title: Favored subjects and psychosocial needs in music therapy in terminally ill cancer patients: a content analysis.
abstract: BACKGROUND
  Research has shown positive effects of music therapy on the physical and mental well-being of terminally ill patients. This study aimed to identify favored subjects and psychosocial needs of terminally ill cancer patients during music therapy and associated factors.
  
  
  METHODS
  Forty-one Patients receiving specialized inpatient palliative care prospectively performed a music therapy intervention consisting of at least two sessions (total number of sessions: 166; per patient average: 4, range, 2-10). Applied music therapy methods and content were not pre-determined. Therapeutic subjects and psychosocial needs addressed in music therapy sessions were identified from prospective semi-structured "field notes" using qualitative content analysis. Patient- and treatment-related characteristics as well as factors related to music and music therapy were assessed by questionnaire or retrieved from medical records.
  
  
  RESULTS
  Seven main categories of subjects were identified: "condition, treatment, further care", "coping with palliative situation", "emotions and feelings", "music and music therapy", "biography", "social environment", and "death, dying, and spiritual topics". Patients addressed an average of 4.7 different subjects (range, 1-7). Some subjects were associated with gender (p = .022) and prior impact of music in patients' life (p = .012). The number of subjects per session was lower when receptive music therapy methods were used (p = .040). Psychosocial needs were categorized into nine main dimensions: "relaxing and finding comfort", "communication and dialogue", "coping and activation of internal resources", "activity and vitality", "finding expression", "sense of self and reflection", "finding emotional response", "defocusing and diversion", and "structure and hold". Patients expressed an average of 4.9 psychosocial needs (range, 1-8). Needs were associated with age, parallel art therapy (p = .010), role of music in patient's life (p = .021), and the applied music therapy method (p = .012).
  
  
  CONCLUSIONS
  Seven main categories of therapeutically relevant subjects and nine dimensions of psychosocial needs could be identified when music therapy was delivered to terminally ill cancer patients. Results showed that patients with complex psychosocial situations addressed an average number of five subjects and needs, respectively. Some socio-demographic factors, the role of music in patient's lives and the applied music therapy methods may be related with the kind and number of expressed subjects and needs.
authors.affiliation: Department of Oncology, Hematology and BMT with section of Pneumology, University Medical Center Eppendorf, Hamburg, Germany.|Department of Medical Psychology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Pia
authors.initials: P
authors.lastname: Preissler
authors.affiliation: Department of Oncology, Hematology and BMT with section of Pneumology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kordovan
authors.affiliation: Department of Oncology, Hematology and BMT with section of Pneumology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Anneke
authors.initials: A
authors.lastname: Ullrich
authors.affiliation: Department of Oncology, Hematology and BMT with section of Pneumology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
authors.affiliation: Department of Oncology, Hematology and BMT with section of Pneumology, University Medical Center Eppendorf, Hamburg, Germany. k.oechsle@uke.de.
authors.forename: Karin
authors.initials: K
authors.lastname: Oechsle
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D005190:Family; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009147:Music Therapy / Q000379:methods / Q000706:statistics & numerical data; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology*; D016896:Treatment Outcome
keywords: Cancer; Music therapy; Needs; Palliative care; Psychosocial; Subjects; Terminally ill