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Jodie F, Anna K, Ursula W. Effectiveness of music therapy, aromatherapy, and massage therapy on people in palliative care with end-of-life needs: A systematic review. J Pain Symptom Manage 2024:S0885-3924(24)00903-5. [PMID: 39142496 DOI: 10.1016/j.jpainsymman.2024.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/08/2024] [Accepted: 07/21/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Music therapy, aromatherapy and massage therapy are widely used in palliative care in patients near end-of-life with the aim to reduce symptom burden and improve quality of life (QoL). Recent research shows an increase in popularity and use of complementary and integrative medicine however a more thorough evidence base about their usefulness is required. OBJECTIVES The aim of this study was to evaluate the available evidence on the use of music therapy, aromatherapy and massage therapy in palliative and hospice care and summarize findings. METHODS A defined search strategy was used in reviewing literature from two major databases, MEDLINE and Embase for the period between 2010 and 2022. Studies were selected for further evaluation based on intervention type and relevancy. After evaluation using quality assessment tools, findings were summarised, and potential benefits were identified. RESULTS Out of 1261 studies initially identified, 26 were selected for further evaluation. 16 evaluated music therapy, 4 aromatherapy and massage therapy. The most represented outcomes were pain, anxiety, well-being and QoL. Many studies demonstrated a short-term benefit in symptom improvement. Qualitative studies showed that these complementary methods are highly valued. CONCLUSION Main results found that music and massage therapy had the most potential benefits on a range of outcome parameters, including pain and QoL. Future studies may consider using more qualitative and/or mixed methods to provide a more comprehensive evaluation of treatment.
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Affiliation(s)
- Freeman Jodie
- Institute of Complementary and Integrative Medicine, University of Bern, Switzerland.
| | - Klingele Anna
- Institute of Complementary and Integrative Medicine, University of Bern, Switzerland
| | - Wolf Ursula
- Institute of Complementary and Integrative Medicine, University of Bern, Switzerland
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2
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Rom-Arjona B, Atanacio E, Crisologo D, Narvaez RA. Impact of Environment and Milieu Therapy in Palliative Care. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231180235. [PMID: 37258425 DOI: 10.1177/00302228231180235] [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: 06/02/2023]
Abstract
The collaborative approach offered by palliative care benefits both patients and their caregivers. They provide a system of support that enables patients to lead as active a life as possible. This integrative review aimed to find out whether milieu and environment therapy has a significant impact on palliative care patients. Analyses and summaries of seventeen (17) papers were completed. There were three themes identified: environmental factors for quality of life, milieu therapy in forms of arts and music, and milieu therapy is safe, structured, and psychotherapeutic. This review demonstrates that milieu and environment therapy may also help to reduce physical symptoms, such as pain, and enhance quality of life. The study suggests that even if there are many interventions for palliative patients, more research is needed to generate a more thorough evaluation of the efficacy of various environmental control components and milieu therapies for palliative care patients.
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3
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Rusowicz J, Szczepańska-Gieracha J, Kiper P. Neurologic Music Therapy in Geriatric Rehabilitation: A Systematic Review. Healthcare (Basel) 2022; 10:2187. [PMID: 36360527 PMCID: PMC9690210 DOI: 10.3390/healthcare10112187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 09/08/2024] Open
Abstract
(1) Introduction: Neurologic music therapy (NMT) is a non-pharmacological approach of interaction through the therapeutic use of music in motor, sensory and cognitive dysfunctions caused by damage or diseases of the nervous system. (2) Objective: This study aimed to critically appraise the available literature on the application of particular NMT techniques in the rehabilitation of geriatric disorders. (3) Methods: PubMed, ScienceDirect and EBSCOhost databases were searched. We considered randomized controlled trials (RCTs) from the last 12 years using at least one of the NMT techniques from the sensorimotor, speech/language and cognitive domains in the therapy of patients over 60 years old and with psychogeriatric disorders. (4) Results: Of the 255 articles, 8 met the inclusion criteria. All papers in the final phase concerned the use of rhythmic auditory stimulation (RAS) (sensorimotor technique) in the rehabilitation of both Parkinson's disease (PD) patients (six studies) and stroke patients (SPs) (two studies). (5) Conclusion: All reports suggest that the RAS technique has a significant effect on the improvement of gait parameters and the balance of PD patients and SPs, as well as the risk of falls in PD patients.
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Affiliation(s)
- Jagoda Rusowicz
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland
| | | | - Paweł Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venezia, Italy
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4
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Sumneangsanor T, Ruchiwit M, Weglicki L. The effects of a biofeedback and music training programme in reducing stress in Thai patients living with cancer receiving palliative care. Int J Palliat Nurs 2022; 28:453-463. [PMID: 36269291 DOI: 10.12968/ijpn.2022.28.10.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Stress can physically effect patients with cancer undergoing palliative care and should be targeted for prevention. AIM To examine the effects of the biofeedback and music training programme (BMT programme) in decreasing stress among patients living with cancer receiving palliative care. METHODS A randomised controlled trial (RCT) repeated measure study was used to investigate the effects of the BMT programme. FINDINGS The participants in the BMT programme had the lowest mean stress recorded before, during and after the experiment, while the control group had a higher mean of stress in every measurement period. There were significant differences among groups across the time periods (Wilks' lambda =0.269, F=7.081, p<0.01). CONCLUSION Use of the BMT programme resulted in a significant reduction in patient stress. This confirms that the BMT programme plays an important role in helping patients living with cancer that experience high volumes of stress.
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Affiliation(s)
- Tipsuda Sumneangsanor
- Assistant Professor; Associate Dean for Administrative and Academic Service, Faculty of Nursing, Thammasat University, Thailand
| | - Manyat Ruchiwit
- Dean; Professor, Faculty of Nursing, Rattana Bundit University, Thailand
| | - Linda Weglicki
- Dean; Professor, The Medical University of South Carolina, US
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5
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Pérez-Núñez P, Lázaro E, Amayra I, López-Paz JF, Caballero P, Martínez O, Pérez M, Berrocoso S, Al-Rashaida M, García M, Rodríguez AA, Luna PM. Music therapy and Sanfilippo syndrome: an analysis of psychological and physiological variables of three case studies. Orphanet J Rare Dis 2021; 16:486. [PMID: 34801065 PMCID: PMC8605530 DOI: 10.1186/s13023-021-02123-6] [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: 02/22/2021] [Accepted: 11/06/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Mucopolysaccharidosis type III (MPS III) or Sanfilippo syndrome is a neurodegenerative disease caused by the accumulation of mucopolysaccharides in the body. As the symptoms are wide ranging, it is a challenge to provide a diagnosis and psychological treatment for affected children. Method The main objective of this study was to describe a form of music therapy treatment applied to three children diagnosed with MPS III. The psychological variables were evaluated by an ad hoc observation recording template, and the physiological variables were measured with a digital meter before and after each session. The perception of the parents was also considered through a semi-structured interview. Results An improvement in the psychological variables was shown in all cases. Changes in the physiological variables were also noted, although they varied according to each child. The parents report some benefit of music therapy and they share difficulty in assessing the extent of benefits of the music therapy. Discussion Findings indicate that music therapy can be a useful form of treatment with multiple benefits for children with conditions such as MPS III or similar conditions. However, further research is needed in this area and in the development of specific ways of evaluating music therapy.
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Affiliation(s)
- P Pérez-Núñez
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain.
| | - E Lázaro
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - I Amayra
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - J F López-Paz
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - P Caballero
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - O Martínez
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - M Pérez
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - S Berrocoso
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - M Al-Rashaida
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - M García
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - A A Rodríguez
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - P M Luna
- Department of Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
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6
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Sumneangsanor T, Ruchiwit M, Weglicki L. Non-drug Stress Management for Patients with Cancer: A Systematic Review. Open Nurs J 2021. [DOI: 10.2174/1874434602115010211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Patients with cancer suffer from the physical impacts of the disease, including pain in organs where cancer has spread to and treatment side effects. Many factors affect the mental state of cancer patients, especially stress which can cause muscle tension around the affected area and create a higher degree of pain. Stress impacts physical conditions and results in a worse quality of life. Thus, an appropriate approach to cope with, evaluate, and manage stress in cancer patients is considered crucial.
Objective:
The purpose of this systematic review was to determine and evaluate non-drug stress management guidelines for cancer patients.
Methods:
A systematic review was undertaken to synthesize knowledge concerning stress and non-drug stress management for cancer patients. Information was sourced from documents and articles published by related institutions in relevant electronic databases, including PubMed, PsycINFO, Dynamed, and ScienceDirect between 2013 and 2019. No limitations were imposed regarding the type of study design previously used. Conference abstracts were not accepted. The quality of all included studies was independently appraised by two review writers.
Results:
The search generated 129 studies, of which only 20 met the inclusion criteria. The 20 studies cover 11 studies of music for cancer prevention and 6 studies of mindfulness-based stress reduction in cancer patients. The studies utilized both quantitative and qualitative approaches, while three studies of biofeedback in cancer patients only collected quantitative data. For the outcome from the reviews, 6 studies found that music therapy, biofeedback, and mindfulness greatly impact physical alterations such as insomnia, nausea or vomiting, and pain. Furthermore, 17 studies found that non-drug management techniques had a positive impact on psychological adjustments such as stress and anxiety reduction and relaxation promotion. Non-drug stress management such as music, biofeedback, and mindfulness was found to reduce stress among patients.
Conclusion:
This review confirms that non-drug stress management approaches can reduce suffering, lead to a better quality of life, reduce mortality rates, minimize treatment costs, and prevent and mitigate unwanted symptoms in cancer patients. This approach can be adapted and applied to patients with other diseases in the future. However, because several of the reviewed studies did not have a follow-up period, the present study was unable to collect evidence suggesting how long the observed benefits will remain.
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Taylor MR, Scott SR, Steineck A, Rosenberg AR. Objectifying the Subjective: The Use of Heart Rate Variability as a Psychosocial Symptom Biomarker in Hospice and Palliative Care Research. J Pain Symptom Manage 2021; 62:e315-e321. [PMID: 33933615 PMCID: PMC8418996 DOI: 10.1016/j.jpainsymman.2021.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 11/27/2022]
Abstract
Measuring psychosocial symptoms in hospice and palliative care research is critical to understanding the patient and caregiver experience. Subjective patient-reported outcome tools have been the primary method for collecting these data in palliative care, and the growing field of biobehavioral research offers new tools that could deepen our understanding of psychosocial symptomatology. Here we describe one psychosocial biomarker, heart rate variability (HRV), and simple techniques for measurement in an adolescent and young adult cancer population that are applicable to palliative care studies. Complementing self-reported measures with objective biomarkers like HRV could facilitate a more nuanced understanding of physiologic and perceived well-being in patients with serious or life-limiting illness and inform future "precision supportive care" in hospice and palliative medicine.
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Affiliation(s)
- Mallory R Taylor
- University of Washington School of Medicine, Department of Pediatrics, Division of Hematology/Oncology, Seattle, Washington, USA; Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA.
| | - Samantha R Scott
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA; Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Angela Steineck
- University of Washington School of Medicine, Department of Pediatrics, Division of Hematology/Oncology, Seattle, Washington, USA; Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Abby R Rosenberg
- University of Washington School of Medicine, Department of Pediatrics, Division of Hematology/Oncology, Seattle, Washington, USA; Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA
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8
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Potvin N, Hicks M, Kronk R. Retracted: Music Therapy: A Core Service in Integrative Palliative Care. J Altern Complement Med 2021; 27:e1156-e1158. [PMID: 33902291 DOI: 10.1089/acm.2020.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Journal of Alternative and Complementary Medicine (JACM) officially withdraws the article entitled, "Music Therapy: A Core Service in Integrative Palliative Care" by Noah Potvin, Molly Hicks, and Rebecca Kronk (epub: 27 April 2021; DOI: https://doi.org/10.1089/acm.2020.0025). The article had been "provisionally accepted" for possible publication in a special issue of JACM, but by the time articles were selected for that issue, the Guest Editors determined it should not be included and the Editor rescinded the provisional acceptance. Regrettably, the acceptance was reversed after the article was processed through normal production processes and was mistakenly released to the Journal's online platform. After the article was posted, the publisher learned that the authors had submitted and published the article elsewhere since the provisional acceptance had been reversed. Because of this, and in keeping with standard peer review practices, JACM must withdraw the article. It is important to note that this was an editorial error and that the authors bear no fault. The publisher of JACM and its editorial team deeply regret this error and sincerely apologize to Dr. Potvin, Dr. Hicks, and Dr. Kronk.
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Affiliation(s)
- Noah Potvin
- Mary Pappert School of Music and School of Nursing, Duquesne University, Pittsburgh, PA, USA
| | - Molly Hicks
- Penn Medicine Hospice, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Rebecca Kronk
- School of Nursing, Duquesne University, Pittsburgh, PA, USA
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9
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Hohneck A, Reyser C, Merx K, Weingärtner S, Mavratzas A, Schumacher G, Linhuber C, Hofmann WK, Burkholder I, Hofheinz RD. Differential Effects of Sound Intervention and Rest on Cardiovascular Parameters in Cancer Patients: A Randomized Cross-over Trial. Integr Cancer Ther 2021; 20:1534735421995239. [PMID: 33813930 PMCID: PMC8024455 DOI: 10.1177/1534735421995239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Music therapy or sound interventions were shown to confer beneficial effects in patients with cancer for instance in terms of pain or fear relief and improvement of other patient reported outcomes. Cardiovascular parameters, especially heart rate variability (HRV) were found to have prognostic implications in cancer patients. In this trial we aimed to investigate the effects of a sound intervention on cardiovascular parameters compared to rest in patients with cancer. Methods and results: Using a randomized cross-over design, 52 patients (male 13, female 39) with cancer were recruited to receive both a 15-minute sound intervention and a 15-minute rest intervention within 4 weeks with at least a one-week blanking period. Cardiovascular parameters (among others HRV, aortic pulse wave velocity [PWV], augmentation index [Aix], aortic blood pressure [BP], heart rate [HR]) were assessed immediately before (pre) and after (post) the intervention had taken place. HRV (Root mean square of successive RR interval differences [RMSSD, ms]) significantly increased, during sound intervention (median RMSSD pre 24 [range 5-112] vs post 22 [range 9-141], P = .03). Likewise, median PWV, as a direct marker of arterial stiffness, was significantly reduced by sound intervention ([m/s] pre 8.5 [range 5.6-19.6] vs post 8.3 [range 5.6-15.6], P = .04). For both parameters no statistically significant change during rest was observed. HR was lowered by both, rest (P < .0001) and sound intervention (P = .02), with a more pronounced effect by rest. A significant increase in systolic aortic blood pressure was shown by rest ([mmHg] median 101 [range 78-150] vs post median 103 [range 71-152], P = .04) but not during sound intervention (P = .59), while rest intervention led to a decrease in resistance index (pre median 33 [range 13-92] vs post median 32 [11-84], P = .02). Conclusion: In comparison with rest, a single sound intervention in patients with cancer improved cardiovascular parameters commonly associated with increased stress levels. Studies with longer follow-up and multiple interventions are warranted. Trial Registration: ISRCTN registry 70947363.
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Affiliation(s)
- Anna Hohneck
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christina Reyser
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Kirsten Merx
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Simone Weingärtner
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Athanasios Mavratzas
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | | | - Wolf-Karsten Hofmann
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Burkholder
- University of Applied Sciences of the Saarland, Saarbrucken, Germany
| | - Ralf-Dieter Hofheinz
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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10
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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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11
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Gao Y, Wei Y, Yang W, Jiang L, Li X, Ding J, Ding G. The Effectiveness of Music Therapy for Terminally Ill Patients: A Meta-Analysis and Systematic Review. J Pain Symptom Manage 2019; 57:319-329. [PMID: 30389608 DOI: 10.1016/j.jpainsymman.2018.10.504] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 01/30/2023]
Abstract
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.
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Affiliation(s)
- Yinyan Gao
- School of Public Health, Lanzhou University, Gansu, China
| | - Yanping Wei
- Department of Gastroenterology, the First Affiliated Hospital of Lanzhou University, Gansu, China
| | - Wenjiao Yang
- School of Public Health, Lanzhou University, Gansu, China
| | - Lili Jiang
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiuxia Li
- School of Public Health, Lanzhou University, Gansu, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Gansu, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Gansu, China
| | - Jie Ding
- School of Public Health, Lanzhou University, Gansu, China
| | - Guowu Ding
- School of Public Health, Lanzhou University, Gansu, China.
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12
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Warth M, Koehler F, Weber M, Bardenheuer HJ, Ditzen B, Kessler J. "Song of Life (SOL)" study protocol: a multicenter, randomized trial on the emotional, spiritual, and psychobiological effects of music therapy in palliative care. BMC Palliat Care 2019; 18:14. [PMID: 30700278 PMCID: PMC6354383 DOI: 10.1186/s12904-019-0397-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/21/2019] [Indexed: 01/04/2023] Open
Abstract
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).
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Affiliation(s)
- Marco Warth
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
| | - Friederike Koehler
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
| | - Martin Weber
- Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Hubert J. Bardenheuer
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 131, 69120 Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115 Heidelberg, Germany
| | - Jens Kessler
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 131, 69120 Heidelberg, Germany
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13
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Danila MI, Melnick JA, Mudano A, Flood K, Booth K, Kirklin K, Saag KG. A Performing Arts Intervention Improves Cognitive Dysfunction in 50 Hospitalized Older Adults. Innov Aging 2018; 2:igy013. [PMID: 29938231 PMCID: PMC6004786 DOI: 10.1093/geroni/igy013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Indexed: 12/18/2022] Open
Abstract
Background and Objectives Arts in medicine programs have emerged as a patient-centered approach that aims to improve health-related quality of life for patients in U.S. hospitals. Storytelling and poetry/monologue recitation are forms of arts-based experiences designed to enhance healing and are delivered by an artist-in-residence. We evaluated the effect of a storytelling/poetry experience on delirium screening scores and patient satisfaction in hospitalized older adults. Research Design and Methods:
We conducted an observational pre–post study with a control group in the Acute Care for the Elders (ACE) unit at an academic medical center. A convenience sample of 50 participants was recruited to participate and complete two questionnaires measuring pain, anxiety, general well-being, and distress at hospital admission and at hospital discharge. Multivariable regression models were used to compare delirium screening score (primary outcome) between the control and intervention groups and to adjust for the differences in baseline characteristics between groups. Results At baseline participants in the intervention group were younger and had significantly lower cognitive impairment compared with those in the control group. Participants exposed to the storytelling/poetry intervention had a lower delirium screening score at hospital discharge compared with those in the control group. The result remained significant after adjusting for age, baseline cognitive impairment, and general well-being. Participants in the intervention group reported a high level of satisfaction with the interaction with the artist delivering the intervention. Discussion and Implications An artist in residence-delivered storytelling/poetry experience was associated with a lower delirium score at discharge in this pilot study. Further larger studies in diverse inpatient settings are needed to examine whether storytelling/poetry interventions or other types of arts in medicine programs can prevent or reduce delirium in hospitalized older adults.
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Affiliation(s)
- Maria I Danila
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Joshua A Melnick
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Amy Mudano
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Kellie Flood
- Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham
| | - Katrina Booth
- Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham
| | | | - Kenneth G Saag
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
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Bieligmeyer S, Helmert E, Hautzinger M, Vagedes J. Feeling the sound - short-term effect of a vibroacoustic music intervention on well-being and subjectively assessed warmth distribution in cancer patients-A randomized controlled trial. Complement Ther Med 2018; 40:171-178. [PMID: 30219444 DOI: 10.1016/j.ctim.2018.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES So far, the effects of vibroacoustic music therapy in cancer patients are unknown. However, used in anthroposophic medicine, it could be an approach to enhance well-being. The goal of this study was to evaluate the immediate effects of a sound-bed music intervention with respect to the subjective well-being as well as body warmth and pain. PATIENTS AND METHODS We treated 48 cancer patients with 10 min of sound-bed intervention in a cross-over design. Primary outcome was the total sum of the Basler Mood Questionnaire (BMQ), secondary outcomes were subscales of the BMQ and questions addressing body warmth and pain. The EORTC-QLQ C30 was used as baseline assessment for quality of life (QOL). RESULTS Patients had lower QOL values than the EORTC reference samples (p < .001, d = 0.90). The primary outcome increased after music (p < .001, d = 0.47), no changes were seen in the control condition (p = .73, d = 0.04), the time by condition interaction was significant (p < .05). SECONDARY OUTCOMES Increase after music for the BMQ subscales inner balance (p < .001, d = 0.73), vitality (p < .001, d = 0.51) and vigilance (p < .001, d = 0.37) as well as for the additional questions satisfaction (p < .001, d = 0.43), current mood (p < .001, d = 0.43), body warmth (p < .05, d = 0.44) and warmth distribution (p < .01, d = 0.49). No significant changes were seen in pain levels and social extroversion. CONCLUSION Sound-bed intervention improved momentary well-being and caused self-perceived physiological changes associated with relaxation beyond the benefits of simple resting time (control condition). Thus, it might be a promising approach to improve well-being in cancer patients.
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Affiliation(s)
- Sarah Bieligmeyer
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany
| | - E Helmert
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany
| | - Martin Hautzinger
- Department of Clinical Psychology and Psychotherapy, University of Tuebingen, Germany
| | - Jan Vagedes
- ARCIM Institute (Academic Research in Complementary and Integrative Medicine), Filderstadt, Germany; Department of Neonatology, University Children's Hospital, University of Tuebingen, Germany.
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15
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Schmid W, Rosland JH, von Hofacker S, Hunskår I, Bruvik F. Patient's and health care provider's perspectives on music therapy in palliative care - an integrative review. BMC Palliat Care 2018; 17:32. [PMID: 29463240 PMCID: PMC5819707 DOI: 10.1186/s12904-018-0286-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/07/2018] [Indexed: 11/28/2022] Open
Abstract
Background The use of music as therapy in multidisciplinary end-of-life care dates back to the 1970s and nowadays music therapy (MT) is one of the most frequently used complementary therapy in in-patient palliative care in the US. However existing research investigated music therapy’s potential impact mainly from one perspective, referring to either a quantitative or qualitative paradigm. The aim of this review is to provide an overview of the users’ and providers’ perspectives on music therapy in palliative care within one research article. Methods A systematic literature search was conducted using several databases supplemented with a hand-search of journals between November 1978 and December 2016. Inclusion criteria were: Music therapy with adults in palliative care conducted by a certified music therapist. Both quantitative and qualitative studies in English, German or a Scandinavian language published in peer reviewed journals were included. We aimed to identify and discuss the perspectives of both patients and health care providers on music therapy’s impact in palliative care to forward a comprehensive understanding of it’s effectiveness, benefits and limitations. We investigated themes mentioned by patients within qualitative studies, as well as commonly chosen outcome measures in quantitative research. A qualitative approach utilizing inductive content analysis was carried out to analyze and categorize the data. Results Twelve articles, reporting on nine quantitative and three qualitative research studies were included. Seven out of the nine quantitative studies investigated pain as an outcome. All of the included quantitative studies reported positive effects of the music therapy. Patients themselves associated MT with the expression of positive as well as challenging emotions and increased well-being. An overarching theme in both types of research is a psycho-physiological change through music therapy. Conclusions Both quantitative as well as qualitative research showed positive changes in psycho-physiological well-being. The integration of the users´ and providers´ perspectives within future research applicable for example in mixed-methods designs is recommended.
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Affiliation(s)
- W Schmid
- GAMUT (Grieg Academy Research Centre for Music Therapy) Faculty of Fine Arts, Music and Design, University of Bergen, Bergen, Norway. .,Sunniva Centre for Palliative Care, Haraldsplass Deaconess Hospital, Bergen, Norway.
| | - J H Rosland
- Sunniva Centre for Palliative Care, Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Clincal Medicine, University of Bergen, Bergen, Norway
| | - S von Hofacker
- Sunniva Centre for Palliative Care, Haraldsplass Deaconess Hospital, Bergen, Norway.,Regional Centre of Excellence for Palliative Care Western Norway, Haukeland University Hospital, Bergen, Norway
| | - I Hunskår
- VID Specialized University, Bergen, Norway.,Haraldsplass Deaconess Hospital, Bergen, Norway
| | - F Bruvik
- Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
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Latorraca CDOC, Martimbianco ALC, Pachito DV, Pacheco RL, Riera R. Mindfulness for palliative care patients. Systematic review. Int J Clin Pract 2017; 71. [PMID: 29105910 DOI: 10.1111/ijcp.13034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/22/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Nineteen million adults worldwide are in need of palliative care. Of those who have access to it, 80% fail to receive an efficient management of symptoms. OBJECTIVES To assess the effectiveness and safety of mindfulness meditation for palliative care patients. METHODS We searched CENTRAL, MEDLINE, Embase, LILACS, PEDro, CINAHL, PsycINFO, Opengrey, ClinicalTrials.gov and WHO-ICTRP. No restriction of language, status or date of publication was applied. We considered randomised clinical trials (RCTs) comparing any mindfulness meditation scheme vs any comparator for palliative care. Cochrane Risk of Bias (Rob) Table was used for assessing methodological quality of RCTs. Screening, data extraction and methodological assessments were performed by two reviewers. Mean differences (MD) (confidence intervals of 95% (CI 95%)) were considered for estimating effect size. Quality of evidence was appraised by GRADE. RESULTS Four RCTs, 234 participants, were included. All studies presented high risk of bias in at least one RoB table criteria. We assessed 4 comparisons, but only 2 studies showed statistically significant difference for at least one outcome. 1. Mindfulness meditation (eight weeks, one session/week, daily individual practice) vs control: statistically significant difference in favour of control for quality of life - physical aspects. 2. Mindfulness meditation (single 5-minute session) vs control: benefit in favour of mindfulness for stress outcome in both time-points. None of the included studies analysed safety and harms outcomes. CONCLUSIONS Although two studies have showed statistically significant difference, only one showed effectiveness of mindfulness meditation in improving perceived stress. This study focused on one single session of mindfulness of 5 minutes for adult cancer patients in palliative care, but it was considered as possessing high risk of bias. Other schemes of mindfulness meditation did not show benefit in any outcome evaluated (low and very low quality evidence).
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Affiliation(s)
| | | | - Daniela Vianna Pachito
- Evidence Based Health Program, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Rafael Leite Pacheco
- Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Rachel Riera
- Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
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Warth M, Kessler J, Bardenheuer HJ. Insomnia and Autonomic Function Predict Well-Being in Patients Receiving Palliative Care. J Palliat Med 2017; 20:1395-1399. [PMID: 28749715 DOI: 10.1089/jpm.2017.0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The improvement of health-related quality of life (HRQOL) is one of the main treatment goals in end-of-life care. Although definitions and conceptualizations remain heterogeneous, many researchers proposed HRQOL to be considered as subjective patient well-being. However, research on its determinants in palliative care is rare, and little is known about the interplay between psychological and biological variables. OBJECTIVE The aim of this study was to explain differences in terminally ill patients' acute well-being (AWB) by use of a multimethod approach, examining both self-ratings and physiological predictors. SETTING/SUBJECTS The study was conducted on a palliative care unit in Heidelberg, Germany. A total of 69 adult patients receiving palliative care were included in the analysis. MEASUREMENTS Patients filled out the EORTC QLQ-C15-PAL questionnaire and an additional single-item visual analogue scale on AWB. In addition, we recorded a five-minute segment of beat-to-beat fluctuations of heart rate (i.e., heart rate variability, HRV) and calculated three indices of cardiac autonomic function: mean heart rate, the root mean square of successive differences, and the standard deviation of normal-to-normal (SDNN) intervals. Exploratory, multiple regression analyses were used to identify significant predictors among the QLQ subscales and HRV parameters. RESULTS Insomnia (p < 0.001) and SDNN (p < 0.001) were significantly associated with AWB and together explained 26.3% of the variance. All other predictors including pain, fatigue, and physical functioning failed to reach significance (all p > 0.05). CONCLUSION Both autonomic dysfunction and sleep disturbances independently explained differences in patient's AWB among terminally ill patients. Their role within the concept of quality of life needs to be further addressed in future studies.
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Affiliation(s)
- Marco Warth
- 1 Department of Anaesthesiology, Centre of Pain Therapy and Palliative Care Medicine, University Hospital Heidelberg , Heidelberg, Germany .,2 Center for Psychosocial Medicine, Institute of Medical Psychology, University Hospital Heidelberg , Heidelberg, Germany
| | - Jens Kessler
- 1 Department of Anaesthesiology, Centre of Pain Therapy and Palliative Care Medicine, University Hospital Heidelberg , Heidelberg, Germany
| | - Hubert J Bardenheuer
- 1 Department of Anaesthesiology, Centre of Pain Therapy and Palliative Care Medicine, University Hospital Heidelberg , Heidelberg, Germany
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18
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Warth M, Keßler J, Hillecke TK, Bardenheuer HJ. Music Therapy in Palliative Care. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 112:788-94. [PMID: 26806566 DOI: 10.3238/arztebl.2015.0788] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/24/2015] [Accepted: 08/24/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Music therapy has been used successfully for over 30 years as part of palliative care programs for severely ill patients. There is nonetheless a lack of high-quality studies that would enable an evidence-based evaluation of its psychological and physiological effects. METHODS In a randomized controlled trial, 84 hospitalized patients in palliative care were assigned to one of two treatment arms--music therapy and control. The music therapy intervention consisted of two sessions of live music-based relaxation exercises; the patients in the control group listened to a verbal relaxation exercise. The primary endpoints were self-ratings of relaxation, well-being, and acute pain, assessed using visual analog scales. Heart rate variability and health-related quality of life were considered as secondary outcomes. The primary data analysis was performed according to the intention-to-treat principle. RESULTS Analyses of covariance revealed that music therapy was more effective than the control treatment at promoting relaxation (F = 13.7; p <0.001) and well-being (F = 6.41; p = 0.01). This effect was supported by a significantly greater increase in high-frequency oscillations of the heart rate (F = 8.13; p = 0.01). Music therapy did not differ from control treatment with respect to pain reduction (F = 0.4; p = 0.53), but it led to a significantly greater reduction in the fatigue score on the quality-of-life scale (F = 4.74; p = 0.03). CONCLUSION Music therapy is an effective treatment with a low dropout rate for the promotion of relaxation and well-being in terminally ill persons undergoing palliative care.
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Affiliation(s)
- Marco Warth
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, Heidelberg University Hospital, School of Therapeutic Sciences, SRH University Heidelberg
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19
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Warth M, Kessler J, Hillecke TK, Bardenheuer HJ. Trajectories of Terminally Ill Patients' Cardiovascular Response to Receptive Music Therapy in Palliative Care. J Pain Symptom Manage 2016; 52:196-204. [PMID: 27090850 DOI: 10.1016/j.jpainsymman.2016.01.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 01/15/2016] [Accepted: 01/29/2016] [Indexed: 12/28/2022]
Abstract
CONTEXT Relaxation interventions are frequently used to promote symptom relief in palliative care settings, but little is known about the underlying mechanisms. OBJECTIVES The present analysis aimed at examining the psychophysiological pathways of terminally ill patients' cardiovascular response to a live music therapy vs. prerecorded mindfulness exercise. METHODS Eighty-four patients of a palliative care unit were randomly assigned to either of the two interventions. Multilevel modeling was used to analyze trajectories of physiological change. Vagally mediated heart rate variability (VM-HRV) and blood volume pulse amplitude (BVP-A) served as indices of autonomic nervous system response. Participants' gender, age, baseline scores, self-rated pain, and assignment to treatment were entered to the models as predictors. RESULTS Both VM-HRV and BVP-A showed significant linear and quadratic trends over time, as well as substantial heterogeneity among individuals' trajectories. Baseline scores, pain, and treatment significantly accounted for random variation in VM-HRV intercepts. BVP-A levels were significantly higher in women than in men. Moreover, assignment to treatment significantly accounted for differences in the linear slopes of peripheral blood flow. CONCLUSION Higher levels of VM-HRV in the music therapy group highlight the importance of a therapeutic relationship for the effectiveness of relaxation interventions in end-of-life care settings. Music therapy caused significantly stronger reductions of vascular sympathetic tone and, therefore, may be indicated in the treatment of pain and stress-related symptoms in palliative care. Initial self-ratings of pain moderated patients' physiological response and need to be taken into account in clinical practice and future theory building.
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Affiliation(s)
- Marco Warth
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany; School of Therapeutic Sciences, SRH University Heidelberg, Heidelberg, Germany.
| | - Jens Kessler
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas K Hillecke
- School of Therapeutic Sciences, SRH University Heidelberg, Heidelberg, Germany
| | - Hubert J Bardenheuer
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
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Warth M, Keßler J, Hillecke TK, Bardenheuer HJ. In Reply. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 113:374. [PMID: 27504703 PMCID: PMC4908928 DOI: 10.3238/arztebl.2016.0374b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Marco Warth
- *Universität Heidelberg, Zentrum für Schmerztherapie und Palliativmedizin; SRH Hochschule Heidelberg, Fakultät für Therapiewissenschaften,
| | - Jens Keßler
- **Universität Heidelberg, Zentrum für Schmerztherapie und Palliativmedizin
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Warth M, Kessler J, Kotz S, Hillecke TK, Bardenheuer HJ. Effects of vibroacoustic stimulation in music therapy for palliative care patients: a feasibility study. Altern Ther Health Med 2015; 15:436. [PMID: 26669437 PMCID: PMC4681146 DOI: 10.1186/s12906-015-0933-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 11/11/2015] [Indexed: 11/23/2022]
Abstract
Background The present study aimed at examining whether methodological strategies from a previously implemented study design could be transferred to the evaluation of the psychological and physiological effects of a music therapy intervention working with vibroacoustic stimulation in palliative care. Method Nine participants suffering from advanced cancer took part in single-sessions of music therapy, lasting for 30 min. The live music therapy intervention utilized singing chair sounds and vocal improvisation. Visual analogue scales (VAS) were used to assess self-ratings of pain, relaxation, and well-being before and after each session. During the intervention, we continuously recorded heart rate variability (HRV) as a measure of autonomic functioning. Data collection was complemented by a semi-structured interview to explore subjective experiences in more detail. Feasibility was defined as the ability to complete 80 % of the sessions in accordance with the study protocol. Results In 5 out of 9 sessions (55 %) it was possible to deliver the intervention and obtain all data as intended. VAS assessment was feasible, although graphical and statistical examination revealed only marginal mean changes between pre and post. HRV recordings were subject to artifacts. While HRV parameters differed between individuals, mean changes over time remained relatively constant. Interview data confirmed that the individual perception was very heterogeneous, ranging from “calming” to “overwhelming”. Conclusion The criterion of feasibility was not met in this study. Physiological data showed high attrition rates, most likely due to movement artifacts and reduced peripheral blood flow in some participants’ extremities. Examination of individual-level trajectories revealed that vibroacoustic stimulation may have an impact on the autonomic response. However, the direction and mechanisms of effects needs to be further explored in future studies. Trial registration German Clinical Trials Register – DRKS00006137 (July 4th, 2014).
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