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Singing for People with Advance Chronic Respiratory Diseases: A Qualitative Meta-Synthesis. Biomedicines 2022; 10:biomedicines10092086. [PMID: 36140187 PMCID: PMC9495573 DOI: 10.3390/biomedicines10092086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Rationale: Although there remains insufficient evidence regarding singing programs as effective strategies for achieving clinically significant health outcomes, this non-pharmacological intervention appears to be subjectively low-risk and well-tolerated by people with advanced chronic respiratory diseases (CRD). Objective: This study sought to examine and synthesize the current qualitative evidence regarding the experiences of participating in singing for breathing programs by people with advanced CRD. Methods: A meta-synthesis of qualitative data was conducted. Electronic databases (Medline, CINAHL, PsycINFO, and EMBASE) were searched for published qualitative studies reporting the effects of singing programs for adults with advanced CRD and their carers. Primary qualitative data were extracted and analysed, which generated descriptive and analytical themes. Results: Themes identified from seven included studies were: anticipation and reluctance to participate; physical and psychological benefits; new sense of purpose and enjoyment; social connection and achievement; and broad views regarding program structure and content. The themes highlighted changing perspectives before, during and after engaging in the singing program, as participants transitioned from initial anxiety to mastery of their chronic condition as the singing program progressed. Participants, however, raised concerns regarding several singing technicalities, the lack of ongoing support after the singing programs’ conclusion and the social impacts of transitioning the sessions online during the COVID-19 pandemic. Conclusions: This meta-synthesis highlights the positive experiences of people with CRD who participate in singing for breathing programs. Further research, including longitudinal qualitative studies, can provide insight into the acceptability and feasibility of singing programs and inform the broader implementation of the intervention.
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Kaasgaard M, Rasmussen DB, Løkke A, Vuust P, Hilberg O, Bodtger U. Physiological changes related to 10 weeks of singing for lung health in patients with COPD. BMJ Open Respir Res 2022; 9:9/1/e001206. [PMID: 35545297 PMCID: PMC9096537 DOI: 10.1136/bmjresp-2022-001206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Singing for Lung Health (SLH) was non-inferior to physical exercise training in improving 6-minute walking test distance (6MWD) and quality of life (St. George's Respiratory Questionnaire (SGRQ)) within a 10-week pulmonary rehabilitation (PR) programme for COPD in our recent randomised controlled trial (RCT) (NCT03280355). Previous studies suggest that singing improves lung function, respiratory control and dyspnoea, however this has not yet been convincingly confirmed. Therefore, this study aimed to explore the impact of SLH on physiological parameters and the associations with achieving the minimal important difference (MID) in 6MWD and/or SGRQ. METHODS We conducted post hoc, per-protocol analyses mainly of the SLH group of the RCT, exploring associations with 6MWD and SGRQ results by stratifying into achieving versus not-achieving 6MWD-MID (≥30 m) and SGRQ-MID (≤-4 points): changes in lung function, inspiratory muscle strength/control, dyspnoea, and heart rate response using logistic regression models. Further, we explored correlation and association in achieving both 6MWD-MID and SGRQ-MID (or in neither/nor) using Cohen's κ and Cochran-Mantel-Haenszel Test. RESULTS In the SLH study group (n=108), 6MWD-MID was achieved by 31/108 (29%) and in SGRQ by 53/108 (49%). Baseline factors associated with achieving MID in either outcome included short baseline 6MWD and high body mass index. Achieving 6MWD-MID was correlated with improved heart rate response (OR: 3.14; p=0.03) and achieving SGRQ-MID was correlated with improved maximal inspiratory pressure (OR: 4.35; p=0.04). Neither outcome was correlated with significant spirometric changes. Agreement in achieving both 6MWD-MID and SGRQ-MID was surprisingly insignificant. CONCLUSIONS This explorative post hoc study suggests that SLH is associated with physiological changes after short-term PR for COPD. Future physiological studies will help us to understand the mechanisms of singing in COPD. Our study furthermore raises concern about poor agreement between subjective and objective benefits of PR despite state-of-the-art tools.
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Affiliation(s)
- Mette Kaasgaard
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University and the Royal Academy of Music, Aarhus/Aalborg, Aarhus University, Faculty of Health, Aarhus, Denmark .,Pulmonary Research Unit Region Zealand (PLUZ), Department of Respiratory Medicine, Zealand Univsersity Hospital Naestved and Roskilde, Naestved, Denmark
| | - Daniel Bech Rasmussen
- Pulmonary Research Unit Region Zealand (PLUZ), Department of Respiratory Medicine, Zealand Univsersity Hospital Naestved and Roskilde, Naestved, Denmark.,Department of Regional Health Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Anders Løkke
- Department of Regional Health Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark.,Department of Respiratory Medicine, Lillebaelt Hospital, Vejle, Southern Denmark, Denmark
| | - Peter Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University and the Royal Academy of Music, Aarhus/Aalborg, Aarhus University, Faculty of Health, Aarhus, Denmark
| | - Ole Hilberg
- Department of Regional Health Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark.,Department of Respiratory Medicine, Lillebaelt Hospital, Vejle, Southern Denmark, Denmark
| | - Uffe Bodtger
- Pulmonary Research Unit Region Zealand (PLUZ), Department of Respiratory Medicine, Zealand Univsersity Hospital Naestved and Roskilde, Naestved, Denmark.,Department of Regional Health Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
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