Music Therapy Integrated Into Advanced Practice Nursing – Sample

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2007

As most of the researches demonstrate music, therapy provides a wonderful alternative therapy for treating psychological symptoms caused by numerous diseases and disabilities, as well as is useful in reducing anxiety and distress during various unpleasant medical procedures. In some cases, music therapy has decreased the depressive state of the patients and their relatives. Music therapy has positive effects on blood pressure and heart rate, reduces pain and muscular tension, decreases the feeling of helplessness, and produces desirable shifts in physiological and emotional states of patients before surgery.

Goodall Debby and Etters Lynn (2005) (‘The Therapeutic Use of Music on Agitated Behavior in Those with Dementia. Holistic Nursing Practice, Vol. 19, No. 6 (November/December): 258-262), having done the review of the empirical researches dealing with the issue, came to a conclusion that music therapy is a cheap and easy to use way of decreasing agitated behavior in those with dementia. The authors believe that planned music therapy may be applied as an alternative to medication and restraints. The examined studies have also revealed that familiar music evokes a more positive response than unfamiliar music, that music can not only cause the feeling of enjoyment but improve health and quality of life of the patients with dementia. Implementation of music therapy in the nursing homes for those with dementia could ease the nursing work, freeing up the staff time spent on calming an agitated patient. However, further research is needed to study what kinds of music are the best to be used, which the authors haven’t done.

Another study was done by Dianne Smolen, Robert Topp, and Lynda Singer (2002) and is described in ‘The Effect of Self-Selected music during Colonoscopy on Anxiety, Heart Rate, and Blood Pressure.’ Applied Nursing Research, Vol. 16, No. 2 (August): 126-138. The research demonstrated that music has a therapeutic effect of reducing physiological indicators of anxiety and the need for sedation. 32 patients, randomly divided into two groups, completed the State Anxiety Inventory before and after the procedure. Heart rate and blood pressure were measured during the procedure. The music intervention group demonstrated better parameters of heart rate and blood pressure and required less physician-administered sedation than the control group did. However, no significant therapeutic effect was evident from the SAI. Anyway, the study confirmed the earlier suggestions that music therapy should assist the patients undergoing colonoscopy in overcoming anxiety. We can suggest that a larger amount of subjects is likely to show other results. Besides, it could be preferable that the music has been chosen by the music therapist, while self-selected music could be of different kinds, causing various emotional states (let us suppose that some patients listened to hard metal or trash, etc.).

Uedo Noriya, Ishikawa Hideki, Morimolo Kanehisa, Ishihara Ryu, Narahara Hiroyuki, Akedo Ikuko, Ioka Tatsuya, Kaji Itatu and Fukuda Sande (2004) in ‘Reduction in Salivary Cortisol Level by Music Therapy during Colonoscopic Examination’ (Hepatic Gastroenterology, 51: 451-453) proved that music therapy during the colonoscopy reduces fear-related stress and pain. They measured samples of salvia gained before and after colonoscopy from 29 patients undergoing the procedure, randomly assigned to the music intervention and no music groups. The subjects also rated their maximum pain during the procedure. The results showed that patients receiving music had lower pain scores and lower salivary cortisol levels, which indicated less fear-related stress.

Another article reviewed (Clark Michael, Isaacks-Downtown Gloria, Wells Nancy, Redlin-Frazier Sheryl, Eck Carol, Heptworth Joseph, Chakravarthy Bapsi (2006). Use of Preferred Music to Reduce Emotional Distress and Symptom Activity During Radiation Therapy. Journal of Music Therapy, Vol. 43, No. 3 (Fall): 247-265) shows that further research is needed in the field. The described research is based on the earlier studies, has shown the positive effect of music therapy, and on the suggestion that preference, familiarity and extramusical associations with music (Pelletier 2004) are the factors adding to the therapeutic effect of music. 68 patients undergoing RT were randomly divided into experimental and controlled groups. Emotional distress (depression, anxiety, and treatment-related distress) and symptoms (pain and fatigue) were measured at baseline, mid-treatment, and end in both groups. Those in the experimental group were listening to the self-selected music during RT, other relaxation strategies being applied in the control group. Though the experimental group reported a lower level of anxiety and treatment-related distress (higher doses of music producing greater positive impact), the decline in these outcomes became evident in both groups by the end of RT course. However, the study hasn’t proved that depression, pain, and fatigue are influenced by music therapy. Unfortunately, the authors are not particular about exact periods of music therapy causing a better effect. Further, research is needed on the best length of each music therapy intervention.

All the enumerated studies demonstrate that music therapy can and should be implemented as an alternative to medication or other relaxation strategies. Moreover, music therapy is able to provide marvelous effects in cases when no other approaches can help, reducing the depressive thoughts and improving the quality of life of patients. The integration of music therapy into nursing practice obviously would bring great results, whereas the number of music therapists is not sufficient today and it should be enlarged.

References:

Clark, M., Isaacks-Downtown, G., Wells, N., Redlin-Frazier, S., Eck, C., Heptworth, J., Chakravarthy, B., (2006). Use of Preferred Music to Reduce Emotional Distress and Symptom Activity During Radiation Therapy. Journal of Music Therapy, Vol. 43, No. 3 (Fall): 247-265

Goodall, D., & Etters L., (2005). The Therapeutic Use of Music on Agitated Behavior in Those with Dementia. Holistic Nursing Practice, Vol. 19, No. 6 (November/December): 258-262

Lane, D., (2006). Music Therapy: A Gift Beyond Measure. Oncology Nursing Forum, Vol. 33 (4): 863-867

Smolen, D., Topp, R., Singer, L., (2002). The Effect of Self-Selected music during Colonoscopy on anxiety, Heart Rate, and Blood Pressure. Applied Nursing Research, Vol. 16, No. 2 (August): 126-138

Uedo, N., Ishikawa, H., Morimolo, K., Ishihara, R., Narahara, H., Akedo, I., Ioka, T., Kaji, I., Fukuda, S., (2004). Reduction in Salivary Cortisol Level by Music Therapy during Colonoscopic Examination. Hepatic Gastroenterology, 51: 451-453