Melbourne Conservatorium of Music - Theses
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ItemThe effect and experience of therapeutic songwriting on adult cancer patients’ quality of life, mood, distress levels and satisfaction with hospital stay( 2014)This mixed methods multi-site waitlisted randomized controlled trial addressed the overarching research question ‘What is the effect of a specific music therapy songwriting protocol, Guided Original Lyrics and Music (GOLM) on adult cancer patients’ quality of life, mood, distress levels and satisfaction with hospital stay; and how is songwriting experienced?’ This study was conducted at two sites and was open to all adult cancer patients being treated as inpatients or outpatients at both sites. The protocol was for three sessions completed over a maximum of 2 weeks. The control condition of ‘Befriending’ was a standardized talking and support protocol chosen to control for the therapist’s presence and attention. There were 50 participants in this study. An embedded mixed methods design was used in which the qualitative data was embedded within the quantitative data of this study (n=50). Nine participants were interviewed about their experience of songwriting using GOLM. Participants in the therapeutic songwriting group showed significantly higher ratings on quality of life (QOL) (p=0.019) and physical wellbeing (p=0.037) than participants in the waitlist control. There were no significant differences on physical symptoms (p=0.73), psychological wellbeing (p=0.87), existential wellbeing (p=0.15) or the total calculated score for the QOL (p=0.22), although the effect size calculations indicated there was a medium clinical effect. Participants in the therapeutic songwriting group demonstrated a significant reduction in overall Total Mood Disturbance (p =0.027) and significant decreases in tension (p=0.008), depression (p=0.38), and confusion (p=0.017) compared to the waitlist control. There were no significant differences in ratings of anger (p=0.21), vigor (p= 0.40) and fatigue (p= 0.10) however the effect size of 0.49 demonstrated a medium clinical effect in reduction of fatigue. Participants in the therapeutic songwriting group rated their mood significantly higher from baseline to immediately after writing the song (p=0.003) and overall (p<0.0005), than participants in the waitlist control. These findings were supported by the large effect size of 1.37. There was however no significant increase in mood post session 2 to post session 3 (p=0.54). There were no significant differences in distress between the participants in the therapeutic songwriting group when compared to the waitlist control (p=0.083), however there was a medium effect size. There was no significant difference in the means of the hospital satisfaction rating between groups. Overall no significant results were sustained at 2-week follow up. Nine participants’ experience of songwriting was explored in qualitative interviews, and 15 composite themes emerged concluding with the final global essence of the ‘lived experience’. The lived experience of writing an original song in music therapy using the therapeutic songwriting method GOLM was “a dynamic process across an emotional continuum, with challenging aspects of trepidation and excitement, and consequent rewards of feelings of pride and happiness.” Embedding the results in the mixed methodology framework enabled a deeper understanding of the phenomena and its impact on adult cancer patients’ quality of life, mood, and distress levels.
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ItemMusic therapy's relevance in a cancer hospital researched through a constructivist lens( 2001-09)A constructivist research paradigm informed an investigation of the relevance of music therapy (MT) in a cancer hospital, that is, (a) what did MT do(?) and (b) did it help? Over three months, criterion sampling was used to elicit interpretations from five sources: 128 patients who participated in MT, 27 patients who overheard or witnessed MT, 41 visitors, 62 staff, and the researcher who was also the MT clinician in this study. The researcher’s interpretations were recorded in a reflexive clinical journal and the respondents’ interpretations were written on anonymous open-ended questionnaires. The MT program was predominantly characterised by the use of patient and visitor selected live music. Thematic analysis, informed by grounded theory (Strauss & Corbin, 1990), and content analyses were performed on the five groups of data with the support of ATLAS/ti (Muhr, 1997) software. Many patients and visitors who experienced MT reported that MT elicited a range of affective responses and altered imaginings. Responses were especially characterised by memories being revisited but also characterised by the respondents’ “transportation” to new spaces or thoughts and physical sensations. Some staff and patients who overheard MT also reported similar experiences. The researcher, and often staff and visitors, also perceived that MT elicited affective and imagined sensations in patients.