Need for Further Research
Qualitative studies make up the majority of research support in the area of hospice and palliative care music therapy, but there is a real dearth in the literature of empirical, quantitative studies. Because dying is a complex experience, research needs to be conducted to evaluate the efficacy of the support provided for patients with a terminal illness. Although qualitative studies are valuable in illustrating the use of music therapy for the terminally ill, Bosanquet and Salisbury (44) caution that reliability and the ability to generalize results can be limiting. They recommend that researchers conduct quantitative studies because “the advantages of clearly defined outcome measures include the minimization of potential researcher bias in the interpretation of results and also in the testing of hypotheses” (p. 23). Furthermore, quantitative studies provide greater assurance of reliability and results can be more readily generalized than those of qualitative studies.
From the existing literature on music therapy in hospice and palliative care, guidelines for future studies can be established. Because several investigators acknowledged the small sample size and lack of participant randomization as limitations in their studies, it is important to conduct future research with larger sample sizes and to assign participants randomly to conditions to allow for more rigorous statistical analyses and generalization of results. Psychometric tests with established reliability and validity in hospice and palliative care research have been emerging, and they offer music therapists the opportunity to use measurement tools that are designed specifically for the dying. Using measurement tools designed specifically for the population being studied (i.e. the terminally ill) will assist in strengthening the body of research. Because death trajectories can vary widely depending on diagnosis, it may be important for researchers to control for diagnosis in future research. These suggested guidelines may help future researchers in designing studies that allow for the generalization of results.
Research into hospice and palliative care is important in many ways. Robbins (45) provided four reasons for evaluating palliative care. First, government agencies and other funding sources that provide reimbursement for palliative care seek data to indicate that the services provided meet the needs of the patients and families. Second, hospital administrators and hospice administrators need assurance that the allocation of funds for specialty programs serves to raise the standard of care for patients with a terminal illness. From a palliative care clinician's point of view, the quality of services is paramount. Research needs to be conducted to ensure a high quality of care and to provide for the best clinical interventions in meeting the needs of patients and families. Creating an evidence base in hospice and palliative care music therapy will assist music therapy clinicians in establishing best practices in end-of-life care. Finally, new and existing forms of therapy need to be tested to ensure their efficacy. Although research with the terminally ill can be limited owing to ethical considerations, the literature needs to be enriched to include quantitative studies measuring the effects of music therapy on patients who have been diagnosed with a terminal illness.