Introduction: Patients having total joint replacement often experience moderate to severe pain postoperatively. Postoperative pain can reduce patients’ mobility, affecting their motivation to participate in any rehabilitation activities. For patients having total join replacement, rehabilitation plays an important role in promoting their early recovery. Therefore, it is crucial for healthcare professionals to develop and evaluate intervention that can better control patients’ post-operative pain. In the clinical setting that I am working, pharmacological method is the major means of postoperative pain management. However, many Chinese patients are reluctant to use analgesic to control their post-operative pain because of the side effects and adverse reactions of the drugs. In this dissertation, music therapy, a non-pharmacological method that can be managed by nurses, is adopted for postoperative pain control. It is used to promote rehabilitation for patients who have undergone total joint replacement. Objectives: The objectives of this study are (1) to review the published research articles that investigated the effects of music therapy in reducing the post-operative pain and promoting rehabilitation for patients having total joint replacement; and (2) to establish an evidence-based guideline for the use of music therapy by nurses to control postoperative pain and to facilitate rehabilitation for patients having total joint replacement. Methods: A comprehensive literature search on four electronic databases including CHINAL, Medline (OvidSP), PubMed and the British Nursing Index were conducted. A total of eight RCTs and two non-randomized controlled trials were eventually identified. Results: All the reviewed studies showed that music therapy has a statistically significant effect on reducing postoperative pain. Sedative or relaxation music (music which has no lyrics, sustained melodic quality; rate of 60-80 beats per minutes; absence of strong rhythms or percussion) are recommended in the guideline. The target setting is a total joint replacement centre in a public hospital of Hong Kong. The target clients are adult patients (aged 19 or above) that are referred by the orthopedic out-patient department and are pending for their total knee/ hip replacement in the center. The transferability and feasibility of the literature are high. The guideline is developed based on the evidence in reviewed literature. A pilot testing plan is established to detect the potential barrier and friction of the guideline before the implementation. After that, an evaluation plan for patients, healthcare providers and system outcomes was also proposed. Conclusion: An evidence based guideline is developed for the total joint replacement center. It is anticipated that, with the use of this guideline by nurses, it will not only facilitate better rehabilitation for patients having total joint replacement, but also enhances nurses’ autonomy in their nursing practice. / published_or_final_version / Nursing Studies / Master / Master of Nursing

The aim of this research is to determine the therapeutic possibilities in music and books, in group work with middle aged deprived children. Deprivationwith children is an encompassing problem which social workers daily grapple with. A lack of sufficientknowledgeabout deprivationand sufficientknowledgeon the way inwhich to solve the problemmakesit essentialto do researchon the subject. Literature analysis and an empirical research are the two methods used in this study. The literature analysis focuses on the characteristics of the child client, the value of play for the child and the different ways of playing. This is followed by an explanation of the development of the normally developed middle aged child compared to that of the deprived middle aged child. The therapeutic possibilitiesof music and books is also discussed. Experimental research was used for this empirical research. An experimental group and a controlled group was compiled out of deprived middle aged children. Measurements were taken before and afterwards according to an adapted Hudson scale. Music, books and other therapeutic resources were used in the group work with the experimental group. The hypothesis states that the therapeutic use of music and books in work with groups amongst deprived middle aged children results in improvements of behaviour and relationships. The empiricalresearch proved that the therapeutic use of music and books lead to the improvement of behaviour, such as co-operation and consentration and to the establishmentof a therapeutic relationship between the group members and group leader. / Thesis (MA(MW))--PU vir CHO, 1994

Stress can be defined as feelings of frustration or anxiety that arise when individuals face challenges that exceed their capabilities or resources. Consequences of stress generally result from a suppressed immune system and include headaches, sleep problems, and muscle pain. Music as an intervention for relieving pain has increased due to its non-invasive nature, ease of administration, low cost, and lack of adverse side effects. While prior research on music therapy and pain has primarily focused on pain related to surgery, disease, or accidents, there have been no studies to date examining the association between music therapy and stress-induced muscle pain. I have designed a study proposal to establish the relationship between music therapy and muscle pain related to stress. The proposed study will compare salivary cortisol levels, pain visual analogue scale (VAS) scores, the number of painkillers consumed, and the number of doctor visits of healthy individuals experiencing the same stressor (MCAT or GRE) over a 3 month period. One group of participants will be randomly assigned to listen to an additional 30 minutes of self-chosen calming music a day, whereas the other will not listen to any additional music. It is hypothesized that the participants that listen to the additional calming music will experience significantly lower levels of stress and therefore lower muscle pain levels than the participants that did not listen to music. This research is potentially useful for students who undergo constant stress due to the demands of college. Future studies could include whether music therapy allows students to study longer by relieving some of the muscle pain caused by stress.

The widespread prevalence of depression throughout the world, across a variety of demographics, stresses the importance of examining different ways of coping with the affliction. This paper provides a background of different theories of coping with depression and it reviews how therapeutic songwriting, a form of active music therapy, can work as a highly effective method of coping with depression. The review indicates that therapeutic songwriting can be a successful coping mechanism through its positive influence as a primary and secondary control engagement coping strategy. Furthermore, songwriting acts as an adaptive distractor and emotion regulator, and has a positive impact on self-esteem and subsequently self-compassion. Additional benefits of therapeutic songwriting are discussed such as its time effectiveness and its ability to act as a therapy motivator and a psychoeducational tool. The findings indicate a need for future research to examine original therapeutic songwriting, in which the therapy-participant creates both original music and lyrics with the guidance of the therapist, as a potentially successful treatment for depression.

The aim of this research is to determine the therapeutic possibilities in music and books, in group work with middle aged deprived children. Deprivationwith children is an encompassing problem which social workers daily grapple with. A lack of sufficientknowledgeabout deprivationand sufficientknowledgeon the way inwhich to solve the problemmakesit essentialto do researchon the subject. Literature analysis and an empirical research are the two methods used in this study. The literature analysis focuses on the characteristics of the child client, the value of play for the child and the different ways of playing. This is followed by an explanation of the development of the normally developed middle aged child compared to that of the deprived middle aged child. The therapeutic possibilitiesof music and books is also discussed. Experimental research was used for this empirical research. An experimental group and a controlled group was compiled out of deprived middle aged children. Measurements were taken before and afterwards according to an adapted Hudson scale. Music, books and other therapeutic resources were used in the group work with the experimental group. The hypothesis states that the therapeutic use of music and books in work with groups amongst deprived middle aged children results in improvements of behaviour and relationships. The empiricalresearch proved that the therapeutic use of music and books lead to the improvement of behaviour, such as co-operation and consentration and to the establishmentof a therapeutic relationship between the group members and group leader. / Thesis (MA(MW))--PU vir CHO, 1994

Abstrakt   Bakgrund: Demens är ett kroniskt tillstånd i hjärnan som kan försämras med tiden och sjukdomen påverkar främst de kognitiva förmågorna hos personer med demens. I Sverige insjuknar drygt 25 000 personer varje år i en demenssjukdom och antalet personer med demenssjukdom kommer att successivt öka i takt med befolkningen blir allt äldre.  I dagsläget saknas det läkemedel för de sjukdomsmekanismer som orsakar demenssjukdom. Syftet: Att beskriva hur musikterapi påverkar personer med demens. Metod: Metoden som författarna använde i studien var en systematisk litteraturstudie. 12 artiklar varav tio med kvantitativ ansats och två med kvalitativ ansats inkluderades i studien. Manifest innehållsanalys gjordes med stöd av Forsberg och Wengström (2013). Resultat: Resultatet består av tre kategorier och nio subkategorier. Kategorierna var emotionella förändringar, förändrad intellektuell och social förmåga och förändrade livssituationer. Resultatet visade att musikterapi har en påverkan hos personer med demens och de flesta visade sig vara positiva. Musikterapin gav minskad agitation, förbättrad kommunikation samt ökad välbefinnande. Slutsats: Av resultatet från författarnas systematiska litteraturstudie rekommenderas musikterapi som ett alternativ eller kompletterande omvårdnadsåtgärd för personer med demens. Det är viktigt som sjuksköterska att utgå från ett livsvärldsperspektiv vid omvårdnad av personer med demens, eftersom det är via livsvärlden som sjuksköterskan kan främja hälsa och genomföra personcentrerad vård.

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The purpose of this study was to examine the role of music perception in predicting phonological awareness in five- and six-year-old children. This study was based on the hypothesis that music perception and phonological awareness appear to have parallel auditory perceptual mechanisms. Previous research investigating the relationship between these constructs—music perception and phonological awareness—has been promising, but inconclusive. Phonological awareness is an important component of early literacy which many children struggle to acquire. If the constructs are shown to be related, music-based interventions may then be developed to promote phonological awareness, thus enhancing early literacy. Music perception, phonological awareness, and visual-spatial skills of 119 five- and six-year-old children were tested. The researcher administered the Children’s Music Aptitude Test (Stevens, 1987) in order to assess perception of pitch, rhythm, and melody. Subsequently, the Comprehensive Test of Phonological Processing (Wagner, Torgesen, & Rashotte, 1999) was administered in order to measure phonological awareness skills, including blending, elision, and sound matching. The Visual Spatial Relations subtest of the Woodcock Johnson III (Woodcock, McGrew, & Mather, 2001) was later used to assess visual spatial skills. Structural equation modeling (SEM) allowed the researcher to model relationships between the latent variables to investigate the contribution of music perception, visual-spatial skills, and age to phonological awareness. Results supported the hypothesis that music perception, visual spatial skills, and age predict phonological awareness. Additionally, music perception made a statistically significant contribution to phonological awareness, when controlling for visual spatial skills and age. Specifically, music perception predicted a larger amount of standardized unit change in phonological awareness than did the other predictors in the theory. Thus, music perception appears to have a stronger relationship with phonological awareness than age or visual spatial skills. Further, results showed that a model without music perception as a predictor of phonological awareness was not supported. These findings confirm that music perception plays a unique role in predicting phonological awareness, above and beyond the contribution made by visual spatial skills and age. This study’s results could be used in support of the development of music-based interventions for promoting phonological awareness in five- and six-year-old children.

This thesis has set out to investigate the role of music therapy in the form of the specialist Bonny Method of Guided Imagery and Music (GIM) with a view to exploring how meanings related to adjustment from a health crisis (such as cardiac surgery) are depicted in music-supported imagery. Factors shaping clinical interpretations of verbal and musical responses in music therapy practice are often unclear or undelineated. A systematic interpretive process relevant to clinical health care was developed using the Bonny Method of Guide Imagery and Music (GIM), providing a means for exploring the emotional difficulties of coronary bypass patients, who typically recover quickly from physical surgery but often experience residual symptoms such as depression, pain, and anxiety. The interpretive process accessed both verbal and non-verbal texts, playing them against each other in order to find significance for music therapy practice in rehabilitation. A Bonny Method of Guided Imagery and Music (GIM) series was undertaken by patients recovering from coronary artery bypass grafting (CABG), with each session audiotaped and transcribed. This narrative data was analyzed thematically, and grand themes were used to focus further intertextual (semiotic) and Jungian perspectives, in the process of deriving substantial clinical meanings. Results suggested that participants used a wide range of personal, cultural and archetypal texts to convey meanings about their health care situation, including images of the music during the therapeutic process. Clinical change in the rehabilitative process was suggested by grand themes comprising 'Looking through the frame', 'Feeling the impact', 'Spiralling into the unexpected', 'Sublime plateau', and 'Rehearsing new steps' and the further music-related grand theme of 'Sounding the changes'. This project highlights the value of GIM as a vehicle to track clinical change with cardiac patients, based on a systematic interpretive process sensitive to the interweaving verbal and nonverbal texts evident in the music therapy context.

An emergent qualitative design provided the scaffolding for the micro-analysis of video footage and subsequent video-cued discussion with four reviewers. The collated material was used to prepare thick descriptions which were annotated for infant and therapist behaviours. A further thematic analysis of these behaviours provided 14 sets of behaviours used by the medically fragile newborn infants to indicate availability for interplay and 20 sets of behaviours used by the therapist in response to the infant. The interaction of these categorised behaviours provided seven markers of interplay between the music therapist and the medically fragile newborn infant.