[49][50][51][52]60] in paediatric cancer patients. ...
Background
Music therapy is an emerging and useful methodology to improve the quality of life of children and adolescents with cancer.
Objectives
The objective of this scoping review was to examine the available literature and offer an analysis of the relevance of music therapy in paediatric oncology. We considered the effects of music therapy on children and adolescents with cancer as well as the perception of this population, their families, music therapists, and health professionals regarding the music therapy sessions conducted. Finally, we analysed the characteristics of the distinct types of music therapy interventions reported in the literature.
Methods
In this review, we applied the methodology proposed by Arksey and O’Malley. After performing a comprehensive academic literature database search, 522 articles were identified of which, 27 met the inclusion criteria.
Results
The results shed light on the use of music therapy as a means to facilitate self-esteem, to improve the physical, emotional, and cognitive aspects related to disease and, to a lesser extent, alleviate their physiological symptoms. Both children and adolescents with cancer were represented in the academic literature. The most prevalent findings described in these studies were the benefits of music therapy in terms of improved psychological well-being and social relationships in this population.
Conclusions
Music therapy interventions are generally well received, not only by children and adolescents with cancer, but also by their families, music therapists, and health professionals. Nevertheless, several gaps were identified in some of the studies we considered, including a lack of specificity regarding the results obtained or music therapy intervention methods used.
... More than half of the respondents in a study reported serving in high acuity areas such as the pediatric intensive care, hematology/oncology, or neonatal intensive care units [5]. Music therapy has become a consolidated strategy to relieve stress in children during hospitalization, and previous research demonstrated its efficacy on individuals' health [6]. Improvisational musical activity with therapeutic objectives and outcomes has been found to facilitate motivation, communication skills and social interaction, as well as sustaining and developing attention [7]. ...
... Music interventions in people with cancer can have positive effects on anxiety, pain, mood, and quality of life, but have little impact on heart rate, respiratory rate, and blood pressure [27]. Music therapy, in pediatric oncology, seems to have a good feasibility and positive effects on mental and physical health [6]. There are also positive effects of music therapy with female patients with breast cancer. ...
Background:
Recent research found evidence supporting music therapy for hospitalized children with chronic diseases. The aim of this study was to investigate the effect of music therapy on hospitalized children's vital signs.
Methods:
In this prospective study, children with chronic gastroenterological and nephrological diseases received active or receptive music therapy two to four times a week until discharge from hospital at the pediatric special care unit (SCU) and pediatric intensive care unit (ICU). Baseline and post-therapy heart rate, oxygen saturation and blood pressure were recorded and analyzed as control values at three points on the same day when the children were alone in their patient room at rest.
Results:
A total of 83 children, median 3 age of years (range one month to eighteen years) received music therapy. In total, 377 music therapy sessions were treated: 200 receptive therapy (78 ICU, 122 SCU) and 177 with active therapy (0 ICU, 177 SCU). Music therapy interventions showed changes in vital signs during music therapy sessions. After music therapy, heart rates decreased by 18 beats per minute (95% confidence interval (CI), -19.4 to (-16.8)), oxygen saturation increased by 2.3% (95% CI, 2.2 to 2.5), systolic blood pressure decreased by 9.2 (95% CI, -10.6 to -7.7) and diastolic blood pressure decreased by 7.9 (95% CI, -9.6 to -6.3). When music therapy was applied at the SCU (ICU), heart rates significantly reduced by 17.9 (18.9) beats per min, oxygen saturation increased by 2.4% (2.1%) and blood pressure reduced by 9.2 (2.8) mmHg (systolic) and 7.9 (0.3) mmHg (diastolic). Almost all control values were better than directly before the intervention. However, after music therapy intervention, the children showed better values in vital signs compared to being alone in their patient room.
Conclusion:
Music therapy is an added value for children with kidney and liver/gastrointestinal diseases during their hospital stay.
... Music therapy is prominent in all passive distraction therapies because its effects and benefits have been identified and documented in many research studies, reviews, and report guidelines ( DeLoach Walworth, 2005 ;Facchini & Ruini, 2021 ;Standley & Walworth, 2003 ). A systematic review found a positive effect of music therapy on pain reduction and physiologic parameters in children with cancer ( Facchini & Ruini, 2021 ). ...
... Music therapy is prominent in all passive distraction therapies because its effects and benefits have been identified and documented in many research studies, reviews, and report guidelines ( DeLoach Walworth, 2005 ;Facchini & Ruini, 2021 ;Standley & Walworth, 2003 ). A systematic review found a positive effect of music therapy on pain reduction and physiologic parameters in children with cancer ( Facchini & Ruini, 2021 ). Currently, innovative techniques are being used in new digital applications, not only in society at large but also in the healthcare system, to develop new distraction methods, including VR. VR has been identified as "a relatively new medium of human-computer interactions whereby a human becomes an active participant in a virtual world" ( Gershon et al., 2004( Gershon et al., , p. 1243. ...
Background
Distraction is a known behavioral intervention that is widely used for pain management in the pediatric population. However, there is a shortage of reviews reporting the efficacy of distraction for procedural pain reduction in pediatric oncology settings.
Aim
To determine the current evidence on the effects of distraction on procedural pain in children with cancer.
Design
This systematic review and meta-analysis was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
Settings
Six different databases from 1990 to June 2019.
Method
A literature search was conducted to identify the effects of distraction on procedural pain reduction in children with cancer. A meta-analysis was undertaken along with applying a mixed effect model to quantify the standardized mean difference in the 95% confidence interval (CI) as the overall effects.
Results
Ten randomized controlled trials were included. Distraction during an invasive procedure had a large effect on pain intensity (–0.92, 95% CI –1.48 to –0.36, p = .001) and on needle insertion as well (–1.12, 95% CI –1.52 to –0.72, p = .000), but only a moderate effect on lumbar puncture procedures (-0.57, 95% CI -1.02 to -0.12, p = .012). Uncertain effects on pain relief showed up in a virtual reality (VR) distraction (-0.93, 95% CI -2.63 to 0.76, p = .28) and during active distraction (-0.72, 95% CI -1.48 to 0.03, p = .06).
Conclusions
Distraction is an efficacious intervention to reduce procedural pain during needle insertion or lumbar puncture procedures in children with cancer. However, the efficacy of active distraction and VR remain uncertain. Future research should focus on specific comparisons of different forms of distractions with larger sample sizes.
... Apart from the basic functionality of music, which includes chanting our positive and negative experiences within our inner and outer circle, inspiring or motivating us to take action, and arriving at didactic conclusions, it could also serve therapeutic functions, as highlighted in previous studies [1][2][3][4][5][6][7][8][9]. Also, in a bid to achieve the didactic effect and show lyrical creativity, some musicians make use of metaphor-filled lyrics. ...
This paper examines the therapeutic potential of twenty-first century music as a means of supplementary therapeutic care for cancer survivorship. It presents a study of songs by Rihanna, Beyoncé, Adele, Coldplay, and Imagine Dragons, which combines the analysis of relevant music features and conceptual metaphors in the lyrics to examine the effect of the songs on the audience. The main aim of this study was to highlight the emotional and cognitive impact of these songs on listeners and identify their potential role in improving the psychological condition of patients with cancer who are downtrodden or reeling from the pain of surgery, chemotherapy, and side effects of treatment. This article adopts the conceptual metaphorical framework proposed by Lakoff and Johnson (1980) and the metaphor identification procedure (MIP) (Pragglejazz group, 2007) to examine the targeted use of metaphors features in the lyrics of the selected songs. The findings show that although there is a therapeutic potential associated with the songs analyzed, there are also potential risks for patients with cancer. “”.
... On the other hand, hospitals can provide an appropriate environment for music-based interventions: positive effects on mental and physical health can be achieved by encouraging patients to participate in interactive activities or simply by letting them enjoy music performed live on the premises (Facchini & Ruini, 2021). The findings of a Singing Medicine project in a children's hospital showed that participation in such an 'arts-in-health' initiative was associated with benefits for children who suffered from long-term conditions, as well as for their families: specifically, a reduction in negative emotions along with the achievement of enhanced well-being through distraction and the sharing of positive experiences (Blackburn, 2020). ...
Service-learning methodology seeks to achieve a balance between academic learning and the application of the acquired knowledge for the benefit of the community. Our study aims to assess the academic and personal development of the students who participated in the educational experience and identify the benefits it brought to the attended children. The total of 73 participants involved: a) university students of a faculty of education, b) hospitalized children and their families, c) a healthcare worker, and d) several volunteers. We conducted a case study featuring qualitative analysis (based on discussion groups, interviews, and daily narratives), analysis of co-occurrence, and data triangulation. The categories we obtained were related to learning achieved by university students, their personal growth, and the impact of hospital service on the different agents who participated in the experience. Findings suggest that service-learning, along with the positive emotional impact of experiential music learning, was associated with student progress in teacher training and personal development.
... Musikkterapi med denne gruppa kan nyttast for å skape meining, trygg atmosfaere og tilknytting (Carruthers, 2014), og klientar rapporterer at dei kjenner seg trøsta, oppløfta, avslappa og styrka (Patterson et al., 2015). Musikkterapi (Facchini & Ruini, 2021), samtidig som det kan bidra til å styrke bandet mellom barn og foreldre i ein krevande livssituasjon (Loewy, 2011). I skulen kan musikkterapeutisk tilnaerming bidra til at barn med laereutfordringar eller vanskar knytta til emosjonar og atferd kan oppleve meistring, glede og vekst (Brackley, 2012;Derrington, 2012;Uhlig et al., 2018). ...
Denne artikkelen er ein del av eit pågåande ph.d.-prosjekt om forventningar til musikkterapi. Gjennom intervju av musikkterapeutar, samarbeidspartnarar og leiarar vert det utforska kva forventningar som fins til musikkterapi på dette feltet. Å drøfte og synleggjere forventningar er eit avgjerande utgangspunkt for å sikre at tilbod og etterspurnad samsvarer. Denne artikkelen spør: Korleis skildrar musikkterapeutar forventningar til musikkterapi som dei møter i sitt arbeid med barn og unge i utsatte livssituasjonar? Det empiriske materialet inkluderer intervju med tre fokusgrupper med 14 musikkterapeutar og ein dramaterapeut. Ei tematisk analyse av intervjua viser at informantane møter både utopisk høge forventningar, motstand og vegring mot terapi, samt håpet om ei betre framtid. Informantane fortel at dei aktivt justerer desse forventningane i møtet med menneske dei samarbeider med på feltet, samt at dei er opptekne av å ivareta håpet.
... Una review specifica in campo pediatrico è stata pubblicata nel 2021 (Facchini and Ruini, 2021). ...
The research strands of recent decades show how music has an impact
on various medical specialties. The scientific corpus is very broad and includes
randomized clinical trials, mixed methods, and mechanistic research
in the field of neuroscience examining psychosocial and physiological responses
to specific musical interventions. The literature has shown how different
musical techniques can be used with benefit in various clinical settings, e.g.
in cancer and postoperative pain, during labor and delivery, and in all
situations where it is appropriate to counter depression and anxiety including
end-of-life and bereavement. In addition to being a life companion for
well-being and longevity, music has assumed an important therapeutic role
in dementia, neurological rehabilitation, and in childhood neuropsychiatric
illnesses such as autism and schizophrenia. Involvement in music also plays a
key role in building social bonds between individuals and groups, which
in turn, promote health and well-being.
... 5,6 It is increasingly used as an INPT during pediatric oncological treatments 7,8 for the management and prevention of various somatic and psychological symptoms displayed by these patients. 9,10 MT is a component of clinical practice guidelines by the American Pain Society, the American Society of Regional Anesthesia, 11 and the Society for Clinical Oncology 12 for pain and anxiety mitigation. ...
... Play therapy involves a dynamic and interactive connection between the therapist and the child during the game sessions. This therapeutic approach aims to establish a secure and nurturing environment for the child, enabling them to explore and address their emotional challenges through play [5]. Throughout the therapeutic relationship, the child undergoes a decrease in distressing symptoms, a shift in impulsive behaviors, a sense of being understood, emotional release, and a revised emotional understanding. ...
Cancer poses a significant challenge to public health worldwide and ranks as the second most common cause of death in children. Approximately 300,000 cases of cancer are diagnosed among children aged 0 to 19 every year [1]. The incidence of childhood cancer is increasing all over the world. A cancer diagnosis can cause serious psychological problems because cancer and admission to the hospital increase the feeling of pain, anxiety, and fear of death [2]. Children diagnosed with cancer often experience severe and persistent anxiety, which can have long-term effects on their well-being. The stress of being hospitalized, coupled with the limited understanding of their illness by medical professionals, the lack of effective coping strategies, and the pain resulting from invasive procedures and treatment regimens, all contribute to the anxiety experienced by these young patients [3]. Intense anxiety has the potential to impede the progression of treatment, heighten susceptibility to infections, and protract the recovery period, ultimately impacting the efficacy of cancer therapy and diminishing patient contentment [4]. Among the psychological interventions that can affect and reduce the psychological symptoms of physical diseases, we can mention play therapy.
... 18 Music therapy has become a standard palliative care service in many pediatric hospitals, with a growing body of research that supports the use of active music making interventions to reduce distress and improve well-being in young children with cancer. [19][20][21][22] However, few studies have evaluated the mechanisms by which music therapy interventions work, limiting the evidence available to inform clinical decision making and evidence-based care. [23][24][25][26] Based on Robb et al's Contextual Support Model of Music Therapy (CSM-MT), we developed and tested the music-therapist led Active Music Engagement (AME) intervention, establishing it as a feasible/acceptable intervention that reduces distress-related behaviors in young children hospitalized for cancer treatment. ...
Objective
This trial examined the effects of proximal/distal mediators and moderators of an Active Music Engagement (AME) intervention on young child/parent distress, quality of life, and family function outcomes.
Methods
Child/parent dyads (n = 125) were randomized to AME or Audio-storybooks attention control condition. Each group received 3 sessions with a credentialed music therapist for 3 consecutive days with data collection at baseline, post-intervention (T2), and 30-days later (T3). Potential proximal mediators included within session child and parent engagement. Potential distal mediators included changes in perceived family normalcy, parent self-efficacy, and independent use of play materials. Potential moderators included parent/child distress with prior hospitalizations, parent traumatic stress screener (PCL-6), and child age. Outcomes included child emotional distress and quality of life; parent emotion, traumatic stress symptoms (IES-R), well-being; and family function. Mediation effects were estimated using ANCOVA, with indirect effects estimated using the percentile bootstrap approach. Moderation effects were tested by including appropriate interaction terms in models.
Results
No significant mediation effects were observed. Child distress with prior hospitalizations moderated AME effects for IES-R intrusion subscale scores at T2 (P = .01) and avoidance subscale scores at T3 (P = .007). Traumatic stress screener scores (PCL-6) moderated intervention effects for IES-R hyperarousal subscale scores at T2 (P = .01). There were no moderation effects for child age.
Conclusions
AME is a promising intervention for mitigating traumatic stress symptoms and supporting well-being in parents of children with cancer, particularly for parents who screen high for traumatic stress and whose children are more highly distressed with hospitalization.
... Além da diversidade de situações em que a musicoterapia pode ser aplicada com efeitos benéficos para o indivíduo, pode ser usada no tratamento de pacientes de todas as idades, recémnascidos, crianças, adolescentes, adultos e idosos (4)(5)(6)(7) . ...
Objective
To map scientific knowledge about the use of percussion instruments in music therapy in individuals over 18 years of age in the health context.
Method
Scope review with search strategy implemented in September 2021, in 13 databases, using indexed descriptors and keywords. Studies on the use of membranophones for care of people over 18 years of age were included. Studies with the participation of pregnant women, psychiatric patients (schizophrenia, psychosis, addiction), or people with hearing impairment, and journal editorials were excluded. The selection process was carried out by two independent researchers.
Results
Thirteen studies were included and the results showed that the membranophones have a positive impact on the physical, psychological, and social health of people in different care environments, and allow them to repeat rhythmic patterns and play music. Active music therapy was the strategy predominantly used in interventions, and the most used membranophone was the djembe.
Conclusion
The results suggest that music therapy with membranophones proved to be a viable intervention with beneficial results in improving physical, psychological, and social health of people over 18 years of age.
DESCRIPTORS
Complementary Therapies; Acoustic Stimulation; Music Therapy; Nursing; Review Literature as Topic
... Besides the diversity of situations in which music therapy can be applied with beneficial effects for the individual, it can be used in the treatment of patients of all ages: newborns, children, adolescents, adults, and the elderly (4)(5)(6)(7) . ...
Objective:
To map scientific knowledge about the use of percussion instruments in music therapy in individuals over 18 years of age in the health context.
Method:
Scope review with search strategy implemented in September 2021, in 13 databases, using indexed descriptors and keywords. Studies on the use of membranophones for care of people over 18 years of age were included. Studies with the participation of pregnant women, psychiatric patients (schizophrenia, psychosis, addiction), or people with hearing impairment, and journal editorials were excluded. The selection process was carried out by two independent researchers.
Results:
Thirteen studies were included and the results showed that the membranophones have a positive impact on the physical, psychological, and social health of people in different care environments, and allow them to repeat rhythmic patterns and play music. Active music therapy was the strategy predominantly used in interventions, and the most used membranophone was the djembe.
Conclusion:
The results suggest that music therapy with membranophones proved to be a viable intervention with beneficial results in improving physical, psychological, and social health of people over 18 years of age.
... Meaningful engagement with pediatric patients in projects can support the patients' development during their hospital stay [17]. The presence of a parent; interventions such as art therapy, music therapy, sports therapy, and physiotherapy; and visits from the psychosocial service, the hospital school, and clinic clowns can promote psychological health during hospital treatment [18][19][20][21]. Music therapy, a clinical and evidence-based use of music interventions to accomplish individualized aims within a therapeutic relationship [22], can be used to promote children's and parents' psychological wellbeing during their hospitalization [23]. ...
Chronic disease in a child, with the associated hospital stays, places considerable demands on the child and their family. The aim of this study was to investigate the parents’ perceptions of the music therapy used with their child during a hospital stay and to determine whether they felt that it reduced the child’s anxiety and stress generated by hospital admission. We hypothesized that the use of live music therapy from a music therapist would positively support these patients in everyday clinical practice, promote their wellbeing, and have positive impacts on their vital signs and blood pressure. Children with chronic gastroenterological and nephrological diseases included in this prospective study received live music therapy with a median duration of 41 min (range from 12 to 70 min) two to four times per week until discharged from the hospital. At the time of discharge, the parents were asked to complete a Likert-style questionnaire to evaluate the music therapy. Seven items were related to general questions about the patients and sessions, and eleven items evaluated the personal perceptions of the parents. Music therapy was conducted in 83 children, with a median age of 3 years (range from 1 month to 18 years). All parents (100%) completed the questionnaire at the time of discharge. Seventy-nine percent of the parents stated that their children were able to enjoy the music therapy sessions without being stressed. In addition, 98% of the respondents said that they were grateful for the music therapy their children received (97% fully agreed and 1% rather agreed). All parents considered music therapy to be beneficial for their child. The parents’ responses reflected the view that music therapy is beneficial to patients. According to the parents, music therapy can be integrated effectively in the inpatient clinical setting and can support children with chronic illnesses during their hospital stay.
... In a study about attitudes of pediatric oncologists, it is reported that only 41% of the oncologists raise the topic of CAM during the first consultation [55]. The same study [55] also reports that over 70% of the pediatric oncologists [15,16,[57][58][59], massage [12], aromatherapy [60], healing [61], music [62], play therapy [63], and psychodrama [64] have beneficial outcomes in children [17,65]. In general, we found that supportive care modalities are used to provide comfort and control to the patients and parents; this is in line with other studies [66][67][68]. ...
Background
The aim of this study is to gain insight into the clinical experiences and perceptions that pediatric oncology experts, conventional healthcare providers, and complementary and alternative medicine (CAM) providers in Norway, Canada, Germany, the Netherlands, and the United States have with the use of supportive care, including CAM among children and adolescents with cancer.
Methods
A qualitative study was conducted using semi-structured in-depth interviews (n = 22) with healthcare providers with clinical experience working with CAM and/or other supportive care among children and adolescents with cancer from five different countries. Participants were recruited through professional associations and personal networks. Systematic content analysis was used to delineate the main themes. The analysis resulted in three themes and six subthemes.
Results
Most participants had over 10 years of professional practice. They mostly treated children and adolescents with leukemia who suffered from adverse effects of cancer treatment, such as nausea and poor appetite. Their priorities were to identify the parents' treatment goals and help the children with their daily complaints. Some modalities frequently used were acupuncture, massage, music, and play therapy. Parents received information about supplements and diets in line with their treatment philosophies. They received education from the providers to mitigate symptoms and improve the well-being of the child.
Conclusions
Clinical experiences of pediatric oncology experts, conventional health care providers, and CAM providers give an understanding of how supportive care modalities, including CAM, are perceived in the field and how they can be implemented as adaptational tools to manage adverse effects and to improve the quality of life of children diagnosed with cancer and the families.
... [44] The results of the present review support the positive role of art therapy in improving psychological variables and improving the quality of life of children, which is consistent with the Facchini and Ruini review study that showed that music therapy can improve the feeling of well-being and psychological consequences in this group of patients. [45] The results of the research showed that most of the studies have been done on adults with cancer, which also support the positive role of art therapy in adults with cancer and believe that art therapy can have psychological consequences [46,47] and fatigue [46,48] and improve the quality of life of these people. [46,48] Since it is difficult for children to express feelings and emotions, [49] art, as one of the oldest means of communication, [50] helps to express feelings and conflicts, [51] so it has been effective in reducing psychological problems in adults and children. ...
Background:
The integration of art therapy in health care is a growing trend in the care of cancer patients. Therefore, this study aimed to identify the physical and mental benefits of art in children with cancer.
Materials and methods:
A systematic review of English articles using Google Scholar, MEDLINE via PubMed, Scopus, the Cochrane Database of Systematic Reviews, and the Web of Science was conducted. Relevant keywords for cancer, child, art therapy and their synonyms were used accordingly. All searches were conducted to December 31, 2021.Relevant articles were included studies published in English and involving children aged 0-18 years. Studies evaluated the effects of art therapy in children with cancer.
Results:
Seventeen studies had inclusion criteria, of which 12 studies were performed by clinical trial and 5 studies were performed by quasi-experimental method. Sixteen studies evaluated one type of art-therapy intervention, while one study used a combination of art-therapy approaches.The results showed that art-based interventions in the physical dimension lead to more physical activity, stability in breathing, and heart rate, and these children reported less pain. In the dimensions of psychology had less anxiety, depression, and anger but at the same time had a better quality of life and more coping-related behaviors.
Conclusion:
It seems that the use of art therapy in pediatric palliative care with cancer can have good physical and psychological results for the child, but it is suggested to evaluate the effects of these interventions in children at the end of life.
... Research in the past years has focused on the development of effective active and passive distraction methods for pain and anxiety management in children and adolescents, which may easily be integrated into medical and nursing care [18]. Specifically, in oncological settings, these distraction methods include the use of music, massage, breathing exercises, hypnosis, and behavioral therapy [4,[19][20][21][22]. However, distraction interventions are often poorly implemented because they are time-consuming and require adequate training. ...
Simple Summary
Pediatric patients with cancer are often subjected to several invasive procedures and treatments, which may determine pain and induce feelings of anxiety and worry. Inadequate management of pain and anxiety can affect the overall quality of life, affecting the physical and psychological well-being of children and their caregivers. The aim of this systematic review is to summarize the findings of published experimental and quasi-experimental studies on the effectiveness of virtual reality for the management of pain and/or anxiety in children and adolescents with cancer.
Abstract
Invasive and painful procedures, which often induce feelings of anxiety, are necessary components of pediatric cancer treatment, and adequate pain and anxiety management during these treatments is of pivotal importance. In this context, it is widely recognized that a holistic approach, including pharmacological and non-pharmacological modalities, such as distraction techniques, should be the standard of care. Recent evidence suggested the use of virtual reality (VR) as an effective non-pharmacological intervention in pediatrics. Therefore, this systematic review aims to analyze previously published studies on the effectiveness of VR for the management of pain and/or anxiety in children and adolescents with hematological or solid cancer. Medline, SCOPUS, Web of Science, ProQuest, CINAHL, and The Cochrane Central Register of Controlled Trials were used to search for relevant studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Randomized controlled trial, crossover trial, cluster randomized trial, and quasi-experimental studies were included. Thirteen studies, published between 1999 and 2022, that fulfilled the inclusion criteria were included. Regarding the primary outcomes measured, pain was considered in five studies, anxiety in three studies, and the remaining five studies analyzed the effectiveness of VR for both pain and anxiety reduction. Our findings suggested a beneficial effect of VR during painful vascular access procedures. Limited data are available on the reduction of anxiety in children with cancer.
... This multi-faceted nature of music and music therapy allows it to address patients' psychosocial, emotional, and physical needs [38,39]. Previous music therapy studies indicate it helps to reduce anxiety, depression, distress, pain, fatigue, and fosters a relaxation response in reducing heart and respiratory rates [21,[40][41][42][43][44][45][46][47][48][49][50]. Further, music therapy helps to promote supportive relationships, enables patients to engage in self-care, inspires playfulness and creativity, and fosters a sense of agency, control, and hope during the BMT process [16,22,[51][52][53]. ...
(1) Background: Bone marrow transplant (BMT) is an aggressive and complex medical treatment for children with certain types of cancer and other diseases. The transplant process entails replacing the patient’s diseased bone marrow with the healthy marrow of a donor. During the course of treatment, patients are isolated in their room to reduce the risk of infection. Patient’s experience a variety of symptoms and side effects during the process including nausea, vomiting, diarrhea, mouth sores, fatigue, pain, discomfort, extreme muscle weakness, and emotional distress. Children often need a parent or caregiver present with them at all times throughout treatment. This process can cause significant stress and anxiety for the patient and their family. (2) Methods: This study explored the feasibility and acceptability of a patient and family directed active music making protocol during the BMT process. Ten patients, their parents, and family members participated in the study during the course of the BMT. (3) Results: Participants reported engaging in active music making 3–4 times per week and completed 121 journal forms reporting their music making experiences. They indicated using active music making to manage pain, discomfort, stress, anxiety, and boredom, foster relaxation and sleep, for enjoyment, and as a way to connect. (4) Conclusions: Patients, parents and family members reported feeling a sense of empowerment when engaged in making music to support their child or loved one.
... Dikkati başka yöne çekmek ve hayal gücünü artırmak amacıyla sanat terapisi ve müzik temelli uygulamaların hemşire ve hekimlerin sunduğu hizmetlere entegre edilebileceği vurgulanmıştır. [21][22][23][24] Yapılan çalışmalar incelendiğinde, kanser tanısı ile tedavi edilen adölesanlara uygulanan terapötik müzik uygulamasının başa çıkma, sosyal uyum ŞEKİL 1: Müzik temelli uygulamaların pediatri hastalarında kullanım örnekleri ve etkileri. ...
... This is in line with other studies that found art and music therapy beneficial for children with cancer. [26][27][28][78][79][80][81][82][83] Acupuncture was used in 2 studies 40,43 included in this review. Existing acupuncture literature among children 84 and adults 85,86 with cancer is consistent with the findings of this review. ...
Background:
Complementary and Alternative Medicine (CAM) is widely used around the world to treat adverse effects derived from cancer treatment among children and young adults. Parents often seek CAM to restore and maintain the child's physical and emotional condition during and after cancer treatment.
Objectives:
The objectives of this review were (i) to identify literature that investigates CAM use for treating adverse effects of conventional cancer treatment, (ii) to investigate the safety of the included CAM modalities, and (iii) to evaluate the quality of included studies.
Methods:
Five scientific research databases were used to identify observational, quasi-experimental, and qualitative studies from January 1990 to May 2021. Included studies investigated the use of CAM to treat adverse effects of cancer treatment in childhood cancer.
Results:
Fifteen studies were included in this review. Ten quasi-experimental, 3 observational studies (longitudinal/prospective), 2 qualitative studies, and 1 study with a quasi-experimental and qualitative arm were identified. Less than half (n = 6; 40%) of the studies included reported adverse effects for the CAM modality being studied. Among the studies that reported adverse effects, they were mostly considered as direct risk, as 13% reported mainly bleeding and bruising upon acupuncture treatment, and dizziness with yoga treatment. All adverse effects were assessed as minor and transient. CAM modalities identified for treating adverse effects of cancer treatment were alternative medical systems, manipulative and body-based therapies, biologically-based therapies, and mind-body therapies. CAM modalities were used to alleviate anxiety, pain, toxicity, prevent trauma, and improve health-related quality of life, functional mobility, and physical activity levels. All studies assessed scored 70% or above according to the Joanna Briggs Institute critical appraisal for study quality checklists.
Conclusion:
Most of the studies (58.3%) included in this review did not report adverse effects from CAM modalities used to treat adverse effects of cancer treatment in children and young adults. This lack of safety information is of concern because parents need to know whether the modality represents an extra burden or harm to the child. To improve awareness about safety in the field, a universal and uniform reporting system for adverse effects in CAM research is needed.
... Studies excluded from the meta-analysis showed a significant effect of music and art therapy on the quality of life, and relief of symptoms such as pain and anxiety among children undergoing cancer treatment. These results are in line with other studies [58] which confirm that music and art therapy have positive effects on symptoms of anxiety and pain among children. ...
Background
Dealing with the symptom burden of cancer diagnosis and treatment has led parents to seek different self-management strategies including Alternative and Complementary Medicine (CAM). The aim of this study was to perform a systematic review and meta-analysis about the use and effect of CAM modalities to treat adverse effects of conventional cancer treatment among children and young adults.
Methods
Six scientific research databases were used to identify randomized controlled trials (RCTs) from 1990 to September 2020. Included studies investigated the use of CAM to treat cancer treatment related adverse effects in children and young adults compared to controls.
Results
Twenty RCTs comprising 1,069 participants were included in this review. The included studies investigated acupuncture, mind–body therapies, supplements, and vitamins for chemotherapy-induced nausea and vomiting (CINV), oral mucositis, and anxiety among children and young adults who underwent conventional cancer treatment. Seven studies (315 participants) were included in the meta-analysis. The overall effect of CAM (including acupuncture and hypnosis only) on chemotherapy-induced nausea and/or vomiting and controls was statistically significant with a standard mean difference of -0.54, 95% CI [-0.77, -0.31] I ² = 0% ( p < 0.00001). There was a significant difference between acupuncture and controls ( n = 5) for intensity and/or episodes of CINV with an SMD -0.59, 95% CI [-0.85, -0.33] ( p < 0.00001). No significant difference was found between hypnosis and controls ( n = 2) for severity or episodes of CINV with an SMD -0.41, 95% CI [-1.09, 0.27] I ² = 41% ( p = 0.19).
Conclusion
Current evidence from this meta-analysis of randomized controlled trials shows that CAM, including acupuncture and hypnosis only, is effective in reducing chemotherapy-induced nausea and vomiting in children and young adults. More rigorous trials and long-term effects should be investigated if acupuncture and hypnosis are to be recommended for clinical use.
... Credentialed music therapists use music within a therapeutic relationship to address physical, emotional, cognitive, and social needs of patients and their families (American Music Therapy Association, 2021). Research supports the use of music to manage symptoms, support development, improve coping, and provide family support (Bradt et al., 2016;Coughtrey et al., 2018;Facchini & Ruini, 2021;Lee, 2016;O'Callaghan, 2016;Stegemann et al., 2019;Thrane, 2013). ...
Background: Diagnosis and treatment of cancer and blood disorders in childhood, adolescence and young adulthood has a significant impact on patients and families. The Psychosocial Standards of Care project, initiated in 2012, resulted in 15 Psychosocial Standards (PSS) that guide the care patients and families receive throughout treatment. As members of the multidisciplinary psychosocial care team, music therapists play an important role in the advancing the PSS. Most surveys have focused on other commonly provided services (e.g., social work, child life), leaving gaps in our understanding about the availability and use of music therapy services to advance PSS. This paper offers an initial description of how music therapy services contribute to the provision of care under these Standards. Methods: We analyze how music therapy services promote PSS through synthesis of a music therapy clinical practice survey, published literature, and scope of practice documents. A brief overview of music therapy services structure, PSS that music therapy services currently address, and two clinical program descriptions are included. Results: Music therapy services address 9 of the 15 PSS and are well integrated within the larger program of psychosocial care. Findings suggest integration of music therapy services can help ensure personalized, comprehensive care and efficient use of often-limited psychosocial care resources. Discussion: Nurses, as members of the psychosocial and medical teams are uniquely positioned to identify patient and family care needs and refer patients for services. Understanding how music therapy services address PSS and most importantly, the needs of patients and families, will optimize their care.
Introduction: Many children undergo invasive and noninvasive procedures in the pediatric medical setting, which can be associated with pain and anxiety. Both pharmacological and nonpharmacological interventions are currently being used to minimize pain and anxiety in pediatric patients in the medical setting. Music therapy is an evidence-based, cost-effective, and nonpharmacological service administered by a board-certified music therapist which may reduce pediatric pain and anxiety during procedures. We will undertake a systematic review and meta-analysis that will comprehensively analyze the quantitative publications that detail the effects of music therapy on pediatric pain and anxiety for patients undergoing invasive or noninvasive medical procedures. Method: This protocol is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement and is registered in the International Prospective Register of Systematic Reviews (Prospero; CRD42023474635 ). A three-step, iterative search strategy will include (1) an initial scoping search, (2) development and execution of a comprehensive search strategy, and (3) a search for additional publications. Procedures for disagreements among reviewers and the article screening process are outlined. Statistical analyses including analysis of outcomes and sensitivity analysis has been determined. A plan for critical appraisal of sources using the Grading Recommendations Assessment, Development, and Evaluation (GRADE) and quality of evidence using the Outcome Reporting Bias in Trials (ORBIT) of evidence is also present in this protocol. Conclusion: This protocol is presented with the intention to execute and publish results of this systematic review and meta-analysis to help inform clinical practice and future research.
Eine schwere oder lang andauernde Erkrankung stellt die Familien vor Veränderungen und Herausforderungen. Die Musiktherapie ermöglicht den Betroffenen, nonverbal auszudrücken, wofür manchmal keine Worte gefunden werden können. Dieser Beitrag gibt einen Einblick in die musiktherapeutische Begleitung von Kindern und Jugendlichen während ihres stationären Aufenthalts und den aktuellen Forschungsstand zur Wirksamkeit von Musiktherapie.
The need to study the impact of art therapy, in particular music therapy, on the psycho-emotional state of children and adolescents with cancer is dictated by the high prevalence of mental disorders during hospitalization. Purpose: to analyze the literature to study the impact of music therapy on the psycho-emotional state of children and adolescents with cancer during treatment. General information. The most common symptoms experienced by children and adolescents undergoing treatment for cancer are depression, anxiety, pain associated with diagnostic procedures and treatment, nausea and fatigue, sleep disturbances and fatigue. Variations of art therapy using active and receptive methods of music therapy effectively influence the psycho-emotional status of patients, help children get rid of feelings of fear and cope with their anxiety, promote wellness, stress management, pain relief and more. The use of music therapy methods normalizes the psychosomatic state. The goal of psychotherapeutic work with adolescents and children with cancer is, first of all, prevention and correction of psychopathological reactions. Timely psychotherapy provided to cancer patients in childhood will help harmonize the psycho-emotional state associated with the treatment, especially after mutilating operations. The technique is universal and integrative; it can be successfully used in the treatment of many psychological disorders, as well as integrated and combined with other therapeutic approaches (body-oriented approach, drawing, dance-movement method, etc.). To reduce the incidence of mental pathology after illness and achieve its maximum compensation, a multidisciplinary approach is required.
Background:
Children with cancer (ages 3-8 years) and their parents experience significant, interrelated distress associated with cancer treatment. Active music engagement (AME) uses music-based play and shared music-making to mitigate this distress. To advance our understanding about how AME works and its essential features, we interviewed parents who received the AME intervention as part of a multi-site mechanistic trial. The purpose of this qualitative analysis was to describe parents' experiences of AME for themselves and their child and to better understand how the intervention worked to lower parent-child distress.
Procedure:
We conducted a total of 43 interviews with parents/caregivers, and purposively analyzed all interviews from underrepresented groups based on race/ethnicity and parent role. We used thematic analysis and achieved thematic redundancy after analyzing 28 interviews.
Results:
The following statement summarizes resulting themes: Music therapists skillfully use AME to create a safe and healthy space (Theme 1), where parents/children have transformative experiences (Theme 2) that lead to learning and enactment (Theme 3) of new skills that counteract suffering (Theme 4) through empowerment, connectedness, and sustained relief.
Conclusions:
This work elucidates how AME works to counteract stressful qualities of cancer treatment. As parents witnessed positive and transformative changes in their child, they experienced relief and reported shifts in their perspective about cancer treatment. This led to learning and use of music as a coping strategy that extended beyond therapist-led sessions. Accessible, music-based interventions, like AME, offer a developmentally appropriate and effective way to support parents and young children during treatment.
Background: Music therapy as a nonpharmacological means of managing patient pain, anxiety, and
discomfort is a recognised technique, although it is not widely used in the paediatric intensive care unit
(PICU).
Aim: The aim of this study was to assess the clinical effect of a live music therapy intervention on vital
signs and levels of discomfort and pain for paediatric patients in the PICU.
Methods: This was a quasi-experimental pretesteposttest study. The music therapy intervention was
carried out by two music therapists who were specifically trained, each possessing a master's degree in
the field of hospital music therapy. Ten minutes before the start of the music therapy session, the investigators recorded the vital signs of the patients and assessed their levels of discomfort and pain. The
procedure was repeated at the start of the intervention; at 2, 5, and 10 min during the intervention; and
at 10 min following the conclusion of the intervention.
Results: Two hundred fifty-nine patients were included; 55.2% were male, with a median age of 1 year (0
e21). A total of 96 (37.1%) patients suffered a chronic illness. The main reason for PICU admission was
respiratory illness, at 50.2% (n=130). Significantly lower values were observed for heart rate (p=0.002),
breathing rate (p < 0.001), and degree of discomfort (p
< 0.001) during the music therapy session.
Conclusions: Live music therapy results in reduced heart rates, breathing rates, and paediatric patient discomfort levels. Although music therapy is not widely used in the PICU, our results suggest that using interventions such as that used in this study could help reduce patient discomfort.
Chronic stress is a serial of non-specific neuroendocrine reactions in the body when stimulated by stressors for a long time, which has been shown to have a significant effect on tumor development. Chronic stress can activate the hypothalamus-pituitary-adrenal axis and the sense-adrenal myelin system, promote catecholamine and adrenal corticosteroid secretion, regulate the downstream pathways at all levels, and modulate the secretion of immune cells and immune factors, inhibit protective immune response, and induce inflammation, thus promoting tumor cell proliferation and metastasis. Some drugs and psychotherapy can alleviate the patient's stress state, block the nerve signal transmission at all levels of access, regulate the immune system, or can become an effective means to intervene in chronic stress in tumor patients for clinical treatment to provide reference for intervention ideas. However, due to lack of relevant clinical trials, the clinical intervention effect of various drugs and psychotherapy is uncertain and needs more studies to verify the effect.
Background:
Venous access port is commonly used during cancer treatment in children, yet little is known about how children experience such needle insertion procedures.
Aim:
To study distress before and pain after venous access port needle insertion among children and adolescents with cancer. A second aim was to explore associations between their self-report of procedure-related distress and pain with proxy reports by parents and nurses.
Method:
The sample included 43 children/adolescents, aged 1-16 years with cancer, treated at two Norwegian university hospitals. The patient, parent(s), and the nurse performing the procedure completed developmentally appropriate 11-point distress and pain scales before and immediately after the venous access port procedure. Data were analysed using descriptive statistics and non-parametric correlations.
Ethical issues:
The ethical code of conduct was followed and conformed to the ethical guidelines adopted by the Regional Committee for Medicine and Health Research and the data protector officer at the hospitals.
Results:
For the youngest children (1-5 years), the median distress proxy score was 8 (range 0-9) and pain proxy score 4 (range 0-10). Median distress and pain scores for children aged 6-12 years were 3 (range 0-9) and 1 (range 0-10), respectively, and for the adolescents (age 13-16) 0 (range 0-6) and 1 (range 0-5), respectively. Patients' self-reported distress and pain correlated highly with parents' (distress: rho = 0.83, p < 0.001, pain: rho = 0.92, p < 0.001) and with nurses' proxy ratings (distress: rho = 0.89, p < 0.001, pain: rho = 0.88, p < 0.001).
Conclusion:
There were individual age differences in experienced distress/pain associated with venous access port needle insertion, with a trend for younger children to experience higher levels of distress/ pain than the older children. Children's self-report of distress/ pain concurred with both parental and nurse proxy reports.
Tracking citations to my work and connecting research. Publications: 28 | Citations: 1,668 | h-index: 17 | i10-index: 20. Last updated: August 4, 2024.
Aim
Paediatric haematopoietic stem cell transplantation (HSCT) is a stressful treatment, with an impact on health‐related quality of life (HRQoL) and supportive interventions are needed. This study evaluated the effects of music therapy during and after HSCT.
Methods
This was a randomised clinical pilot study of 29 patients aged 0‐17 years who underwent HSCT at Karolinska University Hospital‐Huddinge, Stockholm, Sweden, between February 2013 and May 2017. The music therapy group comprised 14 children who received the music therapy during hospitalisation and the 15 children in the control group received the intervention after discharge. Music therapy was offered twice a week for four to six weeks. The patients’ HRQoL, pain and mood were evaluated at admission, discharge and after six months. The instruments for HRQoL included the Pediatric Quality of Life Inventory 4.0 Generic Core Scale.
Results
The Scale showed that the music therapy group had a higher estimated physical function (adjusted p=0.04) at the time of discharge and the control group showed improved results after the intervention in all domains (p=0.015).
Conclusion
Despite the small sample, we found improved HRQoL after music therapy, which suggests that it could be a complementary intervention during and after paediatric HSCT.
This article is protected by copyright. All rights reserved.
Background:
Although music therapy (MT) is considered an effective intervention for young people with mental health needs, its efficacy in clinical settings is unclear. We therefore examined the efficacy of MT in clinical practice.
Methods:
Two hundred and fifty-one child (8-16 years, with social, emotional, behavioural and developmental difficulties) and parent dyads from six Child and Adolescent Mental Health Service community care facilities in Northern Ireland were randomised to 12 weekly sessions of MT plus usual care [n = 123; 76 in final analyses] or usual care alone [n = 128; 105 in final analyses]. Follow-up occurred at 13 weeks and 26 weeks postrandomisation. Primary outcome was improvement in communication (Social Skills Improvement System Rating Scales) (SSIS) at 13 weeks. Secondary outcomes included social functioning, self-esteem, depression and family functioning.
Results:
There was no significant difference for the child SSIS at week 13 (adjusted difference in mean 2.4; 95% CI -1.2 to 6.1; p = .19) or for the guardian SSIS (0.5; 95% CI -2.9 to 3.8; p = .78). However, for participants aged 13 and over in the intervention group, the child SSIS communication was significantly improved (6.1, 95% CI 1.6 to 10.5; p = .007) but not the guardian SSIS (1.1; 95% CI -2.9 to 5.2; p = .59). Overall, self-esteem was significantly improved and depression scores were significantly lower at week 13. There was no significant difference in family or social functioning at week 13.
Conclusions:
While the findings provide some evidence for the integration of music therapy into clinical practice, differences relating to subgroups and secondary outcomes indicate the need for further study. ISRCTN Register; ISRCTN96352204.
Aim:
Paediatric recipients of haematopoietic stem cell transplants (HSCT) are at increased risk of developing post-traumatic stress disorder (PTSD) and there is a need to identify interventions that can alleviate stress in this group. The aim of this study was to examine the previously unexplored effect of music therapy on children undergoing HSCT, by analysing physiological parameters and comparing them with a control group.
Methods:
We performed a randomised clinical pilot study of 24 patients up to the age of 16 undergoing HSCT at Karolinska University Hospital, Huddinge, Sweden. Music therapy, including expressive and receptive elements, was performed twice a week in the treatment group and compared to standard care in the control group. Physiological parameters were evaluated according to the hospital's protocols.
Results:
The music therapy group had significantly reduced evening heart rates compared to the control group (p<0.001) and the effect was sustainable for four to eight hours after the intervention. There were no significant differences in saturation or blood pressure observed between the groups.
Conclusion:
Music therapy significantly lowered the heart rate of children undergoing HSCT for at least four to eight hours, indicating reduced stress levels and potentially lowering the risk of developing PTSD. This article is protected by copyright. All rights reserved.
Systematic reviews and meta-analyses have become increasingly important in health care. Clinicians read them to keep up to date with their field [1],[2], and they are often used as a starting point for developing clinical practice guidelines. Granting agencies may require a systematic review to ensure there is justification for further research [3], and some health care journals are moving in this direction [4]. As with all research, the value of a systematic review depends on what was done, what was found, and the clarity of reporting. As with other publications, the reporting quality of systematic reviews varies, limiting readers' ability to assess the strengths and weaknesses of those reviews.
Several early studies evaluated the quality of review reports. In 1987, Mulrow examined 50 review articles published in four leading medical journals in 1985 and 1986 and found that none met all eight explicit scientific criteria, such as a quality assessment of included studies [5]. In 1987, Sacks and colleagues [6] evaluated the adequacy of reporting of 83 meta-analyses on 23 characteristics in six domains. Reporting was generally poor; between one and 14 characteristics were adequately reported (mean = 7.7; standard deviation = 2.7). A 1996 update of this study found little improvement [7].
In 1996, to address the suboptimal reporting of meta-analyses, an international group developed a guidance called the QUOROM Statement (QUality Of Reporting Of Meta-analyses), which focused on the reporting of meta-analyses of randomized controlled trials [8]. In this article, we summarize a revision of these guidelines, renamed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), which have been updated to address several conceptual and practical advances in the science of systematic reviews (Box 1).
Box 1: Conceptual Issues in the Evolution from QUOROM to PRISMA
Completing a Systematic Review Is an Iterative Process
The conduct of a systematic review depends heavily on the scope and quality of included studies: thus systematic reviewers may need to modify their original review protocol during its conduct. Any systematic review reporting guideline should recommend that such changes can be reported and explained without suggesting that they are inappropriate. The PRISMA Statement (Items 5, 11, 16, and 23) acknowledges this iterative process. Aside from Cochrane reviews, all of which should have a protocol, only about 10% of systematic reviewers report working from a protocol [22]. Without a protocol that is publicly accessible, it is difficult to judge between appropriate and inappropriate modifications.
In “Flourish,” Martin Seligman maintained that the elements of well-being consist of “PERMA: positive emotion, engagement, relationships, meaning, and accomplishment.” Although the question of what constitutes human flourishing or psychological well-being has remained a topic of continued debate among scholars, it has recently been argued in the literature that a paradigmatic or prototypical case of human psychological well-being would largely manifest most or all of the aforementioned PERMA factors. Further, in “A Neuroscientific Perspective on Music Therapy,” Stefan Koelsch also suggested that “Music therapy can have effects that improve the psychological and physiological health of individuals,” so it seems plausible that engaging in practices of music can positively contribute to one living a more optimally flourishing life with greater psychological well-being. However, recent studies on music practice and participation have not yet been reviewed and integrated under the PERMA framework from positive psychology to further explore and explicate this possibility. This article therefore contributes to extant work by reviewing recent research on psychological well-being and music to offer support for the claim that music practice and participation can positively contribute to one living a flourishing life by positively influencing their emotions, engagement, relationships, meaning, and accomplishment.
In Flourish, the positive psychologist Seligman (2011) identifies five commonly recognized factors that are characteristic of human flourishing or well-being: (1) “positive emotion,” (2) “relationships,” (3) “engagement,” (4) “achievement,” and (5) “meaning” (p. 24). Although there is no settled set of necessary and sufficient conditions neatly circumscribing the bounds of human flourishing (Seligman, 2011), we would mostly likely consider a person that possessed high levels of these five factors as paradigmatic or prototypical of human flourishing. Accordingly, if we wanted to go about the practical task of actually increasing our level of well-being, we ought to do so by focusing on practically increasing the levels of the five factors that are characteristic of well-being. If, for instance, an activity such as musical engagement can be shown to positively influence each or all of these five factors, this would be compelling evidence that an activity such as musical engagement can positively contribute to one’s living a flourishing life. I am of the belief that psychological research can and should be used, not only to identify and diagnose maladaptive psychological states, but identify and promote adaptive psychological states as well. In this article I advance the hypothesis and provide supporting evidence for the claim that musical engagement can positively contribute to one’s living a flourishing life. Since there has not yet been a substantive and up-to-date investigation of the possible role of music in contributing to one’s living a flourishing life, the purpose of this article is to conduct this investigation, thereby bridging the gap and stimulating discussion between the psychology of music and the psychology of well-being.
The sound of music may arouse profound emotions in listeners. But such experiences seem to involve a 'paradox', namely that music - an abstract form of art, which appears removed from our concerns in everyday life - can arouse emotions - biologically evolved reactions related to human survival. How are these (seemingly) non-commensurable phenomena linked together? Key is to understand the processes through which sounds are imbued with meaning. It can be argued that the survival of our ancient ancestors depended on their ability to detect patterns in sounds, derive meaning from them, and adjust their behavior accordingly. Such an ecological perspective on sound and emotion forms the basis of a recent multi-level framework that aims to explain emotional responses to music in terms of a large set of psychological mechanisms. The goal of this review is to offer an updated and expanded version of the framework that can explain both 'everyday emotions' and 'aesthetic emotions'. The revised framework - referred to as BRECVEMA - includes eight mechanisms: Brain Stem Reflex, Rhythmic Entrainment, Evaluative Conditioning, Contagion, Visual Imagery, Episodic Memory, Musical Expectancy, and Aesthetic Judgment. In this review, it is argued that all of the above mechanisms may be directed at information that occurs in a 'musical event' (i.e., a specific constellation of music, listener, and context). Of particular significance is the addition of a mechanism corresponding to aesthetic judgments of the music, to better account for typical 'appreciation emotions' such as admiration and awe. Relationships between aesthetic judgments and other mechanisms are reviewed based on the revised framework. It is suggested that the framework may contribute to a long-needed reconciliation between previous approaches that have conceptualized music listeners' responses in terms of either 'everyday emotions' or 'aesthetic emotions'.
A mixed methods research design was used to investigate the effects of a music therapy CD (MTCD) creation intervention on pediatric oncology patients' distress and coping during their first radiation therapy treatment. The music therapy method involved children creating a music CD using interactive computer-based music software, which was "remixed" by the music therapist-researcher to extend the musical material. Eleven pediatric radiation therapy outpatients aged 6 to 13 years were randomly assigned to either an experimental group, in which they could create a music CD prior to their initial treatment to listen to during radiation therapy, or to a standard care group. Quantitative and qualitative analyses generated multiple perceptions from the pediatric patients, parents, radiation therapy staff, and music therapist-researcher. Ratings of distress during initial radiation therapy treatment were low for all children. The comparison between the two groups found that 67% of the children in the standard care group used social withdrawal as a coping strategy, compared to 0% of the children in the music therapy group; this trend approached significance (p = 0.076). MTCD creation was a fun, engaging, and developmentally appropriate intervention for pediatric patients, which offered a positive experience and aided their use of effective coping strategies to meet the demands of their initial radiation therapy treatment.
Music therapy is a promising approach widening the potential applications of psychotherapy. Music influences both, psychologic and physiologic parameters, and children are especially responsive to this form of therapy. Many aspects of its action mechanisms remain to be elucidated, underscoring the need for evidence-based medicine (EBM) for clinical use of music therapy.
This review seeks to highlight some of the issues of music therapy research and to initiate a discussion about the need for international multicenter cooperation to bring scientifically sound evidence of the benefits of music therapy in pediatric patients.
Scientific bibliographic databases were searched for randomized controlled trials on use of music therapy for children. Identified articles were evaluated according to criteria for scientific quality.
Twenty-eight studies were identified. Most of the trials were biased by the number of participants, and some trials showed the need to improve design of control groups. Indeed, the novelty of this area of study has produced a large number of different studies (with variability in diagnoses, interventions, control groups, duration, and/or outcome parameters), and there is a need for a more homogeneous and systematic approach. Available studies highlight the need to address reproducibility issues.
This analysis identifies the need for a subsequent series of clinical studies on the efficacy of music in the pediatric population, with more focus on eligibility criteria with respect to EBM and reproducibility.
A nonpharmacological method can be an alternative or complement to analgesics.The aim of this study was to evaluate if music medicine influences pain and anxiety in children undergoing lumbar punctures. A randomized clinical trial was used in 40 children (aged 7-12 years) with leukemia, followed by interviews in 20 of these participants. The participants were randomly assigned to a music group (n = 20) or control group (n = 20). The primary outcome was pain scores and the secondary was heart rate, blood pressure, respiratory rate, and oxygen saturation measured before, during, and after the procedure. Anxiety scores were measured before and after the procedure. Interviews with open-ended questions were conducted in conjunction with the completed procedures. The results showed lower pain scores and heart and respiratory rates in the music group during and after the lumbar puncture. The anxiety scores were lower in the music group both before and after the procedure. The findings from the interviews confirmed the quantity results through descriptions of a positive experience by the children, including less pain and fear.
Listening to music is amongst the most rewarding experiences for humans. Music has no functional resemblance to other rewarding stimuli, and has no demonstrated biological value, yet individuals continue listening to music for pleasure. It has been suggested that the pleasurable aspects of music listening are related to a change in emotional arousal, although this link has not been directly investigated. In this study, using methods of high temporal sensitivity we investigated whether there is a systematic relationship between dynamic increases in pleasure states and physiological indicators of emotional arousal, including changes in heart rate, respiration, electrodermal activity, body temperature, and blood volume pulse.
Twenty-six participants listened to self-selected intensely pleasurable music and "neutral" music that was individually selected for them based on low pleasure ratings they provided on other participants' music. The "chills" phenomenon was used to index intensely pleasurable responses to music. During music listening, continuous real-time recordings of subjective pleasure states and simultaneous recordings of sympathetic nervous system activity, an objective measure of emotional arousal, were obtained.
Results revealed a strong positive correlation between ratings of pleasure and emotional arousal. Importantly, a dissociation was revealed as individuals who did not experience pleasure also showed no significant increases in emotional arousal.
These results have broader implications by demonstrating that strongly felt emotions could be rewarding in themselves in the absence of a physically tangible reward or a specific functional goal.
Determining how music-based interventions have been described in published literature is an important first step in evaluating whether guidelines for reporting music-based interventions need to be developed. Twenty-two pediatric intervention studies that met specified inclusion criteria were reviewed for content in 11 areas. This review revealed significant gaps in intervention reporting. Problems were particularly pronounced in eight areas: music qualities, intervention materials, intervention components, intervention delivery schedule, interventionist, treatment fidelity, setting and music delivery method. Development of reporting guidelines for music-based interventions is needed to improve reporting and advance evidence-based practice.
The purpose of this research was to develop and evaluate psychometrically an abbreviated instrument to assess hope in adults in clinical settings. The Herth Hope Index (HHI), a 12-item adapted version of the Herth Hope Scale (HHS), was tested with a convenience sample of 172 ill adults. Alpha coefficient was 0.97 with a 2-week test-retest reliability of 0.91. Criterion-related validity was established by correlating the HHI with the parent HHS (r = 0.92), the Existential Well-Being Scale (r = 0.84) and the Nowotny Hope Scale (r = 0.81). Divergent validity with the Hopelessness Scale was established (r = -0.73). Construct validity was supported through the factorial isolation of three factors: (a) temporality and future; (b) positive readiness and expectancy; (c) interconnectedness. These three factors accounted for 41% of the total variance in the measure.
Although the process of coping and utilization of coping strategies has received widespread attention in the adult literature, there is a relative dearth of information on these processes in children and adolescents. As the importance of assessing and teaching coping strategies becomes apparent in behavioral medicine with adults, such investigations need to be extended to pediatric populations. The present study describes the development of a brief coping checklist. Preliminary psychometric investigations conducted with healthy adolescents demonstrated adequate reliability at 3-day, 7-day, 14-day, and 10-week intervals and concurrent validity with previously established measures of coping. The utility of the checklist with pediatric patients and in particular chronically ill children is also examined.
Background
and purpose: The impact of music on the human body extends beyond an emotional response. Music can bring benefits to the cardiovascular system by influencing heart rate variability (HRV), which is a well-accepted method to analyze the oscillations of the intervals between successive heartbeats and investigate the cardiovascular autonomic nervous system (ANS). This study is a systematic review to examine the effect of musical interventions on HRV.
Methods
We conducted a systematic search in PubMed, Scopus, Web of Science, and Cochrane and identified additional studies with hand searching of reference lists of relevant references.
Results
29 original articles (24 pre-post intervention studies and five randomized controlled trials) with a total of 1368 subjects were available and eligible to be included in the systematic review. Within the whole, only three studies reveal no significant impact of music on HRV, which might be due to using a small sample size and a concise duration of music administration. Interestingly, the rest of the studies have suggested a positive impact of music on HRV with a 0.05 level of significance.
Conclusion
This systematic review confirms music as a stimulus acting to the cardiac ANS that increases parasympathetic activity and HRV. The effects are, however, associated with a high risk of bias. Therefore, further studies are necessary to compare the impact of individualized music therapy to passive listening and preferred soundtracks.
The influence of music therapy (MT) on preoperative anxiety in children affected by leukemia undergoing invasive diagnostic procedures (IP) was evaluated. The participants were assigned to two different types of preoperative preparation for IP: MT intervention or standard care. Preoperative anxiety scores were measured with the Modified Yale Pre-operative Anxiety Scale. Interviews with medical staff were performed.
A lower preoperative anxiety score in the MT group (n = 29) compared with standard care (n = 19) was observed. Results support the potential effectiveness of integrating music therapy with a pharmacological approach to reduce preoperative anxiety in IP. More than 90% of the medical staff (n = 19) were very satisfied with the ability of MT to distract the patient and support the staff.
Background
Effectiveness of music-based interventions (Music therapy, MT) on cancer patients’ is a current research theme. Oncology patients may respond to radiation treatment (RT) with anxiety expressed as stress, fear, depression, and frustration.
Objectives
The aim of this review is to discuss the effectiveness of MT in patients undergoing RT.
Data sources
All English medical papers registered in the Web of Knowledge, PubMed, Google Scholar and ScienceDirect from March 1999 to March 2019.
Inclusion and exclusion criteria: We selected all the articles concerning the use of MT in pre-RT anxiety and distress during RT treatment.
Results
Out of 1184 articles selected, 132 abstracts were analyzed and 13 papers were finally evaluated for the current analysis, for a total of 946 participants.
Discussion
We investigated the role and the efficacy of MT for patients receiving RT and the future challenges in the clinical management of oncology patients before and during radiotherapy.
This empirical phenomenology study reports adolescents/young adults (AYA) experiences of the therapeutic music video (TMV) intervention arm of a randomized controlled clinical trial (Children’s Oncology Group; COG-ANUR0631; R01 NR008583) during hospitalization for a hematopoietic stem cell transplant. A purposive subsample of 14 AYA were interviewed using a broad open-ended data-generating question about their TMV intervention experiences. At the end of each interview, we also asked AYA for suggestions on how to improve the TMV. Analysis of the narrative data resulted in four theme categories: (a) An Interwoven Experience of the Transplant and TMV Intervention; (b) TMV as a Guided Opportunity for Reflection, Self-Expression, and Meaning-Making; (c) Telling My Story: The Work of Deriving Meaning; and (d) A Way to Overcome the Bad Side of Cancer. AYA suggestions for improving the TMV are also summarized. Findings provide insight into ways the TMV supports AYA efforts to overcome distress and challenges by providing opportunities to reflect on what is meaningful, connect with others, and explore/identify personal strengths. Findings also inform our understanding about how the TMV may have functioned (i.e., mechanisms of action) to bring about significant change in AYA self-reported outcomes (i.e., positive coping, social support, and family function) for this trial.
Background:
Although childhood cancer mortality rates are decreasing, intensive treatment modalities and missed school days may leave childhood cancer patients psychologically and socially vulnerable. Children with cancer often have increased anxiety, lower levels of self-esteem, and higher rates of depression, all of which may impair their psychosocial wellbeing. Specialized camps for children with cancer are becoming increasingly popular, as they provide a stress-free, outdoor environment in which children are able to interact with individuals similar to themselves, while experiencing the joys of a "normal childhood."
Objective:
The aim of this review was to explore how camp participation impacts the psychosocial wellbeing of childhood cancer patients and survivors.
Methods:
Six databases (MEDLINE, PsychINFO, EMBASE, CINHAL, Sociological Abstracts, Social Sciences Citation Index) were systematically searched for English literature published between 2007 and 2018. The search generated 1707 titles, and after being evaluated for relevance, 18 articles met the inclusion criteria. A thematic analysis was conducted.
Results:
A variety of camp programs and methodologies were employed among the studies. Camp participation led to improved social health, followed by enhanced constructions of the self, quality of life, sense of normalcy, and attitude.
Conclusion:
This review demonstrates the potential ability of camp to buffer psychosocial losses for children affected by cancer. Addressing limitations, such as the lack of child-centered methodologies employed in camp settings, may not only help to guide future research on therapeutic recreation experiences for children with cancer, but also expand the evidence base for children living with other chronic illnesses and disabilities.
Background
Effectiveness of music-based interventions (MI) on cancer patients’ anxiety, depression, pain and quality of life (QoL) is a current research theme. MI are highly variable, making it challenging to compare studies. Objective and methods: To summarize the evidence on MI in cancer patients, 40 studies were reviewed following the PRISMA statement. Studies were included if assessing at least one outcome among anxiety, depression, QoL and pain in patients aged ≥ 18, with an active oncological/onco-haematological diagnosis, participating to any kind of Music Therapy (MT), during/after surgery, chemotherapy or radiotherapy.
Results
A positive effect of MI on the outcomes measured was supported. Greater reductions of anxiety and depression were observed in breast cancer patients. MI involving patients admitted to a hospital ward were less effective on QoL.
Conclusion
The increasing evidence about MI effectiveness, tolerability, feasibility and appreciation, supports the need of MI implementation in Oncology, Radiotherapy and Surgery wards, and promotion of knowledge among health operators.
A brief review of attachment theory and attachment-focused music therapy literature is presented with respect to the influence of music on a child's internal working models of their caregiver during hospitalization for a life-threatening illness. The role of music in attachment is described in language common to attachment researchers outside the field of music therapy in an effort to unify terminology between therapeutic disciplines. Two possible pathways are proposed by which the child-caregiver attachment relationship can be a focus of a music therapy session when working with children hospitalized with life-threatening illness. Case vignettes provide examples of these proposed pathways.
Background:
Existing systematic reviews provide evidence that music therapy is an effective intervention in the treatment of children and adolescents with psychopathology. The objective of the present review was to systematically review and quantify the effects of music-based interventions in reducing internalizing symptoms (i.e., depression and anxiety) in children and adolescents using a meta-analytical approach.
Methods:
Databases and journals were systematically screened for studies eligible for inclusion in meta-analysis on the effects of music-based interventions in reducing internalizing symptoms. A random-effect meta-analysis using standardized mean differences (SMD) was conducted.
Results:
Five studies were included. Analysis of data from (randomized) controlled trials, yielded a significant main effect (Hedge's g = -0.73; 95%CI [-1.42;-0.04], Z = 2.08, p = 0.04, k = 5), indicating a greater reduction of internalizing symptoms in youth receiving music-based interventions (n = 100) compared to different control group interventions (n = 95).
Limitations:
The existing evidence is limited to studies of low power and methodological quality. Included studies were highly heterogeneous with respect to the nature of the intervention, the measurements applied, the samples studied, and the study design.
Conclusions:
Findings indicate that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents. While these results are encouraging with respect to the application of music-based intervention, rigorous research is necessary to replicate existing findings and provide a broader base of evidence. More research adopting well controlled study designs of high methodological quality is needed.
Both music therapy and reminiscence therapy are currently being used to increase aspects of wellbeing in older people, including those with memory diseases such as dementia, as alternatives to pharmacological treatments. There is growing evidence that combining these therapies in a focused way would provide unique wellbeing outcomes for this population. This review aims to report on the existing intervention studies that utilize both music and reminiscence activities in equal measure in elderly adult populations. A systematic review of intervention-based studies published between 1996 and 2016 was carried out: five studies were included in this review. Included studies were predominantly carried out in aged care facilities with aged populations affected by a range of conditions; all studies assessed aspects of mental well-being. The review found music reminiscence therapy to have positive effects for participants in four out of five studies. Further research incorporating qualitative methods and mapping of intervention procedures would complement existing findings.
This systematic review investigated the use and efficacy of music listening as an intervention for children and adolescents in clinical and non-clinical settings. Database search was carried out via EMBASE, MEDLINE, PsycARTICLES Full Text, PsycINFO, PubMed together with hand-search in related journals using an age restriction of 0–18 years and the following keywords: music (therapy) AND receptive OR passive. Only original studies that were peer-reviewed were included. The searched publication period was between 1980 and up until March, 2015. In summary, 36 studies were identified as satisfying inclusion criteria, 28 being randomized controlled trials. One half of included studies (n = 18) focused on music listening in pediatrics, indicating a significant reduction of pain, anxiety, and distress. One quarter of studies were set in mental health contexts (n = 9), and the remaining nine studies were varied in focus and contents, also supporting the beneficial effects of music listening for specific symptom reduction and enhancement of specific skills. Included studies varied with respect to diagnosis, sample size, design, choice and delivery of music and duration of interventions. Results show that music listening in health care contexts is a feasible, easily applicable, and cost effective intervention for children and adolescents. As expected with such diversity, there was a marked variability in results. Careful consideration in interpreting the results and also in designing future studies is needed. Clinical and research implications are discussed further.
Objectives To examine the feasibility/acceptability of a parent-delivered Active Music Engagement (AME + P) intervention for young children
with cancer and their parents. Secondary aim to explore changes in AME + P child emotional distress (facial affect) and parent
emotional distress (mood; traumatic stress symptoms) relative to controls. Methods A pilot two-group randomized trial was conducted with parents/children (ages 3–8 years) receiving AME + P (n = 9) or attention control (n = 7). Feasibility of parent delivery was assessed using a delivery checklist and child engagement; acceptability through
parent interviews; preliminary outcomes at baseline, postintervention, 30 days postintervention. Results Parent delivery was feasible, as they successfully delivered AME activities, but interviews indicated parent delivery was
not acceptable to parents. Emotional distress was lower for AME + P children, but parents derived no benefit. Conclusion Despite child benefit, findings do not support parent delivery of AME + P.
Cancer and its treatment are generally considered to be stressful. One of the important approaches used to reduce the anxiety is therapeutic music. The purpose of this study was to examine the effects of therapeutic music on anxiety in children with ALL. This study was conducted as single-grouped pre-test, post-test quasi-experimental design at the paediatric oncology unit of a university hospital in Turkey between February 2010 and June 2010. 28 children were selected by using convenience sampling. In order to obtain the study data, the VAS was used. The duration of the therapeutic music sessions ranged from 15 to 30 minutes during the chemotherapy procedure in the child’s room. At the beginning and end of therapeutic music session, the child completed 0-10 point VAS. In this study, it was determined that anxiety of post-test measures decreased to pre-test measures for all age groups and the difference between them was found as statistically very significant (p<0.05). P<0.05 is a standard level of significance. The findings of this study, which are consistent with previous reports, support the opinion that therapeutic music may have a positive effect on hospitalised paediatric oncology patients. © 2015, National Institute of Science Communication and Information Resources (NISCAIR). All rights reserved.
Currently there is a growing interest in non-invasive methods of pain management with pediatric patients. Needle insertions
are a major source of distress for children. The term “needle insertions” includes intravenous starts, venipunctures, injections,
and infant heel sticks. Distraction has proven effective in helping children to cope and adding music as a non-invasive method
of pain management is a unique way to achieve this technique of distraction. To assess the benefits of live music on the behavioral
distress levels of pediatric patients, an experimental group of 20 patients age 7 and under received live music as they experienced
a variety of needle insertions in a treatment room and emergency room setting at a local hospital. The music intervention
consisted of age-appropriate children's songs led by the researcher with guitar accompaniment. This group was compared to
a control group of 20 pediatric patients who did not receive music. Groups were matched on the basis of age, site of procedure
(floor or ER), and type of needle insertion. Two-way analysis of variance (ANOVA) revealed a statistically significant difference
between groups for the pre-needle and post-needle stages (F = 9.6, p < .05) with the music group exhibiting less behavioral distress. A Mann-Whitney U test revealed statistically significant differences between age groups with less behavioral distress exhibited in the music
group for children 1 year old and younger (U = 14, crit. value = 15).
This article presents the results of a national clinical practice review conducted in Australia of music therapy services in pediatric oncology hospitals. Literature specifically related to music therapy and symptom management in pediatric oncology is reviewed. The results from a national benchmarking survey distributed to all music therapists working with children with cancer in Australian pediatric hospitals are discussed. Patient and family feedback provided from a quality improvement activity conducted at a major pediatric tertiary hospital is summarized, and considerations for future growth as a profession and further research is proposed.
The aim of this study was to investigate acute cardiac response and heart rate variability (HRV) when listening to differing forms of music. Eleven healthy men aged between 18 and 25 years old were included in the study. HRV was recorded at rest for ten minutes with no music, then were asked to listen to classical baroque or heavy metal music for a period of 20 min. It was noted that heart rate variability did not affect HRV indices for time and frequency. In conclusion, music with different tempos does not influence cardiac autonomic regulation in men. However more studies are suggested to explore this topic in greater detail.
Emotion regulation (ER) is an internal process through which a person maintains a comfortable state of arousal by modulating one or more aspects of emotion. The neural correlates underlying ER suggest an interplay between cognitive control areas and areas involved in emotional reactivity. Although some studies have suggested that music may be a useful tool in ER, few studies have examined the links between music perception/production and the neural mechanisms that underlie ER and resulting implications for clinical music therapy treatment. Objectives of this systematic review were to explore and synthesize what is known about how music and music experiences impact neural structures implicated in ER, and to consider clinical implications of these findings for structuring music stimuli to facilitate ER.
A comprehensive electronic database search resulted in 50 studies that met predetermined inclusion and exclusion criteria. Pertinent data related to the objective were extracted and study outcomes were analyzed and compared for trends and common findings.
Results indicated there are certain music characteristics and experiences that produce desired and undesired neural activation patterns implicated in ER. Desired activation patterns occurred when listening to preferred and familiar music, when singing, and (in musicians) when improvising; undesired activation patterns arose when introducing complexity, dissonance, and unexpected musical events. Furthermore, the connection between music-influenced changes in attention and its link to ER was explored.
Implications for music therapy practice are discussed and preliminary guidelines for how to use music to facilitate ER are shared.
To reduce the risk of adjustment problems associated with hematopoietic stem cell transplant (HSCT) for adolescents/young adults (AYAs), we examined efficacy of a therapeutic music video (TMV) intervention delivered during the acute phase of HSCT to: 1) increase protective factors of spiritual perspective, social integration, family environment, courageous coping, and hope-derived meaning; 2) decrease risk factors of illness-related distress and defensive coping; and 3) increase outcomes of self-transcendence and resilience.
This was a multisite randomized, controlled trial (COG-ANUR0631) conducted at 8 Children's Oncology Group sites involving 113 AYAs aged 11-24 years undergoing myeloablative HSCT. Participants, randomized to the TMV or low-dose control (audiobooks) group, completed 6 sessions over 3 weeks with a board-certified music therapist. Variables were based on Haase's Resilience in Illness Model (RIM). Participants completed measures related to latent variables of illness-related distress, social integration, spiritual perspective, family environment, coping, hope-derived meaning, and resilience at baseline (T1), postintervention (T2), and 100 days posttransplant (T3).
At T2, the TMV group reported significantly better courageous coping (Effect Size [ES], 0.505; P = .030). At T3, the TMV group reported significantly better social integration (ES, 0.543; P = .028) and family environment (ES, 0.663; P = .008), as well as moderate nonsignificant effect sizes for spiritual perspective (ES, 0.450; P = .071) and self-transcendence (ES, 0.424; P = .088).
The TMV intervention improves positive health outcomes of courageous coping, social integration, and family environment during a high-risk cancer treatment. We recommend the TMV be examined in a broader population of AYAs with high-risk cancers. Cancer 2013. © 2013 American Cancer Society.
The use of music-assisted relaxation in the reduction of childrens distress associated with bone marrow aspirations was evaluated Six pediatric cancer patients ages 6 to 15 years were observed during a baseline procedure and then received music-assisted relaxation during the second of two consecutive bone marrow aspirations Childrens anticipatory and experienced feat and pain and their observed behavioral distress during the procedures were evaluated systematically using a within-subjects experimental design Analysis of the data indicated strong trends tor reductions in anticipatory fear experienced fear, and experienced pain A strong trend for reduction in anticipatory behavioral distress was found, but there was no significant reduction in total observed behavioral distress Implications for clinical applications and further research were discussed.
Background:
Resilience is a positive health outcome identified by the Committee on Future Direction for Behavioral and Social Sciences as a research priority for the National Institutes of Health. The Resilience in Illness Model (RIM) was developed from a series of qualitative and quantitative studies, to increase understanding of how positive health protective factors (ie, social integration, family environment, courageous coping, and derived meaning) may influence resilience outcomes. The RIM also includes 2 risk factors: illness-related distress and defensive coping.
Objective:
The purpose of this 2-part article was to report on evaluation of the RIM for adolescents/young adults (AYAs) with cancer. Here, in part 1, our purpose was to describe the exploratory RIM evaluation, and in part 2 we describe the confirmatory RIM evaluation.
Methods:
An exploratory evaluation of RIM was done using exploratory latent variable structural equation modeling with a combined sample from 2 studies of preadolescents and AYAs with cancer aged 10 to 26 years (n = 202).
Results:
Results, including goodness-of-fit indices, support the RIM as a theory with a high level of explained variance for outcomes of resilience (67%) and self-transcendence (63%). Variance explained for proximal outcomes ranged from 18% to 76%.
Conclusions:
Findings indicate that, following confirmatory testing, the RIM may be a useful guide to developing targeted interventions that are grounded in the experiences of the AYAs.
Implications for practice:
Understanding of the AYA cancer experience to improve holistic care is increased.
Purpose:
This article describes parental perspectives on the helpfulness and meaningfulness of a behavioral health music therapy intervention targeted to adolescents/young adults (AYA) with cancer undergoing stem cell transplantation. We demonstrate how qualitative methods may be used to understand critical aspects of an intervention and mechanisms by which the intervention impacts the target AYA outcomes of resilience and quality of life.
Methods:
A qualitative descriptive design was used to obtain parents' perspectives. A maximum-variation purposive sampling technique was used to sample 16 parents whose AYA had been randomized to the intervention group. A semistructured open-ended interview was conducted between 100 and 160 days after the AYA's transplant.
Results:
Results were grouped into three categories: (1) helpfulness and meaningfulness of the intervention to AYA adjustment to the transplantation experience; (2) helpfulness and meaningfulness of the intervention for parents; and (3) AYA ability to participate in the intervention during the acute phase of transplant.
Conclusions:
Parents observed and interacted with their AYA who participated in a targeted behavioral intervention. Thus, parents were able to describe mechanisms through which the intervention was helpful and meaningful for the AYA and indirect personal benefits for themselves. The results suggest the importance of the targeted outcomes identified in the Resilience in Illness Model and mechanisms of action in the Contextual Support Model of Music Therapy, and identify approaches for future study.
Background:
Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in cancer patients.
Objectives:
To compare the effects of music therapy or music medicine interventions and standard care with standard care alone, or standard care and other interventions in patients with cancer.
Search strategy:
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 10), MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, Science Citation Index, CancerLit, www.musictherapyworld.net, CAIRSS, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, and the National Research Register. All databases were searched from their start date to September 2010. We handsearched music therapy journals and reference lists and contacted experts. There was no language restriction.
Selection criteria:
We included all randomized controlled trials (RCTs) and quasi-randomized trials of music interventions for improving psychological and physical outcomes in patients with cancer. Participants undergoing biopsy and aspiration for diagnostic purposes were excluded.
Data collection and analysis:
Two review authors independently extracted the data and assessed the risk of bias. Where possible, results were presented in meta analyses using mean differences and standardized mean differences. Post-test scores were used. In cases of significant baseline difference, we used change scores.
Main results:
We included 30 trials with a total of 1891 participants. We included music therapy interventions, offered by trained music therapists, as well as listening to pre-recorded music, offered by medical staff. The results suggest that music interventions may have a beneficial effect on anxiety in people with cancer, with a reported average anxiety reduction of 11.20 units (95% confidence interval (CI) -19.59 to -2.82, P = 0.009) on the STAI-S scale and -0.61 standardized units (95% CI -0.97 to -0.26, P = 0.0007) on other anxiety scales. Results also suggested a positive impact on mood (standardised mean difference (SMD) = 0.42, 95% CI 0.03 to 0.81, P = 0.03), but no support was found for depression.Music interventions may lead to small reductions in heart rate, respiratory rate, and blood pressure. A moderate pain-reducing effect was found (SMD = -0.59, 95% CI -0.92 to -0.27, P = 0.0003), but no strong evidence was found for enhancement of fatigue or physical status. The pooled estimate of two trials suggested a beneficial effect of music therapy on patients' quality of life (QoL) (SMD = 1.02, 95% CI 0.58 to 1.47, P = 0.00001).No conclusions could be drawn regarding the effect of music interventions on distress, body image, oxygen saturation level, immunologic functioning, spirituality, and communication outcomes.Seventeen trials used listening to pre-recorded music and 13 trials used music therapy interventions that actively engaged the patients. Not all studies included the same outcomes and due to the small number of studies per outcome, we could not compare the effectiveness of music medicine interventions with that of music therapy interventions.
Authors' conclusions:
This systematic review indicates that music interventions may have beneficial effects on anxiety, pain, mood, and QoL in people with cancer. Furthermore, music may have a small effect on heart rate, respiratory rate, and blood pressure. Most trials were at high risk of bias and, therefore, these results need to be interpreted with caution.
Parents experience high levels of distress during their child's stem cell transplant that can decrease the ability to support their child and effectively communicate with healthcare providers. Because parents are a primary source of support, their perspectives are very important when evaluating supportive care interventions for their adolescents/young adults.
This study examined parents' perspective of their adolescents or young adults' (AYAs') experience with stem cell transplantation (SCT) and involvement in a therapeutic music video (TMV) intervention.
This was a phenomenological study using parents' interviews. The sample included 7 parents of 6 adolescents/young adults ranging in age from 13 to 21 years hospitalized for SCT for an oncology-related condition. Parents' interviews were conducted 100 days after transplantation. Sessions were audio taped, transcribed, and analyzed using Colaizzi's phenomenological analysis.
We analyzed more than 350 significant statements from 7 parents. Seven theme categories emerged: (1) humbling, humiliating, horrible: parents' perspectives on the cancer experiences and SCT; (2) gratitude for the benefits of TMV intervention; (3) enhanced communication; (4) connectedness; (5) watching my AYA change and grow; (6) process of parent gaining insight; and (7) and an ironic recognition of both the sad and beautiful: parents' response to the TMV intervention.
Parents' narratives suggest that the TMV intervention is a way to buffer the challenges related to SCT, and a larger study is warranted.
These preliminary data offer clinicians insight into parent perceptions about the cancer experience, specifically SCT for their AYA child, and can be used to inform and shape clinical care. Findings reinforce the importance of offering AYAs opportunities to experience independence and mastery and engage in meaningful communication during transplant.
During the last years, a number of studies demonstrated that music listening (and even more so music production) activates a multitude of brain structures involved in cognitive, sensorimotor, and emotional processing. For example, music engages sensory processes, attention, memory-related processes, perception-action mediation ("mirror neuron system" activity), multisensory integration, activity changes in core areas of emotional processing, processing of musical syntax and musical meaning, and social cognition. It is likely that the engagement of these processes by music can have beneficial effects on the psychological and physiological health of individuals, although the mechanisms underlying such effects are currently not well understood. This article gives a brief overview of factors contributing to the effects of music-therapeutic work. Then, neuroscientific studies using music to investigate emotion, perception-action mediation ("mirror function"), and social cognition are reviewed, including illustrations of the relevance of these domains for music therapy.
The purpose of this study was to explore the feasibility and preliminary efficacy of a therapeutic music video (TMV) intervention for adolescents and young adults (AYAs) undergoing stem-cell transplantation (SCT). Twelve AYAs (aged 11-24 years) were randomized to the TMV or an audio-book protocol. The TMV was designed to diminish symptom distress and improve coping, derived meaning, resilience, and quality of life by supporting AYAs in exploring thoughts and feelings. Six sessions with a board-certified music therapist were held twice a week for 3 weeks. The Adolescent Resilience Model guided the selection of a large, comprehensive battery of outcome measures. Major data collections occurred before admission, after intervention, and at 100 days after transplantation. Participants completed a brief set of measures at presession/postsessions 2, 4, and 6. Rates of consent, session completion, and questionnaire completion supported feasibility. Immediate follow-up measures suggest positive trends in the TMV group for hope, spirituality, confidence/mastery, and self-transcendence. Positive trends at 100 days include MOS, symptoms distress, defensive coping, spirituality, and self-transcendence. Therapeutic music video participants also demonstrated gains in quality of life. The TMV intervention may buffer the immediate after-effects of the stem-cell transplantation experience, and a larger study is warranted.
Coping theorists argue that environmental factors affect how children perceive and respond to stressful events such as cancer. However, few studies have investigated how particular interventions can change coping behaviors. The active music engagement (AME) intervention was designed to counter stressful qualities of the in-patient hospital environment by introducing three forms of environmental support.
The purpose of this multi-site randomized controlled trial was to determine the efficacy of the AME intervention on three coping-related behaviors (i.e. positive facial affect, active engagement, and initiation). Eighty-three participants, ages 4-7, were randomly assigned to one of three conditions: AME (n = 27), music listening (ML; n = 28), or audio storybooks (ASB; n = 28). Conditions were videotaped to facilitate behavioral data collection using time-sampling procedures.
After adjusting for baseline differences, repeated measure analyses indicated that AME participants had a significantly higher frequency of coping-related behaviors compared with ML or ASB. Positive facial affect and active engagement were significantly higher during AME compared with ML and ASB (p<0.0001). Initiation was significantly higher during AME than ASB (p<0.05).
This study supports the use of the AME intervention to encourage coping-related behaviors in hospitalized children aged 4-7 receiving cancer treatment.
Two studies are reported describing the development of a short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI) for use in circumstances where the full-form is inappropriate. Using item-remainder correlations, the most highly correlated anxiety-present and anxiety-absent items were combined, and correlated with scores obtained using the full-form of the STAI. Correlation coefficients greater than .90 were obtained using four and six items from the STAI. Acceptable reliability and validity were obtained using six items. The use of this six-item short-form produced scores similar to those obtained using the full-form. This was so for several groups of subjects manifesting a range of anxiety levels. This short-form of the STAI is therefore sensitive to fluctuations in state anxiety. When compared with the full-form of the STAI, the six-item version offers a briefer and just as acceptable scale for subjects while maintaining results that are comparable to those obtained using the full-form of the STAI.
In this article, I have presented an overview of the conceptual and methodological issues that need to be taken into account when selecting an instrument to measure symptom occurrence and distress. In addition, I have listed available tools in the literature. Below is a list of critical questions that need to be considered when selecting an instrument to measure symptom distress.1.What is my purpose for using the tool?—clinical assessment v research study; measurement of symptom occurrence or symptom distress.2.Are the individual items on the instrument useful for my needs?—what symptoms or symptom complexes are included?3.What population do I want to study?—age, type of illness, setting; has the tool been used previously with this population?4.Who will administer the instrument?—patient v observer.5.How long does it take to complete the instrument?6.What standardization procedures are necessary for administering and scoring the instrument?—clear and concise instructions; training sessions for recorders and scorers.7.Is the instrument reliable and valid?8.Do I need more than one instrument? If so, how do I combine results?9.Does the discussion of the instrument in the literature correspond to my desired study outcome?
This study is on the development and validity of the Observation Scale of Behavioral Distress (OSBD), a scale developed to
measure childrens' behavioral responses to painful medical procedures. Subjects were 55 pediatric cancer patients, ages 3
to 13, who were observed during bone marrow aspirations (BMAs). To investigate validity, OSBD scores were correlated with
nurse ratings, childrens' self-report ratings of pain and anxiety, and physiological measures taken before, during, and after
the BMA. Analyses were also conducted to investigate whether the use of interval recording and severity weights for distress
behaviors increased the validity of the OSBD. Results indicate that the OSBD is a valid scale and that the additional interval
recording and severity weights increased the validity coefficiencies on certain variables such as nurse rating and blood pressure
scores.