The Impact of Music Therapy on Anxiety in Cancer Patients Undergoing Simulation for Radiation Therapy

Abstract

Purpose: Radiation therapy (RT) is associated with high stress levels. The role of music therapy (MT) for patients receiving RT is not well described. This study evaluates the impact of MT on anxiety and distress during simulation in patients with newly diagnosed head and neck or breast cancer.

Methods and materials: This institutional review board-approved randomized trial of MT versus no MT at the time of simulation included the pre-State-Trait Anxiety Inventory (STAI-S Anxiety) questionnaire and Symptom Distress Thermometer (SDT). Patients randomized to MT received a consultation with a music therapist, during which music of the patients' choice to be played during simulation was selected. The no-MT patients did not receive the MT consultation, nor did they hear prerecorded music during simulation. Subsequent to the simulation, all patients repeated the STAI-S Anxiety questionnaire and the SDT.

Results: Of the 78 patients enrolled (39 in MT group and 39 in no-MT group), 38 had breast cancer and 40 had head and neck cancer. The male-female ratio was 27:51. The overall mean pre- and post-simulation STAI-S scores were 38.7 (range, 20-60) and 35.2 (range, 20-72), respectively. The overall mean pre- and post-simulation SDT scores were 3.2 (range, 0-10) and 2.5 (range, 0-10), respectively. The MT group had mean pre- and post-simulation STAI-S scores of 39.1 and 31.0, respectively (P<.0001), and the mean SDT scores before and after simulation were 3.2 and 1.7, respectively (P<.0001). The no-MT group's mean pre- and post-simulation STAI-S scores were 38.3 and 39.5, respectively (P=.46), and the mean SDT scores were 3 and 3.2, respectively (P=.51).

Conclusions: MT significantly lowered patient anxiety and distress during the simulation procedure on the basis of the STAI-S questionnaire and SDT. Incorporating culturally centered individualized MT may be an effective intervention to reduce stressors. Continued research defining the role of MT intervention in improving the patient experience by reducing anxiety is warranted.

Fig. 1.

CONSORT (Consolidated Standards of Reporting Trials) diagram: patient flow through trial. Abbreviations: MT = music therapy intervention; NO MT = standard treatment alone.

Fig. 2.

State-Trait Anxiety Inventory (STAI) scores for patients with high pre-STAI scores (≥40). Mean STAI scores with error bars (±1 standard error) are shown for the control group (solid line) and music therapy group (dashed line) at the pre– and post–music therapy time points for patients with high STAI scores.

Fig. 3.

State-Trait Anxiety Inventory (STAI) scores for patients with distress related to high emotional factors. Mean STAI scores with error bars (±1 standard error) are shown for the control group (solid line) and music therapy group (dashed line) at the pre– and post–music therapy time points for patients with high pre-emotional distress (emotional block 8–12).

Fig. 4.

Mean distress scores with error bars (±1 standard error) for control group (solid line) and music therapy group (dashed line) at pre– and post–music therapy time points for subgroup of patients with high pre-simulation emotional distress (emotional block 8–12).

Fig. 5.

Mean distress scores with error bars (±1 standard error) for control group (solid line) and music therapy group (dashed line) at pre– and post–music therapy time points for subgroup of patients with pre-simulation distress scores ≥4.