《生命之歌》：多中心随机临床试验结果，探讨传记音乐疗法在姑息治疗中的作用。
"Song of Life": Results of a multicenter randomized trial on the effects of biographical music therapy in palliative care.
机构信息
Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
出版信息
Palliat Med. 2021 Jun;35(6):1126-1136. doi: 10.1177/02692163211010394. Epub 2021 Apr 20.
BACKGROUND
Awareness for the importance of psychological and spiritual needs in patients with terminal diseases has increased in recent years, but randomized trials on the effects of psychosocial interventions are still rare.
AIM
To investigate the efficacy of the "Song of Life" music therapy intervention regarding the emotional and psycho-spiritual dimensions of quality of life.
DESIGN
Patients were randomly assigned to either "Song of Life" or a relaxation intervention. "Song of Life" is a novel three-session music therapy intervention working with a biographically meaningful song. Primary outcome was the improvement in psychological quality of life. Secondary outcomes included spiritual well-being, ego-integrity, momentary distress, and global quality of life and the explorative assessment of treatment satisfaction (patient and family member version). Intention-to-treat analysis was conducted including adjustment for multiple testing in secondary outcomes.
SETTING/PARTICIPANTS: Between December 2018 and August 2020, 104 patients receiving specialized palliative care were recruited from two palliative care wards.
RESULTS
No significant differences were found regarding psychological and global quality of life, but "Song of Life" participants reported significantly higher spiritual well-being ( = 0.04) and ego-integrity ( < 0.01), as well as lower distress ( = 0.05) than patients in the control group. Both patients' and family members' treatment satisfaction was higher after "Song of Life" with large between-group effect sizes on items asking for meaningfulness ( = 0.96) and importance ( = 1.00).
CONCLUSIONS
Our findings provide evidence that "Song of Life" is an effective and meaningful biographical music therapy intervention to facilitate psycho-spiritual integration in terminally ill patients.
TRIAL REGISTRATION
German Clinical Trials Register (DRKS)-DRKS00015308 (date of registration: September 7th 2018).
背景
近年来，人们对终末期疾病患者心理和精神需求重要性的认识有所提高，但针对心理社会干预效果的随机试验仍然很少。
目的
调查“生命之歌”音乐治疗干预对生活质量的情感和心理-精神维度的疗效。
设计
患者被随机分配到“生命之歌”或放松干预组。“生命之歌”是一种新的三阶段音乐治疗干预，采用具有传记意义的歌曲。主要结局是改善心理生活质量。次要结局包括精神幸福感、自我完整性、瞬间困扰以及整体生活质量，以及治疗满意度的探索性评估（患者和家属版本）。进行意向治疗分析，包括对次要结局进行多次检验调整。
地点/参与者：2018 年 12 月至 2020 年 8 月，从两个姑息治疗病房招募了 104 名接受专业姑息治疗的患者。
结果
在心理和整体生活质量方面，两组间无显著差异，但“生命之歌”组的精神幸福感（ = 0.04）和自我完整性（ < 0.01）显著更高，困扰程度（ = 0.05）显著更低。与对照组相比，患者和家属对“生命之歌”的治疗满意度更高，对询问意义（ = 0.96）和重要性（ = 1.00）的项目的组间差异较大。
结论
我们的研究结果表明，“生命之歌”是一种有效的、有意义的传记音乐治疗干预措施，可以促进终末期患者的心理-精神整合。
试验注册
德国临床试验注册处（DRKS）-DRKS00015308（注册日期：2018 年 9 月 7 日）。
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