The Use of Music Intervention in Healthcare Research: A Narrative Review of the Literature

應用音樂療法於健康照護研究：研究回顧及評論

唐心怡(Hsin-Yi (Jean) Tang) ； Toni Vezeau

《The Journal of Nursing Research》 18卷3期 (2010/09) Pp. 174-190

https://doi.org/10.1097/JNR.0b013e3181efe1b1

摘要

背景　音樂療法在健康照護中已經被廣泛採用，但是針對音樂療法的研究方法分析卻非常有限。
目的　本篇研究的主旨在於分析音樂療法於成年人健康照護之運用。其分析分為以下四個方向：(1)族群及情境、(2)音樂種類、(3)進行方式、及(4)衡量指標。
方法　於主要學術資料庫（PubMed, CINAHL與PsyINFO），使用”Music Therapy”、”adults: 19+years”、”humans”、”clinical randomized controlled studies”及”English”等關鍵字詞進行搜尋，共33篇文獻符合納入原則。
結果　(1)納入的文獻中，最廣泛被研究之族群為失智病患；而最常見的研究情境為焦慮的減緩。(2)被採用的音樂療法可分為被動或主動。在被動的模式中，受試者通常在放鬆的狀態下收聽音樂；而在主動的模式中，受試者通常在團體中參與音樂活動。(3)每個研究的音樂療法次數及療程長短各有不一；且多數的研究並未交待實驗場所的管控，加深了評估的困難度。研究人員的在場協助有利於受試者完成療程。(4)療效的評估一般可分為心理及生理的測量。絕大部分的研究都指出音樂療法頗有其成效。
結論　從事音樂療法相關研究時，應該考慮參與者對音樂的個人偏好；並且對於選擇主動式或被動式音樂療法的決定，須有清楚的理論架構。考慮合併使用生理與心理的評量指標，以增加研究結果的信效度。

關鍵字

音樂療法 ； 音樂措施 ； 臨床隨機控制研究 ； 文獻回顧

並列摘要

Background: Although music has been widely used in healthcare, there has been scant review of literature analyzing the use of music as an intervention in healthcare research.
Purpose: The purpose of this article was to provide a narrative review of the literature to explore how ”music therapy” has been used in healthcare research to promote healing in adult populations. The following five questions were addressed: (a) In what populations and under what conditions has music intervention been studied? (b) What specific kinds of music have been used for study intervention? (c) How has the music intervention been operationalized? (d) What metrics have been used as outcome measures? (e) Have music interventions been effective?
Methods: Articles were retrieved from several scientific databases (PubMed, CINAHL, and PsycINFO) using the following search parameters: MeSH search terms ”music therapy” in the title field with the search limit to ”adults 19 years and older,” ”humans,” ”clinical randomized controlled studies,” and ”English.” A total of 33 clinical randomized controlled studies that met the search criteria were reviewed.
Results: (a) In the reviewed studies (studied articles), subjects with dementia were the most commonly studied population group, and the predominant aim of the study was to alleviate anxiety. (b) Employedmusic interventionsmay be categorized as one of two types: passive (receptive) and active. The passive (receptive) music intervention commonly involved subjects in a resting position listening to music, whereas the active music intervention is usually carried out in a group format in which subjects are actively involved in the music intervention. (c) Intervention frequency, dosing, and duration were highly variable across the reviewed studies. Very few studies described the intervention setting, which made evaluation of these studies difficult. Direct supervision seemed to be an influential factor for adherence. (d) Outcome measures in retrieved articles involved two types: psychological and physiological or biological. (e) The effectiveness of music intervention was reported as successful in most of the retrieved studies.
Conclusion: Much work has been done on the use of music interventions in the clinical setting. Future research should consider participant music selection preferences, and the selection of active versus passive intervention approach should be based on a clear conceptual framework. Combining both physiological and psychological measures in the study design is a recommended approach to increase measurement validity.

並列關鍵字

music therapy ； music intervention ； clinical randomized controlled studies ； review of literature

參考文獻

Andrada, L. C.,Vidal, A.,Aguilar-Tablada, C.,Reina, G.,Silva, L.,Guinaldo, R.(2004).Anxiety during the performance of colonoscopies: Modification using music therapy.European Journal of Gastroenterology & Hepatology.16(12),1381-1386.

American Music Therapy Association. (2005). What is music therapy. Retrieved October 21, 2009, from http://www.musictherapy.org/faqs.html#WHAT_IS_MUSIC_THERAPY

Bittman, B. B.,Berk, L. S.,Felten, D. L.,Westengard, J.,Simonton, O. C.,Pappas, J.(2001).Composite effects of group drumming music therapy on modulation of neuroendocrine-immune parameters in normal subjects.Alternative Therapies in Health and Medicine.7(1),38-47.

Browning, C. A.(2001).Music therapy in childbirth: Research in practice.Music Therapy Perspectives.19(2),74-81.

Bruer, R. A.,Spitznagel, E.,Cloninger, C. R.(2007).The temporal limits of cognitive change from music therapy in elderly persons with dementia or dementia-like cognitive impairment: A randomized controlled trial.Journal of Music Therapy.44(4),308-328.