Active Music Engagement and Cortisol as an Acute Stress Biomarker in Young Hematopoietic Stem Cell Transplant Patients and Caregivers: Results of a Single Case Design Pilot Study

Abstract

This paper reports the results of a single case design pilot study of a music therapy intervention [the Active Music Engagement (AME)] for young children (age 3.51 to 4.53 years) undergoing hematopoietic stem cell transplantation (HCST) and their caregivers. The primary aims of the study were to determine feasibility/acceptability of the AME intervention protocol and data collection in the context of HCST. Secondary aims were to examine caregivers' perceptions of the benefit of AME and whether there were changes in child and caregiver cortisol levels relative to the AME intervention. Results indicated that the AME could be implemented in this context and that data could be collected, though the collection of salivary cortisol may constitute an additional burden for families. Nevertheless, data that were collected suggest that families derive benefit from the AME, which underscores the need for devising innovative methods to understand the neurophysiological impacts of the AME.

Keywords: HPA axis (hypothalamus-pituitary-adrenal); HSCT; cortisol; hematopoietic (stem) cell transplantation (HCT); music therapy.

FIGURE 1

Conceptual framework. Reprinted from Russ et al. (2020).

FIGURE 2

Collection schedule for children undergoing autologous transplant. Reprinted from Russ et al. (2020).

FIGURE 3

Collection schedule for children undergoing allogenic transplant. Reprinted from Russ et al. (2020).

FIGURE 4

Simplified collection schedule for self- and proxy-report measures (ESAS), salivary cortisol, and blood cortisol. As shown in Figures 2, 3, the correspondence of AME sessions and data collection varied for children undergoing autologous and allogenic transplants; for illustrative purposes, this figure depicts days for a child undergoing an autologous transplant. Pre, Post, and Morning refer to the time of day during which samples were collected. Pre indicates that data collection occurred before the AME session, whereas Post indicates collection occurred after the session (Post 1 and Post 2) are used to indicate that data were collected twice after the session. C and T refer to control and treatment condition days within each pair of days on which data were collected for a given AME session.

FIGURE 5

Child ESAS scores (as reported by caregivers).

FIGURE 6

Child blood cortisol concentrations.

FIGURE 7

Caregiver salivary cortisol concentrations.