Perioperative Case Study

Music therapy has proven beneficial to patients with cancer most notably the psychological and physical end-results. More than one million people in the United States get cancer each year (cancer.org). Most have heard or know of someone who has had cancer and the stories of the chemo radiation therapy that goes along with it. Imagine the emotions that one feels when diagnosed with cancer. The patient is ultimately suffering from the whole ordeal physically and emotionally. Music interventions are employed to “alleviate symptoms and treatment side effects in cancer patients” (Cochrane review).

Some women may feel mentally prepared for cancer treatment, but most feel anxious and fearful about the treatment and how it will affect their lives and their families. Anxiety and fear of the unknown can bring about heightened levels of stress and this has been associated with less effective cancer treatment response.

The effect of music on postoperative pain and anxiety was studied on an orthopedic unit in a central Florida hospital (Allred, Byers, & Sole, 2010). The authors clearly identified the problem many total knee arthroplasty patients experience after surgery is moderate to severe postoperative pain and increased anxiety. Throughout the introduction of the study, it was stressed the importance and need for this research to be conducted. The authors discussed the effects of inadequately treated pain and how health care professionals, including nursing, should make it a priority in a patient’s treatment plan (Allred et al., 2010). Several references were provided supporting the issue

Due to the extensive procedures surrounding treatment, patients often experience a variety of physical and psychological symptoms and side effects that negatively impact their quality of life and ability to cope with and manage an illness. Providing a choice of music during a receptive music therapy session may not only distract the patient from negative affective states, but also may provide a sense of autonomy and control over a patient 's immediate environment. The purpose of the essay was to determine whether receptive music therapy can improve two general dimensions of emotional experience and pain in a single session for patients. The guiding research question was: Will participants experience improved positive affect following a music therapy session? In my opinion ,I think the answer is yes. music therapy definitely have a positive effect on patients.

Therapeutic use of music is also extremely effective at reducing the everyday aches and pains that humans experience. Slow and methodical music slows the brain waves and helps the muscles in our body to relax, reducing muscle pain (Coleman). A significant amount of today’s population also experiences depression in some shape way or form and music therapy has been proven to be one of the most successful ways to help patients cope with depression. “Individual music therapy combined with standard care is extremely effective for lowering [depression] among working age people,” says Professor Christian Gold at the University of British Columbia (Paddock). “Music therapy is so effective because it allows patients to express their feelings in a safe way,” mentions Elizabeth Fawcett (MT-BC) (Peach). Hospital patients experienced consistently shorter and more pleasant stays when undergoing music therapy along with traditional treatment (Meyer).

Carr, B. (2013). Psychological aspects of cancer: A guide to emotional and psychological consequences of cancer, their causes and their management. New York: Springer.

Women may experience a range of emotions with the diagnosis as well as throughout the treatment as a result of breast cancer, such as: sadness, anger, fear and guilt. Therefore, it is essential to closely monitor the client for their psychosocial adjustment to the diagnosis and treatment, and identifying those that need further psychological interventions (Boehmke & Dickerson, 2006). This includes being aware of the impact the diagnosis will have on the family members and loved ones; as their support is warranted as possible caregivers during the process. Appropriate nursing diagnoses for a woman with a new verdict of breast cancer may include (but not limited to): disturbed body image related to loss of hair due to chemotherapy; fear related to the diagnosis and prognosis of the disease; and knowledge deficit of cancer treatment options and reconstructive surgery. Other diagnosis will be added and removed as the patient decides if she wants treatment; and the psychological, psychosocial, and physical changes that may affect her quality of life. For instance, after a mastectomy the patient may have a nursing diagnosis of: risk for disturbed body

For this example, we develop the question: In a pre-procedure setting, does listening to music help reduce the level of anxiety for adult patients undergoing a stressful procedure? The question falls into the clinical therapy category because it seeks to answer the question about the effectiveness of music. To find best practice, we search literature databases for recent experimental or quasi-experimental studies that are appropriate to the question (LoBiondo-Wood & Haber, 2014-a). The following articles show examples of research that examine the relationship between music and anxiety. Kim, Evangelista, and Park (2015) conducted an integrative review and meta-analysis that finds music intervention has a positive effect on reducing anxiety for patients on hemodialysis. Mohammadi, Mirhagher, Torabi, Mirsane, and Moradi (2014) conducted and randomized quasi-experimental study that shows a significant decrease in physiological parameters and anxiety levels in the trial group when compared to the control group. Thompson, Moe, and Lewis (2014) conducted a quasi-experimental study that finds a significant decrease in anxiety for patients who listen to music before surgery. It shows that the higher the level of anxiety, the greater the benefit from the

The therapeutic and healing properties of music have been recognized throughout history. Rothrock (2011) stated that music is recognized as a way to decrease the physiologic and behavioral anxiety found in most surgical patients. Anxiety is a powerful emotion that can trigger physiological responses, cause stress, increase pain sensation and delay wound healing (Upton, 2014). Surgeons often prescribe medication to relieve anxiety preoperatively without consideration of an alternative intervention. Complementary interventions such as music therapy can provide a level of distraction, thus promoting a reduction in anxiety level (Comeaux, & Steele-Moses, 2013).

There have been many studies on music, palliative care, and the effect that music could have on improving patient outcomes associated with pain. The studies that were examined all had a common theme - that music interventions were effective in decreasing pain level to some extent. While

The researchers believed that if they could find a way to make the process of a mammogram less painful and anxiety producing, they would be able to decrease the amount of women who skip routine tests for these reasons (Zavatsky et al, 2014, pg.1). In this particular study, 100 samples were used. Of these samples, 50 received music therapy of their choice before the exam and 50 received no music therapy at all. The researchers allowed the women to choose the music they listened to in order to maximize the enjoyment from the session (Zavatsky et al, 2014, pg.2). Women who received music that they didn’t enjoy obviously wouldn’t feel soothed by the session. Self selected music would be an important variable in the study. The researchers hypothesized that music would have a positive effect on patients and cause them to feel less pain and anxiety during the

“…. when my doc asked if I was anxious or depressed I hesitated to answer as it felt like a weakness,…” (community.breastcancer.org).

A person in one’s lifetime has felt anxious or depressed at a time due to difficult situations, and this is a normal reaction to life stressors. But these feelings are experienced by some people daily or nearly daily with no reasons, and this makes it difficult for them to carry out normal daily functioning. Anxiety disorder, depression, or both can be noted in such people. Depression and anxiety disorders are different, but both often exhibit similar symptoms such as nervousness, irritability, and problems sleeping and concentrating.

Music during surgery was first introduced in the early 20th century as a complementary therapy with anaesthesia (Light, Love, Benson, & Trier Morch, 1954). They argued that music distracted the patient from the fear of surgery and complemented analgesia effect with the use of nitrous oxide, which ultimately effected, the pain suffered by the patients..

While the completion of treatment is excitedly anticipated, many cancer survivors would still be disturbed by the emotional and physical tribulation of their breast cancer trajectory (Surbone & Peccatori, 2006). This is because, the impact of cancer remains long even after treatment ended. Besides the common issues that accompany any cancer diagnosis, breast cancer survivors also have to deal with exclusive concerns such as decreased sexual function, relationship issues, fears about genetic inheritability of cancer and complications from this disease such as lymphedema (Hodgkinson, Butow, Fuchs, et al., 2007). Therefore, the completion of treatment does not equate to lesser need for health care. Long term health issues related to breast cancer survivors have thus emerged as a public health concern.