BackgroundMusic therapy is increasingly used as an adjunct therapy to support symptom management in palliative care. However, studies to date have paid little attention to the processes that lead to changes in patient outcomes. To fill this gap, we examined the processes and experiences involved in the introduction of music therapy as an adjunct complementary therapy to palliative care in a hospice setting in the United Kingdom (UK).MethodsUsing a realistic evaluation approach, we conducted a qualitative study using a variety of approaches. These consisted of open text answers from patients (n = 16) on how music therapy helped meet their needs within one hospice in Northern Ireland, UK. We also conducted three focus groups with a range of palliative care practitioners (seven physicians, seven nursing staff, two social workers and three allied health professionals) to help understand their perspectives on music therapy’s impact on their work setting, and what influences its successful implementation. This was supplemented with an interview with the music therapist delivering the intervention.ResultsMusic therapy contains multiple mechanisms that can provide physical, psychological, emotional, expressive, existential and social support. There is also evidence that the hospice context, animated by a holistic approach to healthcare, is an important facilitator of the effects of music therapy. Examination of patients’ responses helped identify specific benefits for different types of patients.ConclusionsThere is a synergy between the therapeutic aims of music therapy and those of palliative care, which appealed to a significant proportion of participants, who perceived it as effective.Electronic supplementary materialThe online version of this article (10.1186/s12904-017-0253-5) contains supplementary material, which is available to authorized users.
In this small sample of patients with bronchiolitis, B lines were associated with older age and an absence of atopic features. Lung ultrasound interpretation had poor interrater reliability.
BackgroundMusic therapy is frequently used as a palliative therapy. In consonance with the goals of palliative care, the primary aim of music therapy is to improve people’s quality of life by addressing their psychological needs and facilitating communication. To date, primarily because of a paucity of robust research, the evidence for music therapy’s effectiveness on patient reported outcomes is positive but weak. This pilot and feasibility study will test procedures, outcomes and validated tools; estimate recruitment and attrition rates; and calculate the sample size required for a phase III randomised trial to evaluate the effectiveness of music therapy in improving the quality of life of palliative care patients.MethodsA pilot randomised controlled trial supplemented with qualitative methods. The quantitative data collection will involve recruitment of >52 patients from an inpatient Marie Curie hospice setting over a 12-month period. Eligibility criteria include all patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 03− indicating they are medically fit to engage with music therapy and an Abbreviated Mental Test (AMT) score of ≥7 indicating they are capable of providing meaningful informed consent and accurate responses to outcome measures. Baseline data collection will include the McGill Quality of Life Questionnaire (MQOL); medical and socio-demographic data will be undertaken before randomisation to an intervention or control group. Participants in the intervention arm will be offered two 30–45 min sessions of music therapy per week for three consecutive weeks, in addition to care as usual. Participants in the control arm will receive care as usual. Follow-up measures will be administered in 1, 3 and 5 weeks. Qualitative data collection will involve focus group and individual interviews with HCPs and carers.DiscussionThis study will ensure a firm methodological grounding for the development of a robust phase III randomised trial of music therapy for improving quality of life in palliative care patients. By undertaking the pilot and feasibility trial under normal clinical conditions in a hospice setting, the trial will result in reliable procedures to overcome some of the difficulties in designing music therapy RCTs for palliative care settings.Trial registrationClinicaltrials.gov Identifier: NCT02791048 Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-016-0111-x) contains supplementary material, which is available to authorized users.
Children with emotional difficulties often experience problems at school in terms of academic progress and within peer relationships. They are also more likely to continue to experience emotional problems in their adult lives. Nurture groups (NGs) were developed in the 1960s by the educational psychologist Majorie Boxall and their aim is to improve the emotional well-being of children who are struggling, through providing them with reparative attachment experiences. This review aims to evaluate the effectiveness of NGs. Eleven papers examining the effectiveness of NGs were included, as well as two papers which explore the particular communication styles adopted by NG teachers. There was evidence that NGs are effective in improving the emotional wellbeing of children, but there is a need for higher quality and longitudinal research. There is a paucity of research into secondary school NGs. The review highlighted the NG teachers' use of more positive verbal and non-verbal behaviour. Implications for future research are discussed.
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