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Music interventions for psychological and physical outcomes in cancer: a systematic review and meta-analysis

Abstract

Purpose

A systematic review and meta-analysis to examine the effect of music interventions on psychological and physical outcome measures in cancer patients.

Methods

We searched six English-language databases and three major Chinese-language databases in March 2011. Nine databases were reviewed from 1966 or the start of the database to March 2011. All randomized controlled trials comparing music intervention with standard care, other interventions, or placebo for psychological and physical outcomes in cancer were included. Study quality was evaluated by the Grading of Recommendations Assessment, Development, and Evaluation Working Group. We then performed a meta-analysis of music interventions for psychological and physical outcomes in cancer.

Results

Of 322 total studies found, 32 randomized trials (3181 participants) met the inclusion criteria. Seven high-quality studies indicated music had positive effects on coping anxiety assessed by the Self-Rating Anxiety Scale. Two moderate-quality studies suggested music reduced anxiety assessed by the Hamilton Anxiety Scale. Eight moderate-quality studies revealed music lowered anxiety assessed by the Spielberger State-Trait Anxiety Inventory. Seven moderate-quality studies demonstrated that music improved depression. Seven moderate-quality studies observed that music had positive effects on pain management. Two moderate-quality studies suggested music worsened fatigue. Four moderate-quality studies indicated music lowered heart rate. Three low-quality studies suggested music could reduce respiratory rate. Two moderate-quality studies indicated that music improved quality of life.

Conclusions

Individual randomized trials suggest that music intervention is accepted by patients and associated with improved psychological outcomes. The effects of music on vital signs especially blood pressure are small. High-quality trials are needed to further determine the effects of music intervention.

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References

  1. Walsh D, Donnelly S, Rybicki L (2000) The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer 8:175–179

    PubMed  Article  CAS  Google Scholar 

  2. van’t Spijker A, Trijsburg RW, Duivenvoorden HJ (1997) Psychological sequelae of cancer diagnosis: a meta-analytical review of 58 studies after 1980. Psychosom Med 59:280–293

    Google Scholar 

  3. Norton TR, Manne SL, Rubin S et al (2004) Prevalence and predictors of psychological distress among women with ovarian cancer. J Clin Oncol 22:919–926

    PubMed  Article  Google Scholar 

  4. Sellick SM, Crooks DL (1999) Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psychooncology 8:315–333

    PubMed  Article  CAS  Google Scholar 

  5. Massie MJ (2004) Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 32:57–71

    PubMed  Article  Google Scholar 

  6. Parle M, Jones B, Maguire P (1996) Maladaptive coping and affective disorders among cancer patients. Psychol Med 26:735–744

    PubMed  Article  CAS  Google Scholar 

  7. Raison CL, Miller AH (2003) Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry 54:283–94

    PubMed  Article  Google Scholar 

  8. Thune-Boyle IC, Myers LB, Newman SP (2006) The role of illness beliefs, treatment beliefs, and perceived severity of symptoms in explaining distress in cancer patients during chemotherapy treatment. Behav Med 32:9–29

    Article  Google Scholar 

  9. Tascilar M, de Jong FA, Verweij J et al (2006) Complementary and alternative medicine during cancer treatment: beyond innocence. Oncologist 11:732–741

    PubMed  Article  Google Scholar 

  10. Burns J, Labbé E, Williams K et al (1999) Perceived and physiological indicators of relaxation: as different as Mozart and Alice in chains. Appl Psychophysiol Biofeedback 24:197–202

    PubMed  Article  CAS  Google Scholar 

  11. Haun M, Mainous RO, Looney SW (2001) Effect of music on anxiety of women awaiting breast biopsy. Behav Med 27:127–132

    PubMed  Article  CAS  Google Scholar 

  12. Sendelbach SE, Halm MA, Doran KA et al (2006) Effects of music therapy on physiological and psychological outcomes for patients undergoing cardiac surgery. J Cardiovasc Nurs 21:194–200

    PubMed  Google Scholar 

  13. Chikamori F, Kuniyoshi N, Shibuya S et al (2004) Perioperative music therapy with a key-lighting keyboard system in elderly patients undergoing digestive tract surgery. Hepatogastroenterology 51:1384–1386

    PubMed  Google Scholar 

  14. Lin PC, Lin ML, Huang LC et al (2011) Music therapy for patients receiving spine surgery. J Clin Nurs 20:960–968

    PubMed  Article  Google Scholar 

  15. Leardi S, Pietroletti R, Angeloni G et al (2007) Randomized clinical trial examining the effect of music therapy in stress response to day surgery. Br J Surg 94:943–947

    PubMed  Article  CAS  Google Scholar 

  16. Clark M, Isaacks-Downton G, Wells N et al (2006) Use of preferred music to reduce emotional distress and symptom activity during radiation therapy. J Music Ther 43:247–65

    PubMed  Google Scholar 

  17. Ferrer AJ (2007) The effect of live music on decreasing anxiety in patients undergoing chemotherapy treatment. J Music Ther 44:242–55

    PubMed  Google Scholar 

  18. Bulfone T, Quattrin R, Zanotti R et al (2009) Effectiveness of music therapy for anxiety reduction in women with breast cancer in chemotherapy treatment. Holist Nurs Pract 23:238–242

    PubMed  Google Scholar 

  19. Frank JM (1985) The effects of music therapy and guided visual imagery on chemotherapy induced nausea and vomiting. Oncol Nurs Forum 12:47–52

    PubMed  CAS  Google Scholar 

  20. Bozcuk H, Artac M, Kara A et al (2006) Does music exposure during chemotherapy improve quality of life in early breast cancer patients? A pilot study. Med Sci Monit 12:200–205

    Google Scholar 

  21. Ezzone S, Baker C, Rosselet R et al (1998) Music as an adjunct to antiemetic therapy. Oncol Nurs Forum 25:1551–1556

    PubMed  CAS  Google Scholar 

  22. Murrock CJ (2002) The effects of music on the rate of perceived exertion and general mood among coronary artery bypass graft patients enrolled in cardiac rehabilitation phase II. Rehabil Nurs 27:227–231

    PubMed  Article  Google Scholar 

  23. Cassileth BR, Vickers AJ, Magill LA (2003) Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation: a randomized controlled trial. Cancer 98:2723–2729

    PubMed  Article  Google Scholar 

  24. Sarkamo T, Tervaniemi M, Laitinen S et al (2008) Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 131:866–876

    PubMed  Article  Google Scholar 

  25. Barrera ME, Rykov MH, Doyle SL (2002) The effects of interactive music therapy on hospitalized children with cancer: a pilot study. Psychooncology 11:379–388

    PubMed  Article  Google Scholar 

  26. Burns DS (2001) The effect of the bonny method of guided imagery and music on the mood and life quality of cancer patients. J Music Ther 38:51–65

    PubMed  CAS  Google Scholar 

  27. Bailey LM (1986) Music therapy in pain management. J Pain Symptom Manage 1:25–28

    PubMed  Article  CAS  Google Scholar 

  28. Beck SL (1991) The therapeutic use of music for cancer-related pain. Oncol Nurs Forum 18:1327–37

    PubMed  CAS  Google Scholar 

  29. Cepeda MS, Carr DB, Lau J et al (2006) Music for pain relief. Cochrane Database Syst Rev 2:CD004843

    PubMed  Google Scholar 

  30. Ferguson SL, Voll KV (2004) Burn pain and anxiety: the use of music relaxation during rehabilitation. J Burn Care Rehabil 25:8–14

    PubMed  Article  CAS  Google Scholar 

  31. Burns SJ, Harbuz MS, Hucklebridge F et al (2001) A pilot study into the therapeutic effects of music therapy at a cancer help center. Altern Ther Health Med 7:48–56

    PubMed  CAS  Google Scholar 

  32. Hamai A, Benlalam H, Meslin F et al (2010) Immune surveillance of human cancer: if the cytotoxic T-lymphocytes play the music, does the tumoral system call the tune? Tissue Antigens 75:1–8

    PubMed  Article  CAS  Google Scholar 

  33. Urakawa K, Yokoyama K (2004) Can relaxation programs with music enhance human immune function? J Altern Complement Med 10:605–606

    PubMed  Article  Google Scholar 

  34. Hilliard RE (2003) The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. J Music Ther 40:113–37

    PubMed  Google Scholar 

  35. Dileo C (1999) A classification model for music and medicine. National Association of Music Therapy, Washington, DC, pp. 1–6

  36. Dileo C (2006) Effects of music and music therapy on medical patients: a meta-analysis of the research and implications for the future. J Soc Integr Oncol 4:67–70

    PubMed  Article  Google Scholar 

  37. Guyatt G, Oxman AD, Akl EA et al (2011) GRADE guidelines: introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64:383–394

    PubMed  Article  Google Scholar 

  38. Higgins JPT, Green S (eds) (2006) Cochrane Handbook for Systematic Reviews of Interventions, section 6.7.1., version 4.2.6. [updated Sept 2006]. The Cochrane Library, issue 4. Wiley, Chichester.

  39. Review Manager (RevMan) [Computer program] Version 5.0. Copenhagen: The Nordic Cochrane Centre, the Cochrane Collaboration. 2008. Available at: www.cc-ims.net/RevMan

  40. Cai GR, Li PW, Jiao LP (2001) Clinical observation of music therapy combined with anti-tumor drugs in treating 116 cases of tumor patients. Zhongguo Zhong Xi Yi Jie He Za Zhi 21:891–894

    PubMed  CAS  Google Scholar 

  41. Li HM, Wang YQ, Yang ZH (2007) Effect of background music on anxiety and depression of patients during thermotherapy of cancer. Nursing Journal of Chinese People’s Liberation Army 24:16–17

    Google Scholar 

  42. Liu L, Qu AW, Zeng ZF (2003) The influence of background music for tumour patients’ anxiety when waiting for the surgery. J Clin Nurs 2:56–57

    Google Scholar 

  43. Shen S (2006) Music intervention reduce breast tumor patients’ anxiety before outpatient surgery. Henan Journal of Surgery 12:7–8

    Google Scholar 

  44. Wang YY (2006) The research of music therapy reduce anxiety and stress of patients with lung cancer before operation. Chinese Journal of Practical Nursing 22:14–15

    CAS  Google Scholar 

  45. Yang XH (2008) Influence of music therapy on the anxiety and immunity of patients with gastric cancer during chemotherapy. Chinese Journal of Practical Nursing 24:11–13

    CAS  Google Scholar 

  46. Yang XH, Jing ZP (2008) Music therapy to reduce cancer patients’ discomfort during chemotherapy. Health Vocational Education 26:149–150

    Google Scholar 

  47. Zhang WZ, Zhao YL (2010) The influence of music therapy on cancer patients’ emotions during chemotherapy. Nursing Pratice and Research 7:25–26

    Google Scholar 

  48. Zhao PT, Liang J, Shao QJ et al (2008) Interventional effects of musical therapy to physiological and psychological conditions in process of radiotherapy for patients with cancer. Chinese Journal of Cancer Prevention and Treatment 15:1097–1099

    Google Scholar 

  49. Cao CQ (2007) The effect of music therapy in the course of thermotherapy for cancer patients. J Nurs Adm 7:28

    Google Scholar 

  50. Kwekkeboom KL (2003) Music versus distraction for procedural pain and anxiety in patients with cancer. Onc Nurs Forum 30:433–440

    Article  Google Scholar 

  51. Nguyen TN, Nilsson S, Hellström SL et al (2010) Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial. J Pediatr Oncol Nurs 27:146

    PubMed  Article  Google Scholar 

  52. Wan YH, Mao ZF, Qiu YR (2009) Influence of music therapy on anxiety, depression and pain of cancer patients. Can J Nurs Res 5:1172–1175

    Google Scholar 

  53. Liu AM, Jia T, Liu XM et al (2006) Music relaxing therapy on psychological status of the patients with malignant tumors subject to radiofrequency heat therapy. Journal of Nursing Science 21:60–61

    Google Scholar 

  54. Lu ZQ, Hu Y (2010) The effect of music relaxation therapy on the adverse reactions induced by chemotherapy in patients with breast cancer. Chinese Journal of Nursing 5:405–408

    Google Scholar 

  55. Zhang YW (2010) Effect of music and mood relaxation training for anxiety reduction in patients with breast tumor before operation. Cancer Research and Clinic 22:692–694

    Google Scholar 

  56. Xu LT, Han JH, Le YQ et al (2008) The impact of music therapy on cancer patients’ pain and depression. Chinese Journal of Practical Nursing 24(Supplement 2):2

    Google Scholar 

  57. Zhou KN, Li XM (2010) The effectiveness of music therapy reduces breast cancer patients’ depression and time of hosptalization after eradicative operation. Chinese Journal of Practical Nursing 26:55–57

    CAS  Google Scholar 

  58. Bi XQ, Li JP, Zhao FR et al (2007) Music therapy to release pains for patients with maxillofacial cancer. Chinese Journal of Practical Nursing 23:38–40

    Google Scholar 

  59. Fan YY, Hu W, Xiao CQ et al (2008) Application of music therapy in patients with nasopharyngeal carcinoma during radiotherapy. Chinese Journal of Practical Nursing 24:3

    Google Scholar 

  60. Wu YF (2009) The influence of background music on the psychological status of patients with breast cancer during operation. Hei Longjiang Medical Journal 9:709–710

    CAS  Google Scholar 

  61. Zhou KN, Li XM (2010) Effect of music therapy on pain of breast cancer patients after radical mastectomy. Chinese Journal of Nursing 12:1086–1088

    Google Scholar 

  62. Huang ST, Good M, Zauszniewski JA (2010) The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Int J Nurs Stud 47:1354–1362

    PubMed  Article  Google Scholar 

  63. Hanser SB, Wu SB, Kubicek L et al (2006) Effects of a music therapy intervention on quality of life and distress in women with metastatic breast cancer. J Soc Integr Oncol 4:116

    PubMed  Article  Google Scholar 

  64. Xie Z, Huang G (2001) The influence of music therapy plus relaxation method on the quality of life of cancer patients during chemotherapy. Chinese Mental Health Journal 15:176–178

    Google Scholar 

  65. Lai HL, Good M (2002) The overview of music therapy. The Journal of Nursing 49:80–84

    Google Scholar 

  66. Chlan LL (1998) Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung 27:169–176

    PubMed  Article  CAS  Google Scholar 

  67. Chlan LL (2000) Music therapy as a nursing intervention for patient supported by mechanical ventilation. American Association of Critical Care Nurse 11:128–138

    CAS  Google Scholar 

  68. Chin CC, Good M (1994) The effect of western music on postoperative pain in Taiwan. Kaohsiung Journal of Medical Science 14:94–103

    Google Scholar 

  69. Lai HL (2004) Music preference and relaxation in Taiwanese elderly people. Journal of Geriatric Nursing 25:286–291

    Article  Google Scholar 

  70. Vanderark SD, Ely D (1993) Cortisol, biochemical and galvanic skin responses to music stimuli of different preference values by college students in biology and music. Perceptual and Motor Skill 77:227–234

    Article  CAS  Google Scholar 

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Correspondence to Guang H. Yue.

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Jun-Mei Zhang and Pu Wang share equal coauthorship.

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Zhang, JM., Wang, P., Yao, Jx. et al. Music interventions for psychological and physical outcomes in cancer: a systematic review and meta-analysis. Support Care Cancer 20, 3043–3053 (2012). https://doi.org/10.1007/s00520-012-1606-5

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  • DOI: https://doi.org/10.1007/s00520-012-1606-5

Keywords

  • Cancer
  • Music
  • Outcome
  • Physical
  • Psychological
  • Music medicine
  • Music therapy
  • Music intervention