Effects of Music Therapy on Anxiety of Patients with Breast Cancer by Li, X, Zhou, K - Article Example

Title: Journal Article Critical Review Name Course Tutor April 3rd, 2013 1.0 Introduction The paper herein presents a critical analysis of the journal paper by Li, X., Zhou, K., Yan, H., & Wang D. (2012), titled the “Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: a randomized clinical trial”. According to the authors, breast cancer is the one of the most common cancer that affects women in the world. The rate at which women are being treated of breast cancer has been increasingly steady. This disease has been proved to be a major cause of psychological distress and a major contributing factor to anxiety in women (Li et al., 2012). Supported with other literature it has been proved that music therapy can successfully reduce anxiety in the patients as asserted by the authors of the article. 1.1 Overview of Research Design The aim of the research was to provide a clinical trial of the effects that music therapy could have on the anxiety of female breast cancer patients especially after radical mastectomy. The research was focused on a Chinese setting. 1.2 The Research design The authors employed a randomized, controlled clinical trial conducted between two groups of female patients with patient cancer. These two groups were compared. One group according to their different responses suggested that after receiving music therapy alongside getting treatment for cancer. The other group included a controlled group of patients that only received nursing care. It was not subjected to music therapy. In my view, I think that the research design was appropriate as it would lead to varying results related to the objectives of the study and therefore produce valid and accurate findings that would lead to accurate conclusions. 2.0 Sampling 2.1 The Study Participants The participants in the study were a group of female patients suffering from breast cancer admitted in one of the hospitals in china. The target population was specifically at an oncology centre of one of the general hospitals in the Xian town of China. The sampling technique was by random headcount. The total number of those sampled was a hundred and twenty female breast cancer patients. The patients were randomly allocated to the two different groups and the size calculated based on the state of anxiety amongst the different patients. This technique was also previously employed in Wan et al., (2009) where a hundred patients were divided into equal groups and a study on anxiety conducted. The technique is thus of such technical significance as it proves successful. 2.2 What are the inclusion and exclusion criteria of the sample? The inclusion criteria used by the authors was a convenient sample of female breast cancer patients aged between 25-65 years. In addition, the participants included were also those who had undergone a pathological diagnosis of breast cancer that required radical mastectomy. Patients with allergic reactions to sound and those who had voice sensitivity of epilepsy were excluded from the study it was important to have these criteria identified before recruitment because patients who have sound allergies as well as those with epileptic voice sensitivity would not be able to listen to music. It would be vain including them in the study. 2.3 Allocation into groups and relevance The participants in the study were randomly allocated into groups of each comprising half of the participants. Sixty of them comprised the experimental group while the other sixty participants made up the control group. The experimental group was represented by n=60, similar to the control group which was also represented by n=60. In my view, this kind of allocation was very appropriate as the results of the study are measured against equal value of statistics. Equal allocation is also very valid for comparison reasons. 2.4 The interventions administered for each group Patients who were allocated in the experimental group were the ones subjected to music therapy in order to test whether music therapy can be effective in reducing the levels of anxiety. The patients were first introduced to the music name and the type of music they were to listen to. Then the music was converted into MP3 players and was administered to the patients by the researchers themselves. The experimental time was the total time of stay of the patients in the hospital after undergoing the radical mastectomy. It totalled to two days and two chemotherapy sessions. The music therapy was administered twice each day for thirty minutes per session, once in the morning and once in the evening. Follow up was also done for the patients who were discharged. The researchers encouraged them to finish up the experimental time required for the study. Secondly, participants in the control group in four tests. One was before and the other three were after. This group of participants were not subjected to music therapy after radical mastectomy. They only received the routine nursing care required for breast cancer and chemotherapy. 3. Data Collection 3.1 From the final report of the study given, data was collected between March and November 2009. 3.2 The instruments used Data was collected by use of a standardized demographical data questionnaire. This particular questionnaire included 15 items in total. The patients answered questions touching on different aspects of the study such as age, their education level, occupation, and their places of residence, marital status as well as their monthly income. Most importantly, the patients were to give their age at the first time they started to suffer from breast cancer. Both groups filled in and completed the questionnaire. Another instrument used was the State Anxiety Inventory (SAI) in its Chinese version. According to research, the SAI is an instrument most commonly used to measure anxiety. It is self-reporting (Li et al., 2012, p. 1148). It measures anxiety on a measured scale of 1-4. One indicates the lowest level of anxiety while 4 show that the patient has very high levels of anxiety. It was first used in early Chinese clinical settings (Li et al., 2012, p. 1148). It indicates scores ranging between 20 and 80 with a higher value indicating a higher value of anxiety. According to Lin et al., (2003) as cited in Li et al., (2012), this instrument is usually very effective in randomized clinical trials. 3.3 The concept of reliability and its demonstration in the study The reliability of data in any study indicates that other users of the information must be able to rely on it for reference and for any other purpose. The co-efficients for reliability range from 0 to 1 (Kimberlin & Winterstein, 2008, p. 2277). The higher the value of co-efficient the higher the levels of reliability according to the research. In Li et al., (2012), I can assert that the data presented in the research has fully met the threshold of reliability since it is stable and demonstrates internal consistency. The methods used, the research design, the results, the conclusions made have all been sufficiently justified. 3.4 The concept of validity and its demonstration in the study Validity of data on the other hand, requires that the data presented in research be legitimate and be capable of being generalized into other settings. The study has been focused on female cancer patients who have just undergone radical mastectomy but can also be able to apply to other settings since the same results have been proved to be valid for other populations such as children, the terminally ill and even generally all cancer patients. 4. Results The results of the study showed that there was a decrease in the experimental group of the state of anxiety after they were subjected to music therapy. All the patients who were receiving music therapy recorded a considerable reduction in their levels anxiety after listening to music (Li et al., 2012, p. 1152). It was found that music therapy has positive effects in reducing the levels of anxiety in female patients of breast cancer who had just undergone radical mastectomy (Li et al., 2012, p. 1153). 4.1. The differences in outcomes between the intervention and control groups In the experimental group, music therapy used had significant impacts on reducing the levels of anxiety in the participating patients. On the other hand all the anxiety tests were indicated that the experimental group had significantly lower levels of anxiety than the control group which was not subjected to music therapy. 4.2. Significance of the results The results from the study are very significant. This is because they add up to the existing literature on the benefits of music therapy for female patients who have just undergone radical mastectomy. As it is indicated in the article, the authors concluded that the music always has a positive effect, or even alternatively, it could be used as an option to nursing procedures in the care of female breast cancer patients (Li et al., 2012, p. 1153). The results can be proved to be very consistent with other literature in place as indicated in the text. 4.3. Can the study results be generalised to other settings? According to me, the results could easily be generalized into other settings, mostly because all other studies relating to the effect of music therapy in reducing the anxiety of patients indicate the same results. For instance, a clinical trial by Wan et al., (2009) also indicated that music therapy can improve the state anxiety of patients. Accordingly, music therapy can also reduce anxiety in patients who are terminally ill (Horne-Thompson & Grocke, 2008). 5.0 Ethical consideration and applications of the study 5.1 Ethical considerations in the study Any study should take into account all accruing ethical considerations that are likely to crop up in the course of the study. In this case the Human Research Ethics Committee reviewed and approved the study. Moreover, the participants were given all the explanations pertains the study before participating and gave informed consent before participating in the study. There was also the option of voluntary participation. This is a positive aspect for the study since participants are not to be forced into participating in any study especially if they are not willing. Ethical considerations are essential in any kind of study and this is no exception as it entails the protection of the human participants, avoids harm and avoids any possibilities of human rights abuses (Rossi et al., 2009). The research may also have some effects on the participants and the researchers took in this into consideration. The participants were not deceived about the aim of the study and this is a positive aspect about the study. In my view the ethical considerations were well met and effectively accounted for. 5.2 The Significance of the Study on Clinical Practice Conclusively, the study on music therapy and the effect it can have on reducing anxiety in patients with breast cancer who have undergone radical mastectomy is significant enough to inform clinical practice. In fact, much of recent literature supports the use of music therapy in nursing care (Horne-Thompson & Grocke, 2008, p. 582). The research of Horne-Thompson and Grocke was also to determine the effectiveness of a single session of music therapy in reducing the anxiety of terminally ill patients and the results were positive. The authors concluded that recorded music was very effective in managing anxiety for patients before, during and after undergoing surgery (Horne-Thompson & Grocke, 2008, p. 583). Works Cited Li, X. M., Zhou, K. N., Yan, H., Wang, D. L., & Zhang, Y. P. (2012). Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: a randomized clinical trial. Journal of Advanced Nursing, 68, 5, 1145-55. Kimberlin, C. L., & Winterstein, A. G. (2008). Validity and reliability of measurement instruments used in research. American Journal of Health-System Pharmacy : Ajhp, 65, 23, 2276. Retrieved from http://www.ashpfoundation.org/MainMenuCategories/ResearchResourceCenter/FosteringYoungInvestigators/AJHPResearchFundamentalsSeries/KimberlinArticle.aspx Rossi, S., Hallett, M., Rossini, P. M., Pascual-Leone, A., & Safety of TMS Consensus Group. (2009). Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology, 120, 12, pp. 2008-39. Retrieved from http://www.icts.uci.edu/neuroimaging/SafetyTMSrvw09.pdf Wan Y.H., Mao Z.F. & Qiu Y.R. (2009) Influence of music therapy on anxiety, depression and pain of cancer patients. Chinese Nursing Research 23(5A), pp. 1172–1175. Horne-Thompson, A., & Grocke, D. (January 01, 2008). The effect of music therapy on anxiety in patients who are terminally ill. Journal of Palliative Medicine, 11, 4, pp. 582-90. 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