Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T04:43:01.017Z Has data issue: false hasContentIssue false

Soothing the heart with music: A feasibility study of a bedside music therapy intervention for critically ill patients in an urban hospital setting

Published online by Cambridge University Press:  20 May 2019

Ronit Fallek*
Affiliation:
Montefiore Health System, Bronx, NY, USA
Kristen Corey
Affiliation:
Montefiore Health System, Bronx, NY, USA
Aamna Qamar
Affiliation:
Albert Einstein College of Medicine, Bronx, NY, USA
Shawna N. Vernisie
Affiliation:
Montefiore Health System, Bronx, NY, USA
Alexander Hoberman
Affiliation:
Montefiore Health System, Bronx, NY, USA
Peter A. Selwyn
Affiliation:
Montefiore Health System and Albert Einstein College of Medicine, USA
James A. Fausto
Affiliation:
Montefiore Health System, Bronx, NY, USA
Paula Marcus
Affiliation:
Montefiore Health System, Bronx, NY, USA
Vladimir Kvetan
Affiliation:
Montefiore Health System, Bronx, NY, USA
David W. Lounsbury
Affiliation:
Albert Einstein College of Medicine, Bronx, NY, USA
*
Author for correspondence: Ronit Fallek, MPA Montefiore Medical Center, Department of Family and Social Medicine, 3544 Jerome Avenue, Bronx, NY10467, Phone: 718-920-6576, Fax: 718-515-5416 Email: [email protected]

Abstract

Objectives

Music therapy has been shown to be effective for reducing anxiety and pain in people with a serious illness. Few studies have investigated the feasibility of integrating music therapy into general inpatient care of the seriously ill, including the care of diverse, multiethnic patients. This leaves a deficit in knowledge for intervention planning. This study investigated the feasibility and effectiveness of introducing music therapy for patients on 4 inpatient units in a large urban medical center. Capacitated and incapacitated patients on palliative care, transplantation, medical intensive care, and general medicine units received a single bedside session led by a music therapist.

Methods

A mixed-methods, pre-post design was used to assess clinical indicators and the acceptability and feasibility of the intervention. Multiple regression modeling was used to evaluate the effect of music therapy on anxiety, pain, pulse, and respiratory rate. Process evaluation data and qualitative analysis of observational data recorded by the music therapists were used to assess the feasibility of providing music therapy on the units and patients’ interest, receptivity, and satisfaction.

Results

Music therapy was delivered to 150 patients over a 6-month period. Controlling for gender, age, and session length, regression modeling showed that patients reported reduced anxiety post-session. Music therapy was found to be an accessible and adaptable intervention, with patients expressing high interest, receptivity, and satisfaction.

Significance of Results

This study found it feasible and effective to introduce bedside music therapy for seriously ill patients in a large urban medical center. Lessons learned and recommendations for future investigation are discussed.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Al-Amin, M and Makarem, SC (2016) The effects of hospital-level factors on patients’ ratings of physician communication. Journal of Healthcare Management 61, 2841.CrossRefGoogle ScholarPubMed
Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services (2018) 2017 National Healthcare Quality and Disparities Report. AHRQ Publication No. 18-0033-EF. Available at www.ahrq.gov/research/findings/nhqrdr/index.htmlGoogle Scholar
Baciu, A, Negussie, Y, and Geller, A (eds.) (2017) Communities in action: pathways to health equity. National Academies of Sciences, Engineering, and Medicine. Washington, DC: National Academies Press.Google Scholar
Bezold, C, Calvo, A, Fritts, M, et al. (2008) Integrative Medicine and Health Disparities: A Scoping Meeting. Available at http://www.altfutures.org/pubs/DRA/Report_09_04_Integrative_Medicine_and_Health_Disparities_A_Scoping_Meeting.pdfGoogle Scholar
Bradt, J and Dileo, C (2014) Music interventions for mechanically ventilated patients. Cochrane Database of Systematic Reviews 12, CD006902.Google Scholar
Bradt, J, Dileo, C, Magill, L, et al. (2016) Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database of Systematic Reviews 8, CD006911.Google Scholar
Çıracı, Y, Nural, N, and Saltürk, Z (2016) Loneliness of oncology patients at the end of life. Supportive Care in Cancer 24, 35253531.CrossRefGoogle ScholarPubMed
Ettema, EJ, Derksen, LD, and van Leeuwen, E (2010) Existential loneliness and end-of-life care: A systematic review. Theoretical Medicine and Bioethics 31, 141169.CrossRefGoogle ScholarPubMed
Gallagher, LM, Lagman, R, Bates, D, et al. (2017) Perceptions of family members of palliative medicine and hospice patients who experienced music therapy. Supportive Care in Cancer 25, 17691778.CrossRefGoogle ScholarPubMed
Karhe, L and Kaunonen, M (2015) Patient experiences of loneliness: An evolutionary concept analysis. Advances in Nursing Science 38, E21E34.CrossRefGoogle ScholarPubMed
McConnell, T and Porter, S (2017) Music therapy for palliative care: A realist review. Palliative & Supportive Care 15, 454464.CrossRefGoogle ScholarPubMed
Mitchell, AJ, Chan, M, Bhatti, H, et al. (2011) Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. The Lancet Oncology 12, 160174.CrossRefGoogle ScholarPubMed
Mofredj, A, Alaya, S, Tassaioust, K, et al. (2016) Music therapy, a review of the potential therapeutic benefits for the critically ill. Journal of Critical Care 35, 195199.CrossRefGoogle ScholarPubMed
Newell, S and Jordan, Z (2015) The patient experience of patient-centered communication with nurses in the hospital setting: A qualitative systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports 13, 7687.CrossRefGoogle ScholarPubMed
New York Academy of Medicine (NYAM). New York City health provider partnership Bronx community needs assessment. 2014. Available at https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/pps_applications/docs/st_barnabas_hosp_dba_sbh_health_system/3.4_st_barnabas_cna.pdfGoogle Scholar
New York State Department of Health. Bronx County Indicators for Tracking Public Health Priority Areas. 2012. Available at https://www.health.ny.gov/prevention/prevention_agenda/indicators/county/bronx.htmGoogle Scholar
Nipp, RD, El-Jawahri, A, Moran, SM, et al. (2017) The relationship between physical and psychological symptoms and health care utilization in hospitalized patients with advanced cancer. Cancer 123, 47204727.CrossRefGoogle ScholarPubMed
O'Callaghan, CC, McDermott, F, Reid, P, et al. (2016) Music's relevance for people affected by cancer: A meta-ethnography and implications for music therapists. Journal of Music Therapy 53, 398429.CrossRefGoogle ScholarPubMed
Potvin, N, Bradt, J, and Kesslick, A (2015) Expanding perspective on music therapy for symptom management in cancer care. Journal of Music Therapy 52, 135167.CrossRefGoogle ScholarPubMed
Roze des Ordons, AL, Sinuff, T, Stelfox, HT, et al. (2018) Spiritual distress within inpatient settings - A scoping review of patient and family experiences. Journal of Pain and Symptom Management 56, 122145.CrossRefGoogle Scholar
Schmid, W, Rosland, JH, von Hofacker, S, et al. (2018) Patient's and health care provider's perspectives on music therapy in palliative care - an integrative review. BMC Palliative Care 17, 32.CrossRefGoogle ScholarPubMed
Steinhauser, KE, Clipp, EC, McNeilly, M, et al. (2000) In search of a good death: Observations of patients, families, and providers. Annals of Internal Medicine 132, 825832.CrossRefGoogle ScholarPubMed
Teno, JM, Clarridge, BR, Casey, V, et al. (2004) Family perspectives on end-of-life care at the last place of care. Journal of the American Medical Association 291, 8893.CrossRefGoogle ScholarPubMed
Tuskeviciute, R, Hoenig, J, and Norman, C (2018) Depression among New York City adults. NYC Vital Signs 17, 14.Google Scholar
United States Census Bureau. Quick facts: Bronx county (Bronx borough), New York. 2016. Available at https://www.census.gov/quickfacts/fact/table/bronxcountybronxboroughnewyork/RHI225216#viewtopGoogle Scholar
Warth, M, Kessler, J, Hillecke, TK, et al. (2016) Trajectories of terminally ill patients’ cardiovascular response to receptive music therapy in palliative care. Journal of Pain and Symptom Management 52, 196204.CrossRefGoogle ScholarPubMed