Trajectories of Terminally Ill Patients' Cardiovascular Response to Receptive Music Therapy in Palliative Care
Warth M, Kessler J, Hillecke TK, Bardenheuer HJ
Journal of pain and symptom management · 29 citas
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Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2016-04-15 · J Pain Symptom Manage · vol. 52 · número 2 · págs. 196–204
- Editorial
- Elsevier BV
- Citado
- 48 citas · más que el 96% de estudios similares · 7.0× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 91 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Music Therapy and Health · Palliative Care and End-of-Life Issues · Palliative and Oncologic Care
- Palabras clave
- music therapy, palliative care, dying patients, cardiovascular response, heart rate variability, autonomic nervous system, relaxation intervention, mindfulness practice, end-of-life care, pain, gender differences, peripheral blood flow, therapeutic relationship
- MeSH
- humans, neoplasms, music therapy, palliative care, terminal care, linear models, sex factors, blood volume, heart rate, nonlinear dynamics, middle aged, terminally ill, female, male, pain management, mindfulness
4 autores
- Marco Warth🇩🇪 · autor de correspondenciaHeidelberg University; University Hospital Heidelberg; SRH University of Applied Sciences Heidelberg
- Jens Keßler🇩🇪Heidelberg University; University Hospital Heidelberg
- Thomas Karl Hillecke🇩🇪SRH University of Applied Sciences Heidelberg
- Hubert J. Bardenheuer🇩🇪Heidelberg University; University Hospital Heidelberg
Resumen
El texto original del estudio, en el idioma en que se publicó.
Context
Relaxation interventions are frequently used to promote symptom relief in palliative care settings, but little is known about the underlying mechanisms.
Objectives
The present analysis aimed at examining the psychophysiological pathways of terminally ill patients' cardiovascular response to a live music therapy vs. prerecorded mindfulness exercise.
Methods
Eighty-four patients of a palliative care unit were randomly assigned to either of the two interventions. Multilevel modeling was used to analyze trajectories of physiological change. Vagally mediated heart rate variability (VM-HRV) and blood volume pulse amplitude (BVP-A) served as indices of autonomic nervous system response. Participants' gender, age, baseline scores, self-rated pain, and assignment to treatment were entered to the models as predictors.
Results
Both VM-HRV and BVP-A showed significant linear and quadratic trends over time, as well as substantial heterogeneity among individuals' trajectories. Baseline scores, pain, and treatment significantly accounted for random variation in VM-HRV intercepts. BVP-A levels were significantly higher in women than in men. Moreover, assignment to treatment significantly accounted for differences in the linear slopes of peripheral blood flow.
Conclusion
Higher levels of VM-HRV in the music therapy group highlight the importance of a therapeutic relationship for the effectiveness of relaxation interventions in end-of-life care settings. Music therapy caused significantly stronger reductions of vascular sympathetic tone and, therefore, may be indicated in the treatment of pain and stress-related symptoms in palliative care. Initial self-ratings of pain moderated patients' physiological response and need to be taken into account in clinical practice and future theory building.
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