title: Massage, Music, and Art Therapy in Hospice: Results of a National Survey.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) provides clinical benefits to hospice patients, including decreased pain and improved quality of life. Yet little is known about the extent to which U.S. hospices employ CAM therapists.
  
  
  OBJECTIVE
  To report the most recent national data regarding the inclusion of art, massage, and music therapists on hospice interdisciplinary teams and how CAM therapist staffing varies by hospice characteristics.
  
  
  METHODS
  A national cross-sectional survey of a random sample of hospices (n = 591; 84% response rate) from September 2008 to November 2009.
  
  
  RESULTS
  Twenty-nine percent of hospices (169 of 591) reported employing an art, massage, or music therapist. Of those hospices, 74% employed a massage therapist, 53% a music therapist, and 22% an art therapist, and 42% expected the therapist to attend interdisciplinary staff meetings, indicating a significant role for these therapists on the patient's care team. In adjusted analyses, larger hospices compared with smaller hospices had significantly higher odds of employing a CAM therapist (adjusted odds ratio 6.38; 95% CI 3.40, 11.99) and for-profit hospices had lower odds of employing a CAM therapist compared with nonprofit hospices (adjusted odds ratio 0.52; 95% CI 0.32, 0.85). Forty-four percent of hospices in the Mountain/Pacific region reported employing a CAM therapist vs. 17% in the South Central region.
  
  
  CONCLUSIONS
  Less than one-third of U.S. hospices employ art, massage, or music therapists despite the benefits these services may provide to patients and families. A higher proportion of large hospices, nonprofit hospices, and hospices in the Mountain/Pacific region employ CAM therapists, indicating differential access to these important services.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York, USA; James J. Peters VA, Bronx, New York, USA.
authors.forename: Aleksandra S
authors.initials: AS
authors.lastname: Dain
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Bradley
authors.affiliation: The John D. Thompson Hospice Institute for Education, Training, and Research, Inc., Branford, Connecticut, USA.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Hurzeler
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: Melissa.Aldridge@mssm.edu.
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Aldridge
mesh_terms: D001155:Art Therapy / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006282:Health Personnel / Q000706:statistics & numerical data; D017051:Hospice Care / Q000379:methods / Q000706:statistics & numerical data*; D006738:Hospices / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008405:Massage / Q000706:statistics & numerical data*; D009147:Music Therapy / Q000706:statistics & numerical data*; D014481:United States
keywords: Hospice; art therapy; complementary and alternative medicine; massage therapy; music therapy