Quality-of-Life Enhancement with Music Therapy
Abbott's (42) master's thesis documented the effects of music therapy on the quality of life of patients with a terminal illness. Music therapists from three hospices selected the 28 adult subjects for the study, and subjects were divided into music and non-music groups by therapist selection. Diagnoses of subjects included cancer, AIDS, heart disease, pulmonary disease and amyotrophic lateral sclerosis. Quality of life was measured using the Profile of Mood States (POMS) during sessions. Music therapy was provided by music therapists working in the hospices and was designed specifically for each patient. Subjects received at least 5 hours of music therapy in the study. Music therapy techniques employed included listening to music, relaxation to music, playing instruments, life-review activities, song composition and improvisation. A total of six factors were measured on the POMS, and matched pairs of factors were analyzed using paired t-tests. The results indicated that there were no significant differences between the music and non-music groups. It was concluded that the sample size was a confounding factor, and the author suggested that measurement tools such as those that measure physiological changes may be less fatiguing for patients.
In a randomized clinical trial, Hilliard (8) studied the effects of cognitive-behavioral music therapy on quality of life, length of life and time of death in relation to last visit, by discipline, for people diagnosed with terminal cancer who were receiving hospice care services. Participants (n = 80 adults) were randomly assigned to one of two conditions: (i) control (routine hospice care services only) or (ii) experimental (routine hospice care services and music therapy). The study controlled for place of residence in that all participants resided in their homes, and conditions were matched by age and sex such that each condition included an equal number of men and women as well as of those over and under age 65 years. Controlling for these variables was important since quality-of-life studies in end-of-life care indicate a need to control for residence, the music therapy literature indicates a need to control for sex and the pain literature indicates a need to control for age. The Hospice Quality-of-Life Index–Revised (HQOLI), a 29-question self-report tool, was used to measure quality of life. Participants in the control condition completed the HQOLI following the social work sessions, and those in the experimental condition completed it following the music therapy sessions. Because music therapists often report qualitatively that music assists the dying in releasing life, this study evaluated the time of death of each participant in the experimental condition in relation to the last visit, by hospice discipline (social worker, nurse and music therapist). Length of life was the last dependent variable in the study, and length of life and time of death were measured using medical record analysis.
Statistical analyses indicated no significant differences in time of death in relation to last visit by discipline or in length of life between treatment conditions. The data do not support the concept that music assists the dying in releasing life, nor that it lengthens life. There was, however, a significant difference for quality of life for participants receiving music therapy. Furthermore, the more music therapy sessions participants received, the higher the quality of life, even as their physical health declined. This was not the case in the control group, where quality of life declined as physical status declined. The study supports the idea that live music therapy sessions increase perceived quality of life for people with terminal cancer, and that sessions should be provided with a relatively high frequency since quality of life increased with each music therapy session.