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Good morning Welcome to all Syed Imran 117/Jan 2014 Guide Dr M S Moosabba Professor Co-guide Yenepoya Medical College Dr. Sr. Alphonsa Ancheril Professor Mangalore Athena College of Nursing Mangalore Introduction • Person with cancer experience a range of symptoms related to both the disease and its treatment. • Spending time in the hospital and undergoing for many investigations and numerous treatment modalities can be highly upsetting particularly chemotherapy. • This experience can influence physiological and psychosocial aspects that can impact the physical and mental health of the patient with cancer. Cont… • Increased anxiety and enhanced pain perception are self-reported psychosocial and physiological measures respectively that also may be affected. • The efforts of the patients to different treatment options can be observed through changes in these physiological and psychosocial measures. Cont… • Listening to music can positively benefit neurophysiologic and emotional responses as well as promote relaxation, which may be especially beneficial for cancer patients undergoing painful and anxiety inducing treatments. Title of the study Interventional effect of Receptive Music Therapy on physiological and psychological outcomes during chemotherapy among patients with cancer in a selected oncology centers of Dakshina Kannada. Aim of the study The aim of the study is to evaluate the effectiveness of receptive music therapy on physiological (pain, blood pressure, heart rate) and psychological (anxiety, stress, depression) conditions. Objectives 1. To assess the physiological and psychological outcomes before and after the music therapy. 2. To find out the effectiveness of music therapy on physiological and psychological outcomes in process of chemotherapy. Cont… 3. To find out the relationship between physiological and psychological outcome and music therapy. 4. To find out the association between physiological and psychological outcome and music therapy. Hypotheses H1:The mean post-test physiological and psychological outcome will be significantly lower than the mean pre-test score. H2:There will be significant relationship between physiological and psychological outcome and music therapy. Cont… H3:There will be significant association between physiological and psychological outcome and the selected demographic variables. Literature Review • 1. Anne Horne T, Denise G. The Effect of Music Therapy on Anxiety in Patients who are terminally ill. Journal of Palliative Medicine 2008; 11(4): 582-90. • This study was conducted in Australia to examine the “effectiveness of a single music therapy session in reducing anxiety for terminally ill patients”. Results demonstrated a significant reduction in anxiety for the experimental group (Anne Horne et al 2008). Cont… • Fulvia L, Carla C, Francesco G, Vittorio M. Music therapy and emotional expression during chemotherapy. How do breast cancer patients feel? European Journal of Integrative Medicine. http://dx.doi.org/10.1016/j.eujim.2013.04.001 • The results showed in this study the experimental group had significant reductions in stress, anxiety, depression and anger (Fulvia Et al 2013) Cont… • Zhou KN, Li XM, Yan H, Dang SN, Wang DL. Effects of music therapy on depression and duration of hospital stay of breast cancer patients after radical mastectomy. Chin Med J 2011; 124(15):2321-7. • In this study, After music therapy, depression scores of the experimental group were lower than that of the control group in the three post-tests, with significant differences (Zhou et al 2011). Cont… • Li XM, Zhou KN, Yan H, Wang DL, Zhang YP. Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: a randomized clinical trial. J Adv Nurs 2012; 68(5):1145-55. • . The repeated-measure ANCOVA model analysis indicated that the mean state anxiety score was significantly lower in the experimental group than those in the control group at each of the three post-test measurements (Li Xm et al. 2012). Methods Research Design True experimental Solomon four group design Sample and sampling technique Purposive sampling technique will be used to select 60 patients with any type of cancer. Cont… Exclusion criteria Patients who are, 1. Having hearing problems. 2. Having cancer of ear. Cont… Data Collection Instrument 1. In vivo biophysiological tools for assessment of pain, BP, heart rate 2. Psychological scales for assessment of stress, depression, anxiety and quality of life. Data Collection method • The investigator will obtain written permission from the directors of the respected hospitals prior to the data collection. • The purpose of the study will be explained to the patients and informed consent will be obtained. • Patients will be randomly assigned to the four groups (two experimental and two controls) by using random number table. Cont… • Physiological and psychological assessment will be done by using the tools before starting (pre test) the chemotherapy treatment for A and B group. • Physiological and psychological assessment will not be done by using the tools before starting (pre test) the chemotherapy treatment for C and D group. • Music will be given to the patients of A and C group with the help of an iPods and ear phone. Cont… • Music will not be provided to the patients of B and D group. Only standard routine care will be provided during chemotherapy. • Post-tests will be done for all the four groups (A, B, C and D) soon after the chemotherapy, to record the physiological and psychological parameters. • Data will be analyzed by using descriptive (mean, median and standard deviation) and inferential (repeated measure ANOVA, Chi Square) statistics. Proposed budget • Direct expenses= 18000/• Personnel expenses= 35000/• Travel expenses= 10000/• Total expenses= 63000/- Clearance certificates, Health & Safety Requirements (list the necessary permits, e.g. Human ethics, Animal Ethics, Biosafety permission, Validation of tools if any, etc. (NO SAMPLE COLLECTION / DATA COLLECTION CAN BE DONE TILL ETHICAL CLEARANCE CERTIFICATE IS OBTAINED) Prior permission will be taken from the concerned authorities of the hospitals before starting the data collection. References 1. Nightingale CL, Rodriguez C, Carnaby G. The Impact of Music Interventions on Anxiety for Adult Cancer Patients: A Meta-Analysis and Systematic Review; 2013 Apr 26. [Epub ahead of print] 2. Kristine L. Kwekkeboom, Catherine H. Cherwin, Jun W. Lee, Britt Wanta, Mind-Body Treatments for the Pain-Fatigue- Sleep Disturbance Symptom Cluster in Persons with Cancer. Journal of Pain and Symptom Management 2010; 39 (1):126-38 3. Anne Horne T, Denise G. The Effect of Music Therapy on Anxiety in Patients who are terminally ill. Journal of Palliative Medicine 2008; 11(4): 582-90. 4. Chih-Yuan C, Wei-Ru H, Pei-Chun L, Shuenn-Tsong Y. Effects of music therapy on subjective sensations and heart rate variability in treated cancer survivors: A pilot study. Complementary Therapies in Medicine 2010; 18(5): 224–6 Thank you