Music for Wellness: An 8-Week Study of the Psychosocial Effects of Music Therapy on Cancer Patients

Background: Music therapy offers patients a way to address the psycho-social impacts of a cancer diagnosis and treatment. Research suggests that complementary therapies, such as music and art therapy, provide an opportunity for patients to express their emotions and make meaning of their experiences, as well as providing social connections to other patients. A better understanding of the specific benefits that may be achieved from these programs and the mechanism through which this might occur will help us better tailor services to patients' needs. While an increasing number of cancer care centers now offer complementary therapies as a way to support patients with cancer, there are few prospective evaluations that examine the benefits derived from program completion beyond patient satisfaction measures. Aim: The aim of this project is to examine the impact of music therapy on specific patient reported outcomes and the factors that influence how and why this occurs. Methods: Participants in an 8-week group music therapy program will be asked to complete a suite of measures prior to program commencement, and at 1-week and 1-month postprogram completion. Measures include core constructs of well-being such as distress, quality of life and symptom severity, as well as constructs specifically targeted by the music therapy program, such as meaning making, emotional expression and social connectedness. A waitlist control will provide comparison data at comparable time-points. Results: The music therapy program will run from April-May 2018, with the postprogram evaluation being completed in June 2018. Preliminary data will be presented and the suitability of this method will be considered. Conclusion: In the context of a comprehensive cancer center in Victoria, Australia, we will present data on the effectiveness of a music therapy program for addressing patients' well-being. We will discuss implications for the provision of supportive care for cancer patients and survivors and how the design of future programs might be tailored to achieve key outcomes.

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Complementary Therapies for Cancer Patients: A Narrative Inquiry from the Perspective of Three Health Care Practitioners

MCAST Journal of Applied Research & Practice ◽

10.5604/01.3001.0015.0188 ◽

2021 ◽

Vol 5 (1) ◽

pp. 104-126

Author(s):

Stephanie Borg Spagnol

Keyword(s):

Narrative Inquiry ◽

Cancer Patients ◽

Narrative Analysis ◽

Cancer Care ◽

Complementary Therapies ◽

Well Being ◽

Cross Sectional Study ◽

Clinical Psychologist ◽

Cross Sectional ◽

The Impact

This paper explores the experiences of an oncologist, a clinical complementary therapist, and a clinical psychologist regarding the use of complementary therapies (CTs) by cancer patients. Additionally, it also investigates the efficacy of CTs and their contribution in alleviating the side-effects of cancer and its treatment when used simultaneously with conventional cancer medication. A qualitative research design using narrative inquiry was adopted to gain the in-depth experience of the three participants. It is a cross-sectional study, portraying a longitudinal perspective through the professional years of experience that these research participants have in the oncology domain. Purposive sampling was the method used to choose the participants, and data was collected through in-depth narrative interviewing. The interviews were transcribed and analysed using thematic narrative analysis. Four central themes emerged from this study that depict: (1) the impact of cancer on the patients’ well-being, (2) the role of complementary therapies from the practitioners’ perspective, (3) the need for reliable information that is easily accessible to both patients and healthcare practitioners, and (4) the imminent demand for therapists who are qualified in clinical complementary therapies. Conclusions drawn from this study indicate that more evidence-based research is required to support the use of CTs in cancer care as well as additional training on CTs to the healthcare professionals. It is advised that oncology doctors are informed about the versatility of CTs, their benefits and the possible harmful interactions with conventional cancer medication, and additionally, it is recommended that in order to increase patients’ awareness of the use of CTs within cancer care, information on their safety and efficacy should be made more readily available to the patients. Furthermore, the need for more complementary therapists who are specialised to work within the field of oncology was identified, hence it is recommended that local vocational institutions such as MCAST address this demand by providing accredited courses and training in clinical complementary therapies.

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Linguistic and Psychometric Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia

Journal of Global Oncology ◽

10.1200/jgo.18.60700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 115s-115s

Author(s):

B. Shunnmugam ◽

S. Sinnadurai ◽

S.H. Chua ◽

T. Islam ◽

M.H. See ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Intraclass Correlation ◽

Well Being ◽

Cancer Surgery ◽

Psychometric Validation ◽

Breast Cancer Surgery ◽

Breast Cancer Patients ◽

Patient Reported ◽

The Impact

Background: BREAST-Q is a PROMs used to measure and assess patient satisfaction and quality of life before and after breast cancer surgery. BREAST-Q composed of 5 different modules and each module comprised of multiple scales. Each module has preoperative and postoperative versions to assess the impact of surgery. Four subscales with common items from the 5 modules: “satisfaction with the breast”, psychosocial, sexual and physical well-being were subjected to testing. Two other subscales, “satisfaction with overall outcomes” and “satisfaction with the care” were only validated linguistically. Currently, the BREAST-Q has already been translated into 25 languages. Linguistic and psychometric validation of BREAST-Q has not been performed in Malaysia. Aim: To translate the BREAST-Q into Malay language and perform psychometric validation. Methods: Translation of the English BREAST-Q to Malay language was done based on linguistic validation protocol provided by MAPI Research Trust. Content and face validation were performed to determine contextual accuracy, acceptability and understanding of the items. The finalised Malay BREAST-Q then underwent psychometric testing. Breast cancer patients (n=186) who were planned for breast cancer surgery were conveniently sampled at the breast clinic of UMMC between June 2015 to June 2016. Consented participants completed the questionnaire in the same visit following their diagnosis. Retest was done 2-3 weeks after the first questionnaire administration in 62 patients who were admitted for their surgery. Data were analyzed using SPSS and AMOS software. Results: Content experts (4 breast surgeons) agreed the items in BREAST-Q comprehensively measured the concept of interest and I-CVI for each item was 1.0. Participants agreed the questionnaire was comprehensive and easy to understand. The average time taken to complete the questionnaire was 15.3 minutes. Test–retest analysis showed good reproducibility with intraclass correlation coefficient (ICC) value of 0.71-0.98. Internal consistencies were good for all items in each subscale with Cronbach's alpha values of 0.83-0.95. The highest interitem correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation (CITC) values ranged from 0.47 to 0.72. In exploratory factor analysis, the KMO values were excellent in all 4 subscales (0.76, 0.92, 0.91, and 0.86). Single factor was extracted in 3 subscales that explained more than 50% of the variance and 3 factors (breast pain, general pain, and discomfort) were extracted in “physical well-being” subscale that cumulatively explained more than 50% of the variance. Conclusion: The Malay BREAST-Q demonstrated good reliability, content and face validity, and excellent psychometric properties. Hence, we propose the use of the Malay BREAST-Q to measure patient reported outcomes among breast cancer patients in Malaysia undergoing breast cancer surgery.

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Vision-related quality of life in adults with severe peripheral vision loss: a qualitative interview study

Journal of Patient-Reported Outcomes ◽

10.1186/s41687-020-00281-y ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Ryan Lange ◽

Abigail Kumagai ◽

Sara Weiss ◽

Katherine B. Zaffke ◽

Sherry Day ◽

...

Keyword(s):

Quality Of Life ◽

Contrast Sensitivity ◽

Qualitative Interviews ◽

Well Being ◽

Vision Impairment ◽

Qualitative Interview Study ◽

Patient Reported ◽

Related Quality ◽

The Impact

Abstract Background Existing patient-reported outcome (PRO) measures may not be relevant to the full range of functional and vision-related quality of life (VR-QOL) concerns of individuals with vision impairment due to severe peripheral field loss (PFL). Measurement of VR-QOL in severe PFL is important in order to determine the effectiveness of vision rehabilitation interventions for this population. The purpose of this study was to characterize the impact of severe PFL due to retinitis pigmentosa (RP) and glaucoma on VR-QOL as the initial phase in the development of a novel PRO measure. Methods Individuals with severe PFL due to RP or glaucoma were recruited from the Kellogg Eye Center and the Association for the Blind and Visually Impaired. Participants completed semi-structured qualitative interviews, the Impact of Vision Impairment (IVI) questionnaire and the RAND 36-Item Health Survey. Interviews were analyzed by two coders using thematic analysis. A matrix analysis was conducted to compare VR-QOL by cause of severe PFL. Sample size was determined by thematic saturation. Results The study included 37 participants (19 RP, 18 glaucoma). Median best-corrected visual acuity for those with RP and glaucoma was 20/40 and 20/27.5, while Pelli-Robson contrast sensitivity was 1.2 log contrast sensitivity (logCS) and 1.1 logCS, respectively. Median domain scores on the IVI (reading, mobility, well-being) ranged from a low of − 0.2 to a high of 0.7 logits in those with RP and from 0.5 to 1.2 logits in those with glaucoma. Qualitative interviews identified six VR-QOL themes relevant across participants with both RP and glaucoma, including activity limitations, driving, emotional well-being, reading, mobility, and social function. VR-QOL concerns were largely consistent among those with severe PFL due to RP and glaucoma. These overarching themes contained content relevant to specific challenges related to severe PFL. Conclusions There are commonly occurring VR-QOL concerns among individuals with severe PFL due to RP and glaucoma. The outlined themes will serve as the basis for development of the Low Vision Severely Constricted Peripheral Eyesight (LV-SCOPE) Questionnaire.

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Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ quality of life: An Arabic version of the Functional Living Index-Emesis

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155221998447 ◽

2021 ◽

pp. 107815522199844

Author(s):

Abdullah M Alhammad ◽

Nora Alkhudair ◽

Rawan Alzaidi ◽

Latifa S Almosabhi ◽

Mohammad H Aljawadi

Keyword(s):

Quality Of Life ◽

Cancer Patients ◽

Arabic Language ◽

Nausea And Vomiting ◽

Cancer Center ◽

Arabic Version ◽

Patient Reported ◽

Arabic Speaking ◽

The Impact

Introduction Chemotherapy-induced nausea and vomiting is a serious complication of cancer treatment that compromises patients’ quality of life and treatment adherence, which necessitates regular assessment. Therefore, there is a need to assess patient-reported nausea and vomiting using a validated scale among Arabic speaking cancer patient population. The objective of this study was to translate and validate the Functional Living Index-Emesis (FLIE) instrument in Arabic, a patient-reported outcome measure designed to assess the influence of chemotherapy-induced nausea and vomiting on patients’ quality of life. Methods Linguistic validation of an Arabic-language version was performed. The instrument was administered to cancer patients undergoing chemotherapy in a tertiary hospital's cancer center in Saudi Arabia. Results One-hundred cancer patients who received chemotherapy were enrolled. The participants’ mean age was 53.3 ± 14.9 years, and 50% were female. Half of the participants had a history of nausea and vomiting with previous chemotherapy. The Cronbach coefficient alpha for the FLIE was 0.9606 and 0.9736 for nausea and vomiting domains, respectively, which indicated an excellent reliability for the Arabic FLIE. The mean FLIE score was 110.9 ± 23.5, indicating no or minimal impact on daily life (NIDL). Conclusions The Arabic FLIE is a valid and reliable tool among the Arabic-speaking cancer population. Thus, the Arabic version of the FLIE will be a useful tool to assess the quality of life among Arabic speaking patients receiving chemotherapy. Additionally, the translated instrument will be a useful tool for future research studies to explore new antiemetic treatments among cancer patients.

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Changes in fatigue, barriers, and predictors towards physical activity in advanced cancer patients over a period of 12 months—a comparative study

Supportive Care in Cancer ◽

10.1007/s00520-021-06020-3 ◽

2021 ◽

Author(s):

J. Frikkel ◽

M. Beckmann ◽

N. De Lazzari ◽

M. Götte ◽

S. Kasper ◽

...

Keyword(s):

Physical Activity ◽

Cancer Patients ◽

Advanced Cancer ◽

Physical Functioning ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Advanced Cancer Patients ◽

Psychological Conditions ◽

Patient Reported

Abstract Purpose Physical activity (PA) is recommended to improve advanced cancer patients’ (ACP) physical functioning, fatigue, and quality of life. Yet, little is known about ACPs’ attitude towards PA and its influence on fatigue and depressiveness over a longer period. This prospective, non-interventional cohort study examined ACPs’ fatigue, depression, motivation, and barriers towards PA before and after 12 months of treatment among ACP Methods Outpatients with incurable cancer receiving treatment at a German Comprehensive Cancer Center reporting moderate/severe weakness/tiredness during self-assessment via MIDOS II were enrolled. Fatigue (FACT-F), depression (PHQ-8), cancer-related parameters, self-assessed PA behavior, motivation for and barriers against PA were evaluated (T0). Follow-up data was acquired after 12 months (T1) using the same questionnaire. Results At follow-up, fatigue (p=0.017) and depressiveness (p=0.015) had increased in clinical relevant extent. Physically active ACP did not show significant progress of FACT-F (p=0.836) or PHQ-8 (p=0.799). Patient-reported barriers towards PA remained stable. Logistic regression analyses identified motivation as a positive predictor for PA at both time points (T0, β=2.152, p=0.017; T1, β =2.264, p=0.009). Clinically relevant depression was a negative predictor for PA at T0 and T1 (T0, β=−3.187, p=0.044; T1, β=−3.521, p=0.041). Conclusion Our findings emphasize the importance of psychological conditions in physical activity behavior of ACP. Since psychological conditions seem to worsen over time, early integration of treatment is necessary. By combining therapy approaches of cognitive behavioral therapy and exercise in interdisciplinary care programs, the two treatment options might reinforce each other and sustainably improve ACPs’ fatigue, physical functioning, and QoL. Trial registration German Register of Clinical Trials, DRKS00012514, registration date: 30.05.2017

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Music therapy effectiveness by duration in patients with cancer: a meta-regression

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2021-003163 ◽

2021 ◽

pp. bmjspcare-2021-003163

Author(s):

Ronald Chow ◽

Robert Bergner ◽

Elizabeth Prsic

Keyword(s):

Quality Of Life ◽

Music Therapy ◽

Positive Association ◽

Well Being ◽

Patients With Cancer ◽

Therapy Effectiveness ◽

Meta Regression ◽

Meta Analyses ◽

The Impact

ObjectivesSeveral reviews and meta-analyses have reported on music therapy for physical and emotional well-being among patients with cancer. However, the duration of music therapy offered may range from less than 1 hour to several hours. The aim of this study is to assess whether longer duration of music therapy is associated with different levels of improvement in physical and mental well-being.MethodsTen studies were included in this paper, reporting on the endpoints of quality of life and pain. A meta-regression, using an inverse-variance model, was performed to assess the impact of total music therapy time. A sensitivity analysis was conducted for the outcome of pain, among low risk of bias trials.ResultsOur meta-regression found a trend for positive association between greater total music therapy time and improved better pain control, but it was not statistically significant.ConclusionThere is a need for more high-quality studies examining music therapy for patients with cancer, with a focus on total music therapy time and patient-related outcomes including quality of life and pain.

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P1062EXPANDED DIALYSIS (HDX): IS THERE AN IMPACT ON PATIENT REPORTED SYMPTOM?

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1062 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Jarrin Penny ◽

Fabio R Salerno ◽

Lisa Hur ◽

Christopher McIntyre

Keyword(s):

Quality Of Life ◽

Clinical Outcomes ◽

Symptom Burden ◽

Well Being ◽

Response To Therapy ◽

High Flux ◽

Patient Reported ◽

Dialysis Membranes ◽

The Impact

Abstract Background and Aims High flux dialysis membranes sufficiently remove smaller sized uremic toxins however, the accumulation and retention of larger middle molecular weight toxins, which are associated with chronic inflammation, cardiovascular disease and suboptimal outcomes are poorly cleared. The recent advent of medium-cut-off dialysis membranes, labelled “expanded dialysis” (HDx) are permeable to molecules of larger size responsible for poor clinical outcomes. However, it remains unclear if HDx can directly impact the symptoms associated with hemodialysis (HD). Symptom burden plays a significant role in quality of life (QOL) and mortality rates in the HD population. The London Evaluation of Illness (LEVIL), an application-based platform has been developed to measure patient reported outcomes (PROM). In comparison to cross-sectional PROM’s, LEVIL more accurately represents the fluctuations in daily symptoms and the impact of intervention. LEVIL evaluates general well-being, energy, sleep, appetite, pain and breathing, all of which are outcomes of interest on symptom burden in chronic kidney disease. Our aim was to determine if HDx therapy had any effect on symtoms/QOL domains using LEVIL. Method 28 patients from two dialysis centers in London Ontario were consented to participate. Patients were required to be over 18 years of age and on conventional thrice weekly maintenance HD for at least three months. 23 participants completed study and analyzed (five lost for various reasons). Baseline (BL) symptom characteristics were obtained while using high flux membrane for two weeks. Symptoms continued to be measured throughout the 12 weeks of HDx therapy two-three times weekly using LEVIL. Laboratory biomarkers including beta-2 microglobulin and free-light chains were collected at baseline and after 12 weeks of HDx therapy. Results Patients were stratified into tertiles (high/middle/low) using mean values of BL symptoms scores in each domain (wellbeing, energy, sleep, appetite, pain, breathing). Those in the high BL group were labeled as “control”. Low and middle BL measures were further stratified into responders vs. non-responders (responders were considered to have a 50% increase in any symptom domain by ≥50%). Of those domains which responded to HDx, 76% also had low BL scores with 27% having middle BL scores. General wellbeing, energy and sleep were domains with the greatest response reaching statistical significance after eight weeks of therapy. HDx had limited effect on appetite, pain and breathing. Although stratification was per domain, overall, 74% of the population studied did respond in at least one domain, with some responding in as many as five. Conclusion HDx using Theranova (Baxter) shows the most benefit in domains with low BL measures. Additionally, not everyone who had low BL scores responded after 12 weeks of therapy, leaving us to question whether HDx may have a latent effect in some individuals/populations. Those who had no response to therapy in certain domains also had greater baseline quality of life respectively. This information may assist in decision making/rationale for the utilization and implementation of such therapy. Although more work is required to further stratify symptoms in relation to demographic/biochemical finding and clinical outcomes. It is evident that HDx improves patient reported symptoms and QOL.

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Power and physician leadership

BMJ Leader ◽

10.1136/leader-2019-000139 ◽

2019 ◽

Vol 3 (3) ◽

pp. 92-98 ◽

Cited By ~ 3

Author(s):

Anurag Saxena ◽

Diane Meschino ◽

Lara Hazelton ◽

Ming-Ka Chan ◽

David A Benrimoh ◽

...

Keyword(s):

Interprofessional Education ◽

Meaning Making ◽

Well Being ◽

Power Bases ◽

Physician Leadership ◽

Abuse Of Power ◽

Inappropriate Use ◽

Physician Leaders ◽

Study Power ◽

The Impact

Power and leadership are intimately related. While physician leadership is widely discussed in healthcare, power has received less attention. Formal organisational leadership by physicians is increasingly common even though the evidence for the effectiveness of physician leadership is still evolving. There is an expectation of leadership by all physicians for resource stewardship. The impact of power on interprofessional education and practice needs further study. Power also shapes the profession’s attempts to address physician and learner well-being with its implications for patient care. Unfortunately, the profession is not exempt from inappropriate use of power. These observations led the authors to explore the concept and impact of power in physician leadership. Drawing from a range of conceptualisations including structuralist (French and Raven), feminist (Allen) and poststructuralist (Foucault) conceptualisations of power, we explore how power is acquired and exercised in healthcare systems and enacted in leadership praxis by individual physician leaders (PL). Judicious use of power will benefit from consideration and application of a range of concepts including liminality, power mediation, power distance, inter-related use of power bases, intergroup and shared leadership, inclusive leadership, empowerment, transformational leadership and discourse for meaning-making. Avoiding abuse of power requires moral courage, and those who seek to become accountable leaders may benefit from adaptive reflection. Reframing ‘followers’ as ‘constituents or citizens’ is one way to interrupt discourses and narratives that reinforce traditional power imbalances. Applying these concepts can enhance creativity, cocreation and citizenship-strengthening commitment to improved healthcare. PLs can contribute greatly in this regard to further transform healthcare.

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Fatigue in patients on oral targeted or chemotherapy for cancer and associations with anxiety, depression, and quality of life

Palliative & Supportive Care ◽

10.1017/s147895151900066x ◽

2019 ◽

Vol 18 (2) ◽

pp. 141-147

Author(s):

Hanneke Poort ◽

Jamie M. Jacobs ◽

William F. Pirl ◽

Jennifer S. Temel ◽

Joseph A. Greer

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Oral Treatment ◽

Depression Scale ◽

Well Being ◽

Anxiety Symptoms ◽

Severe Fatigue ◽

Patient Reported ◽

The Impact

AbstractObjectivesOral treatment (targeted or chemotherapy) for cancer is being increasingly used. While fatigue is a known side effect of intravenous chemotherapy, the rate of fatigue and the impact of fatigue on other patient-reported outcomes are not well described.MethodAt Massachusetts General Hospital Cancer Center, 180 adult patients prescribed oral targeted or chemotherapy for various malignancies enrolled in a randomized controlled trial of adherence and symptom management. Patients completed baseline self-reported measures of fatigue (Brief Fatigue Inventory; BFI), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale; HADS), and quality of life, including subscales for physical, social, emotional, and functional well-being ([QOL] Functional Assessment of Cancer Therapy — General; FACT-G). We examined clinically relevant fatigue using a validated cut-off score for moderate-severe fatigue (BFI global fatigue ≥4) and tested the associations with anxiety symptoms, depressive symptoms, and QOL with independent samples t-tests.ResultsAt baseline, 45 of 180 participants (25.0%) reported moderate-severe fatigue. Fatigued patients experienced more anxiety symptoms (mean diff. 3.73, P < 0.001), more depressive symptoms (mean diff. 4.14, P < 0.001), and worse QOL on the total FACT-G score (mean diff. −19.58, P < 0.001) and all subscales of the FACT-G compared to patients without moderate-severe fatigue.Significance of resultsOne in four patients on oral treatment for cancer experienced clinically relevant fatigue that is associated with greater anxiety and depressive symptoms and worse QOL.

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Complementary therapies in pain management

10.1093/med/9780199656097.003.0912 ◽

2015 ◽

Cited By ~ 3

Author(s):

Gary Deng ◽

Barrie R. Cassileth

Keyword(s):

Pain Management ◽

Music Therapy ◽

Complementary Therapies ◽

Emotional State ◽

Belief System ◽

Management Plan ◽

Opioid Therapy ◽

Analgesic Effects ◽

Anxiety Depression ◽

The Impact

Complementary therapies are modalities that are not traditionally part of Western medical care. Some of these therapies have demonstrated a favourable benefit:risk ratio in recent research and many can be incorporated into a multimodality pain management plan. In general, complementary therapies reduce pain by interfering with the processing of pain signals or lessen the impact of pain on the patient’s emotional state. Mind-body therapies, such as hypnosis, meditation, yoga/qigong, and music therapy, can reduce anxiety, depression, and stress-all common in patients experiencing pain. Acupuncture appears to have direct analgesic effects and reduce nausea and vomiting, which are potential side effects from opioid therapy. Massage therapy may reduce anxiety, and to a lesser degree, depression and pain. Complementary therapies are generally safe when provided by trained practitioners, although certain safety precautions still need to be exercised. The origin of pain, the factors complicating it, burdens and risks to patient, and each patient’s belief system and cultural background should all be considered when selecting from among the complementary modalities for pain.

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