Utilization of Music Therapy in Palliative and Hospice Care

Abstract

The purpose of this integrative review was to discuss the utilization and effectiveness of music therapy as an adjunct therapy in symptom management for adult patients in palliative care and/or hospice. This review sought to extend empirical knowledge for the use of music as a therapeutic modality by determining which symptoms are most commonly treated with music interventions and how efficacious treatments are. Guided by the Roy Adaptation Model, music is a positive stimulus to improve coping for patients at end of life. An extensive search using CINAHL and the keywords music therapy, hospice, and symptom management was performed for the period of 2006 to 2013. Inclusion criteria were English language, peer reviewed, adult, and use of music as a therapy for symptom management. Exclusion criteria were articles related to program development/evaluation, pediatrics, mechanical injury symptoms, and nonresearch. Seventeen articles were selected for this review. Anxiety and pain were found to be the most commonly addressed symptoms by music therapy, and the interventions decreased the intensity of these symptoms. Limitations included nonrandom sampling and small sample sizes in 6 studies. Most of these studies were of moderate levels of evidence. Implications for advanced practice nurse practice, education, and research are addressed.

Patient’s and health care provider’s perspectives on music therapy in palliative care – an integrative review

“…However, Quality of life as well as relaxation and fatigue did not show clearly positive or negative results in the studies (Table 4 ). These findings are in line with research conducted earlier [ 4 , 12 ]. Nakayama and colleagues [ 20 ] employed the salivary cortisol level to measure stress in participants, and found significant lowering of levels after music therapy session.…”

“…We have been able to identify only one integrative review with the focus of MT in palliative care [ 12 ]. According to this review, music is a positive stimulus to improve coping for patients at the end of life.…”

Music Therapy Is Associated With Family Perception of More Spiritual Support and Decreased Breathing Problems in Cancer Patients Receiving Hospice Care

“…Anxiety and pain are common reasons for referral to music therapy; however, research supporting the use of music therapy to decrease anxiety and pain is equivocal. 7,9,10,25 Improvisation, songwriting, and pairing live or recorded music with imagery experiences are examples of common interventions used by hospice music therapists. 26 These interventions are differentially effective when targeting anxiety and stress related outcomes.…”

“…Systematic reviews summarizing the available quantitative evidence for music therapy in hospice and cancer care arrive at similar conclusions: preliminary evidence from small scale studies included in reviews suggests music therapy interventions may be beneficial in decreasing patient-perceived anxiety and pain and improving quality of life. 7,[9][10][11] Studies published after the most recent reviews as well as interpretive research provide further support that music therapy improves quality of life, specifically in terms of psychophysiological issues such as anxiety, pain, and shortness of breath as well as spirituality. [12][13][14][15] Interpretive research describes patients and families experience music and music therapy as providing ways to remain connected to self and others, a means for expression, and a way to stimulate reminiscence and life review.…”

“…5 Emotional distress, pain management, and attention to spiritual needs are critical to high quality end of life care. [6][7][8] Despite widespread use of music therapy in hospice care, empirical evidence of benefit is sparse. Systematic reviews summarizing the available quantitative evidence for music therapy in hospice and cancer care arrive at similar conclusions: preliminary evidence from small scale studies included in reviews suggests music therapy interventions may be beneficial in decreasing patient-perceived anxiety and pain and improving quality of life.…”