Medical Research: What is the background for this study? What are the main findings?
Response: Patients awaiting breast cancer surgery may be understandably anxious. While pharmacologic intervention may reduce anxiety, higher doses of preoperative drugs can depress circulation and respiration, making alternative measures a particular interest. Music therapy is the clinical use of music interventions to accomplish individualized goals within a therapeutic relationship by a board-certified music therapist. While music in surgery has been researched under the label of “music therapy”, many of the studied investigations illicit recorded music provided by non-music therapy staff, making it truly “music medicine” practices instead. In this investigation, the effect of both live and recorded music therapy on anxiety, anesthesia requirements, recovery time and patient satisfaction were studied perioperatively. Breast cancer surgery patients were engaged in a brief music therapy session which consisted of one live or recorded preferred song choice, followed by discussion and processing of emotions. Compared to usual care, both live and recorded music therapy groups experienced significantly greater reductions in anxiety (p<.001) with point reductions of 27.5 (42.5%) and 26.7 (41.2%), respectively. During surgery, both music groups listened to music-therapist selected recorded, instrumental harp music, chosen for it’s evidence-based therapeutic value of smooth lines, consistent volumes and stable melodies. In measuring the amount of interoperative drug (propofol) needed to reach moderate sedation, the intraoperative music was not found to have an effect in this trial. Patient satisfaction was universally high in all three study groups. Those who received live music preoperatively were discharged an average of 12.5 minutes sooner than those who received recorded music preoperatively, although neither music group was dischanged significantly sooner than the control group. Subjective reactions to the music interventions relayed that music therapy in surgery was an enjoyable addition.
Medical Research: What should clinicians and patients take away from your report?
Response: There is a place for music therapy and board certified music therapists in the surgical arena. While the operating ward is a busy clinical setting, our investigation found that one song presented within a 5-minute music therapy session can significantly reduce surgical anxiety in a safe, cost-effective and enjoyable way. Music therapists can engage patients with live music therapy preoperatively as well as create and train staff on effective recorded music implementation, so that every surgical patient may benefit from the anxiolytic properties of music. Of the 220 patients invited to participate in our study, 94% agreed to the possibility of music during surgery. We can speculate then, that music therapy is not only an effective adjunct to standard surgical care, but a welcome addition as well.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: Certainly more research on the effect of surgical music therapy is warranted, especially with live music interventions. Although personal contact can not be removed from traditional music therapy practices, future research may wish to employ an attention control group to assure that the effect is not due to the additional presence of a caring staff member. It is my hope that continued research will inspire surgical units to employ music therapists and allow surgical music therapy practices to commence nationwide.
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Jaclyn Bradley Palmer, MM, MT-BC (2015). Music Therapy Reduced Anxiety During Ambulatory Breast Cancer Surgery