The effect of a music-based caregiving intervention on pain intensity in nursing home patients with dementia: a cluster-randomized controlled study.

ABSTRACT: Treatment of chronic pain in patients with dementia is challenging because they have reduced ability to report pain and are particularly vulnerable to side effects of analgesics. Different types of music-based therapy have been recommended and are used as an alternative to analgesics, but the evidence is lacking. Therefore, we performed a cluster-randomized controlled study (RCT) to reduce pain intensity using music-based caregiving (MBC) over 8 weeks in nursing home patients with dementia and chronic pain. We also investigated if the amount of MBC and different chronic pain syndromes would impact on the effect. Of the 645 patients, 498 patients from 36 wards in 12 nursing homes were screened for dementia and pain. Using the Clinical Dementia Rating Scale and the Mobilization-Observation-Behavior-Intensity-Dementia Pain Scale (range 0-10), 279 (71% females, 42% severe dementia) nursing home patients were randomized to intervention group (n = 134, 18 wards) or control group (n = 145, 18 wards). The main outcome was change in pain intensity before and after the intervention. The study did not reveal any effect of MBC on pain intensity when compared with the control group (B = -0.15, 95% CI [-0.72 to 0.43]). No significant difference was found within the intervention group analyzing the impact of intervention time (B = 0.73, 95% CI [-0.55 to 2.02]) or chronic primary vs secondary pain syndromes (B = 0.45, 95% CI [-0.05 to 0.96]). Our data from this first RCT on music and pain intensity in patients with dementia and chronic pain did not find an effect of MBC on pain.

[What do we know about participation in cultural activities and health?]. / Hva vet vi om kulturdeltakelse og helse?

BACKGROUND: Knowledge of the association between health status and lifestyle factors, such as food habits, smoking and physical activity, is abundant. Other lifestyle factors, such as participation in cultural activities, have attained less attention. MATERIAL AND METHODS: The article is based on studies of the literature. Reference lists in key articles have been used as well as references given by research colleagues. RESULTS AND INTERPRETATION: The survey shows an association between participation in cultural activities, cultural experiences and health status, also when measured by differing methods. Further population studies, longitudinal studies and controlled studies are needed in order to expand our knowledge of the relationship between participation in cultural activities and health status. There is a need for multidisciplinary cooperation and increased use of combined quantitative and qualitative methods.

[Cultural approaches to treatment and public health work]. / Kulturelle virkemidler i behandling og folkehelsearbeid.

BACKGROUND: Improvement of health status due to physical activity is well documented. Research on health effects of other cultural measures is more scarce. During recent years, considerable work in these fields has been presented in the Nordic countries and there is a good basis for further research. MATERIAL: The article is a literature study based on reports and literature from projects in which cultural measures have been used as elements in treatment, rehabilitation, preventive and health promotion in the Nordic countries, primarily in Norway. Prominent workers within cultural and health work in the Nordic countries have contributed with information on relevant literature and reports. RESULTS AND INTERPRETATION: Reports from projects in Norway on culture and health indicate an improvement on individual life quality and experienced health status. Lack of research leaves an uncertainty as to whether the effects are lasting and whether other measures would have had similar effects. International research literature indicates that cultural activities may have health effects. There is a need for further research based on multidisciplinary approaches.