Cortisol as an Acute Stress Biomarker in Young Hematopoietic Cell Transplant Patients/Caregivers: Active Music Engagement Protocol

Abstract

Objective: Primary aims of the proposed protocol are to determine the feasibility/acceptability of the active music engagement intervention protocol during hematopoietic stem cell transplantation (HSCT) and clinical feasibility/acceptability of the biological sample collection schedule. Design: The authors propose a single-case, alternating treatment design to compare levels of child and caregiver cortisol in blood and saliva collected on alternating days, when the dyad receives and does not receive AME sessions. Included are the scientific rationale for this design and detailed intervention and sample collection schedules based on transplant type. Setting/Location: Pediatric inpatient HSCT unit. Subjects: Eligible participants are dyads of children 3-8 years old, hospitalized for HSCT, and their caregiver. Children with malignant and nonmalignant conditions will be eligible, regardless of transplant type. Intervention: AME intervention is delivered by a board-certified music therapist who tailors music-based play experiences to encourage active engagement in, and independent use of, music play to manage the interrelated emotional distress experienced by children and their caregivers during HSCT. Dyads will receive two 45-min AME sessions each week during hospitalization. Outcome Measures: Eight collections of blood (child) and saliva (child/caregiver) will be performed for cortisol measurement. The authors will also collect self-report and caregiver proxy measures for dyad emotional distress, quality of life, and family function. At study conclusion, qualitative caregiver interviews will be conducted. Results: Planned analyses will be descriptive and evaluate the feasibility of participant recruitment, cortisol collection, planned evaluations, and AME delivery. Analysis of qualitative interviews will be used to gain an understanding about the ease/burden of biological sample collection and any perceived benefit of AME. Conclusions: Behavioral intervention studies examining biological mechanisms of action in pediatric transplant populations are rare. Findings will provide important information about the feasibility/acceptability

Depresssion, anxiety and other cognitive consequences of social isolation: Drug and non‐drug treatments

“…Physicians have found music therapy as a method to alleviate patients who had shown regression and weak sociability during housing isolation. 150 Two types of patients, adults in the general ward of the hospital and children with leukaemia in an isolated room, have experienced it as an enjoyable practice. 151 impairment.…”

Active Music Engagement and Cortisol as an Acute Stress Biomarker in Young Hematopoietic Stem Cell Transplant Patients and Caregivers: Results of a Single Case Design Pilot Study

“…As specified in our previously published protocol, the current study comprised two sets of aims (Russ et al, 2020). The primary aims were to: determine feasibility/acceptability of the AME intervention protocol during HSCT; evaluate clinical feasibility/acceptability of collecting data in this context, including collection of biological samples according to a rigorous schedule required when using a single-case design; and assess caregivers' perspectives about the collection of these samples.…”

“…To overcome these challenges, we used a single-case design study, which allows for estimation of intervention effects in small samples that are drawn from low-incidence populations. Details of the study protocol were published by Russ et al (2020), with outcomes reported in this manuscript.…”

Effekte von Musik in der Intensivmedizin

“…Es ist unstrittig, dass Kortisol als akuter Biomarker für Stress angesehen werden kann [ 40 ]. In einigen Studien über die Wirkung von Musik und Stress wurde Kortisol als „Stressparameter“ herangezogen.…”