| Quantitative Research |
|
Quality assurance study
| O'Brien (1999a) surveyed 52 patients aged 19-60, who rated the efficacy of a MT program in a cancer ward at an adult hospital. Patients rated MT methods against physical, emotional, and psycho-social therapeutic objectives (tabled below) on a linear scale of 1-5 (1=inadequate -5=extremely helpful). Participants involved were undergoing various aggressive treatments for cancer including BMT, and some were also in the palliative stages of their treatment. |
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MT methods evaluated were live music, taped music with semi-scripted relaxation, song writing, music and movement, pre-recorded music, vocal improvisation and instrumental improvisation. Participants were asked to identify the MT methods they received during their treatment. The most commonly rated methods were live music (96%), music with a semi-scripted relaxation (78%), song writing (60%) and music and gentle movement (58%). All methods were assessed against the therapeutic objectives listed in the following table with the ratings from the participants in this study represented in the right hand column.
Table 1: Results from O'Brien (1999a) patient evaluation of MT program in a cancer care
| Physical, emotional and psycho-social therapeutic objectives |
Patient's ratings of MT methods on a linear scale of 1-5 |
Relaxation and stress reduction |
Extremely helpful - 45%
Helpful - 44%
Quite helpful - 11%
|
Treatment tolerance
|
Extremely helpful - 33%
Helpful - 34%
Not applicable - 33%
|
A distraction from medical procedures
|
Extremely helpful - 54%
Helpful - 23%
Quite helpful - 23%
|
A creative experience |
Extremely helpful - 54%
Helpful - 23%
Quite helpful - 11%
Not applicable - 12%
|
A means of self expression |
Extremely helpful - 45%
Helpful - 44%
Not applicable - 11%
|
Reduced pain perception (as an
adjunct to pain medication) |
Extremely helpful - 45%
Helpful - 44%
Not applicable - 11%
|
Relieved boredom
|
Extremely helpful - 66%
Helpful - 23%
Not applicable - 11%
|
Alleviated anxiety
|
Extremely helpful - 45%
Helpful - 38%
Quite helpful - 17%
|
Relieved treatment symptoms
|
Extremely helpful - 11%
Helpful - 33%
Quite helpful - 34%
Not applicable - 22%
|
The participants were also asked to rate the MT program as a whole in meeting their needs during their hospital stay. Overall the MT program was rated excellent by 66% of patients, very good by 23% and good by 11%. There were no negative measures given for the program by the participants. O'Brien concluded that MT is an effective adjunct and therapeutic intervention in the treatment of cancer patients in a public adult hospital setting. It can offer patients a multi-modal approach to meeting their possible complex needs, both physiologically and psychosocially.
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Music to reduce anxiety for breast cancer patients prior to their
first cycle of adjuvant chemotherapy (current pilot study)
Protocol Synopsis
A pilot study of live music to reduce anxiety in patients with breast cancer prior to receiving adjuvant chemotherapy.
Objectives
Primary objective: To assess the feasibility to perform a randomised study to investigate the therapeutic application of live music prior to chemotherapy in cancer patients.
Secondary objective: To evaluate the effectiveness of music in reducing patients'experience of treatment-related anxiety before receiving adjuvant chemotherapy.
Patient Population
Patients with newly diagnosed breast cancer commencing adjuvant chemotherapy.
Study Design
Patients will receive live music therapy prior to their first cycle of chemotherapy. The effectiveness of music therapy will be assessed by measuring the difference in scores collected from the self-administrated questionnaire.
Method
Twenty-five patients will be requested to attend the appointment of the first cycle of chemotherapy 30 minutes earlier. Patients will be asked to wait in the waiting room at Oncology Day centre. A 5-minute of questionnaire (HADs) will be filled by all patients to establish their baseline anxiety level. Afterwards all patients will be requested to fill another 5-minute of questionnaires (STAI and Anxiety Scale) as pre-music therapy assessment. The patients will then have a 20-minute music session with live music with voice and guitar by the music therapist. The patients will choose the songs for the music therapy session from the provided song list. On the completion of music therapy session, the patients will fill another 5-minute of questionnaire (STAI and Anxiety Scale) and a self-evaluation form.
Music Intervention
The session will run for 20 minutes. At the beginning of the session the patient will be offered a song list of popular songs grouped basically by era. (See Appendix A) They will be informed that they do not have to restrict their song choice to the list but that the list acts merely as a means of stimulating possible song choice. As most songs run for approximately 2 to 3 minutes the patients will be asked to select 8 to 10 songs. Words will also be available for the patients if they wish to sing along.
Once the song choices have been made by the patient the live music will commence. The therapist will play through the songs totalling 20 minutes. Any verbal interactions will be validated either by reflective counselling techniques or through further song choice. All live music sessions will be audio recorded to collect data on 1) the choice of songs, and 2) the spontaneous musical and non-musical interactions that take place between the patient and music therapist.
If a patient becomes distressed during the session supportive counselling techniques will be used. If the patient finds any of the lyrics distressing the therapist will alter the music program instantaneously.
Assessment Tools
- Hospital Anxiety Depression Scale - HADS (see Appendix A)
- State Trait Anxiety Inventory - STAI (see Appendix B)
- Self-Evaluation Form
Data Collection
Data will be collected by the self-reported questionnaires. Patients will be identifiable by initials and date of birth only. All data will be entered in an appropriate data base for analysis.
Outcomes Measures
To assess the feasibility to perform a randomised study to investigate the therapeutic application of live music before chemotherapy by:
- Total number of patients accrued in the anticipated period of the project
- Duration of time required for patient accrual
- Percentage of questionnaires forms completed
- Ability to incorporate the live music into the general treatment plan
To measure the effectiveness of music therapy in reducing patients' experience of treatment-related anxiety before chemotherapy by:
- Establishing a profile of anxiety and depression personality trait of individual patient
- Comparing the percentage reduction in the anxiety level before and after the music therapy by measuring the difference in the scores of the STAI questionnaires and the Stress and Anxiety Scale
- Evaluating the opinion of patients on the effectiveness of music therapy in reducing anxiety by the self-assessment questionnaires
Anticipated Patient Accural
25 patients
We currently have six patients on the study, and the results have revealed a positive trend. | 
