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Study Finds Music Therapy Lowers Anxiety During Surgical Breast Biopsies

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Key Points

  • Patients were randomly assigned to one of three groups: one listened to preferred live music before surgery, one listened to preferred recorded music, and one experienced usual care with no music before surgery.
  • Both live and recorded preoperative music therapy interventions reduced anxiety significantly more than usual preoperative management by 28 and 27 points.
  • The music groups and controls did not differ in their anesthesia requirement, and satisfaction scores were universally high across all groups. Recovery time did not differ among the music and control groups, but those who listened to live music had a shorter recovery time than those who listened to recorded music.

A first-of-its-kind study published by Bradley Palmer et al in the Journal of Clinical Oncology found that music therapy lessened anxiety for women undergoing surgical breast biopsies for cancer diagnosis and treatment. The 2-year study, conducted at University Hospitals (UH) Seidman Cancer Center, Cleveland, involved 207 patients.

“To the best of our knowledge, this is the first randomized controlled trial to test music therapy for anxiety management with women undergoing outpatient breast cancer surgery, and the largest study of its kind to use live music therapy in the surgical arena,” said lead author Jaclyn Bradley Palmer, MT-BC, music therapist at UH. “Our aim was to determine if music therapy affected anxiety levels, anesthesia requirements, recovery time, and patient satisfaction with the surgical experience,” she said.

Methodology

Patients were randomly assigned to one of three study groups. One group listened to preferred live music before surgery, one listened to preferred recorded music, and one experienced usual care with no music before surgery. The participants who listened to either recorded or live music selected their song choice, which was either downloaded and played or learned and performed by the music therapist preoperatively.

“We discovered that anxiety levels dropped significantly from pretest to post-test in patients who heard one preferred song of either live or recorded music before surgery,” said Ms. Bradley Palmer. “In this trial, both live and recorded preoperative music therapy interventions reduced anxiety significantly more than usual preoperative management by 28 and 27 points, representing percent reductions of 43% and 41%, respectively.”

For the study, a nurse research assistant administered a pretest to obtain a baseline reading on the women's anxiety levels, then a post-test after 5 minutes of music therapy or usual care without music. Live music was performed vocally with guitar or keyboard accompaniment by a music therapist who stood at the patient's bedside and presented the brief music therapy session as the patient awaited surgery.

Whether patients heard live music or prerecorded music before surgery, music therapists in both instances would engage the patients for 5 minutes in a short music therapy session, which included the preferred song, conversation over the music choice, and processing of any emotions which may have arisen. During surgery, the two groups that experienced live or recorded music also listened to staff-selected, prerecorded harp music through headphones. The harp arrangement was carefully chosen for its smooth, melodic lines, stable rhythms, and consistent dynamics.

Patients in the control group received usual preoperative care with no music therapy and awaited surgery in typical fashion. The control group was given noise-blocking earmuffs during surgery to cancel out any potential music played by the surgeon.

In addition to anxiety measurement, researchers also looked at patient satisfaction, recovery time, and the amount of anesthesia (propofol) administered to reach moderate sedation during surgery.

The music groups and controls did not differ in the amount of anesthesia requirement needed to reach moderate sedation, and satisfaction scores were universally high across all groups. Recovery time did not differ among the music and the control groups, but those who listened to live music preoperatively had a shorter recovery time when compared to those who listened to recorded music.

An Effective, Enjoyable Stress Reliever

“There wasn't a significant difference in anxiety between live music and recorded music,” added Ms. Bradley Palmer. “It seems like music, no matter how it is delivered, had a similar effect on reducing a patient's preoperative anxiety.”

Deforia Lane, PhD, Director of Art and Music Therapy at UH Seidman Cancer Center, said, “We know that music touches parts of our brain—for example, the emotional center that initiates the release of our body's natural opiates: endorphins, enkephalins, and serotonin. All of those things that are released are triggered by auditory stimulation … and it's without using any pharmacologic intervention. It is simply using the music as medicine.”

Additionally, subjective reactions to perioperative music therapy revealed that it might be an enjoyable addition to the surgical experience.

“What we can conclude from our findings is that music therapy may effectively serve as a complementary modality during cancer surgery treatment. A brief music therapy session has the ability to manage the anxiety that surrounds breast cancer surgery in a way that is effective, safe, time-efficient, and enjoyable,” concluded Ms. Bradley Palmer.

Videos about the study are available at www.youtube.com/watch?v=JO44KzjTXVU and www.youtube.com/watch?v=m21P3bLj0RA.

Ms. Bradley Palmer is the corresponding author for the Journal of Clinical Oncology article.

The study was funded by a Kulas Foundation Grant.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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