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Abstract

Music therapy is increasingly used in end-of-life care, with a growing number of music therapists being employed in hospices and hospital-based palliative care programs each year. Music therapy in end-of-life care aims to improve a person's quality of life by helping relieve symptoms, addressing psychological needs, offering support and comfort, facilitating communication, and meeting spiritual needs. In addition, music therapists assist family and caregivers with coping, communication, and grief/bereavement. Music therapy requires the implementation of a music intervention by a trained music therapist, the presence of a therapeutic process, and the use of personally tailored music experiences. These music experiences may include listening to live, therapist-composed, improvised, or pre-recorded music, performing music on an instrument, improvising music spontaneously using voice or instruments, composing music, and music combined with other modalities (e.g. movement, imagery, art). Results indicate that music therapy may have a beneficial effect on the quality of life of people in end-of-life care. However, the results stem from a limited number of studies and the quality of the evidence is not strong. More research is needed. No evidence of effect was found for pain or anxiety. This may be due to the fact that only two studies with very small samples examined the effects of music therapy on these outcomes. There were insufficient data to examine the effect of music therapy on other physical, psychological, or social outcomes. More research is needed.

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... D'autre part, la musicothérapie est de plus en plus utilisée dans les soins de fin de vie, et un nombre croissant de musicothérapeutes travaillent chaque année dans des unités de soins palliatifs et participent à des programmes hospitaliers [10,11]. La musicothérapie a déjà été évaluée à plusieurs reprises dans le cadre des SP, en témoignent les revues de la littérature réalisées par Bradt & Dileo [12], Archie, Bruera & Cohen [13] et McConnell, Scott & Porterb [14]. Mais la qualité statistique des résultats issus de ces différentes recherches demeure faible du fait d'un risque élevé de biais et de difficultés méthodologiques ; et à ce jour les bénéfices supposés d'une intervention musicale restent encore à valider. ...
... De plus, cette évolution négative est d'autant plus marquée que l'on observe un changement immédiat de l'ensemble des données au premier temps de la phase d'intervention. De tels résultats tranchent avec ceux des précédentes revues de littératures qui, bien que non consensuelles, concluaient majoritairement en faveur des bénéfices de la musicothérapie [12][13][14]. Cependant, bien que l'intervention ait pu activer des souvenirs douloureux, nous pouvons tout de même souligner le bénéfice qu'a la musicothérapie de permettre au patient d'exprimer ses émotions, de se remémorer son passé, et peut-être même de faire le point sur des aspects encore insondés de sa vie. ...
... Ainsi, pendant les interventions, les participants étaient tout le temps sous l'effet des traitements, et cet effet variait en fonction du moment de la journée où nous effectuions les séances. Dans ce contexte, il est difficile de déterminer finement dans quelle mesure l'intervention est responsable des changements observés entre les phases, s'il existe un effet d'interaction, ou si les médicaments entravent la réceptivité des patients pendant l'écoute [12]. Au final, les protocoles à cas unique ne permettraient pas d'échapper à l'ensemble des contraintes classiques de la recherche en soins palliatifs, et seraient même plus difficiles à mettre en place sur certains points, puisqu'ils exigent un nombre minimum de points de mesures répétées [20]. ...
Article
Résumé Introduction Bien que les avancées médicales permettent de mieux soigner le cancer, il arrive que la progression de la maladie ne permette plus de la guérir. Le but devient alors d’en contrôler et réduire les symptômes grâce à des soins palliatifs adaptés. Dans ce cadre, les interventions non médicamenteuses ont toute leur place, parmi lesquelles la musicothérapie qui offre des perspectives intéressantes. Objectif L’objectif de la présente recherche est de mettre à l’épreuve expérimentale des faits l’intérêt d’une prise en charge thérapeutique par la musique dans l’accompagnement de fin de vie. Méthode Un protocole à cas unique avec baseline multiple évaluant une intervention musicale a été appliqué à deux sujets hospitalisés en soins palliatifs. Le premier a répondu à 4 mesures en baseline sur 3 jours, et participé à 2 séances d’intervention musicale sur deux jours. Le second a répondu à 3 mesures en baseline sur deux jours, et participé à 3 séances d’intervention musicale sur 3 jours. À chaque temps de mesure, les sujets rapportaient leur degré de douleur perçue et de qualité de vie. Résultats Les résultats vont à l’encontre des hypothèses formulées, et témoignent d’effets d’aggravation de la douleur et de la qualité de vie pour l’un des participants, tandis que l’autre semble peu impacté par l’intervention. Conclusion Des difficultés de terrains et de méthodes pourraient expliquer ces résultats. Toutefois, il est aussi de bon aloi de s’interroger sur les limites des interventions de musicothérapie dans le cadre des soins palliatifs.
... 1,8,9 A clear understanding of the difference between music medicine (i.e., listening to music provided by health care staff and volunteers) and music therapy (i.e., facilitation of individualized, goal-based music interventions implemented by a credentialed music therapist [MT] within a therapeutic relationship) ensures that patients and family members/caregivers receive the appropriate and effective clinical support required based on their emotional, physical, spiritual, psychological, and/or social needs. 10 Similarly, professional art therapy requires art-based interventions to be facilitated by a credentialed art therapist (AT) through which self-expression and reflection through creative, visual modalities foster health and alleviation from suffering, with an overall focus on enhancing one's wellbeing and quality of life amidst a serious illness experience. [11][12][13] As such, music and art therapies are evidence-based practices that rely on clinical research to guide the interventions and experiences facilitated. ...
... 3,4,[15][16][17] Specifically, music and art therapy expe-riences have been shown to improve patient and family quality of life, psychophysiological wellbeing, and symptom relief outcomes. 10,[20][21][22][23] Therapeutic relationships are further enhanced through the use of creative media, which provide meaningful insights around value-based goals of care, psycho-social-spiritual background, and stressors of serious illness. 6 Evidence-based approaches of music and art therapy are developed from assessments of the patient's clinical needs. ...
... Multiple systematic reviews and meta-analyses have demonstrated a wide range of symptomatic improvement associated with both music and art therapies in medical settings, although findings are limited by a high variance in methodologies and heterogeneous interventions. 10,[20][21][22][23] Notable randomized controlled trials of music therapy in palliative care settings include the following: a study of 200 inpatients receiving palliative care, which demonstrated a significant decrease in pain for a group receiving a music therapy intervention (compared to standard care alone) 31 ; and a study of 25 participants receiving inpatient hospice services, which showed a significant reduction in anxiety after a single music therapy session (as well as reductions in pain, tiredness, and drowsiness in post hoc analysis). 32 A large, randomized controlled trial of art therapy (for 240 breast cancer survivors) is currently evaluating outcome measures of pain, fatigue, and depression. ...
Article
Palliative care is provided by an interdisciplinary team, including physicians, advanced practice providers, nurses, social workers, chaplains, and other disciplines based on need. Music therapists and art therapists are becoming increasingly available to palliative care teams and are advancing the diverse and unique clinical services available to effectively meet the holistic needs of patients with serious illnesses and their families. This article provides a concrete exploration of clinical music therapy and art therapy within palliative care and hospice paradigms, with discussion of therapists' training and expertise, therapeutic approaches within the setting of interprofessional team-based care, and discussion of evidence-based symptom management and outcomes supporting the inclusion of music and art therapies within medical education and clinical employment.
... Simple pleasures like listening to music and creating artwork may improve quality of life by helping relieve symptoms such as pain and anxiety among people who have a life-threatening illness (Bradt andDileo, 2010, Chao et al., 2002). Cognitively, music and artwork help patients by focusing their attention away from stressful events to calming, peaceful, and pleasant thoughts (Bradt andDileo, 2010, Chao et al., 2002). ...
... Simple pleasures like listening to music and creating artwork may improve quality of life by helping relieve symptoms such as pain and anxiety among people who have a life-threatening illness (Bradt andDileo, 2010, Chao et al., 2002). Cognitively, music and artwork help patients by focusing their attention away from stressful events to calming, peaceful, and pleasant thoughts (Bradt andDileo, 2010, Chao et al., 2002). Viewing nature from indoors also helps relax patients who are lying in bed or sitting in a chair. ...
... Examples are listening to music, gardening, reading a newspaper, looking out of a window, building a shed, playing cards, fixing the back patio or viewing nature from indoors (Andersson et al., 2008, Cottingham et al., 2018, Johnston, 2010. It is also important to relieve symptoms like pain and anxiety for people who have a life-threatening illness (Bradt andDileo, 2010, Chao et al., 2002). The researchers in the reviewed literature highlight that having conversations with patients about their hobbies or daily lives may enhance their capacity to live in the moment (Harstäde et al., 2018, Kvale, 2007. ...
Article
Full-text available
Background 'Living in the moment' is an essential part of dignity-conserving practice in end-of-life care settings. Although living in the moment is important for care at the end of life, from the perspective of both the person and their family, there is no clear conceptual understanding of what it represents. Objective To explore the concept of 'living in the moment' in the context of dignity-conserving care at the end of life. Design A concept analysis. Data sources The databases of Medline, CinAHL, PubMed, Web of Science, PsycINFO, SocINDEX and Cochrane were searched for studies published between 1941 and 2019, and searches of dictionaries and grey literature, as well as hand-searching were conducted, to yield qualitative, mixed methods and systematic reviews published in English, related to the term 'living in the moment'. Method The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of 'living in the moment'. Results The literature review generated a total of 37 papers for this concept analysis. The attributes identified were (1) simple pleasure, (2) prioritising relationships, (3) living each day to the fullest, (4) maintaining normality, and (5) not worrying about the future. The antecedents were (1) awareness of dying, (2) living with life-threatening illness, (3) positive individual growth, and (4) living with an uncertain future. The consequences were (1) a good quality of life, (2) preserving dignity, and (3) coping with the uncertainty of life. Conclusions A universal definition and conceptual model of the main concept, including theoretical relationships between its antecedents, attributes and consequences, was developed. The definition and proposed conceptual model can allow instruments to be developed that measure the effects, existence or attributes of the concept, and identify a theoretical model, and can also lead to new perspectives and strategies for implementation by nurses to improve dignified person-centred care at the end of life.
... A musicoterapia é muito utilizada na terminalidade da vida como forma de auxílio à expressão dos sentimentos particulares associados a experiências pregressas psicossociais e espirituais presentes na vivência do paciente e/ou dos seus familiares, propiciando uma mais coerente comunicação e atendimento de instâncias espirituais muitas vezes desconhecidas pelo próprio paciente, além de contribuir com o alívio de sintomas físicos, o que levou a uma maior empregabilidade dos musicoterapeutas nos hospitais que possuem o setor de cuidados paliativos. BRADT;DILEO, 2011). ...
... Terceira Etapa: Categorização dos estudos: Na pesquisa utilizando-se a combinação dos descritores MeSH: "palliative care" e "music therapy" com o operador boleano "AND" PORTER et al., 2018;ZENG et al., 2018;WARTH et al., 2016;BRADT;DILEO, 2011;SCHIMID;OSTERMANN, 2010). A musicoterapia, tanto na forma ativa, quanto receptiva, apresenta-se, em associação aos cuidados paliativos, como uma configuração de atendimento holístico prestado a indivíduos com prognóstico ruim ou com doenças sem potencial de cura e é usualmente a escolha terapêutica adjuvante preferida nos 240ospice. ...
... A música, dentro de seus aspectos rítmicos e sonoros, quando já reconhecida e possuidora de significância pessoal, adquire um melhor engajamento do paciente com o musicoterapeuta, facilitando a expressão dos sentimentos e consequente melhoria da comunicação interpessoal, trazendo à tona reminiscências, levando assim, para um maior estado de bem-estar do paciente e da família que consegue retornar vínculos importantes com essas sessõesCAIRES et al., 2014;GUTGSELL et al., 2013). Na terminalidade da vida, a musicoterapia pode ser empregada em inúmeras enfermidades, tais como insuficiência cardíaca congestiva, câncer e doenças neurodegenerativas, sendo realizadas intervenções com o uso da música e sons, com práticas tanto ativas, quanto receptivas que objetivam envolver o paciente em um ambiente individualizado de acordo com suas necessidades no estágio que se encontra, seja para revigorar-se com músicas improvisadas ou mesmo para recordar momentos passados com músicas gravadas.PORTER et al., 2018;BRADT; DILEO, 2011; SCHIMID;OSTERMANN 2010). Sendo retratada na Figura 3 os principais tópicos pertinentes ao uso da musicoterapia.240 ...
Article
Os cuidados paliativos, associados à musicoterapia, pretendem aliviar e confortar os pacientes em final de vida. A terminalidade da vida configura-se como um período de adaptação e ressignificação de muitos conceitos prévios. Sendo assim, é necessário que haja um acompanhamento multidisciplinar desse enfermo enfocando nas suas necessidades apresentadas que podem ser físicas, espirituais ou psicossociais, oferecendo todo o suporte para a melhoria da qualidade de vida. Esse trabalho tem como objetivo apontar o que é realizado dentro da musicoterapia nos cuidados paliativos e se é efetivo o uso para a terminalidade da vida. Para isso, foi realizada uma revisão sistemática utilizando a base de dados e o Portal de Periódicos CAPES. Incluíram-se, nesta busca, os artigos publicados entre 2010 a 2019, empregando os descritores MeSH: “music therapy” e “palliative care” com o operador boleano “AND”. Dentre os 431 artigos, 14 preencheram os critérios de elegibilidade. A maioria discursou sobre o bem-estar e alívio da dor com, principalmente, a prática receptiva da musicoterapia, tendo resultados positivos. O uso da música, como parte integrativa da terapia multidisciplinar dos cuidados paliativos, evidencia uma forma de conexão importante com a essência pessoal, ao passo que a pessoa que recorre à música tanto com o ato de cantar, como também escrever, tocar ou apenas ouvir, recorda, muitas vezes, memórias pregressas, reconectando o vínculo familiar e individual. Além disso, a musicoterapia ainda se alia ao estado de criatividade e arte, quando é avaliada a perspectiva de escrever suas próprias letras de músicas, e à capacidade de relaxamento e lazer, ao tocar instrumentos musicais ou escutar as músicas já gravadas, principalmente quando se correlaciona com sua cultura e sua preferência musical. Demonstrada a importância desse tema, por fim, é relevante que sejam feitos mais estudos relativos a essa temática com um maior rigor metodológico.
... In the literature, six reviews on music therapy have been published (Bradt & Dileo, 2010;Keenan & Keithley, 2015;Nightingale, Rodriguez, & Carnaby, 2013;Ostermann, Boyde, & Linden, 2012;Tsai et al., 2014;Zhang et al., 2012). In three reviews (Ostermann et al., 2012;Tsai et al., 2014;Zhang et al., 2012), the effects of music therapy on patients with cancer were analysed and similar results were obtained, thereby demonstrating that music therapy effectively improved the pain, anxiety and depression of patients with cancer. ...
... In three reviews (Ostermann et al., 2012;Tsai et al., 2014;Zhang et al., 2012), the effects of music therapy on patients with cancer were analysed and similar results were obtained, thereby demonstrating that music therapy effectively improved the pain, anxiety and depression of patients with cancer. In one review (Bradt & Dileo, 2010), the effects of music therapy on psychological, physiological and social responses in end-of-life care were analysed. However, these results were based on only five studies (175 participants). ...
... The effectiveness of music therapy on patients with cancer has not yet fully been elucidated. Based on the findings of the above published reviews (Bradt & Dileo, 2010;Keenan & Keithley, 2015; Impact statement • The necessity of music therapy for cancer nursing was demonstrated. ...
Article
Full-text available
Aims: To assess the effectiveness of music therapy on the quality of life, anxiety, depression, and pain of patients with cancer. Design: Systematic review. Data sources: Five electronic databases were searched in September 2018 for randomized controlled trials evaluating music therapy for patients with cancer. Review methods: The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook Version 5.1.0 and the Revman version 5.3 software was used to perform the meta-analysis. The outcomes were overall quality of life, anxiety, depression and pain. Results: A total of 19 trials evaluating 1548 patients were included in this study, of which 765 were in the control group and 783 in the experimental group. Compared with standard care, music therapy can significant increase the score of overall quality of life in patients with cancer. In addition, music therapy was found to be more effective for decreasing the score of anxiety, depression, and pain. Conclusion: Music therapy can improve the overall quality of life of patients with cancer, with an observed optimal intervention duration of 1-2 months. Meanwhile, anxiety, depression, and pain are improved as well. Nevertheless, high-quality trials are still needed to further determine the effects of music intervention in supportive cancer care.
... Despite its apparent potential, there is limited evidence to support or refute the effectiveness of music therapy for improving EOL care in the hospice palliative care population. 4,[9][10][11] The heterogeneity of interventions used (active versus passive) and settings (hospice, hospital or home) make it difficult to compare results across studies. Additionally, experimental designs frequently lack the rigor necessary to support arguments for the effectiveness of MT. 9,12,13 Therefore, the objective of this study was to develop and test the feasibility of a clinical trial protocol that addressed the three components lacking in previous studies on MT at EOL, namely: (i) outcomes of MT beyond physical changes, (ii) bias reduction through randomization, inclusion of a control group and standardization, and (iii) active participation of patients, family members and staff at each stage of protocol development. ...
... 4,[9][10][11] The heterogeneity of interventions used (active versus passive) and settings (hospice, hospital or home) make it difficult to compare results across studies. Additionally, experimental designs frequently lack the rigor necessary to support arguments for the effectiveness of MT. 9,12,13 Therefore, the objective of this study was to develop and test the feasibility of a clinical trial protocol that addressed the three components lacking in previous studies on MT at EOL, namely: (i) outcomes of MT beyond physical changes, (ii) bias reduction through randomization, inclusion of a control group and standardization, and (iii) active participation of patients, family members and staff at each stage of protocol development. As research has shown that seniors benefit from music interventions in a wide range of situations, 2,3,14 and addressing seniors' health is a priority in our region, this age contingent was targeted for the present study. ...
... Only one manuscript met our original inclusion criteria: a systematic review that included interventions with seniors, at a hospice or palliative care unit, and included MT interventions led by a music therapist. 9 Another article, although not a systematic review (described by the authors as a narrative review), was also read in full, as it met all other inclusion criteria. 10 We subsequently expanded our PubMed search by removing the "systematic review" search term and found four more articles. ...
... Systematic reviews showed the effects of musical interventions on different variables, including spirituality, in cancer patients and people in end-oflife care (Bradt & Dileo, 2010;Bradt, Dileo, Magill, & Teague, 2016). The rationale for the present review of recent publications was to broaden the search to include experimental and quasi-experimental studies with patients suffering not only with cancer or in palliative care but also with other physical problems; in addition, we examined the instruments used to measure spirituality. ...
... The search and database selection were based on the strategy employed in previously published literature reviews (Bradt & Dileo, 2010;Bradt et al., 2011;Bradt et al., 2016;Treurnicht, Kingsnorth, Lamont, McKeever, & Macarthur, 2011;Zhang et al., 2012) and defined and agreed by the authors based on the consultation with a research librarian. Searches were conducted independently by two reviewers (WAA and ACABL) in the PubMed, Web of Science, CINAHL, PsycINFO, ScienceDirect, and LILACS databases. ...
... The positive benefits of musical interventions in the improvement of spirituality in this review are still not clear, and further investigation is required. The systematic reviews by Bradt et al. (2011), Bradt et al. (2016, and Bradt and Dileo (2010) also did not support conclusions about the effect of music on spirituality. ...
... As Bruscia's definition demonstrates, music therapy is much more complex. It shouldn't be confused with 'music medicine' -which is music interventions delivered by medical or healthcare professionals (Bradt & Dileo, 2010). MT, on the other hand, is administered by trained music therapists (Bradt & Dileo, 2010). ...
... It shouldn't be confused with 'music medicine' -which is music interventions delivered by medical or healthcare professionals (Bradt & Dileo, 2010). MT, on the other hand, is administered by trained music therapists (Bradt & Dileo, 2010). ...
Chapter
Music is like the panacea for all duhkha (mental and physical pain) of human beings. Most of us are convinced of the fact that music can induce emotions and alter our mood and thought patterns. Music can create a space where we can express our inner feelings and can heal our duhkha. However, very few of us know the deliberate use of music which can serve the above mentioned functions at our own will. Moreover, those who are musically trained, they hardly are aware of the therapeutic effects of music on mind, body and soul. It is high time when musicians should be encouraged to learn and practice the therapeutic principles of music. In order to meet health challenges which have taken all of us into its grip, there is a need to produce more and more music therapists and to promote music therapy (MT) as one of the mental health professions. This chapter aims to make the reader aware of the core and context of MT, its underlying principles, and its applications.
... 19 Over the past 9 years, 3 reviews have been conducted of the research in this area, all highlighting the need for greater systematization. [20][21][22] found that music therapy is beneficial but was unable to achieve solid results. They concluded that a larger review should be conducted, with a greater number of studies. ...
... A few years later, McConnel, Scott and Porter, 21 set out to analyze the number of randomized controlled trials; an essential improvement highlighted in the first Cochrane review. 20 Their review provides no details about the musical interventions and calls for further randomized controlled trials, with larger sample groups. Lastly, Schmid, Rosland, Von Hofacker et al. 22 focused on qualitative studies and the scales used in quantitative studies of research dating up to 2016. ...
Article
The purpose of this research is to analyze the significant impact music therapy can have on a group of adolescents who have committed Child to Parent Violence and a second group of teenagers at social risk. Both groups were made up of 11 participants between 13 and 21 years of age ( M = 16 years, SD = 1.66 years) with six males in each group. Both groups participated in eight music therapy interventions where state-trait anxiety levels were measured before and after each session. Furthermore, trait anxiety levels were measured after the first and eighth sessions. Our findings indicate that the treatment used performs differently in each group: a more significant reduction in state anxiety levels was observed among participants who had used Child to Parent Violence, where trait anxiety levels were more significantly reduced among participants at social risk. Our findings also indicate that music therapy can be effectively used to reduce anxiety levels among socially vulnerable groups, and that it may have a significant impact on the reduction of this disorder, depending on the anxiety level.
... 19 Over the past 9 years, 3 reviews have been conducted of the research in this area, all highlighting the need for greater systematization. [20][21][22] found that music therapy is beneficial but was unable to achieve solid results. They concluded that a larger review should be conducted, with a greater number of studies. ...
... A few years later, McConnel, Scott and Porter, 21 set out to analyze the number of randomized controlled trials; an essential improvement highlighted in the first Cochrane review. 20 Their review provides no details about the musical interventions and calls for further randomized controlled trials, with larger sample groups. Lastly, Schmid, Rosland, Von Hofacker et al. 22 focused on qualitative studies and the scales used in quantitative studies of research dating up to 2016. ...
Article
Background: Palliative care is an interdisciplinary medical approach for people with illnesses that are unresponsive to curative treatment. Music therapy has been gaining ground in this field since the 1970s, with a not-always-standardized range of interventions and musical techniques. Objective: The purpose of this systematic review is to analyze interventions with music therapy and new developments in this area in the field of palliative care. Methods: The primary source of data for this review was the online database Web of Science (WOS). We also used other databases such as Medline and Scopus. A systematic search was performed of the past 6 years following the PRISMA criteria. Results: From a selection of 310 documents, we reviewed 54 completed articles and included 19 studies in the review. The percentage of agreement in the selection of articles was 87.5% and the Cohen Kappa index of inter-rater reliability was 0.727. In 5 of the articles, the musical interventions were not specified. However, in the remaining 14 they were, including new developments such as use of the monochord and the body tambura, and adaptation of the RBL (Rhythm, Breath & Lullaby) method. Conclusions: There has been notable improvement in the specification of musical interventions during music therapy sessions in palliative care. However, articles in this field need to describe how these techniques are carried out and any new developments. All this without forgetting that the patient's musical preferences are a fundamental aspect when performing music therapy sessions.
... Results are comparable to those existing in the literature on music therapy with in advancer cancer patients [17,25,34,35]. Although the majority of published studies do not compare the results with a control group, there are some controlled trials that indicate that music therapy produces emotional and physiological benefits, reducing anxiety, stress, depression, and pain [24,25,28,[36][37][38]. In a randomized controlled trial of cancer patients undergoing autologous stem cell transplantation, anxiety, depression, and total mood disturbance scores were significantly lower in the music therapy group as compared with standard-care controls [39]. ...
... In recent years, the music therapy collective has called for efforts to improve the quality of research, and emphasizes the importance of evidence-based care [27]. To the best of our knowledge, the majority of end-of-life studies in the body of music therapy literature are descriptive and with small samples [36]. With this in mind, in the present study a strong emphasis was placed on methodological concerns in the design. ...
... Conversely, the illness itself or the cancer treatments may lead to a radical modification of patients' activities of daily living, especially in cases of advanced illness [6]. These conditions can have a relevant impact on patients' quality of life [7], and eventually induce elevated levels of psychological distress, anxiety and depression [8][9][10][11]. ...
... Amongst these interventions, music therapy (MT) is recognized as an effective treatment in cancer patients leading to a general improvement of patients' quality of life, as it has been shown to be directly correlated with beneficial effects on anxiety, pain, fatigue, heart rate, respiratory rate and blood pressure in this population [8,[14][15][16][17][18]. ...
Article
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.
... Music also helps in reducing stress, anxiety, nervousness, tension, and fear [38][39][40]. It also acts like medicine [41], as many therapists use it to reduce depressive symptoms and pain [42][43][44] and for motor and neurological rehabilitation [45,46]. There is little consensus in literature when it comes to the effectiveness of music type on psychological stress. ...
Chapter
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The imposition of strict lockdown by the government of India during the first outbreak of COVID-19 had a remarkable impact on the well-being/wellness of the citizens. Studies around the globe demonstrated music as one of the effective strategies to enhance well-being during the lockdown. However, response to stressful events is modulated by individual characteristics like coping styles and locus of control (internal/external dependence) which have received little attention. The present chapter examined the use of music to cope with COVID-19 lockdown by these individual traits and their musical preferences during this period. A factor analysis yielded four music dimensions preferred by the participants during the lockdown: intense and electronic; cultural, emotional, and melodious; Indian contemporary and popular; and devotional music. Among the music genres, new and old Bollywood music were the most preferred genres. Participants with a higher internal locus of control, emotion, and problem-focused coping style demonstrated greater use of music in coping with stress. Problem-focused coping showed significant positive correlations with all the music dimensions, and emotion-focused coping style correlated with intense and electronic music; cultural, emotional, and melodious music; and devotional music. Internals showed no correlation with the different music genres. Externals showed a preference for intense and electronic and Indian contemporary and popular music. Listening to music had a significant positive effect on people high in emotion-focused and problem-focused coping styles and internal locus of control. However, it was not necessarily effective for people endorsing high external locus of control and avoidant coping. It implies that it can be used as a self-administered tool and therapeutically for people who engage in these coping styles and locus of control.
... End-of-life care is certainly one of the areas in which humanization of care is most firmly established. The transition from restorative to palliative care is a frequent referral criterion for music therapists in hospital settings and many studies indicate that music-based interventions can improve quality of life, reduce pain, and provide comfort during end-of-life care (64)(65)(66). At the FSFB, the music therapy service is regularly asked to accompany patients, families, and caregivers during end-of-life care. ...
Article
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Humanization of care is becoming an increasingly important aspect in providing high-quality health services and the arts are more and more implemented to support and foster humanization and person-centered care efforts. Musical experiences are one of the most frequently encountered art forms in medical settings. Music therapy as a healthcare profession has a decades-long tradition in hospitals, both in inpatient and outpatient areas. However, while studies regarding the effectiveness of music therapy are on the forefront of clinical research, little attention has been paid to the profession's inherent opportunities to assist the hospitals' strategies in terms of humanization of care. Yet, the musical experiences in music therapy are especially versatile in supporting healthcare users from a holistic perspective, contributing to a more compassionate, personalized, and humanized environment. In this article, the basic pillars of humanized and person-centered care will be outlined, followed by examples of seven intersections in which the music therapy service of the University Hospital Fundación Santa Fe de Bogotá aligns with its Humanized and Compassionate Care Model. The aim of this article is to stimulate the discussion on music therapy not only as a profession that provides safe and effective treatment, but also as a therapeutic art experience that can add value for hospitals on their path toward a more humanized care culture.
... We used R to determine the effect size for which 80% power is reached with a two-sample t-test with 160 participants in total, adjusted for clustering, with a two-sided 2.5% significance level, and found that the effect size that can be reliably determined with this substudy is d = 0.51, i.e., a medium effect size [51]. This seems reasonable compared to previous studies of music therapy [14,52]. The actual power may be higher in a longitudinal model if time points are correlated. ...
Article
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Recently, a large cluster-randomized controlled trial was designed—Music Interventions for Dementia and Depression in ELderly care (MIDDEL)—to assess the effectiveness of music interventions on depression in care home residents with dementia (ClinicalTrials.gov NCT03496675). To understand the pathophysiological mechanisms, we observed the effect of repeated music interventions on stress in this population since chronic stress was associated with depression and an increased risk for dementia. An exploratory study was designed to assess: (1) changes in hair cortisol concentrations as an indicator of longer-term stress; (2) whether baseline stress is a predictor of therapy outcome; (3) pre- and post-treatment effects on salivary α-amylase and cortisol response as an indicator of immediate stress in 180–200 care home residents with dementia and depressive symptoms who partake in the MIDDEL trial. Insights into mediatory effects of stress to explain the effect of music interventions will be gained. Hair cortisol concentrations were assessed at baseline and at 3, 6, and 12 months along with the Perceived Stress Scale. Salivary α-amylase and cortisol concentrations were assessed at 1, 3, and 6 months. Saliva was collected just before a session and 15 and 60 min after a session, along with a stress Visual Analogue Scale.
... The literature includes a large number of studies organised according to scientific criteria as well as a large number of systematic reviews (including the Cochrane Reviews) that document the effects of those interventions [1][2][3][4][5]. Some of these reviews, along with single studies, relate to the use of music in hospital settings, in the pre-surgical and surgical phases [6], and to specific interventions in oncology [7], including radiation therapy/chemotherapy treatments [8][9][10][11][12]. In these contexts, application experiences are generally characterised by two factors: the first concerns the technique used, i.e., the use of music listening rather than active music therapy interventions (instrumental and/or vocal sonorous-music improvisation, but also, specific techniques such as song-writing and activities based on music-assisted relaxation); the second is concerned with the possible effectiveness of music on momentary symptoms, particularly anxiety, stress, and pain, resulting from disease conditions and/or particularly invasive medical procedures. ...
Article
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Music listening is a widespread approach in the field of music therapy. In this study, the effects of music listening on anxiety and stress in patients undergoing radiotherapy are investigated. Sixty patients with breast cancer who were candidates for postoperative curative radiotherapy were recruited and randomly assigned to three groups: Melomics-Health (MH) group (music listening algorithmically created, n = 20); individualized music listening (IML) group (playlist of preferred music, n = 20); no music group (n = 20). Music listening was administered for 15 min immediately before simulation and during the first five radiotherapy sessions. The State-Trait Anxiety Inventory (STAI) and the Psychological Distress Inventory (PDI) were administered before/after treatment. Cochran’s Q test and McNemar test for paired proportions were performed to evaluate if the proportion of subjects having an outcome score below the critical value by treatment and over time was different, and if there was a change in that proportion. The MH group improved in STAI and PDI. The IML group worsened in STAI at T1 and improved STAI-Trait at T2. The IML group worsened in PDI at T2. The No music group generally improved in STAI and PDI. Clinical and music listening-related implications are discussed defining possible research perspectives in this field.
... In a narrative review, a researcher reported that compared to silence, use of soothing music could reduce stress and blood pressure among patients and caregiving nurses [29]. Music has been used in hospital setting among children, [30]- [33] in supportive cancer care, [34], [35] in psychiatric patients, [36] among the mentally retarded, [37] for the elderly for psychologic wellbeing, [38] in hospital waiting rooms, [39] for relieving anxiety in preoperative setting, [40] in intensive coronary care unit, [41] in anxiety care among the terminally ill [42], [43] and for anxiety and pain care [44]- [46]. A proposal has been made for music usage in many hospital settings [47]. ...
Article
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Aim: To determine the opinion of operating theatre users on the role of operating theatre background music on theatre users and patients in tertiary health care facilities in Port Harcourt. Background: The relationship between music and health has been described by researchers. Music has been used in several hospital settings with effects which some consider beneficial and others harmful. Materials and Methods: This cross-sectional descriptive study was carried out among theatre users from March to June 2020 in two multispecialty tertiary healthcare facilities in Port Harcourt Nigeria. Using the convenience sampling method, data collected with pretested semi-structured questionnaires were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0. Results: One hundred and twenty-one (82.9%) respondents asserted to knowledge of relationship between music and stress hormone. 97 (66.4%) agreed that music has positive effect on workers in the operating theatre. One hundred and seventeen (80.1%) respondents were of the opinion that background music in the operating theatre is not a distraction, while 22 (15.1%) respondents felt otherwise. One hundred and forty-four (98.8%) respondents agreed to usefulness of background music while at work. High proportion of respondents who lack knowledge of the relationship between stress hormone and music had no preference for operating theatre background music and the relationship was statistically significant (P<0.05). Conclusion: Operating theatre background music is useful as opined by the majority of operating theatre staff, though its preference is low among those with less knowledge of the positive relationship between such music and stress hormones.
... Another framework for understanding and applying music in therapy relates specifically to medical fields, using methods and measurements standard in medicine known generically as "music and medicine." Systematic reviews in the Cochrane database reveal that music therapy seems to be most effective in depression, autism spectrum disorders, dementia, schizophrenia, and end-of-life care (Aalbers et al., 2017;Bradt & Dileo, 2010;Geretsegger et al., 2014;Christian Gold et al., 2005;Koger & Brotons, 2000). In oncology settings, music therapy aims to enhance quality of life, promote self-expression, improve mood, reduce stress, facilitate social interaction, and improve emotional well-being (Colwell, 2016). ...
Thesis
Frameworks for the application of the arts in community settings tend to focus on the development of individuals’ empathy or social bonds. A commensurate level of consideration tends not to be given to the socio-economic, political, and institutional forces and processes that shape such development and to how the arts might help build capacities to manage the impact of such forces and processes. The recognition of persons as interdependent in systems reliant on mutual care has implications for applications of the arts in many specialised domains as well as in general public life. Especially in clinical or social interventions, unrecognised institutional dynamics may introduce or maintain imbalances of power in community and professional practice. Music, as a participatory and temporal activity facilitating social synchrony, can foster dialogic and reciprocal relations in social life. To systematise and study a participatory music activity on an organisational and community level, I designed and implemented two collaborative songwriting programs in clinical and social service settings carried out through the nonprofit organisation, Humans in Harmony. One activity, music corps¸ was a two-month program in New York City involving participants from colleges and social service organisations serving adults with disabilities, at-risk youth, and nursing home residents. Another activity, implemented through a Humans in Harmony chapter at Columbia University Medical Center, paired health professional students with patients in palliative care support groups. Ethnographic observations and participant interviews revealed that engagement in interpersonal processes aligned with a capabilities-informed approach which emphasised social reciprocity, well-being, and flourishing. Moreover, evaluations of the activities through pre- and post-program measures supported a hypothesis of enhancement of interpersonal closeness and in attitudes about empathy and care. Such participatory approaches may offer new frameworks for the application of the arts in response to current geopolitical and cultural challenges.
... By now there are Cochrane reviews on music therapy for people suffering from schizophrenia (Mössler, Chen, Heldal, & Gold, 2011), children with autistic spectrum disorder (Gold, Wigram, & Elefant, 2006), clients suffering from depression (Maratos et al., 2008), psychotic clients (Gold, Heldal, Chapter 1 Chapter 1 Dahle, & Wigram, 2005), elderly suffering from dementia (Vink, Birks, Bruinsma, & Scholten, 2003), and people with brain injury (Bradt, Magee, Dileo, Wheeler, & McGilloway, 2007). Cochrane reviews are also established to report about the effect of music to improve psychological and physical well-being of cancer-patients (Dileo, Bradt, Grocke, & Magill, 2008), as well as for the provision of end-of-life care (Bradt & Dileo, 2010). However most of these reviews are inconclusive, specifically because the sample size tends to be too small. ...
Book
There is a widespread assumption that music therapy is mainly suited to improve the well-being of people. The field of forensic psychiatry is no exception. Recent music therapy literature suggests the core treatment goals of music therapy to be mental health issues of offenders or forensic psychiatric patients. These mental-health issues are defined, among others, as building self-esteem, empathy, and an improved concept of self. The present dissertation outlines an alternative point of departure. The main argument being that music therapy—approached from a scientific, neurologic, and cognitive behavioral perspective, could offer a wider treatment perspective for forensic psychiatric patients or other offenders than mainly focusing on accommodating mental growth for this population. In order to facilitate this step in the development of music therapy, an alternative theoretical foundation is developed for the treatment of forensic psychiatric patients with respect to the primary goals in forensic psychiatric treatment. According to the evidence-based practice in this field these goals comprise among others: the elaboration of coping skills, anger management, and aggression regulation. The present dissertation proposes that music therapy can have the potential to advance such behavioral changes in forensic psychiatric patients—changes that ultimately may help them reduce the probability of relapse. The main goal of the present dissertation is to theoretically and empirically explore which underlying mechanisms can drive music therapy treatment to results in forensic psychiatry. At the same time the connection with evidence-based literature in this field and in the field of music therapy is considered. The core of the theoretical and empirical evidence built in forensic psychiatry points at the risk, need and responsivity (RNR) principles of forensic psychiatric patients. Using this evidence, as well as results from natural and behavioral science towards the applicability of music, we focus on developing a model of music therapy treatment that not only could accommodate mental health issues, but also might contribute to the need principles of forensic psychiatric patients. From these considerations the main research question of this dissertation is formulated, as: “Can we create a theoretical framework —through literature review as well as empirical research—that explains possible effectiveness of music therapy within forensic psychiatry by validating core assumptions of the risk-, need and responsivity principles as well as musical ones for forensic psychiatric patients with personality disorders as their primary psychiatric diagnosis?” Different studies (literature studies, theoretical work, and empirical studies) are conducted to address four sub-questions that are derived from the main research question.
... Conversely, the illness itself or the cancer treatments may lead to a radical modification of patients' everyday life activities, especially in cases of advanced illness (Zaza et al., 2005). These conditions can have a relevant impact on patients' quality of life (Tang et al., 2017) and eventually induce mood disorders such as psychological distress, anxiety, and depression (Andersen et al., 1984;Andersen and Tewfik, 1985;Stiegelis et al., 2004;Bradt and Dileo, 2010). ...
Article
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Introduction: Novel coronavirus (COVID-19) is having a devastating psychological impact on patients, especially patients with cancer. This work aims to evaluate mood disorders of cancer patients undergoing radiation therapy during COVID-19 in comparison with cancer patients who underwent radiation therapy in 2019. Materials and Methods: We included all the patients undergoing radiation therapy at our department in two-time points (once a week for a month in May 2019) and during the COVID-19 outbreak (in April 2020). All the patients were asked to fulfill a validated questionnaire (STAI-Y1, State trait anxiety inventory scale), the Symptom Distress thermometer (SDT) (from 0 to 10 score), and the Beck Depression Inventory v.2 (BDI-2). We took into account the COVID-19 outbreak and also sex, age, week of radiation treatment, and disease. Results: We included 458 patients (220 males and 238 females), with a median age of 64 years. STAI-Y1 median score was 40 (mean 41,3, range 19–79), whereas the median score of SDT was five and BDI-2 median score was 11. STAI-Y1, SDT, and BDI-2 were significantly correlated with the COVID-19 outbreak ( p < 0,001 for all the tests), sex ( p : 0,016 for STAI-Y1, p < 0.001 for SDT, p :0.013 for BDI-2), week of treatment ( p : 0.012 for STAI-Y1 and p : 0.031 for SDT), and disease ( p :0.015 for STAI-Y1, p < 0.001 for SDT and p :0.020 for BDI-2). Conclusions: The prevalence of mood disorders in patients undergoing radiation therapy is higher than expected and even higher during the COVID-19 outbreak. These measurements could be useful as a baseline to start medical humanities programs to decrease these scores.
... 60,61 Its effectiveness as an integrative intervention has been documented with hospitalized children during painful procedures such as venipuncture, 62e64 and debridement, 65 and increasingly in addressing the needs of patients who are approaching end of life. 66,67 Studies have also measured music's effect on stress hormones 68 and immune function and salivary immunoglobulin A. 69,70 Integrating standard medical procedures with music therapy in the treatment of spinal pain, 35 patientpreferred live music interventions provides a direct means of expression and supports tension release. These outcomes that have a significant impact on mood state and resilience suggest that conventional pain-alleviating medical interventions can be enhanced through integrative treatment modalities. ...
Article
Context Eighty-seven patients newly diagnosed with lung, breast, or gastrointestinal cancer and undergoing chemotherapy in the infusion suite of a large urban hospital in New York City. Objective Patients were enrolled in this study of music therapy's impact on resilience in coping with the impact of symptoms inclusive of symptom clustering. Methods Patients were randomly assigned to three arms: clinical instrumental improvisation or clinical vocal improvisation 43 subjects to instrumental improvisation or vocal improvisation and 44 subjects to control. All subjects received a Medical Music Psychotherapy Assessment including psychosocial information and music preferences, pre-/post-Resilience Scale, Hospital Anxiety and Depression Scale, Visual Analogue Scale/Faces Scale, and a pain—Color Analysis Scale. Interventions included 20-minute music therapy (MT) and two additional sessions. Results Significant increases in Resilience Scale in MT groups after treatment with instrumental and vocal MT interventions equally potent-reflect average changes of 3.4 and 4.83 (P = 0.625), respectively. Although Hospital Anxiety and Depression Scale scores showed little impact of MT on perceived anxiety/depression, a strong correlation is seen between vocal intervention and lower depression scores through Visual Analogue Scale–rendered postsessions. This yielded a significant decrease in pain levels immediately after MT, with the final session showing the most significant change in pain level. Resilience in enduring procedures is a necessary component of combating potential negative illness perception. Conclusion Our study shows MT's facility to propel resilience in patients newly diagnosed with cancer, particularly when promoting and pairing adaptation toward coping through the expression of perceived negative effects of emotional and physiological symptoms.
... At the same time, it should be recognized that the extended period over which grieving normally takes place means that it is obviously not an easy subject for empirical research on the impact of music. It is also worth noting that music may help temper other kinds of lossrelated grief, including end-of-life care [163][164][165]. ...
Article
A large and growing body of empirical research now demonstrates the positive impact that music and other auditory stimuli (such as nature soundscapes) can have across the entire spectrum of the healthcare ecosystem. From the point of entry and onward to the operating room/theatre, in the peri-operational environment, patient wards, and medical waiting rooms, music affects all of those who hear it: Patients, their families, surgeons, caregivers, and hospital staff alike. In the age of the “experience economy,” where patients are considered both guests and consumers, private healthcare is increasingly starting to focus on customer satisfaction, and its impact on both financial performance and (not unrelated) health outcomes. In this review, we summarize the latest evidence concerning the impact of music, soundscapes, and noise, on medical outcomes and healthcare provision. We highlight the importance of the auditory (and, ultimately, the multisensory) environment, not only for health and well-being, but also in terms of improving patient satisfaction and managing costs.KEYWORDS: MUSIC; MEDICINE; ATMOSPHERICS; SOUNDSCAPES
... Therapeutic benefits of music have been reported in various clinical conditions (Guerrero et al., 2012;Kulkarni et al., 2012;Tang and Vezeau, 2010). Recently this topic has been thoroughly and independently reviewed in a systematic review and meta-analysis which showed that music have some beneficial influences on BP and HR in patients with coronary artery disease (Bradt et al., 2013) and cancer (Bradt and Dileo, 2010;Nightingale et al., 2013). The tempo of music has its own influence on exercise. ...
Article
Hypertensive individuals tend to have autonomic dysfunction indicated by sympathetic dominance or delayed parasympathetic reactivation. A complimentary therapy such as music following exercise is considered to be beneficial in improving autonomic recovery. The purpose of this study was to assess the effect of differential music tempo on post-exercise cardiovascular recovery parameters in hypertensive individuals. Thirty hypertensive individuals were recruited for the present study which were randomly allocated to no music (n=10), slow music (n=10) and fast music (n=10) group. Participants in all three groups were subjected to submaximal exercise bout by Harvard step test. The cardiovascular recovery parameters i.e. heart rate recovery (HRR), blood pressure recovery (BPR) and rating of perceived exertion recovery (RPER) were assessed in all three groups after 1 min, 2 min and 3 min following termination of exercise. A significant decline was observed in HRR (P=0.002) and RPER (P=0.008) following exercise in slow music group as compared to fast and no music while no significant differences were observed in BPR between the three groups. The study concluded that music accelerates post-exercise recovery and slow music has greater effect as compared to fast or no music. These findings may have potential implications in the cardiovascular recovery dynamics in hypertensive individuals participating in submaximal exercise.
... The utilization of music therapy is increasing in palliative care as music therapists are gaining employment opportunities in hospices and as members of the multidisciplinary palliative care team in hospitals. There is a growing body of evidence that shows how music interventions have a positive contribution to health outcomes of palliative and dementia care patients (Bradt and Dileo, 2010). As patients and families gain access to a variety of therapies in hospice and palliative care, it is important to note that the most popularly chosen forms of complementary therapies currently are massage and music (Hilliard, 2004;Oneschuk et al., 2007). ...
Article
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Objective There is an increasing recognition of the significance of music as a complementary therapy in palliative care. Limited studies exist on how music is used as a coping mechanism by palliative care patients. Therefore, the purpose of this scoping review was to explore the efficacy of music interventions for palliative care. Method We conducted a literature search between June and November 2019 in the Cumulative Index of Nursing and Allied Health Literature (CINAHL), British Nursing Index (BNI), and PubMed, which includes MEDLINE. The search identified eight articles which met the inclusion and exclusion criteria. Results Using thematic analysis, six themes were synthesied to show how music contributes to palliative care. The six themes include Pain management; Relaxation; Happiness and hope; Anxiety and depression management; Enhanced spirituality; and Improved quality of life. These themes reflect the psychological and emotional benefits palliative care patients derive from music therapies. Significance of results Music therapy can be an effective psychosocial approach when managing palliative symptoms through its therapeutic effects on physical, psychological, emotional, and spiritual well-being.
... In Palliative care MT is often use as a complementary approach to improve a person's quality of life by helping to relieve symptoms, addressing psychological needs, offering support and comfort, facilitating communication, and meeting spiritual needs. In addition, music therapists assist family and caregivers with coping, communication, and grief/ bereavement (Dileo and Dneaster, 2005) (Bradt and Dileo, 2010). "Song writing" in MT, offers the possibility of giving voice to what cannot (unconsciously or voluntarily) be expressed directly through words alone. ...
Article
Keywords: end of life, musictherapy, pediatric cancer, songwriting, supportive care End-of-life accompaniment requires even greater care of the patient and their family by the multi-disciplinary team, which requires a clear, wellorganized interdisciplinary and interprofessional approach. Musictherapy (MT) is often use as a complementary approach to improve a person’s quality of life by helping to relieve symptoms, addressing psychological needs, offering support and comfort, facilitating communication, and meeting spiritual needs. Through songwriting, Ettore, a teenager was able to make choices and act on his own will. Songwriting represented a channel for effective and powerful communication and expression. The song became the means by which the relationship with the team was maintained and deepened; it became something tangible, a product with its own consistency, a further bond that unites Ettore to his family to this day.
... The voice is one of the primary instruments music therapists use in work with a variety of clients including those receiving cancer and/or palliative care; and clients also use their voices in the therapeutic process. The majority of the literature verifying vocal interventions in music therapy and oncology have been concentrated on receptive interventions which seems consistent with the findings of Bradt and Dileo (2010) that receptive approaches are commonplace in end-of-life care due to physical and energy levels of clients. ...
Conference Paper
Neurodiversity, a term, associated with a rights-based disability agenda (Silverman, 2015), proposes that people's neurologically-based differences are no different to other social classifications such as gender and race (Singer, 2017). The Neurodiversity movement challenges systems and interventions with “normalization” as the core agenda (Bascom, 2012). Instead, “maximization” of strengths and resources is encouraged, with advocates seeking to influence all levels of society, from policy to interpersonal, everyday practices. The deep humanistic inheritance of the music therapy profession (Abrams 2015), along with ecological and community paradigms that have become more prevalent in recent times are perhaps well aligned with the principles of neurodiversity. However, disability scholars have critiqued music therapy as supporting the medical model of disability and therefore risk contributing to oppression (Cameron, 2014; Straus, 2011). During a roundtable at the European Congress of Music therapy, 2019, we are planning to discuss the possible contributions of the neurodiversity movement to music therapy. Important questions will be raised about definitions and ethics in music therapy, and on the personhood of less advocated individuals. In the present roundtable we will further discuss these topics as well as the role of music and the music therapist as viewed through the neurodiversity perspective. References Abrams, B. (2015). Humanistic approaches. In B. L. Wheeler (Ed.) Music therapy handbook (p148-160). NY: The Guilford Press. Ansdell, G. (2002). Community Music Therapy & the Winds of Change. A Discussion Paper Voices 2(2), July 1. Retrieved from: http://www.voices.no/mainissues/Voices2(2)ansdell.html Bascom, J. (2012). Loud hands: Autistic people, speaking. Washington DC: Autism Self-Advocacy Network Press. Cameron, C. (2014). Does Disability Studies have Anything to Say to Music Therapy? And Would Music Therapy Listen if it Did?. Voices: A World Forum for Music Therapy, 14(3). https://doi.org/10.15845/voices.v14i3.794 Silberman, S. (2015). Neurotribes: The legacy of autism and how to think smarter about people who think differently. Atlantic Books. Singer, J. (2017). Neurodiversity: The Birth of an idea. (Kindle Edition). Retrieved from Amazon.com Straus, J. (2011). Extraordinary Measures: Disability in Music. Oxford: Oxford University Press.
... Music care is a person-centered approach to practice, similar to palliative care. Unfortunately, few patients currently receive music care interventions as healthcare professionals lack knowledge and training [19,20]. ...
Article
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Background Music as a therapeutic tool, defined as “music care,” can help manage physical and psychological symptoms in individuals with cancer. There is further need to understand interest level and the potential role of music care among health professionals working in the field of oncology. Purpose To investigate knowledge of and attitudes toward the use of music as a therapeutic tool in cancer and palliative care, as well as to identify barriers associated with learning to use music in care among health professionals. Methods Participants (N = 204), mostly nurses working in oncology and palliative care, completed a survey to assess awareness, knowledge, and attitudes toward the use of music in healthcare practice. Results In total, 55.5% of participants reported being “somewhat or very knowledgeable” about how to apply/use music therapy for the management of symptoms or on how to make a music therapy referral or for any application of music care. Participants demonstrated a high interest level in learning how to incorporate music into practice (mean = 4.05; SD = 1.045). Conclusion While there is generally high interest and perceived value among nurses in music care interventions, knowledge level about such interventions was low. The study has implications for knowledge translation and education needed to further support uptake and use of music care in nursing practice.
... The illness itself or the necessary treatments may lead to a radical modification of patients' life habits. Especially in cases of advanced illness, symptoms can be very disabling (Zaza et al., 2005;Cheng and Zhang, 2016) and have a relevant impact on patients' physical well-being and quality of life (QoL), leading to emotional, physical and social suffering (Bradt et al., 2011;Tang et al., 2017) and eventually to elevated levels of psychological distress and depression (Bradt and Dileo, 2014;Massie, 2004;Watts et al., 2014;Fradelos et al., 2017). ...
Article
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.
... Scientific literature has reported significant effects of music and music therapy approaches in different diseases and in clinical and non-clinical settings. [25][26][27][28][29][30][31][32][33][34] It is proved that music can have important psycho-biological effects on stress conditions reducing the hypothalamus-pituitary-adrenal axis activity and consequently decreasing cortisol production. 11,35 The regulation of cortisol level can improve individuals' health, reducing stress conditions and allowing the control of blood sugar levels and blood pressure, but also the modulation of heart activity and the prevention of inflammatory processes. ...
Article
Background: Literature shows that music can reduce stress conditions. This pilot study investigated the effects of music listening on work-related stress and well-being in healthcare professionals. Method: A total of 45 subjects were randomly assigned to three treatment groups: No Music, Individualized Music and Melomics-Health Listening. Music groups experienced a daily 30-min-playlist listening for 3 weeks at home. The Maugeri Stress Index-Revised (MASI-R) and the Psychological General Well-Being Index (PGWBI) were administered at baseline, after 3 weeks and after 7 weeks (follow-up). Longitudinal data were analyzed by means of a nested ANOVA model, testing the main effects of time and treatment and the interaction between them. Results: MASI-R scores showed a positive trend in music groups and a worsening in the control group. Only the interaction time/treatment emerged as supporting a trend toward statistical significance (P = 0.07). PGWBI showed a stability in music groups and a clear decline in controls, without significant effects. Conclusions: Results from the study support the need for a larger clinical trial: it is suggested that daily music listening could be implemented to reduce work-related stress and that the effects may be related, not only to individual musical preferences and familiarity, but also to specific music structures and parameters.
... 21 Music has been shown to be effective in reducing pain, fatigue, and anxiety, improving QoL in various research. 13,22,23 In pain management, music interventions are applied as a nonpharmacological pain management strategy, increasing pain thresholds by providing relaxation and emotional stabilization. 16,17 For QoL improvement, music provides a means of promoting emotional expression and acceptance of critical situations. ...
Article
Background: Patients with a terminal illness receiving hospice care suffer from high psychological and emotional distress and physical pain, which impact quality of life. Music therapy has been shown to be an effective approach in reducing pain and improving quality of life. Methods: Three female patients with terminal cancer participated in a structured singing program, which comprised breathing, humming, toning, listening to songs, and singing songs. In order to examine the psychological well-being of participants, vocal and verbal responses of patients were recorded and analyzed qualitatively using three subcategories of psychological well-being:, autonomy, self-acceptance, and positive relationship. Results: Results showed positive changes in the responses of participants experiencing increased psychological well-being during their participation in the singing program. Singing offered opportunities to build a positive self-image, interact with the therapist, and build autonomy in musical and nonmusical behavior. Conclusion: The findings from this study suggest that a singing experience structured to meet patients' individual needs and their condition can help enhance their psychological well-being during hospice care.
... Sample size calculations for this study are adjusted for intervention effects on psychological quality of life (i.e. the primary outcome). A systematic review [85] suggests that medium-sized effects are most likely to be expected for the impact of music therapy on psychosocial outcomes in palliative care. Our own studies support this assumption finding effect sizes varying between d = 0.35 and d = 0.80 for generic quality-of-life measures [40]. ...
Article
Full-text available
Background Although patients in palliative care commonly report high emotional and spiritual needs, effective psychosocial treatments based on high quality studies are rare. First research provides evidence for benefits of psychosocial interventions in advanced cancer care. To specifically address end-of-life care requirements, life review techniques and creative-arts based therapies offer a promising potential. Therefore, the present study protocol presents a randomized controlled trial on the effectiveness of a newly developed music therapy technique that is based on a biographically meaningful song (“Song of Life”; SOL). Methods In a design with two parallel arms, 104 patients at two palliative care units will be randomly assigned to three sessions of either SOL (experimental group) or relaxation exercises (control group). Improvements in the psychological domain of quality of life will be the primary endpoint, while secondary outcomes encompass spiritual well-being, ego-integrity, overall quality of life, and distress. Additionally, caregivers will be asked to provide feedback about the treatment. Assessment of biopsychological stress markers and qualitative analysis of perceived strengths and weaknesses will complement data collection. Discussion Based on the results of a previous pilot study, we dedicated considerable efforts to optimizing the intervention and selecting appropriate outcomes for the present trial. We are confident to have designed a methodologically rigorous study that will contribute to the evidence-base and help to develop the potential of psychosocial interventions in palliative care. Trial registration German Clinical Trials Register (DRKS) – DRKS00015308 (date of registration: September 07th 2018).
... A person-centred and creative music therapy approach which employed a systematic therapeutic process that included assessment, therapy and evaluation was adopted, guided by each patient's needs, interests, preferences and energy levels, and adapted accordingly in the moment [21]. During sessions, an interactive music therapeutic approach was used, whereby the client would engage by singing, playing or listening to known music, or extemporaneously create a melody, rhythm, song or instrumental piece with the therapist's support. ...
Article
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Background: Evidence about the effectiveness of music therapy for improving the quality of life of palliative care patients is positive but weak in terms of risk of bias. Methods: This study aimed to determine the feasibility of a randomised controlled trial to evaluate the effectiveness of music therapy for improving the quality of life of hospice inpatients, as measured by the McGill Quality of Life questionnaire. Objectives included recruitment of 52 participants over 12 months and provision of data to support the calculation of the required sample size for a definitive randomised trial, taking into account the retention rates of recruited participants; and evaluation of the viability of the intervention and the acceptability of the assessment tool. The design was a single-centre, researcher-blinded randomised pilot and feasibility study involving two parallel groups. Participants were recruited from one inpatient hospice unit in Northern Ireland. Eligibility criteria were an Eastern Cooperative Oncology Group performance status of two or lower and an Abbreviated Mental Test score of seven or more. Consenting patients were randomly allocated to the intervention or control group using a 1:1 allocation ratio. The intervention group received up to six individual music therapy sessions over 3 weeks in addition to usual care. The control group received usual care only. Results: Fifty one participants were recruited over 12 months. Twenty five were allocated to the intervention group and 26 to the control group. Seventy one percent of participants were lost to follow up by week 3, the proposed primary endpoint. The primary endpoint was moved from week 3, when 71% were lost to follow up to week 1, when 33% were lost. The McGill Quality of Life questionnaire was generally acceptable to participants. In order to detect a small to moderate effect size of 0.3, a fully powered study would require the recruitment of 698 participants. Conclusions: A Phase III randomised controlled trial to evaluate the effectiveness of music therapy in improving the quality of life of hospice inpatients is feasible. Trial registration: ClinicalTrials.gov: NCT02791048 . Registered 6 June 2016.
... Palliative care represents an effective approach to reduce the suffering of these patients. 2 Palliative care initially focused on advanced cancer but in recent years has increasingly extended to the early stage of serious illness, and it has proliferated around the world. 3e5 The World Health Organization delimited that Y. G and Y. W. contributed equally to this work and should be considered co-first authors. ...
Article
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Context: The quality of death has increasingly raised concern because of the physical and psychological suffering of patients with advanced disease. Music therapy has been widely used in palliative care; however, its physical and mental effectiveness remains unclear. Objective: To assess the effectiveness of music therapy during palliative care in improving physiology and psychology outcomes. Methods: Randomized controlled trials evaluating music therapy for terminally ill patients were searched and included from inception up to April 25, 2018. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook V.5.1.0. Results: In this study, 11 randomized controlled trials (inter-rater agreement, κ = 0.86) involving 969 participants were included. The quality of the included studies ranged from moderate to high. Compared with general palliative care, music therapy can reduce pain (standardized mean difference: -0.44, 95% confidence interval: -0.60 to -0.27, P < 0.00001) and improve the quality of life (standardized mean difference: 0.61, 95% confidence interval: 0.41 to 0.82, P < 0.00001) in terminally ill patients. In addition, anxiety, depression, and emotional function are improved as well. However, no significant differences were found in the patient's physical status, fatigue, and social function. Conclusion: This meta-analysis study demonstrated that music therapy served as an effective intervention to alleviate pain and psychological symptoms of terminally ill patients. However, considering the limitation of the quantity of the studies included, these results would need to be further confirmed.
Book
This book presents advances in speech and music in the domain of audio signal processing. The book begins with introductory chapters on the basics of speech and music, and then proceeds to computational aspects of speech and music, including music information retrieval and spoken language processing. The authors discuss the intersection in the field of computer science, musicology and speech analysis, and how the multifaceted nature of speech and music information processing requires unique algorithms, systems using sophisticated signal processing, and machine learning techniques that better extract useful information. The authors discuss how a deep understanding of both speech and music in terms of perception, emotion, mood, gesture and cognition is essential for successful application. Also discussed is the overwhelming amount of data that has been generated across the world that requires efficient processing for better maintenance, retrieval, indexing and querying and how machine learning and artificial intelligence are most suited for these computational tasks. The book provides both technological knowledge and a comprehensive treatment of essential topics in speech and music processing.
Chapter
Music is not just a complex sound encompassing multiple tones but an amalgamation between the harmonicity of the spectral components and its temporal relationships. Music perception involves complex auditory processing, starting at cochlea wherein fundamental pitch, duration, and loudness are encoded in the tiny hair cells of the inner ear. Derailing of the hair cells causes hearing loss, which in turn affects the spectrotemporal resolution. The offshoot of the hearing loss at the cochlear level translates physiologically into deficits in the extraction and coding of the pitch at the brainstem level, which in turn impairs pitch and temporal perception at the cortical level. Thus, hearing loss adversely affects perception of pitch, temporal, and loudness, all of which compound as difficulty appreciating the normal aspects of music perception. The contemporary solution FOR improving audibility and perception of speech sounds in the hearing-impaired population are the use of hearing aids and cochlear implants. Although these devices are primarily meant to amplify speech sounds, their utility is also advocated for music perception. Digital hearing aids employ sophisticated signal processing techniques to improve the perception of speech sounds. However these techniques do not, in music processing, and are not an alternative to human cochlea. The multichannel amplitude compression, used in hearing aids to improve audible range of loudness levels, can cause distortions in the temporal envelope of sounds resulting in poor quality for music perception. Additionally, fast-acting compression circuitry used in the modern digital hearing aids causes more temporal smearing (compared to slow-acting compression), adversely affecting music perception. The limited input dynamic range and higher crest ratio in AD converters of hearing aids fall short of processing live music. Unlike hearing aids, cochlear implants work on the principle of electrical stimulation. This auditory prosthesis processes the incoming sound and delivers its electrical output directly into the auditory nerve bypassing the cochlea. Though it is more sophisticated and advanced than hearing aids, it was developed to improve speech perception rather than music perception. A cochlear implant uses “N” number of electrode channels situated along the human cochlea to deliver its output. Since the partition along the human cochlea codes various frequencies in sounds (place coding) which cannot be matched by a surgically implanted electrode array, the cochlear implant users experience difficulties with pitch perception. The rate of stimulation used by the cochlear implant may not be higher enough to deliver the higher harmonics of musical sounds. The above discussed physiological limitations of hearing loss and technological limitations of hearing amplification devices on music perception are elaborated in this chapter. The book chapter also features comprehensive discussion on the advancements in signal processing techniques available in hearing amplification devices (hearing aids and cochlear implants) that can address these shortcomings.
Article
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This contribution aims to offer food for thought on the ancestral role of music for mankind, considering its potential, transversal to different areas of interest, including psycho-pedagogical, clinical and didactic, as a heterogeneous expression of cultures, communities and characters. In spite of the fact that music education is compulsory in secondary schools, not in all contexts the activities are structured and carried out taking into account the positive implications on pupils’ psycho-physical well-being, rehabilitative potential and increased motivation to learn. Just as the possibilities for dynamics and time in music are manifold, so too is the horizon of options that looms over the sky of educational action, intersecting also with the world of technology, which puts innovative tools such as serious games at the service of education.
Article
Music therapy is an important psychosocial aspect of hospice and palliative care programs to address pain, grief, and anxiety. The COVID-19 pandemic introduced new challenges to psychosocial therapies in palliative care, including the inability of families to be at the bedside of seriously ill patients, and the need to provide services remotely through video technology. Due to this sudden shift in service delivery, music therapists adapted without research evidence or evaluation of service quality. This evidence-based quality improvement (QI) evaluation examined the program effectiveness of music therapy telehealth services at one Veterans Affairs Medical Center (VAMC) for patients in palliative care, their family members, and VAMC staff during this time of societal grief, anxiety, and isolation. Evaluation metrics included patient (n = 39), staff (n = 27), and family member (n = 3) responses to QI surveys, and analysis of journal entries from key stakeholders (i.e., music therapist, nurse case manager, palliative care physician). We conducted a content analysis of QI surveys and completed the first and second cycle coding of journal entries. Results from the QI survey indicated that music therapy telehealth provided affective and interpersonal benefits, and increased compliance with other therapies. Reflections from key stakeholders included clinical recommendations for service implementation and descriptions of the influence of the telehealth modality on the therapeutic relationship. Findings suggested that music therapy telehealth services can provide psychosocial support for veterans, families, and staff in palliative care. QI research may be utilized to provide helpful ongoing feedback regarding clinical effectiveness.
Thesis
Les Interventions Non-Médicamenteuses (INM), et autres procédures qui peuvent leur être associées (Médecine Traditionnelle, Médecines Complémentaires et Alternatives), sont aujourd’hui d’une prépondérance à ne pas sous-estimer dans l’optique d’une santé intégrative. Une évaluation scientifique robuste est nécessaire afin de trier les pratiques néfastes ou inefficaces, de celles attestant de réels bénéfices. Dans ce domaine, les essais randomisés contrôlés (ERC) font loi, à un titre discutable du fait de leurs limites intrinsèques. Par le biais d’une revue systématique de littérature centrée sur les pratiques de manipulation corporelles comme soins de support proposés en oncologie, nous confirmons la difficulté qu’ont les ERCs de tirer des conclusions fermes et bien appuyées. Nous présentons alors une méthode interventionnelle différente et peu enseignée, les protocoles expérimentaux à cas unique, et proposons leur illustration à travers quatre études. Celles-ci portent sur l’évaluation de différentes interventions dans des contextes de maladies chroniques ou de problèmes de santé variables : 1) Jeu vidéo thérapeutique dans le cadre de la réadaptation physique de la maladie de Parkinson, 2) Intervention musicale en Soins Palliatifs, 3) Hypnose face aux restrictions hydriques de patients sous hémodialyse et 4) Séances de shiatsu face à la dysménorrhée primaire. Ces études rendent compte de résultats intéressants, et permettent de discuter des forces et faiblesses de cette méthode. Nous plaidons alors en sa faveur du fait de ses principes expérimentaux légitimes ainsi que son adéquation avec la pratique fondée sur la preuve. Nous profitons enfin de la faible qualité des études que nous avons menées pour dresser une liste de recommandations et d’écueils à considérer afin de les employer de façon optimale.
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Collective mourning is an expression of societal maturity, cohesion, and respect. The world is in grief, but in early January 2020, before nobody could even imagine that SARS-CoV-2 would turn into the COVID-19 pandemic, a music video version of a pop ballad about love and isolation was spread across a Chinese social network. The song ‘You Are Not Alone’ was adapted as a cover by young foreigners living in China to express their support to bereaved families and frontline workers and encourage the people of China, their second home. At that time, the rest of the world looked to distant China but could hardly expect to face the same adversity months later. The authors reported that the music video was a spontaneous artistic expression copying such traumatic events and the mourning process. The present work analyses how the music was blended with lyrics and images describing the outbreak in Wuhan to reach their goal. The original song and this shortened version for China were compared regarding musical and lyric structures and main characteristics. Additionally, an analysis of the two videos was done regarding cinemetric variables and non-verbal communication that emphasized the power of songs to express deep sorrow and sympathy but also to give hope. Psychological first aid, the five stages of the mourning process by Kübler-Ross, the dual-process model by Stroebe and Schut, and Taylor’s tend-to-befriend provided a better understanding of the translation from interpersonal to societal mourning. Finally, other memorable songs that society spontaneously chose to be performed alone or together to cope with sudden and dramatic situations, mitigate physical distancing, and alleviate human suffering are discussed. Music, lyrics, and artistic performance are playing a key role in building social and emotional ties during this pandemic, hampering individual and social pain and sorrow despite cultural barriers.
Article
Background: This is an update of the review published on the Cochrane Library in 2016, Issue 8. Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in people with cancer. This review includes music interventions defined as music therapy offered by trained music therapists, as well as music medicine, which was defined as listening to pre-recorded music offered by medical staff. Objectives: To assess and compare the effects of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 3) in the Cochrane Library, MEDLINE via Ovid, Embase via Ovid, CINAHL, PsycINFO, LILACS, Science Citation Index, CancerLit, CAIRSS, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, the RILM Abstracts of Music Literature, http://www.wfmt.info/Musictherapyworld/ and the National Research Register. We searched all databases, except for the last two, from their inception to April 2020; the other two are no longer functional, so we searched them until their termination date. We handsearched music therapy journals, reviewed reference lists and contacted experts. There was no language restriction. Selection criteria: We included all randomized and quasi-randomized controlled trials of music interventions for improving psychological and physical outcomes in adults and pediatric patients with cancer. We excluded patients undergoing biopsy and aspiration for diagnostic purposes. Data collection and analysis: Two review authors independently extracted the data and assessed the risk of bias. Where possible, we presented results in meta-analyses using mean differences and standardized mean differences. We used post-test scores. In cases of significant baseline difference, we used change scores. We conducted separate meta-analyses for studies with adult participants and those with pediatric participants. Primary outcomes of interest included psychological outcomes and physical symptoms and secondary outcomes included physiological responses, physical functioning, anesthetic and analgesic intake, length of hospitalization, social and spiritual support, communication, and quality of life (QoL) . We used GRADE to assess the certainty of the evidence. Main results: We identified 29 new trials for inclusion in this update. In total, the evidence of this review rests on 81 trials with a total of 5576 participants. Of the 81 trials, 74 trials included adult (N = 5306) and seven trials included pediatric (N = 270) oncology patients. We categorized 38 trials as music therapy trials and 43 as music medicine trials. The interventions were compared to standard care. Psychological outcomes The results suggest that music interventions may have a large anxiety-reducing effect in adults with cancer, with a reported average anxiety reduction of 7.73 units (17 studies, 1381 participants; 95% confidence interval (CI) -10.02 to -5.44; very low-certainty evidence) on the Spielberger State Anxiety Inventory scale (range 20 to 80; lower values reflect lower anxiety). Results also suggested a moderately strong, positive impact of music interventions on depression in adults (12 studies, 1021 participants; standardized mean difference (SMD): -0.41, 95% CI -0.67 to -0.15; very low-certainty evidence). We found no support for an effect of music interventions on mood (SMD 0.47, 95% CI -0.02 to 0.97; 5 studies, 236 participants; very low-certainty evidence). Music interventions may increase hope in adults with cancer, with a reported average increase of 3.19 units (95% CI 0.12 to 6.25) on the Herth Hope Index (range 12 to 48; higher scores reflect greater hope), but this finding was based on only two studies (N = 53 participants; very low-certainty evidence). Physical outcomes We found a moderate pain-reducing effect of music interventions (SMD -0.67, 95% CI -1.07 to -0.26; 12 studies, 632 adult participants; very low-certainty evidence). In addition, music interventions had a small treatment effect on fatigue (SMD -0.28, 95% CI -0.46 to -0.10; 10 studies, 498 adult participants; low-certainty evidence). The results suggest a large effect of music interventions on adult participants' QoL, but the results were highly inconsistent across studies, and the pooled effect size was accompanied by a large confidence interval (SMD 0.88, 95% CI -0.31 to 2.08; 7 studies, 573 participants; evidence is very uncertain). Removal of studies that used improper randomization methods resulted in a moderate effect size that was less heterogeneous (SMD 0.47, 95% CI 0.06 to 0.88, P = 0.02, I2 = 56%). A small number of trials included pediatric oncology participants. The findings suggest that music interventions may reduce anxiety but this finding was based on only two studies (SMD -0.94, 95% CI -1.9 to 0.03; very low-certainty evidence). Due to the small number of studies, we could not draw conclusions regarding the effects of music interventions on mood, depression, QoL, fatigue or pain in pediatric participants with cancer. The majority of studies included in this review update presented a high risk of bias, and therefore the overall certainty of the evidence is low. For several outcomes (i.e. anxiety, depression, pain, fatigue, and QoL) the beneficial treatment effects were consistent across studies for music therapy interventions delivered by music therapists. In contrast, music medicine interventions resulted in inconsistent treatment effects across studies for these outcomes. Authors' conclusions: This systematic review indicates that music interventions compared to standard care may have beneficial effects on anxiety, depression, hope, pain, and fatigue in adults with cancer. The results of two trials suggest that music interventions may have a beneficial effect on anxiety in children with cancer. Too few trials with pediatric participants were included to draw conclusions about the treatment benefits of music for other outcomes. For several outcomes, music therapy interventions delivered by a trained music therapist led to consistent results across studies and this was not the case for music medicine interventions. Moreover, evidence of effect was found for music therapy interventions for QoL and fatigue but not for music medicine interventions. Most trials were at high risk of bias and low or very low certainty of evidence; therefore, these results need to be interpreted with caution.
Article
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Banyak ahli dan pakar psikologi meneliti peran musik terhadap proses penyembuhan pada praktik klinis untuk berbagai macam penyakit. Dewasa ini musik dan elemen yang terkandung di dalamnya sering digunakan sebagai media intervensi selama proses penyembuhan medis berlangsung. Tujuan penelitian ini adalah untuk mengetahui sejauh mana musik dapat berperan sebagai media intervensi dalam praktik klinis. Metodologi yang digunakan dalam penelitian ini adalah studi pustaka dengan memanfaatkan jurnal online, buku serta disertasi. Hasilnya adalah musik sebagai media intervensi ternyata sangat membantu dalam pasien mengatasi rasa takut, cemas, dan nyeri baik sebelum, selama, dan setelah proses perawatan medis berlangsung. Lebih dari itu, Intervensi musik pada pasien terbukti dapat membangun rasa percaya diri serta memunculkan energi positif dari hasil pengalaman menyenangkan yang telah dialami sebelumnya. Hal ini tentunya sangat baik untuk memajukan kualitas hidup dan kesejahteraan psikologis pasien.Many experts and psychologists examine how big music is taking a role in the healing process in clinical practice for various diseases. Nowdays music and the elements contained in it are often used as a medium of intervention during the medical healing process. The purpose of this study is to determine the extent to which music can act as a medium of intervention in clinical practices. The methodology used in this research is literature approach by utilizing online journals, books, and dissertations. The result is music as an intervention media is very helpful in patients in order to overcome fear, anxiety, and pain both before, during, and after the medical treatment process. More than that, music intervention in patients is proven to build self-confidence and generate positive energy which are coming from their pleasant experiences they feel before. This is certainly very good for advancing the quality of life and psychological well-beeing of them.
Chapter
„Mit einem Bild möchte ich etwas Tröstliches sagen, so wie Musik tröstlich ist“ Vincent van Gogh
Thesis
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Musiktherapie mit seinem wirkmächtigen Medium Musik kann bei Menschen in ihrer letzten Lebensphase zu bedeutsamen inneren und äusseren Veränderungen verhelfen, welche als Wandlung begriffen werden können. Anhand einer Literaturrecherche und einer empirischen Untersuchung in Form von Expertinneninterviews wird den Fragen nachgegangen, inwiefern Musiktherapie durch die musik-immanenten Funktionen einen Beitrag zur Steigerung der Widerstandskraft palliativ betreuter Patienten sowie zur Emergenz von Wandlungsmomenten resp. der Unterstützung von Wandlungsprozessen leisten kann. Aus der Resilienzforschung werden Resilienzfaktoren extrahiert und zu therapeutisch wirksamen Funktionen der Musik in Bezug gesetzt. Beide, Funktionen wie Faktoren, werden theoretisch sowie praktisch erörtert. Die qualitative Analyse der Daten mittels der Grounded Theory-Methode bringt einen bestimmten therapeutischen Rahmen sowie Haltungsaspekte als Vorbedingung für Wandlung hervor. Auch kommt die Arbeit zum Ergebnis, dass verschiedene Funktionen der Musik die Widerstands- kraft von Menschen in Hospiz- und Palliative Care stärken kann. Anhand von Fallbei- spielen dokumentiert sie, wie durch Musiktherapie Wandlung auf seelischer, körperlich- sinnlicher, transformativ-spiritueller und kommunikativer Ebene möglich ist.
Article
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Service evaluation is a professional requirement for music therapy practitioners and organisations. Yet service evaluation findings are rarely published within the professional literature, and there is limited documentation of the processes and methods of such evaluations, including the rationale, dilemmas, and challenges encountered. This is perhaps due to the perceived status, methodological weaknesses, and context-specificity of service evaluation work. Drawing on our engagement with service evaluation in diverse settings, we have become aware of its potential beyond its typical current uses in the field as well as of the need for open discussion and debate about the service evaluation tools that are available. This is where the aim of this paper lies: to introduce a service evaluation tool, the Impact Areas Questionnaire (IAQ), alongside the studies that led to its construction. Developed originally through a review of 27 individually designed service evaluation projects, this questionnaire contains a number of different impact areas. Adopting an ecological perspective, these areas refer to music therapy’s perceived impact not only on service users, but also on families/carers/friends, staff, and the organisational context in its entirety. Following its original development within Nordoff Robbins England and Wales, this questionnaire was tested in the context of Nordoff Robbins Scotland with the aim of exploring its applicability and transferability to other music therapy settings. In addition to presenting the findings of this testing, we discuss the potential use of the IAQ, which is included as an appendix to this article, in other settings and its relevance for knowledge and policy making in the field.
Article
Many studies have shown the positive effects of music therapy on managing anxiety, stress and depression of hospitalized patients. However, data on mood, anxiety, pain, depression, stress and attention level in Australia is limited where music therapy is involved. This randomized controlled pilot study examines this issue. A sample of 26 patients (12 male and 14 female) from the General Medicine Ward were recruited and randomly assigned to a treatment group (n = 12) and control group (n = 14). The treatment group received 30-minutes of individualized music therapy sessions for five consecutive days; they are compared to standard care in the control group. Pain and mood were measured using a Visual Analog Scale, and stress, anxiety and depression were measured using the Depression, Anxiety and Stress Scale (DASS 21). Multivariate regression models were used to examine the change in mood, pain, depression, anxiety and stress in the both groups. Results showed a statistically significant difference in mood, pain and anxiety, but not in depression and stress scores. Moreover, participants in the treatment group showed more hospital satisfaction compared to those in the control group.
Thesis
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The master thesis deals with the music therapeutic support of patients in palliative or hospice care. In particular, it is about finding out to what extent music therapy can initiate or support transformation on a mental, spiritual and physical level.
Chapter
Musiktherapie wird als „beziehungsmedizinischer“ Ansatz komplementär zur biomedizinischen Behandlung skizziert. Zentrale beziehungsmedizinische Aspekte werden in ihrem anthropologischen und biologischen Zusammenhang erläutert (Kommunikation, emotionale Resonanz, biologische Regulation, musikalische Biografie). Zudem wird der wissenschaftliche, gesetzliche und die Ausbildung betreffende Rahmen von Musiktherapie angesprochen. Kunsttherapeut ist ein Gesundheitsberuf mit diversen Ansätzen. Ein therapeutischer Ansatz ist mehr als eine Technik oder eine Methode. Damit eine Therapie sich auf die Künste als Methode stützen kann, braucht sie das Elaborieren von vier Bereichen: Meta-Theorie, Therapie-Theorie, Methodologie und Praxeologie. Die „Musiktherapie“ ist das erste therapeutische Verfahren im Raum der Künste mit einem expliziten Berufsgesetz. Die „Ganzheitliche Kunsttherapie“ baut auf der Synergie aller Künste auf und nimmt Geräusche, Klänge, Töne und alle anderen Sinnesmodalitäten hinzu.
Chapter
Im palliativen Setting geht es im Gegensatz zur Philosophie einer Intensivstation nicht mehr darum Leben zu erhalten, sondern Betroffenen ein Sterben in Würde zu ermöglichen und Leiden am Lebensende zu verhindern. Leid wird neben psychischen und sozialen Faktoren auch durch körperliche Symptome ausgelöst oder verstärkt. Entsprechende Maßnahmen zur Linderung solcher Symptome sind Teil der palliativen Pflege. In der medizinisch orientierten Umgebung einer Intensivstation stellt das Symptommanagement am Lebensende eine besondere Herausforderung dar. Dieses Kapitel beschäftigt sich mit den Möglichkeiten aber auch Schwierigkeiten, Symptome im Setting Intensivstation zu kontrollieren. Neben der Definition und den möglichen Assessmentmethoden werden pflegerische Maßnahmen zur Linderung der ausgewählten Symptome Schmerz, Atemnot, Juckreiz und Xerostomie geklärt. Um den Blickwinkel möglicher Linderungsmethoden zu erweitern, wird auch auf komplementäre Pflegemethoden eingegangen.
Article
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Music therapy in the treatment of chronic neurological illness typically focuses on the use of music to address the emotional and psychosocial impact of loss and change stemming from pathology. A range of clinical techniques is described in anecdotal accounts spanning instrumental improvisation, song composition and singing. However, there is scant reference to the musical and emotional experience of singing as a clinical technique with individuals living with chronic degenerative illness. Drawing on the results of an empirical investigation into the effects of music therapy with clients with chronic neurological illness, this paper reveals how singing may be used by clients to monitor their physical disease process. Grounded theory research with this population has revealed that music therapy elicits processes in which individuals monitor the physical changes caused by their disease process (Magee and Davidson 2004). Based upon these research findings, this paper illustrates that individuals living with illnesses which cause loss of voice function may find the act of singing a highly physical experience. As such, singing may be used to monitor subtle changes which have occurred due to the disease process. Individuals living with degenerative illness may use singing within therapy as a way to defy their illness process and as an expression of life's breath running through the body. Singing and voice work within clinical music therapy is therefore not only a vehicle for emotional expression, but also an invaluable tool in gaining an understanding of the client's experience, offering a boundaried environment for exploration of loss and degeneration. Finally, the paper provides a theoretical framework for the emotional experience of singing songs of personal meaning in therapy.
Article
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This article describes the process and results of a three-month music therapy clinical effectiveness study conducted with terminally ill patients. The purpose of this study was to quantify and evaluate the effectiveness of single-session music therapy interventions with hospice patients in three patient problem areas: pain control; physical comfort; and relaxation. Data from a total of 90 sessions conducted with a total of 80 subjects served by Hospice of Palm Beach County, Florida, were included in the study. Music therapy services were provided by five board-certified music therapists and one music therapist eligible for board certification. The subjects in this study were receiving regularly scheduled music therapy services from the hospice organization. The study used both behavioral observation and subject's self-reporting as methods of data reporting and recording. Subjects were observed for, or self-reported, their levels of pain control, physical comfort, and relaxation, both before and after each music therapy session. The subjects were served in the environments where music therapy services would normally be delivered (i.e., home, hospital, nursing home, or inpatient acute-care unit of the hospice organization). Music therapy services included live active and passive music-based experiences. These were designed to build and to establish rapport with patient or family, to facilitate family interaction and patient control, to provide support and comfort, to facilitate relaxation, to enable reminiscence and life review, to provide a frame-work for spiritual exploration and validation, and to encourage the identification and expression of feelings of anticipatory mourning and grief. A total of six hypotheses stated that there would be significant pre- to postsession differences in each of the three variables: pain control, physical comfort, and relaxation, as measured during two different session and data collection scenarios. These scenarios included the independent observation and recording of the three subject variables and the subject's self-report of each variable. Reliability correlation coefficients were calculated for each of the different session and data-collection scenarios to help assess the correlation between primary and reliability observers. Pearson product moment correlations indicated reliability agreement coefficients of r = .85 and r = .90. One-tailed t-tests were performed on the collected data for subject pain control, physical comfort, and relaxation. Results of the t-tests were significant at the p < or = .001 (for observed pain control, physical comfort, and relaxation) and p < or = 005 (for self-reported pain control, physical comfort, and relaxation) levels. These results suggest that single-session music therapy interventions appear to be effective in increasing subject pain control, physical comfort, and relaxation during both data collection scenarios. Based on the results of these tests of the analyzed data, the hypotheses were all accepted. Tables illustrate pre- to post-session changes in levels of all three variables from both session and data-collection scenarios. Copies of the data-collection forms are also included in the Appendix. The discussion section addresses limitations of this study and suggestions for future studies.
Article
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Although music therapy is an established allied health profession and is used with increasing frequency in the treatment of those with a terminal illness, there is a real dearth of empirical research literature supporting the use of music therapy in end-of-life care. This article reviews the empirical studies found in the literature and documents the emergence of an evidenced-based approach to the use of music therapy in hospice and palliative care. A total of 11 studies are reviewed; of these, six show significant differences supporting the use of music therapy in this area. Dependent variables positively affected by music therapy include pain, physical comfort, fatigue and energy, anxiety and relaxation, time and duration of treatment, mood, spirituality and quality of life. Guidelines for future research are considered, and variables that need to be controlled are presented. The need to create an evidence-based approach to hospice and palliative care music therapy is articulated, and future researchers are empowered to continue to conduct investigations among this population.
Article
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This study was to objectively assess the effect of music therapy on patients with advanced disease. Two hundred patients with chronic and/or advanced illnesses were prospectively evaluated. The effects of music therapy on these patients are reported. Visual analog scales, the Happy/Sad Faces Assessment Tool, and a behavior scale recorded pre- and post-music therapy scores on standardized data collection forms. A computerized database was used to collect and analyze the data. Utilizing the Wilcoxon signed rank test and a paired t test, music therapy improved anxiety, body movement, facial expression, mood, pain, shortness of breath, and verbalizations. Sessions with family members were also evaluated, and music therapy improved families' facial expressions, mood, and verbalizations. All improvements were statistically significant (P<0.001). Most patients and families had a positive subjective and objective response to music therapy. Objective data were obtained for a large number of patients with advanced disease. This is a significant addition to the quantitative literature on music therapy in this unique patient population. Our results suggest that music therapy is invaluable in palliative medicine.
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Little research has compared the perceptions of health professionals (HPs), patients, and caregivers about the communication of prognostic information. The objectives of this literature review were to determine 1) patient and caregiver perceptions of levels of information received about prognosis and end-of-life (EoL) issues regarding a life-limiting illness; 2) patient perceptions of and factors related to their understanding and awareness of prognosis; 3) HPs' perceptions of patients' wishes about disclosure of prognosis and factors related to their decision whether to disclose; and 4) concordance between HPs and patients/caregivers regarding the information given by HPs about prognostic and EoL issues. Relevant studies meeting the inclusion criteria were identified by searching computerized databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Cochrane Register of Controlled Trials [Central]) up to November 2004. The reference lists of identified studies were hand searched for further relevant studies. Inclusion criteria were studies of any design evaluating communication of prognostic information that included adult patients with an advanced, life-limiting illness; their caregivers; and qualified HPs. Fifty-one studies were identified. There was a large discrepancy between patients/caregivers and HPs regarding the amount of information they believed had been given. Patients' understanding and awareness of information received conflicted with the HPs' perceptions of patients' understanding and awareness of the information that had been given. HPs tended to underestimate patients' need for information and overestimate patients' understanding and awareness of their prognosis and EoL issues. HPs need to repeatedly check patients' understanding and preferences for information.
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Little is known about complementary therapy services (CTs) available in Canadian palliative care settings. An online survey was e-mailed to multiple Canadian palliative care settings to determine the types and frequency of CTs provided and allowed, who are the CT providers, funding of CT services, and barriers to the provision of CTs. The response rate was 54% (74/136). Eleven percent of surveyed palliative care settings provided CTs, and 45% allowed CTs to be brought in or to be used by patients. The three most commonly used CTs were music (57%), massage therapy (57%), and therapeutic touch (48%). Less than 25% of patients received CTs in the settings that provided and/or allowed these therapies. CTs were mostly provided by volunteers, and at most settings, limited or no funding was available. Barriers to the delivery of CTs included lack of funding (67%), insufficient knowledge of CTs by staff (49%), and limited knowledge on how to successfully operate a CT service (44%). For settings that did not provide or allow CTs, 44% felt it was important or very important for their patients to have access to CTs. The most common reasons not to provide or allow CTs were insufficient staff knowledge of CTs (67%) and lack of CT personnel (44%). Overall, these findings were similar to those reported in a US-based hospice survey after which this survey was patterned. Possible reasons for these shared findings and important directions regarding the future of CT service provision in Canadian palliative care setting are discussed.
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The literature supporting the use of music therapy in palliative care is growing. However, the number of quantitative research studies investigating the use of music therapy in palliative care, and specifically anxiety, is limited. The aim of this research project was to examine the effectiveness of a single music therapy session in reducing anxiety for terminally ill patients. A randomized-controlled design was implemented and the following hypotheses tested. There will be a significant difference between the experimental and control groups on anxiety levels as demonstrated by the anxiety measurement of the Edmonton Symptom Assessment System (ESAS), and heart rate. The experimental group received a single music therapy intervention and the control group received a volunteer visit. Twenty-five participants with end-stage terminal disease receiving inpatient hospice services were recruited. The first hypothesis was supported. Results demonstrated a significant reduction in anxiety for the experimental group on the anxiety measurement of the ESAS (p = 0.005). A post hoc analysis found significant reductions in other measurements on the ESAS in the experimental group, specifically pain (p = 0.019), tiredness (p = 0.024) and drowsiness (p = 0.018). The second hypothesis was not supported. The study supports the use of music therapy to manage anxiety in terminally ill patients. Further studies are required to examine the effect of music therapy over a longer time period, as well as addressing other symptom issues.
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This article describes the origins of song writing in music, its use in palliative care, and offers distinctions between song writing and poetry writing. Although both writing poetry and writing songs can enable patients to communicate messages and express memories and inner states, the unique impact of music in palliative care is discussed Ten therapeutic opportunities found to be associated with music when using song writing are suggested.
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The purpose of this study was to examine the quality of life, anxiety level, and the family satisfaction of patients’ during their end of life experience within a medical setting. Any patient admitted to Tallahassee Memorial HealthCare that met the criteria of End of Life intervention, as determined by the medical personnel, was considered as a potential subject. The End of Life celebration included any or all of the activities listed: a “song” written about the patient and family, live music as a sing along, patient preferred music to reminisce, and counseling to bring closure for the patient and family. The experimental and control groups were randomly assigned. The experimental group (N=10), received two sessions of music therapy. The first music therapy session was, used to gather family and patient information and also included, singing patient preferred music, seeking information about patient’s favorite song and preference, and assessing patient and family levels of coping. The second music therapy session for the experimental group was the end of life celebration that ended with patient and family providing self-report data on the Visual Analog Scale (VAS) (see Appendix B), Hospice Quality of Life Index (see Appendix D) questionnaire, and the Family Satisfaction Survey (see Appendix C). The control group N=10), agreed to participate in the study but received no music therapy services. However, each control subject completed the Hospice Quality of Life Index- Revised (see Appendix D) questionnaire and a self-report using a Visual Analog Scale (VAS) (see Appendix B) that measured anxiety levels. There was no change in the usual procedure of hospital care for those subjects. The self-report questionnaire from the Visual Analog Scale, (VAS) showed significantly lower anxiety scores for the experimental subjects then for the control subjects. The Family Satisfaction Survey filled out only by the experimental subjects, also showed a 97% satisfaction of music therapy and its uses in the medical setting. There were no significant differences between groups for quality of life measure.
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The purpose of this study was to investigate the effects of music therapy interventions on grief and spirituality of family members of patients in a hospice setting. The subjects (N = 60) were the family members or significant others of hospice patients who had been in the hospice program for at least 2 weeks. The subjects were divided into a control group (N = 30), the family members of patients previously with no music therapy visit, and an experimental group (N = 30), the family members of patients receiving music therapy interventions. Three imminent patients were also included in both groups. A self-report questionnaire was used for a post-test only in this study and had 5 categories: grief, coping strategies, spirituality, satisfaction with hospice care, and satisfaction for family members’ or significant other’s perceptions of the loved one’s quality of life (QOL). A multivariate analysis of variance (MANOVA) was applied to analyze data in each subtest. There was a significant difference in mean scores of QOL between the control and experimental groups. Although the mean scores of grief and spirituality in the experimental group were higher than the scores of those with no music therapy, a significant difference was not found in the 4 subtests. However, there was a tendency that those who received music therapy showed higher scores than those who did not in each subtest. In addition, the mean scores of family members of imminent patients were much higher than those with no music therapy in all 5 categories. The results in this study support that music has a potential to provide a positive influence for patients and their family members in a hospice setting. Further quantitative research for family members of imminent patients were suggested to provide better music therapy services in a hospice and palliative care.
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Examined the effects of music on perceived degree of pain relief, physical comfort, relaxation, and contentment, using 9 White patients with terminal malignant disease. Three conditions were presented: no intervention, background sound, and a personalized recording of music based on the S's preference and perception of calmness. Each condition was presented for 15 min twice daily for 2 days. Results show no significant difference in the dependent variables under the experimental conditions; however, contentment score differences approached significance. Findings highlight the efficacy of music as an intervention with the terminally ill. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This study aims at determining the effectiveness of music therapy in a hospice setting. We employed the salivary cortisol level, which is widely used to measure stress level, as an objective and physical indicator and the Mood Inventory, which measures mood change, as the subjective and psychological indicators. Though many preceding studies have demonstrated that listening to music lowers cortisol levels and reduces stress, no study seems to have included hospice patients. This study measured, with the consent of 10 hospice inpatients, their salivary cortisol levels. Individual interviews, according to the Mood Inventory, were conducted before and after a small-group session. Since all the participants had terminal cancer, the 40-minute live session of songs of seasons and the participants' requests was given in a mostly passive manner considering their physical strength. Results showed significant lowering of salivary cortisol levels after the therapy session. As for the parameters of mood, refreshment was significantly increased. Though fatigue remained unchanged, anxiety and depression decreased while the score for excitement tended to increase. Thus, it was indicated that music therapy in a hospice setting reduces the stress level of patients and thereby plays a positive role in improving patients' quality of life.
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The inclusion of only a subset of all available evidence in a meta-analysis may introduce biases and threaten its validity; this is particularly likely if the subset of included studies differ from those not included, which may be the case for published and grey literature (unpublished studies, with limited distribution). We set out to examine whether exclusion of grey literature, compared with its inclusion in meta-analysis, provides different estimates of the effectiveness of interventions assessed in randomised trials. From a random sample of 135 meta-analyses, we identified and retrieved 33 publications that included both grey and published primary studies. The 33 publications contributed 41 separate meta-analyses from several disease areas. General characteristics of the meta-analyses and associated studies and outcome data at the trial level were collected. We explored the effects of the inclusion of grey literature on the quantitative results using logistic-regression analyses. 33% of the meta-analyses were found to include some form of grey literature. The grey literature, when included, accounts for between 4.5% and 75% of the studies in a meta-analysis. On average, published work, compared with grey literature, yielded significantly larger estimates of the intervention effect by 15% (ratio of odds ratios=1.15 [95% CI 1.04-1.28]). Excluding abstracts from the analysis further compounded the exaggeration (1.33 [1.10-1.60]). The exclusion of grey literature from meta-analyses can lead to exaggerated estimates of intervention effectiveness. In general, meta-analysts should attempt to identify, retrieve, and include all reports, grey and published, that meet predefined inclusion criteria.
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Pain associated with advanced cancer is multifaceted and complex, and is influenced by physiological, psychological, social, and spiritual phenomena. Suffering may be identified in patients when pain is associated with impending loss, increased dependency, and an altered understanding of one's existential purpose. Comprehensive pain management aims to address problematic symptoms in order to improve comfort, peace of mind, and quality of life. Music therapy is a treatment modality of great diversity that can offer a range of benefits to patients with advanced cancer pain and symptoms of suffering. Music therapists perform comprehensive assessments that include reviews of social, cultural, and medical history; current medical status; and the ways in which emotions are affecting the pain. A variety of music therapy techniques may be used, including vocal techniques, listening, and instrumental techniques. These techniques provide opportunities for exploration of the feelings and issues compounding the pain experience. Case examples are presented to demonstrate the "lifting", "transporting", and "bringing of peace" qualities of music that offer patients moments of release, reflection, and renewal.
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The extent of heterogeneity in a meta-analysis partly determines the difficulty in drawing overall conclusions. This extent may be measured by estimating a between-study variance, but interpretation is then specific to a particular treatment effect metric. A test for the existence of heterogeneity exists, but depends on the number of studies in the meta-analysis. We develop measures of the impact of heterogeneity on a meta-analysis, from mathematical criteria, that are independent of the number of studies and the treatment effect metric. We derive and propose three suitable statistics: H is the square root of the chi2 heterogeneity statistic divided by its degrees of freedom; R is the ratio of the standard error of the underlying mean from a random effects meta-analysis to the standard error of a fixed effect meta-analytic estimate, and I2 is a transformation of (H) that describes the proportion of total variation in study estimates that is due to heterogeneity. We discuss interpretation, interval estimates and other properties of these measures and examine them in five example data sets showing different amounts of heterogeneity. We conclude that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity. One or both should be presented in published meta-analyses in preference to the test for heterogeneity.
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The purpose of this study was to evaluate the effects of music therapy on quality of life, length of life in care, physical status, and relationship of death occurrence to the final music therapy interventions of hospice patients diagnosed with terminal cancer. Subjects were adults who were living in their homes, receiving hospice care, and were diagnosed with terminal cancer. A total of 80 subjects participated in the study and were randomly assigned to one of two groups: experimental (routine hospice services and clinical music therapy) and control (routine hospice services only). Groups were matched on the basis of gender and age. Quality of life was measured by the Hospice Quality of Life Index-Revised (HQOLI-R), a self-report measure given every visit. Functional status of the subjects was assessed by the hospice nurse during every visit using the Palliative Performance Scale. All subjects received at least two visits and quality of life and physical status assessments. A repeated measures ANOVA revealed a significant difference between groups on self-report quality of life scores for visits one and two. Quality of life was higher for those subjects receiving music therapy, and their quality of life increased over time as they received more music therapy sessions. Subjects in the control group, however, experienced a lower quality of life than those in the experimental group, and without music, their quality of life decreased over time. There were no significant differences in results by age or gender of subjects in either condition. Furthermore, there were no significant differences between groups on physical functioning, length of life, or time of death in relation to the last scheduled visit by the music therapist or counselor. This study provides an overview of hospice/palliative care, explains the role of music therapy in providing care, and establishes clinical guidelines grounded in research for the use of music therapy in improving the quality of life among the terminally ill.
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A questionnaire was mailed to 300 randomly selected hospices in the United States, to gather preliminary data on the nature of complementary therapy services provided by hospices. Information included types of complementary therapies offered, utilization, staffing, obstacles, as well as suggestions for improving hospice complementary therapy services. Of a total of 169 responding hospices, 60% offered complementary therapies to patients. The most popular therapies were massage therapy and music therapy. Only a portion of patients in these hospices received complementary therapy. Many hospices were limited in the amount of complementary therapy services they could provide because of program constraints, such as funding problems, lack of qualified complementary staff, inadequate knowledge of complementary therapies and how to offer these services, and resistance to complementary therapies by some staff and patients. A crucial challenge for hospices interested in providing complementary therapies to patients is to find ways to overcome these obstacles.
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