Live Music Intervention Research Articles

The effectiveness of live music intervention on psychological distress among adolescent and young adult patients undergoing hematopoietic stem cell transplantation

Objective To explore the effects of live music to decrease psychological distress in adolescent and young adult (AYA) patients undergoing hematopoietic stem cell transplantation (HSCT). Method A quasi-experimental study was conducted. Sixty patients undergoing HSCT were divided into two groups, receiving either 4 week of live music (n = 31) or standard care (n = 29). Psychological distress, anxiety, the severity of symptom clusters and symptom interference were measured. Results When compared with the immediately and 1 month after intervention, patients in LM intervention group had significantly lower psychological distress and anxiety level than wait-list group. AYA undergoing HSCT reported significantly milder general symptom cluster and neurological symptom cluster at T3 than at baseline. Conclusions Live music intervention showed a positive effect on relieving psychological distress and anxiety in AYA patients undergoing HSCT. However, further researches are warranted to explore the effects of live music intervention on symptom cluster.

Live music in the intensive care unit – a beautiful experience

ABSTRACT Background The growing number of lightly or non-sedated patients who are critically ill means that more patients experience the noisy and stressful environment. Live music may create positive and meaningful moments. Purpose To explore non-sedated patients’ experiences of patient-tailored live music interventions in the intensive care unit. Design A qualitative study using a phenomenological-hermeneutic approach. Data were collected at two intensive care units from September 2019 to February 2020 exploring 18 live music interventions performed by music students from The Royal Academy of Music, Aarhus, Denmark. Methods Observations of live music interventions followed by patient interviews. All data together were analysed using Ricoeur’s theory of interpretation. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used. Results Five themes emerged: 1) A break from everyday life, 2) A room with beautiful sounds and emotions, 3) Too tired to participate, 4) Knowing the music makes it meaningful and 5) A calm and beautiful moment. Conclusion Patient-tailored live music to awake patients is both feasible and acceptable and perceived as a break from every-day life in the ICU. Implications for practice Supporting health and well-being by bringing a humanizing resource into the intensive care setting for patients and nurses to enjoy.

A Retrospective Study: Reduction of Anxiety Through Music Therapy During Hospitalization

Abstract This retrospective review of 56 charts of adult hospital patients examined verbal anxiety ratings (VAR) of premusic therapy- and post-music therapy sessions to report on the preliminary efficacy of live music interventions on anxiety. Due to the high rate of anxiety associated with hospitalization and its negative somatic and psychological effects, it is important that anxiety is assessed and treated by qualified professionals. Nonpharmacological approaches such as music therapy help to address the root of anxiety by providing a relaxation cue to patients’ parasympathetic nervous system and also address patients’ psychological concerns. This retrospective analysis explores the real-world evidence of music therapy for the treatment of hospital-associated anxiety symptoms through a review of all music therapy sessions with a charted verbal anxiety rating (VAR) ≥3 documented in the electronic health record. Paired samples t-test showed that music therapy sessions resulted in a statistically significant reduction in pre- and post-verbal anxiety rating; t(60) = 9.806, p < .001. This study demonstrates that music therapy is a feasible treatment modality for assessing and ameliorating self-reported anxiety symptoms in hospitalized adults.

Development of a person-centered caregiver singing model for formal caregivers of people living with dementia in South Africa

This action research study explored the co-design of a person-centered caregiver singing (PCCS) protocol and caregivers’ experiences of applying the PCCS intervention with people living with dementia. Eight caregivers across two care homes participated in four iterative cycles aimed at refining the training. Qualitative data collected from semi-structed group interviews, individual interactions and researcher reflections were analysed via thematic analysis which informed the refinements to the training protocol. A Person-Centered Caregiver Singing Model was developed from the thematic findings relating to caregivers’ experiences of applying the PCCS intervention: enhanced caregiver capabilities, resident's wellbeing, improved relationship, the positive ecological shift, and ease of caregiving. PCCS fostered caregivers’ empathy and self-efficacy, helping them better attune to and meet the needs of people with dementia. Findings suggest music therapists could share music therapy-informed skills with caregivers for use in daily care. Further research would be beneficial to understand the relationship between live music interventions and caregivers’ self-efficacy and empathy, and to explore the training barriers in South Africa.

Live and Recorded Music Interventions to Reduce Postoperative Pain: Protocol for a Nonrandomized Controlled Trial.

Postoperative patients who were previously engaged in the live musical intervention Meaningful Music in Healthcare reported significantly reduced perception of pain than patients without the intervention. This encouraging finding indicates a potential for postsurgical musical interventions to have a place in standard care as therapeutic pain relief. However, live music is logistically complex in hospital settings, and previous studies have reported the more cost-effective recorded music to serve as a similar pain-reducing function in postsurgical patients. Moreover, little is known about the potential underlying physiological mechanisms that may be responsible for the reduced pain perceived by patients after the live music intervention. The primary objective is to see whether a live music intervention can significantly lower perceived postoperative pain compared to a recorded music intervention and do-nothing control. The secondary objective is to explore the neuroinflammatory underpinnings of postoperative pain and the potential role of a music intervention in mitigating neuroinflammation. This intervention study will compare subjective postsurgical pain ratings among 3 groups: live music intervention, recorded music intervention, and standard care control. The design will take the form of an on-off nonrandomized controlled trial. Adult patients undergoing elective surgery will be invited to participate. The intervention is a daily music session of up to 30 minutes for a maximum of 5 days. The live music intervention group is visited by professional musicians once a day for 15 minutes and will be asked to interact. The recorded music active control intervention group receives 15 minutes of preselected music over headphones. The do-nothing group receives typical postsurgical care that does not include music. At study completion, we will have an empirical indication of whether live music or recorded music has a significant impact on postoperative perceived pain. We hypothesize that the live music intervention will have more impact than recorded music but that both will reduce the perceived pain more than care-as-usual. We will moreover have the preliminary evidence of the physiological underpinnings responsible for reducing the perceived pain during a music intervention, from which hypotheses for future research may be derived. Live music can provide relief from pain experienced by patients recovering from surgery; however, it is not known to what degree live music improves the patients' pain experience than the logistically simpler alternative of recorded music. Upon completion, this study will be able to statistically compare live versus recorded music. This study will moreover be able to provide insight into the neurophysiological mechanisms involved in reduced pain perception as a result of postoperative music listening. The Netherlands Central Commission on Human Research NL76900.042.21; https://www.toetsingonline.nl/to/ccmo_search.nsf/fABRpop?readform&unids=F2CA4A88E6040A45C1258791001AEA44. PRR1-10.2196/40034.

Effects of environmental music therapy on anxiety and waiting in radiation oncology

A randomized control trial investigated perceived waiting time in patient and caregivers, and live music’s effects on anxiety levels prior to daily radiation therapy (RT). Environmental Music Therapy (EMT) is a live music intervention by music therapists meant to modify perception of potentially stressful environments through constructing dynamic soundscapes to provide enhanced comfort and safety. This study (a) rated participants’ state anxiety and distress experienced in the waiting area pre-RT, (b) determined if the EMT protocol moderated baseline treatment experience-related anxiety and (c) evaluated EMT’s affects on perceived waiting time pre-treatment, versus actual waiting time. We hypothesized EMT would reduce state anxiety, distress, and regulate distortion of waiting time, ultimately changing overall RT perception. 160 randomized patients and caregivers were accrued- 82 receiving EMT, 78 randomized to control. Assessment pre/post intervention measured anxiety and distress with the STAI 6 and Visual Analogue Distress Scale. A time survey assessed waiting perception. Data collected and recorded by research assistants naïve to treatment conditions found EMT interventions showed significantly reduced perceived incidences of anxiety and distress, significantly shortening perceived waiting times in the EMT arm compared to controls. Reduced anxiety, distress, and temporal distortion can enhance patients’ and caregivers’ perception of hospital environments.

Musical Breaks-Live Music in a Hemodialysis Setting-A Qualitative Study on Patient, Nurse, and Musician Perspectives.

The aim of this hermeneutic-phenomenological study was to explore the perspectives of 12 patients, 17 nurses, and 4 musicians on patient-tailored live music interventions in a hemodialysis setting. Twenty-six semi-structured interviews were collected—17 with patients, 9 with nurses. Furthermore, 18 moderate participation observations, whilst 1 semi-structured group interview with 3 nurses and 3 musicians, and 13 reflective journals from musicians were collected. Within the analysis—based on Ricoeur’s theory of interpretation—two overall themes emerged: (1) the inner space and (2) the participating space, followed by five subthemes: (1a) Entering a calm and enjoyable pause bubble; (1b) Resting in a thought-free state of mind; (1c) Traveling in the past and catching the moment through heartfelt music; (2a) Bringing positive changes into life; (2b) The artistic quality mediating a magnificent and beautiful experience. We found that patient-tailored live music was a meaningful break, influencing mental and physical well-being, time perception, community, work environment, and artistic approach. The artistic quality of the music was essential—together with the musicians’ social awareness, empathy, and ability to interact with the patients—in creating meaningful moments for patients and staff. Overall, the music interventions were a welcome change in a predictable world of stressful routines and repetitive treatments.

Musicdrops@work: Impact of Shared Listening to Short Live Music Interventions on Sense of Belonging and Subjective Wellbeing at Work.

Assuming live music can foster belonging in the workplace, this study linked companies in the secondary and tertiary sectors with the world of music performance. Specifically, students from a Swiss music university offered live mini-concerts (10 min of classical music) on the premises of three companies over a period of 3 months. To analyze the impact of these brief musical interventions on the sense of belonging of staff in these companies, a mixed methods approach was adopted using a standardized questionnaire (Barcelona Music Reward Questionnaire, a short online questionnaire on the appreciation of the music and the emotional state induced, and focus groups interviews at the end of the experiment). The short concerts were much appreciated. On the individual level, they led to a greater sense of pleasure and were perceived as a break, a possibility to connect to one’s emotions and above all, as a “moment for oneself.” On the group level, the short concerts allowed the members of teams to meet, prompted conversations and new ways of sharing, created links, and offered opportunities to get to know work colleagues differently and to discover them on a more personal level.

Effect of Live Versus Recorded Music on Children Receiving Mechanical Ventilation and Sedation.

Music is often used as a nonpharmacological pain management strategy, but little evidence is available about its role in pediatric critical care patients. To determine the effect of a live music intervention versus a recorded music intervention on heart rate, blood pressure, and respiratory rate in pediatric critical care patients receiving mechanical ventilation and sedation. An exploratory randomized controlled trial was performed in a pediatric intensive care unit. Participants were randomly allocated to receive a live music intervention with standard care or a recorded music intervention with standard care. Each intervention was delivered by a board-certified music therapist for 15 minutes. Heart rate, respiratory rate, and blood pressure were measured at baseline and at 15-minute intervals for 60 minutes after the intervention. A total of 33 patients aged 0 to 2 years completed the study: 17 were assigned to the live music group and 16 to the recorded music group. In the live music group, a significant reduction in heart rate was observed immediately after the intervention and was sustained at 60 minutes after the intervention. Although the live music group also exhibited a downward trend in blood pressure, those differences were not significant. The results of this study indicate that live music interventions may be more effective than recorded music interventions in reducing pain and anxiety in pediatric critical care patients. The advantage of live music may be due to the adaptability of the music delivery by a trained music therapist.

Live music in hospital oncology settings: environmental, interpersonal, and personal outcomes for staff, patients, and carers

ABSTRACT Background: This paper explores the environmental, interpersonal, and personal outcomes of music performance in a hospital oncology setting. An original, qualitative research study examined the impact of live music for staff, patients, and carers. Methods: Data were collected using a multi-method approach of observations and semi-structured interviews and were analysed using inductive and theory-driven theming that was shaped by a determinants of health framework. Results: The research found that live music promoted stronger relationships and calmer environments, among other environmental, social and individual outcomes. Improved communication between staff through the creation of a more supportive environment was a pertinent finding of the research. No negative effects were reported. Conclusions: We discuss research findings in the context of relevant literature and suggest recommendations for future hospital-based live music programs. Results of this study indicate that live music interventions impacted individual, interpersonal, social and environment factors that led to health and wellbeing outcomes for participants.

The Effects of Contingent Lullaby Music on Parent-Infant Interaction and Amount of Infant Crying in the First Six Weeks of Life

PurposeThe purpose of this study was to examine the effect of a live music intervention provided by the mother on full term infants' amount of crying and parent-infant interaction in the first six weeks of life. Design and methodsA randomized posttest-only experimental/no-contact control group design was used for this study. A sample of 66 mothers with healthy, newborn infants were recruited. The researcher wrote an original lullaby with each mother in the experimental group and gave instructions as to how to use the lullaby as reinforcement for infant quiet, non-crying behavior. Mother-infant dyads were assessed over a six-week period for infant crying amounts and parent-infant interaction behaviors. Demographic variables, postpartum depression, and value of music were assessed as well to detect associations between variables and groups. ResultsResults indicated that there were significant differences between groups for mean crying time per week and mother-infant interaction behaviors. Analysis by demographic variables such as mother parity, socioeconomic status, and marital status showed no significant group differences on infant crying or interaction scores. Mothers who used the contingent music intervention were more motivated to sing and valued the use of music with their infants more than mothers in the control group. ConclusionsThe outcomes of this study demonstrate importance of parental singing for mother-infant bonding. Practice implicationsImplementing early intervention services, such as music therapy in the postpartum unit, can provide new mothers useful music applications that can enhance mother-infant interaction, especially mothers living in high stress or negative environments.

Preterm infant physiological responses to music therapy: a systematic review

Background Prematurity is still the leading cause of mortality and morbidity in neonates. The premature change of the environment causes stress, which leads to hemodynamic instability. Music therapy may have a positive impact on hemodynamic parameters of preterm infants in the NICU.
 Objective To evaluate preterm infants’ physiological responses to music therapy in NICU setting.
 Methods A systematic review was performed in 12 electronic databases from March 2000–April 2018. Our review included all English language publications on parallel or crossover RCTs of music therapy versus standard care or placebo in preterm infants. The outcomes were physiological indicators [heart rate (HR), respiratory rate (RR), and oxygen saturation (SaO2)]. Risk of bias was assessed using the Revised Cochrane risk of bias tool for randomized trials (RoB 2.0).
 Results The search yielded 20 articles on 1,148 preterm infants of gestational age 28 and 37 weeks, who received recorded music, recorded maternal/male voice or lullaby, or live music interventions in the NICU with intensity of 30–76 dB. Recorded music improved all outcomes in 6, 6, and 4 of 16 studies for HR, RR, and SaO2, respectively. Seven studies used classical music as melodic elements. However, eight studies showed no significant results on all outcomes.
 Conclusion Despite the finding that music interventions demonstrate promising results in some studies, the variation in quality of the studies, age groups, outcome measures, as well as type and timing of the interventions across the studies make it difficult to draw overall conclusions about the effects of music in preterm infants.

Music Intervention as a Tool in Improving Patient Experience in Palliative Care.

The pain, anxiety, and stress associated with end-of-life care are paramount issues to address for both patients and their families. Reduction in these factors could translate to improved quality of life. We studied the effect of adding music to standard care for patients receiving a hospice or palliative care consult at 2 hospitals in the Care New England health-care system. In this mixed quantitative and qualitative study, we implemented live music intervention sessions. Outcomes include symptom burden pre- and post-intervention using the Edmonton Symptom Assessment Scale, opioid use in equivalent time periods before and after the music intervention, and qualitative personal narratives of patients' and families' experiences with the music. There were significant decreases in pain, anxiety, nausea, shortness of breath, and feelings of depression along with significant increase in feelings of well-being. Opioid use in time periods after the music intervention trended toward decreased usage when compared to the equivalent time period before. Finally, compiled personal narratives of patients' and families' experiences of the music intervention demonstrated common themes of spirituality, comfort, relaxation, escape, and reflection. This project demonstrated the beneficial effects of music in a patient population that struggles with symptom management when only pharmacologic management is used. These data elucidate biological and psychosocial factors that are positively impacted by the intervention. With additional evidence in music as well as other artistic modalities, it is promising that arts-based programs in inpatient hospice and palliative care settings will continue to expand and flourish.

Music Intervention as a Nonpharmacological Tool in Improving Quality of Life of Palliative Care Patients (S780)

•Identify appropriate patients to receive music intervention.•Discuss how to select appropriate pieces to perform for patients and their families. The pain, anxiety, and stress associated with end-of-life care are paramount issues to address for both patients and their families. Reduction of these factors could translate to improved quality of life for patients approaching the end of life. We studied the effect of adding music to standard care for patients receiving palliative care in two hospitals in the Care New England healthcare system. In this mixed quantitative and qualitative study, we implemented live music intervention sessions. Outcomes collected include symptom burden pre- and post-intervention using the Edmonton Symptom Assessment Scale, opioid use in 24-hour periods before and after the music intervention, as well as qualitative personal narratives of patients’ and families’ experiences with the music. We collected data from 45 patients. Notably, on the ESAS there were significant decreases in pain, anxiety, and feelings of depression, along with significant increase in feelings of well-being. Opioid use in 24-hour periods after the music intervention showed a trend toward decreased usage, when compared the 24-hour period before. Finally, we compiled qualitative personal narratives of patients’ and families’ experiences of the music intervention. We found common themes of comfort, relaxation, escape, and reflection. This pilot project demonstrated the beneficial effects of music in a specific patient population that often struggles with symptom management when only pharmacologic management is used. These data more quantifiably elucidates tangible biological and psychosocial factors that are positively impacted by the intervention.

Do Hospitalized Premature Infants Benefit from Music Interventions? A Systematic Review of Randomized Controlled Trials

ObjectiveNeonatal intensive care units (NICU) around the world increasingly use music interventions. The most recent systematic review of randomized controlled trials (RCT) dates from 2009. Since then, 15 new RCTs have been published. We provide an updated systematic review on the possible benefits of music interventions on premature infants’ well-being.MethodsWe searched 13 electronic databases and 12 journals from their first available date until August 2016. Included were all RCTs published in English with at least 10 participants per group, including infants born prematurely and admitted to the NICU. Interventions were either recorded music interventions or live music therapy interventions. All control conditions were accepted as long as the effects of the music intervention could be analysed separately. A meta-analysis was not possible due to incompleteness and heterogeneity of the data.ResultsAfter removal of duplicates the searches retrieved 4893 citations, 20 of which fulfilled the inclusion/exclusion criteria. The 20 included studies encompassed 1128 participants receiving recorded or live music interventions in the NICU between 24 and 40 weeks gestational age. Twenty-six different outcomes were reported which we classified into three categories: physiological parameters; growth and feeding; behavioural state, relaxation outcomes and pain. Live music interventions were shown to improve sleep in three out of the four studies and heart rate in two out of the four studies. Recorded music improved heart rate in two out of six studies. Better feeding and sucking outcomes were reported in one study using live music and in two studies using recorded music.ConclusionsAlthough music interventions show promising results in some studies, the variation in quality of the studies, age groups, outcome measures and timing of the interventions across the studies makes it difficult to draw strong conclusions on the effects of music in premature infants.

Live wind music within an acute ward for people with dementia

Abstract This project sought to examine the effects of live music as an intervention to improve the well-being of people with dementia who had been admitted to an acute dementia assessment ward following severe psychological and behavioural distress. The literature search revealed little into the use of a group of musicians, none using a wind quintet (flute, oboe, clarinet, bassoon and horn), and few studies involving a group of wind musicians and people with dementia experiencing severe distress. Measurements were taken using Dementia Care Mapping (DCM) and the Bradford well-being and ill-being profiles. Data collected from individuals with dementia, carers, staff and players provided evidence to show that intervention using live group music had a positive effect upon individuals’ well-being. The number of participants was restricted to twelve – the capacity of the assessment unit – and there was no control group. This pilot study could lead to a larger, controlled research study. The interesting findings were observations of well-being in favour of ill-being in responses to the live music interventions. The precise mechanisms responsible for these affects appear complex, relating to both the musical and socially therapeutic dimensions of the intervention. An important secondary finding related to the positive effect of the whole process on musicians’ development in person-centred skills appropriate for working with people with severe dementia. The project also extended ward staff’s facilitation skills encouraging individuals’ participation in a new situation with a group of players on the ward.

Towards Prescribed Music in Clinical Contexts: More Than Words

The use of pre-recorded music has become status quo in a growing number of clinical music & medicine contexts. The process for choosing music used in both music therapy and music medicine interventions however has received surprisingly little attention in the literature, and might benefit from a more systematic approach. Applications made should ultimately provide for greater therapeutic efficacy. The following guidelines seek to contribute to the development of such a system in an effort to move toward a less arbitrary practice- thereby focusing greater attention to accurately match pre-recorded music to meet desired clinical goals. A systematic approach was developed and implemented in a music psychotherapy program which treated patients receiving radiation therapy for cancer in contexts in which the use of live music interventions were not feasible (e.g. during simulation for external beam radiation therapy and radiation therapy). The protocolized music therapy intervention that sought to address state anxiety in patients with cancer was examined in a randomized control study. This article will describe a developing system resulting from this study, thereby qualifying the clinical context of how musical decisions are made.

Effects of Music Intervention on Patients Undergoing Hemodialysis in the Bangkok Metropolitan Administration Hospitals

This research focused on the use of music interventions in 54 patients receiving hemodialysis treatments at the Bangkok Metropolitan Administration hospitals. The purpose of this study was to compare the effects of live music or music listening interventions on pre and postmeasures of patients’ blood pressure, pulse rate, pain, and anxiety. The results showed significant improvements in blood pressure and pulse rate and statistically significant reductions in pain and anxiety for patients in both music interventions (P < .05). There were no significant differences in these effects between live music intervention and music listening. Both kinds of music interventions were found to significantly reduce the rate of perceived pain and anxiety. It can be summarized that both types of music interventions can be used according to patients’ need and necessity, and concern of budget, personnel, and facility within each hospital are taken into consideration.

The Effects of Music Therapy on Vital Signs, Feeding, and Sleep in Premature Infants

Recorded music risks overstimulation in NICUs. The live elements of music such as rhythm, breath, and parent-preferred lullabies may affect physiologic function (eg, heart and respiratory rates, O2 saturation levels, and activity levels) and developmental function (eg, sleep, feeding behavior, and weight gain) in premature infants. A randomized clinical multisite trial of 272 premature infants aged ≥32 weeks with respiratory distress syndrome, clinical sepsis, and/or SGA (small for gestational age) served as their own controls in 11 NICUs. Infants received 3 interventions per week within a 2-week period, when data of physiologic and developmental domains were collected before, during, and after the interventions or no interventions and daily during a 2-week period. Three live music interventions showed changes in heart rate interactive with time. Lower heart rates occurred during the lullaby (P < .001) and rhythm intervention (P = .04). Sucking behavior showed differences with rhythm sound interventions (P = .03). Entrained breath sounds rendered lower heart rates after the intervention (P = .04) and differences in sleep patterns (P < .001). Caloric intake (P = .01) and sucking behavior (P = .02) were higher with parent-preferred lullabies. Music decreased parental stress perception (P < .001). The informed, intentional therapeutic use of live sound and parent-preferred lullabies applied by a certified music therapist can influence cardiac and respiratory function. Entrained with a premature infant's observed vital signs, sound and lullaby may improve feeding behaviors and sucking patterns and may increase prolonged periods of quiet-alert states. Parent-preferred lullabies, sung live, can enhance bonding, thus decreasing the stress parents associate with premature infant care.