Potvin Noah, Bradt Joke, Ghetti Claire
Mary Pappert School of Music & School of Nursing, Duquesne University, Pittsburgh, PA.
Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA.
J Music Ther. 2018 Mar 9;55(1):27-61. doi: 10.1093/jmt/thx019.
Over the past decade, caregiver pre-bereavement has received increased scholarly and clinical attention across multiple healthcare fields. Pre-bereavement represents a nascent area for music therapy to develop best practices in and an opportunity to establish clinical relevancy in the interdisciplinary team.
This study was an exploratory inquiry into the role of music therapy with pre-bereaved informal hospice caregivers. This study intended to articulate (a) what pre-bereavement needs are present for informal hospice caregivers, (b) which of those needs were addressed in music, and (c) the process by which music therapy addressed those needs.
A constructivist grounded theory methodology using situational analysis was used. We interviewed 14 currently bereaved informal hospice caregivers who had participated in music therapy with the care recipient.
Analysis resulted in a theoretical model of resource-oriented music therapy promoting caregiver resilience. The resource, caregivers' stable caring relationships with care recipients through their pre-illness identities (i.e., spouse, parent, or child), is amplified through music therapy. Engagement with this resource mediates the risk of increased care burden and results in resilience fostering purposefulness and value in caregiving.
Resource-oriented music therapy provides a unique clinical avenue for supporting caregivers through pre-bereavement, and was acknowledged by caregivers as a unique and integral hospice service. Within this model, caregivers are better positioned to develop meaning from the experience of providing care through the death of a loved one.
在过去十年中，丧亲前的照护者在多个医疗领域受到了越来越多的学术和临床关注。丧亲前阶段是音乐治疗发展最佳实践的一个新兴领域，也是在跨学科团队中确立临床相关性的一个机会。
本研究旨在探索音乐治疗在临终关怀机构丧亲前非正式照护者中的作用。本研究旨在阐明：（a）临终关怀机构非正式照护者丧亲前存在哪些需求；（b）音乐满足了其中哪些需求；（c）音乐治疗满足这些需求的过程。
采用基于情境分析的建构主义扎根理论方法。我们采访了14名目前已丧亲的非正式临终关怀照护者，他们曾与受照护者一起参与音乐治疗。
分析得出了一个促进照护者复原力的以资源为导向的音乐治疗理论模型。通过音乐治疗，照护者与受照护者在患病前身份（即配偶、父母或子女）基础上建立的稳定照护关系这一资源得到了强化。与这一资源的互动调节了照护负担增加的风险，并在照护中产生了促进复原力的目标感和价值感。
以资源为导向的音乐治疗为在丧亲前支持照护者提供了一条独特的临床途径，并且被照护者认可为一种独特且不可或缺的临终关怀服务。在这个模型中，照护者更有能力从在亲人去世过程中提供照护的经历中找到意义。
