Music therapy has emerged as a valuable adjunctive intervention in palliative care settings, specifically within hospice care. This systematic review aims to explore and summarize the benefits of music therapy. 6 relevant studies were identified and included in this review.
The study discusses the potential benefits of music therapy for individuals receiving palliative care due to life-limiting illnesses. It highlights how music therapy can enhance the quality of life, manage symptoms, reduce stress and anxiety, and deliver palliative care. The study draws on existing research and emphasizes the potential of music therapy as a valuable form of supportive care for patients in hospice.
Music therapy is an evidence-based approach that has been shown to provide a range of benefits for palliative care patients in hospice. Research has demonstrated the effectiveness of music therapy in hospice care, and it is increasingly being recognized as a valuable form of supportive care for patients with life-limiting illnesses.
Contents
Summary
Acknowledgement
Glossary
List of Illustrations
List of abbreviations
Introduction
Search strategy
Critical Appraisal and Data Extraction
Narrative
Overview of music therapy for patients receiving end of life care
The implementation of music therapy in hospice settings
Music to enhance the quality of life
Music therapy in cancer patients and pain management
Effectiveness of music therapy for palliative care
Conclusion and implication of practice
References
Summary
Review Question
Our study discusses the potential benefits of music therapy for individuals receiving palliative care due to life-limiting illnesses. It highlights how music therapy can enhance the quality of life, manage symptoms, reduce stress and anxiety, and deliver palliative care. The study draws on existing research and emphasizes the potential of music therapy as a valuable form of supportive care for patients in hospice.
Background
Music therapy is an evidence-based approach that has been shown to provide a range of benefits for palliative care patients in hospice. Research has demonstrated the effectiveness of music therapy in hospice care, and it is increasingly being recognized as a valuable form of supportive care for patients with life-limiting illnesses.
Search History
We search relevant databases like MEDLINE, EMBASE, CINAHL etc. Our search limiters were articles under 10 years and major search terms were ‘music therapy’, ‘palliative care’ and ‘end of life care’.
Main Findings
Music therapy can be personalized to the individual needs of patients and can be delivered in a variety of settings, including individual and group sessions, as well as through the use of technology. By using music as a therapeutic tool, music therapists can help patients manage symptoms such as pain, anxiety, and depression, as well as improve their reduce stress, quality of life, and increase feelings of relaxation and comfort in cancer patients and in pain management.
Conclusion
As per the findings above we identified various implications that can help the utilization of music therapy in hospice care. Need for the training of music professionals for helping pain management patients and cancer patients. The second implication was to increase awareness among hospital staff, patients, their families and the general public via posters and CMEs.
In addition to providing insightful information about the subject, the selected papers have made a significant contribution to the subject's knowledge. There are, however, certain research limitations in some of these papers, which may affect the credibility of their results.
Acknowledgement
I am delighted to express my sincere gratitude to everyone who helped this dissertation be completed successfully. I want to start by expressing my gratitude to my supervisor for their advice, knowledge, and steadfast support during the entire process. I also want to express my gratitude to my family and friends for their consistent support, inspiration, and tolerance over this trying three-year time.
Glossary
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List of Illustrations
Table 1: PEO Analysis
Table 2: Inclusion and exclusion criteria
Table 3: PEO search keywords/ phrases
Table 4: Search terms and database hits
Table 6: Critical appraisal tool
Table 7: (Liu et al., 2015)
Table 8: (Graham-Wisener et al., 2018)
Table 9: (Porter et al., 2018)
Table 10: (Porter et al., 2017)
Table 11: (Pommeretet al., 2019)
Table 12: (Nyashanu et al., 2021)
List of abbreviations
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1. Introduction
Palliative care is a method that helps patients' (adults and children's) and their families' quality of life when they are dealing with issues brought on by a life-threatening illness. Through the early detection, accurate assessment, and treatment of pain and other issues, whether they are physical, psychosocial, or spiritual, it avoids and alleviates suffering (Radbruchet al., 2020WHO, 2020). According to an article published by Royal College of nursing, Palliative care is provided to patients with serious or life-limiting illnesses, such as cancer, heart failure, and advanced stages of chronic obstructive pulmonary disease (COPD) Shaw et al., (2007), Dalgaard et al., (2014)
British association of music therapy explained music therapy as; a recognized psychological treatment intervention in order to assist the psychological, emotional, cognitive, physical, communicative, and social needs of persons whose lives have been impacted by injury, sickness, or disability (BAMT, 2020). Like nursing, music therapy is a board-certified, evidence-based health profession with a growing clinical and academic impact in hospice and palliative care (Potvinet al., 2021).
The rising amount of research demonstrating that music therapy treats a variety of symptoms and health issues such as pain and anxiety, across numerous diseases present in hospice care must be recognized and promoted by nursing (Warthet al., 2016). In this regard there are several studies are found in literature, explaining Music-Therapy for healing or improving quality of life in hospice patients; For example, Music therapy has showed to decrease stress response and pain in clinically admitted patients. reducing stress response (Wallerstedtet al., 2019). Another study reported. decreases in pain and the stress response may lessen the need for sedative drugs and hasten the recovery process in the intensive care unit (Tanet al., 2010Chlanet al., 2013). Music therapy also gives patients and caregivers the support they need to face death, say their final goodbyes while they are dying, and derive meaning from these events (DiMaio, 2019)
Best practices for hospice care have now emerged, educating clinicians on clinical decision-making in the light of indications for potential benefit and contraindications for potential harm of using Music as therapy (Kirkwoodet al., 2019Potvinet al., 2021). Regardless of these advances in practice, it has been difficult to integrate music therapy into hospice care due to the numerous barriers that prevent it from working effectively with nurses as a member of the multidisciplinary treatment team. One such challenge is the uneven use and function of music therapists across hospital organizations (Potvinet al., 2021) Hierarchical service delivery and administrative processes impede the widespread acceptance and use of music therapy in hospices. While hospices refer to music therapy as a "complementary" or "adjunctive" therapy (Kligleret al., 2016Porteret al., 2017O'Kelly and Koffman, 2007).
Studies have been conducted to employ music therapy in health care settings especially hospice. A study examined the viability and efficacy of introducing music therapy to hospice patients. Which concludes that implementing bedside music therapy for very ill patients in a medical facility is approachable, practical and efficient intervention (Falleket al., 2020). Another retrospective study was conducted patients symptoms like SOB, anxiety, pain, depression, and mood were assessed in cancer patients. clinical and statistical significance were found (Gallagheret al., 2018).
Despite the benefits of music therapy in palliative care, there are several challenges that healthcare providers face in delivering this type of care. The difficulty in obtaining sufficient sustainable funding and the misconception that MT is entertainment are ongoing obstacles to the field (O'Kelly and Koffman, 2007). The board-certified music therapists' rigorous training and the neurobiology of MT need to be explained to health care employees and administration. Tools and tactics to make the financial programs for the establishment of MT programs as a component of high-quality interdisciplinary palliative care are greatly needed in the field of palliative care (Reidy and MacDonald, 2021Hilliard, 2003). Given the issues outlined above, our analytical study is the needed and will provide a significant value in solving these issues.
This research will study the use of music therapy based on research in enhancing quality of life for those who are terminally ill, it also provides a review of the benefits of music therapy for patients in hospice; the current research will also discuss the function of music therapy in delivering palliative care.
2. Search strategy
Systematic searching is a critical aspect of research that involves gathering and evaluating literature pertinent to a research question or topic. It is a step-by-step process that involves understanding the research question, searching for relevant literature, evaluating the literature, and synthesizing the data from the literature (Uman, 2011). Primary sources are usually considered more reliable than secondary sources, as they are the original work and are less likely to be misunderstood or selectively reported. Systematic reviews are important for determining the accuracy of a data tool or data collection, as they can help to identify any gaps in the knowledge and the applicability of the data. Additionally, systematic reviews provide a comprehensive overview of the current state of research in a certain area, allowing researchers to make informed decisions regarding the direction of their research (Bartels, 2013).
Evidence-based practice (EBP) is a process of making clinical decisions based on the best available evidence. It involves the integration of clinical expertise, patient values, and preferences, and the latest research evidence to provide the best possible care for patients. In order to implement EBP, it is essential to identify the clinical question, search for the best available evidence, and critically appraise the quality of the evidence. The PICO and PEO frameworks are commonly used tools in EBP to help define and structure the clinical question.
The components of a well-constructed clinical question are described by the acronym PICO. Population, intervention, comparison, and outcome are its acronyms. The population refers to the group of patients or individuals being studied, the intervention refers to the treatment or intervention being evaluated, the comparison refers to the alternative treatment or intervention, and the outcome refers to the results or effects of the intervention (Bettany-Saltikov, 2016).
The PEO framework is an extension of the PICO framework and includes additional elements to provide a more comprehensive picture of the clinical question. The PEO framework stands for population, exposure, and outcome. The exposure refers to the cause of the problem, and the outcome refers to the effects of the exposure. The PEO framework can be used in situations where the cause-and-effect relationship between the exposure and the outcome is not clear or when the exposure is not a treatment (EBSCO, 2019).
To determine the effectiveness of music therapy in hospice for palliative care patients, a systematic search strategy is necessary. This section will outline the steps involved in conducting a comprehensive search for evidence-based information on the topic of music therapy in hospice for palliative care patients.
The first step in the search strategy was to search electronic databases such as CINAHL, PubMed, the Cochrane Library as well as PsycINFO – and advanced search terms. These databases are well known for their comprehensive collections of articles and research on a wide range of health-related topics. The ProQuest-facilitated British Nursing Databases (BND) was selected because it strives to offer pertinent articles for nursing and midwifery in the UK. To make sure the most recent research is utilized, it is important to limit the search to the past 10 years. This will help ensure that the information being used is current and relevant to the current state of knowledge in the field.
By using Boolean operators, such as AND, OR, and NOT, the search was narrowed down to academic research articles published within the last 10 years, using the keywords ‘palliative care’, ‘hospice’, and ‘music therapy’ and related keywords. This combination of keywords will help ensure that the articles retrieved are relevant to the topic of interest. Polit and Beck (2010, p.175) advocated the use of boolean operators to combine words or sentences. AND—track down references that use each of the given words or phrases. A keyword or phrase with an asterisk (*) at the end is searched for in citations that also include any additional characters that were added to it to form a longer word or phrase. NOT-excludes citations that contain all exact keyword or phrase combinations, OR-find citations that contain either exact keyword or phrase combinations. The articles found through this search strategy were analyzed to identify the benefits of music therapy for palliative care patients in hospice. The results of this research showed that music therapy can improve a number of physical, psychological, and social outcomes for palliative care patients in hospice. Physically, music therapy has been found to reduce pain, improve breathing, and even raise oxygenation levels. Psychologically, it has been found to reduce anxiety and depression, improve mood, and enhance overall quality of life. Socially, it can help patients to feel more connected to family and friends, and create a meaningful and comforting experience for them (Polit & Beck, 2010).
The inclusion and exclusion criteria that would be applied, the inclusion of any research articles in the systematic review, and the exclusion of any studies were all necessary in order to formulate a research question. That were unnecessary (Table2). Holyet al.(2021, p. 50) assert that rather than relying on shaky clinical theory or subjective judgement, it is recommended that inclusion and exclusion standards be put into practice based on a strong philosophy gleaned from the nursing and medical literature..
Once the search results have been retrieved, the next step was to read the abstracts of the articles and select those that are relevant to the PICO and PEO analysis. This step was important because it helps to narrow down the search results to a manageable number of articles. During this step, the articles should be evaluated based on their relevance to the topic and their potential to contribute to the evidence-based knowledge of music therapy in hospice for palliative care patients.
We reviewed the full-text articles to determine their quality and relevance to the topic. This step was important because it allows for a more in-depth evaluation of the articles and helps to identify any limitations or strengths of the studies. During this step, the articles were evaluated based on their methodology, study design, sample size, and results. To assess the validity, reliability, and generalizability of the results, it is important to evaluate the evidence using critical appraisal tools. This step is important because it helps to identify any biases, limitations, or strengths in the studies and helps to determine the overall quality of the evidence.
The final step in the search strategy was to synthesize the results of the articles to form a conclusion about the effectiveness of music therapy in hospice for palliative care patients. This step is important because it allows for an overall interpretation of the evidence and helps to identify any gaps in the evidence-based knowledge. During this step, the articles were synthesized to form a comprehensive picture of the evidence and to determine the overall effectiveness of music therapy in hospice for palliative care patients.
PEO/PICO
The PEO/PICO framework is a useful tool for creating a focused question and searching for relevant literature. The question in this case is: "What is the effectiveness of music therapy for palliative care patients in hospice?" In terms of PEO/PICO, the Population can be identified as palliative care patients in hospice, the Exposure is music therapy, and the Outcome is the effectiveness of the therapy.
Table 1: PEO Analysis
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Table 2: Inclusion and exclusion criteria
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The PEO keywords and phrases used to search the chosen databases are displayed in table number 3. Table 4 displaysusing the selected search terms, the search behaviour and outcomes for each database.
Table 3: PEO search keywords/ phrases
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Table 4: Search terms and database hits
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PRISMA flow diagram: Figure 1
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3. Critical Appraisal and Data Extraction
With the use of the Holland and Rees (2010) Critical Appraisal Tool, each article underwent thorough evaluation.to assess its methodology, rigor, and methodical approach.Several databases can be searched when looking for relevant research. The databases that may be most useful in this case include PubMed, EMBASE, CINAHL, MEDLINE, and the Cochrane Library. The key concepts identified in this question are music therapy, palliative care, hospice, and effectiveness. These concepts can be used to construct search strings for locating relevant data and literature for answering this question.
Inclusion and Exclusion Criteria
The inclusion criteria for this research question specify that the studies should involve music therapy for palliative care patients in hospice, and should evaluate the effectiveness of the therapy. The exclusion criteria can include any studies not involving music therapy, or studies involving patients not in palliative care or hospice.
The evaluation results are presented in Table 6 and the data from the studies are organized in evidence matrices in Tables 7 to 12. Our tool employs questions to help reviewers consider the articles methodically, determine the calibre and strength of the study, and determine whether the articles were considered methodically with the review. (Holland and Rees, 2010)
Table 5: Critical appraisal tool
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Table 6: (Liu et al., 2015)
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Table 7: (Graham-Wisener et al., 2018)
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Table 8: (Porter et al., 2018)
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Table 9: (Porter et al., 2017)
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Table 10: (Pommeretet al., 2019)
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Table 11: (Nyashanu et al., 2021)
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4. Narrative
Overview of music therapy for patients receiving end of life care
The findings of six studies were analysed in order to pinpoint key themes about music therapy in patients receiving palliative care in hospice settings. Our selection of articles consisted of both meta-analyses and primary researches. Four dominant themes emerged and were used to form the basis of this narrative. First is the implementation of music therapy in hospices for patients receiving end of life care. The second component assesses how patients' quality of life is affected by music therapy. Therapy through music is also used for management of pain and cancer treatment as the third theme. Fourth is about, Effectiveness of music therapy.
In hospice settings, music therapy is becoming more and more common as a supplemental therapy for palliative care. A growing corpus of research has examined how music therapy might help patients undergoing palliative care, including how it might lessen their anxiety, pain, and depression symptoms. (Bradt,et al., 2016; Hilliard, 2005; Li,et al., 2019; Nyashanu, etal.,2021). As a worthwhile and non-pharmacological treatment option, music therapy is an established therapeutic method (Creechet al., 2013). According to González-Ojeaet al.(2022) older people's health and wellbeing can be greatly enhanced by music.
Although music therapy's potential benefits in palliative care are widely acknowledged, academics continue to disagree about how successful it is in hospice settings.We shall critically assess several aspects of music therapy for palliative care in hospice in this part. including its effectiveness, implementation in health care settings, patient demographics, and its implementation for Cancer and pain management.
The implementation of music therapy in hospice settings
In hospice settings, the implementation of music therapy is another area of focus in the literature. Some articles suggest that music therapy can be effectively integrated into hospice settings, but this requires proper training and resources for music therapists. According to Wigramet al. (2002), with the right training and resources for music therapists, music therapy may be successfully incorporated into a hospice setting and was well-received by patients in hospice care. However, other articles emphasize the need for careful consideration of the availability of resources and the training of music therapists before implementing music therapy in hospice settings.
The articles by Porteret al. (2018) and (2017) evaluate the implementation of music therapy in hospice settings through a randomized controlled pilot, feasibility study as well as a critical realist evaluation, respectively. Both studies found that music therapy enhanced hospice patients' quality of life, proving that it would be advantageous to use it as an intervention in this setting. The article by Pommeretet al. (2019) conducted a qualitative study of patients with cancerto investigate the views and experiences with therapy by music for palliative care. According to this report, music was perceived as beneficial in managing physical and psychological symptoms, reducing stress and anxiety, and improving overall quality of life. These articles suggest that music therapy may have a valuable role in hospice care.
The article by Nyashanuet al. (2021) presents a review study of music therapy's effectiveness in hospice settings. The authors conducted a comprehensive search of the literature and analyzed the results to give a summary of the present situation of research on the topic. The scoping review found that therapy by In palliative care patients, music has been proven to be effective in enhancing quality of life and easing symptoms. However, the authors noted that the quality of evidence was moderate to low and It is necessary to do a more thorough examination of the potential benefits of music therapy in hospice settings. Overall, music therapy may benefit hospice patients, but further studies are required to determine its effectiveness.
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- Quote paper
- Anonymous,, 2023, The benefits of music therapy for palliative care patients in hospice, Munich, GRIN Verlag, https://www.hausarbeiten.de/document/1358789
