In adult oncology patients at an infusion Center at Queens Hospital Center, does the implementation of a music therapy program compared to current practice, impact pain scores during chemotherapy over 8-10 weeks?
discuss your evidence-based intervention and the rationale behind choosing this option.
The evidence-based intervention for the proposed project is implementing therapeutic music to reduce pain scores among cancer patients. Pain is the most reported complaint among cancer patients and is inadequately controlled with current treatment modalities (Behzadmehr et al., 2020; Fernando et al., 2019; Yangoz & Ozer, 2019). Complementary and alternative medicine interventions are getting more popularity and acceptance among cancer patients (Behzadmehr et al., 2020; Fernando et al., 2019). The healing power of music has been well recognized in many cultures for several centuries and is used to cure the disorders of mind and body (Schnieider,2018; Spilioti et al., 2017). Music is beneficial, safe, and economical adjuvant treatment modality and is frequently used in palliative care (Bro et al., 2019; Li et al., 2020). Additionally, music is a universal language, which produces phenomena of music-induced analgesia ( Lu et al., 2019) and positively influences physical and emotional symptoms of cancer ( Bro et al., 2019). In other words, music distracts unpleasant symptoms, promotes expressing their inner feelings, and causes reduction of anxiety, depression, and pain (Antoich et al., 2020; Li et al., 2020; Sibanda et al., 2018; Spilioti et al., 2017). Furthermore, listening to favorite music reduces pain perception and feeling of well-being secondary to the release of dopamine and serotonin (Antoich et al., 2020; Sibanda et al., 2018; Wurjatmiko,2019). Music stimulates the limbic system to release endorphins and parasympathetic system activation and leads to relaxation of the body and natural analgesia (Antoich et al., 2020; Sibanda et al., 2018; Wurjatmiko,2019). Strong neuroscientific evidence of music-induced analgesia is revealed with the help of real-time functional magnetic imaging, which showed unique brain activation for subjects in pain while listening to music (Li et al., 2020). Also, the study (Li et al., 2020) found a very promising fact that subjects in pain listening to music also developed activation of descending pain pathway and dorsal gray matter of spinal cord, which causes diminished pain perception. In short, music is a beneficial, safe, and economical adjuvant treatment modality and is recommended in cancer pain management (Bro et al., 2019; Li et al., 2020; Wurjatmiko, 2019; Yangoz and Ozer, 2019).
There is robust research evidence to support the use of music as an adjunct non-pharmacological intervention. An extensive systematic review by Wurjatmiko (2019) and another systematic review and meta-analysis by Yangoz and Ozer (2019) revealed music reduces cancer pain. Both studies strongly support using passive listening of nonlyrical/ instrumental music from a CD player using earphones to reduce pain. The music selection in the reviewed studies was different ( Wurjatmiko, 2019; Yangoz and Ozer, 2019), and Wurjatmiko (2019) concluded from the reviewed evidence that using soft melodic music with a tempo of 60 to 80 beats per minute is therapeutic in reducing pain. Poulsen and Coto (2018) also found closely similar findings after an extensive literature search and formulated a music protocol that nurses could quickly adapt to manage pain. Even though nurses appreciate the benefits and scientific evidence of many multi-modal treatment modalities for cancer pain management, use is limited secondary to lack of resources, knowledge, and clinical care coordination (Erol et al., 2018; Rini et al., 2017). The DNP student is highly motivated to implement this evidence-based intervention to improve the pain scores of adult cancer patients at the practicum site.
Did you consider the needs of the project site? Did you feel the resources available at the site and the potential cost? What about buy-in from stakeholders for your chosen intervention?