A music therapy support group to ameliorate psychological distress in adults with coronary heart disease in a rural community.

摘要

The purpose of this study was to examine the effect of a music therapy support group on depression, anxiety, anger/hostility, and stress of adults with coronary heart disease. The study used a split-plot factorial design with random assignment of participants to the music therapy experimental group or the wait-list comparison group. Depression, anxiety, anger/hostility, and total mood disturbance were measured with Profile of Mood States -- Short Form (POMS-SF; McNair, Lorr, & Droppleman, 1992). Stress was measured with the intensity value of Hassles Scale (HS; Kanner, Coyne, Schaefer, & Lazarus, 1981). The measures were administered at pre-test, post-test, and four-week follow-up. The experimental group completed a satisfaction survey at post-test to offer their opinions about the components of the music therapy treatment including the interventions, the length of treatment, and the music therapist. Seven women and six men (n = 13) completed the protocol through follow-up with eight participants assigned to the experimental group and five participants assigned to the comparison group. The mean age was 68 years old. Music therapy sessions were held weekly for six weeks and lasted for 1.5 hours. The purpose of the group was to improve participant functioning in the areas of identification and expression of the feelings. The sessions included active and receptive music therapy experiences consisting of an opening check-in, music-assisted relaxation (MAR), active music therapy interventions, and a closing. The active music therapy interventions included expressive singing, song lyric analysis, songwriting, and instrumental improvisation. Topics included active listening, recognizing personal strengths, coping with change, assertiveness, expressing feelings, resolving conflict, learning/maintaining new health-protective behaviors, and celebrating accomplishments. As determined by repeated measures ANOVA, the results indicated that there was no difference between groups at all data collection points for the depression, anger/hostility, and stress dependent variables. For total mood disturbance, there was a marginally significant difference between groups. A post-hoc t-test between groups showed that there was a significant difference between groups at post-test, t(1) = -2.41, p = .03 that was not sustained at follow-up. For tension-anxiety, the repeated measures ANOVA indicated a group by time interaction that approached significance, p = .06. A simple effects analysis revealed that the participants in the experimental group reported a significant decrease in tension-anxiety at posttest, which was no longer present at follow-up. In an unanticipated finding, the experimental group reported a significant increase in vigor-activity at posttest that was not sustained at follow-up. Findings suggest that a weekly six-week music therapy group may be effective in reducing total mood disturbance and tension-anxiety for adults with coronary heart disease at least in the short-term. Additionally, music therapy may help to increase vigor and activity levels; therefore, increasing compliance with the lifestyle changes associated with heart disease (Dornelas, 2008). Increased treatment compliance may help decrease complications from heart disease, including morbidity and mortality, helping the individual to demonstrate their personal performance of health (Ruud, 2010). Should future studies support these findings, music therapists are encouraged to provide group music therapy programs consisting of both active and receptive interventions for adults with heart disease.