1
|
Stegenga K, Henley AK, Harman E, Robb SL. Shifting perspectives and transformative change: Parent perspectives of an active music engagement intervention for themselves and their child with cancer. Pediatr Blood Cancer 2024; 71:e30913. [PMID: 38337169 PMCID: PMC10959685 DOI: 10.1002/pbc.30913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Children with cancer (ages 3-8 years) and their parents experience significant, interrelated distress associated with cancer treatment. Active music engagement (AME) uses music-based play and shared music-making to mitigate this distress. To advance our understanding about how AME works and its essential features, we interviewed parents who received the AME intervention as part of a multi-site mechanistic trial. The purpose of this qualitative analysis was to describe parents' experiences of AME for themselves and their child and to better understand how the intervention worked to lower parent-child distress. PROCEDURE We conducted a total of 43 interviews with parents/caregivers, and purposively analyzed all interviews from underrepresented groups based on race/ethnicity and parent role. We used thematic analysis and achieved thematic redundancy after analyzing 28 interviews. RESULTS The following statement summarizes resulting themes: Music therapists skillfully use AME to create a safe and healthy space (Theme 1), where parents/children have transformative experiences (Theme 2) that lead to learning and enactment (Theme 3) of new skills that counteract suffering (Theme 4) through empowerment, connectedness, and sustained relief. CONCLUSIONS This work elucidates how AME works to counteract stressful qualities of cancer treatment. As parents witnessed positive and transformative changes in their child, they experienced relief and reported shifts in their perspective about cancer treatment. This led to learning and use of music as a coping strategy that extended beyond therapist-led sessions. Accessible, music-based interventions, like AME, offer a developmentally appropriate and effective way to support parents and young children during treatment.
Collapse
Affiliation(s)
- Kristin Stegenga
- Children’s Mercy, Kansas City, Division of Hematology/Oncology/BMT, Kansas City, MO
| | - Amanda K. Henley
- Indiana University, Herron School of Art and Design, Indianapolis, IN
| | | | - Sheri L. Robb
- Indiana University, School of Nursing, Indianapolis, IN
| |
Collapse
|
2
|
Oyedele OO, Phillips C, Robb SL. Spirituality in Adolescents and Young Adults With Cancer: An Evolutionary Concept Analysis. J Pediatr Hematol Oncol Nurs 2024; 41:16-31. [PMID: 37853729 DOI: 10.1177/27527530231190375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: Despite an increased focus on the importance of spirituality to human health, including adolescent health outcomes there remains an absence of evidence-based programs to address the spiritual needs of patients and families. A critical barrier is the absence of a clear conceptual understanding and operational definitions of spirituality for adolescents/young adults (AYAs) with cancer. The purposes of this concept analysis were to (a) clarify the concept of spirituality in the context of the AYAs' cancer experience and (b) generate a definition based on a review of the literature examining spiritual development and the role of spirituality in AYAs' health and cancer treatment. Method: We used Roger's evolutionary concept analysis method to identify antecedents, attributes, and consequences of spirituality in the context of AYAs' cancer using thematic analysis and included identification of case exemplars. Results: Of the 86 articles identified, 21 met our inclusion criteria. Analysis revealed four attributes of spirituality in AYAs with cancer: meaning and purpose, connectedness, life-long universal experience, and independent of or related to religion and faith traditions. Identified antecedents included the presence of spiritual resources, chronic illness, belief, or wonder about a higher power, and existential questions. Identified consequences included hope, meaning, feelings of peace, and enhanced well-being and illness acceptance. Based on the findings, we generated a definition of spirituality in AYAs with cancer. Discussion: Findings inform the development of measures and spiritual care interventions specific to AYAs with cancer. An important limitation to address in future research is the absence of AYAs' first-person accounts of their own spirituality.
Collapse
Affiliation(s)
| | | | - Sheri L Robb
- Indiana University School of Nursing, Indianapolis, IN, USA
| |
Collapse
|
3
|
Robb SL. Opportunity and Responsibility in Music Therapy Research. J Music Ther 2023; 60:378-391. [PMID: 37955941 DOI: 10.1093/jmt/thad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Affiliation(s)
- Sheri L Robb
- School of Nursing, Indiana University, Indianapolis, IN, USA
| |
Collapse
|
4
|
Story KM, Flanagan ME, Robb SL, Bravata DM, Bair MJ, Otto D, Damush TM. Rapid implementation of Veterans Health Administration telehealth creative arts therapies: survey evaluation of adoption and adaptation. BMC Health Serv Res 2023; 23:769. [PMID: 37468861 PMCID: PMC10357876 DOI: 10.1186/s12913-023-09796-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 07/10/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Creative arts therapies (CAT) are employed throughout the Veterans Health Administration (VHA) and are predominantly delivered in-person. Though telehealth delivery of CAT was used at several VHA facilities to increase services to rural Veterans, due to guidance from the Center for Disease Control and VHA that temporarily suspended or reduced in-person services, there was a large increase of CAT therapists enterprise-wide who adopted telehealth delivery. The aims of this study were to evaluate adoption and adaptation of CAT telehealth delivery and identify related barriers and facilitators. METHODS We deployed a survey guided by the Consolidated Framework for Implementation Research and administered it via email to all VHA CAT therapists (N = 120). Descriptive statistics were used to summarize data and responses were compared based on therapists' age, years of experience and CAT discipline. Open survey field responses were summarized, qualitatively coded, and analyzed thematically. RESULTS Most therapists (76%) reported adopting telehealth with 74% each delivering > 50 CAT sessions in the prior year. Therapists adapted interventions or created new ones to be delivered through telehealth. Barriers included: technical challenges, control of the virtual space, and building rapport. Facilitators included added equipment, software, and infrastructure. CAT therapists adapted their session preparation, session content, outcome expectations, and equipment. CAT therapists reported being able to reach more patients and improved access to care with telehealth compared to in person visits. Additional benefits were patient therapeutic effects from attending sessions from home, therapist convenience, and clinician growth. CONCLUSIONS VHA CAT therapists used their inherent creativity to problem solve difficulties and make adaptations for CAT telehealth adoption. Future studies may explore CAT telehealth sustainment and its effectiveness on clinical processes and outcomes.
Collapse
Affiliation(s)
- Kristin M Story
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, USA.
| | - Mindy E Flanagan
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, USA
| | - Sheri L Robb
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Dawn M Bravata
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, USA
- VA HSR&D Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA
- Departments of Medicine and Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Regenstrief Institute, Indianapolis, USA
| | - Matthew J Bair
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, USA
- Regenstrief Institute, Indianapolis, USA
- Departments of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David Otto
- VA Rehabilitation and Prosthetic Service, Recreation Therapy and Creative Arts Therapy Service, Washington, DC, USA
| | - Teresa M Damush
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, 46202, USA
- VA HSR&D Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA
- Regenstrief Institute, Indianapolis, USA
- Departments of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
5
|
Robb SL, Russ KA, Holochwost SJ, Stegenga K, Perkins SM, Jacob SA, Henley AK, MacLean JA. Protocol and biomarker strategy for a multi-site randomized controlled trial examining biological mechanisms and dosing of active music engagement in children with acute lymphoblastic leukemia and lymphoma and parents. BMC Complement Med Ther 2023; 23:90. [PMID: 36973774 PMCID: PMC10041701 DOI: 10.1186/s12906-023-03909-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/04/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Music therapy is a standard palliative care service in many pediatric and adult hospitals; however, most research has focused on the use of music to improve psychosocial dimensions of health, without considering biological dimensions. This study builds on prior work examining psychosocial mechanisms of action underlying an Active Music Engagement (AME) intervention, designed to help manage emotional distress and improve positive health outcomes in young children with cancer and parents (caregivers), by examining its effects on biomarkers of stress and immune function. METHODS This two-group randomized controlled trial (R01NR019190) is designed to examine biological mechanisms of effect and dose-response relationships of AME on child/parent stress during the consolidation phase of Acute B- or T-cell Lymphoblastic Leukemia (ALL) and T-cell Lymphoblastic Lymphoma (TLyLy) treatment. Child/parent dyads (n = 228) are stratified (by age, site, risk level) and randomized in blocks of four to the AME or attention control condition. Each group receives one session (30-minutes AME; 20-minutes control) during weekly clinic visits (4 weeks standard risk B-cell ALL; 8 weeks high risk B-cell ALL/T-cell ALL/TLyLy). Parents complete questionnaires at baseline and post-intervention. Child/parent salivary cortisol samples are taken pre- and post-session (sessions 1-4). Child blood samples are reserved from routine draws before sessions 1 and 4 (all participants) and session 8 (high risk participants). We will use linear mixed models to estimate AME's effect on child/parent cortisol. Examining child/parent cortisol as mediators of AME effects on child and parent outcomes will be performed in an ANCOVA setting, fitting the appropriate mediation models using MPlus and then testing indirect effects using the percentile bootstrap approach. Graphical plots and non-linear repeated measures models will be used to examine dose-response relationship of AME on child/parent cortisol. DISCUSSION During pediatric cancer treatment there are special challenges that must be considered when measuring cortisol and immune function. In this manuscript we discuss how we addressed three specific challenges through our trial design. Findings from this trial will increase mechanistic understanding of the effects of active music interventions on multiple biomarkers and understanding of dose-response effects, with direct implications for clinical practice. TRIAL REGISTRATION ClinicalTrials.gov: NCT04400071.
Collapse
Affiliation(s)
- Sheri L Robb
- School of Nursing, Indiana University, 600 Barnhill Drive, Indianapolis, IN, 46202, USA.
| | - Kristen A Russ
- School of Medicine, Indiana University , 351 W 10th Street, Indianapolis, IN, 46202, USA
| | - Steven J Holochwost
- Department of Psychology, Lehman College, City University of New York, 250 Bedford Park Boulevard, West Bronx, NY, 10468, USA
| | - Kristin Stegenga
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA
| | - Susan M Perkins
- School of Medicine, Indiana University, 340 W 10th Street, Indianapolis, IN, 46202, USA
| | - Seethal A Jacob
- School of Medicine, Indiana University, 410 W 10th Street, Indianapolis, IN, 46202, USA
| | - Amanda K Henley
- Purdue School of Engineering and Technology, IUPUI, 535 W. Michigan Street, Indianapolis, IN, 46202, USA
| | - Jessica A MacLean
- School of Nursing, Indiana University, 600 Barnhill Drive, Indianapolis, IN, 46202, USA
| |
Collapse
|
6
|
Robb SL, Stegenga K, Perkins SM, Stump TE, Moody KM, Henley AK, MacLean J, Jacob SA, Delgado D, Haut PR. Mediators and Moderators of Active Music Engagement to Reduce Traumatic Stress Symptoms and Improve Well-being in Parents of Young Children With Cancer. Integr Cancer Ther 2023; 22:15347354231218266. [PMID: 38145309 PMCID: PMC10750508 DOI: 10.1177/15347354231218266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/03/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023] Open
Abstract
OBJECTIVE This trial examined the effects of proximal/distal mediators and moderators of an Active Music Engagement (AME) intervention on young child/parent distress, quality of life, and family function outcomes. METHODS Child/parent dyads (n = 125) were randomized to AME or Audio-storybooks attention control condition. Each group received 3 sessions with a credentialed music therapist for 3 consecutive days with data collection at baseline, post-intervention (T2), and 30-days later (T3). Potential proximal mediators included within session child and parent engagement. Potential distal mediators included changes in perceived family normalcy, parent self-efficacy, and independent use of play materials. Potential moderators included parent/child distress with prior hospitalizations, parent traumatic stress screener (PCL-6), and child age. Outcomes included child emotional distress and quality of life; parent emotion, traumatic stress symptoms (IES-R), well-being; and family function. Mediation effects were estimated using ANCOVA, with indirect effects estimated using the percentile bootstrap approach. Moderation effects were tested by including appropriate interaction terms in models. RESULTS No significant mediation effects were observed. Child distress with prior hospitalizations moderated AME effects for IES-R intrusion subscale scores at T2 (P = .01) and avoidance subscale scores at T3 (P = .007). Traumatic stress screener scores (PCL-6) moderated intervention effects for IES-R hyperarousal subscale scores at T2 (P = .01). There were no moderation effects for child age. CONCLUSIONS AME is a promising intervention for mitigating traumatic stress symptoms and supporting well-being in parents of children with cancer, particularly for parents who screen high for traumatic stress and whose children are more highly distressed with hospitalization.
Collapse
Affiliation(s)
| | | | | | | | | | - Amanda K. Henley
- Purdue School of Engineering and Technology, IUPUI, Indianapolis, IN, USA
| | | | | | - David Delgado
- Astellas Pharma Global Development, Inc, Northbrook, IL, USA
| | | |
Collapse
|
7
|
MacLean JA, Stegenga KA, Henley AK, Robb SL. Implementing NIH Behavior Change Consortium Treatment Fidelity Recommendations in a Multi-Site Randomized Controlled Trial of an Active Music Engagement Intervention for Young Children with Cancer and Parents. Integr Cancer Ther 2022; 21:15347354221140491. [PMID: 36510388 PMCID: PMC9751171 DOI: 10.1177/15347354221140491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Treatment fidelity is the use of methodological strategies to monitor and enhance reliability and validity of behavioral intervention trials. Despite availability of guidelines and checklists, treatment fidelity remains underreported, hindering evaluation, interpretation, and cross-study comparisons. Treatment fidelity is particularly important for music interventions given the inherent complexity of musical stimuli and flexibility required for tailored delivery. The purpose of this paper is to define and describe treatment fidelity strategies for our trial of a music-based play intervention for young children with cancer and parents grounded in the NIH Behavior Change Consortium Treatment Fidelity Recommendations. We report strategies for all 5 areas: study design, training providers, delivery of treatment, receipt of treatment, and enactment of treatment skills. We also discuss 4 challenges our team encountered, including: (1) standardizing live music delivery, (2) defining boundaries for tailored intervention delivery, (3) managing extended time between participants, and (4) minimizing risk for bias. This paper expands on current fidelity literature and may provide a working model for other investigators examining dyadic and/or active music interventions.
Collapse
Affiliation(s)
| | | | | | - Sheri L. Robb
- Indiana University School of Nursing, Indianapolis, IN, USA,Sheri L. Robb, Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA.
| |
Collapse
|
8
|
Story KM, Bravata DM, Robb SL, Wasmuth S, Slaven JE, Whitmire L, Barker B, Menen T, Bair MJ. Feasibility and Acceptability of Music Imagery and Listening Interventions for Analgesia: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e38788. [PMID: 36136377 PMCID: PMC9539652 DOI: 10.2196/38788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/27/2022] [Accepted: 07/30/2022] [Indexed: 11/22/2022] Open
Abstract
Background Chronic pain and access to care are identified as critical needs of the Veterans Health Administration. Music imagery and music listening interventions have shown promise as effective nonpharmacological options for pain management. However, most studies have focused on acute pain, passive music experiences, and in-person delivery. Objective In this study, we aimed to examine the feasibility and acceptability of 2 music interventions delivered through telehealth for chronic musculoskeletal pain, trial design, and theoretical model before conducting a fully powered efficacy or comparative effectiveness trial. Methods FAMILIA (Feasibility and Acceptability of Music Imagery and Listening Interventions for Analgesia) is a 3-arm, parallel group, pilot trial. A total of 60 veterans will be randomized to one of the three conditions: music imagery, music listening, or usual care. Aim 1 is to test the feasibility and acceptability of a multicomponent, interactive music imagery intervention (8-weekly, individual sessions) and a single-component, minimally interactive music learning intervention (independent music listening). Feasibility metrics related to recruitment, retention, engagement, and completion of the treatment protocol and questionnaires will be assessed. Up to 20 qualitative interviews will be conducted to assess veteran experiences with both interventions, including perceived benefits, acceptability, barriers, and facilitators. Interview transcripts will be coded and analyzed for emergent themes. Aim 2 is to explore the effects of music imagery and music listening versus usual care on pain and associated patient-centered outcomes. These outcomes and potential mediators will be explored through changes from baseline to follow-up assessments at 1, 3, and 4 months. Descriptive statistics will be used to describe outcomes; this pilot study is not powered to detect differences in outcomes. Results Recruitment for FAMILIA began in March 2022, and as of July 2022, 16 participants have been enrolled. We anticipate that enrollment will be completed by May 2023. We expect that music imagery and music listening will prove acceptable to veterans and that feasibility benchmarks will be reached. We hypothesize that music imagery and music listening will be more effective than usual care on pain and related outcomes. Conclusions FAMILIA addresses four limitations in music intervention research for chronic pain: limited studies in veterans, evaluation of a multicomponent music intervention, methodological rigor, and internet-based delivery. Findings from FAMILIA will inform a fully powered trial to identify putative mechanisms and test efficacy. Trial Registration ClinicalTrials.gov NCT05426941; https://tinyurl.com/3jdhx28u International Registered Report Identifier (IRRID) DERR1-10.2196/38788
Collapse
Affiliation(s)
- Kristin M Story
- Center for Health Information and Communication (CHIC), Health Services Research & Development (HSRD), Richard L Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States
| | - Dawn M Bravata
- Center for Health Information and Communication (CHIC), Health Services Research & Development (HSRD), Richard L Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States.,Expanding Expertise through E-health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Veterans Affairs Health Services Research and Development (HSR&D), Indianapolis, IN, United States.,Departments of Medicine and Neurology, Indiana University School of Medicine, Indianapolis, IN, United States.,Regenstrief Institute Inc, Indianapolis, IN, United States
| | - Sheri L Robb
- Indiana University School of Nursing, Indianapolis, IN, United States
| | - Sally Wasmuth
- Department of Occupational Therapy, Indiana University School of Health and Human Sciences, Indianapolis, IN, United States
| | - James E Slaven
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Leah Whitmire
- Creative Forces, National Endowment for the Arts, Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Indianapolis, IN, United States
| | - Barry Barker
- Center for Health Information and Communication (CHIC), Health Services Research & Development (HSRD), Richard L Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States
| | - Tetla Menen
- Center for Health Information and Communication (CHIC), Health Services Research & Development (HSRD), Richard L Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States
| | - Matthew J Bair
- Center for Health Information and Communication (CHIC), Health Services Research & Development (HSRD), Richard L Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States.,Regenstrief Institute Inc, Indianapolis, IN, United States.,Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| |
Collapse
|
9
|
Knott D, Krater C, MacLean J, Robertson K, Stegenga K, Robb SL. Music Therapy for Children with Oncology & Hematological Conditions and Their Families: Advancing the Standards of Psychosocial Care. J Pediatr Hematol Oncol Nurs 2022; 39:49-59. [PMID: 35722869 PMCID: PMC9839310 DOI: 10.1177/27527530211059726] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Diagnosis and treatment of cancer and blood disorders in childhood, adolescence and young adulthood has a significant impact on patients and families. The Psychosocial Standards of Care project, initiated in 2012, resulted in 15 Psychosocial Standards (PSS) that guide the care patients and families receive throughout treatment. As members of the multidisciplinary psychosocial care team, music therapists play an important role in the advancing the PSS. Most surveys have focused on other commonly provided services (e.g., social work, child life), leaving gaps in our understanding about the availability and use of music therapy services to advance PSS. This paper offers an initial description of how music therapy services contribute to the provision of care under these Standards. Methods: We analyze how music therapy services promote PSS through synthesis of a music therapy clinical practice survey, published literature, and scope of practice documents. A brief overview of music therapy services structure, PSS that music therapy services currently address, and two clinical program descriptions are included. Results: Music therapy services address 9 of the 15 PSS and are well integrated within the larger program of psychosocial care. Findings suggest integration of music therapy services can help ensure personalized, comprehensive care and efficient use of often-limited psychosocial care resources. Discussion: Nurses, as members of the psychosocial and medical teams are uniquely positioned to identify patient and family care needs and refer patients for services. Understanding how music therapy services address PSS and most importantly, the needs of patients and families, will optimize their care.
Collapse
Affiliation(s)
- David Knott
- Creative Arts Therapies, Seattle Children's Hospital, Seattle, WA, USA
| | - Caitlin Krater
- Music Therapy, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
| | | | - Kim Robertson
- Music Therapy and Hospital-Based School Program, Children's Mercy Hospital Kansas City, Kansas City, MO, USA
| | | | - Sheri L. Robb
- Indiana University School of Nursing, Indianapolis, IN, USA
| |
Collapse
|
10
|
Story KM, Flanagan ME, Brown HA, Robb SL, Damush TM, Otto D. Veterans Hospital Administration Telehealth Utilization for Recreation and Creative Arts Therapies: A Brief Report. Telemed J E Health 2021; 28:752-757. [PMID: 34432540 PMCID: PMC9127826 DOI: 10.1089/tmj.2021.0363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: A brief query was fielded to Veterans Health Administration (VHA) facilities across the United States to provide an initial assessment of recreation therapy (RT) and creative arts therapy (CAT) telehealth utilization. Methods: To develop an understanding of barriers and identify potential solutions for better delivery of services, a cross-sectional survey was deployed to points of contact at 136 VHA facilities. The survey included questions across five areas: staff, infrastructure, barriers to use, training, and interventions being deployed. Descriptive statistics were calculated, and a thematic analysis of qualitative responses was conducted. Results: The most frequent themes from aggregated responses indicated a need for hands-on training, reliable telehealth equipment, and accessible training and tools for Veteran patients who want to use telehealth services. Conclusion: Telehealth delivery of RT/CAT has increased services to Veteran patient populations; however, equipment and training are needed to expand consistent delivery to enhance patient reach across a national health care system.
Collapse
Affiliation(s)
- Kristin M. Story
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA
- Address correspondence to: Kristin M. Story, PhD, Richard L. Roudebush VA Medical Center, HSR&D Mail Code 11H, 1481 West 10th Street, Indianapolis, IN 46202, USA
| | - Mindy E. Flanagan
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA
| | - Heather A. Brown
- Veteran Health Administration (VHA) Rehabilitation and Prosthetic Service, National Veterans Sports and Special Events, Washington, District of Columbia, USA
| | - Sheri L. Robb
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Teresa M. Damush
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E-health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, Indiana, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Regenstrief Institute, Inc., Indianapolis, Indiana, USA
| | - David Otto
- Veteran Health Administration (VHA) Rehabilitation and Prosthetic Service, Recreation Therapy Service, Washington, District of Columbia, USA
| |
Collapse
|
11
|
Holochwost SJ, Robb SL, Henley AK, Stegenga K, Perkins SM, Russ KA, Jacob SA, Delgado D, Haase JE, Krater CM. Active Music Engagement and Cortisol as an Acute Stress Biomarker in Young Hematopoietic Stem Cell Transplant Patients and Caregivers: Results of a Single Case Design Pilot Study. Front Psychol 2020; 11:587871. [PMID: 33224077 PMCID: PMC7667234 DOI: 10.3389/fpsyg.2020.587871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
This paper reports the results of a single case design pilot study of a music therapy intervention [the Active Music Engagement (AME)] for young children (age 3.51 to 4.53 years) undergoing hematopoietic stem cell transplantation (HCST) and their caregivers. The primary aims of the study were to determine feasibility/acceptability of the AME intervention protocol and data collection in the context of HCST. Secondary aims were to examine caregivers' perceptions of the benefit of AME and whether there were changes in child and caregiver cortisol levels relative to the AME intervention. Results indicated that the AME could be implemented in this context and that data could be collected, though the collection of salivary cortisol may constitute an additional burden for families. Nevertheless, data that were collected suggest that families derive benefit from the AME, which underscores the need for devising innovative methods to understand the neurophysiological impacts of the AME.
Collapse
Affiliation(s)
| | - Sheri L Robb
- School of Nursing, Indiana University, Indianapolis, IN, United States
| | - Amanda K Henley
- School of Nursing, Indiana University, Indianapolis, IN, United States
| | | | - Susan M Perkins
- School of Medicine, Indiana University, Indianapolis, IN, United States.,Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United States
| | - Kristen A Russ
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN, United States
| | - Seethal A Jacob
- School of Medicine, Indiana University, Indianapolis, IN, United States.,Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States
| | - David Delgado
- Astellas Pharma Global Development, Northbrook, IL, United States
| | - Joan E Haase
- School of Nursing, Indiana University, Indianapolis, IN, United States
| | - Caitlin M Krater
- Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States
| |
Collapse
|
12
|
Fleming R, Robb SL. Can Music Touch the Heart? Commentary on the Benefits of Music Listening for People Living With Heart Failure. J Card Fail 2020; 26:552-554. [PMID: 32680581 DOI: 10.1016/j.cardfail.2020.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Renée Fleming
- Artistic Advisor, John F. Kennedy Center for the Performing Arts
| | - Sheri L Robb
- Professor, Indiana University School of Nursing; Director, Indiana CTSI KL2 Young Investigators Program
| |
Collapse
|
13
|
Henley AK, Collier E, Robertson K, Biard MA, Bruno K, Bush H, Frees E, Krater C, Woolever S, Burns DS, Robb SL. Music Therapist Experiences of a Randomized Controlled Trial as Clinician Researchers. J Music Ther 2020; 57:315-352. [PMID: 32227108 DOI: 10.1093/jmt/thaa005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Music therapy clinicians bring an important perspective to the design and conduct of clinically meaningful studies. Unfortunately, there continue to be roadblocks that hinder clinician involvement in research and the development of successful partnerships between academic researchers and practicing clinicians. To help grow clinician involvement, it is important that research teams share their experiences. As such, the purpose of this qualitative study was to share music therapists' perspectives about their experience of working as a research clinician on a large multisite randomized controlled trial. 10 board-certified music therapists provided written responses to 6 data-generating questions about: (a) reasons for participating, (b) perceived challenges and benefits, (c) experiences of quality assurance monitoring, (d) professional growth, (e) value of research, and (f) advice for clinicians considering research involvement. Using thematic content analysis, we identified primary themes and subthemes for each question (20 themes; 30 subthemes). Qualitative analysis revealed not only common challenges, such as reconciling clinical and research responsibilities, but also benefits, including continued professional growth, greater understanding of research processes, and research participation as a way to advocate and advance the profession. Finally, for clinicians interested in becoming involved in research, therapists noted the importance of having workplace support from a mentor, supervisor, and/or administrator; seeking out available resources; and knowing roles and responsibilities before initiating research involvement. Findings offer important insight and recommendations to support the involvement of clinicians in research and support further exploration of clinician involvement in dissemination efforts to improve translation and uptake of research into practice.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Caitlin Krater
- Riley Hospital for Children at Indiana University Health, Indianapolis, IN
| | | | - Debra S Burns
- School of Engineering and Technology at IUPUI Department of Music and Arts Technology, Indianapolis, IN
| | - Sheri L Robb
- Indiana University School of Nursing, Indianapolis, IN
| |
Collapse
|
14
|
Haase JE, Robb SL, Burns DS, Stegenga K, Cherven B, Hendricks-Ferguson V, Roll L, Docherty SL, Phillips C. Adolescent/Young Adult Perspectives of a Therapeutic Music Video Intervention to Improve Resilience During Hematopoietic Stem Cell Transplant for Cancer. J Music Ther 2020; 57:3-33. [PMID: 31802124 PMCID: PMC7041545 DOI: 10.1093/jmt/thz014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This empirical phenomenology study reports adolescents/young adults (AYA) experiences of the therapeutic music video (TMV) intervention arm of a randomized controlled clinical trial (Children's Oncology Group; COG-ANUR0631; R01 NR008583) during hospitalization for a hematopoietic stem cell transplant. A purposive subsample of 14 AYA were interviewed using a broad open-ended data-generating question about their TMV intervention experiences. At the end of each interview, we also asked AYA for suggestions on how to improve the TMV. Analysis of the narrative data resulted in four theme categories: (a) An Interwoven Experience of the Transplant and TMV Intervention; (b) TMV as a Guided Opportunity for Reflection, Self-Expression, and Meaning-Making; (c) Telling My Story: The Work of Deriving Meaning; and (d) A Way to Overcome the Bad Side of Cancer. AYA suggestions for improving the TMV are also summarized. Findings provide insight into ways the TMV supports AYA efforts to overcome distress and challenges by providing opportunities to reflect on what is meaningful, connect with others, and explore/identify personal strengths. Findings also inform our understanding about how the TMV may have functioned (i.e., mechanisms of action) to bring about significant change in AYA self-reported outcomes (i.e., positive coping, social support, and family function) for this trial.
Collapse
Affiliation(s)
| | | | - Debra S Burns
- Indiana University Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Kristin Stegenga
- Children’s Mercy Hospitals and Clinics, Kansas City, Missouri, USA
| | - Brooke Cherven
- Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | | | - Lona Roll
- The University of Texas Health Sciences Center, San Antonio, Texas, USA
| | | | | |
Collapse
|
15
|
Knott D, Biard M, Nelson KE, Epstein S, Robb SL, Ghetti CM. A Survey of Music Therapists Working in Pediatric Medical Settings in the United States. J Music Ther 2020; 57:34-65. [PMID: 31901199 DOI: 10.1093/jmt/thz019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Music therapy is becoming a standard supportive care service in many pediatric hospitals across the United States. However, more detailed information is needed to advance our understanding about current clinical practice and increase availability of pediatric music therapy services. The purpose of this cross-sectional survey study was to collect and summarize data about music therapists working in pediatric medical settings. Specifically, we collected information about (1) therapist demographics, (2) organizational structure, (3) service delivery and clinical practice, and (4) administrative/supervisory responsibilities. Board-certified music therapists working in pediatric medical settings (n = 118) completed a 37-item online questionnaire. We analyzed survey data using descriptive statistics and content analysis. Findings indicated that there is a ratio of approximately one music therapist for every 100 patient beds, that one-third of respondents are the only music therapist in their setting, and that half of the surveyed positions are philanthropically funded. Prioritizing patient referrals based on acuity was common (95.7%, n = 110), with palliative care and pain as the most highly prioritized needs. More than half of respondents reported serving in high acuity areas such as the pediatric intensive care, hematology/oncology, or neonatal intensive care units. We recommend replication of this survey in five years to examine growth and change in service delivery among pediatric music therapists over time, with additional studies to (a) explore how therapist-to-patient ratios influence quality of care, (b) identify factors that contribute to sustainability of programs, and (c) determine how expansion of services support a broader population of patients and families.
Collapse
Affiliation(s)
| | | | - Kirsten E Nelson
- University of Iowa Stead Family Children's Hospital, Iowa City, IA
| | - Stephanie Epstein
- Holtz Children's Hospital, Jackson Memorial Medical Center, Miami, FL
| | - Sheri L Robb
- Indiana University School of Nursing, Indianapolis, IN
| | | |
Collapse
|
16
|
Russ KA, Holochwost SJ, Perkins SM, Stegenga K, Jacob SA, Delgado D, Henley AK, Haase JE, Robb SL. Cortisol as an Acute Stress Biomarker in Young Hematopoietic Cell Transplant Patients/Caregivers: Active Music Engagement Protocol. J Altern Complement Med 2020; 26:424-434. [PMID: 32073877 PMCID: PMC7232696 DOI: 10.1089/acm.2019.0413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: Primary aims of the proposed protocol are to determine the feasibility/acceptability of the active music engagement intervention protocol during hematopoietic stem cell transplantation (HSCT) and clinical feasibility/acceptability of the biological sample collection schedule. Design: The authors propose a single-case, alternating treatment design to compare levels of child and caregiver cortisol in blood and saliva collected on alternating days, when the dyad receives and does not receive AME sessions. Included are the scientific rationale for this design and detailed intervention and sample collection schedules based on transplant type. Setting/Location: Pediatric inpatient HSCT unit. Subjects: Eligible participants are dyads of children 3–8 years old, hospitalized for HSCT, and their caregiver. Children with malignant and nonmalignant conditions will be eligible, regardless of transplant type. Intervention: AME intervention is delivered by a board-certified music therapist who tailors music-based play experiences to encourage active engagement in, and independent use of, music play to manage the inter-related emotional distress experienced by children and their caregivers during HSCT. Dyads will receive two 45-min AME sessions each week during hospitalization. Outcome Measures: Eight collections of blood (child) and saliva (child/caregiver) will be performed for cortisol measurement. The authors will also collect self-report and caregiver proxy measures for dyad emotional distress, quality of life, and family function. At study conclusion, qualitative caregiver interviews will be conducted. Results: Planned analyses will be descriptive and evaluate the feasibility of participant recruitment, cortisol collection, planned evaluations, and AME delivery. Analysis of qualitative interviews will be used to gain an understanding about the ease/burden of biological sample collection and any perceived benefit of AME. Conclusions: Behavioral intervention studies examining biological mechanisms of action in pediatric transplant populations are rare. Findings will provide important information about the feasibility/acceptability of collecting cortisol samples during a high-intensity treatment and advance understanding about the use of active music interventions to mitigate child/caregiver distress during the transplant period.
Collapse
Affiliation(s)
- Kristen A Russ
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA
| | | | - Susan M Perkins
- Indiana University School of Medicine, Indianapolis, IN, USA.,Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | | | - Seethal A Jacob
- Indiana University School of Medicine, Indianapolis, IN, USA.,Riley Hospital for Children at IU Health, Indianapolis, IN, USA
| | - David Delgado
- Astellas Pharma Global Development, Northbrook, IL, USA
| | | | - Joan E Haase
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Sheri L Robb
- Indiana University School of Nursing, Indianapolis, IN, USA
| |
Collapse
|
17
|
Docherty SL, Crane S, Haase JE, Robb SL. Improving recruitment and retention of adolescents and young adults with cancer in randomized controlled clinical trials. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0215/ijamh-2018-0215.xml. [PMID: 30973826 DOI: 10.1515/ijamh-2018-0215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 11/29/2018] [Indexed: 11/15/2022]
Abstract
Participation of adolescents and young adults (AYAs) with cancer in randomized clinical trials (RCTs) is necessary to advance treatments and psychosocial programs. Exploring AYAs experiences in an RCT will inform strategies to support recruitment and retention. A qualitative design was used to study the experiences of 13 AYAs in the Stories and Music for Adolescent and Young Adult Resilience during Transplant I (SMART I) trial. Key themes included: Weighing the Pros and Cons; Randomization Preferences; Completing Measures; and Worthwhile Experience. The experiences of AYAs during RCTs can bring insights that inform the design and management of AYA trials. Strategies include improving assent/consent processes, design of electronic interfaces and encouraging researcher flexibility.
Collapse
Affiliation(s)
- Sharron L Docherty
- Duke University, School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA, Phone: (+919) 668-3836
| | - Stacey Crane
- Indiana University, School of Nursing, Indianapolis, IN, USA
| | - Joan E Haase
- Indiana University, School of Nursing, Indianapolis, IN, USA
| | - Sheri L Robb
- Indiana University, School of Nursing, Indianapolis, IN, USA
| |
Collapse
|
18
|
Robb SL, Hanson-Abromeit D, May L, Hernandez-Ruiz E, Allison M, Beloat A, Daugherty S, Kurtz R, Ott A, Oyedele OO, Polasik S, Rager A, Rifkin J, Wolf E. Reporting quality of music intervention research in healthcare: A systematic review. Complement Ther Med 2018; 38:24-41. [PMID: 29857877 PMCID: PMC5988263 DOI: 10.1016/j.ctim.2018.02.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 01/14/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Sheri L. Robb
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Deanna Hanson-Abromeit
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Lindsey May
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Eugenia Hernandez-Ruiz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Megan Allison
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Beloat
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Sarah Daugherty
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Rebecca Kurtz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Ott
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | | | - Shelbi Polasik
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Allison Rager
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Jamie Rifkin
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Emily Wolf
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| |
Collapse
|
19
|
Oruche UM, Robb SL, Aalsma M, Pescosolido B, Brown-Podgorski B, Draucker CB. Developing a Multiple Caregiver Group for Caregivers of Adolescents With Disruptive Behaviors. Arch Psychiatr Nurs 2017; 31:596-601. [PMID: 29179827 DOI: 10.1016/j.apnu.2017.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/13/2017] [Accepted: 08/18/2017] [Indexed: 11/18/2022]
Abstract
This article describes the development of a 6-week multiple caregiver group intervention for primary caregivers of adolescents diagnosed with Oppositional Defiant Disorder or Conduct Disorder in low-income African American families. The intervention is aimed at increasing the primary caregivers' self-efficacy in managing interactions within the family and especially with child serving educational, mental health, juvenile justice, and child welfare systems. Development of the intervention involved seven iterative activities performed in a collaborative effort between an interdisciplinary academic team, community engagement specialists, members of the targeted population, and clinical partners from a large public mental health system. The intervention development process described in this article can provide guidance for teams that aim to develop new mental health interventions that target specific outcomes in populations with unique needs.
Collapse
Affiliation(s)
- Ukamaka M Oruche
- School of Nursing, Indiana University-Purdue University Indianapolis, United States.
| | - Sheri L Robb
- School of Nursing, Indiana University-Purdue University Indianapolis, United States
| | - Matt Aalsma
- Section of Adolescents Health and Medicine, School of Medicine, Indiana University, United States
| | | | - Brittany Brown-Podgorski
- Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis, United States
| | | |
Collapse
|
20
|
Robb SL, Haase JE, Perkins SM, Haut PR, Henley AK, Knafl KA, Tong Y. Pilot Randomized Trial of Active Music Engagement Intervention Parent Delivery for Young Children With Cancer. J Pediatr Psychol 2017; 42:208-219. [PMID: 27289068 PMCID: PMC5896608 DOI: 10.1093/jpepsy/jsw050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 05/06/2016] [Accepted: 05/06/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives To examine the feasibility/acceptability of a parent-delivered Active Music Engagement (AME + P) intervention for young children with cancer and their parents. Secondary aim to explore changes in AME + P child emotional distress (facial affect) and parent emotional distress (mood; traumatic stress symptoms) relative to controls. Methods A pilot two-group randomized trial was conducted with parents/children (ages 3-8 years) receiving AME + P ( n = 9) or attention control ( n = 7). Feasibility of parent delivery was assessed using a delivery checklist and child engagement; acceptability through parent interviews; preliminary outcomes at baseline, postintervention, 30 days postintervention. Results Parent delivery was feasible, as they successfully delivered AME activities, but interviews indicated parent delivery was not acceptable to parents. Emotional distress was lower for AME + P children, but parents derived no benefit. Conclusions Despite child benefit, findings do not support parent delivery of AME + P.
Collapse
Affiliation(s)
| | | | - Susan M. Perkins
- Department of Biostatistics, Indiana University School of Medicine
| | - Paul R. Haut
- Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health
| | | | | | - Yan Tong
- Department of Biostatistics, Indiana University School of Medicine
| |
Collapse
|
21
|
Hullmann SE, Robb SL, Rand KL. Life goals in patients with cancer: a systematic review of the literature. Psychooncology 2015; 25:387-99. [PMID: 25990641 DOI: 10.1002/pon.3852] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 03/16/2015] [Accepted: 04/14/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Purposes of this systematic review of life goal research in cancer patients were to (1) identify life goal characteristics and processes being examined, (2) describe instruments used to assess life goal constructs, (3) identify theoretical models being used to guide research, and (4) summarize what is known about the impact of the cancer experience on life goal characteristics, processes, and psychological outcomes. METHODS We conducted this systematic review using MEDLINE, PubMed, CINAHL, and PsycINFO databases. Inclusion criteria were as follows: (1) published between 1993 and 2014, (2) English language, (3) cancer patient population, and (4) original research articles that assessed life goal characteristics and/or goal processes. One hundred ninety-seven articles were screened and 27 included in the final review. RESULTS Seven life goal characteristics and seven life goal processes were identified, and less than half of studies investigated associations between goal characteristics and processes. Conceptual definitions were not provided for about half of the identified life goal constructs. Studies used both validated and author-developed instruments to assess goal constructs. Twenty-four different theoretical models were identified, with self-regulation theory most frequently cited. Overall, the literature suggests that cancer impacts patients' life goal characteristics and processes, and life goal disturbance is related to poorer psychological outcomes. CONCLUSIONS The impact of the cancer experience on life goals is an important and emerging area of research that would benefit from conceptual and theoretical clarity and measurement consistency.
Collapse
Affiliation(s)
| | - Sheri L Robb
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - Kevin L Rand
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| |
Collapse
|
22
|
Affiliation(s)
- Sheri L Robb
- Indiana University Editor, Journal of Music Therapy
| |
Collapse
|
23
|
Robb SL, Burns DS, Stegenga KA, Haut PR, Monahan PO, Meza J, Stump TE, Cherven BO, Docherty SL, Hendricks-Ferguson VL, Kintner EK, Haight AE, Wall DA, Haase JE. Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant: a report from the Children's Oncology Group. Cancer 2014; 120:909-17. [PMID: 24469862 DOI: 10.1002/cncr.28355] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/19/2013] [Accepted: 08/08/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND To reduce the risk of adjustment problems associated with hematopoietic stem cell transplant (HSCT) for adolescents/young adults (AYAs), we examined efficacy of a therapeutic music video (TMV) intervention delivered during the acute phase of HSCT to: 1) increase protective factors of spiritual perspective, social integration, family environment, courageous coping, and hope-derived meaning; 2) decrease risk factors of illness-related distress and defensive coping; and 3) increase outcomes of self-transcendence and resilience. METHODS This was a multisite randomized, controlled trial (COG-ANUR0631) conducted at 8 Children's Oncology Group sites involving 113 AYAs aged 11-24 years undergoing myeloablative HSCT. Participants, randomized to the TMV or low-dose control (audiobooks) group, completed 6 sessions over 3 weeks with a board-certified music therapist. Variables were based on Haase's Resilience in Illness Model (RIM). Participants completed measures related to latent variables of illness-related distress, social integration, spiritual perspective, family environment, coping, hope-derived meaning, and resilience at baseline (T1), postintervention (T2), and 100 days posttransplant (T3). RESULTS At T2, the TMV group reported significantly better courageous coping (Effect Size [ES], 0.505; P = .030). At T3, the TMV group reported significantly better social integration (ES, 0.543; P = .028) and family environment (ES, 0.663; P = .008), as well as moderate nonsignificant effect sizes for spiritual perspective (ES, 0.450; P = .071) and self-transcendence (ES, 0.424; P = .088). CONCLUSIONS The TMV intervention improves positive health outcomes of courageous coping, social integration, and family environment during a high-risk cancer treatment. We recommend the TMV be examined in a broader population of AYAs with high-risk cancers.
Collapse
Affiliation(s)
- Sheri L Robb
- Indiana University School of Nursing, Indianapolis, Indiana
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Phillips-Salimi CR, Robb SL, Monahan PO, Dossey A, Haase JE. Perceptions of communication, family adaptability and cohesion: a comparison of adolescents newly diagnosed with cancer and their parents. Int J Adolesc Med Health 2014; 26:19-26. [PMID: 24501152 PMCID: PMC5497841 DOI: 10.1515/ijamh-2012-0105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 11/07/2012] [Indexed: 11/15/2022]
Abstract
PURPOSE To describe and compare adolescent and parent perspectives on communication, family adaptability and cohesion, as well as relationships among these variables, during the first month of an adolescent's cancer diagnosis. METHODS Seventy adolescent-parent dyads were enrolled as part of a larger multi-site study. The adolescents ranged in age from 11 to 19, and 61% were males. Parents were predominately mothers (83%). Dyads were predominately non-Hispanic Caucasian (63%). Measures included the Parent-Adolescent Communication Scale and the Family Adaptability and Cohesion Evaluation Scale (FACES II). Paired t-tests, Pearson correlations, intra-class correlation coefficients and multiple linear regression analyses were completed. RESULTS Adolescent scores on communication, family adaptability and cohesion were significantly lower than parent scores. The inter-dyadic agreement between adolescents and parents was low. Communication, family adaptability and cohesion were examined separately for adolescents and for parents, and significant relationships were found. Both adolescent- and parent-perceived communication was significantly associated with family adaptability and cohesion outcomes. CONCLUSIONS Differences were found in adolescent and parent perceptions of communication, family adaptability and cohesion. When both adolescents and parents had better perceived communication, this was associated with better perceived family adaptability and cohesion. Results suggest that the development of interventions to enhance adolescent-parent communication could help foster better family adaptability and cohesion, which may ultimately impact their psychological adjustment. In addition, understanding the degree to which adolescents and parents disagree on their perceptions, including the results that parents generally have more favorable perceptions, may be a useful starting point when developing interventions.
Collapse
|
25
|
Docherty SL, Robb SL, Phillips-Salimi C, Cherven B, Stegenga K, Hendricks-Ferguson V, Roll L, Donovan Stickler M, Haase J. Parental perspectives on a behavioral health music intervention for adolescent/young adult resilience during cancer treatment: report from the children's oncology group. J Adolesc Health 2013; 52:170-8. [PMID: 23332481 PMCID: PMC3552240 DOI: 10.1016/j.jadohealth.2012.05.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 05/07/2012] [Accepted: 05/09/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE This article describes parental perspectives on the helpfulness and meaningfulness of a behavioral health music therapy intervention targeted to adolescents/young adults (AYA) with cancer undergoing stem cell transplantation. We demonstrate how qualitative methods may be used to understand critical aspects of an intervention and mechanisms by which the intervention impacts the target AYA outcomes of resilience and quality of life. METHODS A qualitative descriptive design was used to obtain parents' perspectives. A maximum-variation purposive sampling technique was used to sample 16 parents whose AYA had been randomized to the intervention group. A semistructured open-ended interview was conducted between 100 and 160 days after the AYA's transplant. RESULTS Results were grouped into three categories: (1) helpfulness and meaningfulness of the intervention to AYA adjustment to the transplantation experience; (2) helpfulness and meaningfulness of the intervention for parents; and (3) AYA ability to participate in the intervention during the acute phase of transplant. CONCLUSIONS Parents observed and interacted with their AYA who participated in a targeted behavioral intervention. Thus, parents were able to describe mechanisms through which the intervention was helpful and meaningful for the AYA and indirect personal benefits for themselves. The results suggest the importance of the targeted outcomes identified in the Resilience in Illness Model and mechanisms of action in the Contextual Support Model of Music Therapy, and identify approaches for future study.
Collapse
|
26
|
Robb SL, Burns DS, Docherty SL, Haase JE. Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial. Psychooncology 2012; 20:1193-201. [PMID: 22012943 DOI: 10.1002/pon.1845] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies.
Collapse
|
27
|
Abstract
Music-based interventions are used to address a variety of problems experienced by individuals across the developmental lifespan (infants to elderly adults). In order to improve the transparency and specificity of reporting music-based interventions, a set of specific reporting guidelines is recommended. Recommendations pertain to reporting seven different components of music-based interventions including intervention theory, intervention content, intervention delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Recommendations are intended to support CONSORT and TREND statements for transparent reporting of interventions while taking into account the variety, complexity, and uniqueness of music-based interventions.
Collapse
|
28
|
Abstract
Music-based interventions are used to address a variety of problems experienced by individuals across the developmental lifespan (infants to elderly adults). In order to improve the transparency and specificity of reporting music-based interventions, a set of specific reporting guidelines is recommended. Recommendations pertain to seven different components of music-based interventions, including theory, content, delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Recommendations are intended to support Consolidated Standards for Reporting Trials (CONSORT) and Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statements for transparent reporting of interventions while taking into account the variety, complexity, and uniqueness of music-based interventions.
Collapse
|
29
|
Abstract
Determining how music-based interventions have been described in published literature is an important first step in evaluating whether guidelines for reporting music-based interventions need to be developed. Twenty-two pediatric intervention studies that met specified inclusion criteria were reviewed for content in 11 areas. This review revealed significant gaps in intervention reporting. Problems were particularly pronounced in eight areas: music qualities, intervention materials, intervention components, intervention delivery schedule, interventionist, treatment fidelity, setting and music delivery method. Development of reporting guidelines for music-based interventions is needed to improve reporting and advance evidence-based practice.
Collapse
Affiliation(s)
- Sheri L Robb
- Indiana University School of Nursing, Indianapolis, IN 46202-5107, USA.
| | | |
Collapse
|
30
|
Robb SL, Clair AA, Watanabe M, Monahan PO, Azzouz F, Stouffer JW, Ebberts A, Darsie E, Whitmer C, Walker J, Nelson K, Hanson-Abromeit D, Lane D, Hannan A. A non-randomized [corrected] controlled trial of the active music engagement (AME) intervention on children with cancer. Psychooncology 2008; 17:699-708. [PMID: 18033724 DOI: 10.1002/pon.1301] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Coping theorists argue that environmental factors affect how children perceive and respond to stressful events such as cancer. However, few studies have investigated how particular interventions can change coping behaviors. The active music engagement (AME) intervention was designed to counter stressful qualities of the in-patient hospital environment by introducing three forms of environmental support. METHOD The purpose of this multi-site randomized controlled trial was to determine the efficacy of the AME intervention on three coping-related behaviors (i.e. positive facial affect, active engagement, and initiation). Eighty-three participants, ages 4-7, were randomly assigned to one of three conditions: AME (n = 27), music listening (ML; n = 28), or audio storybooks (ASB; n = 28). Conditions were videotaped to facilitate behavioral data collection using time-sampling procedures. RESULTS After adjusting for baseline differences, repeated measure analyses indicated that AME participants had a significantly higher frequency of coping-related behaviors compared with ML or ASB. Positive facial affect and active engagement were significantly higher during AME compared with ML and ASB (p<0.0001). Initiation was significantly higher during AME than ASB (p<0.05). CONCLUSION This study supports the use of the AME intervention to encourage coping-related behaviors in hospitalized children aged 4-7 receiving cancer treatment.
Collapse
|
31
|
Robb SL, Clair AA, Watanabe M, Monahan PO, Azzouz F, Stouffer JW, Ebberts A, Darsie E, Whitmer C, Walker J, Nelson K, Hanson-Abromeit D, Lane D, Hannan A. Randomized controlled trial of the active music engagement (AME) intervention on children with cancer. Psychooncology 2008. [DOI: 10.1002/pon.1448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
32
|
Robb SL. Music Interventions and Group Participation Skills of Preschoolers with Visual Impairments: Raising Questions about Music, Arousal, and Attention. J Music Ther 2003; 40:266-82. [PMID: 15015909 DOI: 10.1093/jmt/40.4.266] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purposes of this pilot study were two-fold: First, to document and compare attentive behavior during music and play-based group instructional sessions and second, to document and compare 4 group participation behaviors during music and play-based sessions. The 4 group participation behaviors included facing a central speaker, following onestep directions, manipulating objects according to their function, and remaining seated. Six of the 12 children enrolled completed the study, with all participants enrolled in an early intervention program due to visual impairments. Study participants were between the ages of 4 and 6 years inclusively. Children participated in 4, 30-minute instructional sessions. Two instructional sessions were music-based and two were play-based with the 4 sessions equally distributed across a 2-week period. An ABBA design was used to control for possible order effects. Each session was videotaped to facilitate collection of behavioral data. Statistical analysis of these data revealed that attentive behavior was significantly higher during music based-sessions (t(5) = 5.81; p =.002). Mean scores for the remaining group participation behaviors were higher in the music condition, but these differences were not statistically significant. Discussion regarding differential outcomes among participants, as well as an exploration of theories related to music, arousal, and attention are discussed in an effort to guide future research.
Collapse
|
33
|
Robb SL, Ebberts AG. Songwriting and digital video production interventions for pediatric patients undergoing bone marrow transplantation, part I: an analysis of depression and anxiety levels according to phase of treatment. J Pediatr Oncol Nurs 2003; 20:2-15. [PMID: 12569430 DOI: 10.1053/jpon.2003.3] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purposes of this exploratory case study were: (1) to examine how anxiety and depression levels vary with phase of bone marrow transplantation (BMT) and (2) to examine the effect of the proposed music therapy treatment protocol on anxiety and depression levels. Six pediatric BMT patients participated in the study. Three participants experienced the music condition and three participants experienced the no-music contact condition. Both conditions consisted of six, one-hour sessions that occurred over a three week period. The Children's Depression Inventory (CDI) was administered at the conclusion of each session to examine changes in depression levels across each phase of treatment. The State Trait Anxiety Inventory for Children (STAIC) served as a pre-/post-session measure of state anxiety. Graphic analysis of scores from the CDI and STAIC indicated a consistent trend in depression and anxiety levels according to phase of treatment for all participants. Four participants (3 music; 1 no-music) experienced decreased anxiety following a majority of sessions.
Collapse
Affiliation(s)
- Sheri L Robb
- University of Missouri-Kansas City and Children's Mercy Hospitals & Clinics, Kansas City, Missouri 64110, USA
| | | |
Collapse
|
34
|
Robb SL, Ebberts AG. Songwriting and digital video production interventions for pediatric patients undergoing bone marrow transplantation, part II: an analysis of patient-generated songs and patient perceptions regarding intervention efficacy. J Pediatr Oncol Nurs 2003; 20:16-25. [PMID: 12569431 DOI: 10.1053/jpon.2003.4] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Part I of this exploratory case study examined patient anxiety levels and depressive symptoms according to phase of bone marrow transplantation (BMT). The second part of this study examines more qualitative outcomes of the music therapy intervention. Purposes of this part of the study included: (1) to examine the lyrical content of patient-generated songs and (2) to compare patient perceptions regarding the effectiveness of a 6-week music condition with a no-music contact condition. Six pediatric BMT patients participated in the study. Three participants experienced the music condition and three participants experienced the no-music contact condition. Both conditions consisted of six, 1-hour sessions that occurred over a 3-week period. Content analysis of patient-generated songs revealed expression of issues related to the following themes: hope, positive coping, appreciation, mental status, control, time, bewilderment, treatment, and diagnosis. Examination of patient-generated songs provided insight into each patient's experience with transplantation and the coping strategies used during treatment. Outcomes from a poststudy questionnaire are summarized.
Collapse
Affiliation(s)
- Sheri L Robb
- University of Missouri-Kansas City and Children's Mercy Hospitals & Clinics, Kansas City, Missouri 64110, USA
| | | |
Collapse
|
35
|
Robb SL. Music assisted progressive muscle relaxation, progressive muscle relaxation, music listening, and silence: a comparison of relaxation techniques. J Music Ther 2001; 37:2-21. [PMID: 10806470 DOI: 10.1093/jmt/37.1.2] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this study was to compare the effects of music assisted progressive muscle relaxation (M + PMR), progressive muscle relaxation (PMR), music listening, and silence/suggestion on measures of anxiety and perceived relaxation. The study also examined participant responses to a posttreatment questionnaire to identify relationships between musical and nonmusical elements in relaxation techniques. Sixty university students participated in the study. Fifteen participants were randomly assigned to each treatment condition. Subjects were tested individually using the same relaxation script for M + PMR and PMR conditions. One-way analyses of covariance were computed to compare pre and posttest differences among groups. Results of the ANCOVA revealed no differences among groups for the State Trait Anxiety Inventory (STAI) or the Visual Analog Scale (VAS). Analysis of variance, however, revealed each treatment condition to be equally effective in producing significant changes in anxiety and perceived relaxation from the pre to posttest period. Additionally, mean score differences revealed decreases for all conditions with M + PMR eliciting the greatest amount of change. A content analysis of posttreatment questionnaire items revealed detailed information about each participant's relaxation experience, state of mind, and use of self-generated relaxation techniques.
Collapse
Affiliation(s)
- S L Robb
- The University of Missouri, Kansas City, USA
| |
Collapse
|
36
|
Robb SL. The effect of therapeutic music interventions on the behavior of hospitalized children in isolation: developing a contextual support model of music therapy. J Music Ther 2000; 37:118-46. [PMID: 10932125 DOI: 10.1093/jmt/37.2.118] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this study was to provide preliminary data that support or negate a contextual support model of music therapy. The contextual support model of music therapy, based on Skinner and Wellborn's (1994) motivational theory of coping, argues that therapeutic music environments possess elements of structure, autonomy support, and involvement that lead children to become more actively engaged with their environment. This study examined three basic suppositions of the theory: (a) that music interventions create supportive environments, (b) that music interventions increase children's active engagement, and (c) that relationships exist between supportive environments and engaging behavior. Ten pediatric oncology patients restricted to an isolated environment participated in the study. Participants, serving as their own controls, experienced four different environmental conditions. Each condition was videotaped to facilitate collection of environmental and behavioral data. Statistical analyses of these data revealed: (a) that the music environment possessed a significantly higher frequency of environmental support elements than other activities typically experienced by hospitalized children, (b) that therapeutic music interventions elicited significantly more engaging behaviors from hospitalized children than other hospital activities, (c) that positive behavioral effects of music interventions were not maintained in hospital experiences that followed the music session, and (d) that environmental support elements were related to some positive behaviors but these behaviors were not consistent across environments.
Collapse
Affiliation(s)
- S L Robb
- University of Missouri-Kansas City, USA
| |
Collapse
|
37
|
Abstract
The purpose of this historical study was to investigate the life experiences of Marian Erdman, specifically her use of music in military hospitals. The work of Marian Erdman, as a hospital recreation worker for the American Red Cross from 1945 through 1948, provides personal insights into the role of musicians and music in military hospitals at the close of World War II. Questions addressed by this biographical study include (1) What were the professional experiences of Marian Erdman? (2) What were her views regarding the purpose and function of music in hospitals during the post-war era? (3) Did the Red Cross provide guidelines regarding the purpose and use of music with patients?, and (4) How did the events of the mid-1940s contribute to the formation of music therapy as an organized profession?
Collapse
Affiliation(s)
- SL Robb
- University of Missouri-Kansas City
| |
Collapse
|