The effects of single-session music therapy interventions on the observed and self-reported levels of pain control, physical comfort, and relaxation of hospice patients.

摘要

This article describes the process and results of a three-month music therapy clinical effectiveness study conducted with terminally ill patients. The purpose of this study was to quantify and evaluate the effectiveness of single-session music therapy interventions with hospice patients in three patient problem areas: pain control; physical comfort; and relaxation. Data from a total of 90 sessions conducted with a total of 80 subjects served by Hospice of Palm Beach County, Florida, were included in the study. Music therapy services were provided by five board-certified music therapists and one music therapist eligible for board certification. The subjects in this study were receiving regularly scheduled music therapy services from the hospice organization. The study used both behavioral observation and subject's self-reporting as methods of data reporting and recording. Subjects were observed for, or self-reported, their levels of pain control, physical comfort, and relaxation, both before and after each music therapy session. The subjects were served in the environments where music therapy services would normally be delivered (i.e., home, hospital, nursing home, or inpatient acute-care unit of the hospice organization). Music therapy services included live active and passive music-based experiences. These were designed to build and to establish rapport with patient or family, to facilitate family interaction and patient control, to provide support and comfort, to facilitate relaxation, to enable reminiscence and life review, to provide a frame-work for spiritual exploration and validation, and to encourage the identification and expression of feelings of anticipatory mourning and grief. A total of six hypotheses stated that there would be significant pre- to postsession differences in each of the three variables: pain control, physical comfort, and relaxation, as measured during two different session and data collection scenarios. These scenarios included the independent observation and recording of the three subject variables and the subject's self-report of each variable. Reliability correlation coefficients were calculated for each of the different session and data-collection scenarios to help assess the correlation between primary and reliability observers. Pearson product moment correlations indicated reliability agreement coefficients of r = .85 and r = .90. One-tailed t-tests were performed on the collected data for subject pain control, physical comfort, and relaxation. Results of the t-tests were significant at the p < or = .001 (for observed pain control, physical comfort, and relaxation) and p < or = 005 (for self-reported pain control, physical comfort, and relaxation) levels. These results suggest that single-session music therapy interventions appear to be effective in increasing subject pain control, physical comfort, and relaxation during both data collection scenarios. Based on the results of these tests of the analyzed data, the hypotheses were all accepted. Tables illustrate pre- to post-session changes in levels of all three variables from both session and data-collection scenarios. Copies of the data-collection forms are also included in the Appendix. The discussion section addresses limitations of this study and suggestions for future studies.