Online group music therapy: proactive management of undergraduate students' stress and anxiety.

Introduction: In alignment with the World Health Organization's (WHO) goal to provide comprehensive and integrated mental health services in community-based settings, this randomized control trial explored the efficacy of online group music therapy as a proactive intervention for reducing stress and anxiety in university students who do not necessarily have a diagnosis. Methods: The study took place during COVID-19 restrictions. Students who volunteered were randomly assigned to 6 weeks of weekly (1) online active group music therapy, (2) online receptive group music therapy, (3) online group verbal therapy (standard of care), or (4) no-intervention (control group). Students rated their stress (Likert scale) and anxiety [State-Trait Anxiety Inventory, State version (STAI-S)], and provided heart rate variability (HRV) using a phone app, pre and post each therapy session. Results: STAI-S and Likert stress scores significantly reduced from pre to post 45-min online music therapy sessions, with moderate evidence that these changes did not differ from the standard of care (verbal therapy). HRV results were not analyzed statistically as HRV collection was likely compromised due to challenges of remote collection. Students completed the Perceived Stress Scale (PSS) and provided a hair sample for cortisol analysis before and after the 6-week intervention. Changes in stress from week 1 to week 6 were not observed in the PSS measure; however, cortisol increased significantly in the control group as the term progressed, while it remained relatively stable in the therapy groups, suggesting therapy may lead to greater control of stress. Of participants' demographic characteristics, music sophistication, personality, and changes in quality of life, only the personality trait of conscientiousness correlated significantly with PSS, suggesting online group therapy may be beneficial for a wide range of university students. Discussion: The results suggest group music therapy can be as effective as group verbal therapy. Further, the study indicates that online delivery can be achieved effectively, supporting the idea that remote therapy may be a viable option for other populations. While the study should be replicated with a larger multi-site sample, it provides one example toward achieving a health-promoting culture on university campuses, consistent with the mental health goals of the Okanagan Charter.

The Use of Music to Manage Burnout in Nurses: A Systematic Review.

OBJECTIVE: There is a high prevalence of burnout in nurses. This systematic review investigates the use of music to manage burnout in nurses. DATA SOURCE: MEDLINE (Ovid), MEDLINE InProcess/ePubs, Embase, APA PsycINFO, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched. STUDY INCLUSION AND EXCLUSION CRITERIA: Full-text articles were selected if the study assessed the use of music to manage burnout in nurses. Burnout was defined according to the International Classification of Diseases 11th Revision. DATA EXTRACTION: Data were extracted using an Excel sheet. The second and third authors independently extracted study characteristics, frequency and type of music engagement, measures of burnout, and burnout outcomes (occupational stress, coping with stress, and related symptoms such as anxiety). DATA SYNTHESIS: Study and outcome data were summarized. RESULTS: The literature search resulted in 2210 articles and 16 articles were included (n = 1205 nurses). All seven cross-sectional studies reported upon nurses' self-facilitated use of music including music listening, playing instruments, and music entertainment for coping or preventing stress, supporting wellbeing, or enhancing work engagement. Externally-facilitated music engagement, including music listening, chanting, percussive improvisation, and song writing, was reported in the four randomized controlled trials and five cohort studies with reductions in burnout outcomes. CONCLUSIONS: Self-facilitated and externally-facilitated music engagement can help to reduce burnout in nurses.

Extra-Curricular Activities and Well-Being: Results From a Survey of Undergraduate University Students During COVID-19 Lockdown Restrictions.

Participation in extra-curricular activities has been found to associate with increased well-being. Here we investigated in a survey (n = 786) what activities university students at a Canadian university engaged in during the stressful COVID-19 pandemic lockdown in April, 2020, which coincided with a novel online exam period, and how these activities related to perceived well-being, anxiety (STAI-S), social aspects of activities, and personality. Sixty-five percentage of students scored in the high anxiety category of the STAI-S, an alarming statistic given that only 24% had reached out for professional supports. This is consistent with reports that current supports on university campuses are inadequate. Listening to music (92%) and watching movies/series (92%) were engaged in most frequently, followed by socializing virtually (89%) and engaging in social media (85%). The activities students rated as most helpful to their well-being were somewhat different, with outdoor exercise rated highest, followed by socializing virtually and listening to music. While all activities were rated as beneficial, those with a social component tended to have high ratings, consistent with students attempting to replace lost social interactions. Linear regression models found few associations between STAI-S scores and other measures, likely because of large individual differences and lack of a pre-pandemic baseline needed to assess changes in anxiety. The importance of individual differences was evident in that those higher in conscientiousness or extraversion or emotional stability were more likely to engage in exercise, while those higher in openness to experience were more likely to engage in journaling, playing a musical instrument, or singing, with a trend for higher engagement in song writing. Individual differences were also evident in that equal numbers of students gave positive and negative comments related to their well-being during the pandemic. The individual differences uncovered here suggest that having a variety of proactive interventions would likely reach more students. Indeed, 52% indicated an interest in online group music therapy, 48% in art therapy and 40% in verbal therapy, despite music and art therapies being virtually non-existent on campuses. In sum, the findings highlight the importance of choice in extra-curricular activities and therapies that support well-being.

Biomarkers of Stress in Music Interventions: A Systematic Review.

Psychological stress is a significant public health concern as it is associated with various comorbidities and long-term health implications. Music interventions are emerging therapies for alleviating psychological stress and improving one's physical and mental well-being. We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines for reporting to identify all neuroendocrine biomarkers used to evaluate psychological stress in randomized control trials involving music interventions. We identified 18 unique biomarkers of stress from 14 full-text randomized controlled trials studies. Only one of the 14 music studies included a music therapy intervention. The most frequently used biomarkers across the studies were plasma cortisol, salivary cortisol, and salivary α-amylase. Of the 14 studies, 12 included in this review assessed at least one of these three biomarkers. Of these 12 studies, five papers reported p-values for changes in both stress biomarkers and psychological stress outcome measures. Four of the five studies found significant p-values for the reduction of both stress biomarkers and psychological stress in music intervention groups. The variety of stress biomarkers used and the variance in study protocols makes it difficult to assess the magnitude of effect of music interventions on psychological stress. However, our findings suggest that music interventions have the potential for reducing both stress biomarker levels and psychological stress in acute stress situations.