While the research literature does not include studies that utilize improvisational, compositional, and re- creative methods, this does not mean that these methods are contraindicated for surgical and procedural support. It does require careful consideration regarding the patient’s needs and what is feasible during the procedure. The music therapy method should in no way interfere with the procedure. The procedure should be able to be conducted and completed as it typically would be. The music therapy method employed is designed to enhance the patient experience and patient care. Be sure, when selecting the method, to review the important considerations for surgical and procedural support denoted earlier in this chapter.
It is important to inform the staff of how music therapy is being utilized and how this is intended to assist the patient to give them a clear understanding of the intervention (Heiderscheit, Chlan, &
Donley, 2011). This can allow the staff to feel prepared in understanding the role of each team member involved in the procedure, and it helps to ensure support for the patient throughout the process. The process of the procedure should be clear, so that questions and clarifications do not need to take place in the midst of the procedure, as this can cause anxiety for the patient and impact patient care.
S
UMMARY ANDC
ONCLUSIONSThe Department of Health and Human Services reports in the National Survey of Ambulatory Surgery (NSAS) Survey, that in 2006 an estimated 53.3 million nonsurgical and surgical procedures were performed (Cullen et al., 2009). With so many procedures being completed each year, there are many opportunities for music therapists to provide support and nonpharmacological means of anxiety and pain management for patients. There is a wide variety of surgeries and procedures conducted, and the level of invasiveness of procedures differs greatly. In order to best meet with needs of patients during procedures, understanding the level of invasiveness is required, as well as having an understanding of the procedure itself and the patient’s needs throughout this process.
The current body of research surrounding surgical and medical procedures does demonstrate a positive trend toward the use of receptive methods. Currently, there is no evidence in the research literature utilizing creative, re-creative, and improvisational methods in surgical and medical procedures with adults. While this is absent in the literature surrounding adults, it is evident in procedures for pediatric patients (Loewy, 1997; Standley, 2005). Additionally, these methods may currently be utilized in clinical settings and currently have not been reported in the literature. While various methods of music therapy may be suitable for surgical and procedural support, it is important to determine what method is best suited for the patient and for the given procedure. This requires the music therapist to understand the procedure the patient will be undergoing and then to complete an assessment of the patient’s needs before, during, and after this procedure, as well as music preferences.
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ESOURCESHealth Journeys. Dr. Belleruth Naparstek has created and produced a wide array of directed imagery
recordings. They can be purchased and downloaded at www.HealthJourneys.com
Wellscapes. This is an iApp that includes five different five-minute videos with guiding and music.
Videography is by renowned nature photographer Craig Blacklock, with guiding script and music
accompaniment by Annie Heiderscheit. These can be purchased and downloaded at www.csph.umn.edu. Twenty-minute versions are also available as well.
A
PPENDIXA
M
USICA
SSESSMENTT
OOL(MAT)*
Chlan and Heiderscheit, 2009 *used with permission Background Information: Patient Name: ______________________________________________________________ Date: ____________________________________________________________________ Diagnosis: ________________________________________________________________ Age: ________Education: ____________________________________________________ Vocation: _________________________________________________________________ Ethnic background: __________________________________________________________ Religion/Faith practice: _______________________________________________________ Date of ICU admission:
________________________________________________________________________ Reason for admission:
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Significant events prior to admission:
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Current mood state
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Any hearing impairment? Specify.
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ PART I: Patient Music Assessment
1. Do you like to listen to music? Yes No 2. Do you play an instrument(s)? Yes No
If yes, what do you play?
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________
3. Are you a professional musician? Yes No 4. Are you a hobbyist musician? Yes No
5. When do you like to listen to music? (Check all that apply)
___ relaxation ___ stress reduction ___ during meals ___ pure enjoyment ___ to pass time ___ w/ family/friends ___ with exercise ___ for prayer ___ during work Other: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 6. What types of music do you enjoy? (Check all that apply)
___ Classical ___ Religious/Sacred ___ Rock
___ Rhythm & Blues ___ Country ___ Hip-Hop
___ Reggae ___ Jazz ___ Rap
___ New Age ___ World Music ___ Alternative
___ Heavy Metal ___ Oldies (1950–1970) ___ Pop music ___ Other ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 7. Any particular group(s) or artist(s) you prefer?
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 8. What instruments or instrumental sounds do you like? (Check all that apply)
___ Orchestral ___ Harp ___ Classical guitar
___ Vocal ___ Flute ___ Folk guitar
___ Piano ___ Saxophone ___ Percussion/drumming
___ Brass or horns ___ Clarinet ___ World instruments ___ Oboe ___ Ocean waves ___ Environmental sounds Other: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 9. Are there any types of music that you DO NOT like?
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________
10. Are there any groups or artists you DO NOT like? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 11. Are there any instruments or instrumental sounds that you DO NOT like?
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 12. Are there any cultural considerations or is culture an important aspect of your music selection? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 13. Any other information you would like to share or that I should know?
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ General Information & Comments:
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________