Melbourne Conservatorium of Music - Research Publications
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ItemNo Preview AvailableMusic interventions for dementia and depression in elderly care (MIDDEL): The Australian part of an international cluster randomised controlled trial(Wiley, 2021-12-01)BACKGROUND: Dementia and depression are highly prevalent, comorbid conditions in older adults residing in care homes and are associated with individual distress and associated challenges for care staff. Music-based interventions are widely used and potentially effective nonpharmacological interventions, due to the relative preservation of the ability of people with dementia to respond to music even with disease progression. However, there is a lack of large-scale studies evaluating the effectiveness of music-based interventions in dementia care. Music Interventions for Dementia and Depression in the Elderly (MIDDEL) is the first large-scale international cluster-randomised controlled trial to investigate the effectiveness of small group music therapy (GMT), recreational choir singing (RCS) and their combination on levels of depression in residents with dementia. The trial is currently being conducted across six countries, and this presentation will outline the study outcomes from the Australian arm of the trial. METHOD: Between June 2018 and November 2019, 20 care home units were randomised to music interventions (GMT, RCS, GMT and RCS) or standard care delivered over 6 months. The primary outcome was level of depression as measured by the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcomes included neuropsychiatric symptoms, quality of life, care staff burden and adverse events collected at baseline, 3-months, 6-months and 12-months post-randomisation. Outcomes were analysed as intention-to-treat, per-protocol, and with exploratory predictor analyses. RESULTS: 318 participants (215 female; 103 male) aged 65 years or more with diagnoses of dementia and at least mild depressive symptoms (as defined by score of 8 or above on MADRS) residing in care homes were recruited. In addition, 131 care staff (108 female; 23 male) answered questions regarding perceived care burden to search for potential ripple effects of the music interventions. We will present the main findings of the study including the predictive effects of clinical characteristics on efficacy. CONCLUSION: The presentation will include discussion of contextual factors and conditions that support efficacy, and clinical implications for safety and quality of life for people with dementia living in care homes.
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ItemNo Preview AvailableHOMESIDE-A home-based family caregiver-delivered music and reading intervention for people living with dementia: A randomised controlled trial.(Wiley, 2021-12)BACKGROUND: Pharmacological interventions to address behavioural and psychological symptoms of dementia (BPSD) can have undesirable side effects, therefore non-pharmacological approaches to managing symptoms may be preferable. Past studies show that music therapy can reduce BPSD, and other studies have explored how formal caregivers use music in their caring roles. However, no studies have examined the effects on BPSD of music interventions delivered by informal caregivers (CGs) in the home setting. Our project addresses the need for improved informal care by training cohabiting family CGs to implement music interventions that target BPSD, and the quality of life (QoL) and well-being of people with dementia and CGs. METHODS: An international three-arm parallel-group randomised controlled trial has so far randomised 130 of the target 495 dyads from Australia, Germany, UK, Poland and Norway. Dyads are randomised equally to standard care (SC), a home-based music programme plus SC, or a home-based reading programme plus SC for 12 weeks. The primary outcome is BPSD of people with dementia (measured using the Neuropsychiatric Inventory-Questionnaire). Secondary outcomes examine relationship quality between CG and people with dementia, depression, resilience, competence, QoL for CG and QoL for people with dementia. Outcomes are collected at baseline, at the end of the 12-week intervention and at 6 months post randomisation. Resource Utilisation in Dementia captures economic data across the life of the intervention and at 6-month follow-up. Our presentation will briefly outline the study protocol and describe the caregiver training protocol and interventions in detail with video footage illustrating how the intervention looks in practice.
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ItemA 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(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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ItemMusic therapy responds to societal challenges – Music therapy for geriatric care(University of Applied Sciences Würzburg-Schweinfurt, 2021)Music Therapy in the care of older adults, in dementia care and for families with people with special needs is located in the comprehensive field of music-therapy- and interdisciplinary research. Conference proceedings present and discuss current developments and evaluations of music therapy interventions in PhD-research projects, furthermore outcomes on quality of relationship of caregivers, relevant brain research on music and emotion, musical entrainment and social brain in music therapy and for people living with dementia, relevant health technology assessment models in Germany and UK, and sociological research on homebased family caregivers of researchers and research centers of FHWS, Germany, Australia, Switzerland and UK.
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ItemHope for in-person human connection in a virtual music therapy world(GRIEG ACADEMY, 2021-10-20)
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ItemMusic listening interventions for physical activity: a systematic review and meta-analysis of randomised controlled trials(TAYLOR & FRANCIS LTD, 2024-01-02)PURPOSE: Music listening is widely used during exercise, but effects on physical activity are unknown. This review aimed to examine the effectiveness of music listening on physical activity of adults. MATERIALS AND METHODS: Searches were conducted until September 2022. Eligible randomised controlled trials examined intentional music listening to enhance physical activity in adults. Trials were assessed using the Revised Cochrane risk-of-bias tool. The GRADE approach assessed certainty of evidence. RESULTS: One high and two low risk-of-bias trials (113 participants, 63-68 years) from cardiac and pulmonary rehabilitation programs were included. Moderate certainty evidence favoured music listening for total amounts of physical activity (n = 112, δ = 0.32, 95% CI = -0.06-0.70) and weekly moderate intensity physical activity (n = 88, MD = 52 min, 95% CI = -8-113). Low certainty evidence favoured music listening for exercise capacity (6-min walk test) (n = 79, MD = 101 metres, 95% CI = 2.32-199.88). CONCLUSIONS: There is imprecise, moderate certainty evidence that music listening increases physical activity by a small amount in older adults. Future research including adults of all ages with and without health conditions might investigate music listening with focussed behaviour change interventions.IMPLICATIONS FOR REHABILITATIONThere is uncertainty in the current evidence but listening to music may lead to small increases physical activity in older adults with health conditions.Listening to music while walking may lead to improved exercise capacity.Rehabilitation professionals might consider using music listening as an adjunct with focussed behaviour change interventions aiming to increase physical activity.
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ItemThe Effect of Music Listening During Pulmonary or Cardiac Rehabilitation on Clinical Outcomes: A Systematic Review and Meta-analysis(Ovid Technologies (Wolters Kluwer Health), 2023-01)Purpose: To determine the effects of music listening during pulmonary rehabilitation (PR) or cardiac rehabilitation (CR) or their corresponding maintenance programs on clinical outcomes in people with respiratory or cardiac conditions. Methods: Studies were identified from 4 electronic databases. Two reviewers independently reviewed randomized controlled or crossover studies examining the effects of music listening compared with no music listening in individuals undertaking PR or CR or corresponding maintenance programs. Methodologic quality was assessed using the Cochrane Risk of Bias tool. Results: Nine studies were included. Music listening during PR improved the incremental shuttle walk distance (mean difference [MD] of73 m [95% CI 25.9–119.8]) compared with no music listening. This impact was absent in a CR maintenance program. When applied during PR programs, music listening had no effect on quality of life (standardized MD24.6 points [95% CI211.8 to 2.6]). Music listening had inconsistent effects on dyspnea and fatigue during PR and PR maintenance programs, but no impact on physical activity levels following CR or CR maintenance programs. Conclusions: Music listening during PR improved exercise capacity but had no effect on quality of life. When applied during CR or CR maintenance, the impact on physical activity was negligible.
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ItemThe Bonny Method of Guided Imagery and Music for family caregivers of people with dementia: A within subject feasibility study(GRIEG ACADEMY, 2023-05-27)Introduction: The Bonny Method of Guided Imagery and Music (BMGIM) is a psycho-therapeutic intervention that has not been examined with family caregivers of people with dementia. Method: This within subject pre-post feasibility study aimed to examine a protocol involving six sessions of BMGIM with family caregivers. Estimates of effect examined sensitivity of the Patient Health Questionnaire-9 (PHQ-9) and Quality of Life-6 Dimensions (AQoL-6D). Qualitative interviews explored participant experiences. Results: Of 11 participants who enrolled (nine women/two men, M age = 71.2 years), seven completed the study and four withdrew. Music programs used in BMGIM sessions were diverse and often modified to accommodate individual participant needs. Favourable small to moderate effect sizes were observed for the PHQ-9 (r = 0.11), and for the AQoL-6D global score (r = 0.18) and domains examining independent living (r = 0.20), mental health (r = 0.30), pain (r = 0.29), and senses (r = 0.44). Thematic analysis of interviews recognised BMGIM as: something different that might help; an empathic therapeutic space with aptly selected music; insightful and transformative; and psycho-educative. Discussion: The majority of participants completed the project and described important benefits from BMGIM, suggesting that the protocol was acceptable. However, a large sample would be required to detect change in a fully powered trial based on effects observed for the PHQ-9 and AQoL-6D following six BMGIM sessions. Conclusion: While early evidence from this study recognised the therapeutic potential of BMGIM for family caregivers, further feasibility research with this population is warranted.
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ItemLearning 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(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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ItemNo Preview AvailableExploring Shared Musical Experiences in Dementia Care: A Worked Example of a Qualitative Systematic Review and Thematic Synthesis(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.