Decreased risk of falls in patients attending music sessions on an acute geriatric ward: results from a retrospective cohort study

'It helps you forget your worries': A pilot study exploring music therapy in the acute hospital aged care setting

OBJECTIVES

Few studies have explored music therapy (MT) in an acute aged care inpatient setting. We aimed to assess feasibility and patient/staff perceptions of an 8-week MT program on an acute geriatric ward.

METHODS

An 8-week in-person MT program, comprising brief receptive musical interventions up to twice-weekly. All patients admitted to the aged care ward were eligible for inclusion. A hard copy survey was used to assess patient and staff perceptions of MT. Themes raised in free-text responses were manually coded within a thematic analysis approach. A mixed methods approach was used to obtain and analyse data relating to feasibility and patient and staff perceptions of the MT intervention.

RESULTS

The 8-week program ran to completion and was delivered to a median of 11 patients (IQR 9-12) each session (median 8 new/day). In total, 10 patients completed surveys, mean age 81.1 (SD 7.7); 60% were women and all had cognitive impairment. Following an MT session, eight of eight responding patients reported feeling happy and eight of eight reported they would recommend MT. Staff respondents (n = 19) reported patients appeared happy (19/19), relaxed (13/19) and all would recommend MT to other patients. Common themes were that MT was followed by improved patient behaviour and mood, and stimulated patients.

CONCLUSIONS

An acute aged care inpatient MT program proves feasible and well-received by staff and patients. Future research may focus on more robust data collection in larger sample sizes, specific types of MT and more in-depth exploration of the patient and carer experiences.

A scoping review of the use of music as an arts-based method in migrant health research

Background

There is a growing awareness of the need to include people's lived experiences in health decision-making. While much progress has been made in this field, exclusionary patterns persist regarding migrant participation in health research. The aim of this scoping review was to examine the available literature around the use of music as an arts-based research (ABR) method in migrant health research in order to extend knowledge of creative methods and tools used for migrant participation in health research.

Methods

Our review follows a scoping review methodology. Searches were conducted in 11 electronic databases between June and August, 2020. We identified 14 eligible references published between January 2009 and August 2020. We analysed how music is utilised as an arts-based research method in community-based health and wellbeing contexts primarily with refugees, asylum seekers, undocumented migrants, and members of resettled immigrant communities.

Results

The findings show that music's role is most prominent as a tool for recruitment and engagement followed by its use as a tool for dissemination. Music is effective as a means to co-produce and communicate knowledge of lived experiences of migration and related wellbeing issues.

Recommendations and conclusions

Our recommendations for further research include the need for increased detail on the musical element in ABR projects; Explicit identification of such research as ABR; Greater recognition of a multi-arts understanding of music in the context of ABR; Harnessing the potential of music in ABR across the research cycle. We conclude that arts-based research using music shows promise for capturing the complexity of migrants' lives and health issues in an ethical way. It warrants further investigation in empirical studies in multiple clinical and community settings to understand its processes and impacts on the evidence base for migrant health.

Identification and Illustration of Means to a Critical Assessment of Music and Health Research Literature

In 2019, the WHO released a scoping review investigating art therapies in evidence-based healthcare practices to identify and understand the gaps in the literature. However, the studies curated were not evaluated for their quality. To address this limitation, several assessment tools to critically appraise music-based research studies that investigate therapies pertaining to preventative healthcare were investigated. Two critical appraisal tools were selected for their robustness and appropriateness for the studies in question: the Joanna Briggs Institute checklists and the Music-Based Intervention Guidelines. These tools were tested by two assessors on a total of 23 music studies from the Preventative and Prevention Health section of the WHO report. Based on the requirements for each critical appraisal tool, seven studies received a full assessment utilizing both checklists. Of these seven, two studies scored on the higher index, indicating that the studies followed a detailed methodology to provide concrete and accurate results. The findings of the study highlighted the limitations of study designs and music-based interventions. With this information, beneficial recommendations for future research in this domain are provided to improve the quality of research, ensuring its place in evidence-based healthcare practices.

The use of music as an arts-based method in migrant health research: a scoping review protocol

There is increasing recognition that people's lived experience needs to be incorporated into health decision-making. This has led to rising imperatives for involving the public in health processes, including research. While there have been significant advances in the field, patterns of exclusion still exist in some areas, including migrant participation in health research. Migration and mobility create challenges around social inclusion and this extends to social and cultural practices used in research. There is an emerging body of literature about improving meaningful, participatory spaces for migrants' involvement in health research using creative tools and techniques that are attuned to cultural diversity. These include the use of arts-based research methods. There is strong evidence for the use of music, particularly singing, as an effective arts-based participatory tool . The goal of this scoping review is to investigate the evidence for the use of music as an arts-based method in migrant health research. Developed by an interdisciplinary team specialising in public and patient involvement; nursing and midwifery; primary health care; and the performing arts, it aims to analyse existing evidence across disciplines that are not usually studied together, identify gaps in current knowledge and use these as a foundation to build effective strategies towards increasing access to and knowledge of participatory, arts-based methods using music in migrant health research. Methods: The protocol for this scoping review follows the guidelines and stages set out in the JBI Reviewer's Manual ( Peters et al., 2017), and by Levac et al, (2010), which build on the methodological framework of Arksey and O'Malley (2005). This incorporates six stages: 1) Identifying the research question; 2) Identifying relevant studies; 3) Study selection; 4) Charting the data; 5) Collating, summarising, and reporting results; and 6) Consultation.

"Music Makes My Old Heart Beat": A Randomised Controlled Study on the Benefits of the Use of Music in Comprehensive Care for Institutionalised Older Adults

BACKGROUND

Research on the therapeutic use of music is growing, but the lack of experimental rigour and outcomes diversity has impeded researchers from obtaining clear evidence of the multiple benefits of music interventions in older adults. We explored the outcomes of a music-complemented intervention integrated into the therapeutic activities of institutionalised elderly people.

METHODS

A randomised controlled study with baseline, post-intervention, and 2-week follow-up measures was carried out with 50 residents in a caring institution. Several indicators of physical health, cognitive functioning, emotional well-being, pain, and happiness were assessed at all phases.

RESULTS

Mixed factorial ANOVAs showed a positive impact of the music intervention on the outcomes in the intervention group (effect sizes up to .78) compared to the stability in the control (waiting list) group. Notably, the benefits seemed to be temporary, as they decreased progressively after the discontinuation of the intervention.

CONCLUSIONS

This study demonstrates the effects of a planned music-based intervention on several health- and well-being-related outcomes and has important applications regarding the use of music as a complement in therapeutic interventions with elderly people. The implementation of music therapy within the comprehensive care of institutionalised people must be maintained over time for the effects to be durable.

Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes

Background/Purpose: Although gait disorders occur early in the course of Alzheimer's disease (AD) and increase the risk of falling, methods to improve walking in the home setting are poorly understood. This study aimed to determine the feasibility of a home-based gait training program using rhythmic auditory cues for individuals living with mild to moderately severe AD.

Methods: Participants had probable AD with no other major conditions affecting locomotion. The intervention consisted of eight progressively modified 45-min gait training sessions delivered during home visits over 4 weeks. Experienced physiotherapists provided the therapy that incorporated rhythmic music cues for a range of locomotor tasks and ambulatory activities. On the days when the physiotherapist did not attend, participants independently performed a seated music listening activity. Walking speed, cadence, stride length, double limb support duration, and gait variability (coefficient of variation) were measured using an 8-m GAITRite® computerized walkway immediately before and after the physiotherapy intervention. Participant satisfaction was also assessed using a purpose-designed questionnaire.

Results: Eleven (median age, 77.0 years; median ACE III score, 66/100; 3 females and 8 males) community-dwelling adults living with AD participated. Wilcoxon signed rank tests revealed statistically significant increases in gait speed following the home-based physiotherapy intervention (baseline = 117.5 cm/s, post-intervention = 129.9 cm/s, z = −2.40, p < 0.05). Stride length also improved (baseline = 121.8 cm, post-intervention = 135.6 cm, z = −2.67, p < 0.05). There was no significant change in gait variability. The program was found to be feasible and safe, with no attrition. Participant satisfaction with the home-based music-cued gait training was high, and there were no adverse events.

Conclusion: A progressively modified gait training program using rhythmic auditory cues delivered at home was feasible, safe, and enjoyable. Music-cued gait training can help to reduce the rate of decline in gait stride length and speed in some individuals living with AD.

Trial Registration:http://www.anzctr.org.au/Default.aspx, ACTRN12616000851460.

Universal Trial Number: U1111-1184-5735.