‘Song of Life’: music therapy in terminally ill patients with cancer

2018 ◽  
Vol 8 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Marco Warth ◽  
Jens Kessler ◽  
Josien van Kampen ◽  
Beate Ditzen ◽  
Hubert J Bardenheuer

ObjectivesMusic therapy (MT) holds a promising potential to meet emotional and existential needs in palliative care patients. The aim of the present pilot study was to assess the feasibility, acceptance and potential effectiveness of a novel MT intervention to improve life closure and spiritual well-being of terminally ill patients with cancer receiving palliative care.MethodsThe ‘Song of Life’ (SOL) intervention was provided on two consecutive sessions containing a biographical interview and a live performance of a song with high biographical relevance to the patient in a lullaby style. Pre-to-post intervention assessments comprised brief self-report measures on life closure, well-being, stress, worry and pain.Results13 out of 15 patients were able to complete the protocol as intended. The chosen songs were associated with a close person, an important place or event or with a religious belief. The results showed medium-sized improvements with regard to life closure, well-being, relaxation, worry and pain.Conclusion‘SOL’ proved to be a feasible and highly accepted intervention for patients approaching the end of their lives. Further consideration with regard to the procedures and outcomes is necessary before implementation of a randomised trial.

Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Yuuna Tahara ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
...  

Abstract Purpose The aims of the present study were to investigate the symptom clusters in terminally ill patients with cancer using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL), and to examine whether these symptom clusters influenced prognosis. Methods We analyzed data from 130 cancer patients hospitalized in the palliative care unit from June 2018 to December 2019 in an observational study. Principal component analysis was used to detect symptom clusters using the scored date of 14 items in the QLQ-C15-PAL, except for overall QOL, at the time of hospitalization. The influence of the existence of these symptom clusters and Palliative Performance Scale (PPS) on survival was analyzed by Cox proportional hazards regression analysis, and survival curves were compared between the groups with or without existing corresponding symptom clusters using the log-rank test. Results The following symptom clusters were identified: cluster 1 (pain, insomnia, emotional functioning), cluster 2 (dyspnea, appetite loss, fatigue, and nausea), and cluster 3 (physical functioning). Cronbach’s alpha values for the symptom clusters ranged from 0.72 to 0.82. An increased risk of death was significantly associated with the existence of cluster 2 and poor PPS (log-rank test, p = 0.016 and p < 0.001, respectively). Conclusion In terminally ill patients with cancer, three symptom clusters were detected based on QLQ-C15-PAL scores. Poor PPS and the presence of symptom cluster that includes dyspnea, appetite loss, fatigue, and nausea indicated poor prognosis.


2020 ◽  
Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Yoshihiro Shitashimizu ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
...  

Abstract Background The clinical use of patient-reported outcomes as compared to inflammatory biomarkers for predicting cancer survival remains a challenge in palliative care settings. We evaluated the accuracy of survival prediction in both indicators of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative scores (EORTC QLQ-C15-PAL) and the inflammatory biomarkers C-reactive protein (CRP), albumin (Alb), and neutrophil-lymphocyte ratio (NLR) in patients with advanced cancer. Methods This was an observational study in terminally ill patients with cancer hospitalized in a palliative care unit between June 2018 and December 2019. Patients’ data collected at the time of hospitalization were analyzed. Cox regression was performed to examine significant factors influencing survival. A receiver operating characteristic (ROC) analysis was performed to estimate cut-off values for predicting survival within 3 weeks, and a log-rank test was performed to compare survival curves between groups divided by the cut-off values. Results Totally, 130 patients participated in the study. Cox regression suggested that the QLQ-C15-PAL dyspnea and fatigue scores and levels of CRP, Alb, and NLR were significantly associated with survival time, and cut-off values were 66.67, 66.67, 3.0 mg/dL, 2.5 g/dL, and 8.2, respectively. The areas under ROC curves of these variables were 0.6–0.7. There were statistically significant differences in the survival curves between groups categorized using each of these cut-off values (p < .05 for all cases). Conclusion Our findings suggest that the assessment of not only objective indicators for the systemic inflammatory response but also patient-reported outcomes using EORTC QLQ-C15-PAL is beneficial for the prediction of short-term survival in terminally ill patients with cancer.


Author(s):  
Chikako Matsumura ◽  
Nanako Koyama ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
Takehisa Nomura ◽  
...  

Background: Few studies evaluated whether health care professionals accurately assess several symptoms for patients with cancer in palliative care units. We determined the agreement level for several symptoms related to quality of life (QOL) between patient-reported QOL assessment and health care professional-assessed symptoms based on the Support Team Assessment Schedule (STAS). Method: An observational study was performed with terminally ill patients with cancer hospitalized in the palliative care unit between June 2018 and December 2019. Patients and health care professionals independently assessed 7 symptoms at the time of hospitalization and after 1 week. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL). In examining the proportions of exact agreement, “exact agreement” referred to the pairs of the scores (QLQ-C15-PAL vs STAS) being (1 vs 0), (2 vs 1), (3 vs 2 or 3), or (4 vs 4). The relationships of physical functioning between QLQ-C15-PAL and Palliative Performance Scale (PPS) were examined. Results: Of 130 patients, approximately 60% had PPS scores from 40 to 60. The highest mean score on QLQ-C15-PAL was for fatigue (63.8). The exact agreement on symptoms between patients and health care professionals ranged from 15.4% (fatigue) to 57.7% (nausea and vomiting). The mean of the transformed QLQ-C15-PAL and proportions of exact agreement were negatively correlated ( R 2 = 0.949, P < .05). The physical function scores in QLQ-C15-PAL for each PPS group showed no differences. Conclusion: We expect patient-reported outcomes including QLQ-C15-PAL to be added to health care professionals’ assessment of serious symptoms such as fatigue in terminally ill patients with cancer.


2012 ◽  
Vol 30 (7) ◽  
pp. 730-733 ◽  
Author(s):  
Koji Amano ◽  
Tatsuya Morita ◽  
Mika Baba ◽  
Muneyoshi Kawasaki ◽  
Shinichiro Nakajima ◽  
...  

2021 ◽  
pp. bmjspcare-2021-003180
Author(s):  
Ruishuang Zheng ◽  
Qiaohong Guo ◽  
Zhiqian Chen ◽  
Yingchun Zeng

ObjectivesDignity therapy (DT) is a brief, individualised psychotherapy that aims to alleviate psychosocial and spiritual distress in the final stages of life. It is unknown yet whether DT can enhance sense of dignity and improve psychological and spiritual well-being as well as quality of life of terminally ill patients.MethodsWe searched PubMed, EMBASE, CINAHL plus, ProQuest Health & Medical Complete, PsycINFO and the Cochrane Library, as well as Chinese databases including Weipu Data, Wanfang Data and China National Knowledge Infrastructure from inception to 30 April 2021, for randomised controlled trials (RCTs) assessing the effects of DT on dignity, psycho-spiritual well-being and quality of life of terminally ill patients receiving palliative care.ResultsWe identified 507 unique records, and included 9 RCTs (871 participants). Comparator was standard palliative care. DT did not improve terminally ill patients’ sense of dignity (p=0.90), hope (p=0.15), spiritual well-being (p=0.99) and quality of life (p=0.23). However, DT reduced anxiety and depression after intervention (standardised mean difference, SMD=−1.13, 95% CI (−2.21 to –0.04), p=0.04; SMD=−1.22, 95% CI (−2.25 to –0.18), p=0.02, respectively) and at 4 weeks post-intervention (SMD=−0.89, 95% CI (−1.71 to –0.07), p=0.03; SMD=−1.26, 95% CI (−2.38 to –0.14), p=0.03, respectively).ConclusionDT can be offered as a psychological intervention for terminally ill patients to reduce their anxiety and depression. More studies are needed to further evaluate the effects of DT on terminally ill patients’ dignity, spiritual well-being and quality of life.


Author(s):  
Caroline Leite de Lima ◽  
Mariane De Jesus Carvalho ◽  
Elaine Reda da Silva

Este estudo teve como objetivo apresentar e analisar a produção científica nacional e internacional envolvendo a aplicação da musicoterapia em pacientes portadores de câncer e/ou em cuidados paliativos. Realizou-se uma revisão integrativa na base de dados Scientific Eletronic Library Online (SciELO) e Biblioteca Virtual em Saúde (BVS). Dos 18 artigos selecionados, 12 abordaram os benefícios da utilização da musicoterapia; 4 às percepções de familiares e 2 outras abordagens (um avaliou a qualidade de evidências científicas sobre intervenções musicais e outro assuntos e necessidades apresentados durante a musicoterapia). Conclui-se que a musicoterapia contribui para o controle de sinais e sintomas, promove a comunicação, as expressões de sentimentos, emoções, bem-estar e conforto aos clientes e seus familiares. Porém, verifica-se a necessidade de mais pesquisas para determinar a melhor metodologia de intervenção, além de facilitar os contextos de implementação.Descritores: Cuidados paliativos, Neoplasias, Musicoterapia, Cuidados de enfermagem. Music therapy for cancer patients and/or in palliative care: an integrative literature reviewAbstract: This study aimed to present and analyze the national and international scientific production involving the application of music therapy in patients with cancer and/or palliative care. An integrative review was carried out in the Scientific Electronic Library Online (SciELO) and Virtual Health Library (VHL) database. Of the 18 articles selected, 12 addressed the benefits of using music therapy; 4 to the perceptions of family members and 2 other approaches (one evaluated the quality of scientific evidence on musical interventions and other subjects and needs presented during music therapy). It concludes that music therapy contributes to the control of signs and symptoms, promotes communication, expressions of feelings, emotions, well-being, and comfort to clients and their families. However, there is a need for more research to determine the best intervention methodology, as well as to facilitate implementation contexts.Descriptors: Palliative care, Neoplasms, Music therapy, Nursing care. Musicoterapia para pacientes con cáncer y/o cuidados paliativos: revisión integrativa de la literaturaResumen: Este estudio tenía como objetivo presentar y analizar la producción científica nacional e internacional que implica la aplicación de la musicoterapia en pacientes con cáncer y/o cuidados paliativos. Se llevó a cabo una revisión integradora en la base de datos Scientific Electronic Library Online (SciELO) y Virtual Health Library (VHL). De los 18 artículos seleccionados, 12 abordaron los beneficios del uso de la musicoterapia; 4 a las percepciones de los miembros de la familia y otros 2 enfoques (uno evaluó la calidad de la evidencia científica sobre intervenciones musicales y otros temas y necesidades presentadas durante la musicoterapia). Se concluye que la musicoterapia contribuye al control de los signos y síntomas, promueve la comunicación, las expresiones de sentimientos, las emociones, el bienestar y la comodidad de los clientes y sus familias. Sin embargo, es necesario realizar más investigaciones para determinar la mejor metodología de intervención, además de facilitar los contextos de implementación.Descriptores: Cuidados paliativos, neoplasias, terapia musical, cuidados de enfermería.


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