Rodgers-Melnick Samuel N, Matthie Nadine, Jenerette Coretta, Griest Pell Tara J, Lane Deforia, Fu Pingfu, Margevicius Seunghee, Little Jane A
University Hospitals Connor Integrative Health Network, Cleveland, OH, USA.
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
J Music Ther. 2018 Jun 7;55(2):156-185. doi: 10.1093/jmt/thy004.
Adults with sickle cell disease (SCD) experience acute pain that is multidimensional. Despite recent improvements in treatment, pain management remains a significant challenge for these individuals. Music therapy interventions have the potential to address several dimensions of SCD pain, but they require systematic investigation.
This study investigated feasibility and preliminary efficacy of a single-session electronic music improvisation with a music therapist to diminish pain intensity and improve pain relief and mood in adults with SCD.
Using a three-group mixed methods intervention design, we randomized 60 adults with SCD to standard care plus one of three 20-minute study conditions: 1) electronic music improvisation with a music therapist (MT); 2) recorded music listening (ML); or 3) no intervention (control). Measures of pain intensity (VASPI), pain relief (VASPR), and mood (VASMOOD) were assessed before and after the study conditions, with a subset of MT and ML participants interviewed after measure completion.
Compared to control, MT produced significant improvements in VASPI (odds ratio (OR) = 5.12, P = 0.035) and VASMOOD (OR = 11.60, P = 0.005). ML produced significant improvements in VASMOOD compared to control (OR = 5.76, P = 0.040). Qualitatively, there were two prominent themes directly related to music: 1) ML and MT offered many positive and few negative effects; and 2) music therapists provided comfort beyond the music.
Preliminary findings were promising and support the need for additional studies evaluating improvisational music therapy interventions for acute pain management in adults with SCD.
患有镰状细胞病（SCD）的成年人会经历多维度的急性疼痛。尽管近期治疗有所改善，但疼痛管理对这些患者而言仍是一项重大挑战。音乐治疗干预有可能解决SCD疼痛的多个维度问题，但需要进行系统研究。
本研究调查了与音乐治疗师进行单节电子音乐即兴创作以减轻SCD成年患者疼痛强度、改善疼痛缓解情况和情绪的可行性及初步疗效。
采用三组混合方法干预设计，我们将60名SCD成年患者随机分为接受标准护理加以下三种20分钟研究条件之一：1）与音乐治疗师进行电子音乐即兴创作（MT）；2）听录制音乐（ML）；或3）无干预（对照组）。在研究条件前后评估疼痛强度（视觉模拟疼痛强度量表，VASPI）、疼痛缓解情况（视觉模拟疼痛缓解量表，VASPR）和情绪（视觉模拟情绪量表，VASMOOD），并在测量完成后对MT和ML组的部分参与者进行访谈。
与对照组相比，MT组在VASPI（优势比（OR）=5.12，P=0.035）和VASMOOD（OR=11.60，P=0.005）方面有显著改善。与对照组相比，ML组在VASMOOD方面有显著改善（OR=5.76，P=0.040）。定性分析方面，有两个与音乐直接相关的突出主题：1）ML和MT带来了许多积极影响且负面影响很少；2）音乐治疗师提供的安慰超越了音乐本身。
初步研究结果很有前景，支持开展更多研究来评估即兴音乐治疗干预对SCD成年患者急性疼痛管理的效果。
