Commentary on Lin PC, Lin ML, Huang LC, Hsu HC & Lin CC (2011) Music therapy for patients receiving spine surgery. Journal of Clinical Nursing 20, 960–968

Abstract

Music therapy is increasingly being used as an adjunct to nursing care and has subsequently attracted attention in nursing research. The study by Lin et al. (2011) starts from the premise that anxiety, pain and distress for surgical patients are universal (Sun et al. 2008). The study by Lin et al. (2011) contributes to a growing literature focusing on the effects of preferred music on anxiety and pain in surgical patients derived from structured measures to evaluate the effects of music therapy. This study provides further evidence that music therapy matched with personal preferences has positive effects in alleviating levels of anxiety and pain in surgical patients. Whilst this study lacks follow-up and does not provide substantial evidence of the long-term effects of music therapy, the new findings represent an important step in research on music therapy and highlight the application of preferred music as a promising intervention in surgical care. Apart from the findings of Lin et al.’s (2011) study, it is important to acknowledge the limitations of the study. The two groups did not show significant differences in urine cortisol, norepinephrine or epinephrine values. This may suggest that these physiological parameters are unable to be rapidly and effectively changed in a short time by the music therapy. These non-significant results found in the physiological parameters may also suggest a need for more objective outcome measures that are sufficiently and clinically relevant to support the claim that there are relationships between objective outcome measures and the therapeutic effects of music therapy. Conducting research, particularly experimental studies, can create methodological challenges. A fundamental concern in protocols for music therapy is the dose–response relationship to estimate the true effect of music therapy. In Lin et al.’s (2011) study, participants were asked to listen to music of their preferences in the scheduled time, but probably there was wide variation in the music sessions among participants as stated ‘the patients were encouraged to listen to music at any other times they wanted’. Thus, the numbers of music sessions conducted in this study might vary. In addition, as stated by Lin et al. (2011), the sample selection and sampling are recognised weaknesses such as the advanced age of the study population. The generalisability to typical surgical patients may be limited because of the nature of the study sample. In conclusion, this study delineates a key part of the process in finding out how music therapy works. There are consistent, although often not statistically significant, results from some of the outcome measures that patients in surgical and situations respond to music in a positive way.