Music Therapy Department, University Hospitals Case Medical Center, Cleveland, Ohio 44106, USA.
J Pain Symptom Manage. 2013 May;45(5):822-31. doi: 10.1016/j.jpainsymman.2012.05.008. Epub 2012 Sep 24.
Treatment of pain in palliative care patients is challenging. Adjunctive methods of pain management are desirable. Music therapy offers a nonpharmacologic and safe alternative.
To determine the efficacy of a single music therapy session to reduce pain in palliative care patients.
Two hundred inpatients at University Hospitals Case Medical Center were enrolled in the study from 2009 to 2011. Patients were randomly assigned to one of two groups: standard care alone (medical and nursing care that included scheduled analgesics) or standard care with music therapy. A clinical nurse specialist administered pre- and post-tests to assess the level of pain using a numeric rating scale as the primary outcome, and the Face, Legs, Activity, Cry, Consolability Scale and the Functional Pain Scale as secondary outcomes. The intervention incorporated music therapist-guided autogenic relaxation and live music.
A significantly greater decrease in numeric rating scale pain scores was seen in the music therapy group (difference in means [95% CI] -1.4 [-2.0, -0.8]; P<0.0001). Mean changes in Face, Legs, Activity, Cry, Consolability scores did not differ between study groups (mean difference -0.3, [95% CI] -0.8, 0.1; P>0.05). Mean change in Functional Pain Scale scores was significantly greater in the music therapy group (difference in means -0.5 [95% CI] -0.8, 0.3; P<0.0001) [corrected]: A single music therapy intervention incorporating therapist-guided autogenic relaxation and live music was effective in lowering pain in palliative care patients.
在姑息治疗患者中,疼痛的治疗具有挑战性。辅助性疼痛管理方法是可取的。音乐治疗提供了一种非药物且安全的选择。
确定单次音乐治疗对减轻姑息治疗患者疼痛的疗效。
2009 年至 2011 年,我们在凯斯西储大学医院招募了 200 名住院患者参与该研究。患者被随机分配到以下两组之一:标准护理组(包括计划镇痛在内的医疗和护理)或标准护理加音乐治疗组。一名临床护士专家进行了预测试和后测试,使用数字评分量表作为主要结局评估疼痛水平,并使用面部、腿部、活动、哭泣、安抚性评分量表和功能性疼痛量表作为次要结局评估疼痛水平。干预措施包括音乐治疗师指导的自生放松和现场音乐。
音乐治疗组的数字评分量表疼痛评分显著降低(平均差值[-1.4],[95%置信区间[-2.0,-0.8]);P<0.0001)。两组间面部、腿部、活动、哭泣、安抚性评分的平均变化无差异(平均差值-0.3,[95%置信区间-0.8,0.1];P>0.05)。音乐治疗组功能性疼痛量表评分的平均变化显著更大(平均差值-0.5,[95%置信区间-0.8,0.3];P<0.0001)。
单次音乐治疗干预,包括治疗师指导的自生放松和现场音乐,可有效降低姑息治疗患者的疼痛。