Music Therapy Applications in Healthcare

Historically, music has always been a pathway to improve health and healing among people from around the world. Today, you will find it being used in multiple hospital settings as another therapeutic way to reduce physical and psychological problems of cancer patients. With the aid of a trained certified musical therapist, nurses provide musical therapy sessions that are customized and adapted to fit the special needs and abilities of its patients in order to maximize personal results. Supplemented with pharmaceuticals, a patient’s short- and long-term cancer treatments can benefit from music which strengthens a patient’s ability to cope with their disease process.

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 Cancer is a significant disease that creates a serious life event that is feared and causes stress to the patient and their families. In America, over “482, 543 deaths have occurred from cancer during first decade of the 21st century (******).” Patients with cancer suffer from anxiety, pain, and depression as they progress through traumatic medication therapies that often have side effects on the body and mind. They include symptoms of anorexia, weight loss, fatigue, constipation, headache, weak vitals, and lack of motivation. 

  Music therapy as a form of pain intervention is a growing discipline in today’s medical field. Worldwide, different models and practices consistently show music as is a painless, non-invasive, cost saving, and overall pleasant way to address holistic personal care. American Association of Music Therapy in music therapy as “an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals.” (outcome of music, 2019)

There have been many studies that show its effectiveness in reduction of pain by alleviating patient anxiety and depression. Music has no limitation to its use, as patients of any age, setting, or degree of disease can benefit from it. Active engagement by pediatric patients show increased comfort in hospitalization, reduced pain, and coping skills. Music can improve coping and social integration. Improving quality of life is the main goal of music intervention in that it provides a way for all those to benefit without the fear of potential side effects. For many people, music connects them to their emotions and is often a way to be socially connected. That is why music can be an effective form of therapy for people with cancer. Increasing evidence, tolerability, ease of application and use, advantageous cost-benefit ratio, appreciation shown by patients support its continued research in the field.

Music therapy and its place in healthcare

Many claims that music has the power to heal and affect the human spirit in its application. Since the ancient times, pillars found in ancient Egypt, Greece, and China promote music as a way to create relaxation (*****). The use of music in Western medicine started to emerge in the United States by the late 1940s, as the need for holistic care in patient therapies was recognized to improve a patient and their quality of life. In conjunction with a pharmalogical treatment, applying musical therapy to those suffering from chronic pain, such as cancer patients, allowed a more integrated approach to enhancing the patient’s mental, spiritual, emotional self during a disruptive disease process.

Typically, music therapy has been most popular in clinical settings such as oncology, general surgery, geriatric treatments, and palliative care (Music Therapy, 2017). Working as part of a healthcare multidisciplinary team, a certified trained music therapist works with the nurse to develop an individualized experience custom suited to the patient’s level of needs and abilities. The goal is to utilize the healing aspect of music in order to reduce pain and anxiety of a slowly debilitating disease process and improve some the quality of life.

Cancer is a significant disease that can change a person’s life and creates an environment of stress for the individual and their family. Patients endure short- and long-term effects from their cancer treatments, as well as negative thoughts related to fear of death. With cancer, as the disease progresses, so does the patient’s pain. Over time, the pain becomes directly correlated with psychological and physiological deterioration, impairing their quality of life. Studies suggest non pharmalogical interventions may influence a patient’s coping skills which can help modulate psychobiological impact of stress of current treatments, thus impacting the success of a long-term prognosis. Music therapy for the Cancer patient may provide the relief as a tool towards reducing anxiety, improving mood, and distraction from pain.

When used to reduce pain, Music therapy can offer a therapeutic option for medical purposes that is low risk, non-invasive, and cost effective. It would be utilized in conjunction with morphine or other painkillers as a strategy approach to holistic palliative care. “According to the American Music Therapy Association Music therapy uses music to address physical, emotional, cognitive, and social needs of patients of all ages and abilities. Music therapy interventions can be designed to promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication, and promote physical rehabilitation.”  Though studies are limited, there is evidence that somatic and psychological symptoms are positively affected when analyzing the level of pain perception after the music intervention. If combining both the holistic musical intervention with traditional treatments can produce positive reactions, then giving a patient a higher quality of life should be the goal.

Music Therapy as a Tool in Pain Relief

In a clinical setting, the effectiveness of MT based interventions will vary based on each cancer patient’s level of pain, anxiety, and depression. Even the most resilient individuals over time can be worn down by a life-threatening diagnosis. Mood is impacted Changes how patient copes with disease. So, then a Music therapist rained in areas of psychology, biology, and music theory would analyze the patient’s musical preferences, background, and efficacy of music. Nurses would be responsible for ensuring considerations of hearing disabilities, physical limitations, and pain assessment is considered before and after their patients’ participation. Music has arousal regulating effect. Slow musical tempo helps lower heart rate, bp Faster increases vitals Personalize music choice Positive emotions

Memory retrieval tools, HR, BP, Respiration, Less pain levels

 A MT session has many factors to consider. They can be done with one individual, or as a shared experience. It can be over a course of many sessions, or just one time. It can be live using instruments or played through a stereo. Single session of music therapy-the more a patient got, the more their quality of life improved even with a decline in physical health. ’Live music supports perception that live music increases perception of quality of life for those with end stage cancer, should be promoted and used more frequently.  Ability to elicit emotional responses: calm, excitement, alleviation, cheerfulness. Internections from psycho-acoustic phenomena and emotional responses through communication and evocation of emotions and its effect with different patients. It can also deflect attention with slow/fast temp, pitch changes, familiar timbres.

Two essential formats of music therapy involve the patient to be interactive or passive. In an interactive technique, the patient will be encouraged to sing, clap, or tap their feet to the music and even encouraged to play instruments, or use it with guided imagery and relaxation techniques. This type of improv allows for receptive engagement which can create a mood of peace, relaxation, and improve levels of comfort. In passive therapy, recorded music can include personal CD’s, live taped performances, and relaxation tunes. If used with relaxation techniques, its been shown that patients report muscle relaxation, and easement of signs and symptoms resulting from their invasive cancer treatments causing anxiety, nausea, and pain. Passive is more popular in a healthcare setting because it can easily be introduced into a clinical setting.

Afterwards, Nurses assess and document the effect of music therapy based on patient feedback regarding their patient’s pain scores, and reduction of anxiety levels. Pain, anxiety, HR, BP, sedation Also noted is observed effects of the therapy on observable features, such as facial expression, and positive or negative outlook statement. The desired outcome should include less patient stress, a reduction in pain perception, and overall general wellness. 

Music Therapy: Evaluating pain relief

Music therapy for cancer patients is effective because listening to music is makes people feel good. It is calming and can be relaxing. It provides patients an outlet to explore feelings of fear, anxiety, and anger as an emotional response to their cancer. Music creates a healing environment that distracts away from invasive, painful procedures, and even helps with communication and cooperation in the healthcare setting. Children are a specific demographic affected using music during cancer treatments. In a trial where children underwent a lumbar puncture procedure, those exposed to music reported less pain, anxiety, and felt calmer and more relaxed (MUSIC THERAPY: RELEVANCE IN ONCOLOGY).

MT interventions tx evaluates effectiveness of anxiety, depression, pain, quality of life

Nursing Integrate music with conventional interventions. A MT therapist Understand nature of musical sound to meet individual cancer patient needs and achieve affect. Advise and effectively integrate music. Pt preferences Specific types-cultural, classical, jazz, encourage patient to bring music from home/ No musical experience is required to participate. Interventions are only affected by personal influence of the patient preferred interventions. musical perspective, background, preference, and hearing ability. 

Music provides recovery of self-identity, meaning, and coherence, musical empowerment to the everyday life of the individual patient with cancer Musical choice and content: Patient influenced music choice, individualized from patient needs Music from 4-5 music styles, genres, or general playlist recommended from therapist Purpose: target musical content: tempomelodic quality, instrumentation Patient brought personal selections of music

Patients encouraged to sing along Headphones used to remove distraction, improve concentration, audio quality better-earing problems can be an issue. Example: Patients in chemo, SE nausea, breathing issues, flu sx, experience stress, loneliness, fear. Music listening helps distract from discomfort from tx, cope with stress levels.

Recorded music Self reflecting inner musical experience Supported with verbal relaxation, guided imagery, mood matching Anxiety Description of interventions were subjective. Key phrases from “patients: familiar, soothing, predictable, and relaxing.”

Mood: Depression, spirit, distress, quality of life, relaxation Studies suggest music can relieve anxiety and pain Most well documented mode is passive listening to recorded music single session

Cultural considerations of MT therapy

The power of music to heal has been documented in all parts of the world across traditions and generations. To employ music is to support human interaction between those involved, creating a sense of community within a therapeutic context. This type of group belonging through musical collaboration and interaction from family and medical staff allows an insight into specific cultural and social backgrounds. Music therapy stresses importance of relationship between patient and nurse in such that sessions cannot be ordinarily standardized. It has to consider an individual case by case balanced consideration regarding the rationale and the content exposure of the unique complex music field.

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The Cultural perception of music has to consider patient identity related to their personal background, economic, and social factors. Patients from India may prefer traditional Indian raga Anandabhairavi Veena and flute instruments. The range is limitless to the variety of music, from traditional Celtic melodies, Chinese fold music, to Taiwanese folk songs. Dying patients may be comforted by songs vigil sacred song played by harp to invoke imagery of individual perspective” of the musical environment has great impact on how we respond to music and which music we prefer (********).

Conclusion

In today’s world, cancer is on the rise, so finding ways to improve a patient’s quality of life as they face this disease is important. Music therapy has been a long standing, non-invasive modality that is cost effective without resulting in damaging side effects. Its purpose is not to heal, but to provide a sense of comfort, alleviate physical symptoms of stress, and provide a coping process that is individualized to the patient’s needs and abilities. Many hospitals utilize music therapy as a complementary adjunct, recommending it to reduce stress, anxiety, and depression. Further studies will be needed to support its use how music influences positive outcomes. 

There Needs to be more interest in the field of MT because there is limited numbers of research regarding its effectiveness in the field. Overall, the support seems positive, which is consistent other research, and can suggest that its use is beneficial as an intervention for cancer patient.

It is not the music but the specific qualities of the therapy that improves its efficacy

The treatment involves overall care of pt well-being, Studies are lack standardization of interventions, assessments, but offers further development and improvement, suggesting importance of building more studies Recommendation: emphasize importance of intervention on anxiety, depressive, pain sx, quality of life. 

Music offers range of benefits to address physical, emotional, social, existential needs

Musical activities many can take place in clinical setting-wide variety. Music used relieve stress, fear of hospitalization Supports patients at stages of disease, promote patient wellness, emotional well-being, and improve overall quality of life. Music therapies aim to meet patient needs during their diagnosis, tx, and can be practiced in groups or individually.

 Promotes relaxation, reduce anxiety and stress, relieves discomfort, reduce patient experience of pain, Tx related symptoms, Opportunities for self-expression and positive experiences, though more studies are recommended on how music therapy number of music studies, music varieties, and durations on cancer pain and its acceptability in consideration towards future applications.

References

• Gramaglia, C., Gambaro, E., Vecchi, C., Licandro, D., Raina, G., Pisani, C., … Zeppegno, P. (2019). Outcomes of music therapy interventions in cancer patients—A review of the literature. Critical Reviews in Oncology / Hematology, 138, 241–254. https://doi.org/10.1016/j.critrevonc.2019.04.004
• Jespersen, K., Vuust, P., Abildgaard, N., Gram, J., & Johansen, C. (2018). [Review of Kind of blue: A systematic review and meta‐analysis of music interventions in cancer treatment]. Psycho - Oncology, 27(2), 386–400. https://doi.org/10.1002/pon.4470
• Jasemi, M., Aazami, S., & Zabihi, R. E. (2016). The Effects of Music Therapy on Anxiety and Depression of Cancer Patients. Indian journal of palliative care, 22(4), 455–458. doi:10.4103/0973-1075.191823
• Krishnaswamy, P., & Nair, S. (2016). Effect of Music Therapy on Pain and Anxiety Levels of Cancer Patients: A Pilot Study. Indian journal of palliative care, 22(3), 307–311. doi:10.4103/0973-1075.185042  
• Music Therapy: Relevance in Oncology. (n.d.). Retrieved October 27, 2019, from https://www.ascopost.com/issues/july-25-2017/music-therapy-relevance-in-oncology/.
• Stanczyk M. M. (2011). Music therapy in supportive cancer care. Reports of practical oncology and radiotherapy: Journal of Great Poland Cancer Center in Poznan and Polish Society of Radiation Oncology, 16(5), 170–172. doi:10.1016/j.rpor.2011.04.005
•             https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863265/pdf/main.pdf