A critical realist evaluation of a music therapy intervention in palliative care

Sam Porter, Tracey McConnell, Mike Clarke, Jenny Kirkwood, Naomi Hughes, Lisa Graham-Wisener, Joan Regan, Miriam McKeown, Kerry McGrillen, Joanne Reid, Sam Porter, Tracey McConnell, Mike Clarke, Jenny Kirkwood, Naomi Hughes, Lisa Graham-Wisener, Joan Regan, Miriam McKeown, Kerry McGrillen, Joanne Reid

Abstract

Background: Music therapy is increasingly used as an adjunct therapy to support symptom management in palliative care. However, studies to date have paid little attention to the processes that lead to changes in patient outcomes. To fill this gap, we examined the processes and experiences involved in the introduction of music therapy as an adjunct complementary therapy to palliative care in a hospice setting in the United Kingdom (UK).

Methods: Using a realistic evaluation approach, we conducted a qualitative study using a variety of approaches. These consisted of open text answers from patients (n = 16) on how music therapy helped meet their needs within one hospice in Northern Ireland, UK. We also conducted three focus groups with a range of palliative care practitioners (seven physicians, seven nursing staff, two social workers and three allied health professionals) to help understand their perspectives on music therapy's impact on their work setting, and what influences its successful implementation. This was supplemented with an interview with the music therapist delivering the intervention.

Results: Music therapy contains multiple mechanisms that can provide physical, psychological, emotional, expressive, existential and social support. There is also evidence that the hospice context, animated by a holistic approach to healthcare, is an important facilitator of the effects of music therapy. Examination of patients' responses helped identify specific benefits for different types of patients.

Conclusions: There is a synergy between the therapeutic aims of music therapy and those of palliative care, which appealed to a significant proportion of participants, who perceived it as effective.

Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was given by the Office of Research Ethics Committee Northern Ireland (ORECNI). All participants provided their written, informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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