Melbourne Conservatorium of Music - Research Publications

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    Home-based family caregiver-delivered music and reading interventions for people living with dementia (HOMESIDE trial): an international randomised controlled trial
    Baker, FA ; Soo, VP ; Bloska, J ; Blauth, L ; Bukowska, AA ; Flynn, L ; Hsu, MH ; Janus, E ; Johansson, K ; Kvamme, T ; Lautenschlager, N ; Miller, H ; Pool, J ; Smrokowska-Reichmann, A ; Stensaeth, K ; Teggelove, K ; Warnke, S ; Wosch, T ; Odell-Miller, H ; Lamb, K ; Braat, S ; Sousa, TV ; Tamplin, J (ELSEVIER, 2023-11)
    BACKGROUND: Music interventions provided by qualified therapists within residential aged care are effective at attenuating behavioural and psychological symptoms (BPSD) of people with dementia (PwD). The impact of music interventions on dementia symptom management when provided by family caregivers is unclear. METHODS: We implemented a community-based, large, pragmatic, international, superiority, single-masked randomised controlled trial to evaluate if caregiver-delivered music was superior to usual care alone (UC) on reducing BPSD of PwD measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q). The study included an active control (reading). People with dementia (NPI-Q score ≥6) and their caregiver (dyads) from one of five countries were randomly allocated to caregiver-delivered music, reading, or UC with a 1:1:1 allocation stratified by site. Caregivers received three online protocolised music or reading training sessions delivered by therapists and were recommended to provide five 30-min reading or music activities per week (minimum twice weekly) over 90-days. The NPI-Q severity assessment of PwD was completed online by masked assessors at baseline, 90- (primary) and 180-days post-randomisation and analysed on an intention-to-treat basis using a likelihood-based longitudinal data analysis model. ACTRN12618001799246; ClinicalTrials.govNCT03907748. FINDINGS: Between 27th November 2019 and 7th July 2022, we randomised 432 eligible of 805 screened dyads (music n = 143, reading n = 144, UC n = 145). There was no statistical or clinically important difference in the change from baseline BPSD between caregiver-delivered music (-0.15, 95% CI -1.41 to 1.10, p = 0.81) or reading (-1.12, 95% CI -2.38 to 0.14, p = 0.082) and UC alone at 90-days. No related adverse events occurred. INTERPRETATION: Our findings suggested that music interventions and reading interventions delivered by trained caregivers in community contexts do not decrease enduring BPSD symptoms. FUNDING: Our funding was provided by National Health and Medical Research Council, Australia; The Research Council of Norway; Federal Ministry of Education and Research, Germany; National Centre for Research and Development, Poland; Alzheimer's Society, UK, as part of the Joint Programme for Neurodegenerative Diseases consortia scheme.
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    Older adults' music listening preferences to support physical activity following cardiac rehabilitation
    Clark, IN ; Baker, FA ; Taylor, NF ( 2016-01-01)
    Background: Music listening during exercise is thought to increase physiological arousal and enhance subjective experience, and may support physical activity participation among older adults with cardiac disease. However, little is known about how music preferences, or perceptions of music during exercise, inform clinical practice with this population. Objective: Identify predominant musical characteristics of preferred music selected by older adults, and explore participants' music listening experiences during walking-based exercise following cardiac rehabilitation. Methods: Twenty-seven participants aged 60 years and older (21 men, 6 women; mean age = 67.3 years) selected music to support walking over a 6-month intervention period, and participated in post-intervention interviews. In this two-phase study, we first identified predominant characteristics of participant-selected music using the Structural Model of Music Analysis. Second, we used inductive thematic analysis to explore participant experiences. Results: Predominant characteristics of participant-selected music included duple meter, consistent rhythm, major key, rounded melodic shape, legato articulation, predictable harmonies, variable volume, and episodes of tension with delayed resolution. There was no predominant tempo, with music selections ranging from slow through to medium and fast. Four themes emerged from thematic analysis of participant interviews: psycho-emotional responses, physical responses, influence on exercise behavior, and negative experiences. Conclusions: Findings are consistent with theory and research explaining influences from music listening on physiological arousal and subjective experience during exercise. Additionally, for older adults with cardiac disease, a holistic approach to music selection considering general well-being and adjustment issues, rather than just exercise performance, may improve long-term lifestyle changes and compliance with physical activity guidelines.
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    Older Adults' Music Listening Preferences to Support Physical Activity Following Cardiac Rehabilitation
    Clark, IN ; Baker, FA ; Taylor, NF (OXFORD UNIV PRESS INC, 2016)
    BACKGROUND: Music listening during exercise is thought to increase physiological arousal and enhance subjective experience, and may support physical activity participation among older adults with cardiac disease. However, little is known about how music preferences, or perceptions of music during exercise, inform clinical practice with this population. OBJECTIVE: Identify predominant musical characteristics of preferred music selected by older adults, and explore participants' music listening experiences during walking-based exercise following cardiac rehabilitation. METHODS: Twenty-seven participants aged 60 years and older (21 men, 6 women; mean age = 67.3 years) selected music to support walking over a 6-month intervention period, and participated in post-intervention interviews. In this two-phase study, we first identified predominant characteristics of participant-selected music using the Structural Model of Music Analysis. Second, we used inductive thematic analysis to explore participant experiences. RESULTS: Predominant characteristics of participant-selected music included duple meter, consistent rhythm, major key, rounded melodic shape, legato articulation, predictable harmonies, variable volume, and episodes of tension with delayed resolution. There was no predominant tempo, with music selections ranging from slow through to medium and fast. Four themes emerged from thematic analysis of participant interviews: psycho-emotional responses, physical responses, influence on exercise behavior, and negative experiences. CONCLUSIONS: Findings are consistent with theory and research explaining influences from music listening on physiological arousal and subjective experience during exercise. Additionally, for older adults with cardiac disease, a holistic approach to music selection considering general well-being and adjustment issues, rather than just exercise performance, may improve long-term lifestyle changes and compliance with physical activity guidelines.
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    Participant-selected music and physical activity in older adults following cardiac rehabilitation: a randomized controlled trial
    Clark, IN ; Baker, FA ; Peiris, CL ; Shoebridge, G ; Taylor, NF (SAGE PUBLICATIONS LTD, 2017-03)
    OBJECTIVE: To evaluate effects of participant-selected music on older adults' achievement of activity levels recommended in the physical activity guidelines following cardiac rehabilitation. DESIGN: A parallel group randomized controlled trial with measurements at Weeks 0, 6 and 26. SETTING: A multisite outpatient rehabilitation programme of a publicly funded metropolitan health service. SUBJECTS: Adults aged 60 years and older who had completed a cardiac rehabilitation programme. INTERVENTIONS: Experimental participants selected music to support walking with guidance from a music therapist. Control participants received usual care only. MAIN MEASURES: The primary outcome was the proportion of participants achieving activity levels recommended in physical activity guidelines. Secondary outcomes compared amounts of physical activity, exercise capacity, cardiac risk factors, and exercise self-efficacy. RESULTS: A total of 56 participants, mean age 68.2 years (SD = 6.5), were randomized to the experimental ( n = 28) and control groups ( n = 28). There were no differences between groups in proportions of participants achieving activity recommended in physical activity guidelines at Week 6 or 26. Secondary outcomes demonstrated between-group differences in male waist circumference at both measurements (Week 6 difference -2.0 cm, 95% CI -4.0 to 0; Week 26 difference -2.8 cm, 95% CI -5.4 to -0.1), and observed effect sizes favoured the experimental group for amounts of physical activity (d = 0.30), exercise capacity (d = 0.48), and blood pressure (d = -0.32). CONCLUSIONS: Participant-selected music did not increase the proportion of participants achieving recommended amounts of physical activity, but may have contributed to exercise-related benefits.
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    Content development and validation for a mobile application designed to train family caregivers in the use of music to support care of people living with dementia
    Thompson, Z ; Tamplin, J ; Sousa, TV ; Carrasco, R ; Flynn, L ; Lamb, KEE ; Lampit, A ; Lautenschlager, NTT ; McMahon, K ; Waycott, J ; Vogel, APP ; Woodward-Kron, R ; Stretton-Smith, PAA ; Baker, FAA (FRONTIERS MEDIA SA, 2023-05-12)
    BACKGROUND: Music therapy is increasingly recognized as an effective support for people living with dementia. However, with incidences of dementia increasing, and limited availability of music therapists, there is a need for affordable and accessible ways that caregivers can learn to use music-therapy based strategies to support the people they care for. The MATCH project aims to address this by creating a mobile application that can train family caregivers in the use of music to support people living with dementia. METHODS: This study details the development and validation of training material for the MATCH mobile application. Training modules developed based on existing research were assessed by 10 experienced music therapist clinician-researchers, and seven family caregivers who had previously completed personalized training in music therapy strategies via the HOMESIDE project. Participants reviewed the content and scored each training module based on content (music therapists) and face (caregivers) validity scales. Descriptive statistics were used to calculate scores on the scales, while thematic analysis was used to analyze short-answer feedback. RESULTS: Participants scored the content as valid and relevant, however, they provided additional suggestions for improvement via short-answer feedback. CONCLUSION: The content developed for the MATCH application is valid and will be trailed by family caregivers and people living with dementia in a future study.
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    A Light at the End of the Tunnel: The Experiences of Members of a Therapeutic Community Choir for People Living with Dementia and their Care-Partners who ‘Went Online’ During the COVID-19 Pandemic – an Arts-Based Phenomenological Study
    Thompson, Z ; Baker, FA ; Clark, IN ; McLachlan, G ; Mountain, S ; Mountain, D ; Radford, M ; Reid, M ; Reid, N ; Reid, T ; Tkalcevic, V ; Hodgson, M ; Tamplin, J (GAMUT - Grieg Academy Music Therapy Research Centre (NORCE & University of Bergen), 2023)
    Background: This paper presents the results of an arts-based, phenomenological research project in which members of a therapeutic community choir for people living with dementia and their family and friends reflected on their experiences of singing together pre and post the transition to online sessions as a result of the COVID-19 pandemic. Method: Eleven choir members (three living with dementia and eight family care-partners) participated in interviews about their experience of the choir and its transition to an online format during the COVID-19 pandemic. Interviews were conducted in either a traditional, semi-structured interview format, or as a collaborative songwriting session, and participants were able to choose the format that they preferred. Transcripts of the interviews and songs that were composed were analysed using an adapted Interpretative Phenomenological Analysis and arts-based research method. Participants verified key themes that emerged from the analysis, which formed the basis of an 18-part Song Cycle, which included two original songs by participants, and 16 songs composed by the first author. Results: Eighteen sub-themes were generated from the analysis, which are expressed as songs and grouped into four overarching themes or ‘Movements’: i) the dementia experience; ii) the choir experience; iii) the COVID-19 experience; and iv) the virtual experience. The songs depict how participants experienced each of the overarching themes, and revealed challenges, new opportunities and resilience. Conclusion: Navigating COVID-19 while living with or caring for someone with dementia was challenging. The virtual choir format was acceptable, provided relief from the stress of COVID-19, and kept members connected, however, there were technological limitations that made the experience challenging at times.
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    Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study
    McMahon, K ; McFerran, K ; Clark, IN ; Odell-Miller, H ; Stensaeth, K ; Tamplin, J ; Baker, FA (FRONTIERS MEDIA SA, 2023-05-18)
    An increasing number of people with dementia receive informal care from family members to help them remain living in the community. Music therapy is particularly beneficial for supporting the wellbeing of people living with dementia. However, little is known about how music therapy might support people with dementia and their family care partners as dyads. This study explored the experiences of six dyads participating in a 12-week home-based skill-sharing music intervention facilitated by a music therapist. We examined their experiences during the intervention period and in the 3-6 months following. This study was conducted within a larger randomised control trial, HOMESIDE. Data was collected through video-recorded music-based interviews, participant diaries, and a semi-structured interview. Data was analysed using an abductive and relational-centred research approach in consideration of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. The study found fifteen themes that describe dyads' supported experiences of sharing music in their homes. These were organised into three global themes: (1) experiences were shaped by complex influences; (2) a connected musical ecosystem; and (3) music was a resource for wellbeing. This study highlighted the important role of personalised facilitation and the therapeutic relationship as dyads learned to use music as a resource through a process of trial and error. The implications for skill-sharing, indirect music therapy and direct music therapy practice are discussed.
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    Exploring Shared Musical Experiences in Dementia Care: A Worked Example of a Qualitative Systematic Review and Thematic Synthesis
    McMahon, K ; Clark, IN ; Stensaeth, K ; Odell-Miller, H ; Wosch, T ; Bukowska, A ; Baker, FA (SAGE PUBLICATIONS INC, 2022-09)
    Qualitative systematic reviews, or qualitative evidence syntheses (QES), are increasingly used in health settings to guide the development of practice and policy. Thematic synthesis is one of the most well-developed approaches used for QES, however there are limited worked examples describing how to apply the steps of analysis in the literature. This paper describes the processes and decisions undertaken in a qualitative systematic review and thematic synthesis from the perspective of a novice researcher. The described review aimed to explore the shared musical experiences of people living with dementia and their family care partners across a range of settings. We found that shared musical activities fostered experiences of connection and wellbeing for people living with dementia and their family care partners. This was demonstrated with moderate-high confidence through six themes, and our findings informed the development of the Contextual Connection Model of Health Musicking. In presenting a worked example of our review, this paper introduces a systematic approach to coding and discusses the complexities of developing and reporting on analytical themes. We identify the need for a specific thematic synthesis reporting tool, and the need to embed reflexive practices into QES tools more broadly.
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    Statistical analysis plan for HOMESIDE: a randomised controlled trial for home-based family caregiver-delivered music and reading interventions for people living with dementia
    Soo, VP ; Baker, FA ; Sousa, TV ; Odell-Miller, H ; Stensaeth, K ; Wosch, T ; Bukowska, AA ; Tamplin, J ; Lautenschlager, N ; Braat, S ; Lamb, KE (BMC, 2023-05-08)
    BACKGROUND: Most people with dementia live in the community, not in residential care. Therefore, quality informal care for them is critical for managing behavioural and psychological symptoms of dementia (BPSD). Music therapy has been shown to reduce BPSD. However, no randomised controlled trial has examined the effects of music interventions delivered by caregivers in home settings. The HOME-based caregiver-delivered music intervention for people living with dementia (HOMESIDE) trial aims to evaluate the effectiveness of a 12-week music intervention in addition to standard care for BPSD. This article describes the statistical analysis plan. METHODS AND ANALYSIS: HOMESIDE is a large, pragmatic international three-arm parallel-group randomised controlled trial. Dyads (persons with dementia and caregiver) in Australia, Germany, the UK, Poland and Norway were randomised to receive music and standard care, reading and standard care or standard care alone. The primary outcome is BPSD (proxy) of the person living with dementia, measured using the Neuropsychiatric Inventory-Questionnaire (NPI-Q) at 90 and 180 days post-randomisation. Longitudinal analysis will compare NPI-Q severity between music and standard care versus standard care alone. Secondary outcomes include quality of life and depression (both person with dementia and caregiver), cognition (person with dementia only), distress, resilience, competence and caregiver-patient relationship (caregiver only). Treatment effects will be obtained at 90 and 180 days post-randomisation, where applicable. Safety outcomes (adverse events, hospitalisations, deaths) will be summarised. DISCUSSION: This statistical analysis plan provides a detailed methodology for the analysis of HOMESIDE and will improve the validity of the study and reduce the potential for bias. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12618001799246. Registered on November 05, 2018. CLINICALTRIALS: gov NCT03907748. Registered on April 09, 2019.