Music Therapy for Pain Management for People With Advanced Cancer: A Randomized Controlled Trial.

IF 3.3 2区医学 Q2 ONCOLOGY

Psycho‐Oncology Pub Date : 2024-10-01 DOI:10.1002/pon.70005

Joke Bradt, Amy Leader, Brooke Worster, Kate Myers-Coffman, Karolina Bryl, Jacelyn Biondo, Brigette Schneible, Carrie Cottone, Preethi Selvan, Fengqing Zhang

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引用次数: 0

Abstract

Objective: To improve mechanistic understanding, this randomized controlled trial examined anxiety, mood, emotional support, and pain-related self-efficacy as mediators of music therapy for pain management in people with advanced cancer.

Methods: People with advanced cancer who had chronic pain were randomized (1:1) to 6 weekly individual music therapy or social attention control sessions. We measured mediators and pain outcomes (pain interference and pain intensity) using self-report measures at baseline, session 4, and post-intervention. We included outcome expectancy/treatment credibility, music reward, adult playfulness, and baseline pain interference and pain intensity as moderators.

Results: Participants (n = 92) had a mean age of 56 years. Most were female (71.7%), white (47.8%) or Black (39.1%), and had stage IV cancer (75%). Self-efficacy was found to be a significant mediator of music therapy for pain intensity (indirect effect ab = 0.79, 95% CI 0.01-1.82) and pain interference (indirect effect ab = 1.16, 95% CI 0.02-2.51), while anxiety, mood, and emotional support were not. The mediating effect of pain-related self-efficacy was significantly moderated by baseline pain interference but not by the other moderators.

Conclusions: The findings suggest that the impact of music therapy on chronic pain is mediated by self-efficacy. This knowledge can help optimize music therapy interventions for chronic pain management for people with advanced cancer by capitalizing on teaching music-based self-management strategies.

Trial registration: ClinicalTrials.gov identifier: NCT03432247.

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音乐疗法用于晚期癌症患者的疼痛控制：随机对照试验

目的为了加深对机制的理解，本随机对照试验研究了焦虑、情绪、情感支持和疼痛相关自我效能作为音乐疗法治疗晚期癌症患者疼痛的中介因素：方法：患有慢性疼痛的晚期癌症患者被随机（1:1）分配到每周6次的个人音乐治疗或社会关注控制课程中。我们在基线、第 4 次治疗和干预后使用自我报告测量法测量了中介因素和疼痛结果（疼痛干扰和疼痛强度）。我们将结果预期/治疗可信度、音乐奖励、成人游戏性、基线疼痛干扰和疼痛强度作为调节因素：参与者（n = 92）的平均年龄为 56 岁。大多数人是女性（71.7%）、白人（47.8%）或黑人（39.1%），并患有 IV 期癌症（75%）。研究发现，自我效能是音乐疗法对疼痛强度（间接效应 ab = 0.79，95% CI 0.01-1.82）和疼痛干扰（间接效应 ab = 1.16，95% CI 0.02-2.51）的显著中介效应，而焦虑、情绪和情感支持则不是。疼痛相关自我效能感的中介效应受到基线疼痛干扰的显著调节，但未受到其他调节因素的显著调节：结论：研究结果表明，音乐疗法对慢性疼痛的影响受自我效能的调节。这些知识有助于通过教授基于音乐的自我管理策略，优化晚期癌症患者慢性疼痛管理的音乐疗法干预措施：试验注册：ClinicalTrials.gov identifier：NCT03432247.

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.