eHealth mindfulness-based music therapy for patients undergoing allogeneic hematopoietic stem cell transplantation: A pilot randomized controlled trial protocol.

BACKGROUND: Allogeneic stem cell transplantation (allo-SCT) is the preferred therapy for patients with high-risk or relapsed hematologic malignancies, but may be complicated by psychological distress (e.g., depression, anxiety) and symptom burden (e.g., fatigue, pain). Mindfulness-based music therapy (MBMT), a relatively novel integrative medicine intervention that draws from mindfulness and music therapy principles, has shown promise in improving psychosocial outcomes and symptom burden in cancer patients. We outline an eHealth-based MBMT (eMBMT) intervention protocol examining: (1) feasibility, acceptability, and intended effects of eMBMT in improving HRQOL, symptom burden, and clinical markers of disease activity (e.g., infections), and (2) the extent to which eMBMT music therapy component-associated improvements in HRQOL, symptom burden, and disease activity are mediated by improvements in psychosocial and physiological (e.g., systemic inflammation, immune recovery) adaptation. METHODS: Participants (n = 60) with a hematologic malignancy undergoing allo-SCT will be randomized to receive eMBMT or an eHealth-based mindfulness meditation (eMM) intervention. eMBMT includes eight 60-min sessions facilitated by a music therapist focusing on mindfulness and music therapy. eMM includes eight 60-min self-led MM practices. RESULTS: Feasibility, acceptability, HRQOL, symptom burden, disease activity, and mediation effects of psychosocial and physiological adaptation will be assessed at baseline, pre-infusion, and post-engraftment with blood collection at baseline and post-engraftment. CONCLUSION: The current pilot RCT is the first eMBMT intervention to address the HRQOL and symptom burden of patients who are undergoing allo-SCT. Results will inform a fully powered RCT to establish preliminary efficacy of eMBMT on improvements in HRQOL, symptom burden, and disease activity.

A Rationale for Music Training to Enhance Executive Functions in Parkinson's Disease: An Overview of the Problem.

Music listening interventions such as Rhythmic Auditory Stimulation can improve mobility, balance, and gait in Parkinson’s Disease (PD). Yet, the impact of music training on executive functions is not yet known. Deficits in executive functions (e.g., attention, processing speed) in patients with PD result in gait interference, deficits in emotional processing, loss of functional capacity (e.g., intellectual activity, social participation), and reduced quality of life. The model of temporal prediction and timing suggests two networks collectively contribute to movement generation and execution: the basal ganglia-thalamocortical network (BGTC) and the cerebellar-thalamocortical network (CTC). Due to decreases in dopamine responsible for the disruption of the BGTC network in adults with PD, it is hypothesized that rhythmic auditory cues assist patients through recruiting an alternate network, the CTC, which extends to the supplementary motor areas (SMA) and the frontal cortices. In piano training, fine motor finger movements activate the cerebellum and SMA, thereby exercising the CTC network. We hypothesize that exercising the CTC network through music training will contribute to enhanced executive functions. Previous research suggested that music training enhances cognitive performance (i.e., working memory and processing speed) in healthy adults and adults with cognitive impairments. This review and rationale provides support for the use of music training to enhance cognitive outcomes in patients with Parkinson’s Disease (PD).

The Development of a Mindfulness-Based Music Therapy (MBMT) Program for Women Receiving Adjuvant Chemotherapy for Breast Cancer.

Problems with attention and symptom distress are common clinical features reported by women who receive adjuvant chemotherapy for breast cancer. Mindfulness practice significantly improves attention and mindfulness programs significantly reduce symptom distress in patients with cancer, and, more specifically, in women with breast cancer. Recently, a pilot investigation of a music therapy program, built on core attitudes of mindfulness practice, reported significant benefits of enhanced attention and decreased negative mood and fatigue in women with breast cancer. This paper delineates the design and development of the mindfulness-based music therapy (MBMT) program implemented in that pilot study and includes clients' narrative journal responses. Conclusions and recommendations, including recommendation for further exploration of the function of music in mindfulness practice are provided.

The Effect of Mindfulness-Based Music Therapy on Attention and Mood in Women Receiving Adjuvant Chemotherapy for Breast Cancer: A Pilot Study.

PURPOSE/OBJECTIVES: To explore the efficacy of mindfulness-based music therapy (MBMT) to improve attention and decrease mood distress experienced by women with breast cancer receiving adjuvant chemotherapy. DESIGN: Quantitative, descriptive, longitudinal approach. SETTING: A comprehensive cancer hospital and a university in southern Florida. SAMPLE: 15 women with a diagnosis of breast cancer, stages I-III, receiving adjuvant chemotherapy. METHODS: Participants individually received MBMT for one hour per week for four weeks. The sessions consisted of varied music activities accompanied by mindfulness attitudes, or mental strategies that enhance moment-to-moment awareness, and weekly homework. Demographic information was collected at baseline. MAIN RESEARCH VARIABLES: Attention was measured using Conners' Continuous Performance Test II. Mood was measured using the Profile of Mood States-Brief Form. Narrative comments collected from the homework assignments served to reinforce quantitative data. FINDINGS: Repeated measures analysis of variance showed that attention improved significantly over time. Although all mood states significantly improved from the beginning to the end of each MBMT session, the mood state of fatigue decreased significantly more than the other mood states. CONCLUSIONS: MBMT enhances attention and mood, particularly the mood state of fatigue, in women with breast cancer receiving adjuvant chemotherapy. 
. IMPLICATIONS FOR NURSING: A preferred music listening and mindfulness exercise may be offered to women with breast cancer who experience attention problems and mood distress.

Development and preliminary evaluation of a music-based attention assessment for patients with traumatic brain injury.

Impairments in attention are commonly seen in individuals with traumatic brain injury (TBI). While visual attention assessment measurements have been rigorously developed and frequently used in cognitive neurorehabilitation, there is a paucity of auditory attention assessment measurements for patients with TBI. The purpose of this study was to field test a researcher-developed Music-based Attention Assessment (MAA), a melodic contour identification test designed to assess three different types of attention (i.e., sustained attention, selective attention, and divided attention), for patients with TBI. Additionally, this study aimed to evaluate the readability and comprehensibility of the test items and to examine the preliminary psychometric properties of the scale and test items. Fifteen patients diagnosed with TBI completed 3 different series of tasks in which they were required to identify melodic contours. The resulting data showed that (a) test items in each of the 3 subtests were found to have an easy to moderate level of item difficulty and an acceptable to high level of item discrimination, and (b) the musical characteristics (i.e., contour, congruence, and pitch interference) were found to be associated with the level of item difficulty, and (c) the internal consistency of the MAA as computed by Cronbach's alpha was .95. Subsequent studies using a larger sample of typical participants, along with individuals with TBI, are needed to confirm construct validity and internal consistency of the MAA. In addition, the authors recommend examination of criterion validity of the MAA as correlated with current neuropsychological attention assessment measurements.

The effect of preferred music on mood and performance in a high-cognitive demand occupation.

Mild positive affect has been shown in the psychological literature to improve cognitive skills of creative problem-solving and systematic thinking. Individual preferred music listening offers opportunity for improved positive affect. The purpose of this study was to examine the effect of preferred music listening on state-mood and cognitive performance in a high-cognitive demand occupation. Twenty-four professional computer information systems developers (CISD) from a North American IT company participated in a 3-week study with a music/no music/music weekly design. During the music weeks, participants listened to their preferred music "when they wanted, as they wanted." Self-reports of State Positive Affect, State Negative Affect, and Cognitive Performance were measured throughout the 3 weeks. Results indicate a statistically significant improvement in both state-mood and cognitive performance scores. "High-cognitive demand" is a relative term given that challenges presented to individuals may occur on a cognitive continuum from need for focus and selective attention to systematic analysis and creative problem-solving. The findings and recommendations have important implications for music therapists in their knowledge of the effect of music on emotion and cognition, and, as well, have important implications for music therapy consultation to organizations.