Heterogeneity in Danish lung choirs and their singing leaders: delivery, approach, and experiences: a survey-based study

Abstract

ObjectivesSinging is considered a beneficial leisure time intervention for people with respiratory diseases, and lung choirs have gained increasing attention. However, there is no available guideline on preferred methodology, and hence, outcomes, delivery, and benefits are unclear. The present study investigated for the first time ever emerged delivery, approach, and experiences in Danish lung choirs and their singing leaders, hypothesising the array to be heterogeneous, without disease-specific approach, and a challenging field to navigate for the singing leaders.SettingAn online survey comprising 25 questions was performed individually, May 2017, in Denmark.ParticipantsCurrent singing leaders of Danish lung choirs, identified by hand searches on the internet. In total, 33 singing leaders in formal and informal settings were identified and 20 (67%) responded.Primary and secondary outcome measuresDistribution in content, delivery, and approach; level of disease-specific knowledge and modification; experience of challenges and benefits. Quantitative variables were counted, and an inductive content analysis approach was used for the qualitative study component.ResultsThe lung choirs were heterogeneous concerning setting, duration, and content. The approach was traditional without disease-specific content or physical activity. Most singing leaders held various academic degrees in music, but lacked skills in lung diseases. However, they experienced lung choirs as a highly meaningful activity, and reported that participants benefited both musically, psychosocially, and physically. Singing leaders were enthusiastic regarding potentials in the ‘arts-and-health’ cross-field and experienced an expansion of their role and overall purpose, professionally as well as personally. However, they also experienced insecurity, inadequacy, and isolation, and requested methodological guidelines, formal support, and peer network.ConclusionDanish lung choirs are led without any disease-specific guideline or methodological approach. Further studies are needed to develop and distribute a preferred methodological approach.Trial registration numberThis study is linked to clinical trial number NCT03280355 and was performed prior to data collection and results of the clinical trial

Use of Singing for Lung Health as an alternative training modality within pulmonary rehabilitation for COPD: a randomised controlled trial

“…This aligns well with recommendations on both physical and psychosocial elements in PR [1,3]. So far, SLH is the best documented singing training programme in respiratory disease, though the evidence is primarily based on qualitative research [10,24,29,30]. Several studies suggest that SLH improves QoL [11,19,20], yet we did not find that SLH improved QoL significantly (secondary outcome) (Table 3).…”

“…Currently, there is no international consensus guideline on singing as a training intervention for lung disease. Generally, singing for people with respiratory disease has evolved as a leisure activity rather than a structured health-related activity, and most lung choirs still have heterogeneous leadership and lack of standard training or guideline [10,24,29,30]. The British Lung Foundation initiative SLH includes systematic training of singing teachers in lung physiology/pathophysiology and a methodological approach to singing as a physical activity providing respiratory control [10,27,28].…”

“…In regard to physical outcomes, singing may improve respiratory muscle strength, coordination, and performance [14,15,[21][22][23], reduce hyperinflation [10,24], improve lung function [25], and may enhance functional exercise capacity in COPD [14,26]. The specific methodological concept "Singing for Lung Health" (SLH) was developed in the UK [10,24,27,28], and has become increasingly popular, although heterogenous singing approaches are applied in other countries [24,29,30]. The growing body of research on SLH and singing in COPD is mostly based on small-scale and descriptive studies without primary focus on key objective variables, relevant in PR research [1,10,14,24,29].…”

Physiological changes related to 10 weeks of singing for lung health in patients with COPD

“…Singing has become widely acknowledged as a beneficial activity for people living with chronic respiratory disease and is proposed to improve physical, psychological, and social health. 1 2 An initial body of research in respiratory disease suggests that singing addresses dyspnoea control, 3–10 improves exercise capacity, 4 11 12 enhances quality of life (QoL), 3 4 13 14 and reduces anxiety and depression. 14 Moreover, singing with peers builds meaningful cohesion and reduces experiences of isolation.…”

“… 14 Moreover, singing with peers builds meaningful cohesion and reduces experiences of isolation. 1 3 4 15–20 …”