Music Therapy's Relevance in a Cancer Hospital Researched through a Constructivist Lens
O'Callaghan, Clare, McDermott, Fiona, Journal of Music Therapy
The constructivist research paradigm informed a research investigation on the relevance of music therapy in a cancer hospital, that is, what did the music therapy do and did it help? Over 3 months, criterion sampling was used to elicit interpretations in 5 studies from 5 sources: 128 patients who participated, 27 patients who overheard or witnessed music therapy, 41 visitors, 61 staff, and the music therapist-researcher. Fifty-seven percent of the patients who participated had advanced or end stage cancer. The music therapist's interpretations were recorded in a reflexive clinical journal and the respondents' interpretations were written on anonymous open-ended questionnaires. Thematic and content analyses were performed on the 5 groups of data with the support of qualitative data management software. Findings from the 5 data groups were contrasted and compared. Many patients', visitors' and staff members' affective, contemplative, and imagined moments in music therapy affirmed their "aliveness," resonating with an expanded consciousness, in a context where life's vulnerability is constantly apparent. Philosophical depictions about the relevance of music in human life, including theories by Addis and Winnicott, substantiated the therapeutic reactions.
The choice of method is ... influenced by the assumptions that the researcher makes about science, people and the social world. In turn, the method used will influence what the researcher will see (Minichiello, Aroni, Timewell, & Alexander, 1995, p. 9).
Palliative medicine, with its emphasis on helping patients and families achieve the best quality of life possible, should be an integral component of cancer care (MacDonald, 1998). While music therapy in palliative care has received widespread attention (Aldridge, 9 1999; Gallagher, Huston, Nelson, Walsh, & Steele, 2001; Milliard, 2003; Krout, 2000; Lee, 1995; Martin, 9 199 89; Munro, 1984; Munro & Mount, 1978; O'Callaghan, 2003; O'Kelly, 2002; Rykov & Salmon, 1998; Thematic issue, 2001), limited research on music therapy with hospitalized cancer patients exists (Bailey, 1983; Boldt, 1996; O'Brien, 1999; O'Callaghan & Colegrove, 1998). The constructivist research paradigm (Cuba & Lincoln, 1994) informed the research investigation described in this article. It consisted of five studies, designed to investigate the relevance of music therapy in a 110 bed cancer treatment and research centre. Relevance was examined through inquiring about what music therapy did and whether it helped. The five studies' findings, which were contrasted and compared, were substantiated by philosophical and psychoanalytic reflections about music's importance (O'Callaghan, 2001).
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Music therapy in cancer care is the creative and professionally informed use of music in a therapeutic relationship with people identified as needing physical, psychosocial, or spiritual help, or with people aspiring to experience further self-awareness, enabling increased life satisfaction and quality. While the focus of music therapy is on the therapeutic relationship, therapeutic components of straightforward applications of music are also evident in cancer care (Beck, 9 1999 1; Zimmerman, Pozehl, Duncan, & Schmidt, 1989). Pertinent research reflects varied philosophical orientations, providing different lenses through which the use of music and music therapy in cancer care can be examined.
Quantitative research demonstrated that live music conditions resulted in cancer inpatients experiencing (a) reduced tension anxiety and improved vigor, when examined with the Profile of Mood States Questionnaire (Bailey, 1983), and (b) a helpful means of self-expression, improved relaxation, and reduced stress, boredom, and anxiety, when answering a structured questionnaire (O'Brien, 1999).
Studies using taped music conditions with people living with cancer (either inpatients, day patients, or a "cancer help center"), usually in convenience samples, revealed reports of reduced pain (Beck, 1991; Zimmerman etal, 1989), anxiety (Frank, 1985; Sabo & Rush Michael, 1996), perceived nausea (Standley, 1992), tension and energetic arousal, and improved well-being and immunological responses (Burns, Harbuz, Hucklebridge, & Bunt, 2001). …