BACKGROUND: Anxiety and pain are prevalent symptoms experienced by inpatients in acute, long-term and rehabilitation care settings. There is a need for effective relief from these symptoms without increasing the risks as a result of the intervention. Empirical evidence supports the use of music as a complementary therapy for the management of anxiety and pain. However, there is limited knowledge of nurses’ awareness of and intention to use music therapy in clinical practice. AIMS: This study examined nurses’ awareness of and intention to use music therapy for the management of anxiety and pain, and factors that influenced nurses’ intention to implement music therapy in practice. A conceptual framework incorporating elements of the Theory of Planned Behaviour and Triandis’ Theory of Interpersonal Behaviour guided the study. METHOD: A correlational, survey-type design was used. The sample consisted of 161 Registered Nurses who were currently providing direct care to patients in acute, rehabilitation and long-term care settings in Ontario. Data were collected using adapted instruments that were pilot tested. RESULTS: Attitudes, subjective norms, perceived behavioural control, moral norms, and awareness were positively and moderately (all β > 0.20, p < .05) associated with nurses’ intention to use music therapy for the management of anxiety and pain. Role beliefs, selected demographic and professional characteristics were not significantly related to nurses’ intention to use music therapy for either anxiety or pain management. Nurse, client and unit factors were additional factors reported by nurses as affecting their use of music therapy in practice. IMPLICATIONS: The findings suggested the need for strategies to educate nurses about music therapy to facilitate its implementation in clinical practice. Research exploring why nurses are unaware of music therapy as an intervention and revisions to the current conceptual framework to incorporate additional factors influencing intervention use are required.

BACKGROUND: Anxiety and pain are prevalent symptoms experienced by inpatients in acute, long-term and rehabilitation care settings. There is a need for effective relief from these symptoms without increasing the risks as a result of the intervention. Empirical evidence supports the use of music as a complementary therapy for the management of anxiety and pain. However, there is limited knowledge of nurses’ awareness of and intention to use music therapy in clinical practice. AIMS: This study examined nurses’ awareness of and intention to use music therapy for the management of anxiety and pain, and factors that influenced nurses’ intention to implement music therapy in practice. A conceptual framework incorporating elements of the Theory of Planned Behaviour and Triandis’ Theory of Interpersonal Behaviour guided the study. METHOD: A correlational, survey-type design was used. The sample consisted of 161 Registered Nurses who were currently providing direct care to patients in acute, rehabilitation and long-term care settings in Ontario. Data were collected using adapted instruments that were pilot tested. RESULTS: Attitudes, subjective norms, perceived behavioural control, moral norms, and awareness were positively and moderately (all β > 0.20, p < .05) associated with nurses’ intention to use music therapy for the management of anxiety and pain. Role beliefs, selected demographic and professional characteristics were not significantly related to nurses’ intention to use music therapy for either anxiety or pain management. Nurse, client and unit factors were additional factors reported by nurses as affecting their use of music therapy in practice. IMPLICATIONS: The findings suggested the need for strategies to educate nurses about music therapy to facilitate its implementation in clinical practice. Research exploring why nurses are unaware of music therapy as an intervention and revisions to the current conceptual framework to incorporate additional factors influencing intervention use are required.

The sensory control of movements has been shown to be impaired with Parkinson’s disease. I investigated the task, reach-to-eat, in which advancing of the limb towards a target is guided by vision and withdrawal of the grasped target to the mouth is guided by somatosensation (i.e., haptics and proprioception). Parkinson’s diseased subjects display an alteration in the balance of visual and proprioceptive guidance, such that they display increased visual fixation on the target prior to movement onset that persists following the grasp. Music therapy can normalize the balance between visual and proprioceptive guidance on the reach-to-eat task, as visual fixation with the target prior to movement onset is consistent with controls, and disengagement following grasp no longer differs from mild Parkinson’s disease subjects. These results are the first to demonstrate that music can have an ameliorating effect on the sensory impairments seen in the control of forelimb movements in Parkinson’s disease. / xiv, 147 leaves : ill. ; 29 cm. --

This paper describes the processes under taken by a student music therapist to improve her clinical practice and enhance the quality of service provided to children with profound and multiple disabilities. Using an Action Research model it aims to show how rigorous investigation of one's own practice can improve understanding of the clients and enhance students' abilities and confidence when carrying out placement work. An interview process with three registered music therapists preceded a 12 week action research process. Three cycles were undertaken with each lasting 4 weeks and the interview material informed the initial cycle. Clinical notes, a research journal and video recordings of sessions were three data gathering tools used to evaluate the success of techniques employed. This intensive critical analysis led to a greater awareness of in session communications and an improvement in techniques such as active waiting and repetition of activities. This in turn created increased opportunities for response to musical offerings by this client group.

The present research examines the effect of music therapy on the affect of hospitalised children. It took place on a paediatric ward of a New Zealand public hospital. This study aimed to investigate the role of music therapy in addressing patients’ psychosocial needs. Literature on the impact of hospitalisation, and on the use of music therapy in hospitals and paediatrics was reviewed. The research involved an audit of the therapist’s clinical notes from music therapy sessions over the course of seven months. The clinical notes included measurements of children’s mood from the beginning and end of sessions, using McGrath’s (1990) Affective Facial Scale. It was hypothesised that mood measures following music therapy would be higher than pre-music therapy scores. Statistical analysis of the facial scale data did not show a significant difference between ‘before’ and ‘after’ measures. These results were discussed with regard to a ceiling effect (this is, the measurements indicated patients were at the happy end of the scale before the music therapy session, so there was little room on the scale for mood to improve following music therapy). The measurement of emotion did not prove to be straightforward. The hospital environment may have influenced the patients’ responses in a number of ways. These environmental influences are discussed with reference to examples from the clinical notes. The usefulness of facial scales in this context is discussed, as well as other limitations of the research. Suggestions for future research include the use of other mood measures, and the inclusion of measurements of parental mood and how this affects the child.

This study explores how other music therapists and mental health professionals process and reflect on their sessions and what issues are relevant and instrumental in achieving this. The primary focus is on an acute psychiatric ward for adolescents. The intent is to improve my ability to process and reflect on my clients’ responses and actions during and after future Music Therapy sessions. Research began by exploring the various ways of processing content that emerge during sessions by exploring the literature, interviewing an Occupational Therapist and a Clinical Psychiatrist from the unit and by analysing my reflective journal. Using multiple sources of information, methods, techniques and theories I will endeavour to uncover meaning, improve my understanding and thus improve my future practice. The initial perspective was endeavouring to discover how a therapist can better reflect on or process their sessions. Findings showed that the therapist processing with intent to “fix” or “cure” a client is misdirected. Through self-reflection, observation, ‘mindfulness’ , empathy, awareness of countertransference and several other tools, a therapist is able to become client-centred and potentially assist the client to self-reflect and develop mindfulness. The way in which a therapist processes and reflects is often influenced by an underlying psychodynamic theory that they adhere to. Experience and training can also influence this processing. With this client group, it is difficult to fully comprehend what a client is feeling or thinking. A therapist best serves the client by initially focusing on the client-therapist relationship. By building a trusting, safe environment, meeting the clients where they are emotionally or physically and by making exercises meaningful, clients needs can begin to be met. This all contributes to the ultimate goal of the therapy at this unit - to help clients “gain skills, gain independence and gain wellness”.

The present research examines the effect of music therapy on the affect of hospitalised children. It took place on a paediatric ward of a New Zealand public hospital. This study aimed to investigate the role of music therapy in addressing patients’ psychosocial needs. Literature on the impact of hospitalisation, and on the use of music therapy in hospitals and paediatrics was reviewed. The research involved an audit of the therapist’s clinical notes from music therapy sessions over the course of seven months. The clinical notes included measurements of children’s mood from the beginning and end of sessions, using McGrath’s (1990) Affective Facial Scale. It was hypothesised that mood measures following music therapy would be higher than pre-music therapy scores. Statistical analysis of the facial scale data did not show a significant difference between ‘before’ and ‘after’ measures. These results were discussed with regard to a ceiling effect (this is, the measurements indicated patients were at the happy end of the scale before the music therapy session, so there was little room on the scale for mood to improve following music therapy). The measurement of emotion did not prove to be straightforward. The hospital environment may have influenced the patients’ responses in a number of ways. These environmental influences are discussed with reference to examples from the clinical notes. The usefulness of facial scales in this context is discussed, as well as other limitations of the research. Suggestions for future research include the use of other mood measures, and the inclusion of measurements of parental mood and how this affects the child.

The present research examines the effect of music therapy on the affect of hospitalised children. It took place on a paediatric ward of a New Zealand public hospital. This study aimed to investigate the role of music therapy in addressing patients’ psychosocial needs. Literature on the impact of hospitalisation, and on the use of music therapy in hospitals and paediatrics was reviewed. The research involved an audit of the therapist’s clinical notes from music therapy sessions over the course of seven months. The clinical notes included measurements of children’s mood from the beginning and end of sessions, using McGrath’s (1990) Affective Facial Scale. It was hypothesised that mood measures following music therapy would be higher than pre-music therapy scores. Statistical analysis of the facial scale data did not show a significant difference between ‘before’ and ‘after’ measures. These results were discussed with regard to a ceiling effect (this is, the measurements indicated patients were at the happy end of the scale before the music therapy session, so there was little room on the scale for mood to improve following music therapy). The measurement of emotion did not prove to be straightforward. The hospital environment may have influenced the patients’ responses in a number of ways. These environmental influences are discussed with reference to examples from the clinical notes. The usefulness of facial scales in this context is discussed, as well as other limitations of the research. Suggestions for future research include the use of other mood measures, and the inclusion of measurements of parental mood and how this affects the child.

This project aims to investigate how carers and other professionals perceive the music therapy process over time. Music therapy has been used to address a wide range of diagnoses and developmental issues of young children. The research was conducted during my clinical placement working with young children who have been referred to a child development team. The participants in this project were carers with children with special needs. The children were diagnosed with various disabilities and required different support and developmental goals. Each child attended individual music therapy sessions once a week over a period of three to nine months. It was speculated that many other changes or developmental progress could occur along with the goals and objectives set by me in the music therapy process. To understand fully what other changes or progress the children have made with the input of music therapy, the research was designed using open-ended interviews to find out what the carers and a professional witnessed during and in between the sessions. Three carers were involved in a one-on-one in-depth interview in which they were encouraged to talk about their observation and perception of music therapy. A speech-language therapist was also invited to participate in an in-depth interview. Data derived from the interviews was analysed using a thematic analysis approach. The findings compare themes generated from the clinical notes and interview data. The results showed some shared experiences amongst the participants as well as exceptions influenced by parental differences and the children’s conditions. Examination of the similarities and differences between the clinical notes and the interview data helped me validate the outcome of music therapy intervention and gain more insights into effective practice.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.