Effects of Hope-Based Music Therapy on Hope and Pain in Hospitalized Patients on Blood and Marrow Transplant Unit: A Convergent Parallel Mixed-Methods Pilot Study

Abstract

Background: Among continuous improvements in treating cancer as a physical malady, there has been an increased focus on the psychological health of cancer patients. Patients undergoing Blood and Marrow Transplantation (BMT) are particularly susceptible to the deterioration of psychological health due to the demanding nature of BMT procedures. Hope is a multidimensional construct that can impact a patient’s psychological well-being. Extant research on hope with cancer patients has promoted psychological interventions to foster and maintain hope, but has been conducted almost exclusively within the field of oncology nursing. Although researchers have identified that music therapy can be effective in the treatment and psychological care of BMT patients, to date there has been no music therapy literature with a specific focus on hope in the psychological care and support of cancer patients. Objective: The purpose of this convergent parallel mixed-methods pilot study was to target hope by adapting an existing hope intervention to music therapy treatment with patients on a BMT unit. Methods: Patients (N = 10) were randomly assigned to experimental or wait-list control conditions and all patients completed the Herth Hope Index supplemented with an 11-point Likert-Type Pain Scale at pre- and posttest. Experimental participants engaged in a two-session individualized music therapy treatment consisting of patient-preferred live music chosen from a hope-based song menu coupled with therapeutic dialogue that was adapted from the Hope Intervention Program. Experimental participants also participated in an individual semi-structured interview in an attempt to understand their experiences and perceptions of how music therapy may affect hope. The six steps of thematic analysis, as identified by Braun and Clarke (2006), were used to analyze qualitative data. Results: There was no significant between-group difference at pretest. Posttest analyses utilizing Mann-Whitney U tests revealed significant between-group differences in measures of hope with patients in experimental condition demonstrating higher hope. Although not statistically significant, there was a slight tendency for a decrease in pre- to posttest pain for the experimental condition but not for the control condition. Qualitative analyses resulted in three emerging themes: 1. Hope-based music therapy provides opportunities for positive experiences including comfort and interpersonal connection; 2. Hope-based music therapy facilitates personal depth though self-awareness and self-identity; and 3. Hope-based music therapy provides a platform to discuss and confront hope including motivations for and obstacles to hope. Conclusion: Although generalization is limited by a small sample, quantitative results supported hope-based music therapy as an effective intervention with BMT patients in this pilot study. Qualitative data reinforced and provided depth to quantitative results, revealing that hope-based music therapy elicited positive experiences, comfort, and interpersonal connection; acted as a platform to discuss hope; and supported self-awareness and self-identity. Study limitations, implications for clinical practice, and suggestions for future research are provided.