• Guided imagery and music: using the Bonny method to evoke emotion and access the unconscious

    J Psychosoc Nurs Ment Health Serv. 2009 Jan;47(1):29-33

    • Beebe LH, Wyatt TH.
    • University of Tennessee College of Nursing, Knoxville, Tennessee 37996, USA

    The healing power of music has been recognized since ancient times. The use of music has been documented in diverse cultures worldwide, for ailments ranging from pain and cancer to depression and posttraumati stress disorder. The various models of music therapy are based on different theoretical traditions, including behaviorist, humanist, and psychodynamic approache This article describes the music therapy approach known as the Bonny Method of Guided Imagery and Music (GIM) therapy, reviews its research base, and presents a first-person account of the experience of GIM treatment.

  • Resounding attachment: cancer inpatients' song lyrics for their children in music therapy

    Support Care Cancer. 2008 Dec 17

    • O'Callaghan C, O'Brien E, Magill L, Ballinger E.
    • Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett Street, Melbourne, VIC, 8006, Australia

    GOALS OF WORK: Scant attention focuses on supporting parent-child communication during the parents' cancer hospitalizations. Parents may struggle to remain emotionally available. Caregiver absences may threaten secure attachment relationships with infants and elicit problems amongst older children. Music therapists help many parents with cancer to compose songs for their children. Their lyric analysis may provide insight into song writing's communicative and therapeutic potential. MATERIALS AND METHODS: Two song lyric groups were comparatively analyzed (based on grounded theory). One group included 19 songs written by 12 patients with the first author. Another included 16 songs written by 15 patients with three music therapists (including two authors), which were previously published or recorded for the public. Songs were composed by 20 mothers and seven fathers for at least 46 offspring. All parents had hematological or metastatic diseases. Qualitative inter-rater reliability was integrated. MAIN RESULTS: Comparable lyrical ideas in the two parent song groups included: love; memories; yearning for children; metaphysical presence (now and afterlife); loss and grief; the meaning and helpfulness of the children in their lives; hopes for and compliments about their children; encouragement; requests; personal reflections; existential beliefs; and suggestions about to whom the children can turn. CONCLUSIONS: Parents' song lyric messages may support their children during the parents' illnesses and through the children's developmental transitions and possible bereavement. Some parents use song writing for catharsis and to encourage their children's continuing attachment with them after death. Through promoting parent-child connectedness and emotional expression, therapeutic song writing can be a valuable oncologic supportive care modality.

  • The meaning of the music: the role of music in palliative care music therapy as perceived by bereaved caregivers of advanced cancer patients

    Am J Hosp Palliat Care. 2009 Feb-Mar;26(1):33-9. Epub 2008 Dec 1

    • Magill L.
    • University of Windsor, 1671 Victoria Avenue, Windsor, Ontario, Canada

    In an earlier qualitative research study exploring the meaning of preloss music therapy to bereaved caregivers who participated in sessions through a home-based hospice program, various narrative accounts revealed the significance of music in music therapy sessions. In this study, the role of music in palliative care music therapy is examined and representatively summarized, followed by a review of strategies provided by this author to home hospice patients and their caregivers. The reported perceptions of the meaning of music to 7 bereaved caregivers are presented, including a review of themes and associated narrations that illustrated its significance. The caregivers described these aspects of music in sessions to have memorable and lasting effects as follows: "music is a conduit,'' "music gets inside us,'' "live music makes a difference,'' and "music is love.'' Findings support the benefits of preloss music therapy for bereaved caregivers.

  • Effects of live music therapy sessions on quality of life indicators, medications administered and hospital length of stay for patients undergoing elective surgical procedures for brain.

    J Music Ther. 2008 Fall;45(3):349-59

    • Walworth D, Rumana CS, Nguyen J, Jarred J.
    • Tallahassee Memorial HealthCare, FL, USA

    The physiological and psychological stress that brain tumor patients undergo during the entire surgical experience can considerably affect several aspects of their hospitalization. The purpose of this study was to examine the effects of live music therapy on quality of life indicators, amount of medications administered and length of stay for persons receiving elective surgical procedures of the brain. Subjects (N = 27) were patients admitted for some type of surgical procedure of the brain. Subjects were randomly assigned to either the control group receiving no music intervention (n = 13) or the experimental group receiving pre and postoperative live music therapy sessions (n = 14). Anxiety, mood, pain, perception of hospitalization or procedure, relaxation, and stress were measured using a self-report Visual Analog Scale (VAS) for each of the variables. The documented administration of postoperative pain medications; the frequency, dosage, type, and how it was given was also compared between groups. Experimental subjects live and interactive music therapy sessions, including a pre-operative session and continuing with daily sessions until the patient was discharged home. Control subjects received routine hospital care without any music therapy intervention. Differences in experimental pretest and posttest scores were analyzed using a Wilcoxon Matched-Pairs Signed-Rank test. Results indicated statistically significant differences for 4 of the 6 quality of life measures: anxiety (p = .03), perception of hospitalization (p = .03), relaxation (p = .001), and stress (p = .001). No statistically significant differences were found for mood (p > .05) or pain (p > .05) levels. Administration amounts of nausea and pain medications were compared with a Two-Way ANOVA with One Repeated Measure resulting in no significant differences between groups and medications, F(1, 51) = 0.03; p > .05. Results indicate no significant differences between groups for length of stay (t = .97, df = 25, p > .05). This research study indicates that live music therapy using patient-preferred music can be beneficial in improving quality of life indicators such as anxiety, perception of the hospitalization or procedure, relaxation, and stress in patients undergoing surgical procedures of the brain.

  • The conjoint use of music therapy and reflexology with hospitalized advanced stage cancer patients and their families

    Palliat Support Care. 2008 Sep;6(3):289-96

    • Magill L, Berenson S.
    • School of Music, Faculty of Arts and Social Sciences, University of Windsor, Windsor, Ontario, Canada

    Advanced stage cancer patients experience debilitating physical symptoms as well as profound emotional and spiritual struggles. Advanced disease is accompanied by multiple changes and losses for the patient and the family. Palliative care focuses on the relief of overall suffering of patients and families, including symptom control, psychosocial support, and the meeting of spiritual needs. Music therapy and reflexology are complementary therapies that can soothe and provide comfort. When used conjointly, they provide a multifaceted experience that can aid in the reduction of anxiety, pain, and isolation; facilitate communication between patients, family members, and staff; and provide the potential for a more peaceful dying experience for all involved. This article addresses the benefits of the combined use of music therapy and reflexology. Two case studies are presented to illustrate the application and benefits of this dual approach for patients and their families regarding adjustment to the end of life in the presence of anxiety and cognitive impairment.

  • Music therapy in a comprehensive cancer center

    J Soc Integr Oncol. 2008 Spring;6(2):76-81

    • Richardson MM, Babiak-Vazquez AE, Frenkel MA
    • Integrative Medicine Program, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA

    The use of music as a therapeutic tool in health and medicine dates back to ancient times. In modern Western medicine, music therapy has been available since the 1950s and is now often incorporated into conventional medicine care. Music therapy is a common modality that is used in hospital settings as part of complementary and integrative medicine programs. It is also a key therapeutic tool used within most integrative medicine programs at large cancer centers in the United States. When used in conjunction with conventional cancer treatments, music therapy has been found to help patients promote a better quality of life; better communicate their fear, sadness, or other feelings; and better manage stress, while alleviating physical pain and discomfort. In this article, we review the literature on the value of integrating music therapy in cancer care and describe the experience of music therapy at a large comprehensive cancer center and the benefits that patients with cancer obtain from this service.

  • Integrative oncology: complementary therapies for cancer survivors

    Hematol Oncol Clin North Am. 2008 Apr;22(2):343-53, viii.

    • Wesa K, Gubili J, Cassileth B.
    • Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue (at 74(th) Street), New York, NY 10021, USA

    Cancer survivors experience a wide range of symptoms during and following completion of treatment, and some of these symptoms may persist for years or even decades. While pharmacologic treatments relieve many symptoms, they too may produce difficult side effects. Complementary therapies are noninvasive, inexpensive, and useful in controlling symptoms and improving quality of life, and they may be accessed by patients themselves. Rigorous scientific research has produced evidence that acupuncture, massage therapy, music, and mind-body therapies effectively and safely reduce physical and emotional symptoms. These therapies provide a favorable risk-benefit ratio and permit cancer survivors to help manage their own care.

  • Impact of music on pediatric oncology outpatients

    Pediatr Res. 2008 Jul;64(1):105-9

    • Kemper KJ, Hamilton CA, McLean TW, Lovato J.
    • Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA

    Music is widely used to enhance well-being. We wished to assess music's effect on pediatric oncology outpatients. Patients who had leukemia and were in maintenance or consolidation outpatient treatment served as their own control at two visits. At visit 1, children rested for 20 min; at visit 2, for 20 min they listened to music designed to increase vitality and improve heart rate variability (HRV). At both visits, parents completed before and after treatment visual analog scales (VAS) of their child's relaxation, well-being, vitality, anxiety, stress, and depression; patients' heart rates were monitored during treatments to calculate HRV. The 47 patients with complete VAS data and 34 patients with usable HRV data were similar. At baseline, VAS scores for negative states were low (average <2.5 of 10) and positive states were high (average 7> of 10). Relaxation improved more with music than rest (p < 0.01). The HRV parasympathetic parameter was significantly lower with music than rest. No other differences were significant. Further studies are needed to better delineate the relationship between subjective and objective measures of well-being among patients who are not in severe distress.

  • Experiencing music therapy cancer support

    J Health Psychol. 2008 Mar;13(2):190-200

    • Rykov MH
    • PO Box 142, Station C, Toronto, Ontario, M6J 3M9, Canada

    I portray health-related research outcomes in an arts-informed representation that disrupts the traditional discursive-scholarly format of journal writing to privilege better the participants' accounts and communicate these experientially. The representation uncovers meaning through alternative ways of communicating and conveys the ineffable quality of music in a manner that may be understood through and beyond words. This expands the convention of health-related research outcomes, including ways of knowing, what can be known and how this can be represented. I elaborate my intentions for this experiential report, discuss theoretical underpinnings of this methodology and describe a music therapy support group model.

  • Lullament: lullaby and lament therapeutic qualities actualized through music therapy

    Am J Hosp Palliat Care. 2008 Apr-May;25(2):93-9. Epub 2008 Jan 15

    • O'Callaghan C.
    • Peter MacCallum Cancer Centre and Caritas Christi Hospice, St Vincent's Health, Victoria, Australia

    Lullabies and laments promote new awareness, enculturation, adaptation, and grief expression. These concepts' relevance to palliative care, however, has not been examined. In this study, a music therapist used a grounded theory-informed design to reflexively analyze lullaby and lament qualities, evident in more than 20 years of personal palliative care practice. Thus, the construct "lullament" emerged, which signified helpful moments when patients' and families' personal and sociohistorical relationship with lullabies and laments were actualized. Specific music could be both a lullaby and a lament. A music therapist can enable the lullament through providing opportunities for music-contextualized "restorative resounding," expressed psychobiologically, verbally, musically, and metaphorically.

  • Pneumological aspects of wind instrument performance--physiological, pathophysiological and therapeutic considerations

    Pneumologie. 2008 Feb;62(2):83-7. Epub 2007 Dec 13

    • Kreuter M, Kreuter C, Herth F.
    • Innere Medizin/Pneumologie und Beatmungsmedizin, Thoraxklinik am Universit√§tsklinikum Heidelberg, Heidelberg

    Wind instrument performance is a notable feature in pneumology under aspects of ventilatory physiology and respiratory diseases. It requires an adequate ventilatory function combined with precise control of air flow and the ability to generate sufficient mouth pressures. Depending on the type of wind instrument, the required rates of airway pressure and air flow differ significantly. The cause of respiratory disease in wind instrument players may be related to these increased airway pressures in terms of a barotrauma. Wind instrumentalists may suffer from hemoptysis, laryngoceles, velopharyngeal insufficiency and pneumoparotitis due to their musical performance. Even the development of lung cancer has been assumed to be related to wind instrument playing. Controversy exists about implicating wind instrument use as the cause of pulmonary emphysema or in changes of pulmonary function, which is, however, unlikely under physiological aspects. Furthermore, professional wind instrumentalists may be impaired in their work by the side effects of anti-obstructive medication and respiratory infection. On the other hand, the potential therapeutic effects of wind instrument performance have to be considered. For asthmatic teenagers a significant improvement of pulmonary function and of physical and emotional activities could be related to wind instrument playing. Last but not least, didgeridoo playing was shown to be a promising alternative treatment for obstructive sleep apnoea syndrome.

  • Music and cancer pain management

    Hawaii Med J. 2007 Nov;66(11):292-5

    • Igawa-Silva W, Wu S, Harrigan R.
    • Stanford University, USA

    PROBLEM: When coupled with the often debilitating side-effects of pharmacological interventions, chronic cancer pain may elicit feelings of anxiety and depression and therefore adversely affect patient well-being and quality of life. PURPOSE: This review article is a systematic assessment of the published literature related to music and cancer pain management. METHOD: A comprehensive systematic evaluation of the data based literature was undertaken and analyzed using matrix analysis. RESULTS: As an adjunctive form of pain management, music therapy has been shown to address some of these hardships by providing patients with an alternative effective means by which to reduce their subjective experiences of pain. Studies investigating the efficacy of music therapy during invasive cancer procedures and chemotherapy demonstrated the role that attention states play in distracting patients from, and therefore minimizing their experience of, the pain associated with such treatments. Other studies examining diverse outpatient populations revealed similar findings, illustrating well the cognitive-affective dimensions of pain perception. Although these findings fail to adequately address the ambiguity surrounding music therapy's role in cancer pain management, music therapy has nonetheless been shown to significantly reduce anxiety and, in so doing, indirectly lessen the intensity of pain while improving patient quality of life.

  • Design of an embedded cancer pain-reliever based on ARM

    Zhongguo Yi Liao Qi Xie Za Zhi. 2007 Jul;31(4):259-62, 286

    • Ke Y, Lin JR.
    • Institute of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430074

    This paper introduces a design for an embedded cancer pain-reliever based on ARM. In this pain-reliever, ARM7 S3C44B0 is CPU, CPLD generates precise waves, DC-DC boost convertor generates high voltage and it has a secondary music-therapy function.

  • Oncology nurses' use of nondrug pain interventions in practice

    J Pain Symptom Manage. 2008 Jan;35(1):83-94. Epub 2007 Oct 23

    • Kwekkeboom KL, Bumpus M, Wanta B, Serlin RC
    • University of Wisconsin-Madison, Madison, Wisconsin 53792, USA

    Cancer pain management guidelines recommend nondrug interventions as adjuvants to analgesic medications. Although physicians typically are responsible for pharmacologic pain treatments, oncology staff nurses, who spend considerable time with patients, are largely responsible for identifying and implementing nondrug pain treatments. Oncology nurses' use of nondrug interventions, however, has not been well studied. The purpose of this study was to describe oncology nurses' use of four nondrug interventions (music, guided imagery, relaxation, distraction) and to identify factors that influence their use in practice. A national sample of 724 oncology staff nurses completed a mailed survey regarding use of the nondrug interventions in practice, beliefs about the interventions, and demographic characteristics. The percentages of nurses who reported administering the strategies in practice at least sometimes were 54% for music, 40% for guided imagery, 82% for relaxation, and 80% for distraction. Use of each nondrug intervention was predicted by a composite score on beliefs about effectiveness of the intervention (e.g., perceived benefit; P<0.025) and a composite score on beliefs about support for carrying out the intervention (e.g., time; P<0.025). In addition, use of guided imagery was predicted by a composite score on beliefs about characteristics of patients who may benefit from the intervention (e.g., cognitive ability; P<0.05). Some nurse demographic, professional preparation, and practice environment characteristics also predicted use of individual nondrug interventions. Efforts to improve application of nondrug interventions should focus on innovative educational strategies, problem solving to secure support, and development and testing of new delivery methods that require less time from busy staff nurses.

  • Using complementary therapy with a hemodialysis patient with colon cancer and a sense of hopelessness

    Hu Li Za Zhi. 2007 Oct;54(5):93-8

    • Yeh SC, Yeh HF
    • Hemodialysis Center, ANSN Clinic, ROC

    Hemodialysis patients usually have a sense of hopelessness. This can affect their physical, mental and spiritual health, and can even be life- threatening. This article discusses a nursing experience involving a dialysis patient who also suffered from cancer had and a sense of hopelessness due to the distress caused by the two severe illnesses. The author assessed the patient by means of Roy's theory during the nursing period (5/7/2005-6/18/2005). Data were collected through physical assessments, interviews, observation of interaction with family members and a medical history review. The patient had characteristics of hopelessness, such as pessimism, moodiness, frequent sighing, frowning, eye-closing and negative thinking. The author applied a safe, easy, and non-invasive complementary therapy program including music therapy, aromatherapy and massage with essential oil to improve the patient's physical and mental states. Through these approaches, the patient learned to release stress, and to express his feelings, so that he could adapt to his current life, changed as it was by the illnesses, and face the impact of those illnesses with a positive attitude. The author would like to share this case report to provide nursing professionals with a source of reference for healthcare quality improvement.

  • Music imagery for adults with acute leukemia in protective environments: a feasibility study

    Support Care Cancer. 2008 May;16(5):507-13. Epub 2007 Sep 22

    • Burns DS, Azzouz F, Sledge R, Rutledge C, Hincher K, Monahan PO, Cripe LD
    • Indiana University School of Music, Indianapolis, IN 46202, USA

    BACKGROUND: Patients receiving intensive chemotherapy can experience increased distressed related to both the cancer diagnosis and treatment isolation. If not addressed, distress can lead to anxiety, depression, and post-traumatic stress disorder. The purpose of this study was to determine the feasibility and possible benefits of a music imagery intervention for patients hospitalized in a protective environment for the treatment of acute leukemia or high-grade non-Hodgkin's lymphoma. MATERIALS AND METHODS: Adults receiving intensive myelosuppressive chemotherapy in a protective environment were randomized to standard care or standard care plus music imagery. The music imagery sessions occurred twice weekly for up to eight sessions. Patients were encouraged to use the music imagery daily. RESULTS: The principal criteria of feasibility were rate of consent, rate of completion of scheduled sessions, and rate of questionnaire completion. Forty-nine out of 78 patients consented, a 63% consent rate. Seventy-two percent of all scheduled music imagery sessions were completed. The rate of questionnaire completion was 60% with missing data because of illness severity and early discharge. The principal outcomes of benefit (e.g., efficacy) were positive and negative affects, fatigue, and anxiety. Both groups improved over time on all outcomes (all p < 0.001). However, a subgroup of individuals with low baseline negative affect who received the intervention reported significantly less anxiety at discharge than individuals with low baseline negative affect who did not receive the intervention. CONCLUSIONS: Music imagery is feasible for adults with acute leukemia in protected environments. Patients with lower initial distress may benefit from a music imagery program in terms of reduced anxiety at discharge.

  • Complementary therapies for cancer pain

    Curr Pain Headache Rep. 2007 Aug;11(4):265-9

    • Cassileth B, Trevisan C, Gubili J.
    • Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA

    Pharmacologic treatment of pain does not always meet patients' needs and may produce difficult side effects. Complementary therapies, which are safe, noninvasive, and generally considered to be relatively free of toxicity, may be used adjunctively with standard pain management techniques to improve outcome and reduce the need for prescription medication. Approaches such as acupuncture, massage therapy, mind-body interventions, and music therapy effectively reduce pain, enhance quality of life, and provide patients with the opportunity to participate in their own care. Such therapies have an important role in modern pain management.

  • Interpretive subgroup analysis extends modified grounded theory research findings in oncologic music therapy

    J Music Ther. 2007 Fall;44(3):256-81

    • O'Callaghan C, Hiscock R.
    • Department of Medicine, St Vincent's Hospital, The University of Melbourne, Peter MacCallum Cancer Centre, and Caritas Christi Hospice, St Vincent's Health, USA

    Following an investigation into oncologic patients' experiences of the helpfulness of music therapy (O'Callaghan & McDermott, 2004), it was considered that examining relationships between specific patient characteristics and their responses could yield further interesting understandings. "Interpretative subgroup analysis" is introduced, which adapts principles of subgroup analysis in quantitative research to textual data analysis. Anonymous written responses from 128 oncologic patients were analyzed to compare responses from (a) those that had one music therapy session with those who had more than one session, (b) males and females, and (c) middle and older aged respondents. The number of music therapy sessions had scant effect on reported music therapy experiences, and males were much more likely to return questionnaires but much less likely to participate. Unlike some females, males always described positive affective responses when experiencing both sad and positive memories. Variations in the middle and older aged subgroups were evident in type of affective response, and emphases in descriptions of memories and music therapy's effect. Implications of these findings for music therapy practice are considered. Interpretive subgroup analysis is recommended for extending understanding of subjective within group experiences in music therapy research incorporating a grounded theory approach and large enough samples.

  • The effect of live music on decreasing anxiety in patients undergoing chemotherapy treatment

    J Music Ther. 2007 Fall;44(3):242-55

    • Ferrer AJ
    • The Florida State University, Tallahassee Memorial HealthCare, USA

    The purpose of this study was to investigate the effects of familiar live music on the anxiety levels of patients undergoing chemotherapy treatment. Randomly selected patients were assigned to experimental (n = 25) and control (n = 25) conditions. Pre and posttests consisted of questionnaires and the recording of the patient's heart rate and blood pressures. Subjects in the experimental group received 20 minutes of familiar live music during their chemotherapy treatment. Subjects in the control group received standard chemotherapy. It was assumed that those patients receiving music intervention would: (a) lower their anxiety levels; (b) experience a decrease in heart rate and blood pressure; (c) improve their levels of negative reactions including fatigue, worry, and fear; and (d) improve their levels of positive reactions including comfort and relaxation. Results of the study showed statistically significant improvement for the experimental group on the measures of anxiety, fear, fatigue, relaxation, and diastolic blood pressure. No significant differences between groups were found for heart rate and systolic blood pressure. Descriptive values indicated that, on average, the experimental group was influenced positively by the music intervention, and participants improved their quality of life while undergoing chemotherapy treatment.

  • Creativity, identity and healing: participants' accounts of music therapy in cancer care

    Health (London). 2007 Jul;11(3):349-70

    • Daykin N, McClean S, Bunt L.
    • University of West of England, Bristol, UK

    This article reports on findings from a study of the accounts of people participating in music therapy as part of a programme of complementary and alternative medicine (CAM) in supportive cancer care. The article outlines the perceived effects of music therapy, which shares many characteristics with CAM therapies as well as offering a distinct contribution as a creative therapy. Hence in this article we draw on theories and writings from the sociology of CAM as well as those relating to music, healing and aesthetics in order to explore participants' accounts. The importance of identity and the role of creativity in processes of individuation are key themes emerging from the analysis. While music and creativity are often seen uncritically as resources for health and well-being, we draw attention to the challenges and complexity of diverse responses to music, framed by personal biographies that are in turn often situated within socially constructed notions of aesthetics. We argue that in research on music therapy, as well as other CAM therapies, issues of identity can be key to an understanding of questions of therapeutic impact.

  • Music therapy as a non-pharmacological anxiolytic for paediatric radiotherapy patients

    Australas Radiol. 2007 Apr;51(2):159-62

    • O'Callaghan C, Sexton M, Wheeler G.
    • Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia

    Outpatient radiotherapy treatment in the paediatric cancer patient can be a traumatic and an anxiety-provoking experience for both the patient and the family. Music therapy has been widely reported to have psychosocial, educational and physical benefits for the paediatric cancer patient. Using individual case reports, this paper shows the successful use of music therapy as a non-pharmacological anxiolytic in the paediatric radiotherapy, outpatient waiting room setting, by providing the patient and the family with a means of communication, self-expression and creativity.

  • Nursing students' willingness to use complementary and alternative therapies for cancer patients: Istanbul survey

    Tohoku J Exp Med. 2007 Jan;211(1):49-61

    • Oztekin DS, Ucuzal M, Oztekin I, Issever H.
    • Florence Nightingale College of Nursing, Istanbul University, Kadikoy, 34726 Istanbul, Turkey

    It is important for student nurses to be knowledgeable of the complementary and alternative therapies and to provide accurate information to both cancer patients and other health care professionals. This study examined the nursing students' willingness to use these therapies, availability of sources of information, use of the therapies for self care, opinions about the integration of these therapies into nursing curriculum, and analyzed the differences among the responses. A self-administered questionnaire was offered to 640 nursing students in Istanbul, descriptive statistics were used, and comparisons among responses were made with chi-square test. Willingness to use for cancer patients was highest for nutritional therapy (76.1%), breathing therapies (74.5%), and massage and manipulation-Tui Na, in which pressure and touch are applied to the body (71.9%). Use of information sources was highest for nutritional therapy (75.6%), breathing therapies (71.9%), and massage and manipulation-Tui Na (62.3%). Over half of the nursing students used music therapy (54.2%), and massage and manipulation-Tui Na (53.6%) for self-care. Breathing therapies (87.2%) were the most desired therapy chosen to be included in nursing curriculum. The statistically significant differences were found among the responses related to use five therapies for care and related to desired three therapies to be included in nursing curriculum. Although students had not previously been exposed to these therapies use with oncology patients, many of students expressed a desire to integrate therapies learning into nursing curriculum. The more student nurses document high risk patients, the more effective strategies will be developed by other health care professionals.

  • Use of preferred music to reduce emotional distress and symptom activity during radiation therapy

    J Music Ther. 2006 Fall;43(3):247-65

    • Clark M, Isaacks-Downton G, Wells N, Redlin-Frazier S, Eck C, Hepworth JT, Chakravarthy B.
    • Tennessee Technological University, Cookeville, TN, USA

    Music therapy has decreased anxiety levels in many medical settings. This randomized clinical trial examined the effectiveness of a music listening intervention, delivered by a board-certified music therapist, in patients undergoing curative radiation therapy (RT). Emotional distress (anxiety, depression, and treatment-related distress) and symptoms (fatigue and pain) were measured at baseline, mid-treatment, and end of treatment in 63 patients undergoing RT. Although patients who listened to self-selected music reported lower anxiety and treatment-related distress, there was a decline in these outcomes for patients in both groups over the course of RT. Depression, fatigue, and pain were not appreciably affected by music therapy. Within the music group, there was a significant correlation between number of times music was used/week and the change in treatment-related distress, suggesting that higher doses of music produced greater declines in distress. While these findings provided some support for the use of music in reducing distress during RT, further research demonstrating clear differences between intervention and control conditions is needed. Physical symptoms were not affected by the use of music over the course of RT.

  • Complementary medicine in palliative care and cancer symptom management

    Cancer J. 2006 Sep-Oct;12(5):425-31

    • Mansky PJ, Wallerstedt DB
    • National Center for Complementary and Alternative Medicine, National Institutes of Health, DHHS, Bethesda, Maryland 20892, USA

    Complementary and alternative medicine (CAM) use among cancer patients varies according to geographical area, gender, and disease diagnosis. The prevalence of CAM use among cancer patients in the United States has been estimated to be between 7% and 54%. Most cancer patients use CAM with the hope of boosting the immune system, relieving pain, and controlling side effects related to disease or treatment. Only a minority of patients include CAM in the treatment plan with curative intent. This review article focuses on practices belonging to the CAM domains of mind-body medicine, CAM botanicals, manipulative practices, and energy medicine, because they are widely used as complementary approaches to palliative cancer care and cancer symptom management. In the area of cancer symptom management, auricular acupuncture, therapeutic touch, and hypnosis may help to manage cancer pain. Music therapy, massage, and hypnosis may have an effect on anxiety, and both acupuncture and massage may have a therapeutic role in cancer fatigue. Acupuncture and selected botanicals may reduce chemotherapy-induced nausea and emesis, and hypnosis and guided imagery may be beneficial in anticipatory nausea and vomiting. Transcendental meditation and the mindfulness-based stress reduction can play a role in the management of depressed mood and anxiety. Black cohosh and phytoestrogen-rich foods may reduce vasomotor symptoms in postmenopausal women. Most CAM approaches to the treatment of cancer are safe when used by a CAM practitioner experienced in the treatment of cancer patients. The potential for many commonly used botanical to interact with prescription drugs continues to be a concern. Botanicals should be used with caution by cancer patients and only under the guidance of an oncologist knowledgeable in their use.

  • Critical review of complementary therapies in haemato-oncology

    Intern Med J. 2006 Sep;36(9):579-86

    • Joske DJ, Rao A, Kristjanson L.
    • Cancer Support Centre and Department of Haematology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia

    There is evidence of the increasing use of complementary and alternative medicine by Australians diagnosed with cancer. Given the increasing desire of cancer patients to use complementary and alternative medicine, it is important that clinicians have a good understanding of the evidence available in this field. This critical review aims to provide an overview of the current evidence pertaining to a range of complementary therapies that are used in a supportive role in the treatment of cancer patients. Treatment methods considered are acupuncture, music therapy, massage and touch therapies and psychological interventions. The efficacy of these complementary therapies in terms of improvement in symptoms and quality of life is examined. Evidence that relates to an effect on immune function and survival is also investigated.

  • The pathophysiologic mechanism of cerebellar mutism

    Surg Neurol. 2006 Jul;66(1):18-25

    • Ozgur BM, Berberian J, Aryan HE, Meltzer HS, Levy ML
    • Pediatric Neurosurgery, Children's Hospital of San Diego, San Diego, CA 92123, USA

    OBJECTIVE: Cerebellar mutism (CM) is a postoperative complication of mainly pediatric posterior fossa surgery. Multiple theories exist for explaining this phenomenon. We have made an attempt to further understand this entity given a particularly interesting case as it relates to multiple pathophysiologic pathways. METHODS: We have reviewed the details surrounding a particularly interesting case of CM. A retrospective analysis of this patient's clinical history and recovery is described. An extensive literature review has been performed in conjunction with an attempt to help elucidate details and a better understanding of CM. RESULTS: A thorough analysis of existing theories as to the pathophysiologic mechanism of CM has been performed as it relates to the details of this particular case. A case is described in which a child exhibiting CM abruptly improved and made a relatively quick recovery after the triggering of the melodic speech pathway by way of watching and beginning to sing along with a video. It appears that this incident involving a familiar song catalyzed various speech pathways, which apparently were in some state of shock. This phenomenon seems to be a temporary entity involving not only the mechanical coordination of speech production, but also the initiation of speech itself. CONCLUSIONS: Evidence exists for a pathophysiologic pathway for speech by way of coordinating phonation and articulation. In addition, there seems to exist a pathway by which the initiation of speech may be altered or halted by posterior fossa pathology, namely, vermian or dentate nuclear injury. In particular to this case, we found that the incidental appreciation of other forms of speech, melodic in this instance, may be the key to help stimulate and accelerate the recovery from CM.