Vocal Music Therapy for Chronic Pain: A Mixed Methods Feasibility Study
Vocal Music Therapy for Chronic Pain: A Mixed Methods Feasibility Study
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DOI：
10.1089/acm.2019.0249
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发表时间：
2019-11-21
影响因子：
2.6
通讯作者：
Bradt, Joke
中科院分区：
文献类型：
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作者：
Low, Ming Yuan;Lacson, Clarissa;Bradt, Joke
目的：本研究的目的是确定声乐治疗（VMT）计划对慢性疼痛管理的可行性和初步效果。设计：采用混合方法干预设计，将定性数据嵌入随机对照试验。设置：在美国东海岸的城市护士管理健康中心。受试者：参与者（N = 43）主要为黑人（79%）和女性（76.7%），平均疼痛持续时间为10年。干预：参与者被随机分配到一个12周的VMT计划或候补名单控制。结果测量：我们跟踪了同意率（参与者在筛选的总人数中所占的百分比），流失率和治疗依从性。我们使用PROMIS（R）（患者报告结果测量信息系统）工具测量基线和第12周的疼痛干扰、疼痛相关自我效能、疼痛强度、抑郁、焦虑、积极影响和幸福感、参与社会活动的能力以及对社会角色的满意度。VMT参与者还完成了患者总体印象变化量表。我们进行了半结构化访谈，以更好地了解参与者的干预经验。结果：同意率为56%。流失率为23%。获得了自我效能（0.20）、抑郁（0.26）和参与社会活动能力（0.24）的较大治疗效应（偏eta平方）。中等影响被发现的疼痛强度（0.10），焦虑（0.06），积极的影响，和幸福（0.06），和疼痛干扰（0.03）和社会角色满意度（0.03）的小影响。平均而言，参与者在完成VMT计划后感觉稍微好一些（M = 4.93，标准差= 1.98）。定性研究结果表明，VMT导致更好的自我管理疼痛，增强心理健康，更强的社会和精神联系。结论：招募到12周的计划是具有挑战性的，但定量和定性的研究结果表明，VMT的慢性疼痛管理的显着好处。
Objective: The purpose of this study was to determine the feasibility and preliminary effects of a vocal music therapy (VMT) program on chronic pain management. Design: A mixed methods intervention design was used in which qualitative data were embedded within a randomized controlled trial. Setting: An urban nurse-management health center on the East Coast of the United States. Subjects: Participants (N = 43) were predominantly Black (79%) and female (76.7%) with an average pain duration of 10 years. Intervention: Participants were randomly allocated to a 12-week VMT program or a waitlist control. Outcome measures: We tracked consent rate (percentage of participants enrolled out of total number screened), attrition rate, and treatment adherence. We used PROMIS (R) (Patient Reported Outcomes Measurement Information System) tools to measure pain interference, pain-related self-efficacy, pain intensity, depression, anxiety, positive effect, and well-being, ability to participate in social activities, and satisfaction with social roles at baseline and week 12. VMT participants also completed the Patient Global Impression of Change Scale. We conducted semistructured interviews to better understand participants' experience of the intervention. Results: The consent rate was 56%. The attrition rate was 23%. Large treatment effects (partial eta squared) were obtained for self-efficacy (0.20), depression (0.26), and ability to participate in social activities (0.24). Medium effects were found for pain intensity (0.10), anxiety (0.06), positive effect, and well-being (0.06), and small effects for pain interference (0.03) and satisfaction with social roles (0.03). On average, participants felt moderately better after completion of the VMT program (M = 4.93, standard deviation = 1.98). Qualitative findings suggest that VMT resulted in better self-management of pain, enhanced psychological well-being, and stronger social and spiritual connections. Conclusions: Recruitment into the 12-week program was challenging, but quantitative and qualitative findings suggest significant benefits of VMT for chronic pain management.