A randomised controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety

Effect of music therapy on anxiety and depression in breast cancer patients: systematic review and meta-analysis

To systematically evaluate the intervention effect of music therapy on anxiety and depression in breast cancer patients. Randomised controlled trial (RCT) on music therapy for anxiety and depression in breast cancer patients was searched from 7 major databases, PubMed, Embase, the Cochrane Library, WOS, CNIC, Wanfang, and Wipro, spanning the period of library construction to 23 October 2023, and the literature screening of music therapy for anxiety or depression in breast cancer patients was carried out by 2 experimentalists, each of whom conducted a literature screening RCT independently of the other anxiety or depression in a RCT. Methodological quality was evaluated using the PEDro scale; GRADE profiler software for quality of evidence; and RevMan 5.4 was used for effect size merging and forest plots; publication bias tests and sensitivity analyses were performed using Stata 17.0; and standardized mean difference (SMD) and 95% CI were used as the effect statistics. A total of 13 RCTs with 1326 subjects (aged 18-70 years) were included in the literature, with a mean PEDro score of 6.8, and the literature was overall of good methodological quality. Meta-analysis showed that music therapy improved anxiety in breast cancer patients (841 cases), with a combined effect size (SMD = - 0.82, 95% CI [- 1.03, - 0.61] and P < 0.001); and improved depression in breast cancer patients (387 cases) with a combined effect size (SMD = - 0.76, 95% CI [- 1.15, - 0.38], P < 0.001). Subgroup analyses showed that music intervention with off-site music (757 cases) and music choice of non-self-selected music (537 cases) had the best effect on anxiety improvement, with corresponding combined effect sizes (SMD = - 0.88, P < 0.001; SMD = - 0.83, P < 0.001), respectively; followed by an intervention length of < 30 min (589 cases), a frequency of 2 times/day (382 cases), and intervention period of 2-3 weeks (101 cases) had the best effect on anxiety improvement, and the corresponding combined effect sizes were (SMD = - 0.80, P < 0.001; SMD = - 0.91, P < 0.001; SMD = - 1.02, P < 0.001), respectively; and the music selection was the choice of one's own favourite music among the expert recommendations (219 cases) (270 cases) had the best effect on the improvement of depressed mood, with combined effect sizes of (SMD = - 1.15, P < 0.001; SMD = - 0.71, P < 0.001) and music with an intervention duration of 30 min (287 cases), an intervention frequency of 1 time/day (348 cases), and an intervention period of 2-4 weeks (120 cases), respectively, with corresponding combined effect sizes of (SMD = - 0.75, P < 0.001; SMD = - 0.86, P < 0.001; SMD = - 1.06, P < 0.001), respectively. Music therapy can improve anxiety and depression in breast cancer patients, and the level of evidence is moderate. Although the heterogeneity between studies is high, which may lead to bias in the results, we explored the source of heterogeneity through subgroup and sensitivity analyses, providing a good evidence-based basis for clinical practice. The heterogeneity of anxiety and depression was explored by subgroup analysis, with anxiety due to music duration and music cycle; and depression due to intervention cycles and music duration. Sensitivity analyses also identified music duration and music cycle as contributing to the heterogeneity. Also, this study has some limitations since the included literature did not take into account the duration of the disease, education, and family economic status and did not categorize the age stages. This study found that music therapy improves anxiety and depression in breast cancer patients and the results can be used as a basis for clinical practice and researcher enquiry. This research has been registered on the INPLASY platform ( https://inplasy.com/contact/ ) under the number: INPLASY2023100057.

Impact of background music listening on anxiety in cancer patients undergoing initial radiation therapy: a randomized clinical trial

BACKGROUND

Patients undergoing radiation therapy (RT) often experience anxiety, which may jeopardize the treatment success. The efficacy of music interventions in reducing anxiety remains contentious. This randomized trial aimed to evaluate the impact of music listening on anxiety symptoms in patients undergoing initial RT.

METHODS

First-time RT patients were randomly allocated to experimental and control groups. The Brief Symptom Rating Scale (BSRS-5), Distress Thermometer (DT), and Beck Anxiety Inventory (BAI-C) were administered pre- and post-RT. Changes in physiological anxiety symptoms were monitored over 10 consecutive days starting from the first day of RT. The experimental group received music during RT; the control group did not. The generalized linear mixed model was used to estimate the pre-post difference in the BSRS-5, DT, and BAI-C scores between the music intervention and control group.

RESULTS

This study included 50 patients each in the experimental and control groups. BSRS-5 and DT scores were significantly reduced in the experimental group post-RT (p = 0.0114 and p = 0.0023, respectively). When music listening was discontinued, these scores rebounded. While the posttest BAI-C score was significantly lower in the experimental group (p < 0.0001), the pre-post difference between the two groups was not significant (p = 0.0619). On cessation of music listening, the BAI-C score also rebounded.

CONCLUSIONS

For cancer patients undergoing initial RT, music listening intervention significantly reduced anxiety symptoms measured using the BSRS-5, DT, and BAI-C scores after two weeks. Our results demonstrate the effectiveness of music listening intervention in reducing anxiety symptoms, thereby potentially improving the quality of life of cancer patients undergoing RT.

Biological principles for music and mental health

Efforts to integrate music into healthcare systems and wellness practices are accelerating but the biological foundations supporting these initiatives remain underappreciated. As a result, music-based interventions are often sidelined in medicine. Here, I bring together advances in music research from neuroscience, psychology, and psychiatry to bridge music's specific foundations in human biology with its specific therapeutic applications. The framework I propose organizes the neurophysiological effects of music around four core elements of human musicality: tonality, rhythm, reward, and sociality. For each, I review key concepts, biological bases, and evidence of clinical benefits. Within this framework, I outline a strategy to increase music's impact on health based on standardizing treatments and their alignment with individual differences in responsivity to these musical elements. I propose that an integrated biological understanding of human musicality-describing each element's functional origins, development, phylogeny, and neural bases-is critical to advancing rational applications of music in mental health and wellness.

Using Music as a Tool for Distress Reduction During Cancer Chemotherapy Treatment

PURPOSE

Music may be an effective therapeutic tool during cancer treatment to improve patient psychological and physical well-being. Current research shows a positive effect of music on psychological outcomes; however, many of these studies lacked significant sample size and rigor in monitoring type of music used and duration of music use during treatment.

METHODS

Participants (N = 750) in this open-label, multisite, day-based permuted block randomization study were adult patients receiving outpatient chemotherapy infusion. Patients were randomly assigned to either music (listen to music for up to 60 minutes) or control (no music) conditions. Music patients were allowed to self-select an iPod shuffle programmed with up to 500 minutes of music from a single genre (eg, Motown, 60s, 70s, 80s, classical, and country). Outcomes were self-reported change in pain, positive and negative mood, and distress.

RESULTS

Patients who listened to self-selected music during infusion showed significant benefit in improved positive mood and reduced negative mood and distress (but not pain) from pre- to post-intervention (all two-sample t-tests P < .05). LASSO penalized linear regression models showed a selective benefit for some patients on the basis of relationship (P = .032) and employment (P = .029) status with those who were married or widowed and those on disability showing better outcomes.

CONCLUSION

Music medicine is a low-touch, low-risk, and cost-effective way to manage patients' psychological well-being in the often stressful context of a cancer infusion clinic. Future research should be directed to understanding what other factors may mitigate negative mood states and pain for certain groups during treatment.

The effect of two different types of music played to cancer patients during chemotherapy on anxiety, nausea, and satisfaction levels

PURPOSE

To investigate the effect of two different types of music on anxiety, nausea, and satisfaction levels in cancer patients receiving chemotherapy (CT) for the first time.

METHODS

The study was conducted as a single-blind, pre-test, post-test, three-group randomized controlled trial in an outpatient CT unit between August 2022 and February 2023. A simple (computer-based) and stratified (age and gender) randomization method was used to assign 75 patients to the relaxing music group (RMG), Turkish classical music group (TCMG), and control group (CG) (n = 25 each). The primary outcome was the change in anxiety levels measured by Spielberger's State Anxiety Inventory before (T0) and after (T1) CT session. Secondary outcomes were the change in the severity of nausea from T0 to T1 and the level of satisfaction at T1.

RESULTS

The groups were similar in terms of baseline sociodemographic and health-related characteristics. Anxiety levels were lower than the baseline in RMG and TCMG in comparison to CG, and repeated measures analysis showed a significant group × time interaction (p = 0.001, F = 210.221, η2 = 0.745). Nausea severity increased from T0 to T1 for CG but decreased for RMG and TCMG with a significant group × time interaction (p = 0.001, F = 100.785, η2 = 0.583). The satisfaction level was significantly higher in TCMG than in CG and RMG (8.64 ± 0.95 vs. 7.88 ± 0.72, and 7.00 ± 0.70, respectively).

CONCLUSION

Music may be an effective non-pharmacologic option to relieve patients' anxiety and nausea during first-time CT. Larger, multicenter studies evaluating the long-term effect of music are needed to confirm these findings.

TRIAL REGISTRATION

clinicaltrials.gov (NCT05687838)/2022-13/18.

Significance of music therapy in treating depression and anxiety disorders among people with cancer

Globally, cancer cases and mortality have recently escalated and have attracted global concern. The clinical diagnosis and manifestation of cancer can result in significant mental health issues like depression and anxiety disorders. The tendency of people with cancer to suffer from psychological disorders such as anxiety and depression is usually high. A significant number of deaths related to cancer may likely not be from the killer disease but from psychological disorders associated with the illness. The utilization of music as a remedial approach to healing mental disorders cannot be overstated. Thus, identifying the impacts of music therapy in dealing with depression and anxiety disorders among people with cancer is relevant, as the majority of methods used in treating cancer have some side effects which may trigger psychological disorders in cancer patients. Ultimately, this study explored the significance of music therapy in treating depression and anxiety disorders among people with cancer. To achieve the aim of this study, the authors employed a narrative literature review to investigate the significance of music therapy in addressing depression and anxiety disorders among people with cancer. The type of literature review employed in this study is to provide an understanding of the selected research papers. The review found that music therapy significantly reduces depression and anxiety disorders among breast cancer, lung cancer, prostate cancer, and colorectal cancer patients. It is needful for healthcare providers to incorporate music therapy interventions while treating people with cancer. This will help reduce cancer deaths resulting from psychological disorders rather than the killer disease, cancer. However, the standardized procedures and evaluation criteria for applying music-based intervention strategies in oncology medicine still need to be further established and improved.

Music therapy effect on anxiety reduction among patients with cancer: A meta-analysis

Introduction

The study aimed to investigate the effect of music therapy on anxiety alleviation among cancer patients.

Methods

A comprehensive literature research was performed in four electronic databases (PubMed, Embase, Cochrane Library, and Web of Science). Fifteen randomized controlled trials (RCTs) were included. The risk of bias for the RCTs was evaluated by the Cochrane Risk of Bias tool. Anxiety levels were extracted to synthesize the combined effect by using meta-analysis. All analyses were performed using R version 4.0.4.

Results

In total, 15 RCTs met the inclusion criteria involving 1320 cancer patients (662 patients in the experimental group and 658 patients in the controlled group). The majority of interventions were performed with recorded music lasting for 15-60 minutes. Compared with standard care, music intervention had a moderate superiority of anxiety alleviation (SMD: -0.54, 95% CI: [-0.92, -0.16]).

Discussion

Music intervention could reduce cancer-related anxiety moderately. Nevertheless, the result should be interpreted with caution as high heterogeneity in this pooled study. Well-designed trials with higher quality were still warranted in the future.

Knowledge Mapping of Articles on Application of the Quran and Hadiths in Health Care: VOSviewer Visualization Techniques

This study sought to conduct a knowledge mapping of articles to shed light on the application of the Quran and Hadiths in health care. The study is applied in terms of purpose and scientometrics in terms of type, which has been carried out using retrospective bibliometric analysis methods and visualization through knowledge mapping. In order to do so, the PubMed database with related keywords was thoroughly searched. Then, 302 relevant articles were reviewed in terms of the author, the year of publication, the journal, and the subject. In addition, VOSviewer software was employed to analyze and visualize keywords and maps of the articles. The findings showed that 302 articles were published between 1972 and 2021 in 190 journals, among which the Journal of Religion and Health was ranked first with 43 articles. Word co-occurrence map of scientific products of the Quran and Hadith in health care were categorized into six clusters, namely: "complementary and alternative medicine," "ethics," "the effectiveness of spirituality on the treatment and control of mental illness," "women's rights and status," "family planning, infertility treatment and abortion," and "the views of the Quran and Hadiths on sexual issues." Adopting a holistic approach toward the application of various aspects of the Quran and Hadiths on health care, the present study can be considered as a pioneering research whose results can account for determining relevant applied research projects.

The effect of music on pain and anxiety in patients receiving chemotherapy during COVID-19

OBJECTIVE

This research has been conducted to determine the effect of music on pain and anxiety levels of patients receiving chemotherapy during COVID-19.

METHODS

The research has been carried out in a real trial model with 92 adult patients (45 in the experimental group who received chemotherapy and 47 in the control group). The data have been collected by the researcher with Google Forms (using State and Trait Anxiety Inventory [STAI] and visual analogue scale [VAS]) through the links sent to the phones of participants on the day they received chemotherapy, between March 2020 and July 2020.

RESULTS

The mean scores obtained from the post-test STAI (53.11 ± 4.77) and VAS (3.44 ± 2.53) in the experimental group have been determined to statistically significantly decrease when compared to the pre-test measurement data (STAI: 54.26 ± 4.26; VAS: 4.22 ± 2.41) (p < 0.05). No statistically significant difference has been determined between pre-test and post-test mean scores of the patients in the control group.

CONCLUSION

It has been observed that music applications reduce the pain and anxiety levels of patients receiving chemotherapy during the COVID-19 process. It can be recommended to use music applications in the management of pain and anxiety symptoms.

The influence of visual objects and music on anxiety levels of breast cancer patients scheduled to experience chemotherapy for the first time: a prospective randomized clinical study

OBJECTIVE

To investigate the influence of music together with visual objects as an ambiance in the waiting room on anxiety levels of breast cancer patients scheduled to receive chemotherapy in outpatient setting for the first time.

MATERIAL AND METHOD

Breast cancer patients planned to receive adjuvant or neoadjuvant chemotherapy for the first time between November 1, 2020, and July 31, 2021, were included. Two designs, including a standard waiting room (StWR) and an intervention waiting room (IWR) that was created by adding music and visual objects to the standard room, were constructed. These 2 designs were repeated sequentially in monthly periods, and a total of 104 patients with 52 in each group were randomized. The State Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale (HADs) were used for assessments. Results of the patients in StWR and IWR groups were compared.

RESULTS

Both HADs anxiety and STAI-state anxiety scale scores were lower in patients who waited in IWR compared to those who waited in StWR (p = 0.041, p = 0.012, respectively). In patients in the IWR group, mean heart rate was lower by 7.6 bpm (p = 0.009). No difference was found between the groups with regard to HADs depression score and STAI-trait anxiety score (p = 0.305, p = 0.535, respectively). For all patients, HADs anxiety scale (r = 0.400, p =  < 0.001) and STAI-state anxiety scale (r = 0.475, p =  < 0.001) scores increased as the waiting time increased.

DISCUSSION AND CONCLUSION

The present study is the first to investigate the influence of adding music together with visual objects to the standard ambiance of the chemotherapy waiting room on anxiety levels of breast cancer patients. We propose that introduction of paintings, artificial plants, and music to the ambiance of the waiting room has a significantly positive effect on alleviating anxiety levels of cancer patients waiting for chemotherapy.

Forest 404: Using a BBC drama series to explore the impact of nature's changing soundscapes on human wellbeing and behavior

Extensive ecosystem degradation and increasing urbanization are altering human relationships with nature. To explore these trends, we created a transdisciplinary, narrative-led podcast series produced by the BBC, called Forest 404. The series explored the implications of a world without nature. An online experimental component mobilized audience participation (n = 7,596) to assess responses to natural soundscapes with and without abiotic, biotic, and poetic elements across five biomes. Conditions featuring the sounds of wildlife, such as bird song, were perceived to be more psychologically restorative than those without. Participants' personal lived experiences were strongly related to these outcomes; those who had memories triggered by the sounds were more likely to find them psychologically restorative and exhibited a greater motivation to preserve them. Moreover, the effects of both soundscape composition and memories on preservation behavior were partially mediated by restorative potential; respondents were more likely to want to protect the sounds they heard if they thought they might offer therapeutic outcomes. Our findings highlight the value of art-science collaborations and demonstrate how maintaining contact with the natural world can promote wellbeing and foster behaviors that protect planetary health.

Effects of music intervention on anxiety, depression, and quality of life of cancer patients receiving chemotherapy: a systematic review and meta-analysis

BACKGROUND

Music may be a safe and effective coping strategy for psychological management. The objectives of this review were to identify the effects of music interventions on anxiety, depression, and quality of life (QoL) among cancer patients receiving chemotherapy.

METHODS

Fourteen databases were searched from the inception date to December 2020 to identify eligible randomized controlled trials (RCTs). Gray literature was also examined. The protocol of this systematic review was registered with PROSPERO (registration number: CRD42021223845). Two reviewers independently assessed eligibility, extracted data, and evaluated methodological quality. Meta-analysis was done. Subgroup analysis was conducted for intervention types, the person selecting music, music delivery method, timing, and session duration.

RESULTS

Nine RCTs were identified, among which six were eligible for the meta-analysis. All studies were at a high risk of bias, and the overall quality of evidence was low to very low. The pooled results reveal that music intervention could reduce anxiety (SMD: - 0.29, 95% CI - 0.50 to - 0.08) and improve QoL (SMD: 0.42, 95% CI 0.02 to 0.82). However, it fails to affect depression (p = 0.79). The findings demonstrate no significant difference between patient-selected music and researcher-selected music, recorded music, and live music, while a length of 15-20 min/session and offering immediately before chemotherapy are more effective on anxiety than that of 30-45 min and delivering during chemotherapy.

CONCLUSIONS

Music intervention may be a beneficial tool for anxiety reduction and QoL among cancer patients receiving chemotherapy. More high-quality RCTs are needed to ascertain the true impact of those outcomes.

Music, mental health, and immunity

Music is a crucial element of everyday life and plays a central role in all human cultures: it is omnipresent and is listened to and played by persons of all ages, races, and ethnic backgrounds. But music is not simply entertainment: scientific research has shown that it can influence physiological processes that enhance physical and mental wellbeing. Consequently, it can have critical adaptive functions. Studies on patients diagnosed with mental disorders have shown a visible improvement in their mental health after interventions using music as primary tool. Other studies have demonstrated the benefits of music, including improved heart rate, motor skills, brain stimulation, and immune system enhancement. Mental and physical illnesses can be costly in terms of medications and psychological care, and music can offer a less expansive addition to an individual's treatment regimen. Interventions using music offers music-based activities in both a therapeutic environment (Music therapy) with the support of a trained professional, and non-therapeutic setting, providing an atmosphere that is positive, supportive, and proactive while learning non-invasive techniques to treat symptoms associated with various disorders – and possibly modulate the immune system.

Music interventions for improving psychological and physical outcomes in people with cancer

BACKGROUND

This is an update of the review published on the Cochrane Library in 2016, Issue 8. Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in people with cancer. This review includes music interventions defined as music therapy offered by trained music therapists, as well as music medicine, which was defined as listening to pre-recorded music offered by medical staff.

OBJECTIVES

To assess and compare the effects of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 3) in the Cochrane Library, MEDLINE via Ovid, Embase via Ovid, CINAHL, PsycINFO, LILACS, Science Citation Index, CancerLit, CAIRSS, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, the RILM Abstracts of Music Literature, http://www.wfmt.info/Musictherapyworld/ and the National Research Register. We searched all databases, except for the last two, from their inception to April 2020; the other two are no longer functional, so we searched them until their termination date. We handsearched music therapy journals, reviewed reference lists and contacted experts. There was no language restriction.

SELECTION CRITERIA

We included all randomized and quasi-randomized controlled trials of music interventions for improving psychological and physical outcomes in adults and pediatric patients with cancer. We excluded patients undergoing biopsy and aspiration for diagnostic purposes.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted the data and assessed the risk of bias. Where possible, we presented results in meta-analyses using mean differences and standardized mean differences. We used post-test scores. In cases of significant baseline difference, we used change scores. We conducted separate meta-analyses for studies with adult participants and those with pediatric participants. Primary outcomes of interest included psychological outcomes and physical symptoms and secondary outcomes included physiological responses, physical functioning, anesthetic and analgesic intake, length of hospitalization, social and spiritual support, communication, and quality of life (QoL) . We used GRADE to assess the certainty of the evidence.

MAIN RESULTS

We identified 29 new trials for inclusion in this update. In total, the evidence of this review rests on 81 trials with a total of 5576 participants. Of the 81 trials, 74 trials included adult (N = 5306) and seven trials included pediatric (N = 270) oncology patients. We categorized 38 trials as music therapy trials and 43 as music medicine trials. The interventions were compared to standard care. Psychological outcomes The results suggest that music interventions may have a large anxiety-reducing effect in adults with cancer, with a reported average anxiety reduction of 7.73 units (17 studies, 1381 participants; 95% confidence interval (CI) -10.02 to -5.44; very low-certainty evidence) on the Spielberger State Anxiety Inventory scale (range 20 to 80; lower values reflect lower anxiety). Results also suggested a moderately strong, positive impact of music interventions on depression in adults (12 studies, 1021 participants; standardized mean difference (SMD): -0.41, 95% CI -0.67 to -0.15; very low-certainty evidence). We found no support for an effect of music interventions on mood (SMD 0.47, 95% CI -0.02 to 0.97; 5 studies, 236 participants; very low-certainty evidence). Music interventions may increase hope in adults with cancer, with a reported average increase of 3.19 units (95% CI 0.12 to 6.25) on the Herth Hope Index (range 12 to 48; higher scores reflect greater hope), but this finding was based on only two studies (N = 53 participants; very low-certainty evidence). Physical outcomes We found a moderate pain-reducing effect of music interventions (SMD -0.67, 95% CI -1.07 to -0.26; 12 studies, 632 adult participants; very low-certainty evidence). In addition, music interventions had a small treatment effect on fatigue (SMD -0.28, 95% CI -0.46 to -0.10; 10 studies, 498 adult participants; low-certainty evidence). The results suggest a large effect of music interventions on adult participants' QoL, but the results were highly inconsistent across studies, and the pooled effect size was accompanied by a large confidence interval (SMD 0.88, 95% CI -0.31 to 2.08; 7 studies, 573 participants; evidence is very uncertain). Removal of studies that used improper randomization methods resulted in a moderate effect size that was less heterogeneous (SMD 0.47, 95% CI 0.06 to 0.88, P = 0.02, I² = 56%). A small number of trials included pediatric oncology participants. The findings suggest that music interventions may reduce anxiety but this finding was based on only two studies (SMD -0.94, 95% CI -1.9 to 0.03; very low-certainty evidence). Due to the small number of studies, we could not draw conclusions regarding the effects of music interventions on mood, depression, QoL, fatigue or pain in pediatric participants with cancer. The majority of studies included in this review update presented a high risk of bias, and therefore the overall certainty of the evidence is low. For several outcomes (i.e. anxiety, depression, pain, fatigue, and QoL) the beneficial treatment effects were consistent across studies for music therapy interventions delivered by music therapists. In contrast, music medicine interventions resulted in inconsistent treatment effects across studies for these outcomes.

AUTHORS' CONCLUSIONS

This systematic review indicates that music interventions compared to standard care may have beneficial effects on anxiety, depression, hope, pain, and fatigue in adults with cancer. The results of two trials suggest that music interventions may have a beneficial effect on anxiety in children with cancer. Too few trials with pediatric participants were included to draw conclusions about the treatment benefits of music for other outcomes. For several outcomes, music therapy interventions delivered by a trained music therapist led to consistent results across studies and this was not the case for music medicine interventions. Moreover, evidence of effect was found for music therapy interventions for QoL and fatigue but not for music medicine interventions. Most trials were at high risk of bias and low or very low certainty of evidence; therefore, these results need to be interpreted with caution.

Effects of music therapy on anxiety: A meta-analysis of randomized controlled trials

This study aims to evaluate the efficacy of music therapy on anxiety from randomized controlled trials (RCTs). The following electronic databases were utilized for selecting eligible studies that were published from inception to March 2021: PubMed, Cochrane Library, PsycINFO, Medline, Web of Science, and Embase. Standard mean difference (SMD) with 95% confidence interval (CI) values were used to evaluate the efficacy of music therapy on anxiety. Thirty-two studies with 1,924 participants were included in the meta-analysis. Music therapy lasted an average of 7.5 sessions (range, 1-24 sessions), while the average follow-up duration was 7.75 weeks (range, 1-16 weeks). Music therapy significantly reduced anxiety compared to the control group at post-intervention (SMD = -0.36, 95% CI: -0.54 to -0.17, p < 0.05), but not at follow-up (SMD = -0.23, 95% CI: -0.53 to 0.08, p >0.05). Subgroup analysis found a significantly positive effect of music therapy on anxiety in < 60 and ≥ 60 age-group (SMD = -0.31, 95% CI: -0.52 to -0.09, p < 0.05; SMD = -0.45, 95% CI: -0.85 to -0. 05, p < 0.05), developed and developing country group (SMD = -0.28, 95% CI: -0.51 to -0.06, p < 0.05; SMD = -0.49, 95% CI: -0.80 to -0.17, p < 0.05), < 12 and ≥ 12 sessions group (SMD = -0.24, 95% CI: = -0.44 to -0.03, p < 0.05; SMD = -0.59, 95% CI: -0.95 to -0.22, p < 0.05), respectively. Our study indicated that music therapy can significantly improve anxiety during treatment. But given that only eight RCTs reported the effects of music therapy at follow-up and the duration of follow-up was inconsistent, further researches are needed on the lasting effects after the intervention is discontinued.

Recitation of quran and music to reduce chemotherapy-induced anxiety among adult patients with cancer: A clinical trial

AIM

The aim of this study was to assess the effectiveness of listening to music or Quran in reducing cancer patients' anxiety before chemotherapy administration. Reducing anxiety in people with cancer, prior to chemotherapy administration, is a crucial goal in nursing care.

DESIGN

An experimental comparative study was conducted.

METHODS

A simple randomization sampling method was applied. Two hundred thirty-eight people with cancer who underwent chemotherapy were participated. They are assigned as Quran, music and control groups.

RESULTS

The overall score of Arabic State Anxiety Inventory in all groups revealed that there was a significant difference between pre-test and post-test among participants. Listening to Quran or music reduced the chemotherapy-induced anxiety. There was no difference between these two ways to reduce anxiety in people with cancer. Listening to Quran or music can be added in nursing care plans prior chemotherapy administrations to reduce cancer patients' anxiety.

Effectiveness of different music interventions on managing symptoms in cancer survivors: A meta-analysis

PURPOSE

Music-based interventions can provide non-pharmacological, low-cost treatment for symptoms. This meta-analysis's purpose is to examine music-based interventions' effectiveness on psychological distress symptoms (anxiety, stress, and depressive symptoms), aspects of positive psychology (benefit-finding and resilience), and quality of life (QoL).

METHODS

This meta-analysis was conducted according to PRISMA guidelines and meta-analytic methods suggested by Hedges and Olkin (1985). A systematic literature search between 2000 and 2020 was conducted using CINAHL, MEDLINE, PsycINFO, PubMed, and Web of Science databases. Studies and intervention characteristics were independently coded. The Quality Assessment Tool for Quantitative Studies, Cochrane Collaboration's Tool for Assessing Risk of Bias, Begg and Mazumdar's rank correlation, and Egger's regression test evaluated publication bias.

RESULTS

Twenty-nine of thirty-five eligible studies were included in the statistical analysis. The overall (g = 0.34, SE = 2.27, p < 0.05) and psychological distress symptoms sub-outcome type (g = 0.47, SE = 0.18, p < 0.05) models with moderator analyses were statistically significant.

CONCLUSIONS

Culturally appropriate music-based interventions conducted in the clinical setting that used passive listening with headphones, occurring ≥ 3-times a week over ≥ 2 months, positively impacted gynecology survivors undergoing chemotherapy and surgical treatments. Specifically, interventions that were ≥ 35-minutes, listening to folk or mixed-music positively impacted psychological distress symptoms, whereas new-age music negatively impacted psychological distress symptoms, positive psychology, and QoL outcomes. Future research should examine positive psychology characteristics (perceived levels of positive adjustment, change, and coping) and include larger cohorts with various cancer populations across all cancer survivorship continuum. Culturally appropriate interventions could lead to greater adherence, compliance, and clinical effectiveness and increase the findings' significance and generalizability.

Music-Based Interventions in Paediatric and Adolescents Oncology Patients: A Systematic Review

Background: The implications of cancer and its medical treatment are traumatic, highly stressful and have great psychosocial impact. Therefore, a comprehensive treatment is essential and music-based interventions can play an important role. The objective of this study is to summarise research that assesses the effects of music therapy in paediatric and adolescent patients with cancer during the process of the disease. Methods: A systematic review conducted following PRISMA’s statements. An electronic search of the literature was carried out in the following databases: PubMed, Cochrane, Dialnet, Scopus, IDICEs CSIC and Science Direct. Original studies that conducted music-based interventions with oncology patients between 0 to 18 years old were included. Results: 11 studies were finally included in the review. The sample consisted of two quasi-experimental studies, five randomised clinical controlled trials, one non-randomised controlled trial, one study that involved qualitative and quantitative analysis methods, one descriptive study and one observational study. Conclusions: Music-based interventions decrease anxiety, perceived pain and depression symptoms and improve state of mind, self-esteem and quality of life of paediatric and adolescent patients with cancer. Moreover, they decrease heart rate, respiratory rate and blood pressure and encourage patients to use adaptive coping strategies.

Music Therapy in the Psychosocial Treatment of Adult Cancer Patients: A Systematic Review and Meta-Analysis

Introduction: Music therapy is used as an adjunct oncological treatment aiming at the improvement of psychological and physical well-being through music. A growing body of randomized and non-randomized controlled trials has been published and reviewed recently. However, a global, quantitative assessment of the effectiveness of music therapy in adult cancer care is missing. The present study thus aims to synthesize the evidence of music therapy in different oncological treatment phases.

Methods: We conducted a pre-registered systematic review and meta-analysis (PROSPERO-ID: CRD42019133084) following standard guidelines. We searched electronic databases for studies on music therapy performed by a therapist with adult cancer patients.

Results: The narrative synthesis included thirty studies showing that music therapy overall had positive effects on a broad range of outcomes, with techniques and effects varying in different phases. During curative treatment, results were most promising with regard to anxiety, depression, and pain medication intake, while in palliative settings, improvements with regard to quality of life, spiritual well-being, pain, and stress were reported. Twenty-one studies were included in the meta-analysis which showed small but significant effects of music therapy on psychological well-being (d = 0.35, p < 0.001), physical symptom distress (d = −0.26, p = 0.017), and quality of life (d = 0.36, p = 0.023). Heterogeneity between effect sizes was small to medium. Moderator analyses identified studies with a single session of music therapy and the use of receptive techniques to produce larger effects regarding psychological well-being.

Conclusion: Music therapy can improve relevant health-outcomes in cancer patients and should therefore be offered in various treatment phases. Future research should include potential moderators such as individual information about patients to find out who benefits most from different kinds of music therapy.

A randomized trial of nurse-administered behavioral interventions to manage anticipatory nausea and vomiting in chemotherapy

PURPOSE

Chemotherapy side effects diminish quality of life and can lead to treatment delay. Nausea and vomiting can occur prior to chemotherapy because of classical conditioning. We studied the effects of 20-minute behavioral interventions, administered by oncology nurses, of higher intensity (mindfulness relaxation-MR) or lower intensity (relaxing music-RM), on anticipatory nausea and vomiting (ANV).

PATIENTS AND METHODS

Patients undergoing chemotherapy for solid tumors were randomized to MR (N = 160), RM (N = 159), or standard care SC (N = 155). Subjects were mostly female (91.8%) and white (86.1%) with breast cancer (85%). Most patients had early stage disease (Stage I: 26%; II: 52.9%; III: 19%; IV: 0.1%). Anticipatory nausea and vomiting were assessed at the midpoint and end of the chemotherapy course using the Morrow Assessment of Nausea and Emesis (MANE).

RESULTS

Compared to SC, there was reduced anticipatory nausea at the midpoint of chemotherapy in those receiving MR (OR 0.44, 95% CI 0.20-0.93) and RM (OR 0.40, 95% CI 0.20-0.93), controlling for age, sex, cancer stage, and emetogenic level of chemotherapy. There was no difference between treatment groups in anticipatory nausea at the end of chemotherapy or in anticipatory vomiting and postchemotherapy nausea and vomiting at either time point.

CONCLUSION

A brief nurse-delivered behavioral intervention can reduce midpoint ANV associated with chemotherapy.

A survey of oncology healthcare professionals' knowledge and attitudes toward the use of music as a therapeutic tool in healthcare

BACKGROUND

Music as a therapeutic tool, defined as "music care," can help manage physical and psychological symptoms in individuals with cancer. There is further need to understand interest level and the potential role of music care among health professionals working in the field of oncology.

PURPOSE

To investigate knowledge of and attitudes toward the use of music as a therapeutic tool in cancer and palliative care, as well as to identify barriers associated with learning to use music in care among health professionals.

METHODS

Participants (N = 204), mostly nurses working in oncology and palliative care, completed a survey to assess awareness, knowledge, and attitudes toward the use of music in healthcare practice.

RESULTS

In total, 55.5% of participants reported being "somewhat or very knowledgeable" about how to apply/use music therapy for the management of symptoms or on how to make a music therapy referral or for any application of music care. Participants demonstrated a high interest level in learning how to incorporate music into practice (mean = 4.05; SD = 1.045).

CONCLUSION

While there is generally high interest and perceived value among nurses in music care interventions, knowledge level about such interventions was low. The study has implications for knowledge translation and education needed to further support uptake and use of music care in nursing practice.

Music, heart rate variability, and symptom clusters: a comparative study

PURPOSE

This study aimed to explore the possible range of change of a single-session music intervention (SMI) on symptom clusters and neurological reactivity for women with breast cancer undergoing chemotherapy.

METHODS

A parallel and randomized, controlled study with repeated measures design was used. A total of 100 women with breast cancer were randomly assigned to the SMI or a control group. The outcome measurements of symptom cluster were collected using the Multidimensional Fatigue Symptom Inventory, Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, and the neurological reactivity with heart rate variability at four time points: before commencement of the intervention (T0), immediately afterward (T1), 1 week later (T2), and 3 weeks after the intervention (T3).

RESULTS

Of the 50 women in each group, 46 in the SMI and 48 in the control group completed the post-test at T3. Multivariate analysis of variance indicated that the SMI group had a medium effect in change of symptom clusters compared to the control group at T2. Moreover, after adjusting for baseline between normal and higher levels of sympathetic tone activity, significant differences existed in fatigue and depression at T2 and sleep disturbance at T3.

CONCLUSIONS

A single-session music intervention can be effectively used to reduce symptom clusters for women with breast cancer. Targeting those who have a higher level of sympathetic tone activity is recommended.

Reporting quality of music intervention research in healthcare: A systematic review

INTRODUCTION

Concomitant with the growth of music intervention research, are concerns about inadequate intervention reporting and inconsistent terminology, which limits validity, replicability, and clinical application of findings.

OBJECTIVE

Examine reporting quality of music intervention research, in chronic and acute medical settings, using the Checklist for Reporting Music-based Interventions. In addition, describe patient populations and primary outcomes, intervention content and corresponding interventionist qualifications, and terminology.

METHODS

Searching MEDLINE, PubMed, CINAHL, HealthSTAR, and PsycINFO we identified articles meeting inclusion/exclusion criteria for a five-year period (2010-2015) and extracted relevant data. Coded material included reporting quality across seven areas (theory, content, delivery schedule, interventionist qualifications, treatment fidelity, setting, unit of delivery), author/journal information, patient population/outcomes, and terminology.

RESULTS

Of 860 articles, 187 met review criteria (128 experimental; 59 quasi-experimental), with 121 publishing journals, and authors from 31 countries. Overall reporting quality was poor with <50% providing information for four of the seven checklist components (theory, interventionist qualifications, treatment fidelity, setting). Intervention content reporting was also poor with <50% providing information about the music used, decibel levels/volume controls, or materials. Credentialed music therapists and registered nurses delivered most interventions, with clear differences in content and delivery. Terminology was varied and inconsistent.

CONCLUSIONS

Problems with reporting quality impedes meaningful interpretation and cross-study comparisons. Inconsistent and misapplied terminology also create barriers to interprofessional communication and translation of findings to patient care. Improved reporting quality and creation of shared language will advance scientific rigor and clinical relevance of music intervention research.

Kind of blue: A systematic review and meta-analysis of music interventions in cancer treatment

OBJECTIVES

Music may be a valuable and low-cost coping strategy for cancer patients. We conducted a systematic review and meta-analysis to identify the psychological and physical effects of music interventions in cancer treatment.

METHODS

We included randomized, controlled trials with adult patients in active cancer treatment exposed to different music interventions versus control conditions. Qualitative studies and systematic reviews were excluded. We identified a total of 2624 records through 2 systematic searches (June 2015 and September 2016) in PubMed, Scopus, EMBASE, Cinahl, Web of Science, Cochrane, and PsycINFO and used Risk of Bias Assessment, GRADE and Checklist for Reporting Music-Based Interventions to evaluate the music applied and quality of the studies. We conducted meta-analyses using Review Manager (version 5.3). PROSPERO reg. no. CRD42015026024.

RESULTS

We included 25 RCT's (N = 1784) of which 20 were eligible for the meta-analysis (N = 1565). Music reduced anxiety (SMD -0·80 [95% CI, -1.35 to -0.25]), pain (SMD -0.88 [95% CI -1.45 to -0.32]), and improved mood (SMD -0.55 [95% CI, -0.98 to -0.13]). However, studies were hampered by heterogeneity with I² varying between 54% and 96%. Quality of the studies ranged from very low to low. The most effective mode of music intervention appeared to be passive listening to self-selected, recorded music in a single session design.

CONCLUSIONS

Music may be a tool in reducing anxiety, pain, and improving mood among patients with cancer in active treatment. However, methodological limitations in the studies conducted so far prevent firm conclusions.

Comparison of group vs self-directed music interventions to reduce chemotherapy-related distress and cognitive appraisal: an exploratory study

PURPOSE

The purpose of this study was to determine effects of group music intervention and self-directed music intervention on anxiety, depression, and cognitive appraisal among women with breast cancer.

METHODS

A quasi-experimental design randomly assigned 60 women undergoing chemotherapy to 3 groups: group music intervention, self-directed music intervention, or a control group. The Hospital Anxiety and Depression Scale and the Mini-Mental Adjustment to Cancer Scale were administered before, after the 8-week interventions, and at 3-month follow-up.

RESULTS

Of the 52 women completing the study, results indicated that group music intervention had a significant (p < .01) immediate effect to decrease helplessness/hopelessness and anxious preoccupation and significant effects for reducing anxiety, depression, helplessness/hopelessness, and cognitive avoidance compared to the other two groups at 3-month follow-up.

CONCLUSIONS

Group music intervention can be considered an effective supportive care in alleviating the chemotherapy-related distress and enhancing cognition modification of women with breast cancer. Further research is needed to determine the role of cognitive appraisal in the illness trajectory.

The effects of massage and music on pain, anxiety and relaxation in burn patients: Randomized controlled clinical trial

AIM

The aim of this study was to evaluate the effects of massage and music on pain intensity, anxiety intensity and relaxation level in burn patients.

INTRODUCTION

Pain and anxiety are common among burn patients, but there are many physical and psychological consequences.

METHODS

This randomized controlled clinical trial with factorial design 2×2 included 240 burn patients admitted at Shahid Motahari Burns Hospital, Tehran, Iran, between September 2013 and May 2015. The patients were allocated into the following groups: (i) control (n=60) receiving the conventional primary care, (ii) music group (n=60) receiving their favorite songs, (iii) massage group (n=60) receiving Swedish massage, and (iv) music-plus-massage group (n=60) receiving a combination of their favorite songs and Swedish massage, for 20min once a day for 3 consecutive days, using random permuted blocks of sizes 4 with a 1:1 ratio. To collect the data before and after the intervention, a specific Visual Analogue Scale (VAS) was applied for pain intensity, anxiety intensity, and relaxation level. The data were analyzed using SPSS, version 21.

RESULTS

Our findings showed a decrease in pain and anxiety intensity and an increase in relaxation level in all three intervention groups as compared to the control group, indicating there was no significant difference among the interventions applied. Furthermore, following application of each intervention, pain and anxiety intensity decreased and relaxation level increased in the intervention groups as compared to before intervention.

CONCLUSION

Our results revealed that music, massage and a combination of both interventions were effective on reducing pain and anxiety intensity and increasing relaxation level. Due to easy, low-cost and availability of the interventions applied, these complementary therapies are suggested for the burn patients. Although application of a single complementary therapy is cost-effective, further studies are required to determine the most effective and cost-effective method to improve the burn care.

Symptom Management: The Effects of Self-Affirmation on Chemotherapy-Related Symptoms

BACKGROUND

Positive effects of auditory stimulations are common in symptom management. However, the effect of self-affirmations on symptom management is not well known.

OBJECTIVES

The purpose of this study is to investigate the effects of self-affirmations and nature sounds on chemotherapy-related symptoms.

METHODS

This randomized, controlled experimental study was conducted with 140 patients receiving chemotherapy. The first experimental group listened to affirmations, the second listened to nature sounds, and the third listened to both.

FINDINGS

In the affirmation group, pain, tiredness, drowsiness, lack of appetite, depression, anxiety, and lack of well-being scores were lower. In the affirmation and nature sounds group, drowsiness, depression, anxiety, and lack of well-being scores were reduced. In the nature sounds group, tiredness, drowsiness, and lack of well-being scores were reduced. In the control group, tiredness, drowsiness, nausea, and lack of well-being scores were higher.

Music interventions for improving psychological and physical outcomes in cancer patients

BACKGROUND

Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in cancer patients.

OBJECTIVES

To assess and compare the effects of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 1), MEDLINE, Embase, CINAHL, PsycINFO, LILACS, Science Citation Index, CancerLit, CAIRSS, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, the RILM Abstracts of Music Literature, http://www.wfmt.info/Musictherapyworld/ and the National Research Register. We searched all databases, except for the last two, from their inception to January 2016; the other two are no longer functional, so we searched them until their termination date. We handsearched music therapy journals, reviewed reference lists and contacted experts. There was no language restriction.

SELECTION CRITERIA

We included all randomized and quasi-randomized controlled trials of music interventions for improving psychological and physical outcomes in adult and pediatric patients with cancer. We excluded participants undergoing biopsy and aspiration for diagnostic purposes.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted the data and assessed the risk of bias. Where possible, we presented results in meta-analyses using mean differences and standardized mean differences. We used post-test scores. In cases of significant baseline difference, we used change scores.

MAIN RESULTS

We identified 22 new trials for inclusion in this update. In total, the evidence of this review rests on 52 trials with a total of 3731 participants. We included music therapy interventions offered by trained music therapists, as well as music medicine interventions, which are defined as listening to pre-recorded music, offered by medical staff. We categorized 23 trials as music therapy trials and 29 as music medicine trials.The results suggest that music interventions may have a beneficial effect on anxiety in people with cancer, with a reported average anxiety reduction of 8.54 units (95% confidence interval (CI) -12.04 to -5.05, P < 0.0001) on the Spielberger State Anxiety Inventory - State Anxiety (STAI-S) scale (range 20 to 80) and -0.71 standardized units (13 studies, 1028 participants; 95% CI -0.98 to -0.43, P < 0.00001; low quality evidence) on other anxiety scales, a moderate to strong effect. Results also suggested a moderately strong, positive impact on depression (7 studies, 723 participants; standardized mean difference (SMD): -0.40, 95% CI -0.74 to -0.06, P = 0.02; very low quality evidence), but because of the very low quality of the evidence for this outcome, this result needs to be interpreted with caution. We found no support for an effect of music interventions on mood or distress.Music interventions may lead to small reductions in heart rate, respiratory rate and blood pressure but do not appear to impact oxygen saturation level. We found a large pain-reducing effect (7 studies, 528 participants; SMD: -0.91, 95% CI -1.46 to -0.36, P = 0.001, low quality evidence). In addition, music interventions had a small to moderate treatment effect on fatigue (6 studies, 253 participants; SMD: -0.38, 95% CI -0.72 to -0.04, P = 0.03; low quality evidence), but we did not find strong evidence for improvement in physical functioning.The results suggest a large effect of music interventions on patients' quality of life (QoL), but the results were highly inconsistent across studies, and the pooled effect size for the music medicine and music therapy studies was accompanied by a large confidence interval (SMD: 0.98, 95% CI -0.36 to 2.33, P = 0.15, low quality evidence). A comparison between music therapy and music medicine interventions suggests a moderate effect of music therapy interventions for patients' quality of life (QoL) (3 studies, 132 participants; SMD: 0.42, 95% CI 0.06 to 0.78, P = 0.02; very low quality evidence), but we found no evidence of an effect for music medicine interventions. A comparison between music therapy and music medicine studies was also possible for anxiety, depression and mood, but we found no difference between the two types of interventions for these outcomes.The results of single studies suggest that music listening may reduce the need for anesthetics and analgesics as well as decrease recovery time and duration of hospitalization, but more research is needed for these outcomes.We could not draw any conclusions regarding the effect of music interventions on immunologic functioning, coping, resilience or communication outcomes because either we could not pool the results of the studies that included these outcomes or we could only identify one trial. For spiritual well-being, we found no evidence of an effect in adolescents or young adults, and we could not draw any conclusions in adults.The majority of studies included in this review update presented a high risk of bias, and therefore the quality of evidence is low.

AUTHORS' CONCLUSIONS

This systematic review indicates that music interventions may have beneficial effects on anxiety, pain, fatigue and QoL in people with cancer. Furthermore, music may have a small effect on heart rate, respiratory rate and blood pressure. Most trials were at high risk of bias and, therefore, these results need to be interpreted with caution.

Effectiveness of music intervention in ameliorating cancer patients' anxiety, depression, pain, and fatigue: a meta-analysis

BACKGROUND

This is the first study to use meta-analysis as a scientific technique to provide an integrated analysis of the effectiveness of music intervention in cancer patients.

OBJECTIVES

The purpose of this study was, using the meta-analysis method, to present a summary of existing research and explore the effectiveness of music intervention in ameliorating anxiety, depression, pain, and fatigue in cancer patients.

METHODS

The present study collected quantitative study designs sought of music intervention for cancer patients published from 2002 to 2012. These studies were then cross-referenced using Medical Subject Headings for topics on music intervention and cancer patients. Outcome indicators were anxiety, depression, pain, and fatigue. The quality of the studies was evaluated using Cochrane Collaboration Guidelines. The effect size on outcome indicators used the formula devised by Hedges and Olkin (1985).

RESULTS

Results showed that music interventions were significantly effective in ameliorating anxiety (g = -0.553), depression (g = -0.510), pain (g = -0.656), and fatigue (g = -0.422) in cancer patients. Subgroup analyses revealed that age and who selected the music were major factors influencing the effect size on anxiety reduction.

CONCLUSIONS

Music interventions significantly ameliorate anxiety, depression, pain, and fatigue in cancer patients, especially adults. Music interventions were more effective in adults than in children or adolescents and more effective when patients, rather than researchers, chose the music.

IMPLICATIONS FOR PRACTICE

Our findings provide important information for future music-intervention planners to improve the design and processes that will benefit patients in such programs.

Female Listeners' Autonomic Responses to Dramatic Shifts Between Loud and Soft Music/Sound Passages: A Study of Heavy Metal Songs

Although music and the emotion it conveys unfold over time, little is known about how listeners respond to shifts in musical emotions. A special technique in heavy metal music utilizes dramatic shifts between loud and soft passages. Loud passages are penetrated by distorted sounds conveying aggression, whereas soft passages are often characterized by a clean, calm singing voice and light accompaniment. The present study used heavy metal songs and soft sea sounds to examine how female listeners’ respiration rates and heart rates responded to the arousal changes associated with auditory stimuli. The high-frequency power of heart rate variability (HF-HRV) was used to assess cardiac parasympathetic activity. The results showed that the soft passages of heavy metal songs and soft sea sounds expressed lower arousal and induced significantly higher HF-HRVs than the loud passages of heavy metal songs. Listeners’ respiration rate was determined by the arousal level of the present music passage, whereas the heart rate was dependent on both the present and preceding passages. Compared with soft sea sounds, the loud music passage led to greater deceleration of the heart rate at the beginning of the following soft music passage. The sea sounds delayed the heart rate acceleration evoked by the following loud music passage. The data provide evidence that sound-induced parasympathetic activity affects listeners’ heart rate in response to the following music passage. These findings have potential implications for future research on the temporal dynamics of musical emotions.

Eva Between Anxiety and Hope: Integrating Anthroposophic Music Therapy in Supportive Oncology Care

Music therapy is a significant modality in the treatment of patients with cancer, who suffer emotional and spiritual distress as well as chemotherapy side effects that impair their quality of life. In this article, we present a case study of a patient challenged with recurrent ovarian cancer who received, concomitant with chemotherapy, a special form of music therapy based on anthroposophic medicine (AM) aimed at alleviating anxiety and improving her general well-being. AM-centered music therapy goals are discussed in regard to two modes of treatment: receptive listening and clinical composition. Next, these two treatment modes are discussed in a broader context by reviewing conventional music therapy interventions during chemotherapy on two axes: a. standardized vs. individualized treatment; b. patient’s involvement on a passive to active continuum. In conclusion, psycho-oncology care can be enriched by adding anthroposophic medicine-oriented music therapy integrated within patients’ supportive care.

Update on research-based interventions for anxiety in patients with cancer

Anxiety may begin at the moment a person is diagnosed with cancer and may fluctuate throughout the cancer trajectory as physical illness improves or declines. The purpose of this article is to present current evidence for nurses to implement interventions to reduce anxiety in patients who have cancer. The PubMed and CINAHL® databases were searched to identify relevant citations addressing interventions that treat or prevent anxiety symptoms in patients with cancer. Based on available evidence, the interventions addressed herein are categorized according to the Putting Evidence Into Practice (PEP®) rating schema. Interventions include pharmacologic and nonpharmacologic approaches to care, and meet criteria for three PEP categories: likely to be effective, effectiveness not established (the largest category of results), or effectiveness unlikely.

How to improve the prevention of chemotherapy-induced nausea and vomiting? The French NAVI study

PURPOSE

Chemotherapy-induced nausea and vomiting (CINV) still remain frequent. The procedure for announcing the diagnosis (PAD) was an emblematic measure of the first French Plan Cancer aiming at providing patients with time to listen, information after cancer diagnosis, and discussion on treatments and their side effects. We aimed at assessing the risk factors of CINV, focusing on patients' satisfaction with the PAD.

METHODS

This prospective multicentre study assessed the frequency and intensity of CINV among chemonaïve patients during the first cycle of treatment. CINV was defined by ≥1 emetic episode or reported nausea intensity ≥3 on a 0-10 scale. Multivariate analysis was used to identify factors related to global CINV onset including satisfaction with the PAD (satisfaction score ≥the median on a 0-10 scale).

RESULTS

Data from 291 patients (women, 85.2%; mean age, 57 years) were analyzed. Most patients (69.4%) received highly emetogenic chemotherapy regimens and 77.7% received antiemetic drugs consistent with international guidelines. Acute, delayed and overall CINV were experienced by 40.4, 34.8 and 52.4% of patients, respectively. Sixty-seven per cent of patients were satisfied with the PAD. No relation was noted between PAD satisfaction and CINV onset. The nausea and vomiting dimension of the QLQ-C30 questionnaire before chemotherapy (OR 3.62), motion sickness history (OR 2.73), highly emetogenic CT (OR 2.73), anxiety (OR 1.99) and younger age (OR 1.96) were independent predictive factors.

CONCLUSIONS

Although patients were mostly satisfied with the PAD, half of them experienced CINV. A state of anxiety could be identified during the PAD to be managed.

Application of therapeutic harp sounds for quality of life among hospitalized patients

CONTEXT

Hospitalized patients experience symptoms including pain and anxiety that may negatively affect their well-being and overall quality of life (QOL), even when medical interventions are deemed successful.

OBJECTIVES

The objective of the study was to assess the efficacy of prescriptive live therapeutic harp sounds on patient symptoms and QOL.

METHODS

The study was a two-period, two-treatment arm crossover, randomized clinical trial. Individuals were randomized to harp music and standard care for the first 24 hours of the hospital stay, followed by 24 hours of only standard care, or vice versa. The harp intervention was 30-40 minutes of prescriptive live therapeutic harp sounds in the form of solo harp pieces and improvisations. Patients recorded well-being and symptom scores on linear analogue scales. Entry criteria included at least 18 years and a score of 3 or below on a 1-5 linear analogue scale indicating compromised overall QOL.

RESULTS

Ninety-two eligible patients participated in the clinical trial. All the QOL variables had significantly higher percentages of patients with improvements during the harp treatment than during standard care. Five symptoms--fatigue, anxiety, sadness, relaxation, and pain--were significantly improved following therapeutic harp treatment. Approximately 30% to 50% of patients showed a significant increase in the QOL measures after harp treatment.

CONCLUSION

There is evidence of strong positive effects on the QOL of hospitalized patients who received therapeutic harp sound treatment along with standard care.

Effect of music in endoscopy procedures: systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

Endoscopies are common clinical examinations that are somewhat painful and even cause fear and anxiety for patients. We performed this systematic review and meta-analysis of randomized controlled trials to determine the effect of music on patients undergoing various endoscopic procedures.

METHODS

We searched the Cochrane Library, Issue 6, 2013, PubMed, and EMBASE databases up to July 2013. Randomized controlled trials comparing endoscopies, with and without the use of music, were included. Two authors independently abstracted data and assessed risk of bias. Subgroup analyses were performed to examine the impact of music on different types of endoscopic procedures.

RESULTS

Twenty-one randomized controlled trials involving 2,134 patients were included. The overall effect of music on patients undergoing a variety of endoscopic procedures significantly improved pain score (weighted mean difference [WMD] = -1.53, 95% confidence interval [CI] [-2.53, -0.53]), anxiety (WMD = -6.04, 95% CI [-9.61, -2.48]), heart rate (P = 0.01), arterial pressure (P < 0.05), and satisfaction score (SMD = 1.83, 95% CI [0.76, 2.91]). Duration of the procedure (P = 0.29), except for gastrointestinal endoscopy (P = 0.03), and sedative or analgesic medication dose (P = 0.23, P = 0.12, respectively) were not significantly decreased in the music group, compared with the control group. Furthermore, music had little effect for patients undergoing colposcopy and bronchoscopy in the subanalysis.

CONCLUSION

Our meta-analysis suggested that music may offer benefits for patients undergoing endoscopy, except in colposcopy and bronchoscopy.

Effectiveness of prayer in reducing anxiety in cancer patients

Objective: To evaluate the effect of prayer on anxiety in cancer patients undergoing chemotherapy. Method: Quasi-experimental study, with pre and post-intervention. Twenty patients admitted to treatment of continuous intravenous chemotherapy were recruited. The volunteers were evaluated through interviews using a questionnaire of sociodemographic, clinical and spiritual characteristics, the Index of Religiosity Duke University and the State-Trait Anxiety Inventory. Vital signs were measured and collected salivary cortisol. The intervention was applied prayer and data collection occurred in three phases: first collection (baseline), pre and post-intervention. Results: The data found between the pre and post-intervention samples showed different statistically significant for state anxiety (p= <0.00), blood pressure (systolic, p=0.00, diastolic, p=<0.00) and respiratory rate (p=0.04). Conclusion: Prayer, therefore, proved to be an effective strategy in reducing the anxiety of the patient undergoing chemotherapy.




Why do some cancer patients receiving chemotherapy choose to take complementary and alternative medicines and what are the risks?

Complementary and alternative medicine (CAM) cover a broad and diverse group of treatments and products that do not tend to be widely used by conventional healthcare professions. CAM that is systemically absorbed is the most likely to interfere with concurrent chemotherapy and potentially cause harm to cancer patients. Patients receiving chemotherapy may be consuming CAM to treat cancer, to lessen chemotherapy side effects, for symptom management, or to treat conditions unrelated to their cancer. A small proportion of cancer patients decide to use CAM alone to treat cancer and delay conventional treatment. Cancer patients may be influenced in their CAM decision-making by others: practitioners, family, friends, spouse and even casual acquaintances met in waiting rooms and support groups. This influence may range from encouraging and supporting the patient's decision through to making the decisions for the patient. When tested in rigorous clinical trials, no CAM cancer treatments alone have shown benefit beyond placebo. With the exception of ginger to treat chemotherapy-induced nausea, there is no compelling evidence overriding risk to take complementary medicines for supportive care during chemotherapy treatment. There is, however, established evidence to use mind-body complementary therapies for supportive care during chemotherapy treatment.