Music-based “Play” Helps Young Cancer Patients Cope

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For young cancer patients, acting out a couple of rounds of “Five Little Monkeys Jumping in the Bed” can provide more than just a silly way to have fun or learn math.

It can also help children deal with the significant stress associated with hospital visits for treatment or diagnosis, according to a newly published study.

In a study of 4- to 7-year-old cancer patients, children whose hospital care included music-based activities such as playing handheld instruments or singing action songs like “The Five Little Monkeys,” demonstrated a greater frequency of positive coping behaviors than children who simply listened to music or audio storybooks.

The children who participated in what is called “active music engagement” were more prone to smile or laugh; turn the pages of a book while playing; fix their eyes on an activity; or initiate a comment, question or request from a parent, sibling or other person.

“Those are not things kids tend to do when they are under stress. They tend to withdraw and shut down,” said Dr. Sheri L. Robb, a behavioral oncology fellow in the School of Nursing at Indiana University-Purdue University Indianapolis (IUPUI) and the study’s principal investigator.

The study supports the use of music-based activities to help hospitalized pediatric oncology patients, says Robb, who is also a certified music therapist. The coping behaviors studied included positive facial affect, behavioral engagement and initiation.

“Yes, this music intervention, which is also interactive, helps increase those coping behaviors in kids,” Robb says. “They’re in a better mood . . . they’re more involved, they’re physically more active, they’re are making decisions, they are making choices, they are initiating in the environment. Based on coping research we know that those are good indicators of better coping.”

The study is outlined in “Randomized, Controlled Trial of the Active Music Engagement (AME) Intervention on Children with Cancer,” published online this week by Wiley InterScience (http://www.interscience.wiley.com). It will appear in a 2008 edition of the journal Psycho-Oncology.

The study involved 83 patients from six U.S. hospitals, including patients from the Riley Hospital for Children located at IUPUI. The study was financed by a National Association of Recording Arts and Sciences grant awarded to the American Music Therapy Association. It was completed while Robb, at IUPUI since August 2007, was on the faculty at the University of Missouri-Kansas City.

Robb’s colleagues in the study included music therapists from the University of Kansas, Lawrence, Kan.; Phoenix Children’s Hospital, Phoenix, Ariz.; Penn State Milton S. Hershey Medical Center, Hershey, Penn.; University of Missouri-Kansas City, Kansas City, Mo.; Children’s Mercy Hospitals and Clinics, Kansas City, Mo.; Rainbow Babies and Children’s Hospital, Cleveland, Ohio; Southern Methodist University, Dallas, Texas; Iowa City Hospice, Iowa City, Iowa; University Hospitals Ireland Cancer Center, Cleveland, Ohio; and Riley Hospital for Children, Indianapolis, Ind.

Forty-nine percent of the reported 12, 400 cases of cancer among children and adolescents, occur in children nine and under, according to National Cancer Institute statistics cited in the Wiley InterScience report. Robb’s study is one of few to investigate how interventions can change coping behaviors.

With more children surviving cancer, there is a need to better understand how to make the experience less stressful so that survivors aren’t struggling to adjust, Robb said.

While there is a general consensus that music therapy helps, researchers need to better understand how it helps specifically in order to create better interventions that are more efficient and effective, the IUPUI researcher said.

Studies such as the one recently published are also a step toward making music therapy a standard of care for young cancer patients, she added.

Future studies will look at how music-based activities can be used to help young patients and their families learn to manage anxiety and discomfort during hospitalization.

Source: Indiana University-Purdue University Indianapolis (IUPUI)

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