Music therapy to promote psychological and physiological relaxation in palliative care patients: protocol of a randomized controlled trial.

Marco Warth,Jens Kessler,Hubert J Bardenheuer,Thomas K Hillecke,Julian Koenig,Alexander F Wormit

doi:10.1186/1472-684x-13-60

Abstract

BackgroundMusic therapy is one of the most frequently used complementary therapies in different palliative care settings. Despite its long tradition and high acceptance by other health-care professionals, evidence on the effectiveness of music therapy interventions for terminally ill patients is rare. Recent reviews and health-care reports consistently point out the need of music therapists to provide an evidence-based rationale for their clinical treatments in this field. Therefore, the present study evaluates the psychological and physiological response of palliative care patients to a standardized music therapy relaxation intervention in a randomized controlled trial.Methods/designA sample of 84 participants from a palliative care unit in Heidelberg is randomized to either two sessions of music therapy or two sessions of a verbal relaxation exercise, each lasting 30 minutes. The music therapy sessions consist of live played monochord music and a vocal improvisation, the control group uses a prerecorded excerpt from the mindfulness-based stress reduction program containing no musical elements. Outcome measures include self-report data on subjective relaxation, well-being, pain intensity, and quality of life, as well as continuous recording of heart rate variability and blood volume pulse as indicators of autonomous nervous system functioning.DiscussionTo our knowledge, this study is the first clinical trial in Europe and one of very few randomized controlled trials worldwide to systematically examine the effects of music therapy in palliative care.Trial registrationGerman Clinical Trials Register – DRKS00006137

Highlights

Music therapy is one of the most frequently used complementary therapies in different palliative care settings
The inclusion of pretest values as a covariate in Discussion This paper presents the study protocol of a randomized controlled trial on the psychological and physiological effects of a music therapy relaxation intervention for terminally ill patients in palliative care
One crucial aspect of clinical trials in palliative care research is the design of an adequate control group condition

Summary

Introduction

Music therapy is one of the most frequently used complementary therapies in different palliative care settings. For more than 35 years, music therapists have been working in different settings of end-of-life care. The Canadian music therapist, Susan Munro, was the first to systematically describe the physical, psychological, social, and spiritual impact of her work with terminally ill patients at the world’s first palliative care unit, founded by Balfour Mount in Montréal [1]. In clinical palliative care practice, music therapy generally aims at the improvement or maintenance of the patient’s quality of life, including the management of pain and stress, the regulation of negative emotions (e.g. anxiety, anger, and depression), as well as the facilitation of communication and spiritual experiences [6]. In end-of-life care, techniques typically encompass relaxation or imaginative interventions (receptive), the therapeutic use of songs (active or receptive), and various forms of improvisation (active). The interventions are tailored according to the patient’s physical state and psychosocial needs

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Conclusion