BACKGROUND: Arterial Hypertension (AH) is a mass disease, with consequences for the cardiocirculatory system, since its complications raise the rates of morbidity and mortality. Controlling blood pressure (BP) reduces complications and may preserve the quality of life (QOL) of patients. Studies show positive effects of music therapy as an adjuvant in the treatment of several diseases. OBJECTIVE: to evaluate the effect of music therapy on the QOL and BP control of hypertensive patients. METHODS: This was a controlled clinical study that evaluated patients of both genders, aged over 50 years, with stage 1 hypertension, in use of medication and enrolled in multidisciplinary service for treatment of hypertension. They were divided into an experimental group (EG) and a control group (CG). The EG, in addition to the conventional treatment, participated in weekly music therapy sessions for twelve weeks. The CG received the standard treatment of the service. Before and after the intervention, the SF-36 questionnaire was applied in both groups, and the BP of each patient was measured. The voice, an important element of communication, reflecting the patient's physical, mental and emotional state, was the main resource used. Statistics: Student T-test and Wilcoxon test were considered significant at p <0.05. RESULTS: The groups were initially similar in gender, age, education, and the assessed QOL. In the initial and final comparison of EG patients, we observed a significant improvement on the QOL (p <0.05) and BP control (p <0.05), with no change in adhesion. CONCLUSIONS: Music therapy has contributed to an improvement on the QOL and BP control of patients, suggesting that this activity may represent a therapeutic approach to help strengthen the programs of multidisciplinary care of hypertensive patients.

Arq Bras Cardiol. 2009 Nov;93(5):534-40. Zanini CR, Jardim PC, Salgado CM, Nunes MC, de Urzêda FL, Carvalho MV, Pereira DA, Jardim Tde S, de Souza WK. Liga de Hipertensão Arterial, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, GO, Brasil. mtclaudiazanini@gmail.com

BACKGROUND: Music therapy in end-of-life care aims to improve a person's quality of life by helping relieve symptoms, addressing psychological needs, offering support, facilitating communication, and meeting spiritual needs. In addition, music therapists assist family and caregivers with coping, communication, and grief/bereavement. OBJECTIVES: To examine effects of music therapy with standard care versus standard care alone or standard care combined with other therapies on psychological, physiological, and social responses in end-of-life care. SEARCH STRATEGY: We searched CENTRAL, MEDLINE, CINAHL, EMBASE, PSYCINFO, LILACS, CancerLit, Science Citation Index, www.musictherapyworld.de, CAIRSS for Music, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, and the National Research Register to September 2009. We handsearched music therapy journals and reference lists, and contacted experts to identify unpublished manuscripts. There was no language restriction. SELECTION CRITERIA: We included all randomized and quasi-randomized controlled trials that compared music interventions and standard care with standard care alone or combined with other therapies in any care setting with a diagnosis of advanced life-limiting illness being treated with palliative intent and with a life expectancy of less than two years. DATA COLLECTION AND ANALYSIS: Data were extracted, and methodological quality was assessed, independently by review authors. Additional information was sought from study authors when necessary. Results are presented using weighted mean differences for outcomes measured by the same scale and standardized mean differences for outcomes measured by different scales. Posttest scores were used. In cases of statistically significant baseline difference, we used change scores. MAIN RESULTS: Five studies (175 participants) were included. There is insufficient evidence of high quality to support the effect of music therapy on quality of life of people in end-of-life care. Given the limited number of studies and small sample sizes, more research is needed.No strong evidence was found for the effect of music therapy on pain or anxiety.These results were based on two small studies. There were insufficient data to examine the effect of music therapy on other physical, psychological, or social outcomes. AUTHORS' CONCLUSIONS: A limited number of studies suggest there may be a benefit of music therapy on the quality of life of people in end-of-life care. However, the results stem from studies with a high risk of bias. More research is needed.

Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007169. Bradt J, Dileo C. The Arts and Quality of Life Research Center, Boyer College of Music and Dance, Temple University, Presser Hall, 2001 North 13 Street, Philadelphia, USA.

OBJECTIVE: To observe clinical therapeutic effects of acupuncture combined with music therapy for treatment of cerebral palsy. METHODS: Sixty children with cerebral palsy were randomly divided into an acupuncture group (Group Acup.) and an acupuncture plus music group (Group Acup.+ M). Simple acupuncture was applied in Group Acup., and acupuncture at 5 groups of points plus music were applied in Group Acup. +M. The treatment was given once every two days with 3 treatments weekly, and 36 treatments constituted a therapeutic course. Therapeutic effects including movement improvement were observed for comparison after 3 courses of treatments. RESULTS: The comprehensive functions were elevated in both groups, and the total effective rate in Group Acup. + M was obviously better than that in Group Acup (P < 0.05). Movement functions were also improved in both groups, but the differences in improvement of creeping and kneeling, standing, and walking were significant between the two groups (P < 0.01), showing the effect in Group Acup. + M was better than that in Group Acup.. CONCLUSION: The therapy of acupuncture plus music gained better therapeutic effect on cerebral palsy than simple acupuncture, which provided new thoughts for treating the disease by comprehensive therapies.

J Tradit Chin Med. 2009 Dec;29(4):243-8. Yu HB, Liu YF, Wu LX. Department of Acupuncture, Shenzhen TCM Hospital of Guangdong Province, Shenzhen 518000, China.

Bone marrow biopsy and aspiration are commonly used for diagnosing, treating, and following up after treatment for blood disorders and solid tumors. For adults, the infiltration of local anesthesia at the biopsy site has been used as the principal form of analgesia for bone marrow biopsy and aspiration. Pain relief during these procedures is often incomplete, especially during aspiration of the bone marrow, and pain is likely to contribute to patient anxiety. Researchers at the Tabriz Hematology and Oncology Center in Iran conducted a study to quantify and evaluate the effectiveness of music therapy interventions on pain and anxiety control for 100 patients undergoing bone marrow biopsy and aspiration. Participants in the study were randomly assigned to one of two groups: one group listened to music during the procedure, and the other did not. Patients completed the Spielberger State-Trait Anxiety Inventory both before and after the procedure and reported pain severity by using a visual analog scale. Results showed that participants who listened to music had lower state anxiety and pain levels than those who did not listen to music. Copyright © 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

AORN J. 2010 Jun;91(6):746-751. Shabanloei R, Golchin M, Esfahani A, Dolatkhah R, Rasoulian M.

AIMS: The purpose of the study was to investigate the effects of music on pain reaction and anxiety during labour. BACKGROUND: Music therapy has been used on clinical medicine. Only few scientific studies validate the value on labour women. DESIGN: Randomised controlled trial. METHODS: Sixty primiparas expected to have a normal spontaneous delivery were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received routine care and music therapy, whereas the control group received routine care only. A self-report visual analogue scale for pain and a nurse-rated present behavioural intensity were used to measure labour pain. Anxiety was measured with a visual analogue scale for anxiety and finger temperature. Pain and anxiety between groups were compared during the latent phase (2-4 cm cervical dilation) and active phase (5-7 cm) separately. RESULTS: Our results revealed that compared with the control group, the experimental group had significantly lower pain, anxiety and a higher finger temperature during the latent phase of labour. However, no significant differences were found between the two groups on all outcome measures during the active phase. CONCLUSIONS: This study provides evidence for the use of music as an empirically based intervention of women for labour pain and anxiety during the latent phase of labour. RELEVANCE TO CLINICAL PRACTICE: The findings support that music listening is an acceptable and non-medical coping strategy for labouring women. Especially, apply in reducing the pain and anxiety for women who are at the early phase of labour.

J Clin Nurs. 2010 Apr;19(7-8):1065-72. Liu YH, Chang MY, Chen CH. Fooyin University, Kaohsiung, Taiwan.

Full Title: The Efficacy of Music Therapy Protocols for Decreasing Pain, Anxiety, and Muscle Tension Levels During Burn Dressing Changes: A Prospective Randomized Crossover Trial

The purpose of this study was to explore the efficacy of two music therapy protocols on pain, anxiety, and muscle tension levels during dressing changes in burn patients. Twenty-nine inpatients participated in this prospective, crossover randomized controlled trial. On two consecutive days, patients were randomized to receive music therapy services either on the first or second day of the study. On control days, they received no music. On music days, patients practiced music-based imagery (MBI), a form of music-assisted relaxation with patient-specific mental imagery before and after dressing changes. Also, on music days during dressing changes, the patients engaged in music alternate engagement (MAE), which consisted of active participation in music making. The dependent variables were the patients' subjective ratings of their pain and anxiety levels and the research nurse's objective ratings of their muscle tension levels. Two sets of data were collected before, three sets during, and another two sets after dressing changes. The results showed significant decrease in pain levels before (P < .025), during (P < .05), and after (P < .025) dressing changes on days the patients received music therapy in contrast to control days. Music therapy was also associated with a decrease in anxiety and muscle tension levels during the dressing changes (P < .05) followed by a reduction in muscle tension levels after dressing changes (P < .025). Music therapy significantly decreases the acute procedural pain, anxiety, and muscle tension levels associated with daily burn care.

J Burn Care Res. 2010 May 21. Tan X, Yowler CJ, Super DM, Fratianne RB. From the *The Music Settlement, Cleveland, Ohio; and daggerMetroHealth Medical Center; Campus of Case Western Reserve, University School of Medicine, Cleveland, Ohio.

Full Title: The effects of music therapy on postpartum blues and maternal attachment of puerperal women

PURPOSE: The purpose of this study was to determine the effects of music therapy on postpartum blues and maternal attachment of puerperal women. METHODS: The research design was a nonequivalent control group non-synchronized design. The participants were puerperal women who agreed to participate in this study and through a convenience sampling, 60 puerperal women were recruited (30 in the experimental group, 30 in the control group). After measuring postpartum blues and maternal attachment, music therapy was provided to the experimental group over 40 min, once a day, and for 8 days. Then, postpartum blues and maternal attachment for the experimental and control group were measured again on the 8th day. The data were analyzed using the SPSS WIN 12.0 Program. RESULTS: The first hypothesis that "the degree of postpartum blues for the experimental group who participated in music therapy would be lower than that of the control group" was accepted (t=4.350, p<.001). The second hypothesis that "the degree of maternal attachment of the experimental group who participated in music therapy would be higher than that of the control group" was accepted (t=4.828, p<.001). CONCLUSION: These findings indicate that music therapy has positive influences on decreasing postpartum blues and increasing maternal attachment of puerperal women.

J Korean Acad Nurs. 2010 Feb;40(1):60-8. Lee SM. Department of Nursing, Catholic University of Daegu, Daegu, Korea. selva88@hanmail.net.

This article reviews the evidence for using music therapy with young people who are supported by mechanical ventilation. The author argues that music therapy is essential for developing a holistic approach focusing on the developmental level of a child or young person, as well as being an inexpensive, non-pharmacological, non-invasive therapy, with significant physiological and psychological benefits. She argues that more research is needed in this area to develop a sound evidence base on which guidelines to inform practice could be based.

Paediatr Nurs. 2010 Apr;22(3):14-20. Austin D. Basingstoke and North Hampshire Foundation Trust, Hampshire.

Pain is a normal finding in the postoperative patient, and noise can accentuate one's perception of discomfort. In this study, physiological measurements, intravenous (IV) opioid administration, length of stay, and satisfaction for postoperative patients who listened to music were compared with patients not provided music during their PACU stay. Of the 213 subjects enrolled, 163 experienced postoperative pain. The mean change in experimental subjects' respiratory rate was significantly lower than the controls. Decreases in heart rate and blood pressure from admission to discharge were similar between the two groups. On average, peripheral oxygen saturation and opioid pain control were not significantly different between control and experimental subjects. Subjects provided with music reported acceptable noise levels and increased satisfaction with their PACU experience. Music intervention is therefore a viable, minimal cost, and alternative therapy that PACU nurses can use to assist patients coping with postoperative pain. Copyright 2010 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

J Perianesth Nurs. 2010 Apr;25(2):79-87. Easter B, DeBoer L, Settlemyre G, Starnes C, Marlowe V, Tart RC. Catawba Valley Medical Center PACU, Hickory, NC 28602, USA. beaster@catawbavalleymc.org

Full Title: Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial.

A nonpharmacological method can be an alternative or complement to analgesics.The aim of this study was to evaluate if music medicine influences pain and anxiety in children undergoing lumbar punctures. A randomized clinical trial was used in 40 children (aged 7-12 years) with leukemia, followed by interviews in 20 of these participants. The participants were randomly assigned to a music group (n = 20) or control group (n = 20). The primary outcome was pain scores and the secondary was heart rate, blood pressure, respiratory rate, and oxygen saturation measured before, during, and after the procedure. Anxiety scores were measured before and after the procedure. Interviews with open-ended questions were conducted in conjunction with the completed procedures. The results showed lower pain scores and heart and respiratory rates in the music group during and after the lumbar puncture. The anxiety scores were lower in the music group both before and after the procedure. The findings from the interviews confirmed the quantity results through descriptions of a positive experience by the children, including less pain and fear.

Nguyen TN, Nilsson S, Hellström AL, Bengtson A. National Hospital of Paediatrics, Hanoi, Vietnam.

The aim of this literature review is to explore how music therapy influences the behaviour of older people with dementia. BACKGROUND: Music therapy is often informally used in residential care units to enhance communication, emotional, cognitive and behavioural skills in elderly patients diagnosed with dementia both nationally and internationally. However, in Ireland the benefits of music therapy have not been fully recognized. Many studies have been carried out to establish the effectiveness of music therapy on the behaviour of older people with dementia with positive findings. Music therapy should be welcomed into care of the elderly settings in Ireland and elsewhere; however, more research is required to validate the effects of this therapy as a holistic tool to build altruistic connections between carers and clients. METHOD: A comprehensive review of nursing literature using the online databases CINAHL, PsycINFO and MEDLINE were carried out. The search was limited to articles in the English language and peer-reviewed journals dating 2003-2009. RESULTS: Thirteen studies were reviewed and the majority of these studies reported that music therapy influenced the behaviour of older people with dementia in a positive way by reducing levels of agitation. The research further identified a positive increase in participants' mood and socialization skills, with carers having a significant role to play in the use of music therapy in care of the elderly nursing. However, methodological limitations were apparent throughout each of the studies reviewed. RECOMMENDATIONS: With reference to clinical practice, the authors recommend the undertaking of further research to explore the effects of music therapy on the behaviour and wellbeing of older people with dementia.

Br J Nurs. 2010 Jan 28-Feb 10;19(2):108-13. Wall M, Duffy A. St Vincent's Hospital, Athy, Co Kildare, Ireland.

Full Title: Effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture: A randomized controlled trial

OBJECTIVES: To study the effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture daily in a clinical setting. DESIGN: A randomized controlled trial. SETTING: Acupuncture Unit at Shenzhen Hospital of Traditional Chinese Medicine in Shenzhen City of China. PARTICIPANTS: Sixty children with cerebral palsy undergoing acupuncture. METHODS: Intervention: Children listened to their favorite music or a blank disc for 30min. Measurements: (1) the modified Yale preoperative anxiety scale for children's anxiety (mYPAS); (2) children's hospital of eastern Ontario pain scale (CHEOPS) and Wong-Baker faces pain rating scale (FACES) for pain intensity; (3) vital signs including mean arterial blood pressure (MAP), heart rate (HR) and respiratory rate (RR). RESULTS: An independent sample t-test showed significantly lower mYPAS scores in the music group 30min after the intervention compared with the control group (t=4.72, P=0.00). Significant differences between groups were found in mYPAS scores (F=4.270, d.f.=1, P=0.043, Partial eta(2)=0.069) and over treatment duration (F=143.421, d.f.=1.521, P=0.000, Partial eta(2)=0.712). A significant interaction was also found (F=4.298, d.f.=1.521, P=0.025, Partial eta(2)=0.069). LSD's post hoc testing confirmed that the mYPAS scores significantly increased from the baseline to 1min (P=0.000, 95% CI 14.913, 20.257) and then gradually decreased from 1 to 30min (P=0.000, 95% CI -18.952, -13.714). For pain intensity scores, a highly significant time effect was found in both the CHEOPS (F=87.347, d.f.=2, P=0.000, Partial eta(2)=0.601) and FACES (F=225.871, d.f.=1.822, P=0.000, Partial eta(2)=0.796), and a significant interaction effect was found as well (F=4.369, d.f.=2, P=0.015, Partial eta(2)=0.070; F=5.859, d.f.=1.822, P=0.005, Partial eta(2)=0.092). However, no significant difference between groups was present (F=2.343, d.f.=1, P=0.131, Partial eta(2)=0.039; F=3.738, d.f.=1, P=0.058, Partial eta(2)=0.061). Significant differences between groups were found in MAP and HR (P<0.05) and over time (P<0.05), but no significant effects in RR were apparent (P>0.05). A significant interaction effect was found in HR (P<0.05), but not in MAP or RR (P>0.05). CONCLUSIONS: This study demonstrates that listening to music while receiving acupuncture can relieve anxiety among children with cerebral palsy; however, no effect was observed in terms of pain reduction. Further research is needed to explore the types of music which best impact an individual's treatment. Whether music results in fewer accidents and side effects of acupuncture should be investigated. Music can be considered as adjunctive therapy in clinical situations that may be anxiety-provoking for children.

Int J Nurs Stud. 2009 Jun 2. Yu H, Liu Y, Li S, Ma X. Department of Acupuncture and Moxibustion, Traditional Chinese Medicine Hospital of Shenzhen, No. 1, Fu-hua Road, Fu-tian District, Shenzhen 518000, Guangdong Province, China.

Full Title: Neural reorganization underlies improvement in stroke-induced motor dysfunction by music-supported therapy

Motor impairments are common after stroke, but efficacious therapies for these dysfunctions are scarce. By extending an earlier study on the effects of music-supported therapy, behavioral indices of motor function as well as electrophysiological measures were obtained before and after a series of therapy sessions to assess whether this new treatment leads to neural reorganization and motor recovery in patients after stroke. The study group comprised 32 stroke patients in a large rehabilitation hospital; they had moderately impaired motor function and no previous musical experience. Over a period of 3 weeks, these patients received 15 sessions of music-supported therapy using a manualized step-by-step approach. For comparison 30 additional patients received standard rehabilitation procedures. Fine as well as gross motor skills were trained by using either a MIDI-piano or electronic drum pads programmed to emit piano tones. Motor functions were assessed by an extensive test battery. In addition, we studied event-related desynchronization/synchronization and coherences from all 62 patients performing self-paced movements of the index finger (MIDI-piano) and of the whole arm (drum pads). Results showed that music-supported therapy yielded significant improvement in fine as well as gross motor skills with respect to speed, precision, and smoothness of movements. Neurophysiological data showed a more pronounced event-related desynchronization before movement onset and a more pronounced coherence in the music-supported therapy group in the post-training assessment, whereas almost no differences were observed in the control group. Thus we see that music-supported therapy leads to marked improvements of motor function after stroke and that these are accompanied by electrophysiological changes indicative of a better cortical connectivity and improved activation of the motor cortex.

Ann N Y Acad Sci. 2009 Jul;1169:395-405. Altenmüller E, Marco-Pallares J, Münte TF, Schneider S. Institute of Music Physiology and Musicians' Medicine, University of Music and Drama Hannover, Hannover, Germany.

OBJECTIVE: To explore the perceptions of group music therapy among elderly nursing home residents in Taiwan. METHODS: Focus group methodology was used to explore the perceptions of elderly participants about their experience of group music therapy. Verbatim transcripts of audiotaped interviews were analysed by content analysis. RESULTS: In total, 3 focus groups were held with 17 wheelchair-bound elderly residents. Analysis of participants' perceptions of group music therapy revealed two major themes: (1) strength derived from the group dynamic and (2) enhanced quality of life. The first theme included three subthemes: (1) sense of energy, (2) distraction from suffering, and (3) confirmation as a person. The second major theme included four subthemes: (1) variety added to life, (2) motivation to exercise, (3) learning positive behaviour, and (4) greater life satisfaction. CONCLUSION: Elderly, wheelchair-bound residents of a nursing home in Taiwan positively viewed their experiences with our group music therapy programme, particularly its active component. The findings of this study suggest that healthcare providers should consider integrating group music therapy into their programmes for elderly nursing home residents and design the therapy to add variety to their life, give them a sense of autonomy by having them choose their preferred musical activities, and improve their cognitive function.

Complement Ther Med. 2009 Aug;17(4):190-5. Epub 2009 Apr 29. Chen SL, Lin HC, Jane SW. Department of Nursing, Hung Kuang University, Taiwan. slchen@sunrise.hk.edu.tw

Full Title: Neurologic music therapy improves executive function and emotional adjustment in traumatic brain injury rehabilitation

This study examined the immediate effects of neurologic music therapy (NMT) on cognitive functioning and emotional adjustment with brain-injured persons. Four treatment sessions were held, during which participants were given a pre-test, participated in 30 min of NMT that focused on one aspect of rehabilitation (attention, memory, executive function, or emotional adjustment), which was followed by post-testing. Control participants engaged in a pre-test, 30 min of rest, and then a post-test. Treatment participants showed improvement in executive function and overall emotional adjustment, and lessening of depression, sensation seeking, and anxiety. Control participants improved in emotional adjustment and lessening of hostility, but showed decreases in measures of memory, positive affect, and sensation seeking.

Ann N Y Acad Sci. 2009 Jul;1169:406-16. Thaut MH, Gardiner JC, Holmberg D, Horwitz J, Kent L, Andrews G, Donelan B, McIntosh GR. Center for Biomedical Research in Music, Colorado State University, Fort Collins, Colorado 80523, USA. michael.thaut@colostate.edu

National experts have recommended that children with life-limiting illnesses receive integrated palliative and medical care. These programs offer a variety of services, including music therapy. Using survey data from parents whose were enrolled in Florida's Partners in Care: Together for Kids (PIC:TFK) program, this study investigates parents' experiences with music therapy. About 44% of children with life-limiting illnesses and 17% of their siblings used music therapy. For children who used music therapy, multivariate results suggest that their parents were 23 times as likely to report satisfaction with the overall PIC:TFK program (P < .05) versus parents whose children did not use music therapy. Pediatric palliative care programs should include music therapy, although recruiting licensed music therapists may be challenging.

Am J Hosp Palliat Care. 2009 Aug 7. Knapp C, Madden V, Wang H, Curtis C, Sloyer P, Shenkman E. University of Florida.

Full Title: Music therapy to relieve anxiety in pregnant women on bedrest: a randomized, controlled trial

PURPOSE: To explore the effect of music therapy on anxiety alleviation for antepartal women on bedrest in China. DESIGN AND METHODS: One hundred and twenty patients recruited from one tertiary hospital in Changsha city, China were enrolled in a randomized controlled trial. Women in the experimental group received music therapy for 30 minutes on 3 consecutive days. Usual care participants had a 30-minute rest on 3 consecutive days. Variables included anxiety (State-Trait Anxiety Inventory), and physiological responses (vital signs, fetal heart rate). Descriptive statistics, t tests, chi tests, Wilcoxon rank sum tests, and Pearson correlation analyses were used to analyze the data. RESULTS: Anxiety levels decreased and physiological responses improved significantly in the intervention group, which was provided with music therapy while on bedrest. CLINICAL IMPLICATIONS: Carefully selected music that incorporates a patient's own preferences may offer an inexpensive and effective method to reduce anxiety for antepartal women with high risk pregnancies who are on bedrest.

MCN Am J Matern Child Nurs. 2009 Sep-Oct;34(5):316-23. Yang M, Li L, Zhu H, Alexander IM, Liu S, Zhou W, Ren X. The Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha Hunan, China. yangmin426@yahoo.com.cn

This article describes the experience of a nurse who used music therapy as the intervention to reduce a patient's pain during wound care after orthopedic surgery. The intervention was applied between April 8th and April 29th 2008. The nurse applied Roy's adaptation model as the assessment tool. The major and primary health problem identified was acute pain accelerated by wound care. The pain of this client not only triggered negative feelings, but also affected negatively on his daily life and feelings of self-belongingness. Through an individual-tailored music therapy, the client's pain during wound care was greatly reduced and even completely disappeared. The ultimate outcome of decrease in pain included reductions in negative feelings and increased positive spiritual strength. It is recommended that nurses who are responsible for wound care use this simple and economical music intervention to reduce acute postoperative pain.

Hu Li Za Zhi. 2009 Aug;56(4):105-10. Hsiao TY, Hsieh HF. School of Nursing, Fooyin University, ROC. ns128@mail.fy.edu.tw.

Full Title: Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy

Through behavioural analysis, this study investigated the social-motivational aspects of musical interaction between the child and the therapist in improvisational music therapy by measuring emotional, motivational and interpersonal responsiveness in children with autism during joint engagement episodes. The randomized controlled study (n = 10) employed a single subject comparison design in two different conditions, improvisational music therapy and toy play sessions, and DVD analysis of sessions. Improvisational music therapy produced markedly more and longer events of 'joy', 'emotional synchronicity' and 'initiation of engagement' behaviours in the children than toy play sessions. In response to the therapist's interpersonal demands, 'compliant (positive) responses' were observed more in music therapy than in toy play sessions, and 'no responses' were twice as frequent in toy play sessions as in music therapy. The results of this exploratory study found significant evidence supporting the value of music therapy in promoting social, emotional and motivational development in children with autism.

Autism. 2009 Jul;13(4):389-409. Kim J, Wigram T, Gold C. Department of Arts Therapy, College of Alternative Medicine, Jeonju University, Korea. jinahkim@jj.ac.kr

Earlier studies have demonstrated that music interventions can lessen symptoms of depression. Depression and burnout are closely related. We hypothesized that specially designed receptive music therapy programs and protocols might reduce the symptoms of burnout. In a four-arm randomized, placebo- and waiting-list-controlled double-blind study, including 150 participants, two specific music programs significantly reduced burnout symptoms after 5 weeks. The effects were maintained over a long time period. This newly developed method of receptive music therapy was also evaluated for the treatment of depression and dysthymia, with significant outcomes.

Ann N Y Acad Sci. 2009 Jul;1169:422-5. Brandes V, Terris DD, Fischer C, Schuessler MN, Ottowitz G, Titscher G, Fischer JE, Thayer JF. Research Program MusicMedicine, Paracelsus Medical University, Salzburg, Austria. vera.brandes@pmu.ac.at

Full Title: The effect of group music therapy on quality of life for participants living with a severe and enduring mental illness

A 10-week group music therapy project was designed to determine whether music therapy influenced quality of life and social anxiety for people with a severe and enduring mental illness living in the community. Ten one-hour weekly sessions including song singing, song writing and improvisation, culminated in each group recording original song/s in a professional studio. The principal outcome measure was the WHOQOLBREF Quality of Life (QoL) Scale; other instruments used were the Social Interaction Anxiety Scale (SIAS) and the Brief Symptom Inventory (BSI). Qualitative data were gathered through focus group interviews and an analysis of lyric themes. Statistically significant improvement was found on five items of the QoL Scale. There were no changes on the BSI indicating that QoL improvement was not mediated by symptomatic change. Themes from the focus groups were: music therapy gave joy and pleasure, working as a team was beneficial, participants were pleasantly surprised at their creativity, and they took pride in their song. An analysis of song lyrics resulted in 6 themes: a concern for the world, peace and the environment; living with mental illness is difficult; coping with mental illness requires strength; religion and spirituality are sources of support; living in the present is healing; and working as a team is enjoyable.

J Music Ther. 2009 Summer;46(2):90-104. Grocke D, Bloch S, Castle D. The University of Melbourne, St Vincent's Hospital.

This study aims at determining the effectiveness of music therapy in a hospice setting. We employed the salivary cortisol level, which is widely used to measure stress level, as an objective and physical indicator and the Mood Inventory, which measures mood change, as the subjective and psychological indicators. Though many preceding studies have demonstrated that listening to music lowers cortisol levels and reduces stress, no study seems to have included hospice patients. This study measured, with the consent of 10 hospice inpatients, their salivary cortisol levels. Individual interviews, according to the Mood Inventory, were conducted before and after a small-group session. Since all the participants had terminal cancer, the 40-minute live session of songs of seasons and the participants' requests was given in a mostly passive manner considering their physical strength. Results showed significant lowering of salivary cortisol levels after the therapy session. As for the parameters of mood, refreshment was significantly increased. Though fatigue remained unchanged, anxiety and depression decreased while the score for excitement tended to increase. Thus, it was indicated that music therapy in a hospice setting reduces the stress level of patients and thereby plays a positive role in improving patients' quality of life.

J Music Ther. 2009 Summer;46(2):160-72. Nakayama H, Kikuta F, Takeda H. Sapporo Otani College.

Full Title: The effect of expressive and instrumental touch on the behavior states of older adults with late-stage dementia of the Alzheimer's type and on music therapist's perceived rapport

The purpose of this study was to examine the effect of music therapy interventions utilizing two types of touch, expressive touch and instrumental touch, on the behavior states of older adults who have late-stage dementia of the Alzheimer's type. A secondary purpose of this study was to examine the perceived effectiveness of the music therapist when expressive and instrumental touch was employed during music therapy sessions. A within-subject design was used with 9 participants receiving 3 sessions in each of the experimental conditions: no touch, expressive touch, and instrumental touch. Results of a one-way ANOVA revealed that expressive touch was significantly more effective during the initial session in eliciting and maintaining alert behavior states than the instrumental and control conditions; however, there were no significant differences between the experimental and control conditions during the first and second session repetitions. Rapport ratings revealed that the therapist's client rapport was perceived to be significantly higher during both the expressive touch and instrumental touch conditions than during the control condition. These findings have important implications for music therapy practice and the effective use of nonverbal communication.

J Music Ther. 2009 Summer;46(2):132-46. Belgrave M. The Florida State University, FL, USA.

This contribution focuses on the definition of music therapy as a specific applicative context to be seen as distinct from the generic use of music in a variety of pathologies. Music therapy is presented as a discipline grounded both upon relationship and upon the theoretical-methodological principles peculiar to each applicative model. The therapeutic nature proper to music therapy is highlighted with specific reference to the domain of the dementias. Music therapy facilitates expression, communication and relationship in the non-verbal context. Such an opportunity allows persons with dementia to establish contact, to express, and even contrive an organisation/regulation of their emotions, through the sonorous-musical relationship with the music therapist. On the basis of a brief analysis of the relevant literature, attention is drawn to the importance of both evidence-based clinical practice and music therapy evaluations, aimed at proving the effectiveness of music therapy, while promoting its correct application.

Curr Alzheimer Res. 2009 Jun;6(3):293-301. Raglio A, Gianelli MV. Sospiro Foundation and INTERDEM Group (Psycho-Social Interventions in Dementia), Cremona, Italy. raglioa@tin.it

AIMS: To determine whether definable subtypes exist within a cohort of patients listening to music with regard to their physiological patterns and to compare whether associated factors vary between subjects in groups with different profiles. BACKGROUND: The intensive care unit (ICU) is one of the most stressful environments for patients among various clinical settings in a hospital. ICU patients are not only compromised by illness but also faced with a wide range of stressors. DESIGN: A repeated-measures design was conducted with one music group. METHOD: One hundred and one patients were recruited in three intensive care units in Hong Kong. There were two main outcome variables: demographic characteristics and physiological outcomes. RESULTS: A cluster analysis yielded two clusters. Patients in cluster 1 typically experienced relatively low therapeutic effects from listening to music. There were more males, of a younger age but more educated and employed than patients in cluster 2, and they represented 41.6% of the total respondents. Cluster 2 comprised almost 58.4% of this study sample and they reported high therapeutic effects of music. There were more females in this group as well as more older people and they mainly used a ventilator in the intensive care unit. CONCLUSION: Our study shows that music may have a more positive effect on groups of patients whose profile is similar to that of the patients in cluster 2, than for patients such as those in cluster 1. A clear profile may help health professionals to design appropriate care therapy to target a specific group of patients to improve their physiological outcomes. RELEVANCE TO CLINICAL PRACTICE: The implication of this study is that music therapy should be provided to patients as a relaxation technique if they are willing to accept it, and the selection of music should be based on their preferences. Information should be given to patients so that they can understand how music therapy works and they should be encouraged to focus their attention on listening to the music to maximise its benefits.

J Clin Nurs. 2009 May;18(9):1250-7. Epub 2008 Sep 4. Chan MF, Chung YF, Chung SW, Lee OK. Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore. nurcmf@nus.edu.sg

The purpose of this study was to determine the effect of music on peer awareness in preschool age children with developmental disabilities. Specifically, this study sought to find which combinations of musical and play elements produced the longest durations of sustained attention towards peers and the highest frequency of alternating attention from peer to peer. Nine children between the ages of 2 and 6 who had been diagnosed with a developmental disability participated in the study. Each participant completed 4 small group sessions with the researcher and 2 other research participants. During each session, the children participated in activities targeting peer awareness that incorporated musical and play elements. Behavioral data were recorded representing the children's sustained and alternating attention towards peers. Results indicated that children sustained attention towards peers for the longest durations and alternated attention from peer to peer at the highest frequencies during activities that utilized a musical object within a nonmusical or play-based context.

J Music Ther. 2009 Spring;46(1):53-68. Sussman JE. University of Missouri-Kansas City, USA.

The purpose of this study was to examine the effect of background music and song texts to teach emotional understanding to children with autism. Participants were 12 students (mean age 11.5 years) with a primary diagnosis of autism who were attending schools in Japan. Each participant was taught four emotions to decode and encode: happiness, sadness, anger, and fear by the counterbalanced treatment-order. The treatment consisted of the four conditions: (a) no contact control (NCC)--no purposeful teaching of the selected emotion, (b) contact control (CC)--teaching the selected emotion using verbal instructions alone, (c) background music (BM)--teaching the selected emotion by verbal instructions with background music representing the emotion, and singing songs (SS)--teaching the selected emotion by singing specially composed songs about the emotion. Participants were given a pretest and a posttest and received 8 individual sessions between these tests. The results indicated that all participants improved significantly in their understanding of the four selected emotions. Background music was significantly more effective than the other three conditions in improving participants' emotional understanding. The findings suggest that background music can be an effective tool to increase emotional understanding in children with autism, which is crucial to their social interactions.

J Music Ther. 2009 Spring;46(1):15-31. Katagiri J. The Florida State University, USA.

Full Title: Effects of listening to music on auditory hallucination and psychiatric symptoms in people with schizophrenia

PURPOSE: The purpose of this study was to explore the effects of listening to music in inpatients diagnosed with schizophrenia, on their auditory hallucinations, and positive and negative symptoms. METHODS: A quasi-experimental research design with 2x2 cross-over trial and convenience sample was used. Eleven patients (Group AB) listened to music followed by a wash out period and then a usual care period, and 12 patients (Group BA) had a usual care period followed by a wash out period and then listened to music. For one week those who were in the experimental period listened to individualized music using an MP3 player whenever they heard hallucinations. RESULTS: There was a statistically significant decrease in the frequency of auditory hallucinations after listening to the music. There was a decrease in the mean scores for positive symptoms, negative symptoms, and general psychopathology after listening to music, but only negative symptoms showed a statistically significant decrease. The treatment effects on scores for positive symptoms, negative symptoms, and general psychopathology were greater in Group BA than Group AB. CONCLUSION: These findings suggest that listening to music may be useful for managing auditory hallucinations in schizophrenia inpatients.

J Korean Acad Nurs. 2009 Feb;39(1):62-71. Na HJ, Yang S. College of Nursing, The Catholic University of Korea, Seoul, Korea.

Average age of residents living in National sanatorium Hoshizuka-Keiaien where people have past history of Hansen disease is around 80 years old at present, and many of them spend their whole days in watching TV or sleeping almost alone in their rooms. Therefore music therapy was introduced in order to improve their daily activities in our sanatorium. Singing, listening to music, playing the musical instruments, and dancing were performed, either in a group or individually. Reactivation of their brain function such as recollection, sense of unity and relaxation were expected. Improvement of cardiopulmonary function was also expected. Solidarity and relaxed state were observed by being with the other participants in the group therapy. For example, when using musical instruments, some participants with hesitation tried to use their instruments, and had good performance. They seemed to be satisfied and became confident with the musical instruments. Then their confidence and satisfaction activated the group. After the sessions, mutual conversation increased. These processes obtained a synergy effect, which means that a group affects of individuals at first and next alteration of individual behavior influences the group. We could observe a better effect in their motivation and activity in their daily life in the individual therapy. The music therapy was applied to the senior participants by the music therapist in this study. The participants could easily reinforce their mind and body through this therapy. Music therapy will be continued for the improvement of quality of life of residents in the sanatorium.

Nihon Hansenbyo Gakkai Zasshi. 2009 Feb;78(1):35-9. Fukamizu Y, En J, Kano T, Arikawa I. National Sanatorium Hoshizuka-Keiaien, 4204 Hoshizuka-cho, Kanoya City, Kagoshima 893-8502, Japan. reha-ot@hoshizuka.hosp.go.jp

Full Title: Effect of music therapy on anxiety and depression in patients with Alzheimer's type dementia: randomised, controlled study

BACKGROUND/AIMS: Numerous studies have indicated the value of music therapy in the management of patients with Alzheimer's disease. A recent pilot study demonstrated the feasibility and usefulness of a new music therapy technique. The aim of this controlled, randomised study was to assess the effects of this new music therapy technique on anxiety and depression in patients with mild to moderate Alzheimer-type dementia. METHODS: This was a single-centre, comparative, controlled, randomised study, with blinded assessment of its results. The duration of follow-up was 24 weeks. The treated group (n = 15) participated in weekly sessions of individual, receptive music therapy. The musical style of the session was chosen by the patient. The validated 'U' technique was employed. The control group (n = 15) participated under the same conditions in reading sessions. The principal endpoint, measured at weeks 1, 4, 8, 16 and 24, was the level of anxiety (Hamilton Scale). Changes in the depression score (Geriatric Depression Scale) were also analyzed as a secondary endpoint. RESULTS: Significant improvements in anxiety (p < 0.01) and depression (p < 0.01) were observed in the music therapy group as from week 4 and until week 16. The effect of music therapy was sustained for up to 8 weeks after the discontinuation of sessions between weeks 16 and 24 (p < 0.01). CONCLUSION: These results confirm the valuable effect of music therapy on anxiety and depression in patients with mild to moderate Alzheimer's disease. This new music therapy technique is simple to implement and can easily be integrated in a multidisciplinary programme for the management of Alzheimer's disease. Copyright 2009 S. Karger AG, Basel.

Dement Geriatr Cogn Disord. 2009;28(1):36-46. Epub 2009 Jul 23. Guétin S, Portet F, Picot MC, Pommié C, Messaoudi M, Djabelkir L, Olsen AL, Cano MM, Lecourt E, Touchon J. Service de Neurologie, Centre Mémoire de Ressources et de Recherches (CMRR), Inserm U888, CHRU Montpellier, Montpellier, France. stephane.guetin@yahoo.fr

PURPOSE: Music has been utilized as a therapeutic tool during colonoscopy, but various randomized controlled trials (RCTs) have been inconsistent. We conducted a meta-analysis to analyze the effect of music on patients undergoing colonoscopy. PATIENTS AND METHODS: Multiple medical databases were searched (12/06). Only RCTs on adult subjects that compared music versus no music during colonoscopy were included. Meta-analysis was analyzed for total procedure time, dose of sedative medications (midazolam and mepiridine), and patients' pain scores, experience, and willingness to repeat the same procedure in the future. RESULTS: Eight studies (N = 712) met the inclusion criteria. Patients' overall experience scores (P < 0.01) were significantly improved with music. No significant differences were noted for patients' pain scores (P = 0.09), mean doses of midazolam (P = 0.10), mean doses of meperidine (P = 0.23), procedure times (P = 0.06), and willingness to repeat the same procedure in future (P = 0.10). CONCLUSIONS: Music improves patients' overall experience with colonoscopy.

Dig Dis Sci. 2009 Jan;54(1):19-24. Epub 2008 May 16. Bechtold ML, Puli SR, Othman MO, Bartalos CR, Marshall JB, Roy PK. Division of Gastroenterology, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, USA.

The aim of this study was to determine the effect of music alone, aromatherapy alone, and music in addition to aromatherapy on anxiety levels of adults accompanying children to a pediatricemergency department waiting area. METHODS: The study was conducted over 28 consecutive days, assigned to 1 of 4 groups: no intervention, music, aromatherapy, and both music and aromatherapy. Adults accompanying children to the emergency department of an urban pediatric tertiary care referral center were given a survey including a Spielberger state anxiety inventory with additional questions about whether they noticed an aroma or music and if so their response to it. The music was classic ingenre with a tempo of 60 to 70 beats per minute. The aromatherapyused the essential oil Neroli dispersed using 2 aromatherapydiffusers placed in strategic airflow ends of the emergency department. RESULTS: The 1104 surveys were completed. There was a statistically significant decrease in anxietylevel on those days when music was playing (36.3 vs. 39.2; P = 0.017). There was no difference in anxiety levels on those days when aromatherapy was present compared with the nonaromatherapy days (37.3 vs. 38.0; P = 0.347). CONCLUSIONS: Music is an easy and useful way to decrease the anxiety of visitors in an emergency department waiting area. Although no difference was detected for the aromatherapy group, this could be because of environmental conditions or imprecise application of the aromatherapy; further study is needed to either prove or disprove its effectiveness in this setting.

Pediatr Emerg Care. 2008 Dec;24(12):836-8. Holm L, Fitzmaurice L. Department of Pediatrics, Division of Emergency Medical Services, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. Holml2@ihs.org

The purpose of this study was to assess the effect of lento music on examination anxiety among nursing students. A randomized crossover classroom-based trial was conducted. Thirty-eight students with a mean age of 19.4 years (SD = .54) were randomly assigned to either a music/silence or a silence/music group sequence. The students in the music group were given a 40-min group-based music intervention in a classroom, whereas the students in the silence group received the regular test without music. Using paired t-tests, there were no significant different in pretest scores for state anxiety, examination anxiety, finger temperature and pulse rate between the two conditions. Nonetheless, the findings indicated that music intervention did effectively decrease examination anxiety and state anxiety as well as reducing pulse rate and increasing higher finger temperature (p = 0.05 to 0.001). In addition, significant differences were detected between the pretest and posttest measures for silence (p = 0.001). The results suggest that lento music is effective at anxiety reduction. This study provides evidence for nursing faculty and clinical educators to foster nursing students' mastering over the anxiety of examination by using lento music.

Nurse Educ Today. 2008 Nov;28(8):909-16. Epub 2008 Jul 1. Lai HL, Chen PW, Chen CJ, Chang HK, Peng TC, Chang FM. Department of Nursing, Tzu Chi University, Taiwan, ROC. snowjade@mail.tcu.edu.tw

Full Title: The effects of improvisational music therapy on joint attention behaviors in autistic children: a randomized controlled study

The purpose of this study was to investigate the effects of improvisational music therapy on joint attention behaviors in pre-school children with autism. It was a randomized controlled study employing a single subject comparison design in two different conditions, improvisational music therapy and play sessions with toys, and using standardized tools and DVD analysis of sessions to evaluate behavioral changes in children with autism. The overall results indicated that improvisational music therapy was more effective at facilitating joint attention behaviors and non-verbal social communication skills in children than play. Session analysis showed significantly more and lengthier events of eye contact and turn-taking in improvisational music therapy than play sessions. The implications of these findings are discussed further.

J Autism Dev Disord. 2008 Oct;38(9):1758-66. Epub 2008 Jul 1. Kim J, Wigram T, Gold C. Aalborg University, Aalborg, Denmark. jinahkim@jj.ac.kr

by Tim Brunson, PhD

The words harmonize and harmony are used to describe the adaptation process. Pattern encoding involves intensity and timing, much like that experienced with sound and music. Wayne Perry, a sound therapist in California, (2007), adds insight as he expands this concept into that of rhythm and sound. He sums up these natural tendencies by saying:

Every form of life has its own unique rhythms and cycles that determine its habits and characteristics. For example, insects such as bees, hornets, and locusts fly in swarms; schools of fish swim together, almost as one; geese fly together, locked in a V-formation. In the past, scientists thought this was due to a leader with more intelligence or experience. Now we know these habits are directed by entrainment. (Perry, 2007, p. 204)

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The purose of this study was to investigate bereaved parents' experiences of music therapy with their terminally ill child. In-depth interviews were conducted with 7 bereaved parents who were recruited through a community-based palliative care program. The parent participants' experiences varied as their children who received music therapy ranged in ages from 5 months to 12 years old. The interview transcripts were analyzed using phenomenological strategies. Five global themes emerged from the analysis. These included (a) music therapy was valued as a means of altering the child's and family's perception of their situation in the midst of adversity, (b) music therapy was a significant component of remembrance, (c) music therapy was a multifaceted experience for the child and family, (d) music therapy enhanced communication and expression, and (e) parents shared perceptions of and recommendations for improving music therapy services. These emergent themes yield knowledge into the relevance of music therapy within pediatric palliative care.

J Music Ther. 2008 Fall;45(3):330-48. Lindenfelser KJ, Grocke D, McFerran K. University of Melbourne.

Full Title: The effect of group music therapy on quality of life for participants living with a severe and enduring mental illness.

A 10-week group music therapy project was designed to determine whether music therapy influenced quality of life and social anxiety for people with a severe and enduring mental illness living in the community. Ten one-hour weekly sessions including song singing, song writing and improvisation, culminated in each group recording original song/s in a professional studio. The principal outcome measure was the WHOQOLBREF Quality of Life (QoL) Scale; other instruments used were the Social Interaction Anxiety Scale (SIAS) and the Brief Symptom Inventory (BSI). Qualitative data were gathered through focus group interviews and an analysis of lyric themes. Statistically significant improvement was found on five items of the QoL Scale. There were no changes on the BSI indicating that QoL improvement was not mediated by symptomatic change. Themes from the focus groups were: music therapy gave joy and pleasure, working as a team was beneficial, participants were pleasantly surprised at their creativity, and they took pride in their song. An analysis of song lyrics resulted in 6 themes: a concern for the world, peace and the environment; living with mental illness is difficult; coping with mental illness requires strength; religion and spirituality are sources of support; living in the present is healing; and working as a team is enjoyable.

J Music Ther. 2009 Summer;46(2):90-104. Grocke D, Bloch S, Castle D.

This study aims at determining the effectiveness of music therapy in a hospice setting. We employed the salivary cortisol level, which is widely used to measure stress level, as an objective and physical indicator and the Mood Inventory, which measures mood change, as the subjective and psychological indicators. Though many preceding studies have demonstrated that listening to music lowers cortisol levels and reduces stress, no study seems to have included hospice patients. This study measured, with the consent of 10 hospice inpatients, their salivary cortisol levels. Individual interviews, according to the Mood Inventory, were conducted before and after a small-group session. Since all the participants had terminal cancer, the 40-minute live session of songs of seasons and the participants' requests was given in a mostly passive manner considering their physical strength. Results showed significant lowering of salivary cortisol levels after the therapy session. As for the parameters of mood, refreshment was significantly increased. Though fatigue remained unchanged, anxiety and depression decreased while the score for excitement tended to increase. Thus, it was indicated that music therapy in a hospice setting reduces the stress level of patients and thereby plays a positive role in improving patients' quality of life.

J Music Ther. 2009 Summer;46(2):160-72. Nakayama H, Kikuta F, Takeda H.

Full Title: The effect of single-session psychoeducational music therapy on verbalizations and perceptions in psychiatric patients.

The purpose of this study was to compare group-based psychoeducational music therapy to psychoeducation in measures of satisfaction with life, knowledge of illness, treatment perceptions, and response frequency and type in acute psychiatric inpatients during a randomized and controlled clinical trial. Participants (N = 105) took part in a scripted single session controlled by a treatment manual and facilitated by a Board-Certified Music Therapist. No significant differences were found between groups in measures of helpfulness, enjoyment, satisfaction with life, or psychoeducational knowledge. However, although not significant, the music therapy group tended to have slightly higher mean scores in all aforementioned variables, suggesting music therapy can be as effective as psychoeducation in these measures. There were no significant differences between groups for the number of therapist questions and validations as measured by a trained behavioral observer, although during the music therapy condition the therapist was able to ask a mean of almost 11 additional questions than during the psychoeducational control condition. Although not significant, there were almost 20 more participant mean verbalizations per session during the music therapy conditions. Additionally, many of these verbalizations were categorized as self and cognitive insight statements, indicating participants in the music therapy condition were talking more about themselves and their unique situations. Congruent with this finding, during the music therapy condition, the ratios of participant self statements to therapist questions and participant cognitive insights to therapist questions were higher than in the control condition. There was a significant correlation between participant total verbal participation and perception of helpfulness, enjoyment, and comfort for the control condition. This correlation was not significant for the experimental condition, indicating that the music therapy group did not have to verbally participate to perceive the session as helpful, enjoyable, and comfortable. Implications for psychoeducational music therapy and suggestions for future research are provided.

J Music Ther. 2009 Summer;46(2):105-31. Silverman MJ.

AIMS: To determine whether definable subtypes exist within a cohort of patients listening to music with regard to their physiological patterns and to compare whether associated factors vary between subjects in groups with different profiles. BACKGROUND: The intensive care unit (ICU) is one of the most stressful environments for patients among various clinical settings in a hospital. ICU patients are not only compromised by illness but also faced with a wide range of stressors. DESIGN: A repeated-measures design was conducted with one music group. METHOD: One hundred and one patients were recruited in three intensive care units in Hong Kong. There were two main outcome variables: demographic characteristics and physiological outcomes. RESULTS: A cluster analysis yielded two clusters. Patients in cluster 1 typically experienced relatively low therapeutic effects from listening to music. There were more males, of a younger age but more educated and employed than patients in cluster 2, and they represented 41.6% of the total respondents. Cluster 2 comprised almost 58.4% of this study sample and they reported high therapeutic effects of music. There were more females in this group as well as more older people and they mainly used a ventilator in the intensive care unit. CONCLUSION: Our study shows that music may have a more positive effect on groups of patients whose profile is similar to that of the patients in cluster 2, than for patients such as those in cluster 1. A clear profile may help health professionals to design appropriate care therapy to target a specific group of patients to improve their physiological outcomes. RELEVANCE TO CLINICAL PRACTICE: The implication of this study is that music therapy should be provided to patients as a relaxation technique if they are willing to accept it, and the selection of music should be based on their preferences. Information should be given to patients so that they can understand how music therapy works and they should be encouraged to focus their attention on listening to the music to maximise its benefits.

J Clin Nurs. 2009 May;18(9):1250-7. Chan MF, Chung YF, Chung SW, Lee OK. Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore. nurcmf@nus.edu.sg