Burns Debra S, Perkins Susan M, Tong Yan, Hilliard Russell E, Cripe Larry D
School of Engineering and Technology at IUPUI, Indianapolis, Indiana, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA.
Indiana University School of Medicine, Indianapolis, Indiana, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA.
J Pain Symptom Manage. 2015 Aug;50(2):225-31. doi: 10.1016/j.jpainsymman.2015.02.022. Epub 2015 Apr 1.
Music therapy is a common discretionary service offered within hospice; however, there are critical gaps in understanding the effects of music therapy on hospice quality indicators, such as family satisfaction with care.
The purpose of this study was to examine whether music therapy affected family perception of patients' symptoms and family satisfaction with hospice care.
This was a retrospective, cross-sectional analysis of electronic medical records from 10,534 cancer patients cared for between 2006 and 2010 by a large national hospice. Logistic regression was used to estimate the effect of music therapy using propensity scores to adjust for non-random assignment.
Overall, those receiving music therapy had higher odds of being female, having longer lengths of stay, and receiving more services other than music therapy, and lower odds of being married/partnered or receiving home care. Family satisfaction data were available for 1495 (14%) and were more likely available if the patient received music therapy (16% vs. 12%, P < 0.01). There were no differences in patient pain, anxiety, or overall satisfaction with care between those receiving music therapy vs. those not. Patients who received music therapy were more likely to report discussions about spirituality (odds ratio [OR] = 1.59, P = 0.01), had marginally less trouble breathing (OR = 0.77, P = 0.06), and were marginally more likely to receive the right amount of spiritual support (OR = 1.59, P = 0.06).
Music therapy was associated with perceptions of meaningful spiritual support and less trouble breathing. The results provide preliminary data for a prospective trial to optimize music therapy interventions for integration into clinical practice.
音乐疗法是临终关怀机构提供的一项常见的自主选择服务；然而，在理解音乐疗法对临终关怀质量指标（如家庭对护理的满意度）的影响方面存在重大差距。
本研究的目的是检验音乐疗法是否会影响家庭对患者症状的认知以及家庭对临终关怀护理的满意度。
这是一项对一家大型全国性临终关怀机构在2006年至2010年间护理的10534名癌症患者的电子病历进行的回顾性横断面分析。采用逻辑回归，利用倾向得分来调整非随机分配，以估计音乐疗法的效果。
总体而言，接受音乐疗法的患者女性比例更高、住院时间更长、接受音乐疗法以外的服务更多，结婚/有伴侣或接受家庭护理的比例更低。有1495名患者（14%）有家庭满意度数据，且如果患者接受音乐疗法，获得该数据的可能性更大（16%对12%，P<0.01）。接受音乐疗法的患者与未接受音乐疗法的患者在疼痛、焦虑或对护理的总体满意度方面没有差异。接受音乐疗法的患者更有可能报告关于灵性的讨论（优势比[OR]=1.59，P=0.01），呼吸困难略少（OR=0.77，P=0.06），获得适量灵性支持的可能性略高（OR=1.59，P=0.06）。
音乐疗法与有意义的灵性支持认知和呼吸困难较少有关。这些结果为一项前瞻性试验提供了初步数据，以优化音乐疗法干预措施，使其融入临床实践。
