The Effects of Vocal Music Therapy on Core Outcomes in Chronic Pain Management: A

描述（由申请人提供）：每年在传统疼痛治疗上花费数十亿美元，但对慢性疼痛的适当管理仍然是一个挑战。患有慢性疼痛的人往往在对传统干预措施感到失望之后，越来越多地寻求补充疼痛治疗。在过去的二十年里，音乐作为一种非药物治疗疼痛的方法得到了越来越多的关注。不幸的是，关于使用音乐来控制疼痛的研究主要集中在听预先录制的音乐上。虽然听音乐确实可以起到分散注意力或放松的作用，但临床经验表明，患者积极参与音乐治疗可以增加有效疼痛管理的成分。具体来说，我们已经开发了一种声乐治疗（VMT）治疗方案，激活对改善慢性疼痛患者的身体和情绪功能以及自我效能感重要的机制。这些机制包括增强身体意识，准备好与身体合作而不是对抗它，增加接受，改善情绪表达，增强情绪，增加快乐和能量，以及增强社会支持。我们为期8周的VMT治疗计划使用临床测试的技术，包括咬合（唱拉长的元音），集体歌唱和深呼吸。本探索性研究的目的是测试VMT在慢性疼痛患者中的可行性、接受度和治疗效果。采用等候名单对照组设计，我们将48名患有慢性疼痛的市中心成年人随机分为VMT治疗组和标准护理等候名单对照组（WLC）。我们将：1)与标准治疗相比，评估VMT对身体功能（作为主要结果）和自我效能、疼痛强度、疼痛应对、情绪功能、患者感知的影响程度

DESCRIPTION (provided by applicant): Billions of dollars are spent annually on traditional pain treatments, but adequate management of chronic pain continues to present a challenge. People with chronic pain, often after being disillusioned by traditional interventions, increasingl seek complementary pain treatments. The use of music as a non-pharmacological pain treatment has received growing attention during the past two decades. Unfortunately, research on the use of music for pain management has focused primarily on listening to pre-recorded music. While it is true that listening to music can function as a distractor or a relaxing agent, or clinical experience indicates that patients' active engagement in music therapy enlists added components of effective pain management. Specifically, we have developed a vocal music therapy (VMT) treatment program that activates mechanisms important for im- proved physical and emotional functioning and self-efficacy for people with chronic pain management needs. These mechanisms include augmented body awareness, readiness to work with the body rather than against it, increased acceptance, improved emotional expressivity, enhanced mood, increased joy and energy, and enhanced social support. Our 8-week VMT treatment program uses clinically tested techniques including ton- ing (singing of elongated vowels), group singing, and deep breathing. The purpose of this exploratory study is to test the feasibility, acceptance, and treatment effects of VMT with people who experience chronic pain. Us- ing a wait-list control group design, we will randomize 48 inner-city adults with chronic pain to the VMT treat- ment group or the standard care wait-list control (WLC) group. We will: 1) evaluate the size of the effects of VMT, compared with standard care, on physical functioning as the primary outcome and self-efficacy, pain in- tensity, pain coping, emotional functioning, patient perception of change, and healthcare consumption as sec- ondary outcomes. Outcome measures will be administered at baseline, 4 weeks, 8 weeks, and one-month fol- low-up; 2) evaluate the feasibility and acceptance of the VMT treatment program, as well as the WLC group design; and 3) obtain qualitative participant feedback on the treatment protocol and perceived benefits through a focus group during the one-month follow-up session. The results from this study will be used to support de- sign decisions for a future full-scale randomized controlled trial. If the findings of this proposed pilot study are positive and are replicated in larger trials, VMT could become an attractive, cost-effective adjunctive treatment option with no side-effects or complications. Furthermore, population groups, such as African-Americans and Latinos, for whom community music making is an integral part of their culture may view VMT as a desirable complementary treatment option for their chronic pain management needs.