Music Therapy for Pain in Black and White Cancer Patients: A Retrospective Study.
Music Therapy for Pain in Black and White Cancer Patients: A Retrospective Study.
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DOI：
10.1016/j.jpainsymman.2022.07.007
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发表时间：
2022-11
影响因子：
4.7
通讯作者：
Liou, Kevin T.
中科院分区：
文献类型：
--
作者：
Lichtl, Alexandria;Casaw, Camila;Edwards, Jasmine;Popkin, Karen;Yu, Jennifer;Li, Qing S.;Cadwell, Malik;Mao, Jun J.;Liou, Kevin T.
种族疼痛差异对癌症症状管理提出了挑战。音乐疗法已被证明对疼痛有益，并且由于音乐的多元文化存在，它是一种有希望的治疗选择。然而，黑人癌症患者在音乐治疗试验中的代表性不足。这项研究比较了黑人和白色癌症患者的疼痛严重程度、治疗方法和对音乐治疗的反应。研究结果将用于为未来的音乐治疗研究产生假设，以解决疼痛管理中的种族差异。我们对在NCI-Designated Comprehensive Cancer Center接受音乐治疗的黑人和白色患者进行了回顾性项目评估。我们使用埃德蒙顿症状评估量表（ESAS）评估疼痛。我们从电子健康记录中提取了阿片类药物的使用、音乐治疗转诊原因和治疗方法。在358名患者中，18%是黑人，42%报告中度至重度疼痛，47%接受阿片类药物治疗。黑人患者报告的基线疼痛高于白色患者，但接受阿片类药物治疗的黑人和白色患者比例相似。黑人患者接受音乐治疗的比例更高（73%对56%，P=0.04），并参与积极的技术（92%对82%，P=0.04）。黑人和白色患者报告说，音乐治疗后疼痛减轻程度相似，具有临床意义。黑人患者在音乐治疗期间更常讨论灵性，而白色患者则专注于家庭纽带。黑人和白色患者通过不同的音乐治疗方法报告了具有临床意义的疼痛减轻。我们的研究结果可能有助于为音乐疗法的文化适应提供信息，以解决肿瘤学中的种族疼痛差异。
Racial pain disparities present challenges to cancer symptom management. Music therapy has demonstrated benefits for pain and is a promising treatment option for diverse populations due to music’s multicultural presence. However, Black cancer patients are under-represented in music therapy trials. This study compared pain severity, treatment approaches, and responses to music therapy between Black and white cancer patients. The findings will be used to generate hypotheses for future music therapy research to address racial disparities in pain management. We conducted a retrospective program evaluation of Black and white patients who received music therapy at an NCI-Designated Comprehensive Cancer Center. We used the Edmonton Symptom Assessment Scale (ESAS) to assess pain. We abstracted opioid use, music therapy referral reasons, and treatment approaches from the electronic health record. Among 358 patients, 18% were Black, 42% reported moderate-to-severe pain, and 47% received opioids. Black patients reported higher baseline pain than white patients, but similar proportions of Black and white patients received opioids. Greater proportions of Black patients received music therapy referrals for pain (73% vs. 56%, P=0.04) and engaged in active techniques (92% vs. 82%, P=0.04). Black and white patients reported clinically meaningful pain reduction of similar magnitude after music therapy. Black patients discussed spirituality more commonly during music therapy, whereas white patients focused on family bonds. Black and white patients reported clinically meaningful pain reduction through varying music therapy approaches. Our findings may help inform cultural adaptations of music therapy to address racial pain disparities in oncology.
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