Abstract
: Music is widely used to enhance well-being. We wished to assess music's effect on pediatric oncology outpatients. Patients who had leukemia and were in maintenance or consolidation outpatient treatment served as their own control at two visits. At visit 1, children rested for 20 min; at visit 2, for 20 min they listened to music designed to increase vitality and improve heart rate variability (HRV). At both visits, parents completed before and after treatment visual analog scales (VAS) of their child's relaxation, well-being, vitality, anxiety, stress, and depression; patients' heart rates were monitored during treatments to calculate HRV. The 47 patients with complete VAS data and 34 patients with usable HRV data were similar. At baseline, VAS scores for negative states were low (average <2.5 of 10) and positive states were high (average 7> of 10). Relaxation improved more with music than rest (p < 0.01). The HRV parasympathetic parameter was significantly lower with music than rest. No other differences were significant. Further studies are needed to better delineate the relationship between subjective and objective measures of well-being among patients who are not in severe distress.
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Abbreviations
- CD:
-
compact disk
- HF:
-
high frequency
- HRV:
-
heart rate variability
- IBI:
-
interbeat interval
- LF:
-
low frequency
- SDNN:
-
standard deviation of the interbeat interval of the ECG
- TP:
-
total power
- VAS:
-
visual analog scale
- VLF:
-
very low frequency
References
Rourke MT, Hobbie WL, Schwartz L, Kazak AE 2007 Posttrauamatic stress disorder (PTSD) in young adult survivors of childhood cancer. Pediatr Blood Cancer 49: 177–182
Patino-Fernandez AM, Pai AL, Alderfer M, Hwang WT, Reilly A, Kazak AE 2008 Acute stress in parents of children newly diagnosed with cancer. Pediatr Blood Cancer 50: 289–292
Pai AL, Kazak AE 2006 Pediatric medical traumatic stress in pediatric oncology: family systems interventions. Curr Opin Pediatr 18: 558–562
Cassileth BR, Vickers AJ, Magill LA 2003 Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation: a randomized controlled trial. Cancer 98: 2723–2729
Hilliard RE 2003 The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. J Music Ther 40: 113–137
Kemper KJ, Danhauer SC 2005 Music as therapy. South Med J 98: 282–288
Bouhairie A, Kemper K, Martin K, Woods C 2006 Staff attitudes and expectations about music therapy: pediatric oncology versus neonatal intensive care unit. J Soc Integr Oncol 4: 71–74
Standley JM, Hanser SB 1995 Music therapy research and applications in pediatric oncology treatment. J Pediatr Oncol Nurs 12: 3–8 discussion 9 –10.
Cremeens J, Eiser C, Blades M 2006 Factors influencing agreement between child self-report and parent proxy-reports on the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales. Health Qual Life Outcomes 4: 58
Varni JW, Limbers CA, Burwinkle TM 2007 Parent proxy-report of their children's health-related quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales. Health Qual Life Outcomes 5: 2
Davis E, Nicolas C, Waters E, Cook K, Gibbs L, Gosch A, Ravens-Sieberer U 2007 Parent-proxy and child self-reported health-related quality of life: using qualitative methods to explain the discordance. Qual Life Res 16: 863–871
Waters E, Stewart-Brown S, Fitzpatrick R 2003 Agreement between adolescent self-report and parent reports of health and well-being: results of an epidemiological study. Child Care Health Dev 29: 501–509
Yeh CH, Chang CW, Chang PC 2005 Evaluating quality of life in children with cancer using children's self-reports and parent-proxy reports. Nurs Res 54: 354–362
Cohen H, Neumann L, Shore M, Amir M, Cassuto Y, Buskila D 2000 Autonomic dysfunction in patients with fibromyalgia: application of power spectral analysis of heart rate variability. Semin Arthritis Rheum 29: 217–227
Hoffman JW, Benson H, Arns PA, Stainbrook GL, Landsberg GL, Young JB, Gill A 1982 Reduced sympathetic nervous system responsivity associated with the relaxation response. Science 215: 190–192
White JM 1999 Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction. Am J Crit Care 8: 220–230
1996 Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation 93: 1043–1065
McCraty R, Atkinson M, Tiller WA, Rein G, Watkins AD 1995 The effects of emotions on short-term power spectrum analysis of heart rate variability. Am J Cardiol 76: 1089–1093
Brown RP, Gerbarg PL 2005 Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression: part I-neurophysiologic model. J Altern Complement Med 11: 189–201
Kinnunen S, Laukkanen R, Haldi J, Hanninen O, Atalay M 2006 Heart rate variability in trotters during different training periods. Equine Vet J Suppl 36: 214–217
Nolan RP, Kamath MV, Floras JS, Stanley J, Pang C, Picton P, Young QR 2005 Heart rate variability biofeedback as a behavioral neurocardiac intervention to enhance vagal heart rate control. Am Heart J 149: 1137
Paul-Labrador M, Polk D, Dwyer JH, Velasquez I, Nidich S, Rainforth M, Schneider R, Merz CN 2006 Effects of a randomized controlled trial of transcendental meditation on components of the metabolic syndrome in subjects with coronary heart disease. Arch Intern Med 166: 1218–1224
van Breda E 2006 A nonnatural head-neck position (Rollkur) during training results in less acute stress in elite, trained, dressage horses. J Appl Anim Welf Sci 9: 59–64
van Dijk M, de Boer JB, Koot HM, Duivenvoorden HJ, Passchier J, Bouwmeester N, Tibboel D 2001 The association between physiological and behavioral pain measures in 0- to 3-year-old infants after major surgery. J Pain Symptom Manage 22: 600–609
Biswas AK, Scott WA, Sommerauer JF, Luckett PM 2000 Heart rate variability after acute traumatic brain injury in children. Crit Care Med 28: 3907–3912
Sokhadze EM 2007 Effects of music on the recovery of autonomic and electrocortical activity after stress induced by aversive visual stimuli. Appl Psychophysiol Biofeedback 32: 31–50
Yamashita S, Iwai K, Akimoto T, Sugawara J, Kono I 2006 Effects of music during exercise on RPE, heart rate and the autonomic nervous system. J Sports Med Phys Fitness 46: 425–430
Iwanaga M, Kobayashi A, Kawasaki C 2005 Heart rate variability with repetitive exposure to music. Biol Psychol 70: 61–66
McCraty R, Barrios-Choplin B, Atkinson M, Tomasino D 1998 The effects of different types of music on mood, tension, and mental clarity. Altern Ther Health Med 4: 75–84
Kemper KJ, Hamilton C, Atkinson M 2007 Heart rate variability: impact of differences in outlier identification and management strategies on common measures in three clinical populations. Pediatr Res 62: 337–342
Goldberger AL, Amaral LA, Glass L, Hausdorff JM, Ivanov PC, Mark RG, Mietus JE, Moody GB, Peng CK, Stanley HE 2000 PhysioBank, PhysioToolkit, and PhysioNet: components of a new research resource for complex physiologic signals. Circulation 101: E215–E220
Standley JM 2002 A meta-analysis of the efficacy of music therapy for premature infants. J Pediatr Nurs 17: 107–113
Kwekkeboom KL 2003 Music versus distraction for procedural pain and anxiety in patients with cancer. Oncol Nurs Forum 30: 433–440
Sherman SA, Eisen S, Burwinkle TM, Varni JW 2006 The PedsQL Present Functioning Visual Analogue Scales: preliminary reliability and validity. Health Qual Life Outcomes 4: 75
Acharya UR, Kannathal N, Sing OW, Ping LY, Chua T 2004 Heart rate analysis in normal subjects of various age groups. Biomed Eng Online 3: 24
Choi JB, Hong S, Nelesen R, Bardwell WA, Natarajan L, Schubert C, Dimsdale JE 2006 Age and ethnicity differences in short-term heart-rate variability. Psychosom Med 68: 421–426
Reed KE, Warburton DE, Whitney CL, McKay HA 2006 Differences in heart rate variability between Asian and Caucasian children living in the same Canadian community. Appl Physiol Nutr Metab 31: 277–282
Kemper KJ, Woods CR, Yard B, Cohen DG, McLean T, Atkinson M 2004 Heart rate variability in pediatric patients with leukemia: a brief report. J Cancer Int Med 2: 137–143
Delaney JP, Leong KS, Watkins A, Brodie D 2002 The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects. J Adv Nurs 37: 364–371
Peng CK, Henry IC, Mietus JE, Hausdorff JM, Khalsa G, Benson H, Goldberger AL 2004 Heart rate dynamics during three forms of meditation. Int J Cardiol 95: 19–27
Acknowledgements
Grateful appreciation to Erica Kelly, PA, and Joshua Long for their help in data collection in the pilot phase of this project; to Debbie Dirkse for patient recruitment, enrollment, and data collection in the overall study; and to Paula Stant for assistance with manuscript preparation and submission. We are also grateful to Rollin McCraty, Ph.D., and Randall Moorman, M.D., Ph.D., for their reviews and constructive criticism about the manuscript. We are grateful to Douglas Lake, Ph.D., for his additional analyses of the data.
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The views expressed in this article are those of the authors and do not necessarily represent the views of NIH or Dr. Caryl Guth.
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Kemper, K., Hamilton, C., McLean, T. et al. Impact of Music on Pediatric Oncology Outpatients. Pediatr Res 64, 105–109 (2008). https://doi.org/10.1203/PDR.0b013e318174e6fb
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DOI: https://doi.org/10.1203/PDR.0b013e318174e6fb
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