Rhonda Benzley and Dr. Barbara Mandleco, Department of Nursing
In effort to provide superior nursing practice, current research is examining the efficacy of a variety of novel nursing interventions. One such technique is Music Therapy, defined by Gillam as, “The controlled use of music in treatment, rehabilitation, education, and training of children and adults with a physical, mental or emotional disorder.”7 Numerous studies have shown the ability of music intervention to promote a sense of well being among various patient populations by decreasing anxiety, agitation and pain, promoting relaxation and stress reduction. These studies also show that music has been specifically beneficial in increasing orientation, memory and sociability among the elderly.1-9 Implementation of music as a therapy provides the nursing profession with another tool to provide quality care and promote the patient’s well being. This particular study hypothesizes that music has the potential to promote wellness by elevating the patient’s mood.
A total of thirty four participants for the project were selected from two community convalescent/care centers, twenty seven of the participants being female and 7 male. Participants ages ranged from the thirties to the nineties with the largest proportion (35.3%) of participants being in their eightieth decade of life. The majority of the participants were widowed (55.9%), in the care center for medical reasons (61.8%), and taking medications (79.4%). Of the 34 participants, 58.8% had played a musical instrument previously and 91.2% enjoy listening to music. These demographic variables in addition to others were obtained from each participant as they have the potential to influence the participants’ response to the music therapy.
After signing an informed consent, participants were placed in one of two groups: a music listening group or a music playing group (physical handicaps at times influenced group placement). Each participant in the music listening group was visited individually by the researcher for four one half hour sessions. Before and after each session, participants filled out a “mood rating scale.” The participants then selected music of their choice from a broad selection, and listened to the music in their own bedroom. Participants in the music playing group also were given four one half hour, individual sessions, before and after which they completed the “mood rating scale.” During each session the participants were taught songs, rhythms and notes on the pre-selected instrument of their choice (piano/keyboard or recorder).
Statistical analyses of the data did not give strong evidence that the means of the two groups are significantly different. As a result, one may conclude that playing music is as effective as listening to music to elevate a participant’s mood. However, my personal observations and interpretation of the participant’s verbal responses led me to a different conclusion.
Beginning this research project, I hypothesized that those participating in music would be better satisfied than those only listening to music. I assumed that the movement, change of pace and satisfaction of having accomplished something would prove to elevate the participant’s mood. However, my observations were that those playing music often became more frustrated and discouraged. For those who had had previous experience on the piano, it was frustrating that their eyesight no longer allowed them to see the notes that they had once played so easily. For those playing the recorder, frustrations occurred when fingers wouldn’t moved as they once had due to a stroke or other muscular limitations. Listening to music was also not a guaranteed success to elevate a participant’s mood. Some only endured the music, and if the CD was not the type of music they really enjoyed, it could put them in a worse mood than when we began. On the positive side there were several patients in both groups who loved their music sessions. One, working on the piano, told a director at the care center how excited she was to be learning the piano. Another wanted to keep the recorder music book so that she could continue her progress in learning to play. Some in the music listening group were music lovers and eagerly anticipated our sessions together. These examples lie at the opposite ends of the spectrum and there were many participants whose experiences fall in between these extremes of reaction to the therapy.
As a result of this project, I feel it would be very beneficial to patients in care centers to have music of the patient’s choice available for listening upon demand. These patients are prone to depressions and music of the patient’s choice seemed to always elevate their mood. Another idea would be to have music lessons available for those that are interested. Special tools or instruments and large note music may aid those who are frustrated by physical limitations. A future study may look at the benefits of participating in music with a group of participants as compared to participating one on one as was done in this study.
References
- Aldridge, D. (1995). Music therapy and the treatment of alzheimer’s disease. Clinical Gerontologist, 16(1), 41-53.
- Beck, SCL (1998). The effect of the therapeutic use of music on cancer related pain. The University of Utah PH.D. 204p.
- Chlan, L. (1998). Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. Heart and Lung 27 (3), 169-76.
- Clair, A.A. and Bernstein, B. (1994). The effect of no music, stimulative background music and sedative background music on agitated behaviors in persons with severe dementia. Activities, Adaptation and Aging, 19(1), 61-70.
- Clark, M.E., Lipe, A.W. and Bilbrey, M. (1998). Use of music to decrease aggressive behaviors in people with dementia. Journal of Gerontological Nursing, 24(7), 10-17.
- Gerdner, L.A. and Swanson, E.A. (1993). Effects of individualized music on confused and agitated elderly patients. Archives of Psychiatric Nursing, 7(5), 284-291.
- Gillam, Tony. (1996). Sounds good. Nursing Times 92(41), 28-30. Heiser R.M., Chiles K., Fudge M., and Gray S.E. (1997). The use of music during the immediate postoperative recovery period. AORN Journal 65(4), 777-785.
- Spendlove, Clive (1997). In tune with clients. Nursing Times 93(50) 58-9. Smith-Marchese, K. (1994). The effects of participatory music on the reality orientation and sociability of alzheimers residents in a long-term-care setting. Activities, Adaptation and Aging, 18(2), 41-55.
- Watkins, Gwendolyn R. (1997). Music Therapy: Proposed physiological mechanisms and clinical implications. Clinical Nurse Specialist 11(2), 43-50.