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1.
J Music Ther ; 57(3): 315-352, 2020 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-32227108

RESUMO

Music therapy clinicians bring an important perspective to the design and conduct of clinically meaningful studies. Unfortunately, there continue to be roadblocks that hinder clinician involvement in research and the development of successful partnerships between academic researchers and practicing clinicians. To help grow clinician involvement, it is important that research teams share their experiences. As such, the purpose of this qualitative study was to share music therapists' perspectives about their experience of working as a research clinician on a large multisite randomized controlled trial. 10 board-certified music therapists provided written responses to 6 data-generating questions about: (a) reasons for participating, (b) perceived challenges and benefits, (c) experiences of quality assurance monitoring, (d) professional growth, (e) value of research, and (f) advice for clinicians considering research involvement. Using thematic content analysis, we identified primary themes and subthemes for each question (20 themes; 30 subthemes). Qualitative analysis revealed not only common challenges, such as reconciling clinical and research responsibilities, but also benefits, including continued professional growth, greater understanding of research processes, and research participation as a way to advocate and advance the profession. Finally, for clinicians interested in becoming involved in research, therapists noted the importance of having workplace support from a mentor, supervisor, and/or administrator; seeking out available resources; and knowing roles and responsibilities before initiating research involvement. Findings offer important insight and recommendations to support the involvement of clinicians in research and support further exploration of clinician involvement in dissemination efforts to improve translation and uptake of research into practice.


Assuntos
Musicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Pesquisadores , Certificação , Feminino , Humanos , Mentores , Música , Pesquisa Qualitativa
2.
J Music Ther ; 57(1): 3-33, 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-31802124

RESUMO

This empirical phenomenology study reports adolescents/young adults (AYA) experiences of the therapeutic music video (TMV) intervention arm of a randomized controlled clinical trial (Children's Oncology Group; COG-ANUR0631; R01 NR008583) during hospitalization for a hematopoietic stem cell transplant. A purposive subsample of 14 AYA were interviewed using a broad open-ended data-generating question about their TMV intervention experiences. At the end of each interview, we also asked AYA for suggestions on how to improve the TMV. Analysis of the narrative data resulted in four theme categories: (a) An Interwoven Experience of the Transplant and TMV Intervention; (b) TMV as a Guided Opportunity for Reflection, Self-Expression, and Meaning-Making; (c) Telling My Story: The Work of Deriving Meaning; and (d) A Way to Overcome the Bad Side of Cancer. AYA suggestions for improving the TMV are also summarized. Findings provide insight into ways the TMV supports AYA efforts to overcome distress and challenges by providing opportunities to reflect on what is meaningful, connect with others, and explore/identify personal strengths. Findings also inform our understanding about how the TMV may have functioned (i.e., mechanisms of action) to bring about significant change in AYA self-reported outcomes (i.e., positive coping, social support, and family function) for this trial.


Assuntos
Transplante de Células-Tronco Hematopoéticas/psicologia , Musicoterapia , Resiliência Psicológica , Gravação em Vídeo , Adaptação Psicológica , Adolescente , Ansiedade/prevenção & controle , Criança , Feminino , Células-Tronco Hematopoéticas , Humanos , Masculino , Música , Narração , Neoplasias/terapia , Apoio Social , Estresse Psicológico/prevenção & controle , Adulto Jovem
3.
J Music Ther ; 55(1): 62-82, 2018 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-29514272

RESUMO

BACKGROUND: Although evidence suggests music therapy lowers the heart rate of ill adults undergoing painful procedures and premature infants in the NICU, the effect of music therapy interventions on physiologic response in infants with congenital heart disease (CHD) being cared for in the cardiac intensive care unit (CICU) has not been explored. OBJECTIVE: The purpose of this study was to explore the effect of the music therapy entrainment on physiologic responses of infants with CHD in the CICU. METHODS: Five infants in the CICU received music therapy entrainment 3-5 times per week for up to 3 weeks. Sessions took place both prior to and after the infant's surgical cardiac repair. Heart rate, respiratory rate, blood pressure, and oxygen saturations were recorded every 15 seconds for 20 minutes prior to the intervention (baseline), during the 20-minute music therapy entrainment (intervention), and for 20 minutes after the intervention (return to baseline). Comparisons of baseline to intervention measures were based on means, standard deviations, and derivatives of the signal. RESULTS: Four of 5 infants experienced a decrease in average heart and respiratory rates as well as improvement in the derivative of the heart rate signal. Greater improvements were found when infants were located in the open bay and were receiving sedatives or narcotics. CONCLUSIONS: Our findings provide initial evidence that music therapy entrainment may be a valuable intervention to support improved physiologic stability in infants with CHD.


Assuntos
Cardiopatias/terapia , Recém-Nascido Prematuro/fisiologia , Musicoterapia/métodos , Adulto , Pressão Sanguínea/fisiologia , Feminino , Cardiopatias/congênito , Humanos , Lactente , Unidades de Terapia Intensiva Neonatal , Masculino , Projetos Piloto
4.
J Music Ther ; 55(1): 83-108, 2018 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-29471518

RESUMO

BACKGROUND: Supportive music and imagery and music listening interventions have been effective in decreasing distress and improving mood in cancer patients receiving chemotherapy, but it is unclear whether the two interventions differ in their treatment benefits. Furthermore, previous studies have not examined moderators to determine which subgroup(s) of patients may benefit most from each intervention. OBJECTIVE: To examine the effects of supportive music and imagery compared with preferred music listening on responsiveness to music therapy, distress, anxiety and depression, and benefit finding. A secondary purpose was to explore sense of coherence and locus of control as potential moderators of intervention effectiveness. METHODS: A single-session, two-group comparative effectiveness randomized trial in two cancer centers. Patients were randomized to supportive music and imagery or preferred music listening during outpatient chemotherapy treatment. Data were collected at baseline and immediately after the 45-minute session. ANCOVA models were used to determine main effects of intervention as well as pairing potential moderators with group assignment to explore differences in intervention effects by moderator. RESULTS: There were differential effects between the two interventions with the supportive music and imagery group scoring higher in responsiveness to music therapy and benefit finding. The music listening group scores indicated lower distress. The exploratory moderating analyses suggested Health Locus of Control-Internal and Sense of Coherence influenced intervention effectiveness. CONCLUSIONS: Music and imagery and preferred music listening experiences may serve different therapeutic purposes, access and activate different patient resources, and may be helpful at different stages of treatment.


Assuntos
Ansiedade/terapia , Depressão/terapia , Imagens, Psicoterapia , Musicoterapia/métodos , Neoplasias/tratamento farmacológico , Afeto , Idoso , Percepção Auditiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Música , Neoplasias/psicologia , Pacientes Ambulatoriais , Senso de Coerência , Resultado do Tratamento
5.
J Nurs Scholarsh ; 49(4): 411-420, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28544507

RESUMO

PURPOSE: To assess the efficacy of embedded theta brainwave frequency in music using binaural beat technology (BBT) compared to music alone on the cardiovascular stress response in military service members with postdeployment stress. DESIGN: A double-blinded, randomized, pre- and postintervention trial. METHODS: Seventy-four military services members with complaint of postdeployment stress were randomized to either music with BBT or music alone. Each group listened to their respective intervention for a minimum of 30 min at bedtime for three consecutive nights a week for a total of 4 weeks. A 20-min pre- and postintervention heart rate variability (HRV) stress test and daily perceived stress via diaries assessed intervention efficacy. FINDINGS: There was a statistical difference (p = .01) in low-frequency HRV between the music with BBT group compared to the music only group. The average low-frequency HRV decreased in the music with BBT group 2.5 ms2 /Hz, while in the music only group it increased 7.99 ms2 /Hz. There was also a significant difference (p = .01) in the high-frequency HRV measures, with the music with BBT group showing an increase in HRV by 2.5 ms2 /Hz compared to the music only group, which decreased by 7.64 ms2 /Hz. There were significant (p = .01) differences found in total power measures, with the music only group decreasing by 1,113.64 ms2 /Hz compared to 26.68 ms2 /Hz for the music with BBT group. Finally, daily diaries consistently showed that participants who used BBT reported less stress over the course of the 4 weeks. CONCLUSIONS: When placed under an acute stressor, participants who used music with embedded BBT showed a decrease in sympathetic responses and an increase in parasympathetic responses, while participants who used music alone had the opposite effect. CLINICAL RELEVANCE: The use of BBT in the theta brainwave frequency embedded into music decreases physical and psychological indications of stress. BBT embedded with beta and delta frequencies may improve cognitive functioning and sleep quality, respectively.


Assuntos
Estimulação Acústica/métodos , Frequência Cardíaca/fisiologia , Militares/psicologia , Musicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Estudos Prospectivos , Transtornos de Estresse Pós-Traumáticos/psicologia , Resultado do Tratamento
6.
Cancer Nurs ; 40(6): 454-463, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27984241

RESUMO

BACKGROUND: Empirically derived and tested models are necessary to develop effective, holistic interventions to improve positive health outcomes in adolescents and young adults (AYA) with cancer, yet few exist. This article is the second of 2 articles reporting on evaluation of the Resilience in Illness Model (RIM) as a predictive model to guide positive health research and practice. OBJECTIVE: The aim of this study was to report the confirmatory model evaluation of the RIM. METHODS: A confirmatory evaluation of RIM was done using baseline data from a sample of 113 AYA aged 11 to 24 years who were undergoing hematopoietic stem cell transplant and enrolled in a randomized controlled trial of a behavioral intervention to enhance resilience. Data were analyzed using latent variable structural equation modeling. RESULTS: Goodness-of-fit indices supported RIM as a confirmed model that accounted for large amounts of variance in the outcomes of self-transcendence (62%) and resilience (72%), and in 3 of 5 mediators, specifically social integration (74%), courageous coping (80%), and hope-derived meaning (87%), as well as small to moderate amounts of variance in the remaining mediators of defensive coping (1%) and family environment (35%). CONCLUSIONS: Findings establish the RIM as a plausible predictive framework for explaining ways AYA with cancer transcend their illness and achieve resilience resolution and for guiding intervention studies in this population. Additional research is needed to explore RIM's transferability based on stage of illness, other chronic diseases, and cultural diversity. IMPLICATIONS FOR PRACTICE: Results support the RIM as an appropriate guide for developing and evaluating interventions to foster positive adjustment in AYA with cancer.


Assuntos
Adaptação Psicológica , Transplante de Células-Tronco Hematopoéticas/psicologia , Neoplasias/psicologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Autoimagem , Adulto Jovem
7.
J Music Ther ; 52(3): 376-93, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26405080

RESUMO

BACKGROUND: Hospice music therapy is delivered in both homes and nursing homes (NH). No studies to date have explored differences in music therapy delivery between home and NH hospice patients. OBJECTIVE: To compare music therapy referral reasons and delivery for hospice patients living in NH versus home. METHODS: A retrospective, electronic medical record review was conducted from a large U.S. hospice of patients receiving music therapy between January 1, 2006, and December 31, 2010. RESULTS: Among the 4,804 patients, 2,930 lived in an NH and 1,847 patients lived at home. Compared to home, NH hospice patients were more likely to be female, older, unmarried, and Caucasian. For home hospice patients, the top referral reasons were patient/family emotional and spiritual support, quality of life, and isolation. The most frequent referral reasons for NH hospice patients were isolation, quality of life, and patient/family emotional and spiritual support. Differences in music therapy delivery depended mainly on patients' primary diagnosis and location of care. CONCLUSIONS: Results suggest differences in referral reasons and delivery based on an interaction between location of care and patient characteristics. Delivery differences are likely a result of individualized assessment and care plans developed by the music therapist and other interdisciplinary team members to address the unique needs of the patient. Thus, it is important to have professionally trained music therapists assess and provide tailored music-based interventions for patients with different referral reasons and personal characteristics. This study also supports staffing decisions based on patient need rather than average daily census.


Assuntos
Cuidados Paliativos na Terminalidade da Vida/organização & administração , Hospitais para Doentes Terminais/organização & administração , Musicoterapia/métodos , Casas de Saúde/organização & administração , Cuidados Paliativos , Idoso , Atenção à Saúde , Emoções/fisiologia , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Prontuários Médicos , Música/psicologia , Avaliação de Resultados em Cuidados de Saúde , Qualidade de Vida , Encaminhamento e Consulta , Estudos Retrospectivos , Estados Unidos
8.
J Music Ther ; 52(3): 353-75, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26333953

RESUMO

BACKGROUND: Previous research has demonstrated modest benefits from music-based interventions, specifically music and imagery interventions, during cancer care. However, little attention has been paid to measuring the benefits of music-based interventions using measurement instruments specifically designed to account for the multidimensional nature of music-imagery experiences. OBJECTIVE: The purpose of this study was to describe the development of, and psychometrically evaluate, the Music Therapy Self-Rating Scale (MTSRS) as a measure for cancer patients engaged in supportive music and imagery interventions. METHODS: An exploratory factor analysis using baseline data from 76 patients who consented to participate in a music-based intervention study during chemotherapy. RESULTS: Factor analysis of 14 items revealed four domains: Awareness of Body, Emotionally Focused, Personal Resources, and Treatment Specific. Internal reliability was excellent (Cronbach alphas ranging from 0.75 to 0.88) and construct and divergent-discriminant validity supported. CONCLUSIONS: The MTSRS is a psychometrically sound, brief instrument that captures essential elements of patient experience during music and imagery interventions.


Assuntos
Imagens, Psicoterapia/normas , Musicoterapia/normas , Neoplasias/terapia , Autoeficácia , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Conscientização/fisiologia , Emoções/fisiologia , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Música , Neoplasias/psicologia , Psicometria , Reprodutibilidade dos Testes , Adulto Jovem
9.
J Pain Symptom Manage ; 50(2): 225-31, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25839735

RESUMO

CONTEXT: Music therapy is a common discretionary service offered within hospice; however, there are critical gaps in understanding the effects of music therapy on hospice quality indicators, such as family satisfaction with care. OBJECTIVES: The purpose of this study was to examine whether music therapy affected family perception of patients' symptoms and family satisfaction with hospice care. METHODS: This was a retrospective, cross-sectional analysis of electronic medical records from 10,534 cancer patients cared for between 2006 and 2010 by a large national hospice. Logistic regression was used to estimate the effect of music therapy using propensity scores to adjust for non-random assignment. RESULTS: Overall, those receiving music therapy had higher odds of being female, having longer lengths of stay, and receiving more services other than music therapy, and lower odds of being married/partnered or receiving home care. Family satisfaction data were available for 1495 (14%) and were more likely available if the patient received music therapy (16% vs. 12%, P < 0.01). There were no differences in patient pain, anxiety, or overall satisfaction with care between those receiving music therapy vs. those not. Patients who received music therapy were more likely to report discussions about spirituality (odds ratio [OR] = 1.59, P = 0.01), had marginally less trouble breathing (OR = 0.77, P = 0.06), and were marginally more likely to receive the right amount of spiritual support (OR = 1.59, P = 0.06). CONCLUSION: Music therapy was associated with perceptions of meaningful spiritual support and less trouble breathing. The results provide preliminary data for a prospective trial to optimize music therapy interventions for integration into clinical practice.


Assuntos
Família/psicologia , Cuidados Paliativos na Terminalidade da Vida/psicologia , Musicoterapia , Transtornos Respiratórios/terapia , Espiritualidade , Idoso , Estudos Transversais , Registros Eletrônicos de Saúde , Feminino , Cuidados Paliativos na Terminalidade da Vida/métodos , Humanos , Tempo de Internação , Modelos Logísticos , Masculino , Neoplasias/fisiopatologia , Neoplasias/terapia , Percepção , Garantia da Qualidade dos Cuidados de Saúde , Transtornos Respiratórios/fisiopatologia , Estudos Retrospectivos , Resultado do Tratamento
11.
Cancer ; 120(6): 909-17, 2014 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-24469862

RESUMO

BACKGROUND: To reduce the risk of adjustment problems associated with hematopoietic stem cell transplant (HSCT) for adolescents/young adults (AYAs), we examined efficacy of a therapeutic music video (TMV) intervention delivered during the acute phase of HSCT to: 1) increase protective factors of spiritual perspective, social integration, family environment, courageous coping, and hope-derived meaning; 2) decrease risk factors of illness-related distress and defensive coping; and 3) increase outcomes of self-transcendence and resilience. METHODS: This was a multisite randomized, controlled trial (COG-ANUR0631) conducted at 8 Children's Oncology Group sites involving 113 AYAs aged 11-24 years undergoing myeloablative HSCT. Participants, randomized to the TMV or low-dose control (audiobooks) group, completed 6 sessions over 3 weeks with a board-certified music therapist. Variables were based on Haase's Resilience in Illness Model (RIM). Participants completed measures related to latent variables of illness-related distress, social integration, spiritual perspective, family environment, coping, hope-derived meaning, and resilience at baseline (T1), postintervention (T2), and 100 days posttransplant (T3). RESULTS: At T2, the TMV group reported significantly better courageous coping (Effect Size [ES], 0.505; P = .030). At T3, the TMV group reported significantly better social integration (ES, 0.543; P = .028) and family environment (ES, 0.663; P = .008), as well as moderate nonsignificant effect sizes for spiritual perspective (ES, 0.450; P = .071) and self-transcendence (ES, 0.424; P = .088). CONCLUSIONS: The TMV intervention improves positive health outcomes of courageous coping, social integration, and family environment during a high-risk cancer treatment. We recommend the TMV be examined in a broader population of AYAs with high-risk cancers.


Assuntos
Transplante de Células-Tronco Hematopoéticas/psicologia , Musicoterapia/métodos , Resiliência Psicológica , Adaptação Psicológica , Adolescente , Adulto , Ansiedade/prevenção & controle , Criança , Relações Familiares , Feminino , Células-Tronco Hematopoéticas , Esperança , Humanos , Masculino , Isolamento Social/psicologia , Apoio Social , Estresse Psicológico/prevenção & controle , Adulto Jovem
12.
J Music Ther ; 50(2): 123-48, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24156190

RESUMO

BACKGROUND: Music therapists have an ethical and professional responsibility to provide the highest quality care possible to their patients. Much of the time, high quality care is guided by evidence-based practice standards that integrate the most current, available research in making decisions. Accordingly, music therapists need research that integrates multiple ways of knowing and forms of evidence. Mixed methods research holds great promise for facilitating such integration. At this time, there have not been any methodological articles published on mixed methods research in music therapy. OBJECTIVE: The purpose of this article is to introduce mixed methods research as an approach to address research questions relevant to music therapy practice. METHODS: This article describes the core characteristics of mixed methods research, considers paradigmatic issues related to this research approach, articulates major challenges in conducting mixed methods research, illustrates four basic designs, and provides criteria for evaluating the quality of mixed methods articles using examples of mixed methods research from the music therapy literature. CONCLUSIONS: Mixed methods research offers unique opportunities for strengthening the evidence base in music therapy. Recommendations are provided to ensure rigorous implementation of this research approach.


Assuntos
Atitude Frente a Saúde , Benchmarking , Pesquisa Biomédica/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Pesquisa sobre Serviços de Saúde/métodos , Musicoterapia/métodos , Medicina Baseada em Evidências , Humanos , Planejamento de Assistência ao Paciente , Relações Profissional-Paciente , Pesquisa Qualitativa , Reprodutibilidade dos Testes
13.
Support Care Cancer ; 21(7): 1827-33, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23397094

RESUMO

PURPOSE: Many breast cancer survivors (BCS) take multiple medications for health problems associated with the treated cancer and other noncancer comorbidities. However, there is no published, large-scale descriptive evaluation of medication use in BCS compared to midlife women. The purpose of this study was (1) to compare the number and types of prescription medications and over-the-counter medications between BCS and midlife women without cancer and (2) to assess possible drug-drug interactions by evaluating the cytochrome P450 isoform properties of medications (inductors and inhibitors) in both groups. METHODS: A cross-sectional, descriptive, comparative design was used. Baseline data from 98 BCS and 138 midlife women without cancer was analyzed from a behavioral intervention trial for menopausal symptoms. RESULTS: BCS were taking significantly more prescription medications and a larger variety of different types of medication classifications (p < 0.05) after controlling for group differences (race, noncancer comorbid conditions, marital status, income, and smoking) in demographics. Twenty-four women were taking at least one medication considered to be a cytochrome P450 isoforms (CYP) inhibitor or inducer capable of clinical drug-drug interactions with no differences in CYP inhibitors or inducers found between groups. CONCLUSION: BCS are taking a vast array of medications during survivorship. It is unclear if prescription medications are managed by a single healthcare provider or several providers. Clinical implications are to monitor for possible interactions among the various prescription medications, over-the-counter medications, and supplements. Implications for behavioral and biomedical research are that clinical studies need to carefully assess and account for multiple medication uses. RELEVANCE OF THE STUDY: The findings of this study are relevant to research and practice for both oncology and general practitioners. The importance of assessing medication information provides information about symptom management in individuals surviving cancer. In addition, the potential interaction of drugs impacts efficacy of various treatments and impacts compliance by patients.


Assuntos
Neoplasias da Mama , Suplementos Nutricionais , Medicamentos sem Prescrição/administração & dosagem , Medicamentos sob Prescrição/administração & dosagem , Sobreviventes , Adulto , Idoso , Comorbidade , Interações Medicamentosas , Feminino , Humanos , Pessoa de Meia-Idade , Cooperação do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
CA Cancer J Clin ; 63(3): 167-92, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23355109

RESUMO

Hot flashes are prevalent and severe symptoms that can interfere with mood, sleep, and quality of life for women and men with cancer. The purpose of this article is to review existing literature on the risk factors, pathophysiology, and treatment of hot flashes in individuals with cancer. Electronic searches were conducted to identify relevant English-language literature published through June 15, 2012. Results indicated that risk factors for hot flashes in cancer include patient-related factors (eg, age, race/ethnicity, educational level, smoking history, cardiovascular risk including body mass index, and genetics) and disease-related factors (eg, cancer diagnosis and dose/type of treatment). In addition, although the pathophysiology of hot flashes has remained elusive, these symptoms are likely attributable to disruptions in thermoregulation and neurochemicals. Therapies that have been offered or tested fall into 4 broad categories: pharmacological, nutraceutical, surgical, and complementary/behavioral strategies. The evidence base for this broad range of therapies varies, with some treatments not yet having been fully tested or showing equivocal results. The evidence base surrounding all therapies is evaluated to enhance hot flash treatment decision-making by clinicians and patients.


Assuntos
Fogachos/etiologia , Neoplasias/complicações , Antagonistas Adrenérgicos/uso terapêutico , Anticonvulsivantes/uso terapêutico , Antidepressivos/uso terapêutico , Bloqueio Nervoso Autônomo , Regulação da Temperatura Corporal/fisiologia , Antagonistas Colinérgicos/uso terapêutico , Terapia Cognitivo-Comportamental , Terapias Complementares , Fogachos/fisiopatologia , Fogachos/terapia , Humanos , Neoplasias/fisiopatologia , Neoplasias/terapia , Fitoterapia , Fatores de Risco , Gânglio Estrelado/cirurgia , Vitaminas/uso terapêutico
15.
J Pediatr Health Care ; 27(6): 434-42, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22658379

RESUMO

INTRODUCTION: To provide an overview of factors related to recruitment of adolescents and young adults (AYA) into research and recruitment rates and reasons for refusal from a multicenter study entitled "Stories and Music for Adolescent/Young Adult Resilience during Transplant" (SMART). METHODS: A randomized clinical trial study design was used. The settings included 9 hospitals. The sample included AYAs (aged 11-24 years) who were undergoing a stem cell transplant. Several instruments were used to measure symptom distress, coping, resilience, and quality of life in AYA with cancer. RESULTS: A total of 113 AYA were recruited (50%) for this study. Strategies were refined as the study continued to address challenges related to recruitment. We provide a description of recruitment strategies and an evaluation of our planning, implementing, and monitoring of recruitment rates for the SMART study. DISCUSSION: When designing a study, careful consideration must be given to factors influencing recruitment as well as special considerations for unique populations. Dissemination of strategies specific to unique populations will be helpful to the design of future research studies.


Assuntos
Terapia Comportamental , Musicoterapia , Neoplasias/terapia , Seleção de Pacientes , Adolescente , Comportamento do Adolescente , Serviços de Saúde do Adolescente , Criança , Comunicação , Feminino , Humanos , Masculino , Narração , Neoplasias/epidemiologia , Neoplasias/psicologia , Qualidade de Vida , Resiliência Psicológica , Apoio Social , Estados Unidos/epidemiologia , Adulto Jovem
16.
J Gen Intern Med ; 28(2): 193-200, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22936289

RESUMO

BACKGROUND: Paced respiration has been internationally recommended for vasomotor symptom management, despite limited empirical evidence. OBJECTIVE: To evaluate efficacy of a paced respiration intervention against breathing control and usual care control for vasomotor and other menopausal symptoms. DESIGN: A 16-week, 3-group, partially blinded, controlled trial with 2:2:1 randomization and stratification by group (breast cancer, no cancer), in a Midwestern city and surrounding area. PARTICIPANTS: Two hundred and eighteen randomized women (96 breast cancer survivors, 122 menopausal women without cancer), recruited through community mailings and registries (29 % minority). INTERVENTIONS: Training, home practice support, and instructions to use the breathing at the time of each hot flash were delivered via compact disc with printed booklet (paced respiration intervention) or digital videodisc with printed booklet (fast shallow breathing control). Usual care control received a letter regarding group assignment. MAIN MEASURES: Hot flash frequency, severity, and bother (primary); hot flash interference in daily life, perceived control over hot flashes, and mood and sleep disturbances (secondary). Intervention performance, adherence, and adverse events were assessed. KEY RESULTS: There were no significant group differences for primary outcomes at 8-weeks or 16-weeks post-randomization. Most intervention participants did not achieve 50 % reduction in vasomotor symptoms, despite demonstrated ability to correctly do paced respiration and daily practice. Statistically significant differences in secondary outcomes at 8 and 16 weeks were small, not likely to be clinically relevant, and as likely to favor intervention as breathing control. CONCLUSIONS: Paced respiration is unlikely to provide clinical benefit for vasomotor or other menopausal symptoms in breast cancer survivors or menopausal women without cancer.


Assuntos
Exercícios Respiratórios , Fogachos/terapia , Menopausa/fisiologia , Sistema Vasomotor/fisiopatologia , Adulto , Neoplasias da Mama/terapia , Feminino , Fogachos/fisiopatologia , Humanos , Pessoa de Meia-Idade , Cooperação do Paciente , Índice de Gravidade de Doença , Método Simples-Cego , Transtornos do Sono-Vigília/terapia , Sobreviventes , Resultado do Tratamento
17.
Nurs Res ; 62(1): 59-65, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23222844

RESUMO

BACKGROUND: Treatment fidelity, also called intervention fidelity, is an important component of testing treatment efficacy. Although examples of strategies needed to address treatment fidelity have been provided in several published reports, data describing variations that might compromise efficacy testing have been omitted. OBJECTIVES: The aim of this study is to describe treatment fidelity monitoring strategies and data within the context of a nursing clinical trial. METHODS: A three-group, randomized, controlled trial compared intervention (paced respiration) to attention control (fast, shallow breathing) to usual care for management of hot flashes and other menopausal symptoms. Data from both staff and participants were collected to assess treatment fidelity. RESULTS: Staff measures for treatment delivery indicated good adherence to protocols. Participant ratings of expectancy and credibility were not statistically different between intervention and attention control; however, the attention control was significantly more acceptable (p < .05). Intervention participant data indicated good treatment receipt and enactment with mean breath rates at each time point falling within the target range. Practice log data for both intervention and attention control indicated lower adherence of once-daily rather than twice-daily practice. DISCUSSION: Despite strengths in fidelity monitoring, some challenges were identified that have implications for other similar intervention studies.


Assuntos
Fogachos/psicologia , Fogachos/terapia , Avaliação de Resultados em Cuidados de Saúde/métodos , Cooperação do Paciente , Adulto , Atenção , Exercícios Respiratórios , Feminino , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente
18.
J Music Ther ; 49(1): 7-22, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22803255

RESUMO

BACKGROUND: Music-based interventions have helped patients with cancer improve their quality of life, decrease treatment related distress, and manage pain. However, quantitative findings from music intervention studies are inconsistent. OBJECTIVE: The purpose of this review was to explore the theoretical underpinnings for the selection of the music stimuli used to influence targeted outcomes. It was hypothesized that disparate findings were due in part to the atheoretical nature of music selection and the resulting diversity in music stimuli between and within studies. METHODS: A systematic research synthesis including a comprehensive database and reference list search resulted in 22 studies. Included studies were compiled into two tables cataloging intervention theory, intervention content, and outcomes. RESULTS: A majority of studies did not provide a rationale or intervention theory for the delivery of music or choice of outcomes. Recorded music was the most common delivery method, but the specific music was rarely included within the report. Only two studies that included a theoretical framework reported null results on at least some of the outcomes. Null results are partially explained by an incomplete or mismatch in intervention theory and music selection and delivery. CONCLUSIONS: While the inclusion of an intervention theory does not guarantee positive results, including a theoretical rationale for the use of music, particular therapeutic processes or mechanisms, and the specifics of how music is selected and delivered increases scientific rigor and the probability of clinical translation.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Musicoterapia/métodos , Neoplasias/psicologia , Satisfação Pessoal , Qualidade de Vida/psicologia , Ansiedade/etiologia , Atitude Frente a Saúde , Depressão/etiologia , Humanos , Música/psicologia , Neoplasias/complicações , Neoplasias/terapia , Dor/prevenção & controle , Medição da Dor/métodos
19.
Psychooncology ; 20(11): 1193-201, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22012943

RESUMO

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies.


Assuntos
Neoplasias/terapia , Cooperação do Paciente/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Adaptação Psicológica , Adolescente , Terapia Comportamental/métodos , Terapia Comportamental/normas , Criança , Humanos , Musicoterapia/métodos , Musicoterapia/normas , National Institutes of Health (U.S.) , Neoplasias/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Estados Unidos , Adulto Jovem
20.
J Health Psychol ; 16(2): 342-52, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20709884

RESUMO

Music-based interventions are used to address a variety of problems experienced by individuals across the developmental lifespan (infants to elderly adults). In order to improve the transparency and specificity of reporting music-based interventions, a set of specific reporting guidelines is recommended. Recommendations pertain to seven different components of music-based interventions, including theory, content, delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Recommendations are intended to support Consolidated Standards for Reporting Trials (CONSORT) and Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statements for transparent reporting of interventions while taking into account the variety, complexity, and uniqueness of music-based interventions.


Assuntos
Guias como Assunto , Notificação de Abuso , Musicoterapia , Prática Clínica Baseada em Evidências , Humanos
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