Impact of Music Therapy Interventions (Listening, Composition, Orff-Based) on the Physiological and Psychosocial Behaviors of Hospitalized Children: A Feasibility Study

doi:10.1016/j.pedn.2012.08.008

Journal of Pediatric Nursing

Volume 28, Issue 3, May–June 2013, Pages 249-257

https://doi.org/10.1016/j.pedn.2012.08.008 Get rights and content

The purpose of this study was to compare three music therapy strategies (music listening, music composition, and Orff-based active engagement) on physiological (heart rate, blood pressure, oxygen saturation, and pain) and psychosocial (anxiety) behaviors of hospitalized children (N = 32, 17 females,15 males, ranging in age from 6 to 17). This study was designed and facilitated cooperatively by pediatric nurses and music therapists. Results indicated no clinically significant changes in heart rate, blood pressure, or oxygen saturation (p > .05). Pain and anxiety both decreased significantly (p = .01) but not differentiated among conditions. Videotape analysis determined level of engagement in coping-related behaviors.

Section snippets

Participants

Participants (N = 32, 17 females and 15 males, ranging in age from 6 to 17) were children hospitalized on the pediatric unit of a large mid-western teaching hospital. Participants were admitted to the pediatrics unit, recruited from the current patient population and selected by the nursing staff. Diagnoses of patients varied greatly yet primarily included cancer, sickle cell disease, injuries due to accidents, and respiratory viral infections. Patients might be on the unit for the first time or

Results

As previously stated, the purpose of this study was to compare the impact of three music therapy interventions (listening, composition, and Orff-based) on physiological and psychosocial behaviors of hospitalized children. See Table 1 for data by condition. A nurse measured three physiological behaviors, heart rate, blood pressure, and oxygen saturation. Pain and anxiety were gathered through self-report using the FACES scale and the STAI-C.

Discussion

The impetus behind this study began when a nurse and the primary investigator were discussing ways that the nurses could use music on the unit as a non-pharmacological intervention. This particular nurse was in graduate school and was interested in researching the impact of music listening on the “vital signs” of children on the pediatric unit. This led to discussion about a potential partnership of care for a long term effort targeting decreased “wear and tear” on the nurses through reduced

Acknowledgments

Research was funded in part by the Graduate Research Fund of the University of Kansas.

References (66)

J.R. Boyd et al.
Chronically ill children coping with repeated hospitalizations: Their perceptions and suggested interventions
Journal of Pediatric Nursing
(1998)
J. Edwards
“You are singing beautifully”: Music therapy and the debridement bath
The Arts in Psychotherapy
(1995)
J. Klassen et al.
Music for pain and anxiety in children undergoing medical procedures: A systematic review of randomized controlled trials ambulatory pediatrics
(2008)
N.O. Micci
The use of music therapy with pediatric patients undergoing cardiac catheterization
The Arts in Psychotherapy
(1984)
J.M. Standley et al.
Music therapy research and applications in pediatric oncology treatment
Journal of Pediatric Oncology Nursing
(1995)
J.W. Stouffer et al.
Practice guidelines for music interventions with hospitalized pediatric patients
Journal of Pediatric Nursing
(2007)
T. Aasgaard
An ecology of love: Aspects of music therapy in the pediatric oncology environment
Journal of Palliative Care
(2001)
K. Aldridge
The use of music to relieve pre-operational anxiety in children attending day surgery
Australian Journal of Music Therapy
(1993)
American Orff-Schulwerk Association (AOSA). (2011). What is Orff-Schulwerk? (2011, Apr 1). [On-line]....
L. Avers et al.
Music therapy in pediatrics
Clinical Pediatrics
(2007)

Bae MJ. (2002). The effect of active music making compared to active music listening and artwork making on the level of...

L. Barker

The use of music and relaxation techniques to reduce pain of burn patients during daily debridement

M.E. Barrera et al.

The effects of interactive music therapy on hospitalized children with cancer: A pilot study

Psycho-Oncology

(2002)

M.A. Bellamy

Music therapy in a pediatric oncology setting

E. Bossert

Stress appraisals of hospitalized school-age children

Children's Health Care

(1994)

M.S. Cepeda et al.

Music for pain relief

Cochrane Database of Systematic Reviews

(2006)

H.D. Chetta

The effect of music and desensitization on preoperative anxiety in children

Journal of Music Therapy

(1981)

M. Clark et al.

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

Journal of Music Therapy

(2006)

C. Colwell

The Orff approach to music therapy

The Orff Echo

(2005)

C. Colwell

Orff-based music therapy in the pediatric hospital setting

The Orff Echo

(2009)

C.M. Colwell et al.

The Orff approach to music therapy

C.M. Colwell et al.

The effect of composition (art or music) on the self-concept of hospitalized children

Journal of Music Therapy

(2005)

B.A. Daveson et al.

Music therapy in palliative care for hospitalized children and adolescents

Journal of Palliative Care

(2000)

B. Dun

A different beat: Music therapy in children's cardiac care

Music Therapy Perspectives

(1995)

J. Edwards

The use of music therapy to assist children who have severe burns

Australian Journal of Music Therapy

(1994)

D. Evans

The effectiveness of music as an intervention for hospital patients: A systematic review

Journal of Advanced Nursing

(2002)

T. Fagan

Music therapy in the treatment of anxiety and fear in terminal pediatric patients

Music Therapy

(1982)

A.J. Ferrer

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

Journal of Music Therapy

(2007)

S. Folkman et al.

An analysis of coping in a middle-aged community sample

Journal of Health and Social Behavior

(1980)

Gettel, M. (1985). The use of song writing to reduce anxiety in children undergoing cardiac catheterization....

K. Gil et al.

Sickle cell disease in children and adolescents: The relation of child and parent pain coping strategies to adjustment

Journal of Pediatric Psychology

(1991)

M.C. Grasso et al.

Benefits of music therapy as an adjunct to chest physiolotherapy in infants and toddlers with cystic fibrosis

Pediatric Pulmonology

(2000)

Hartley KE. (1989). The effect of subject improvised recorded music on the stories of chronically ill latency aged...

Cited by (29)

The perception of healthcare professionals, through their own personal experiences, of the use of music therapy in hospitalised children and adolescents
2024, Journal of Pediatric Nursing
Music therapy is an emerging and useful methodology for improving patient environments within healthcare fields. However, although it has been shown that music therapy interventions with hospitalised children and adolescents have been used for decades with positive effects, there are currently very few studies that specifically describe the perspectives of healthcare professionals regarding the value of music therapy when applied in these patients.
To describe the insights of healthcare professionals regarding music therapy, both on a personal level and in terms of its usefulness in the care of hospitalised children and adolescents.
This was a qualitative descriptive-exploratory study with focus groups.
Eighteen healthcare professionals.
In January 2023, two focus groups, containing nine healthcare professionals each, were created to collect data regarding their experiences concerning the effect of music therapy on hospitalised children and adolescents. Before recording their opinions, all these professionals participated in an interactive music therapy session. The thematic analysis in this work was performed using MAXQDA® software.
Two main categories emerged: (a) the effects of music therapy on healthcare professionals, and (b) the benefits of music therapy to patients (children and adolescents).
Music therapy was valued positively by healthcare professionals who described the benefits its use has for hospitalised children and adolescents. They also expressed positive viewpoints regarding the use of music therapy to improve their own self-knowledge and self-care.
Healthcare professionals may utilise music therapists to improve patient outcomes and reduce the negative effects of hospitalisation.
The effect of using a kaleidoscope during central venous catheter dressing changes on pain and anxiety in children with cancer: A randomised controlled trial
2022, European Journal of Oncology Nursing
Citation Excerpt :
This study evaluated the effectiveness of the use of a kaleidoscope on pain and anxiety during CVC dressing changes, which are frequently used in children with cancer. Colwell et al. (2013) stated that the efforts of the hospitalised child to cope with this stressful environment are reflected by changes in physiological measurements (e.g., pain, heart rate, oxygen saturation) and psychosocial (anxiety) measurements; these changes can be used to show the effectiveness of various coping strategies. Our study reported that the kaleidoscope had positive effects on pain, anxiety, and physiological measurements (HR and SPO2) during CVC dressing changes; therefore, it can be said that children with cancer can use a kaleidoscope to successfully cope with the stressful environment during the procedure.
Many medical interventions, including the dressing changes of central venous catheters, a common procedure used for children with cancer, cause pain and anxiety in children. This can adversely affect their care and recovery. This study aims to evaluate the effect of using a kaleidoscope on reducing pain and anxiety in children with cancer during central venous catheter dressing changes.
This was a parallel randomised controlled trial with 60 children aged 6–12 diagnosed with cancer who were placed either in a kaleidoscope group (n = 30) or a control group (n = 30). Each child's anxiety was evaluated by the child using the Children's Fear Scale before, during, and after a central venous catheter dressing change, and each child's pain during and after the procedure was evaluated by the child using the Wong-Baker Faces Pain Rating Scale (WB-FACES). Each child's heart rate and oxygen saturation were measured with a pulse oximeter device before, during, and after central venous catheter dressing changes.
Pain and anxiety scores were significantly lower in the kaleidoscope group than in the control group during and after central venous catheter dressing changes (both p < 0.001). During the procedure, the oxygen saturation values were higher (p <0 .05), and the heart rate was lower (p < 0.001) in the kaleidoscope group compared to the control group.
Distraction with a kaleidoscope was an effective method for pain and anxiety relief during central venous catheter dressing changes in children. ClinicalTrials.gov NCT04924023.
The Effect of Music Therapy, Hand Massage, and Kaleidoscope Usage on Postoperative Nausea and Vomiting, Pain, Fear, and Stress in Children: A Randomized Controlled Trial
2020, Journal of Perianesthesia Nursing
The objective of this study was to investigate the effects of music therapy, hand massage, and kaleidoscope usage on nausea and vomiting, pain, fear, and stress in 7-year-old to 11-year-old children after circumcision.
This study was a prospective and randomized controlled trial.
The study was conducted at the pediatric surgery unit in a hospital in Turkey. The children were assigned to four groups through randomization performed using a computer program: group 1 was the control group with children who received no intervention; group 2 received hand massage; group 3 were distracted using kaleidoscope; and group 4 received music therapy.
There was a significant difference between the postoperative pain scores of the children in the intervention and control groups after the intervention (P < .05). This difference was found to be caused by the music therapy and kaleidoscope methods. There was a significant difference between the intervention and control groups' postoperative fear and anxiety levels in favor of the kaleidoscope group after the intervention (P < .05). But, no significant difference was found between the groups for the children's postoperative vomiting and nausea levels after the intervention (P > .05).
Distraction with music therapy and kaleidoscope is recommended for use in the postoperative period in children with circumcision to reduce the severity of their pain, fear, and anxiety.
Music-based interventions to reduce internalizing symptoms in children and adolescents: A meta-analysis
2018, Journal of Affective Disorders
Citation Excerpt :
One study with no primary music–based intervention was deemed ineligible (Krivolapchuk, 2011). 11 studies were excluded because the presence of psychopathology was unclear (Akombo, 2013; Bittman et al., 2009; Colwell et al., 2013; Delucia-Waack and Gellman, 2007; Gold et al., 2007; Hilliard, 2001; Kazemi et al., 2012; Liebman and MacLaren, 1991; Lindblad et al., 2007; Mulgrew et al., 2014; Oklan and Henderson, 2014) or no relevant psychological outcomes were reported (Giles et al., 1991; Jones and Field, 1999; Kim et al., 2006). Finally, one study was excluded, because the full-text was not available (Bragg, 1980).
Existing systematic reviews provide evidence that music therapy is an effective intervention in the treatment of children and adolescents with psychopathology. The objective of the present review was to systematically review and quantify the effects of music-based interventions in reducing internalizing symptoms (i.e., depression and anxiety) in children and adolescents using a meta-analytical approach.
Databases and journals were systematically screened for studies eligible for inclusion in meta-analysis on the effects of music-based interventions in reducing internalizing symptoms. A random-effect meta-analysis using standardized mean differences (SMD) was conducted.
Five studies were included. Analysis of data from (randomized) controlled trials, yielded a significant main effect (Hedge's g = −0.73; 95%CI [−1.42;−0.04], Z = 2.08, p = 0.04, k = 5), indicating a greater reduction of internalizing symptoms in youth receiving music-based interventions (n = 100) compared to different control group interventions (n = 95).
The existing evidence is limited to studies of low power and methodological quality. Included studies were highly heterogeneous with respect to the nature of the intervention, the measurements applied, the samples studied, and the study design.
Findings indicate that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents. While these results are encouraging with respect to the application of music-based intervention, rigorous research is necessary to replicate existing findings and provide a broader base of evidence. More research adopting well controlled study designs of high methodological quality is needed.
Pain and Complementary Therapies
2017, Critical Care Nursing Clinics of North America
Citation Excerpt :
They may choose their music or listen to a prescribed playlist developed by a music therapist. From classical music to nature sounds, and country to rock and roll, music can have distinct physical effects, including decreased anxiety and stress, improved mood, decreased heart rate and blood pressure, increased circulation, and decreased pain perception.21 Research has shown that music therapy has a positive impact on the pain experience.
Music Therapy in Educational Settings
2017, Music Therapy: Research and Evidence-Based Practice
Music therapy can play a critical role in the academic success of persons with disabilities in the school setting. This chapter aims to increase access to music therapy services in educational settings by providing evidence-based research support and step-by-step strategies to effectively add music therapy to a student’s Individualized Education Program. In addition, the chapter provides recommendations for important areas for future research to further justify the necessity of music therapy for students with disabilities.

View all citing articles on Scopus

View full text

Impact of Music Therapy Interventions (Listening, Composition, Orff-Based) on the Physiological and Psychosocial Behaviors of Hospitalized Children: A Feasibility Study

Section snippets

Participants

Results

Discussion

Acknowledgments

Journal of Pediatric Nursing

The Arts in Psychotherapy

Music for pain and anxiety in children undergoing medical procedures: A systematic review of randomized controlled trials ambulatory pediatrics

The Arts in Psychotherapy

Journal of Pediatric Oncology Nursing

Journal of Pediatric Nursing

An ecology of love: Aspects of music therapy in the pediatric oncology environment

Journal of Palliative Care

The use of music to relieve pre-operational anxiety in children attending day surgery

Australian Journal of Music Therapy

Music therapy in pediatrics

Clinical Pediatrics

The use of music and relaxation techniques to reduce pain of burn patients during daily debridement

The effects of interactive music therapy on hospitalized children with cancer: A pilot study

Psycho-Oncology

Music therapy in a pediatric oncology setting

Stress appraisals of hospitalized school-age children

Children's Health Care

Music for pain relief

Cochrane Database of Systematic Reviews

The effect of music and desensitization on preoperative anxiety in children

Journal of Music Therapy

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

Journal of Music Therapy

The Orff approach to music therapy

The Orff Echo

Orff-based music therapy in the pediatric hospital setting

The Orff Echo

The Orff approach to music therapy

The effect of composition (art or music) on the self-concept of hospitalized children

Journal of Music Therapy

Music therapy in palliative care for hospitalized children and adolescents

Journal of Palliative Care

A different beat: Music therapy in children's cardiac care

Music Therapy Perspectives

The use of music therapy to assist children who have severe burns

Australian Journal of Music Therapy

The effectiveness of music as an intervention for hospital patients: A systematic review

Journal of Advanced Nursing

Music therapy in the treatment of anxiety and fear in terminal pediatric patients

Music Therapy

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

Journal of Music Therapy

An analysis of coping in a middle-aged community sample

Journal of Health and Social Behavior

Sickle cell disease in children and adolescents: The relation of child and parent pain coping strategies to adjustment

Journal of Pediatric Psychology

Benefits of music therapy as an adjunct to chest physiolotherapy in infants and toddlers with cystic fibrosis

Pediatric Pulmonology