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Published on: February 16, 2017
Music Therapy for Pain Management for People With Advanced Cancer: A Randomized Controlled Trial
Joke Bradt1, Amy Leader2, Brooke Worster3
1Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA.
Objective:
To improve mechanistic understanding, this randomized controlled trial examined anxiety, mood, emotional support, and pain-related self-efficacy as mediators of music therapy for pain management in people with advanced cancer.
Methods:
People with advanced cancer who had chronic pain were randomized (1:1) to 6 weekly individual music therapy or social attention control sessions. We measured mediators and pain outcomes (pain interference and pain intensity) using self-report measures at baseline, session 4, and post-intervention. We included outcome expectancy/treatment credibility, music reward, adult playfulness, and baseline pain interference and pain intensity as moderators.
Results:
Participants (n = 92) had a mean age of 56 years. Most were female (71.7%), white (47.8%) or Black (39.1%), and had stage IV cancer (75%). Self-efficacy was found to be a significant mediator of music therapy for pain intensity (indirect effect ab = 0.79, 95% CI 0.01-1.82) and pain interference (indirect effect ab = 1.16, 95% CI 0.02-2.51), while anxiety, mood, and emotional support were not. The mediating effect of pain-related self-efficacy was significantly moderated by baseline pain interference but not by the other moderators.
Conclusions:
The findings suggest that the impact of music therapy on chronic pain is mediated by self-efficacy. This knowledge can help optimize music therapy interventions for chronic pain management for people with advanced cancer by capitalizing on teaching music-based self-management strategies.
Trial Registration:
ClinicalTrials.gov identifier: NCT03432247.
