Single Music Therapy Sessions Exert Limited Ability to Decrease Anxiety
Curtis (34) conducted an empirical study to evaluate the effects of music on pain relief and relaxation of patients with a terminal illness. Five females and four males diagnosed with a terminal illness were included in the study. The experimental conditions implemented were as follows: (A) no intervention, subjects did not receive music therapy; (B) background sound, subjects were instructed to relax while listening to a 15-min tape of hospital sounds; and (C) music, subjects were instructed to relax while listening to a 15-min tape of calm, preferred instrumental music. These conditions were implemented twice daily for 10 days, and subjects were randomly assigned to one of two orders of experimental conditions in this alternating treatments design: ABACA (n = 5) and ACABA (n = 4). Subjects self-rated the four dependent variables (pain relief, physical comfort, contentment and relaxation) using a modified graphic rating scale. Although statistical analysis (Friedman two-way analysis of variance) indicated no significant differences in the dependent variables under the different treatment conditions, a graphic analysis of individual responses indicated that music may have been effective. The researcher suggested that replication of the study with a larger number of subjects and longer duration would allow for results to be generalized.
Whittall (35) conducted an empirical pilot study documenting the effects of music therapy on anxiety among those with a terminal illness. Eight adult patients with advanced malignant disease from the Royal Victoria Hospital's Palliative Care Service were included in the study. Using non-invasive biofeedback equipment, the subjects' heart and respiratory rates and extremity temperature were measured 10 min before music, every 10 min during the 30-min music therapy session and 10 min after music therapy. Guided imagery, deep breathing and muscle relaxation exercises were components of the music therapy sessions. Mean heart rate scores decreased from 85.8 beats min−1 before music therapy to 77.1 beats min−1 following music therapy, and respiratory rates decreased from 19.5 to 15.4 breaths min−1 after music therapy. Extremity temperature increased from 84.8 to 87.9°F, and the researcher indicated that the increase in temperature may suggest vasodilation with relaxation. The limitations of the pilot study included the lack of a control group and the small number of subjects, yet the results of the study encouraged future research with a larger number of subjects.
Calovini's (36) master's thesis in music therapy studied the effects of participation in one music therapy session on state anxiety in hospice patients. Nurses and social workers referred the 11 adult subjects to the music therapist for participation in the study, and data were collected for 4 months. Eight of the subjects were receiving music therapy before the beginning of the study, and all subjects had been diagnosed with a terminal illness (cancer, pulmonary disease, emphysema and congestive heart failure). The study utilized a pre-test and post-test design with various measurements for anxiety: a self-reporting questionnaire (adapted from Spielberger's State–Trait Anxiety Inventory (STAI)) and physiological measures (blood pressure, pulse rate and finger temperature). Music therapy was offered in one of three forms:(i) listening to music and singing, (ii) learning to play an instrument or (iii) using relaxation techniques to music. Each subject chose the type of music therapy desired during the session. There were no statistically significant differences in pre-test and post-test comparisons for the subjects as measured by systolic and diastolic blood pressure, pulse rate, finger temperature and the anxiety questionnaire. The author concluded that single music therapy sessions were limited in their ability to decrease anxiety, and she recommended that further studies use measurement tools designed specifically for the terminally ill.
For her master's thesis in nursing, Longfield (37) conducted a quasi-experimental study measuring the effects on mood and pain in hospice patients receiving music therapy. Eight adult subjects diagnosed with cancer comprised their own control group and received music therapy via taped recordings and a headset for 45 min day−1 for 5 days. The pre-test and post-test measurements used the Short-Form McGill Pain Questionnaire (SFMPQ) and the Linear Analog Self-Assessment Scale (LASA). All subjects were prescribed narcotic pain medications and continued taking medications as prescribed during the study. Inferential statistics (paired t-tests) were used to compare difference scores from pre-test to post-test. There was a significant decrease in pain (P < 0.001) as measured by the SFMPQ, and scores from the LASA showed a positive increase in mood for fatigue, anxiety and energy. The author concluded that although her study supported the use of music therapy, further research with larger sample sizes was necessary.