Fifteen-minute music intervention reduces pre-radiotherapy anxiety in oncology patients
Introduction
Oncology patients often respond to their cancer diagnosis and treatment, including chemotherapy (Lin et al., 2011) and radiation (Chaturvedi et al., 1996; Clark et al., 2006), with emotional symptoms such as anxiety, depression and stress, as well as fear, frustration, loneliness and feelings of loss of control (Magill, 2006).
Music therapy is an evidence-based complementary therapy commonly used in integrative oncology treatment programs (Magill, 2006; Hilliard, 2006). Music therapy has been applied successfully in various clinical settings to help reduce anxiety. Music has improved mood and decreased anxiety and pain associated with surgery, medical procedures, and chronic conditions, as well as helping to improve quality of life during end-of-life care (Kemper and Danhauer, 2005). In integrative oncology, music therapy has been introduced to treat multiple symptoms such as pain, mood disturbances, and communication issues; besides ameliorating pain and anxiety symptoms, it specifically reduced effects of noxious stimuli and enhanced mood and overall feelings of comfort and sense of control (Magill, 2006). Music therapy has also effectively reduced chemotherapy-induced anxiety (Bulfone et al., 2009; Ferrer, 2007; Lin et al., 2011). Acknowledging the high level of fear and anxiety that may be present before and during radiation treatments, Smith et al. (2001) suggested that modifying the treatment environment is one way to address the psychological well-being of patients with cancer, and further suggested that music therapy was an effective therapeutic intervention to moderate treatment-related anxiety (Smith et al., 2001). Music therapy significantly reduced anxiety, current distress and weekly distress in response to radiotherapy (Clark et al., 2006). Introducing music therapy into a pediatric radiotherapy waiting area reduced patients' anxiety and stress as well as that of family members and staff involved in their healthcare program (O'Callaghan et al., 2007). In a mixed-methods analysis, measured effects of a computer-based music CD created by pediatric oncology patients undergoing initial radiotherapy revealed that 67% of children receiving standard care used social withdrawal as a coping mechanism for treatment-related distress but no children in the music therapy group withdrew socially (Barry et al., 2010).
Although both quantitative results (Smith et al., 2001; Clark et al., 2006) and qualitative outcomes (O'Callaghan et al., 2007) of music therapy were promising in terms of reducing anxiety and stress for patients receiving radiation treatments, the music therapy procedures described in these previous studies were diverse. The timing of receiving music therapy in relationship to radiation was also not consistent with the various methods in previous studies. O'Callaghan offered music therapy when the patients were waiting for medical consultations and radiotherapy treatments, Smith's group allowed the patients to listen to the music during their radiation therapy simulation appointment and also during their daily radiation treatments, and Clark's group directed the music therapist to instruct participants to listen to the music at any time during the course of therapy.
We hypothesized that music therapy received in the Radiology waiting room may be able to reduce anxiety and improve anxiety-related physiological parameters in oncology patients prior to undergoing radiotherapy. Therefore, we aimed to evaluate the physiological (e.g., blood pressure) and psychological effects (e.g., anxiety) of a single music intervention delivered to patients prior to a single radiation treatment.
Section snippets
Design
A quasi-experimental study was conducted. Pre- and post-test data were collected from a purposeful sample between April 1, 2011 and October 31, 2011 at the Department of Radiation, Oncology, at Far Eastern Memorial Hospital, Taipei, Taiwan. The internal review board of the hospital reviewed the study protocol and approved the study.
Participants
Patients who were scheduled to receive a treatment protocol of radiation therapy lasting about 5 weeks or more and who were at least 18 years old, were purposefully
Results
Demographic data and baseline characteristics of music group and control group subjects were comparable (Table 1). No significant differences were found between groups in the pre-test (baseline) STAI-S/STAI-T scores and vital signs before intervention (P > 0.05). However, a significant difference was found in oxygen saturation between the two groups (P = 0.005).
Mean changes in STAI-S and STAI-T scores from baseline to post-test are shown in Table 2. Significant decreases were observed in STAI-S
Discussion
In this study, we investigated the effects of music intervention on reducing pre-radiotherapy anxiety in oncology patients. A music group received 15 min of music therapy prior to undergoing one radiation treatment and a control group only had 15 min of rest before radiation. Significant differences were shown in pre- to post-test State and Trait scores in both the music group and the control group. More importantly, a significant increase in mean change was observed in the music group in
Conflict of interest statement
None declared.
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