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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 3  |  Issue : 2  |  Page : 108-110

A quasi-experimental study to assess the effectiveness of music therapy on pain level among cancer patients admitted to regional cancer hospital Indira Gandhi Medical College, Shimla, Himachal Pradesh


Department of Medical Surgical Nursing, Oncology Nursing Akal College of Nursing, Eternal University, Sirmour, Himachal Pradesh, India

Date of Submission04-Oct-2018
Date of Acceptance20-Nov-2018
Date of Web Publication26-Dec-2018

Correspondence Address:
Ms. Navjeet Kaur
Department of Medical Surgical Nursing, Oncology Nursing, Akal College of Nursing, Eternal University, Baru Sahib, Via Rajgarh, Sirmour 73 001, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bjhs.bjhs_29_18

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  Abstract 


INTRODUCTION: Cancer is an uncontrolled growth and spread of abnormal cells. About 53% of patients suffer pain in various stages of their illness. There are different nonpharmacological measures that are used widely for reducing pain. Music is believed to reduce pain and also the intake of analgesic.
AIM: This study aims to find the effect of music therapy in reducing pain among cancer patients.
SETTINGS AND DESIGN: A nonrandomized control group design study was conducted in Regional Cancer Hospital Indira Gandhi Medical College, Shimla, Himachal Pradesh.
MATERIALS AND METHODS: A total of 50 individuals were selected based on inclusion criteria through nonprobability purposive sampling technique. They were divided into experimental and control groups nonrandomly. Background information was collected using structured interview schedule. The pain level was assessed by using a numerical pain rating scale. Indian classical instrumental music was administered for 20 min in the morning and evening for 3 consecutive days.
RESULTS: Majority of the individuals (52%) were in the age group of 41–50 years, and higher proportions (84%) of individuals were females out of which 64% had cancer of cervix in experimental as well as control group. In the experimental group during the posttest, pain level was less than the pretest pain level which was statistically significant (F = 47.21, P < 0.001). However, in the control group, there was no change in pre- and post-test pain level (P = 0.177).
CONCLUSIONS: The findings of the study showed that the pain level in the experimental group during the posttest was less than that in the pretest as compared to the control group which showed that music therapy was effective in reducing the pain level among cancer patients.

Keywords: Cancer pain, effectiveness, music therapy


How to cite this article:
Kaur N, Kesava J. A quasi-experimental study to assess the effectiveness of music therapy on pain level among cancer patients admitted to regional cancer hospital Indira Gandhi Medical College, Shimla, Himachal Pradesh. BLDE Univ J Health Sci 2018;3:108-10

How to cite this URL:
Kaur N, Kesava J. A quasi-experimental study to assess the effectiveness of music therapy on pain level among cancer patients admitted to regional cancer hospital Indira Gandhi Medical College, Shimla, Himachal Pradesh. BLDE Univ J Health Sci [serial online] 2018 [cited 2019 Mar 22];3:108-10. Available from: http://www.bldeujournalhs.in/text.asp?2018/3/2/108/248554



Cancer is an uncontrolled growth and spread of abnormal cells which destroys the normal body tissues with many sign and symptoms such as nausea, vomiting, alopecia, and pain and is considered as one of the primary causes of death throughout the world, with near about 14 million new cases of cancer in 2012. It is considered the second most leading cause of mortality and responsible for nearly 8.8 million deaths in 2015, and 1 in 6 deaths worldwide. Approximately 70% of deaths occur due to cancer in middle- and low-income countries, and by 2030, the global burden will grow to 21.7 million with new cases of cancer.[1],[2]

Among Indian women, cancers of the female reproductive tract and breast have the highest incidence. It has been also highlighted in the cancer registries that in females, >70% of cancers occur in the age group of 35–64 years.[3]

Among many signs and symptoms, such as nausea, vomiting, alopecia, weight loss, insomnia, and headache, the cancer pain is considered to be the main issue. Approximately 53% of patients suffer from pain in different stages of cancer. According to a systematic review of cancer pain prevalence, there are about 59% of patients suffering from pain in the active therapy phase, whereas 65% of patients suffering from pain during the advanced disease.[4]

Pain may affect the normal functioning of the individual by undermining their mood, disturbing sleeping patterns, physical as well as social functioning, and impairing the quality of life. Therefore, it is crucial to bring pain under control. Causes of cancer pain may include progression of the disease condition, various treatment modalities to stop cancer such as surgical procedures, chemotherapy treatment, or radiotherapy and diagnostic procedures.[5]

There are different complementary measures such as yoga, breathing exercise, music therapy, and meditation that can be adopted to reduce pain and anxiety among cancer patients.

Music causes relaxation of muscles, distraction from the pain, and reduction in pain and decreases transfer of pain impulses to the central nervous system by the gate control theory.[6] It decreases pain intensity or analgesic requirements; also, it can be employed as a distraction technique during the intervention or as an alternative therapy. Hence, this can be used as a single intervention or as a complementary therapy to reduce pain among cancer patients and promoting their quality of life.


  Materials and Methods Top


The quasi-experimental study with nonrandomized control group design was conducted on 50 cancer patients selected by nonprobability purposive sampling technique diagnosed with breast, cervix, ovary, lungs, and oral cancer and admitted in the radiotherapy ward. These individuals were divided into experimental and control groups nonrandomly.

The tools used for the study were structured interview schedule for background information and numerical pain rating scale for assessing pain level. The intervention included music therapy which was provided to the experimental group for 20 min after taking the informed consent from the individuals. Posttest was done immediately after giving music therapy. The pain level was recorded every time before and after giving the music therapy in the morning and evening for 3 consecutive days. Only routine care was provided to the control group and posttest was done.


  Results Top


In experimental as well as the control group, 52% of the individuals were in the age group of 41–50 years. About 84% of individuals in both groups were females. In both experimental and control groups, majority of individuals (64%) had cervix cancer.

In experimental group during the posttest, the pain level was less than the pretest which was statistically significant (F = 47.21, P< 0.001). However, in the control group, there was no change in pre test and post test pain level as P = 0.177. Therefore, the results revealed that music therapy was effective in the experimental group in reducing the pain level among cancer patients [Figure 1].
Figure 1: Mean pain score level of experimental and control group (n = 50)

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[Table 1] shows that the t values on day 1, day 2, and day 3 were 14.42, 7.25, and 11.81, respectively, and findings were statistically significant at P< 0.001. Therefore, the results revealed that music therapy was effective in the experimental group in reducing the pain level among cancer patients.
Table 1: Comparison of pre- and post-test pain level among experimental group (n=25)

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[Table 2] depicts that in experimental group during posttest on day I evening, the mean and standard deviation (SD) was 3.44 ± 0.87 and on day III evening, the mean and SD was 2.56 ± 0.58 with mean difference of 0.88. The t value was 4.99 and found statistically significant at P< 0.001. Therefore, the results show that music therapy was effective in reducing the pain level among cancer patients in the experimental group and had a long time effect on the pain if given daily on the regular basis at periodic intervals.
Table 2: Comparison of day 1 and day 3 posttest pain level among experimental group (n=25)

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  Discussion Top


Findings of the study had shown that according to marital status in both experimental and control group 96% and 88% of individuals were married followed by 4% and 12% were widows, respectively. In both experimental and control groups, majority of individuals (64%) had cervix cancer followed by 16% breast cancer. In the experimental group, 52% of individuals had Stage 2 cancer followed by 48% with Stage 3 cancer. Whereas in the control group, majority of individuals (56%) had Stage 3 cancer followed by 44% cases of Stage 2 cancer.

Similar quasi-experimental study was done to assess the effectiveness of music therapy on cancer pain. Results of demographic data showed that in both experimental and control groups, majority of the individuals (80% and 60%) were married. According to the stage of cancer in both groups, majority of individuals (40% and 50%) had Stage 2 and 3 cancer, respectively.[7]

In experimental group during the posttest, pain level was less than the pretest pain level which was statistically significant (F = 47.21, P < 0.001). However, in the control group, there was no change in pre test and post test pain level as P value was greater than 0.05 level of significance. Therefore, the results revealed that music therapy was effective in the experimental group in reducing the pain level among cancer patients.

Similar quasi-experimental study done to see the effect of music on cancer pain identified that in the intervention group the “t” value was significantly higher than the tabulated value at 5%. To find the difference in pain level between experimental and control groups “Z” test was used and the results showed that Z value was higher than the tabulated value at 5% which indicated that music was an effective intervention.[7]

Another semi-experimental study was done on 60 patients suffering from cancer to find out the effect of music therapy on the level of pain. The results showed that the level of pain in music group was reduced after music therapy at P < 0.001, whereas in the control group, there was no change in the pain intensity during the study P = 0.12.[6]

A randomized controlled trial was conducted to assess the effectiveness of music therapy for relieving pain among patients suffering from cancer. The findings showed that there was a significant reduction in the level of pain during postmusic therapy at P < 0.001 than the control group. About 50% of relief in 42% of experimental group was experienced by 30 min of music than the control group.[8]


  Conclusions Top


Findings of the study showed that pain level in the experimental group during the posttest was less than the pretest as compared to the control group which showed that music therapy was effective in reducing the pain level among cancer patients. Hence, it can be concluded that music therapy is a beneficial nursing intervention in the reduction of pain level among cancer patients and can be used along with other modalities to reduce the pain and enhance comfort among the patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Torre L, Siegel RL, Jemal A. Global Cancer Facts & Figures. Atlanta: American Cancer Society; 2015. p. 1 57. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/global-cancer-facts-and-figures/global-cancer-facts-and-figures-3rd-edition.pdf. [Last accessed on 2017 Mar 15].   Back to cited text no. 1
    
2.
World Health Organization. Cancer. Geneva: World Health Organization; 2018. Available from: http://www.who.int/mediacentre/factsheets/fs297/en/. [Last accessed on 2017 Mar 20].  Back to cited text no. 2
    
3.
Uma Devi K. Current status of gynaecological cancer care in India. J Gynaecol Oncol 2009;20:77 80.   Back to cited text no. 3
    
4.
van den Beuken-van Everdingen MH, Hochstenbach LM, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on prevalence of pain in patients with cancer: Systematic review and meta-analysis. J Pain Symptom Manage 2016;51:1070-90.e9.  Back to cited text no. 4
    
5.
Menefee LA, Monti DA. Nonpharmacologic and complementary approaches to cancer pain management. J Am Osteopath Assoc 2005;105:S15-20.  Back to cited text no. 5
    
6.
Jasemi M, Eghtedar S, Aghakhani N, Khodabandeh F, Sayadi L. Music therapy reduces the intensity of pain among patients with cancer. Thrita 2013;2:769.  Back to cited text no. 6
    
7.
Kaliyaperumal R, Subash JG. effect of music therapy for patients with cancer pain. Int J Biol Med Res 2010;1:79-81.  Back to cited text no. 7
    
8.
Huang ST, Good M, Zauszniewski JA. The effectiveness of music in relieving pain in cancer patients: A randomized controlled trial. Int J Nurs Stud 2010;47:1354-62.  Back to cited text no. 8
    


    Figures

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    Tables

  [Table 1], [Table 2]



 

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