Melbourne Conservatorium of Music - Theses
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ItemThe accumulative effects of music therapy on dementia-related speech deficits in a sub-acute hospital setting( 2011)A single blinded randomised control trial was conducted to determine the accumulative effects of Music Therapy on dementia-related speech deficits. The hypotheses to be tested whether a programme of MT will result in greater improvement in dementia-related spontaneous speech deficits (in particular naming), than a programme of DT and 2) whether a programme of either MT or DT will result in a reduction in dementia-related spontaneous speech deficits (in particular naming) compared to a non intervention (control) group. Fifty-one participants with moderate to severe dementia, were randomised into 3 groups, one being the control group, the other two groups receiving either Music Therapy (MT) or Diversional Therapy (DT) (referred to as Recreational Therapy in the USA). The 45 to 60 minute Music Therapy and Diversional Therapy sessions were run concurrently every Monday, Wednesday and Friday morning for 3 weeks by the author, a Registered Music Therapist or a Diversional Therapist. The Music Therapy sessions consisted of MT techniques previously used in Music Therapy dementia-related language studies, which included singing familiar songs, word cueing, instrument playing, music and reminiscence and music and movement. The Diversional Therapy activities were based on cognitive activities, physical stimulation and creative expression through arts and crafts activities. Data was collected at baseline and within 48 hours of the final session by the chief investigator and the research assistant. Data was generated by the following validated and standardised tools for the field of dementia: the Boston Naming Test Short Form (Mack, Freed, Williams, & Henderson, 1992), the Animal Naming Test (Spreen & Strauss, 1998), the Mini Mental State Examination (Folstein, Folstein, & McHugh, 1975), Geriatric Depression Scale, short version (Sheikh, 1986; Yesavage et al., 1983) and the Digit Span Test (Hunsley, Hanson, & Parker, 1988). Using a one-way repeated ANOVA the changes in the scores of the MT group were compared to the DT group (hypothesis 1), and score changes in both the MT and DT group were compared to the non-intervention (NI) group (hypothesis 2). Results of the one way repeated ANOVA did not support the two hypotheses. Changes in the scores of the secondary outcome measures using a one way repeated ANOVA also did not support the two hypotheses. Possible reasons for the null hypotheses are discussed including the research design, choice of research tools, and the challenges faced when conducting research studies within the dementia population. This study, with its large participant numbers and stringent research design significantly contributes to MT research literature. This study is also the first of its kind to define the MT technique of “word cueing”. Recommendations for future MT and dementia-related language deficits are discussed.
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ItemAn investigation of premature infant response to recorded music with maternal involvement versus no maternal involvement: a randomised control trial( 2011)The incidence of premature birth has increased over the past two decades in Australia. While survival rates have improved and stabilised, there has not been a decrease of neuro-developmental and behavioural problems arising from prematurity. Because of this, there is an increasing understanding of the need to address non-medical needs of the premature infant in hospital including the integral role of the family during this time. In a repeated-measures randomised control trial, this study sought to determine the effect of maternal presence on the premature infant’s physiological and behavioural response to recorded music and on infant status overall. Participants were 22 clinically stable premature infants (born at >28 weeks gestation and enrolled at >32 weeks gestation) and their mothers in the NICU. Both Experimental and Control groups were exposed to one session consisting of a baseline of 6 minutes of ambient noise, followed by two alternating 6 minute periods of music and no-music (total 30 minutes). The Experimental group infants had the mother present for the first twelve minutes (baseline and first music period) compared to the Control group without mother present at any time. The auditory stimulus was the NICU ambient noise, and the music stimulus was recorded lullaby music. Physiological monitoring included heart rate and oxygen saturation. The infant's behavioural state was classified using the Six Derived States of Behaviour classifications (Thoman, 1990). A Restricted Maximum Likelihood (REML) model was used to analyse the physiological and behavioural responses. There were no significant effects of maternal presence on physiological or behavioural outcome measures in either group over time. The Experimental group had consistently lower heart rate than the Control group. There was a significant difference in oxygen saturation (p< 0.05) between the Mother Present and Mother Absent periods in the Experimental group and infants responded to music with more Quiet Sleep and higher oxygen saturation in the presence of the mother. Findings from this study suggest that maternal presence had a positive effect on premature infant physiological and behavioural status during music and no music periods and a significant effect on oxygen saturation. This finding is worthy of more substantial investigation.
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ItemThe impact and effect of group music therapy on anxiety, depression, quality of life and coping with women with breast cancer: a mixed methods study( 2011)This mixed method study investigated the impact and effect of group music therapy on anxiety, depression, coping and quality of life, and the experience of music therapy for women with breast cancer. Four groups of women received 6 weekly music therapy sessions that incorporated various music therapy methods. Eighteen women at different stages of the disease trajectory took part in the study. A decision tree was developed to determine the most appropriate intervention to use each session. The pre and post program measures were the Depression Anxiety Stress Scale (DASS), the Coping Orientation to Problems Experienced Inventory (COPE), the European Organisation for Research and Treatment for Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the European Organisation for Research and Treatment for Cancer Quality of Life Questionnaire Breast Cancer Module (QLQ-B23 (breast cancer). Visual Analogue Scales (VAS) measured mood, anxiety, coping and quality of life, pre and post each session. Qualitative data was gathered through focus group interviews which were held post music therapy program. A statistically significant improvement was found on one item of the EORTC QLQ-B23 (breast cancer) inventory, but there were no other notable changes. There were trends on two items of the COPE inventory, but no other changes, and no detected changes on the DASS. Statistically significant improvement was found on all four items on the VAS across all four groups, indicating that the music therapy sessions had a significant impact during the course of the six week program. The themes emerging from the qualitative analysis evolved from discussions about the music therapy sessions, the group experience and living with breast cancer. These were: a) music was heard and appreciated differently, b) the sessions allowed reflection, c) playing the chord harp was a voyage of discovery, d) songwriting was meaningful, e) listening to songs, singing and song writing were very moving experiences, f) confusion over the questionnaires, g) experiencing challenging moments, h) not enough time in the sessions and there were too few people, i) sharing experiences, j) it was a special space, k) the feeling endured, l) appreciation of the music therapist, m) it was a discrete experience, n) wanting to join a choir, o) the need to discuss the effects of treatment, p) silence of breast cancer, q) the impact on others of the diagnosis, r) seeing the funny side, s) it was a dual process coping with many things, and t) travelling similar but different paths. Individual distilled essences were generated from the focus group data, depicting the women’s distinctive experiences. Group essences were also developed from the data, illustrating the different group experiences. This study is one of only a few to examine a group music therapy model for women with breast cancer. Even though the study was small the findings make an important contribution to the research literature on the effect of group music therapy for women living with breast cancer.