Effects of music on major depression in psychiatric inpatients

The study was to assess the effectiveness of soft music for treatment of major depressive disorder inpatients in Kaohsiung City, Taiwan. A pretest-posttest with a two-group repeated measures design was used. Patients with major depressive disorder were recruited through referred by the psychiatric physicians. Subjects listened to their choice of music for 2 weeks. Depression was measured with the Zung's Depression Scale before the study and at two weekly posttests. Using repeated measures ANCOVA, music resulted in significantly better depressive scores, as well as significantly better subscores of depression compared with controls. Depression improved weekly, indicating a cumulative dose effect. The findings provide evidence for psychiatric nurses to use soft music as an empirically based intervention for depressed inpatients.     

Evaluation of music therapy and other treatment modalities by adult psychiatric inpatients

The purpose of this study was to investigate adult psychiatric patients' evaluation of music therapy and other aspects of their overall treatment. Twenty-seven patients hospitalized on an open psychiatric ward of Tulane Medical Center in New Orleans served as subjects. They rated music therapy, art therapy, recreation therapy, traditional therapies, and general aspects of care provided during their hospitalization with a semantic differential consisting of four adjective pairs. Results from a one-way analysis of variance showed that music therapy was rated significantly higher than art and recreation therapy on the pleasurable/painful scale, but no significant differences were found among the activity therapies on the three remaining scales. Further one-way analyses of variance showed that the activity therapies taken as one aspect were rated significantly higher than several therapies on specific scales; also, they were not significantly less important or less successful than medication, which was rated highest on these two scales. The author suggests that an instrument with multiple evaluation scales may be specifically adapted to any program, and can provide information to guide music therapists in delivering valuable therapeutic services.     

Preparation of psychiatric inpatients for group therapy

Nurses have been acquiring the skills necessary for involvement as cotherapists in group therapy with increasing frequency and have been taking a more active role in the inpatient psychiatric treatment. Preparation of patients for group therapy is supported by the literature for outpatients and equivocally supported for inpatients by this study. Nurses, with their frequent and prolonged contact with inpatients, are in the unique position of being able to form a close, consistent relationship that allows them to assess expectations, plan individualized preparation for the patient, and reinforce the importance of group therapy within the total treatment program. Continued research is needed to assess further the effectiveness of preparation for inpatients prior to group therapy and the nurses' role in preparation.     

Evaluation of assertiveness training for psychiatric patients

Aim and objectives. To investigate the effectiveness of assertiveness training programmes on psychiatric patients’ assertiveness, self‐esteem and social anxiety. Background. Assertiveness training programmes are designed to improve an individual’s assertive beliefs and behaviours, which can help the individual change how they view themselves and establish self‐confidence and social anxiety. It is useful for patients with depression, depressive phase of bipolar disorder, anxiety disorder or adjustment disorder. Design. Experimental. Method. There were 68 subjects (28, experimental group; 40, diagnosis‐matched comparison group). Subjects in experimental groups participated in experimenter‐designed assertiveness training twice a week (two hours each) for four weeks. The comparison groups participated the usual activities. Data were collected in the two groups at the same time: before, after and one month after training programme. Efficacy was measured by assertiveness, self‐esteem and social anxiety inventories. A generalised estimating equation was used for analysis. Results. After training, subjects had a significant increase in assertiveness immediately after the assertiveness training programme and one‐month follow‐up. There was a significant decrease in social anxiety after training, but the improvement was not significant after one month. Self‐esteem did not increase significantly after training. Conclusion. With our sample of patients with mixed diagnoses, assertiveness seemed to be improved after assertiveness training. Relevance to clinical practice. Patients would benefit more from the assertiveness training programme for the change in how they view themselves, improve their assertiveness, properly express their individual moods and thoughts and further establish self‐confidence. The assertiveness training protocol could be provided as a reference guide to clinical nurses.     

瑜伽练习和音乐治疗对精神分裂症住院患者生活质量影响的研究

目的 探讨瑜伽练习、音乐治疗对精神分裂症住院患者的生活质量的影响.方法 将107例精神分裂症住院患者随机分为瑜伽练习组(38例)、音乐治疗组(26例)和常规治疗组(43例).瑜伽组和音乐组给予8 w瑜伽练习和音乐治疗.采用GQOLI-74评定三组患者治疗前后的生活质量.结果 治疗结束后,瑜伽组和音乐组在总分以及躯体功能、心理功能和社会功能三个维度,以及除住房、社会环境和经济状况外的17个因子分上均显著高于常规治疗组(P＜0.05).瑜伽治疗组在总分、躯体功能和社会功能2个维度分以及性功能、自尊、工作与学习、业余娱乐生活等4个因子分上均显著高于音乐治疗组(P＜0.05).结论 瑜伽练习和音乐治疗都有利于精神分裂症住院患者的生活质量的提高;瑜伽练习对住院患者生活质量的提高较优于音乐治疗.     

Violent psychiatric inpatients in a public hospital

Violence in inpatient psychiatric settings is a clinically significant and relevant problem requiring attention by the psychiatric community. Despite the prevalence of research on violent behavior, few nursing studies have been conducted that explore the components of nursing care that may influence the amount of violence occurring in inpatient psychiatric settings. The purpose of the study was to identify the characteristics of violent patients and the components of nursing care that are related to violent patient behavior. A qualitative study was conducted using participant observation and grounded theory methodology. Data were collected in a metropolitan public hospital over a 9-month period. Six categories of violent patients were identified during data analysis: (1) the user, (b) the outlaw, (c) the rebel without a cause, (d) the little big man, (e) the child, and (6) the vamp. Implications of the study for clinicians working in inpatient psychiatric settings are discussed.     

Feminist music therapy pedagogy: a survey of music therapy educators

This study surveyed 188 music therapy educators regarding their views and use of feminist pedagogy and feminist music therapy. The purpose of this study was two-fold: (a) to determine how many music therapy educators used feminist pedagogy and (b) to determine if there was a relationship between the use of feminist pedagogy and academic rank of the participants. Seventy-two participants responded to this study, with 69 participants included for data analysis. Stake and Hoffman's (2000) feminist pedagogy survey was adapted for this study, examining four subscales of feminist pedagogy: (a) participatory learning, (b) validation of personal experience/development of confidence, (c) political/ social activism, and (d) critical thinking/open-mindedness. The results revealed that 46% (n=32) of participants identified as feminist music therapists and 67% (n=46) of participants identified as using feminist pedagogy. Results of a mixed analysis of variance revealed a statistically significant difference within the four survey subscales (p<.0001), no significant difference (p=.32) for academic rank, and no significant interaction (p=.08) of academic rank and the four survey subscales. Tukey's post hoc analysis of the data indicated that the survey subscale measuring political activism (p<.0001) was significantly lower than the other three survey subscales. In addition, a qualitative analysis on open-ended responses is also included. Discussion of the results, limitations, and areas for future research are addressed.     

Evaluation of a substance use treatment program for forensic psychiatric inpatients

There have been few evaluations of substance use interventions for forensic psychiatric patients. In this study, we evaluated a manualized substance use treatment for forensic inpatients by comparing 35 treatment completers (who attended 75% or more of their sessions) and 30 non-completers (less than 75%) on self-report and urinalysis measures. The treatment completer group showed significant increases in substance-related knowledge and self-reported relapse prevention skills, but there was no significant difference between completers and non-completers in time to first substance use (if any) or in having a positive urine screen result 12 or 24 months after participation in the program. The results indicated improvement in knowledge and self-reported skills, but this did not translate to decreased substance use as measured by urinalysis. Implications for substance use treatment are discussed.     

Therapeutic music for patients with psychiatric disorders

Many patients with psychiatric disorders struggle with poor skills in coping, communication, socialization, and self-expression that may result in dysfunctional behavioral, cognitive, and emotional responses. Therapeutic music offers a noninvasive approach to strengthen these skills and effect behavior change. At a regional inpatient psychiatric hospital in Colorado, a program of therapeutic music was developed using Rogers' theory of unitary human beings as the theoretical framework. This article describes the approach used to strengthen coping skills in communication, socialization, and self-expression. Suggestions are made for developing a program of music with similar patient populations.     

Piano jacket for perceiving and playing music for patients with cerebral palsy

Purpose: Patients with cerebral palsy with severe motor disabilities are limited not only in everyday life activities but also in choice of their hobbies. Playing a musical instrument is for the majority not possible, even though music constitutes a central component of many relaxation activities for people with disabilities. To give affected patients the opportunity to make music and to learn piano playing through somatosensory perception, a prototype of piano jacket was developed.

Method: A cycling jacket was equipped with boxes, each representing a musical note, incorporated into the sleeves. Each box contains vibration motors and LEDs. These can be used to translate the sequences of piano key presses performed at an external E-piano. An additional operation mode allows the user to actively play a melody himself by touching the same boxes that also incorporate touch sensor components.

Results: A working prototype of the piano jacket was developed.

Conclusion: The sensory piano jacket provides patients with cerebral palsy and contractures the possibility to develop sensorimotor skills, motor abilities and participation in music-related activities. The jacket is planned to be used in music lessons.

• Implications for Rehabilitation

• The system is suitable even for patients with severe motor disabilities and especially joint contractures.

• Excellent handling through large easily accessible communication buttons.

• All building blocks are held in a garment, which allows for easy portability and gripping comfort.

     

Screening child psychiatric inpatients for communication disorders: a pilot study

This study was part of a project concerned with speech and language disorders among child psychiatric inpatients. Twenty-two consecutively admitted children were screened and 10 were positive. Of these, nine were diagnosed with a speech or language delay, prevalence = 40.9 (9 of 22). A chart review of the preceding 2-year period showed that 27 of 128 admissions had been referred to the speech clinic and that 25 had positive findings, for a prevalence of 19.5% (25 of 128). The difference in the observed prevalence in these two studies was significant (chi 2 = 4.89, rho = .03). Standard clinical practice may miss some children with communication disorders (estimated sensitivity = 39%), while the new screening method shows promise (estimated sensitivity = 82%).     

Reasons for participating in occupational therapy groups: perceptions of adult psychiatric inpatients and occupational therapists

Little is known about the attitudes of psychiatric patients towards the specific role of occupational therapy within the overall context of hospital-based treatment. The present study examined this issue by asking 102 adult psychiatric inpatients to indicate their reasons for participating in an occupational therapy group programme, and comparing their responses to those of 31 occupational therapists. Both groups gave high ratings to "reasons for participation" that were related to the achievement of positive therapeutic outcomes, although therapists rated these items significantly higher. The patients, on the other hand, gave higher ratings than therapists to items related to escaping the hospital routine (e.g., "to decrease boredom"), and to achieving "secondary gains" (e.g., to get passes to leave the hospital). The results emphasize the importance of preparing patients for participation in therapy groups in order to enhance the therapeutic value of these experiences.     

Implications of technology in music therapy practice and research for music therapy education: a review of literature

This article reviews the use of technology in music therapy practice and research for the purpose of providing music therapy educators and clinicians with specific and accurate accounts of the types and benefits of technology being used in various settings. Additionally, this knowledge will help universities comply with National Association of Schools of Music requirements and help to standardize the education and training of music therapists in this rapidly changing area. Information was gathered through a literature review of music therapy and related professional journals and a wide variety of books and personal communications. More data were gathered in a survey requesting information on current use of technology in education and practice. This solicitation was sent to all American Music Therapy Association approved universities and clinical training directors. Technology applications in music therapy are organized according to the following categories: (a) adapted musical instruments, (b) recording technology, (c) electric/electronic musical instruments, (d) computer applications, (e) medical technology, (f) assistive technology for the disabled, and (g) technology-based music/sound healing practices. The literature reviewed covers 177 books and articles from a span of almost 40 years. Recommendations are made for incorporating technology into music therapy course work and for review and revision of AMTA competencies. The need for an all-encompassing clinical survey of the use of technology in current music therapy practice is also identified.