Effects of Music Therapy on Anxiety of Patients with Breast Cancer by Li - Article Example

Guided Critical Review of a Journal Article Name: Institution: Guided Critical Review of a Journal Article Overview of the Research Design The primary aim of the research by Li, Zhou, Yan, Wang, and Zhang (2011) was to explore the adjuvant effects of music on the state anxiety on female cancer patients after procedural mastectomy within a Chinese context. The research sought to provide a report based on empirical clinical trials demonstrating the influence of music therapy on anxiety of women after undergoing radical mastectomy. The research established from a randomized, controlled clinical trial study design, which provided a between-group comparative base in which female cancer patients receiving conventional nursing care were compared with the other subjects getting both the routine care and music therapy (Li, Zhou, Yan, Wang, and Zhang (2011). The study was designed in a manner that the state anxiety dissipation of the female breast cancer patients receiving adjuvant aid: music, was compared with the control subjects with similar conditions but getting normal care only following the radical mastectomy. The researchers excluded the need for blinding based on the specificity of the study. The study design was appropriate because it facilitated the differential treatment of the subjects, which enabled the separation of patients benefiting from adjuvant therapy and those receiving none. The randomized approach eliminated bias in the part of gathering individual information from the selected sample, which was appropriate for the reliability and validity of the results. Sampling Li, Zhou, Yan, Wang, and Zhang (2011) conducted their research at an ecology center of a Xian General hospital in China, which primarily targeted the hospitalized population of female breast cancer patients. The study participants were breast cancer women that had been admitted at the hospital, and an inclusion criteria technique was employed. The technique filtered a sample of females aged between 25 and 65 years whose pathological diagnosis had returned positive breast cancer requiring radical mastectomy. The criteria excluded patients that were allergic to sound-based adjuvant. The inclusion and exclusion criteria (Tuszynski et al., 2007) of the sample were the tools that defined the nature of subjects particularly in terms of age and their suitability for music integrated therapy. Additionally, the inclusion component served to particularize that only female cancer patients requiring radical mastectomy, and that had developed the state anxiety. These study elements were critical to first define the scope of the research as regards characteristics of the desired subjects. A definitive criterion for sample selection is important in that it determines the feasibility of the research as regards to empirical data collection and the practicability of interrogating the proposed hypotheses (Nesbitt, 2004). It is also through these components that the lead research team is able to account for reliability and validity of their results by targeting viable and sample size adequate to confer scientifically sufficient data and results. The inherent processes occasioned by these study design features help the researchers to ensure adherence to appropriate ethical requirements for the study. Accordingly, the inclusion and exclusion criteria should be deduced before the recruitment of study subjects in order to assess important characteristics of the sample: size, study variances, and practicability in testing stated hypotheses. The participants were randomly assigned into different groups via computer generated random numbers (Ni & Dai, 2002), which placed the 120 patients into two equal halves (60): the experimental and control groups. The subject allocation method was appropriate because it eliminated researcher subjective influence while reducing bias in subject allocation into the two groups. This particular practice was essential for assurance of the integrity of study results. During the interventions, the subjects received introduction music bearing music name and type of the music copied onto the MP3 player. Though the researchers delivered the music, the patients reserved the right to select their preferred music, device volume, and they were supplied with headphones that they listened through. The patients were required to listen to endure a postoperative stay in the facility for 13.6 and the two chemotherapy periods covering 18.9 days within which the music therapy would be administered. The subjects were required to listen to the music for 30 minutes in two sessions (6-8 a.m. and 9-11 p.m.) and those that were not consistent with the requirements received researchers’ assistant. Effectively, efforts were made to limit researcher’s influence on the music choice and listening desires but for few people that were telephoned to be encouraged to complete the experiment. Without receiving any prior music introductory information, participated in the before and after operation observations. To avoid any bias, this group did not get any information about the treatment of the experimental group, and only continued their routine nursing care that included immediate to operation and post-operative time. It is imperative that this practice would provide an opportunity to discern any differential responses as hypothesized. Data Collection The state anxiety levels upon receipt of different treatment approaches were the dependent variables in this study because healing was hypothesized to be a function of music therapy and routing nursing care. The nursing care and music therapy were the independent variables because they were not directly influenced by the patient’s reaction to their effects. Li, Zhou, Yan, Wang, and Zhang (2011) collected data using standardized demographic questionnaire and the state anxiety inventory (SAI) (Ni et al., 2012) instruments. The questionnaire captured patient’s features such as age, occupation, education level, age of first breast cancer diagnosis, and monthly income among other demographics. The concept of reliability underlines the ability of generalization or interpolation of the study design in studies of similar character but in different locations without significantly reporting discrepancies in results and underlying assumptions. In this study, the concept of reliability was cemented by deployment of standard sampling and data collection techniques. Additionally, explicit declaration of general assumptions chronicled the observation of the principle. However, the component of some patients being followed up outside the hospital to help in completing the experiment could have some marginal impact on the stability and consistency of the results. The concept of validity underscores the ability of the adopted techniques and methods to measure what they are meant to test appropriately (Huijbregts et al., 2009). This concept was fulfilled through adoption of conventionally recognized standard data collection methods and clearly defined intervention procedures. However, the administration of an assortment of music bore some validity issue regarding which particular music and type was generally the primary adjuvant in this context. Results The results demonstrated not statistically significant differences between the intervention and control groups in regards to demographical features. Contextually, the pre-test state anxiety comparisons reported 51.99 with 77.5% moderate level and 15% severe level cases (Li, Zhou, Yan, Wang, and Zhang (2011). The state anxiety score for the experimental group was 51.97% and 52.02 was reported for the control group. Accordingly, the two-sample t-tests demonstrated that opposite to the hypothesized context at the pre-test stage, the difference between the two groups was not statistically significant regarding state anxiety levels. The results demonstrated that the experimental group was comparable to the control group for the tested baseline attributes. In the state anxiety post-test scenario, the inferential statistics generated by the ANCOVA model demonstrated that the state anxiety scores were statistically significantly lower for the intervention group compared with that of the control group. The confidence (p) value affirmatively indicated that the treatment effect of the music therapy increased with follow-up time. The results therefore supported the hypothesized scenarios that music therapy would reduce state anxiety and that the inherent healing effect improved gradually with follow up time. Considering the reliability and validity of research instruments and methodologies, and the statistical integrity of the results, it is apparent that the results can be generalized to other settings. Ethical Considerations The legally designated agency: Human Research Ethics Committee was furnished with appropriate documents demonstrating adherence to stated study requirements that was reviewed and approved. The participants were adequately inducted on the aims and requirements of the study and let to choose to participate or not. Additionally, the patients gave their free informed consent in writing before the voluntary participation. However, it is not clear whether the participant’s condition was considered and thus their kin or care givers allowed helping them conceptualize the extent of their responsibility by admitting to participate. It has been demonstrated by previous studies that music occupies human attention channels thus funneling out of psychological distresses and disorders (Chlan, 2009). The demonstrated ability of music to significantly reduce the state anxiety bolsters this study’s extrapolation in clinical context for healing psychological conditions. The employment of clinical trails in this context underscores the usability of these results for nursing care in clinical practice. Conclusion This study employed standard research methodologies to investigate an important and practicable hypothesis: music reduces state anxiety and the healing impact increases over follow-up time. It was demonstrated that music can be deployed in nursing care practices as an alternative of improving state anxiety in female breast cancer patients after a radical mastectomy. Contextually, the results of the study would be instrumental in helping many Chinese patients by increasing their wellbeing if they are generalized in clinical practice across the country. Conclusively, more research is warranted to unravel the great potential in use of music as an alternative References Chlan, L. (2009). A review of the evidence for music intervention to manage anxiety in critically ill patients receiving mechanical ventilatory support. Archives of Psychiatric Nursing, 23(2), 177–179. Huijbrets, M.P.J. (2009). Standardization of the continuing care activity measure: A multicenter study to assess reliability, validity, and ability to measure change. Physical Therapy, 89(6), 546-555. Li, X., Zhou, K., Yan, H., Wang, D., & Zhang, Y. (2011). Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: A randomized clinical trail. Journal of Advanced Nursing, 68(5), 1145-1155. Nesbitt, L.A. (2004). Clinical research: What it is and how it works. London, UK: Jones & Bartlett Learning. Ni, S.Z., & Dai, S.K. (2002).The fast implementation of balanced and randomized between- group allocation by using Excel. Journal of Guangdong Medical College, 20(3), 242– 244. Ni, C., Tsai, W., Lee, L., Kao., C., & Chen, Y. (2012). Minimizing pre-operative anxiety with music for day surgery patients: A randomized clinical trial. Journal of Clinical Nursing, 21(5/6), 620-625. Tuszynski et al. (2007). Guidelines for conduct of clinical trials for spinal cord injury as developed by ICCP panel: Clinical trial inclusion and exclusion criteria and ethics. Spinal Cord, 45(3), 222-231. Read More