Music versus distraction for procedural pain and anxiety in patients with cancer. Expressive writing in patients receiving palliative care: a feasibility study. Effects of hatha yoga and african dance on perceived stress, affect, and salivary cortisol The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. A randomized trial to test the effectiveness of art therapy for children with asthma. Recruitment and Early Retention of Women with Advanced Breast Cancer in a Complementary and Alternative Medicine Trial Art therapy improves experienced quality of life among women undergoing treatment for breast cancer: a randomized controlled study. A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer. Music Therapy to Reduce Pain and Anxiety in Children With Cancer Undergoing Lumbar Puncture: A Randomized Clinical Trial Dance and Movement Program Improves Quality‐of‐Life Measures in Breast Cancer Survivors A randomised controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety. Effects of music therapy on pain among female breast cancer patients after radical mastectomy: results from a randomized controlled trial Expressive Disclosure and Health Outcomes in a Prostate Cancer Population Efficacy of Music Therapy in the Treatment of Behavioral and Psychiatric Symptoms of Dementia Consultations for holistic pediatric services for inpatients and outpatient oncology patients at a children's hospital. The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. DANCE MOVEMENT THERAPY IMPROVES EMOTIONAL RESPONSES AND MODULATES NEUROHORMONES IN ADOLESCENTS WITH MILD DEPRESSION The influence of personal message with music on anxiety and side effects associated with chemotherapy. Individual brief art therapy can be helpful for women with breast cancer: a randomized controlled clinical study. Use of preferred music to reduce emotional distress and symptom activity during radiation therapy. Music as a therapeutic intervention for anxiety in patients receiving radiation therapy. Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation Narrowing the gap: the effects of an expressive writing intervention on perceptions of actual and ideal emotional support in women who have completed treatment for early stage breast cancer. Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. Effects of music therapy on pain and anxiety in patients undergoing bone marrow biopsy and aspiration.
PURPOSE / OBJECTIVES To test the hypotheses that the effects of a music intervention are greater than those of simple distraction and that either intervention is better at controlling procedural pain and anxiety than treatment as usual . DESIGN R and omized , controlled experiment . SETTING A midwestern comprehensive cancer center . SAMPLE 60 people with cancer having noxious medical procedures such as tissue biopsy or port placement or removal ; 58 provided usable data . METHODS Participants completed measures of pain and anxiety before and after their medical procedures and provided a rating of perceived control over pain and anxiety after the procedure . MAIN RESEARCH VARIABLES Procedural pain , state anxiety , and perceived control over pain and anxiety . FINDINGS Contrary to hypotheses , outcomes achieved with music did not differ from those achieved with simple distraction . Moreover , outcomes achieved under treatment as usual were not significantly different from those obtained with music or distraction interventions . Some patients found that the interventions were bothersome and reported that they wanted to attend to the activities of the surgeon and the medical procedure itself . CONCLUSIONS The effects of music , distraction , and treatment as usual are equivocal . In addition , patients have individual preferences for use of distraction during painful or anxiety-provoking procedures . IMPLICATION S FOR NURSING Patients having noxious medical procedures should be asked about their desire to be distracted before and during the procedure and offered a strategy that is consistent with their preferences BACKGROUND Patients with advanced cancer receiving palliative care often experience severe physical and psychosocial symptoms . However , there are limited re sources for psychological and emotional support . Expressive writing has shown decreased anxiety level in young and healthy people suffering from a number of stressors . OBJECTIVE The purpose of this study was to determine the feasibility of expressive writing in patients receiving palliative care and the most suitable outcomes of expressive writing in this patient population . DESIGN In this pilot study , patients were r and omly assigned to either the expressive writing group ( EW ) or the neutral writing group ( NW ) . Anxiety level before and after the writing session was compared between the two groups . Writing material s were content analyzed using st and ard qualitative research methods . RESULTS A total of 24 patients ( 12 in EW and 12 in NW ) were enrolled in the study between October 2006 and January 2007 . Although the majority of patients ( 83%-100 % ) were able to complete all baseline assessment s , poor adherence was observed during the follow-ups . Only 8 % of patients completed the 2-week study . There was no significant difference in the State-Trait Anxiety Inventory ( STAI ) State-Anxiety scores at baseline , before and after each writing session between the EW and NW groups . DISCUSSION Our rapid accrual suggests that palliative care patients are interested in participating in studies such as expressive writing . The high level of adherence to the baseline assessment s indicates that these assessment s were not particularly difficult for our patients to complete . Future studies may need to include patients with better performance status , better patient education , means of emotional expression ( i.e. , audio recording , telephone interview ) and improved adherence . CONCLUSION We conclude that clinical trials of expressive writing in the palliative care setting are not feasible unless they undergo major modification in methods compared to those previous reported in other patient population . Our findings will hopefully assist research ers considering similar studies Background : Dance and yoga have been shown to produce improvements in psychological well-being . Purpose : The aim of this study was to examine some of the psychological and neuroendocrine responses to these activities . Methods : Sixty-nine healthy college students participated in one of three 90-min classes : African dance ( n = 21 ) , Hatha yoga ( n = 18 ) , or a biology lecture as a control session ( n = 30 ) . Before and after each condition participants completed the Perceived Stress Scale ( PSS ) , completed the Positive Affect and Negative Affect Schedule , and provided a saliva sample for cortisol . Results : There were significant reductions in PSS and negative affect ( ps < .0001 ) and Time × Treatment interactions ( ps < .0001 ) such that African dance and Hatha yoga showed significant declines , whereas there was no significant change in biology lecture . There was no significant main effect for positive affect ( p = .53 ) , however there was a significant interaction effect ( p < .001 ) such that positive affect increased in African dance , decreased in biology lecture , and did not change significantly in Hatha yoga . There was a significant main effect for salivary cortisol ( p < .05 ) and a significant interaction effect ( p < .0001 ) such that cortisol increased in African dance , decreased in Hatha yoga , and did not change in biology . Changes in cortisol were not significantly related to changes in psychological variables across treatments . There was 1 significant interaction effect ( p = .04 ) such that change in positive affect and change in cortisol were negatively correlated in Hatha yoga but positively correlated in African dance and biology . Conclusions : Both African dance and Hatha yoga reduced perceived stress and negative affect . Cortisol increased in African dance and decreased in Hatha yoga . Therefore , even when these interventions produce similar positive psychological effects , the effects may be very different on physiological stress processes . One factor that may have particular salience is the amount of physiological arousal produced by the intervention OBJECTIVES To examine effects of sedative music on  cancer pain .  DESIGN A r and omized controlled trial . SETTING S Two large medical centers in Kaoshiung City , in southern Taiwan . PARTICIPANTS 126 hospitalized persons with cancer pain . METHODS Participants were r and omly assigned to an experimental ( n=62 ) or a control group ( n=64 ) , with computerized minimization , stratifying on gender , pain , and hospital unit . Music choices included folk songs , Buddhist hymns ( Taiwanese music ) , plus harp , and piano ( American ) . The experimental group listened to music for 30 min ; the control group rested in bed .  Sensation and distress of pain were rated on 100 mm VAS before and after the 30-min test . RESULTS Using MANCOVA , there was significantly less posttest pain in the music versus the control group , p<.001 . Effect sizes were large , Cohen 's d=.64 , sensation , d=.70 , distress , indicating that music was very helpful for pain . Thirty minutes of music provided 50 % relief in 42 % of the music group compared to 8 % of the controls . The number needed to treat ( NNT ) to find one with 50 % sensation relief was three patients . More patients chose Taiwanese music ( 71 % ) than American music ( 29 % ) , but both were liked and effective . CONCLUSIONS Offering a choice of familiar , culturally appropriate music was a key element of the intervention . Findings extend the Good and Moore theory ( 1996 ) to cancer pain . Soft music was safe , effective , and liked by participants . It provided greater relief of cancer pain than analgesics alone . Thus nurses should offer calming , familiar music to supplement analgesic medication for persons with cancer pain BACKGROUND Art therapy has been used to help children cope with chronic illness but has not been specifically tested with children who have asthma . OBJECTIVE To test an art therapy intervention in a r and omized controlled trial in children with asthma . METHODS Twenty-two children with asthma were r and omized to an active art therapy or wait-list control group . Those in the active art therapy group participated in 60-minute art therapy sessions once a week for 7 weeks . Sessions included specific art therapy tasks design ed to encourage expression , discussion , and problem-solving in response to the emotional burden of chronic illness . Measures taken at baseline , immediately after , and 6 months after the final art therapy session included the Formal Elements Art Therapy Scale applied to the Person Picking an Apple from a Tree assessment , the parent and child versions of the Pediatric Quality of Life Asthma Module , and the Beck Youth Inventories . Those children assigned to the wait-list control group completed all evaluations at the same intervals as the children receiving art therapy but did not receive the art therapy interventions . RESULTS Score changes from baseline to completion of art therapy indicated ( 1 ) improved problem-solving and affect drawing scores ; ( 2 ) improved worry , communication , and total quality of life scores ; and ( 3 ) improved Beck anxiety and self concept scores in the active group relative to the control group . At 6 months , the active group maintained some positive changes relative to the control group including ( 1 ) drawing affect scores , ( 2 ) the worry and quality of life scores , and ( 3 ) the Beck anxiety score . Frequency of asthma exacerbations before and after the 6-month study interval did not differ between the 2 groups . CONCLUSION This was the first r and omized trial demonstrating that children with asthma receive benefit from art therapy that includes decreased anxiety and increased quality of life More than 80 % of women with breast cancer are now reported to be using complementary and alternative medicine ( CAM ) therapies during conventional treatment . A r and omized clinical trial ( RCT ) of reflexology with late stage breast cancer patients serves as the data source for this article . The purpose s were to investigate : ( i ) reasons for refusal to participate in a RCT of reflexology ; ( ii ) the differences between those who completed the baseline interview and those who dropped out before baseline ; and ( iii ) the utility of the Palliative Prognostic Score ( PPS ) as a prognostic screening tool in minimizing early attrition ( before baseline ) from the trial . Eligible women ( N = 400 ) approached at 12 cancer centers in the Midwest had advanced breast cancer , were on chemotherapy or hormonal therapy , and had a PPS of 11 or less . Comparisons of those who dropped out early ( N = 33 ) to those who stayed in the trial ( N = 240 ) were carried out using Wilcoxon rank , t- , chi-squared and Fisher 's exact tests . The reasons of being “ too sick ” or “ overwhelmed ” were given by less than 12 % of the women who refused to participate . There was a higher early dropout rate among black women compared to other ( primarily white ) women ( P = .01 ) . Cancer recurrence and metastasis , age , and the PPS were not predictive of early retention of women . Specialized techniques may be needed to ensure black women remain in the trial once consented . Women with advanced disease were likely to enter and remain in the trial despite deterioration in health Women with breast cancer are naturally exposed to strain related to diagnosis and treatment , and this influences their experienced quality of life ( QoL ) . The present paper reports the effect , with regard to QoL aspects , of an art therapy intervention among 41 women undergoing radiotherapy treatment for breast cancer . The women were r and omized to an intervention group with individual art therapy sessions for 1 h/week ( n = 20 ) , or to a control group ( n = 21 ) . The WHOQOL-BREF and EORTC Quality of Life Question naire-BR23 , were used for QoL assessment , and administrated on three measurement occasions , before the start of radiotherapy and 2 and 6 months later . The results indicate an overall improvement in QoL aspects among women in the intervention group . A significant increase in total health , total QoL , physical health and psychological health was observed in the art therapy group . A significant positive difference within the art therapy group was also seen , concerning future perspectives , body image and systemic therapy side effects . The present study provides strong support for the use of art therapy to improve QoL for women undergoing radiotherapy treatment for breast cancer The purpose of this study was to gather data on the efficacy of a newly developed psychosocial group intervention for cancer patients , called mindfulness-based art therapy ( MBAT ) .  One hundred and eleven women with a variety of cancer diagnoses were paired by age and r and omized to either an eight-week MBAT intervention group or a wait-list control group .  Ninety-three participants ( 84 % ) completed both the pre- and post- study measurements . As compared to the control group , the MBAT group demonstrated a significant decrease in symptoms of distress ( as measured by the Symptoms Checklist-90-Revised ) and significant improvements in key aspects of health-related quality of life ( as measured by the Medical Outcomes Study Short-Form Health Survey ) . This investigation of MBAT provides initial encouraging data that support a possible future role for the intervention as a psychosocial treatment option for cancer patients A nonpharmacological method can be an alternative or complement to analgesics . The aim of this study was to evaluate if music medicine influences pain and anxiety in children undergoing lumbar punctures .  A r and omized clinical trial was used in 40 children ( aged 7 - 12 years ) with leukemia , followed by interviews in 20 of these participants . The participants were r and omly assigned to a music group ( n = 20 ) or control group ( n = 20 ) . The primary outcome was pain scores and the secondary was heart rate , blood pressure , respiratory rate , and oxygen saturation measured before , during , and after the procedure . Anxiety scores were measured before and after the procedure . Interviews with open-ended questions were conducted in conjunction with the completed procedures . The results showed lower pain scores and heart and respiratory rates in the music group during and after the lumbar puncture . The anxiety scores were lower in the music group both before and after the procedure . The findings from the interviews confirmed the quantity results through descriptions of a positive experience by the children , including less pain and fear A pilot research study was conducted at 2 cancer centers in Connecticut to determine the effect of a dance and movement program on quality of life and shoulder function in breast cancer survivors treated within the prior 5 years . Thirty-five women completed the trial that included a 12-week intervention , using The Lebed Method , Focus on Healing Through Movement and Dance . The study design was a r and omized control trial with a wait list control group crossover to active treatment in weeks 13 to 25 , with the treatment group receiving the program in weeks 1 to 12 , and no program in weeks 13 to 25 . Outcome measures were the Breast Cancer Quality of Life ( FACT-B ) , Shoulder range of motion ( ROM ) , and Body Image Scale . FACT-B significantly improved in the intervention group at 13 weeks from 102.0 ± 15.8 to 116.7 ± 16.9 , compared to the wait list group 108.1 ± 16.4 to 107.1 ± 21.3 ( time × group effect , P = .008 ) . During the crossover phase , the FACT-B score increased in the wait list group and was stable in the treatment group . The overall effect of the training at 26 weeks was significant ( time effect , P = .03 ) , and the order of training was also significant ( P = .015 ) . Shoulder ROM increased in both groups at 13 weeks —15 ° and 8 ° in the intervention and wait list groups ( Time effect , P = .03 ; time × group , P = .58 ) . Body Image improved similarly in both groups at 13 weeks ( time effect , P = .001 ; time × group , P = .25 ) , and at 26 weeks . There was no significant effect of the order of training for these outcome measures . A dance movement program that addressed the physical and emotional needs of women following treatment for breast cancer substantially improved a breast cancer – specific quality -of-life measure . Larger studies are justified to determine the acceptability of this therapy as part of the continuum of care for breast cancer survivors AIMS To determine the effect of music therapy and verbal relaxation on state anxiety and anxiety-induced physiological manifestations among patients with cancer before and after chemotherapy . BACKGROUND Cancer and its treatment provoke a series of changes in the emotional sphere of the patient 's anxiety . Music therapy and verbal relaxation had reported the anxiety reduction effect on patients with cancer receiving chemotherapy . Few studies have been undertaken comparing music therapy and verbal relaxation in differentiating high-normal state anxiety sub sample . DESIGN A r and omised controlled trial and permuted block design were used . Outpatient chemotherapy clinic operated by a University medical centre in southern Taiwan . METHODS Ninety-eight patients were r and omised into three groups : the music therapy group received one-hour single music session ; the verbal relaxation group received 30 minutes of guided relaxation ; the control group received usual care .  Spielberger State-Trait Anxiety Instrument , Emotional Visual Analog Scale , three biobehavioural indicators : skin temperature , heart rate and consciousness level were measured during and after chemotherapy . RESULT Music therapy had a greater positive effect on postchemotherapy anxiety than verbal relaxation and control groups and a significantly increase in skin temperature .  Patients with high state anxiety receiving music therapy had a greater drop in postchemotherapy anxiety than did the normal state anxiety sub sample . CONCLUSIONS Both music and verbal relaxation therapy are effective in reducing chemotherapy-induced anxiety . Thirty minutes of intervention initiates anxiety reduction .  Patients with high state anxiety receiving chemotherapy obtain the most benefit from music or verbal relaxation . RELEVANCE TO CLINICAL PRACTICE Prior to chemotherapy , patients with high state anxiety must be sorted from all patients as they are more responsive to interventions . Oncology nurses can offer music and verbal relaxation as adjuvant interventions to reduce chemotherapy-induced anxiety and enhance the quality of care Music therapy has been used in multiple health care setting s to reduce patient pain , anxiety , and stress . However , few available studies have investigated its effect on  pain among breast cancer patients after radical mastectomy . The aim of this study was to explore the effects of music therapy on pain reduction in patients with breast cancer after radical mastectomy . This r and omized controlled trial was conducted at the Surgical Department of Oncology Center , First Affiliated Hospital of Xi’an Jiaotong University from March to November 2009 . A total of 120 breast cancer patients who received Personal Controlled Analgesia ( PCA ) following surgery ( mastectomy )  were r and omly allocated to two groups , an intervention group and a control group ( 60 patients in each group ) . The intervention group accepted music therapy from the first day after radical mastectomy to the third admission to hospital for chemotherapy in addition to the routine nursing care , while the control group received only routine nursing care .  Pain scores were measured at baseline and three post-tests using the General Question naire and Chinese version of Short-Form of McGill Pain Question naire . The primary endpoint was the change in the Pain Rating Index ( PRI-total ) score from baseline . Music therapy was found to reduce the PRI-total score in the intervention group significantly compared with the control group with a mean difference ( 95 % CI ) of −2.38 ( −2.80 , −1.95 ) , −2.41 ( −2.85 , −1.96 ) , and −1.87 ( −2.33 , −1.42 ) for the 1st , 2nd , and 3rd post-tests , respectively . Similar results were found for Visual Analogue Scale ( VAS ) and Present Pain Intensity ( PPI ) scores . The findings of the study provide some evidence that music therapy has both short- and long-term positive effects on alleviating pain in breast cancer patients following radical mastectomy Objective : This pilot study explored the feasibility and the efficacy of a brief , well-defined psychosocial intervention ( expressive disclosure ) in improving behavioral , medical , immunological , and emotional health outcomes in men with diagnosed prostate cancer . Method : Thirty prostate cancer patients receiving outpatient oncology care were r and omized into  experimental ( disclosure ) and control ( non-disclosure ) groups . All had been previously treated by surgery or radiation within the last 4 years and were being monitored without further intervention for change in PSA levels .  Psychological and physical health surveys were administered and peripheral blood for PSA levels and immune assays was obtained upon study enrollment and again at 3 and 6 months post enrollment . Multivariate analyses were used to examine how the expressive disclosure impacted the hypothesized domains of functioning : physical and psychological symptoms ; health care utilization ; and immunocompetence . Results : Compared to controls , patients in the expressive disclosure condition showed improvements in the domains of physical symptoms and health care utilization , but not in psychological variables nor in disease relevant aspects of immunocompetence . Conclusions : Study results support the feasibility of an expressive disclosure intervention for men with prostate cancer . The intervention was well accepted by this population , and participation/adherence was quite high . Results provide only limited support for the hypothesis that a written emotional disclosure task can positively impact health outcomes in a cancer population . However , this pilot study may have lacked adequate power to detect possible intervention benefits . Further studies with larger sample s are needed to better assess the intervention 's impact on psychological well-being and immunocompetence Background Music therapy ( MT ) has been proposed as valid approach for behavioral and psychologic symptoms ( BPSD ) of dementia . However , studies demonstrating the effectiveness of this approach are lacking . Objective To assess MT effectiveness in reducing BPSD in subjects with dementia . Method Fifty-nine persons with dementia were enrolled in this study . All of them underwent a multidimensional assessment including Mini Mental State Examination , Barthel Index and Neuropsychiatry Inventory at enrolment and after 8 , 16 , and 20 weeks . Subjects were r and omly assigned to experimental ( n=30 ) or control ( n=29 ) group . The MT sessions were evaluated with st and ardized criteria . The experimental group received 30 MT sessions ( 16 wk of treatment ) , whereas the control group received educational support or entertainment activities . Results NPI total score significantly decreased in the experimental group at 8th , 16th , and 20th weeks ( interaction time × group : F3 , 165=5.06 , P=0.002 ) . Specific BPSD ( ie , delusions , agitation , anxiety , apathy , irritability , aberrant motor activity , and night-time disturbances ) significantly improved . The empathetic relationship and the patients ' active participation in the  MT  approach , also improved in the experimental group . Conclusions The study shows that MT is effective to reduce BPSD in patients with moderate-severe dementia BACKGROUND As dem and increases for complementary and alternative medical care , pediatric institutions face the need to answer patients ' and clinicians ' questions about integrating these therapies in hospital setting s. OBJECTIVE To describe the first year of experience in providing holistic medicine consultations in an urban tertiary care teaching hospital . DESIGN Prospect i ve cohort . SUBJECTS Patients seeking consultation from the Center for Holistic Pediatric Education and Research , Boston , Mass , from July 16 , 1999 , to July 15 , 2000 . METHODS Review of consultation notes and medical records . RESULTS Of the 70 physician consultations , most ( n = 43 ) were for oncology patients . Most consultations ( n = 44 ) were accomplished with a single visit . The most common goal for consultation was to obtain help in managing symptoms such as nausea , pain , insomnia , or agitation ( n = 50 ) . The most common questions about specific therapies had to do with herbs ( n = 41 ) or dietary supplements ( n = 42 ) , but there were also frequent questions about diet and nutrition ( n = 33 ) and mind-body therapies such as guided imagery and biofeedback ( n = 28 ) and massage ( n = 25 ) . Approximately 0.3 full-time equivalents of physician time was required to provide clinical consultations , and $ 7315 was collected of the $ 26 638 billed for these services . CONCLUSIONS The complementary medicine consultation service was primarily consulted by oncology patients requesting assistance with pain and symptom management . Patients had questions about various therapies , particularly herbs and dietary supplements . Additional research is necessary to determine the cost-effectiveness of an integrated approach to care , particularly for institutions without access to reliable community re sources for complementary and alternative medical therapies The purpose of this study was to evaluate the effects of music therapy on quality of life , length of life in care , physical status , and relationship of death occurrence to the final music therapy interventions of hospice patients diagnosed with terminal cancer . Subjects were adults who were living in their homes , receiving hospice care , and were diagnosed with terminal cancer . A total of 80 subjects participated in the study and were r and omly assigned to one of two groups : experimental ( routine hospice services and clinical music therapy ) and control ( routine hospice services only ) . Groups were matched on the basis of gender and age . Quality of life was measured by the Hospice Quality of Life Index-Revised ( HQOLI-R ) , a self-report measure given every visit . Functional status of the subjects was assessed by the hospice nurse during every visit using the Palliative Performance Scale . All subjects received at least two visits and quality of life and physical status assessment s. A repeated measures ANOVA revealed a significant difference between groups on self-report quality of life scores for visits one and two . Quality of life was higher for those subjects receiving music therapy , and their quality of life increased over time as they received more music therapy sessions . Subjects in the control group , however , experienced a lower quality of life than those in the experimental group , and without music , their quality of life decreased over time . There were no significant differences in results by age or gender of subjects in either condition . Furthermore , there were no significant differences between groups on physical functioning , length of life , or time of death in relation to the last scheduled visit by the music therapist or counselor . This study provides an overview of hospice/palliative care , explains the role of music therapy in providing care , and establishes clinical guidelines grounded in research for the use of music therapy in improving the quality of life among the terminally ill This study assessed the profiles of psychological health and changes in neurohormones of adolescents with mild depression after 12 weeks of dance movement therapy ( DMT ) . Forty middle school seniors ( mean age : 16 years old ) volunteered to participate in this study and were r and omly assigned into either a dance movement group ( n = 20 ) or a control group ( n = 20 ) . All subscale scores of psychological distress and global scores decreased significantly after the 12 weeks in the DMT group . Plasma serotonin concentration increased and dopamine concentration decreased in the DMT group . These results suggest that DMT may stabilize the sympathetic nervous system . In conclusion , DMT may be effective in beneficially modulating concentrations of serotonin and dopamine , and in improving psychological distress in adolescents with mild depression The purpose of this pilot study was to evaluate the benefits of a message from a patient 's physician audiotaped over music on reducing anxiety and side effects of patients receiving chemotherapy .  A convenience sample of 97 adult patients receiving chemotherapy for the first time was assigned to either an experimental or control group . Before beginning the first chemotherapy treatment , all subjects completed a demographic question naire and the  Spielberger State Anxiety Inventory ( SSAI ) . Participants in the experimental group ( n = 47 ) received taped music and a message from their physicians during the next four chemotherapy treatments . Participants in the control group ( n = 50 ) received no intervention from the research ers and underwent their next four chemotherapy treatments as prescribed . After the fourth chemotherapy treatment , the  SSAI and a  side-effects self- assessment evaluation  were completed by all subjects . A paired one-tailed t test found a significant difference between pre- and postintervention scores on the state anxiety scale ( p < 0.001 ) . In addition , anxiety remained the same over time in the control group . There was no significant difference in the severity of side effects experienced between control and experimental groups . These preliminary findings indicate that a simple and cost-effective intervention can decrease a patient 's anxiety when receiving chemotherapy OBJECTIVE Recent research shows that almost every second woman with breast cancer is depressed or has anxiety ; the risk for younger women is even higher . Moreover , research shows that women are at risk for developing depression , also a threat for women with breast cancer . The aim of this r and omized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy . METHODS The participants were between 37 and 69 years old ; six participants in each group were below 50 years of age . Half of the participants ( n = 20 ) received art therapy and the other half ( n = 21 ) were assigned to a control group . At the first measurement , at least 17 % ( n = 7 ) of the participants medicated with  antidepressants .  Data were collected before and after art therapy and at a 4-month follow-up using self-rating scales that measure self-image ( the Structural Analysis of Social Behaviour ) and psychiatric symptoms ( the Symptom Check List-90 ) . RESULTS At follow-up , significant lower ratings of depression , anxiety , and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group . The regression analysis showed that art therapy relates to lower ratings of depression , anxiety , and general symptoms ; chemotherapeutic treatment predicts lower depressive symptoms ; in contrast to axillary surgery and hormonal treatment as well as being a parent predicts higher ratings of anxiety and general symptoms . SIGNIFICANCE OF RESULTS The conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences Music therapy has decreased anxiety levels in many medical setting s. This r and omized clinical trial examined the effectiveness of a music listening intervention , delivered by a board-certified music therapist , in patients undergoing curative radiation therapy ( RT ) .  Emotional distress ( anxiety , depression , and treatment-related distress ) and symptoms ( fatigue and pain ) were measured at baseline , mid-treatment , and end of treatment in 63 patients undergoing RT .  Although patients who listened to self-selected music reported lower anxiety and treatment-related distress , there was a decline in these outcomes for patients in both groups over the course of RT .  Depression , fatigue , and pain were not appreciably affected by music therapy . Within the music group , there was a significant correlation between number of times music was used/week and the change in treatment-related distress , suggesting that higher doses of music produced greater declines in distress . While these findings provided some support for the use of music in reducing distress during RT , further research demonstrating clear differences between intervention and control conditions is needed . Physical symptoms were not affected by the use of music over the course of RT PURPOSE / OBJECTIVES To determine whether music moderates the level of anxiety that patients experience during radiation therapy . DESIGN Experimental , longitudinal , r and om assignment to music or no music therapy . SETTING Urban radiation oncology center in a Department of Veterans Affairs hospital in the southeastern United States . SAMPLE Forty-two men ( 19 in the experimental group , 23 in the control group ) aged 39 - 80 years ( 74 % white , 12 % African American , 12 % Hispanic , and 2 % other ) receiving definitive external beam radiation therapy for pelvic or abdominal malignancies . METHODS Patients in the experimental group listened to music of their choice provided via audiotapes and headphones before and during their simulation and daily treatments for the duration of the planned course of therapy . The control group received st and ard care . The  State-Trait Anxiety Inventory  was administered initially to participants in both groups at the time of evaluation ( time 1 ) , post-simulation ( time 2 ) , at the end of the first week ( time 3 ) , at the end of the third week ( time 4 ) , and at the end of the fifth week or end of radiation therapy ( time 5 ) . MAIN RESEARCH VARIABLE State anxiety . FINDINGS No significant difference existed between the two groups to suggest that music moderated the level of anxiety during radiotherapy . However , post-hoc analyses identified changes and trends in state anxiety scores , suggesting a possible benefit of music therapy during radiotherapy . CONCLUSIONS Despite a lack of group differences , early intervention with music therapy for patients with high levels of anxiety may be beneficial . IMPLICATION S FOR NURSING PRACTICE Nurses and other clinicians may administer state anxiety scales at the initial visit or prior to pretreatment radiation planning ( simulation ) . Individuals who have high state anxiety scores may receive nursing interventions tailored to reduce anxiety during simulation and the early part of radiotherapy High‐dose therapy with autologous stem cell transplantation ( HDT/ASCT ) is a commonly used treatment for hematologic malignancies . The procedure causes significant psychological distress and no interventions have been demonstrated to improve mood in these patients . Music therapy has been shown to improve anxiety in a variety of acute medical setting s. In the current study , the authors determined the effects of music therapy compared with st and ard care  on mood during inpatient stays for HDT/ASCT OBJECTIVE To assess the effects of an expressive writing ( EW ) intervention on perceptions of emotional support in women completing treatment for early stage breast cancer . METHODS Women were recruited to the study during their final week of treatment . Of 260 eligible patients , 104 ( 40 % ) agreed to participate , and 93 were r and omised . Women in the writing group wrote for 20 min on four consecutive days . The control group received normal care . Women 's perceptions of emotional support , quality of life ( QOL ) , mood , and healthcare utilisation were assessed at baseline , 1 month , 3 months and 6 months . Interviews were conducted to explore women 's experience of writing . RESULTS Eighty participants completed all follow-ups . There was a significant effect of group on women 's perceptions of social support with those in the intervention group being more satisfied with the emotional support they received ( p<0.05 ) . Satisfaction with emotional support was negatively correlated with depression/dejection ( p<0.05 ) and anger/hostility ( p<0.05 ) and positively correlated with social and family well-being ( p<0.001 ) 6 months post intervention . There were no significant effects of the intervention on mood , QOL or healthcare utilisation . Most participants found writing valuable and did not report any long-term negative effects . CONCLUSION EW was associated with a higher level of satisfaction with emotional support compared with controls . Given the existing evidence supporting the importance of social support in adjustment to breast cancer , it seems feasible to suggest that EW may be a cost effective accessible treatment that could be incorporated into the ongoing care of women PURPOSE This study examines the impact of yoga , including physical poses , breathing , and meditation exercises , on quality of life ( QOL ) , fatigue , distressed mood , and spiritual well-being among a multiethnic sample of breast cancer patients . PATIENTS AND METHODS One hundred twenty-eight patients ( 42 % African American , 31 % Hispanic ) recruited from an urban cancer center were r and omly assigned ( 2:1 ratio ) to a 12-week yoga intervention ( n = 84 ) or a 12-week waitlist control group ( n = 44 ) . Changes in QOL ( eg , Functional Assessment of Cancer Therapy ) from before r and om assignment ( T1 ) to the 3-month follow-up ( T3 ) were examined ; predictors of adherence were also assessed . Nearly half of all patients were receiving medical treatment . RESULTS Regression analyses indicated that the control group had a greater decrease in social well-being compared with the intervention group after controlling for baseline social well-being and covariates ( P < .0001 ) . Secondary analyses of 71 patients not receiving chemotherapy during the intervention period indicated favorable outcomes for the intervention group compared with the control group in overall QOL ( P < .008 ) , emotional well-being ( P < .015 ) , social well-being ( P < .004 ) , spiritual well-being ( P < .009 ) , and distressed mood ( P < .031 ) . Sixty-nine percent of intervention participants attended classes ( mean number of classes attended by active class participants = 7.00 + /- 3.80 ) , with lower adherence associated with increased fatigue ( P < .001 ) , radiotherapy ( P < .0001 ) , younger age ( P < .008 ) , and no  antiestrogen therapy  ( P < .02 ) . CONCLUSION Despite limited adherence , this intent-to-treat analysis suggests that yoga is associated with beneficial effects on social functioning among a medically diverse sample of breast cancer survivors . Among patients not receiving chemotherapy , yoga appears to enhance emotional well-being and mood and may serve to buffer deterioration in both overall and specific domains of QOL Bone marrow biopsy and aspiration are commonly used for diagnosing , treating , and following up after treatment for blood disorders and solid tumors . For adults , the infiltration of local anesthesia at the biopsy site has been used as the principal form of analgesia for bone marrow biopsy and aspiration .  Pain relief during these procedures is often incomplete , especially during aspiration of the bone marrow , and pain is likely to contribute to patient anxiety . Research ers at the Tabriz Hematology and Oncology Center in Iran conducted a study to quantify and evaluate the effectiveness of music therapy interventions on pain and anxiety control for 100 patients undergoing bone marrow biopsy and aspiration .  Participants in the study were r and omly assigned to one of two groups : one group listened to music during the procedure , and the other did not . Patients completed the  Spielberger State-Trait Anxiety Inventory  both before and after the procedure and reported pain severity by using a visual analog scale . Results showed that participants who listened to music had lower state anxiety and pain levels than those who did not listen to music
IMPORTANCE Creative arts therapies ( CATs ) can reduce anxiety , depression , pain , and fatigue and increase quality of life ( QOL ) in patients with cancer .
However , no systematic review of r and omized clinical trials ( RCTs ) examining the effects of CAT on psychological symptoms among cancer patients has been conducted .
OBJECTIVES To estimate the effect of CAT on psychological symptoms and QOL in cancer patients during treatment and follow-up and to determine whether the effect varied according to patient , intervention , and design characteristics .