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Music Therapy and Health. NUR 317 Michelle Klenk, Maia Novak, Jessica Olcheske, Ashleigh Wash, Sara Young . Music Therapy Defined.
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Music Therapy and Health NUR 317 Michelle Klenk, Maia Novak, Jessica Olcheske, Ashleigh Wash, Sara Young
Music Therapy Defined “Music therapy is a branch of health care dedicated to the use of music for emotional, physical, functional and educational improvement in a broad range of settings and conditions...the arts (e.g. music and painting) are an important part of the nursing discipline.” (Korhan, Khorshid & Uyar, 2011)
Research Question Is there sufficient evidence that proves that music therapy has a positive effect on psychological and physiological patient outcomes?
Why did we choose this question? Music has been shown to provide positive benefits. • Addresses spiritual, psychological, physical, social, and cognitive needs of individuals. • Improves emotional states. • Increases positive changes in mood. • Is an anxiety, stress reduction, and relaxation tool. (Young & Koopsen, 2011)
Music Therapy and Spirituality Many different cultures and denominations have used music as an essential part of religious practices. • Soothe the spirit • Provide a means for focusing on spiritual awareness. • Brings a person to a peaceful place. (Young & Koopsen, 2011)
Study 1: Korhan, Khorshid & Uyar (2011) Objective: To assess the physiological effects of music therapy on 60 Turkish, mechanically ventilated patients in an intensive care unit. Method: • Patients were randomized to a control or intervention group. • 60 minutes of classical music therapy of 60-66 bpm was played for intervention group via MP3 player and headphones. • No music for control group. • Vitals were taken at the 30th, 60th and 90th minutes of intervention.
Study 1: Korhan, Khorshid & Uyar (2011) Results: • Significant decreases in systolic, diastolic blood pressures & respiratory rates for the intervention group. • Decrease improved progressively at 30, 60, 90 minute intervals. Limitations: • Sample size • Type of music used • Duration of therapy • Cultural diversity
Study 2: Kulkarni, Johnson, Kettles, & Kasthuri (2012) Objective: To assess the effects of playing patient selected music on the doses of sedation and analgesia and anxiety levels during procedures in Interventional Radiology. Method: • Randomized control study of 100 patients. • Experimental group utilized music therapy; control group did not. • Measured required doses of IV narcotics and sedatives for patients during procedures. • Measured anxiety levels of patients before and after procedure (State Anxiety Inventory).
Study 2: Kulkarni, Johnson, Kettles, & Kasthuri (2012) Results: • Sedation was required in 21 (42%) patients in the music group compared with 30 (60%) patients in the control group. • Mean midazolam dose: 2.1 mg (control),1.3 mg (experimental) • Mean fentanyl dose: 29 mg (control), 18 mg (experimental) • Anxiety level: No significant change. Limitations: • Small sample size • Some patients did not bring their own music.
Study 3: Wlodarczyk (2007) Objective: Using a self-report, this study aims to determine the effects of music therapy on the spirituality of participants in an in-patient hospice unit. Method: • 10 volunteering patients in a palliative care unit were studied • Each participant had four 30 minute visits with the researcher • After each visit, a spiritual well-being questionnaire was completed. • Mean scores from the questionnaire were analyzed.
Study 3: Wlodarczyk (2007) Results: • Mean scores of Spiritual Well-Being Questionnaire • 78.5/100 for music group • 73.95/100 for non-music group • Participants requested to play spiritual music 75% of the time. • Initiated discussion of spiritual issues in 35% of the music visits. • Patients expressed verbal disappointment of the lack of music during 80% of the non-music visits. Limitations: There was difficulty acquiring and retaining participants which led to a small sample size.
Implications for Nursing Practice The previous 3 articles showed evidence that music therapy has positive benefits on patient outcomes. • Decreases anxiety and stress levels in patients. • Decreases pain levels and acts as a distracter. • Decreases physiological signs- BP, & resp. rates. • Improves spiritual well-being. • Promotes a positive mood and emotional state. • Positive participation in treatment from patient.
Implications for Further Research • Larger sample sizes. • More research is needed regarding the link between music and well-being. • More research is needed to examine the best type of music to use for relaxation. • More research is needed to examine the best way to incorporate music into practice for a maximum benefit for patients.
How can we help our patients? • Musicians visits • Music channels • Access to portable music players
Our Personal Practice • Michelle: (ICU Nurse) I utilize music to promote relaxation, but I did not have solid medical evidence for using it as an intervention. • Maia: (Pediatric Orthopedic/Nephrology/Cardiac RN) Now understands the importance of allowing the patient to choose their own music and that different age groups may respond differently to the music being played. • Jess: (Private Practice Surgical/Laser RN) Incorporates music therapy into practice by allowing patients to listen to headphones while under local anesthesia, and plans to expand use by teaching others about the benefit of music therapy. • Ashleigh: (Trauma/Burn ICU RN) I will advocate for the use of visiting musicians for my patients. Many patients and nurses do not know that we offer it in our hospital. • Sara: (Progressive Care Unit RN) I would like to see use of music on our unit as a means of non-pharmacological therapy to induce a calm and spiritually healing atmosphere.
References Korhan, A. E., Khorshid, L., & Uyar, M. (2011). The effect of music therapy on physiological signs of anxiety in patients receiving mechanical ventilator support. Journal of ClinicalNursing, 20, 1026-1034. doi: 10.1111/j.1365-2702.2010.03434.x Kulkarni, S., Johnson P.C., Kettles, S., & Kasthuri, R. S. (2012). Music during interventional radiological procedures, effect on sedation, pain and anxiety: A randomized controlled trial. British Journal of Radiology, 85, 1059-1063. doi: 10.1259/bjr/71897605. Young, C., & Koopsen, C. (2011). Spirituality, health, and healing: An integrative approach (2nd ed.). Sudbury, MA: Jones and Bartlett Publishers. Wlodarczyk, N. (2007). The effect of music therapy on the spirituality of persons in an in-patient hospice unit as measured by self-report. Journal of Music Therapy, 44, 113-122.