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Valero-Cantero I, Vázquez-Sánchez MÁ, Casals-Sánchez JL, Espinar-Toledo M, Corral-Pérez J, Casals C. Complementary Musical Intervention for Patients in Palliative Care in Spain: A Randomized Controlled Trial. Healthcare (Basel) 2024; 12:1938. [PMID: 39408117 PMCID: PMC11475251 DOI: 10.3390/healthcare12191938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 09/24/2024] [Accepted: 09/25/2024] [Indexed: 10/20/2024] Open
Abstract
BACKGROUND Patients with advanced cancer often endure a heavy burden of symptoms, both in quantity and intensity. Complementary therapies offer potential relief in this challenging scenario. Increasing the number of randomized controlled trials provides a unique opportunity to generate rigorous data, which can be used to establish causal relationships and evaluate interventions; hence, nurses can strengthen evidence-based practices, leading to better patient outcomes and quality of care. Our study aimed to evaluate the impact of a 7-day pre-recorded music intervention on cancer symptoms and satisfaction in advanced-stage cancer patients receiving palliative care at home. METHODS This multicenter, double-blind, randomized, controlled clinical trial involved 80 Spanish cancer patients receiving palliative care at home, and was conducted from July 2020 to November 2021. The intervention group (n = 40) received self-selected pre-recorded music for 30 min daily over 7 days. The control group (n = 40) received pre-recorded basic health education sessions of equal duration and frequency. Symptoms and patient satisfaction were assessed before and after the intervention using the Edmonton Symptom Assessment System and the Client Satisfaction Questionnaire, respectively. RESULTS Comparing the intervention with the control group, significant improvements were observed in various symptoms: total symptom burden (p < 0.001), pain (p = 0.001), fatigue (p = 0.007), depression (p = 0.001), anxiety (p = 0.005), drowsiness (p = 0.006), appetite (p = 0.047), well-being (p ≤ 0.001), and sleep (p < 0.001); additionally, patient satisfaction was higher in the intervention group (p < 0.001). CONCLUSIONS The 7-day pre-recorded music intervention reduced both physical and psychological symptoms in advanced-stage cancer patients receiving home-based palliative care, demonstrating significant alleviation of overall symptom burden and increased satisfaction with healthcare.
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Affiliation(s)
| | - María Ángeles Vázquez-Sánchez
- Department of Nursing, Faculty of Health Sciences, PASOS Research Group and UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, 29071 Malaga, Spain;
| | | | - Milagrosa Espinar-Toledo
- Rincón de la Victoria Clinical Management Unit, Malaga-Guadalhorce Health District, 29730 Malaga, Spain;
| | - Juan Corral-Pérez
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, 11519 Puerto Real, Spain;
| | - Cristina Casals
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, 11519 Puerto Real, Spain;
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Kwon CY, Kim H, Kim SH. The Modernization of Oriental Music Therapy: Five-Element Music Therapy Combined with Artificial Intelligence. Healthcare (Basel) 2024; 12:411. [PMID: 38338296 PMCID: PMC10855257 DOI: 10.3390/healthcare12030411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
In recent years, music has been regarded as a promising non-pharmacological intervention for a number of physical and mental conditions. Five-elements music therapy-based on the five-element theory-is a unique non-pharmacological therapy of East Asian traditional medicine. It has the potential to effectively provide individualized music therapy to individuals with illness. However, one limitation of this music therapy is that the classification of the five elements and its application is mainly based on subjective judgment. The development of artificial intelligence (AI) has enabled the acoustic analysis of multi-factor sound sources. This can develop five-element music therapy. Here, we discussed the challenges proposed by the future combination of five-element music therapy and AI. Further, we hypothesized that AI may promote its use in the medical field.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-eui University, Busan 47227, Republic of Korea
| | - Hyunsu Kim
- Department of Automotive Engineering, Dong-eui University, Busan 47340, Republic of Korea;
| | - Sung-Hee Kim
- Department of Industrial ICT Engineering, Dong-eui University, Busan 47340, Republic of Korea;
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3
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Düzgün G, Karadakovan A. Effect of Music on Pain in Cancer Patients in Palliative Care Service: A Randomized Controlled Study. OMEGA-JOURNAL OF DEATH AND DYING 2024; 88:1085-1100. [PMID: 34889153 DOI: 10.1177/00302228211059891] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the effect of music on pain, anxiety, comfort, and functional capacity of cancer patients who received care in a palliative care unit. The population of this randomized controlled trial consisted of cancer patients hospitalized in the palliative care service between July 2018 and July 2019. The study included 60 patients (30 interventions/30 controls). The patients in the intervention group were given a total of six music sessions, 10 minutes each with the Turkish classical music in maqams of their choice (Hejaz or Rast accompanied by an expert tambour (drum) player). There was a significant difference between the mean total pain scores, anxiety, comfort, and functional capacity scores of the patients in the intervention and control groups before and after music therapy. Music therapy decreased the level of pain. It is demonstrated that Turkish classical music therapy improved the pain, anxiety, comfort, and functional capacity in the palliative care unit.
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Affiliation(s)
- Gönül Düzgün
- First and Emergency Aid Department, Izmir Tinaztepe University, Aydoğdu, Buca/İzmir, Turkey
| | - Ayfer Karadakovan
- Erzene Mahallesi, Internal Medicine of Nursing, Ege Üniversitesi, Merkez Yerleşkesi Bornova, İzmir, Turkey
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Huda N, Banda KJ, Liu AI, Huang TW. Effects of Music Therapy on Spiritual Well-Being among Patients with Advanced Cancer in Palliative Care: A Meta-Analysis of Randomized Controlled Trials. Semin Oncol Nurs 2023; 39:151481. [PMID: 37541810 DOI: 10.1016/j.soncn.2023.151481] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/30/2023] [Accepted: 07/05/2023] [Indexed: 08/06/2023]
Abstract
PURPOSE Patients with advanced cancer in palliative care often experience physical and psychological symptoms that negatively impact their quality of life (QoL) and spiritual well-being. Music therapy can be used for symptom management in these patients. However, the effectiveness is uncertain. To determine the effectiveness of music therapy on spiritual well-being, QoL, pain, and psychological distress using randomized controlled trials (RCTs). DATA SOURCE A systematic search was conducted in EMBASE, PubMed, Cochrane Library, CINAHL, Web of Science, and the ClinicalTrial.gov registry up to September 2022. CONCLUSION The meta-analysis included seven RCTs with a total of 747 advanced cancer patients. Music therapy was found to significantly improve spiritual well-being with a mean difference of 0.43 (95% CI: 0.25 to 0.61, P < .001) in the intervention group compared to the control group. However, no significant group differences were found between the intervention and control groups for QoL (SMD: 0.53, 95% CI: -0.12 to 1.13, P = .11), pain (MD: -0.81, 95% CI: -2.06 to 0.44, P = .20), and psychological distress (SMD: -0.05, 95% CI: -0.41 to 0.32, P = .81). Music therapy can effectively improve the spiritual well-being of palliative care patients. However, its beneficial effects on QoL, pain, and psychological distress were minimal. IMPLICATIONS FOR NURSING PRACTICE Music therapy interventions can be introduced to help patients deal with spiritual/existential needs. Future studies should identify optimal characteristics of music therapy interventions to aid in enhancing the quality of palliative care for patients with advanced cancer.
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Affiliation(s)
- Nurul Huda
- Nursing Faculty, Universitas Riau, Pekanbaru, Riau, Indonesia; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Kondwani Joseph Banda
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - An-I Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Tsai-Wei Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; TMU Research Center of Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
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Kiernan JM, DeCamp K, Sender J, Given C. Barriers to Implementation of Music Listening Interventions for Cancer-Related Phenomena: A Mapping Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:279-291. [PMID: 36355075 DOI: 10.1089/jicm.2022.0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Introduction: Despite music listening interventions (MLIs) being recommended in multiple clinical practice guidelines, implementation into oncology clinical practice sites has been slow. This mapping review aimed to critique and identify barriers to MLI clinical implementation, as well as offer practical solutions for both clinicians and researchers. Methods: A PRISMA-based mapping review of MLI literature was performed using CINAHL, PubMed, PsycINFO, and Web of Science databases. Eligibility criteria included studies with MLIs as independent variables and cancer-related phenomena as outcome variables. Search was performed in October 2021, and no date limit was set. Results: Thirty-eight studies met the eligibility criteria for inclusion. Several aspects of MLI studies suggested potential barrier status to clinician or patient adoption. These findings included choice of music, music delivery hardware, dose of MLI, and timing of MLI specific to outcomes of interest (e.g., pain, anxiety, mood). Few investigators addressed the concurrent effects of pharmaceuticals (e.g., analgesics, anxiolytics), and controlling for the effects of competing auditory stimuli was minimal. Discussion: This review has identified several barriers that may obstruct clinician and patient adoption of MLIs, despite level of evidence for MLIs that presently exists in the literature. The review makes practical suggestions for clinicians, researchers, and patients to overcome the present barriers and ease MLIs into common practice in clinics and homes.
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Affiliation(s)
| | - Katie DeCamp
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Jessica Sender
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Charles Given
- College of Nursing, Michigan State University, East Lansing, MI, USA
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6
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Kiernan JM, Vallerand AH. Mitigation of Chemotherapy-Induced Nausea Using Adjunct Music Listening: A Pilot Study. Clin Nurs Res 2023; 32:469-477. [PMID: 36744581 DOI: 10.1177/10547738221149895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The persistence of chemotherapy-induced nausea (CIN) underscores the need to consider nonpharmacologic treatments such as music listening as adjunct interventions. This pilot study investigated the feasibility and overall effects of a 30-minute adjunct music listening intervention in 12 patients experiencing CIN. Music listening was started at the time participants took their as-needed antiemetic medication, and it was repeated as needed during the 5 days after chemotherapy. Data for 66 music listening engagements were collected. A significant reduction of nausea severity (t = 10.97, p < .001) and distress (t = 9.86, p < .001) was noted overall, as well as significant reductions when examining the acute and delayed phases of nausea individually. Qualitative data on study feasibility demonstrated the intervention was well received by participants and held minimal operational difficulty. Investigator feasibility data suggested good understanding of data collection tools. Improvements to the study design have been collected and will form the basis of the future randomized controlled trial.
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Chow R, Bergner R, Prsic E. Music therapy effectiveness by duration in patients with cancer: a meta-regression. BMJ Support Palliat Care 2023; 13:117-120. [PMID: 36810298 DOI: 10.1136/bmjspcare-2021-003163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/27/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Several reviews and meta-analyses have reported on music therapy for physical and emotional well-being among patients with cancer. However, the duration of music therapy offered may range from less than 1 hour to several hours. The aim of this study is to assess whether longer duration of music therapy is associated with different levels of improvement in physical and mental well-being. METHODS Ten studies were included in this paper, reporting on the endpoints of quality of life and pain. A meta-regression, using an inverse-variance model, was performed to assess the impact of total music therapy time. A sensitivity analysis was conducted for the outcome of pain, among low risk of bias trials. RESULTS Our meta-regression found a trend for positive association between greater total music therapy time and improved better pain control, but it was not statistically significant. CONCLUSION There is a need for more high-quality studies examining music therapy for patients with cancer, with a focus on total music therapy time and patient-related outcomes including quality of life and pain.
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Affiliation(s)
- Ronald Chow
- Yale School of Public Health, Yale University, New Haven, Connecticut, USA.,Yale New Haven Hospital, Yale University, New Haven, Connecticut, USA
| | - Robert Bergner
- Volunteer Services, Yale New Haven Hospital, Yale University, New Haven, Connecticut, USA
| | - Elizabeth Prsic
- Yale New Haven Hospital, Yale University, New Haven, Connecticut, USA .,Department of Medicine, Yale University, New Haven, Connecticut, USA
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J L, E P, X Z, QN L, A G, F L, Y W, M F. A Cross-Cultural Randomized Pilot Trial of Western-based and Five Elements Music Therapy for Psychological Well-being. Explore (NY) 2022:S1550-8307(22)00205-1. [DOI: 10.1016/j.explore.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/22/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
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Ahlström G, Huang H, Luo Y, Bökberg C, Rasmussen BH, Persson EI, Xue L, Cai L, Tang P, Persson M, Huang J. Similarities and differences between China and Sweden regarding the core features of palliative care for people aged 60 or older: a systematic scoping review. BMC Palliat Care 2022; 21:35. [PMID: 35287635 PMCID: PMC8922883 DOI: 10.1186/s12904-022-00906-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/24/2022] [Indexed: 11/22/2022] Open
Abstract
Background Despite the increasing longevity of the world’s population, with an unprecedented rise in the number of people who need palliative care (PC), there has been sparse research regarding palliative care for older people, especially when it comes to comparison of PC between healthcare systems and cultures. The aim of this systematic scoping review was to identify the characteristics of the body of literature and to examine the knowledge gaps concerning PC research for older people (> 60 years) in two healthcare systems and cultures, mainland China and Sweden. Methods The guidelines PRISMA (Preferred Reporting Items for Systematic Reviews), and PICOS (Patient/population, Intervention, Comparison/control, and Outcome) were used. Empirical studies on patients 60 years or older, next of kin or staff participating in a palliative care intervention or setting were included. They were conducted in mainland China or in Sweden during 2007–2019, were published in English and were extracted from seven databases: Embase, PubMed, Scopus, Cinahl, PsycInfo, Academic Search Complete and Cochrane Library. Two independent researchers conducted the selection of studies, data extraction and methodological evaluation. Any disagreements were resolved in consultation with a third researcher. The analysis was manifest directed content analysis based on PICOS domains. Results Of the 15 studies, four were from mainland China and 11 from Sweden. Both countries included older patients with cancer but also other end-stage diseases such as heart failure and dementia. The studies differed in design, method and the content of the interventions. The study in China based on traditional Chinese medicine concerns traditional Chinese folk music. The six qualitative studies from Sweden were evaluations of five interventions. Conclusions Despite the high age of the participating patients, there was no focus on an ageing perspective concerning palliative care. To adapt to the changes taking place in most societies, future research should have increased focus on older persons’ need for palliative care and should take account of issues concerning research ethics, ethnicity and culture. Registered in Prospero CRD42020078685, available from. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00906-7.
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Affiliation(s)
- Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden.
| | - Hongli Huang
- Hospital Management, the Third People's Hospital of Kunming, Kunming, Yunnan Province, China
| | - Yu Luo
- Hospice Care Department, the Third People's Hospital of Kunming, Kunming, Yunnan Province, China
| | - Christina Bökberg
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden
| | - Birgit H Rasmussen
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden.,The Institute for Palliative Care, Region Skane and Lund University, Lund, Sweden
| | - Eva I Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden
| | - Lian Xue
- Hospice Care Department, the Third People's Hospital of Kunming, Kunming, Yunnan Province, China
| | - Le Cai
- School of Public Health, Kunming Medical University, Kunming, Yunnan Province, China
| | - Pingfen Tang
- School of Public Health, Kunming Medical University, Kunming, Yunnan Province, China
| | - Magnus Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden
| | - Jingjing Huang
- The Medical Record Statistics Department, the Third People's Hospital of Kunming, Kunming, Yunnan Province, China
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Bradt J, Dileo C, Myers-Coffman K, Biondo J. Music interventions for improving psychological and physical outcomes in people with cancer. Cochrane Database Syst Rev 2021; 10:CD006911. [PMID: 34637527 PMCID: PMC8510511 DOI: 10.1002/14651858.cd006911.pub4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
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.
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Affiliation(s)
- Joke Bradt
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Cheryl Dileo
- Department of Music Therapy and The Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, Philadelphia, PA, USA
| | | | - Jacelyn Biondo
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
- Department of Expressive Therapies, Graduate School of Arts and Social Sciences, Lesley University, Cambridge, MA, USA
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11
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Yang T, Wang S, Wang R, Wei Y, Kang Y, Liu Y, Zhang C. Effectiveness of five-element music therapy in cancer patients: A systematic review and meta-analysis. Complement Ther Clin Pract 2021; 44:101416. [PMID: 34020291 DOI: 10.1016/j.ctcp.2021.101416] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/26/2021] [Accepted: 05/11/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To systematically evaluate the effectiveness of five-element music therapy on anxiety, depression, quality of life (QoL), sleep quality and Karnofsky performance score (KPS) in cancer patients. METHODS We searched English databases (PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (CNKI, WanFang, CBM and VIP database) from the inception to December 25, 2020. Two investigators independently screened literature, extracted data, and assessed risk of bias according to the eligibility criteria. The RevMan 5.3 software was used to perform the meta-analysis. RESULTS A total of 22 studies, 2053 people with cancer were included. Meta-analysis showed that five-element music therapy had a significant difference for relieving depression (SMD = -1.11, 95% CI: 1.41 to -0.82, P < 0.00001), QoL (SMD = 1.41, 95% CI:0.58 to 2.23, P = 0.0008), sleep quality (MD = -1.73, 95% CI: 2.34 to -1.12, P < 0.00001), and KPS (MD = 4.75, 95% CI:2.31 to 7.18, P = 0.0001). And five-element music therapy did not show a positive effect on anxiety (SMD = -0.60, 95% CI: 1.47 to 0.27, P = 0.17). CONCLUSIONS Five-element music therapy had a positive effect on depression, QoL, sleep quality, and KPS in cancer patients, while did not show a positive effect on anxiety. Future researchers need to optimize the research program and conduct more high-quality, large sample, multi-center randomized controlled studies. Besides, it would be helpful for future researchers to explain the five-element music therapy being examined and how it is potentially useful in western contexts.
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Affiliation(s)
- Ting Yang
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Shurui Wang
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Ruirui Wang
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Yuqi Wei
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Yannan Kang
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Yanhui Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Chunmei Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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12
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Effectiveness of different music interventions on managing symptoms in cancer survivors: A meta-analysis. Eur J Oncol Nurs 2021; 52:101968. [PMID: 34020137 DOI: 10.1016/j.ejon.2021.101968] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/07/2021] [Accepted: 04/14/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE Music-based interventions can provide non-pharmacological, low-cost treatment for symptoms. This meta-analysis's purpose is to examine music-based interventions' effectiveness on psychological distress symptoms (anxiety, stress, and depressive symptoms), aspects of positive psychology (benefit-finding and resilience), and quality of life (QoL). METHODS This meta-analysis was conducted according to PRISMA guidelines and meta-analytic methods suggested by Hedges and Olkin (1985). A systematic literature search between 2000 and 2020 was conducted using CINAHL, MEDLINE, PsycINFO, PubMed, and Web of Science databases. Studies and intervention characteristics were independently coded. The Quality Assessment Tool for Quantitative Studies, Cochrane Collaboration's Tool for Assessing Risk of Bias, Begg and Mazumdar's rank correlation, and Egger's regression test evaluated publication bias. RESULTS Twenty-nine of thirty-five eligible studies were included in the statistical analysis. The overall (g = 0.34, SE = 2.27, p < 0.05) and psychological distress symptoms sub-outcome type (g = 0.47, SE = 0.18, p < 0.05) models with moderator analyses were statistically significant. CONCLUSIONS Culturally appropriate music-based interventions conducted in the clinical setting that used passive listening with headphones, occurring ≥ 3-times a week over ≥ 2 months, positively impacted gynecology survivors undergoing chemotherapy and surgical treatments. Specifically, interventions that were ≥ 35-minutes, listening to folk or mixed-music positively impacted psychological distress symptoms, whereas new-age music negatively impacted psychological distress symptoms, positive psychology, and QoL outcomes. Future research should examine positive psychology characteristics (perceived levels of positive adjustment, change, and coping) and include larger cohorts with various cancer populations across all cancer survivorship continuum. Culturally appropriate interventions could lead to greater adherence, compliance, and clinical effectiveness and increase the findings' significance and generalizability.
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Music interventions can alleviate cancer-related fatigue: a metaanalysis. Support Care Cancer 2021; 29:3461-3470. [DOI: 10.1007/s00520-021-05986-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
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Wu Q, Liu Z, Pang X, Cheng L. Efficacy of five-element music interventions in perinatal mental health and labor pain: A meta-analysis. Complement Ther Clin Pract 2020; 40:101217. [PMID: 32763833 DOI: 10.1016/j.ctcp.2020.101217] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/26/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To systematically review the efficacy of five-element music interventions in perinatal mental health and labor pain. To provide evidence for future research on Chinese Traditional Music Interventions. METHODS An electronically search was conducted in Web of Science, PubMed, EMbase, The Cochrane Library, CNKI databases, WanFang Data and VIP Database for Chinese Technical Periodicals from inception to January 07, 2020 to collect randomized controlled trials (RCTs) on five-element music interventions for prenatal, perinatal and postpartum women. Literature screening, data extraction, and the risk of bias assessment of all eligible studies were conducted by two reviewers independently. Then, meta-analysis was performed by RevMan 5.3 software. RESULTS A total of 13 RCTs involving 2387 patients were included. The results of meta-analysis showed that five-element music could significantly improve the depression levels (SMD = -2.03, 95%CI: -2.88 to -1.19, P < 0.00001), anxiety levels (SMD = -3.49, 95%CI: -4.47 to -2.24, P < 0.00001) and severe anxiety rate (OR = 0.42, 95%CI: 0.19 to 0.94, P = 0.04) of perinatal women. Additionally, five-element music produced significant effects on labor pain (MD = -0.67, 95%CI: -0.82 to -0.52, P < 0.00001), labor duration (MD = -0.85, 95%CI: -1.07 to -0.63, P < 0.00001), the hemorrhage 2 h after parturition (MD = -19.55, 95%CI: -35.56 to -3.54, P = 0.02) and the Serum DYN expression level (MD = 1.32, 95%CI: 0.23 to 2.40, P = 0.02). CONCLUSIONS Five-element music may be efficacious in improving perinatal women' depression, anxiety, labor pain, labor duration, the hemorrhage 2 h after parturition and the Serum DYN expression level. Because of the limitation of quantity and quality of included studies, more high-quality studies were needed to confirm the above conclusion.
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Affiliation(s)
- Qi Wu
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, PR China
| | - Zhijian Liu
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, PR China
| | - Xiaoli Pang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, PR China.
| | - Ling Cheng
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, PR China
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Li Y, Xing X, Shi X, Yan P, Chen Y, Li M, Zhang W, Li X, Yang K. The effectiveness of music therapy for patients with cancer: A systematic review and meta‐analysis. J Adv Nurs 2020; 76:1111-1123. [DOI: 10.1111/jan.14313] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/15/2019] [Accepted: 01/29/2020] [Indexed: 01/30/2023]
Affiliation(s)
- Yanfei Li
- Evidence Based Social Science Research Center School of Public Health Lanzhou University Lanzhou China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province Lanzhou China
| | - Xin Xing
- Evidence Based Medicine Center School of Basic Medical Sciences Lanzhou University Lanzhou China
| | - Xiue Shi
- Research Institute for Evidence Based Rehabilitation Medicine of Gansu Province Lanzhou China
- Gansu Province Hospital Rehabilitation Center Lanzhou China
| | - Peijing Yan
- Institution of Clinical Research and Evidence Based Medicine The Gansu Provincial Hospital Lanzhou China
| | - Yajing Chen
- Evidence Based Social Science Research Center School of Public Health Lanzhou University Lanzhou China
| | - Meixuan Li
- Evidence Based Social Science Research Center School of Public Health Lanzhou University Lanzhou China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province Lanzhou China
| | - Weiyi Zhang
- Evidence Based Social Science Research Center School of Public Health Lanzhou University Lanzhou China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province Lanzhou China
| | - Xiuxia Li
- Evidence Based Social Science Research Center School of Public Health Lanzhou University Lanzhou China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province Lanzhou China
| | - Kehu Yang
- Evidence Based Social Science Research Center School of Public Health Lanzhou University Lanzhou China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province Lanzhou China
- Evidence Based Medicine Center School of Basic Medical Sciences Lanzhou University Lanzhou China
- Institution of Clinical Research and Evidence Based Medicine The Gansu Provincial Hospital Lanzhou China
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Are the MORECare guidelines on reporting of attrition in palliative care research populations appropriate? A systematic review and meta-analysis of randomised controlled trials. BMC Palliat Care 2020; 19:6. [PMID: 31918702 PMCID: PMC6953282 DOI: 10.1186/s12904-019-0506-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/12/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Palliative care trials have higher rates of attrition. The MORECare guidance recommends applying classifications of attrition to report attrition to help interpret trial results. The guidance separates attrition into three categories: attrition due to death, illness or at random. The aim of our study is to apply the MORECare classifications on reported attrition rates in trials. METHODS A systematic review was conducted and attrition classifications retrospectively applied. Four databases, EMBASE; Medline, CINHAL and PsychINFO, were searched for randomised controlled trials of palliative care populations from 01.01.2010 to 08.10.2016. This systematic review is part of a larger review looking at recruitment to randomised controlled trials in palliative care, from January 1990 to early October 2016. We ran random-effect models with and without moderators and descriptive statistics to calculate rates of missing data. RESULTS One hundred nineteen trials showed a total attrition of 29% (95% CI 28 to 30%). We applied the MORECare classifications of attrition to the 91 papers that contained sufficient information. The main reason for attrition was attrition due to death with a weighted mean of 31.6% (SD 27.4) of attrition cases. Attrition due to illness was cited as the reason for 17.6% (SD 24.5) of participants. In 50.8% (SD 26.5) of cases, the attrition was at random. We did not observe significant differences in missing data between total attrition in non-cancer patients (26%; 95% CI 18-34%) and cancer patients (24%; 95% CI 20-29%). There was significantly more missing data in outpatients (29%; 95% CI 22-36%) than inpatients (16%; 95% CI 10-23%). We noted increased attrition in trials with longer durations. CONCLUSION Reporting the cause of attrition is useful in helping to understand trial results. Prospective reporting using the MORECare classifications should improve our understanding of future trials.
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Yang Y, Fang YY, Gao J, Geng GL. Effects of Five-Element Music on Language Recovery in Patients with Poststroke Aphasia: A Systematic Review and Meta-Analysis. J Altern Complement Med 2019; 25:993-1004. [DOI: 10.1089/acm.2018.0479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yang Yang
- School of Nursing, Nantong University, Nantong, China
| | - Yueh-Yen Fang
- School of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Jing Gao
- School of Nursing, Nantong University, Nantong, China
| | - Gui-Ling Geng
- School of Nursing, Nantong University, Nantong, China
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Teo I, Krishnan A, Lee GL. Psychosocial interventions for advanced cancer patients: A systematic review. Psychooncology 2019; 28:1394-1407. [PMID: 31077475 DOI: 10.1002/pon.5103] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 04/17/2019] [Accepted: 05/07/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Psychosocial care for advanced cancer encompasses a wide range of interventions that help patients make life-changing decisions, manage debilitating symptoms, confront impending mortality, and improve other patient outcomes. Psychosocial care is becoming increasingly available to advanced cancer patients; however, an overview of the various types of interventions is lacking. METHODS The current review systematically examined randomised-controlled trials of psychosocial interventions for advanced cancer patients from January 2007 to June 2018. MEDLINE, CINAHL Plus, PsycINFO, and Scopus databases were searched, and a total of 68 studies were included in the review. RESULTS We found a range of psychosocial interventions studies and grouped them based on six theoretical/clinical approaches: cognitive behavioural therapy based; meaning enhancing; dignity, life review, and narrative; other counselling; education only; and music, writing, and others. The different psychosocial interventions had significantly varied characteristics (eg, format, duration, and resources used) to address issues faced by advanced cancer patients. There is compelling evidence for the use of meaning-centred psychotherapy to improve meaning and quality of life and use of question prompt lists and communication skills training to improve communication with health care providers. CONCLUSIONS Some psychosocial interventions are further along in establishing evidence for effectiveness. Our findings demonstrate a growing capacity within the field to meet the psychosocial needs of advanced cancer patients. Lessons and direction in clinical practice and future research endeavours are discussed.
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Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Anirudh Krishnan
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Geok Ling Lee
- Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
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Gramaglia C, Gambaro E, Vecchi C, Licandro D, Raina G, Pisani C, Burgio V, Farruggio S, Rolla R, Deantonio L, Grossini E, Krengli M, Zeppegno P. Outcomes of music therapy interventions in cancer patients-A review of the literature. Crit Rev Oncol Hematol 2019; 138:241-254. [PMID: 31121392 DOI: 10.1016/j.critrevonc.2019.04.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 11/27/2022] Open
Abstract
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.
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Affiliation(s)
- Carla Gramaglia
- Psychiatry Institute, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy; Psychiatry Ward, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 18, Novara, Via Solaroli 17, Italy.
| | - Eleonora Gambaro
- Psychiatry Institute, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Camilla Vecchi
- Psychiatry Institute, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Davide Licandro
- School of Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Giulia Raina
- Laboratory of Physiology and Experimental Surgery, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Carla Pisani
- Radiotherapy Unit, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 18, 28100, Novara, Italy
| | - Vincenzo Burgio
- Radiotherapy Unit, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Serena Farruggio
- Laboratory of Physiology and Experimental Surgery, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Roberta Rolla
- Clinical Chemistry Unit, Azienda Ospedaliero Universitaria Maggiore della Carità, Corso Mazzini 18, 28100, Novara, Italy; Department of Health Sciences, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Letizia Deantonio
- Radiotherapy Unit, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy; Radiotherapy Unit, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 18, 28100, Novara, Italy
| | - Elena Grossini
- Laboratory of Physiology and Experimental Surgery, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
| | - Marco Krengli
- Radiotherapy Unit, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy; Radiotherapy Unit, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 18, 28100, Novara, Italy
| | - Patrizia Zeppegno
- Psychiatry Institute, Department of Translational Medicine, Università del Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy; Psychiatry Ward, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 18, Novara, Via Solaroli 17, Italy
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Facai L, Dehong H, Nana H, Yihuang G, Yunchuan W. Effect of music therapy derived from the five elements in Traditional Chinese Medicine on post-stroke depression. J TRADIT CHIN MED 2017. [DOI: 10.1016/s0254-6272(17)30322-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Progressive Muscle Relaxation Combined with Chinese Medicine Five-Element Music on Depression for Cancer Patients: A Randomized Controlled Trial. Chin J Integr Med 2017; 24:343-347. [DOI: 10.1007/s11655-017-2956-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Indexed: 10/19/2022]
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Bradt J, Dileo C, Magill L, Teague A. Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev 2016:CD006911. [PMID: 27524661 DOI: 10.1002/14651858.cd006911.pub3] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in cancer patients. OBJECTIVES To 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) (2016, Issue 1), MEDLINE, Embase, 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 January 2016; 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 adult and pediatric patients with cancer. We excluded participants 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. MAIN RESULTS We identified 22 new trials for inclusion in this update. In total, the evidence of this review rests on 52 trials with a total of 3731 participants. We included music therapy interventions offered by trained music therapists, as well as music medicine interventions, which are defined as listening to pre-recorded music, offered by medical staff. We categorized 23 trials as music therapy trials and 29 as music medicine trials.The results suggest that music interventions may have a beneficial effect on anxiety in people with cancer, with a reported average anxiety reduction of 8.54 units (95% confidence interval (CI) -12.04 to -5.05, P < 0.0001) on the Spielberger State Anxiety Inventory - State Anxiety (STAI-S) scale (range 20 to 80) and -0.71 standardized units (13 studies, 1028 participants; 95% CI -0.98 to -0.43, P < 0.00001; low quality evidence) on other anxiety scales, a moderate to strong effect. Results also suggested a moderately strong, positive impact on depression (7 studies, 723 participants; standardized mean difference (SMD): -0.40, 95% CI -0.74 to -0.06, P = 0.02; very low quality evidence), but because of the very low quality of the evidence for this outcome, this result needs to be interpreted with caution. We found no support for an effect of music interventions on mood or distress.Music interventions may lead to small reductions in heart rate, respiratory rate and blood pressure but do not appear to impact oxygen saturation level. We found a large pain-reducing effect (7 studies, 528 participants; SMD: -0.91, 95% CI -1.46 to -0.36, P = 0.001, low quality evidence). In addition, music interventions had a small to moderate treatment effect on fatigue (6 studies, 253 participants; SMD: -0.38, 95% CI -0.72 to -0.04, P = 0.03; low quality evidence), but we did not find strong evidence for improvement in physical functioning.The results suggest a large effect of music interventions on patients' quality of life (QoL), but the results were highly inconsistent across studies, and the pooled effect size for the music medicine and music therapy studies was accompanied by a large confidence interval (SMD: 0.98, 95% CI -0.36 to 2.33, P = 0.15, low quality evidence). A comparison between music therapy and music medicine interventions suggests a moderate effect of music therapy interventions for patients' quality of life (QoL) (3 studies, 132 participants; SMD: 0.42, 95% CI 0.06 to 0.78, P = 0.02; very low quality evidence), but we found no evidence of an effect for music medicine interventions. A comparison between music therapy and music medicine studies was also possible for anxiety, depression and mood, but we found no difference between the two types of interventions for these outcomes.The results of single studies suggest that music listening may reduce the need for anesthetics and analgesics as well as decrease recovery time and duration of hospitalization, but more research is needed for these outcomes.We could not draw any conclusions regarding the effect of music interventions on immunologic functioning, coping, resilience or communication outcomes because either we could not pool the results of the studies that included these outcomes or we could only identify one trial. For spiritual well-being, we found no evidence of an effect in adolescents or young adults, and we could not draw any conclusions in adults.The majority of studies included in this review update presented a high risk of bias, and therefore the quality of evidence is low. AUTHORS' CONCLUSIONS This systematic review indicates that music interventions may have beneficial effects on anxiety, pain, fatigue and QoL in people with cancer. Furthermore, music may have a small effect on heart rate, respiratory rate and blood pressure. Most trials were at high risk of bias and, therefore, these results need to be interpreted with caution.
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Affiliation(s)
- Joke Bradt
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, 1601 Cherry Street, room 7112, Philadelphia, PA, USA, 19102
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