Page 340 - Encyclopedia of Nursing Research

MUSIC THERAPy n 307

Throughout history, music has been meanings, and self-insight. In addition, stud-
used for a variety of therapeutic purposes ies have shown that music reduces pain and
by primitive people to ward off evil spirits, anxiety, reduces muscle tension, raises levels M
to prevent or cure illnesses, to relieve depres- of beta-endorphins, and lowers adrenocor-
sion, to modify emotions, and to achieve ticotropic stress hormones. Music has been
inner harmony. Early cultures had little found to improve the immune system, sali-
means to treat disease, so music and spir- vary cortisol, postoperative and cancer pain,
ituality were used to provide comfort and sleep, nausea and vomiting of chemotherapy,
help people cope. During the Renaissance, mood during stem cell transplantation, pain
physicians became interested in the thera- of osteoarthritis, and cardiac anxiety and
peutic value of music and incorporated it in autonomic balance. It has also been effective
their training and practice. From the seven- for acute and chronic pain and during stress-
teenth century onward, physicians studied ful or painful procedures (e.g., injections,
the effect of music on physiology and psy- gastrointestinal endoscopy, and lumbar
chology and debated whether to focus on punctures). Music has been generally found
the type of music that was effective versus to reduce anxiety before, during, and after
the type of person who responds positively surgery, during burn debridement, in chroni-
to music. Florence Nightingale used music cally ill patients, and after myocardial infarc-
with injured soldiers in the Crimea. She had tion. It has been studied for circumcision
recreation areas where recovering men could pain in infants, for injection pain in children
go to listen to singing or playing of musical and adults, for disturbances in psychiatric,
instruments. demented, and agitated patients, in the criti-
At the beginning of the twentieth cen- cally ill, in dyslexic children, in postanesthe-
tury, the first laboratory studies of the phys- sia patients, in the emergency department,
iological effects of music were conducted on and in those who are comatose or dying.
animals and humans. These experiments Lullabies have shown beneficial effects on
demonstrated changes in vital signs and preterm infants. A double-blind study of
body secretions in response to various types music during surgery showed effects on
of music. They are rejected by most investiga- recovery. In mice, music reduced stress and
tors today because of the poor quality of mea- metastasis and improved immune factors.
surement, analysis, and control. In the 1930s, Music has been categorized into stimu-
music began to be used in patients’ hospital lative and sedative types. Stimulative music
rooms, in surgery before general anesthesia, has strong rhythms, volume, dissonance,
and during local anesthesia. Music was used and disconnected notes, whereas sedative
in obstetrics and gynecology to reduce the music has a sustained melody without strong
side effects of inhalation anesthetics. rhythmic or percussive elements. Stimulative
Nursing reviews of research on the music enhances bodily action and stimu-
effect of music on health outcomes can be lates skeletal muscles, emotions, and sub-
found in chapters by Good (1996), Guzzetta cortical reactions in humans. Sedative music
(1988, 1997), Standley and Hanser (1995), results in physical sedation and responses
and Snyder and Chlan (1999). The American of an intellectual and contemplative nature
Music Therapy Association and two journals, (Gaston, 1951). Precategorization by the
the Journal of Music Therapy and the Music nurse, however, does not consider the kind of
Therapy Perspectives, are excellent resources. subject response. Other ways of categorizing
Music can transport patients’ thoughts to are slow and fast music, or by type of music
a new place, give them new perspectives, lift or instrument.
their mood, provide comfort, familiarity and To choose music that is therapeutic,
pleasure to patients, and stimulate memories, the nurse should consider the nature of