Why Practitioners Should Care About Music Therapy: Understanding its Clinical Relevance and Practical Implications Through an Evidence-Based Study

摘要

Background: With healthcare costs steadily rising, cost-effective alternatives to traditional medical approaches are needed. Specifically, music therapy (MT), a form of complementary and alternative medicine (CAM), is shown to alleviate symptoms of an illness and improve overall well-being, as well as enhance allopathic treatment modalities, making it appropriate for use in various healthcare settings covered under many different payment schedules today. With interdisciplinary healthcare teams becoming the norm in practice, it is increasingly important that practitioners trained allopathi-cally understand the importance of CAM and certain types of CAM practices such as MT that can provide important benefits for patients. Under the Patient Protection and Affordable Care Act of 2010 (PPACA), not only is wellness and well-being emphasized as part of overall healthcare goals, it is also reimbursable. Therefore, although some CAM practices such as MT require special licensure in order to serve clients specifically, any healthcare practitioner can understand and refer patients to MT services, as well as utilize aspects of MT within their own practice areas. Further, as the field of MT and appreciation for its benefits grows, evidence-based practice in MT is also essential. Therefore, research in CAM and MT furthers the overall acceptance over time by interdisciplinary teams, thereby increasing beneficial care approaches for patients. The purpose of this study was to identify and understand differences between physicians' (doctor of medicine [MD], doctor of osteopathic medicine [DO]) and non-physician practitioners' (nurse practitioners [NP], certified registered nurse anesthetists [CRNA], certified nurse rnidwives [CNM], physician assistants [PA], and clinical nurse specialists [CNS]) recommending practices, knowledge, and perspectives (attitudes, beliefs, and expectations) of MT as CAM. Clinically, understanding these differences is important to all practitioners so that they can better determine cost-effective means by which to enhance patient care within the confines of allopathic practice under the PPACA, Medicare, Medicaid, and private insurance payment structures today. Materials and Methods: A quantitative methodology with a descriptive, exploratory, cross-sectional, and correlational research design was used to measure recommending practices, knowledge, attitudes, beliefs, and expectations of physicians and non-physician practitioners utilizing a principal investigator-created valid and reliable tool entitled the Global Complementary/Alternative and Music Therapy Assessment (GCAMTA). A sample of 237 physician and 307 non-physician (total N= 544) practitioners participated. Data were continually collected electronically during a six-month period using various social media platforms: Facebook, Twitter, and Linkedln. Additionally, access was provided to membership in several professional healthcare associations to recruit participants. Results: The GCAMTA revealed that 84.8% of physicians (MD/DO; 77 = 201/237) responded neutrally in their recommending practices, knowledge, attitudes, beliefs, and expectations toward MT as a CAM for their patients. Additionally, 86.6% of non-physician practitioners (NP, NA, CNM, CNS, PA; n = 266/307) responded more favorably toward MT as a CAM. For practitioners exhibiting higher knowledge of MT as a potential CAM (n = 207/307 [67.4%] non-physician practitioners vs. n = 36/237 [15.2%] MD/DO), favorability toward recommending MT as a CAM was also high. Results of the multivariate analysis of variance across all five dependent variables were statistically significant (p = 0.0001; a = 0.01). Conclusion: Educational curricula may contribute to the discrepancy in the views between physicians and non-physician practitioners. Traditional allopathic curricula may need to include teachings in holistic medicine in order to increase awareness of CAM such as MT.