Treatment of Discomfort with Music Therapy
In a pilot study with an ex post facto design, a computerized database for music therapy in palliative care was utilized. The goals of the study were (i) to describe a tool for research, (ii) to evaluate the use of the computerized database and (iii) to investigate the efficacy of music therapy. The database was designed working with a computer consultant and familiar computer programs. Several tools were used for assessment and data collection, and they consisted primarily of visual analog scales (VASs) using separate scales for different problems (i.e. mood, pain, anxiety and shortness of breath). Over a period of 1 year, 150 patients were seen, and 90 of their initial music therapy sessions were analyzed. A pre-test and post-test with the VASs were used, and the data were analyzed using the Wilcoxon signed rank test at the P < 0.05 level. Statistical significance was found for patient-rated scores for pain, mood and anxiety following music therapy. There was no significance for shortness of breath. Although the author acknowledged that this study was limited because subjects were not randomly assigned and it used an ex post facto design, the data indicated that music therapy is beneficial for people suffering from pain, mood distortions and anxiety within the palliative care treatment model (38).
In an empirical study of single-session music therapy, Krout (39) studied the effects of music therapy on pain, physical comfort and relaxation among 80 hospice patients over a total of 90 sessions. Although the number of sessions ranged from one to four for each subject, the average number was one session (74 subjects received only single sessions). Subjects had been referred to music therapy and had a wide range of diagnoses; they were being served in the hospital, their own homes, nursing homes, assisted living facilities and an in-patient hospice setting. Patient data were collected in two ways: independent observation and self-reporting. Music therapy sessions were provided in unique ways for each patient, based on individual clinical needs; however, active and passive experiences were utilized with live music. Using one-tailed t-tests, data analysis indicated a significant difference (P ≤ 0.001) for observer-rated changes in pain, physical comfort and relaxation after the music therapy sessions. From the self-rated changes there was also a significant difference (P ≤ 0.005) on the three dependent variables. The author recognized the following limitations of the study: the treatment strategy used multiple interventions, data were observed primarily over single sessions rather than evaluating the effects of multiple sessions over time and the data were not compared with interventions not based on music therapy.
In a study on the effects of vocal improvisation on discomfort behaviors of in-patient hospice clients, Batzner (40) documented a decrease in discomfort behaviors of clients receiving music therapy. Participants (n = 15) had various terminal diagnoses, excluding dementia, and were randomly assigned to one of two conditions: (i) music or (ii) no music. Each condition utilized an ABA format, where A = 5-min baseline and B = 10-min intervention. In the music condition, the music therapist improvised vocally with guitar accompaniment, and in the no-music condition, the music therapist visited with participants. Sessions were videotaped and discomfort behaviors were tallied. Graphic analysis indicated a decrease in discomfort behaviors for those receiving music therapy.