Effect of a Group Music Nursing Intervention on Anxiety Among Individuals with Mild to Moderate Dementia in Los Angeles Assisted Living Facilities

This study tested the hypothesis that an active-passive group music intervention will decrease anxiety among individuals diagnosed with mild to moderate dementia in assisted living facilities (ALFs) as compared to a control group engaged in care as usual. This study also described the feasibility and acceptability of active-passive group music interventions delivered by a Registered Nurse (RN) without a university or college degree in music intervention techniques to individuals with mild to moderate dementia in an ALF. The study used a quasi-experimental cross-over design with a simplified cluster randomization strategy; simplified because there were only two sites. Thirteen participants were invited, 8 from one facility and 5 from the other. The sample comprised of participants ranging from age 74 thru 98 with Global Deterioration Stages ranging from 2-5. The majority of participants were female, White and were college educated. Music was considered moderately important to very important. Music was used to effect anxiety levels. Altogether 12 intervention sessions were offered or 6 for each arm. There was a 4 week wash-out period. Four RAID measures were taken during each arm at baseline. Specific Aim 1: Insignificant decreases to anxiety existed by group, however, a trend showing decreases to anxiety levels existed over time (p=0.002): Intervention Group 1 = 18.00 at point 1 to 14.83 at point 4; Intervention Group 2 = 17.20 at point 1 to 10.80 at point 4. During control periods, RAID were: Group 1= 13.33 at point 1 to 10.83 at point 4; and Group 2 = 13.60 at point 1 to 10.40 at point 4. Specific Aim 2: With music education, the use of RNs to deliver group music interventions and supervise music interventions in healthcare is promising

Group Music Interventions for Dementia-associated Anxiety: A Systematic Review

OBJECTIVE: This systematic review examines the few published studies using group music interventions to reduce dementia-associated anxiety, the delivery of such interventions, and proposes changes to nursing curriculum for the future. DESIGN: Literature review. METHODS: All quantitative studies from 1989 to 2014 were searched in CINAHL and PubMed databases. Only published articles written in English were included. Studies excluded were reviews, non-human subjects, reports, expert opinions, subject age less than 65, papers that were theoretical or philosophical in nature, individual music interventions, case studies, studies without quantification of changes to anxiety, and those consisting of less than three subjects. Components of each study are analyzed and compared to examine the risk for bias. RESULTS: Eight articles met the inclusion criteria for review. Subject dementia severity ranged from mild to severe among studies reviewed. Intervention delivery and group sizes varied among studies. Seven reported decreases to anxiety after a group music intervention. CONCLUSIONS: Group music interventions to treat dementia-associated anxiety is a promising treatment. However, the small number of studies and the large variety in methods and definitions limit our ability to draw conclusions. It appears that group size, age of persons with dementia and standardization of the best times for treatment to effect anxiety decreases all deserve further investigation. In addition, few studies have been conducted in the United States. In sum, while credit is due to the nurses and music therapists who pioneered the idea in nursing care, consideration of patient safety and improvements in music intervention delivery training from a healthcare perspective are needed. Finally, more research investigating resident safety and the growth of nursing roles within various types of facilities where anxiety is highest, is necessary

Music therapy in Huntington’s disease: a protocol for a multi-center randomized controlled trial

BACKGROUND: Huntington’s disease is a progressive, neurodegenerative disease with autosomal dominant inheritance, characterized by motor disturbances, cognitive decline and behavioral and psychological symptoms. Since there is no cure, all treatment is aimed at improving quality of life. Music therapy is a non-pharmacological intervention, aiming to improve the quality of life, but its use and efficacy in patients with Huntington’s disease has hardly been studied. In this article, a protocol is described to study the effects of music therapy in comparison with a control intervention to improve quality of life through stimulating expressive and communicative skills. By targeting these skills we assume that the social-cognitive functioning will improve, leading to a reduction in behavioral problems, resulting in an overall improvement of the quality of life in patients with Huntington’s disease. METHODS/DESIGN: The study is designed as a multi-center single-blind randomised controlled intervention trial. Sixty patients will be randomised using centre-stratified block-permuted randomisation. Patients will be recruited from four long-term care facilities specialized in Huntington’s disease-care in The Netherlands. The outcome measure to assess changes in expressive and communication skills is the Behaviour Observation Scale Huntington and changes in behavior will be assessed by the Problem Behaviour Assesment-short version and by the BOSH. Measurements take place at baseline, then 8, 16 (end of intervention) and 12 weeks after the last intervention (follow-up). DISCUSSION: This randomized controlled study will provide greater insight into the effectiveness of music therapy on activities of daily living, social-cognitive functioning and behavior problems by improving expressive and communication skills, thus leading to a better quality of life for patients with Huntington’s disease. TRIAL REGISTRATION: Netherlands Trial Register: NTR4904, registration date Nov. 15, 2014