EVIDENCE-BASED NURSING PRACTICE PROJECT

Music therapy for pain management: Article Review

Bradt, J., Potvin, N., Kesslick, A., Shim, M., Radl, D., Schriver, E., et al. (2015). The Impact of Music Therapy Versus Music Medicine on Psychological Outcomes and Pain in Cancer Patients: A Mixed Methods Study. Support Care Cancer, 1261-1271.

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This article represents a study that was carried out to offer a comparison between the impact of music therapy and music medicine interventions on the psychological results and pain management among cancer patients. The paper further aims to offer an understanding the experience of patients with the application of the two types of music interventions. The research has been carried out following a mixed methods intervention design making use of qualitative data gathered through a randomized cross-over trial. The participants of the study were engaged in two sessions of interactive music making with a music therapist and two sessions of listening to recorded music in absence of a music therapist. The study ensured that the respondent reported of their mood, anxiety level, relaxation and pain before commencement of the sessions through methods such as visual analogue and numeric rating scales. 

The article identifies how music interventions have been adopted to deal with different varieties of symptoms among cancer patients ranging from anxiety, stress, moods variations, and pain. The article identifies different ways in which music is applied for interventions such as music listening coming from the patients, music medicine that involves pre-recorded music introduced by a physician to deal with a particular symptom and as music therapy where music is used to attain psychotherapeutic goals. Music therapy involves listening to live, improvised, or already recorded music, playing music instruments, adapting songs and composing new music. 

Evidence from other articles

The article by Vaarala (2014) was aimed to determining the effects of music on chronic pain. The evidence from this article supported the findings of Bradt et al (2015) that music has positive effect on chronic pain. The article further asserted that use of music decreases the sensation of pain. The article offered more insights into the effect of music therapy in pain management by indicating the most commonly used genres of music which include classical, pop, and relaxing music as they were found to have more effects on pain. the article indicated that one crucial attribute that is considered when choosing the music to use for pain management was rhythm where slow, repetitive, and steady rhythm were considered to be most effective in soothing he listener. The study was very supportive of using music for pain management as it was found to have ongoing effect on the patients’ pain. the period and frequency of listening to music were found to be equally important in helping decrease the pain (Vaarala, 2014).

The article by Jafari et al (2012) adds weight by supporting the idea of using music therapy for pain management. The paper considers the use  of music as an effective, non-medicinal, relatively cheap, and non-invasive method with no sideeffects for pain management following an open heart surgery. The paper reviews how music has had a long history in helping reduce discomfort. The paper indicates historical evidence where the Egytptions used muisc to treat infertility while the Iranians uses music instruments to deal with differen situations. In nursing practice, the article has indicated how music is an taken as an effective intervention to deal with pain, stress, and anxiety. It also indicated how music has been though to increase the level of comfort and immunity and help enhance the vital signs (Jafari et al, 2012). 

The article by Jasemi, et al. (2013), echoes the support for the importance of usng music therapy for pain management by carrying out a study to evaluate the effects of music therapy on pain in some cancer patients. the article comes up with a supportive conclusion that urges the health care providers to make use of music and help the cancer patients in easing their pain. It was observed that use of anelgesics can be addictive and its usage for a long period of time may result to drug dependency, hypotensin, weakening of vital functions, drowsiness, nausea, and vomiting (Jasemi, et al., 2013). Other methods were found to be time consuming and inflicting high costs to the health care systems. For thse reasons , it is recommended to use the non-pharmacoloical methids in relieveing pain. music therapy has been recommended as a means  of helping in relieving pain. 

The article by Gutgsell  et al, (2013) offers support for the use of music therapy as  a method of pain management. The article represents a study conducted to determine how musix therapy reduces pain in palliative care patients. the study  aimed to evaluate the efficacy of a sole music therapy session in reducing pain palliative care patients. it was established that usinga  single music intervention involvng a therapist-guided autogenic relaxation and live music was helpful in reducing the pain in palliative care patients.

Article with best design

The study by Bradt, et al. (2015)makes use of a mixed methods of intervention design that involves qualitative data embedded within a randomized cross-over trial. The study made use of both qualitative and quantitative dats and intergrated them to help acquire the benefits of each data set. the qualitative data was collected through semi-structured exit interviews and this was mixed up within a randomized controlled test. The study can be said to have a better design as it allows the research methodology to be guided by research questions other than holding a priori believe on the superiority of a specific design. The use of interviews allowed for a greater understanding of the patients conditions.

Problem statement

The article by Vaarela (2014) has a clearly identified purpose of study. its purpose clearly points out to the aims the article seeks to achieve. This includes determinining the genre of music mostly used for pain management, indicatingt he conditions required for music to be listened as therapy and determine the influence of music on different psychological factor among patients with chronic pain. the problem statement can be considered as the most clear as it has been put in clear terms which avoids ambiguity (Nieswiadomy, 2012). It further shows the specific knowledge that the study aims to acquire.

Article with best sample size

The article by Gutgsell, et al, can be said to have the best sample size among the five  articles selected. The article uses 200 hundred inpatients from the University case Medical Center enrolled between 2009 to 2011. This numbers is more representative as opposed to other articles using sixty and thirty participants. A good sample size should allow for the extrapolation of results to the whole population and should thus be representative enough of the whole population. The time frame within which these patients were admitted in also wider thereby increasing the significance level of this population (Nieswiadomy, 2012).

Article with Best Conclusion

The article by Bradt et al. (2015) can be said to draw the best conclusion from the findings. The findings of the study indicate that the use of music therapy and music medicine have similar effect in attaining target outcomes. 77.4% of the participants showed more preference for the music therapy. The music therapy session were also found out to help participants engage more their inner resources including playfulness and creativity. From these finding, the article concluded by calling for the use of music in cancer care. The conclusion further notes that treatment benefits may be varied due for aspects of patient characteristics. 

Comparison with the National Guidelines

The articles’ findings match with American Music Therapy Association guidelines that indicate how music therapy makes a difference by being an efficacious and valid treatment option for pain management among patients. The guidelines indicated that music therapy can be useful in helping out patients deal with pain during physical rehabilitation, cardiac conditions, surgery, obstetrics, oncology, and burn. The analysis of the articles looked in some of these areas also. Just like as it was identified from the articles, music therapy is a client-based treatment plan and the music therapists assist the patients attain their objectives in pain management. The guideline offers a music protocol that follows a cognitive behavioral model of therapy to create new thoughts, feelings, and conditions that overlap the dysfunctional patterns ( (American Music Therapy Association, 2010)

References

American Music Therapy Association. (2010). Music Therpay and Music-based Interventions in the Treatment and Management of Pain. 

Bradt, J., Potvin, N., Kesslick, A., Shim, M., Radl, D., Schriver, E., et al. (2015). The Impact of Music Therapy Versus Music Medicine on Psychological Outcomes and Pain in Cancer Patients: A Mixed Methods Study. Support Care Cancer, 1261-1271.

Gutgsell, K., Schluchter, M., Margevicius, S., DeGolia, P., McLaughlin, B., Mecklenburg, J., et al. (2013). Music Therapy Reduces Pain in Palliative Care Patients: A Randomized Controlled Trial. Journal of Pain and Symptom Management , Vol. 45 No. 5.

Jafari, H., Zeydi, A., Khani, S., & Esmaeili, R. S. (2012). The Effects of Listening to Preferred Music on Pain Intesity after Open Heart Surgery. Iranian Journal of NUrsing and Midwifery Research , Vol 17, Issue 1.

Jasemi, M., Eghtedar, S., Aghakhani, N., Khodabandeh, F., Sayadi, L., & Khahi, N. (2013). Music Therapy Reduces the Intensity of Pain Among Patients with Cancer. Thrita Journal, 76-79.

Nieswiadomy, R. M. (2012). Foundations of Nursing Research (6th ed.). Boston: Pearson. 978-0-13-211857-6

Vaarala, O. (2014). The Effects of Music on Chronic Pain. Nursing Social Services, Health and Sports.

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