Background: Head and neck cancer patients often suffer from dysphagia after surgery and radiotherapy. A singing-enhanced swallowing protocol was established to improve their swallowing function. This study aimed to evaluate the beneficial effects of therapeutic singing on dysphagia in head and neck cancer (HNC) patients. Methods: Patients who participated in this study were allocated to the intervention group (15 patients) and the control group (13 patients). Patients assigned to the intervention group received therapeutic singing 3 times per week for 4 weeks. Each group was divided into 2 subgroups, including the oral cavity cancer group and the pharyngeal cancer group. The patients’ vocal functions were evaluated in maximum phonation time, pitch, intensity, jitter, shimmer, harmonics to noise ratio, and laryngeal diadochokinesis (L-DDK). To evaluate swallowing function, videofluoroscopic swallowing study was done, and the results were analyzed by videofluoroscopic dysphagia scale (VDS) and dynamic imaging grade of swallowing toxicity (DIGEST). Results: Among the voice parameters, L-DDK of the intervention group significantly increased compared to that of the control group. Swallowing functions of the intervention group were significantly improved in VDS and DIGEST after the intervention. Detailed items of VDS and DIGEST showed improvements especially in the pharyngeal phase score of VDS, such as laryngeal elevation, pharyngeal transit time, and aspiration. In addition, the pharyngeal cancer group showed significant improvements in VDS and DIGEST scores after the intervention. Conclusions: Our outcomes highlight the beneficial effects of singing for HNC patients with dysphagia. The notable improvements in the pharyngeal phase suggest that therapeutic singing would be more appropriate for HNC patients who need to improve their intrinsic muscle movements of vocal fold and laryngeal elevation.
This study aimed to investigate the effects of patient-directed interactive music on saliva melatonin levels and sleep quality among postoperative elderly patients in the intensive care unit (ICU). Patients and Methods: A total of 133 elderly patients were randomized into three groups: interactive music therapy (IMT), passive listening (PL), and the control group. The control group (n = 45) received routine medical care, while IMT and PL groups received music therapy on ICU day 1. The IMT group received up to 20 mins of interactive music sessions, including relaxation techniques. The PL group received only pre-selected relaxing musiclistening for 30 mins. Saliva melatonin and cortisol levels were measured three times at 11 p.m. (preoperative, operation day, and postoperative day [POD] 1). The Richards-Campbell Sleep Questionnaire (RCSQ) and Quality of Recovery-40 questionnaire (QoR40) were administered on the preoperative day, as well as PODs 1 and 2. Results: The RCSQ showed a significant improvement in the IMT group compared to the control group on POD2 (71.50 vs 56.89, p=0.012), but the QoR40 did not show any difference between groups. The quality control of the saliva sample was not available due to the immediate postoperative patient's condition, resulting in a higher dropout rate. Saliva melatonin levels on POD 1 were elevated in the IMT group compared to the control group (1.45 vs 0.04, p=0.0068). The cortisol level did not show a significant difference between groups. Conclusion: Single IMT intervention improved subjectively assessed short-term sleep quality in postoperative elderly patients. It is difficult to conclude whether music therapy intervention affects the level of melatonin and cortisol. Trial Registration: The study was registered at ClinicalTrials.Gov (number NCT03156205).
Swallowing difficulties are a common complaint among patients with a variety of diseases. To address these concerns, a singing-enhanced swallowing protocol was constructed, and its differential benefits for two patient populations were investigated. Two patients with Parkinson’s disease (PD) and two patients with head and neck cancer (HNC) participated in this study. Each patient participated in 30-min individual sessions of a singing-enhanced swallowing protocol two times per week for 12 weeks. Following the intervention, laryngeal diadochokinesis and quality-of-life measurements were found to be higher in all four patients. However, the Videofluoroscopic Dysphagia Scale showed this improvement was associated with different swallowing tasks for each patient group. In addition, the maximum phonation time decreased for patients with HNC, while it increased for patients with PD. The findings support the use of a singing-enhanced swallowing protocol for patients whose swallowing difficulties are due to neurological or structural impairment. In addition, the study results suggest that different intervention components should be considered depending on the etiology of the patient’s swallowing difficulties.
This study aimed to investigate level of the psychological health of family caregivers of critically ill patients, considering quality of life and depression, and whether it varied depending on their individualized music use. A survey was administered in a surgical intensive care unit (ICU) of a university hospital. Adult family caregivers of ICU patients older than 18 years of age were included. Depression and quality of life were measured via self-administered scales, and emotional states were evaluated using a visual analog scale. Music use in daily life was also queried. A total of 195 caregivers (mean age, 51.2 years) participated in this study (spouses 44.6%, offspring 51.3%, and parents 4.1%). Among respondents, 44.6% were at high risk of depression, and 18.0% of these respondents reported their quality of life as poor or very poor. In terms of singing in their everyday lives, respondents who had singing experience reported higher quality of life and lower depression than those without singing experience. The results of this study support the active engagement in music as resource for caregivers of ICU patients to alleviate their emotional distress. Further investigation into diversified music use and music intervention in critical care should focus on the inclusion of family caregivers.
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