Chiara Rutigliano’s research while affiliated with University of Bari Aldo Moro and other places

This article describes the oncology programs developed in Italy for adolescents and young adults with cancer, with a specific focus on the local projects created in pediatric oncology centers. A common feature of such projects is the emphasis on creative and artistic activities and laboratories (involving music, photography, novel writing, fashion design, and so on) designed to give young patients innovative means of expression. This article highlights the amazing powers of adolescents involved in these projects: the power to produce beautiful things in a place that is not normally associated with the idea of beauty; the power to make their doctors smile and grasp the profound sense of life; the power to make hospitals become places for producing culture.

Unlabelled: Music therapy (MT) is a complementary therapy offered to children, young adults, and their families in pediatric oncology and palliative care. We performed a survey to collect information about MT in pediatric oncology in Italy. The outbreak of COVID-19 unavoidably changed the scenario of MT, suggesting some considerations presented in this survey. 27/32 (84.4%) centers belonging to the Infections and Supportive Therapy Working Group of Association of Pediatric Hematology and Oncology (AEIOP) completed in 2 different time points (T1 and T2) an online survey on MT, before and after COVID-19 pandemia. Different kinds of music approach were used taking care of patients in 21/27 centers, while in 14/21 (66%), a specific project of MT conducted by a music therapist was present. In 6/14 centers, MT activities were delivered for < 3 h/week, in 3 centers for > 3 and < 10 h/week, and in the remaining 5 for > 3 h/week. MT sessions were in different areas, day hospital, or ward (patient rooms, operating rooms, waiting rooms), on an individual basis or by groups. Patients were invited to MT by psychologists, caring physician, or nurse, or on equipé decision. MT was evaluated with tools self-made by music therapist in 11/14 centers. After COVID-19, MT has been withdrawn in 3 centers, sessions in the waiting rooms were reduced, individual sessions were preferred, and enrollment by multidisciplinary teams increased. Conclusion: This survey represents the starting platform to compare and discuss different experience of MT in AIEOP centers, to implement MT in pediatric oncology for a more qualified assistance to patients, and to improve quality of care. What is known: • Music therapy in pediatric oncology and palliative care can be used for the management and prevention of various somatic and psychological symptoms of patients and often is provided to children together with their families. • In Italy the application of Music therapy in the AIEOP pediatric oncology centers is constantly increasing, but due to the outbreak of Covid-19 Pandemic, Italian pediatric oncology departments were obliged to adopt restrictive measures. What is new: • Although the majority of Centres did not abrogate MT interventions, judgment about limitation should be carefully taken since MT helps children and even more adolescents in their fight against cancer. • The best practice of Music therapy in pediatric oncology requires communication and collaboration among qualified music therapists and multidisciplinary care team, using a model of family-centered care that actively involves parents/ caregivers in assessment, treatment planning, and care delivery.

Background: Music therapy (MT) is a complementary therapy offered to children, young adults and their families in pediatric oncology and palliative care. We performed a survey to collect information about MT in pediatric oncology in Italy. The outbreak of COVID-19 unavoidably changed the scenario of MT, suggesting some considerations presented in this survey. Methods: 27/32 (84,4%) Centres belonging to the Italian Association of Pediatric Hematology and Oncology (AEIOP) completed in 2 different time points (T1 and T2) an online survey on MT, before and after Covid-19 pandemia. Results: Different kinds of music approach were used taking care of patients in 21/27 centers, while in 14/21 (66%) a specific project of MT conducted by a music therapist was present. In 6/14 Centres MT activities were delivered for <3 hours/week, in 3 Centres for >3 and <10 hours/week, in the remaining 5 for >3 hours/week. MT sessions were in different areas, day hospital or ward (patient rooms, operating rooms, waiting rooms), on an individual basis or by groups. Patients were invited to MT by psychologists, caring physician or nurse, or on equipé decision. MT was evaluated with tools self-made by Music therapist in 11/14 centres. After Covid-19. MT has been withdrawal in 3 centres, sessions in the waiting rooms were reduced, individual sessions were preferred and enrollment by multidisciplinary teams increased. Conclusion: This survey represents the starting platform to compare and discuss different experience of MT in AIEOP Centres, to implement MT in pediatric oncology for a more qualified assistance to patients and to improve quality of care.

Free-download https://authors.elsevier.com/a/1dU%7EqivMu9WwG During COVID-19 pandemic, Italian pediatric oncology departments were obliged to adopt restrictive measures to minimize the risk of in-hospital infections in frail patients and staff members. Access to the wards was significantly reduced and music therapy (MT) activities were suspended. The aim of this study was to compare the level of anxiety and sedation in pediatric patients undergoing invasive procedure before (T1), during(T2) and after(T3) the pandemic, with and without the presence of MT. From January to September 2020, all children aged 2-15 with oncological and hematological diseases undergoing to invasive procedure were enrolled. During T1 and T3 children received preoperative preparation with MT by a certified music-therapist. In T2 they received music or video by clinical staff. Preoperative anxiety scores were measured with the m- YPAS scale. Interviews with mothers were performed. The average consumption of drugs used was analyzed. Significant differences in preoperative anxiety levels between scores in T1, T2 (p.value = 0,0000014) and in T2, T3 (p.value = 0,0000031) were observed. No difference between T1-T3 (p.value = 0,96). Higher dosage of midazolam in T2 (1,14 mg 0,189) compared to T1 (0, 71 mg 0,399) and T2 (1,14 mg 0,189) were observed. Mothers also recorded higher scores on anxiety and stress without music therapy.

The influence of music therapy (MT) on preoperative anxiety in children affected by leukemia undergoing invasive diagnostic procedures (IP) was evaluated. The participants were assigned to two different types of preoperative preparation for IP: MT intervention or standard care. Preoperative anxiety scores were measured with the Modified Yale Pre-operative Anxiety Scale. Interviews with medical staff were performed. A lower preoperative anxiety score in the MT group (n = 29) compared with standard care (n = 19) was observed. Results support the potential effectiveness of integrating music therapy with a pharmacological approach to reduce preoperative anxiety in IP. More than 90% of the medical staff (n = 19) were very satisfied with the ability of MT to distract the patient and support the staff.

La malattia oncologica colpisce l’intero nucleo familiare, per questo la presa in carico da un punto di vista psicologico del bambino, richiede la presa in carico dell’intero sistema familiare. Il ‘funzionamento’ psicosociale dei gli in reazione alla malattia è in uenzato dalla capacità dei genitori di individuare strategie di risposta utili e adattive alla situazione che stanno a rontando. L’interazione tra i genitori e i loro gli ammalati, incide sulla qualità di vita dei pazienti, e sul prevenire o alleviare il disagio psicologico nei minori. La maggior parte dei ricoveri in accompagnamento al bambino è ad opera della MAMMA. La letteratura ci indica che la mamma, che è chiamata a dover assistere il proprio glio, può manifestare una sintomatologia depressiva che aumenta in base all’aumentare dei problemi comportamentali del glio. Dal momento della diagnosi la mamma vive forti sensi di colpa, in rapporto alla perdita d!ell’immagine di genitore capace di tutelare la vita che ha generato. Nonostante questo, sono natural- m! ente proiettate a tutelare e contenere la sfera emotiva del glio malato, piuttosto che la propria. Per una mamma durante il percorso di cura del glio, è di cile autorizzarsi a prendere del tempo per se stessa o concedersi momenti di espressione emotiva. Per questo motivo è stato individuato uno spazio dedicato alle mamme, che attraverso l’uso della musica permetta di ritagliarsi uno spazio. Dal 2014 nasce il progetto ISOLA D’ASCOLTO, incontri di gruppo di musicoterapia recettiva (GrpIM) rivolti esclusivamente alle mamme in regime di ricovero.