The Effect of Music Therapy for Improving Quality of Life in Patients with Cancer Pain: An Evidence Based Case Report.

BACKGROUND: Music therapy is a frequently used complementary and creative arts treatment in psychosocial cancer care. Particularly in advanced cancer populations and palliative care, music therapy has recently received high attention in both research and clinical care. This evidence-based case report is aimed to assesed the effect of music therapy for improving quality of life in patients with cancer pain. METHODS: the search was conducted on Pubmed, Cochrane Library, and EMBASE according to clinical question. The studies were selected based on inclusion and exclusion criteria. The selected study was critically appraised. RESULTS: All selected studies significantly showed effectiveness of music therapy towards quality of life in cancer patient. CONCLUSION: Music therapy might be beneficial adjuvant for cancer patients.

Effect of Cholecalciferol Supplementation on Disease Activity and Quality of Life of Systemic Lupus Erythematosus Patients: A Randomized Clinical Trial Study.

BACKGROUND: Increase in the prevalence and survival rates has led to the assessment of disease activity and quality of life of SLE patients as targets in treatment. Cholecalciferol was considered as having a role in reducing disease activity and improving quality of life. METHODS: A double blind, randomized, controlled trial was conducted on female  outpatients aged 18-60 years with SLE, consecutively recruited from September to December 2021 at Cipto Mangunkusumo Hospital. Sixty subjects who met the research criteria were randomized and equally assigned into the cholecalciferol and placebo groups. The study outcomes were measured at baseline and after 12 weeks of intervention. RESULTS: Out of 60 subjects, 27 subjects in cholecalciferol group and 25 subjects in placebo group completed the intervention. There was a significant improvement on the level of vitamin D (ng/ml) after intervention in the cholecalciferol group, from an average of 15,69 ng/ml (8.1-28.2) to 49,90 ng/ml (26-72.1), and for the placebo group from 15,0 ng/ml (8.1-25,0) to 17.35 ng/ml (8.1-48.3) (p<0,000). Results of the MEX-SLEDAI score showed significant differences in both groups after the intervention, with a significant decrease in the cholecalciferol group from 2,67 (0-11) to 1,37 (0-6), compared to the placebo group from 2,6 (0-6) to  2,48 (0-6) (p<0,001). There were no significant differences on the quality of life in both groups. CONCLUSION: Supplementation of cholecalciferol 5000 IU/day for 12 weeks was statistically significant in increasing vitamin D levels and improving disease activity, but did not significantly improve the quality of life of SLE patients.

The Effect of Vitamin D Supplementation on Symptoms of Depression in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: The effect of vitamin D supplementation on depressive  symptoms in people with type 2 diabetes is still up for debate. The aim of this paper was to investigate the effect of vitamin D supplementation on symptoms of depression in type 2 diabetic patients. METHODS: The protocol for this review has been registered in PROSPERO:CRD42021231713. Searching for literature was conducted using Pubmed, EBSCOhost, and EMBASE. Randomised controlled trials (RCTs) regarding vitamin D supplementation in type 2 diabetic patients with depression were retrieved through a systematic search. The outcome measured was a change in depressive symptoms evaluated with any validated rating scale. Independent data extraction was conducted, and the study quality was assessed. A meta-analysis was carried out to calculate the improvement in depressive symptoms in the group receiving vitamin D and the control group. The available evidence in RCTs was analysed using the PRISMA approach, and clinical significance was determined using the GRADE system. Risk of bias was assessed using the Cochrane Risk of Bias Tool. RESULTS: Four RCTs were reviewed and three RCTs were meta-analysed. In two studies, vitamin D was statistically effective in improving depressive symptoms in type 2 diabetic patients. Three randomised controlled trials  were included in the meta-analysis with 161 subjects using depression score as an outcome assessment. Vitamin D is significantly more effective than placebo (95% CI: -0.70 to - 0.08, p = 0.01). CONCLUSION: Vitamin D supplementation is effective in improving depressive symptoms in type 2 diabetic patients. Future research with different geographical areas and larger samples should be done to further assess the benefits.

Health Issues Among Healthcare Workers During COVID-19 Pandemic: a Psychosomatic Approach.

Healthcare workers as the front-liner to fight COVID-19 pandemic, need reassurance of their safety. The stress and the demands from the healthcare system can affect their health as well as the morality. Hence, psychosomatic approach should be used to keep their condition in good shape. The combination between biological, psychological, and social approaches may affect their vulnerability from SARS-CoV-2 infection. The biological aspect includes personal protective equipment, nutrition, and resting/sleeping time. The psychological distress is shown to affect the immune system; and mental relaxation and management of work shift may reduce the distress. There should be an effort from the stakeholders to keep the morality of the healthcare workers. The social aspect such as providing place to live, having supportive family members, and avoiding stigmatization also improve their psychological health. In conclusion, psychosomatic approach is important to keep the healthcare workers healthy.

Characteristics of Palliative Patients, Insights of Patients and Families, and the Impact of Estimated Survival Time on Therapy Decisions.

BACKGROUND: chronic and terminal diseases require holistic therapy that covers the biopsychosocial aspect, and it can be found in palliative therapy. Patients who receive palliative therapy exhibit very diverse profiles. As such, researchers are keen to study the general characteristics of palliative patients. In addition, researchers will also assess the patient's and their family's insight that influences the success of the therapy and the impact of estimated survival time in making treatment decisions. METHODS: this research used cross-sectional descriptive analytic study and secondary data of 300 palliative patients who consult to Psychosomatic Palliative Team at Dr. Cipto Mangunkusumo Hospital. The data were processed using SPSS version 25. The data processed included: sociodemographic characteristics, length of stay, incidence of death in hospital, DNR cases, the patient's and their family's insight, and the impact of estimated survival time on treatment decisions. RESULTS: most palliative patients were women (52.0%) aged 51 - 60 years (27.0%), unemployed (29.0%), and suffered from cancer (55.3%). In addition, the patients were generally treated for less than 1 month (83.6%), died in the hospital (37.3%), and consented to DNR orders (36.7%). These DNR cases are highly correlated to the family's understanding regarding the prognosis of the patient's condition (p = 0.022). The family's understanding of the diagnosis, prognosis, and treatment goals (92.3%, 81.3%, and 87.7%) was better than the patient's (79.0%, 64.0%, and 69.7%). Furthermore, no link was found between the therapy choice (optimal, withholding, and withdrawing therapies) with the patient's estimated survival time (p = 0.174). CONCLUSION: female, elderly, and cancer patients most often get palliative therapy. The consent for DNR orders to palliative patient is notably frequent. Currently, the family's insight is much better than the patient's, which means that health care providers need to improve patient education and information. In addition, patients and families generally still opt for optimal therapy despite low estimated survival time.

Factors Associated with Pain in Palliative Patients and the Role of Spiritual Services in Pain Management.

BACKGROUND: pain is one of the most often symptoms experienced by patients with advanced or chronic diseases which can cause a decrease in the quality of life of palliative patients. Pain in palliative patients has not yet received enough attention, especially factors associated with pain and its management. This study aimed to determine the factors associated with pain in palliative patients and also assess whether there is a two-way relationship between psychological factors and pain. In addition, we will also see whether spiritual services play a role in relieving pain. METHODS: cross-sectional study were used and secondary data were obtained from medical records of 285 palliative patients at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The data were processed to determine the psycho-socio-demographic characteristics, the reciprocal relationships of psychological and pain aspects, and the relationship of pharmacological therapy (opioids), non-pharmacological therapy (spiritual services), and combination of both therapies in pain management. RESULTS: of the 285 palliative patients, 60.3% had pain, which was found more in cancer patients (74.4% vs 25.6%). Pain was found more in patients aged 41-60 years (51.1%), women (51.2%), and unemployed (30.2%). The severity of the pain was found to be significant in patients with depressive symptoms (p=0.045), while patients with anxiety symptoms (p=0.155) and sleep disorders (p=0.619) had no significant relationship. Pain experienced by palliative patients was not statistically significant in causing depression (p=0.058), anxiety (p=0.107), and sleep disorder (p=0.639). Moreover, pain management with opioids, spiritual services, or combination of them turned out to have significant results (p=0.022). CONCLUSION: pain in palliative patients is mainly experienced by cancer patients and the elderly. Psychological factors affect the condition of pain, so the management that includes biopsychosocial aspect will be able to reduce pain significantly.

Development and challenges of palliative care in Indonesia: role of psychosomatic medicine.

PURPOSE OF REVIEW: To summarize the current status of palliative care and the role of psychosomatic medicine in Indonesia. RECENT FINDINGS: Palliative care is not a new issue in Indonesia, which has been improving palliative care since 1992 and developed a palliative care policy in 2007 that was launched by the Indonesian Ministry of Health. However, the progress has been slow and varied across the country. Currently, palliative care services are only available in a few major cities, where most of the facilities for cancer treatment are located. Psychosomatic medical doctors have advantages that contribute to palliative care because of their special training in communication skills to deal with patients from the standpoints of both mind and body. SUMMARY: Palliative care services in Indonesia are established in some hospitals. Future work is needed to build capacity, advocate to stakeholders, create care models that provide services in the community, and to increase the palliative care workforce. Psychosomatic medicine plays an important role in palliative care services.