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Background: Cancer patients receiving palliative care often endure a variety of distressing symptoms, most notably pain and anxiety. Evidence suggests that music offers a symptom-alleviating effect for these patients and can also influence their physiological parameters.
Aim: This investigation was structured as a quasi-experimental study utilizing a pre-test and post-test design with a control group. Its goal was to ascertain the influence of music on pain levels, anxiety states, and vital signs among cancer patients admitted to a palliative care facility.
Methods: Data collection relied on the Patient Demographic Form, the Visual Analog Scale (VAS), the State-Trait Anxiety Inventory (STAI), and a Physiological Parameter Monitoring Form. The intervention group was exposed to relaxing instrumental Turkish music in the maqams of Hicaz and Buselik for a single 30-minute session using MP3 players and headphones, whereas the control group was instructed to observe 30 minutes of bed rest without any other activity. Measurements were taken at baseline (pre-intervention) and immediately after the 30-minute intervention period between 10:00 AM and 5:00 PM following the patient's morning analgesic dose.
Advances in medicine have increased life expectancy, leading to a rise in chronic diseases like cancer, with 14 million new cases annually, projected to reach 22 million by 2030. Cancer patients often face intensive treatments and severe symptoms, including pain and anxiety, highlighting the need for palliative care.
Nurses play a key role in symptom management, using both pharmacological and non-pharmacological methods, including music therapy. Music can stimulate neuroendocrine responses by increasing dopamine and serotonin release, activating the limbic system, increasing endorphin release, and suppressing sympathetic nervous system activity, which contributes significantly to reducing pain and anxiety while also affecting the regulation of vital signs such as blood pressure, pulse, body temperature, respiratory rate, and oxygen saturation.
This study examined the effects of music on pain, anxiety, and vital signs in 32 palliative care cancer patients using a quasi-experimental design with a pretest-posttest control group. The study was conducted between February 2021 and June 2022 at Yozgat City Hospital Palliative Care Center and Karaman Training and Research Hospital Palliative Care Center.
Patients in the intervention group listened to 30 minutes of instrumental Turkish music in the maqams of Hicaz and Buselik; controls rested quietly. The music CD was prepared by experts from the Applied Music Therapy Association (UMTED) and consisted of 13 instrumental works designed to provide relaxation and have a sedative effect. The volume was kept low and the main melody was emphasized.
Data collection took approximately 60 minutes per participant. The intervention was performed between 10:00 AM and 5:00 PM after patients received their first daily analgesic dose. Headphones were used to maintain focus and block extraneous noise, with separate devices for each patient to ensure infection control standards. Further research should explore mechanisms, patient differences, and optimal implementation protocols.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Music Intervention Group | Experimental | Before the single-session intervention, the researcher administered the Patient Description Form, STAI, and VAS, and recorded baseline vital signs (Blood Pressure, Pulse Rate, Respiratory Rate, Body Temperature, SpO2). The intervention was scheduled between 10:00 a.m. and 5:00 p.m. following the patient's morning analgesic dose. Participants rested comfortably for 30 minutes while listening to music using an MP3 player and headphones. Headphones were used to enhance focus and minimize external noise, with separate devices used for each patient to adhere to infection control standards. Immediately post-intervention (second follow-up), VAS, State Anxiety Inventory, and vital signs were re-measured and recorded. |
|
| Control Group | Other | Procedures for the Control Group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Music Application | Other | Before the single-session intervention, the researcher administered the Patient Description Form, STAI, and VAS, and recorded baseline vital signs (Blood Pressure, Pulse Rate, Respiratory Rate, Body Temperature, SpO2). The intervention was scheduled between 10:00 a.m. and 5:00 p.m. following the patient's morning analgesic dose. Participants rested comfortably for 30 minutes while listening to music using an MP3 player and headphones. Headphones were used to enhance focus and minimize external noise, with separate devices used for each patient to adhere to infection control standards. Immediately post-intervention (second follow-up), VAS, State Anxiety Inventory, and vital signs were re-measured and recorded. |
| Measure | Description | Time Frame |
|---|---|---|
| • Visual Analog Scale | A standard 10 cm tool (Price et al., 1983) where patients mark their current pain level (0 = no pain, 10 = worst possible pain). | Baseline (Pre-Intervention) and Immediately Post-Intervention (Total 30-minute intervention period). |
| Measure | Description | Time Frame |
|---|---|---|
| State Anxiety (State-Trait Anxiety Inventory - State Subscale) | Developed by Spielberger et al. (1970) and validated for Turkish by Öner and Le Compte (1985). This inventory measures transient (State) anxiety; higher scores indicate higher anxiety. Scores range from 20 to 80. Internal consistency (Cronbach's alpha) in this study was 0.81 for State Anxiety. | Baseline (Pre-Intervention) and Immediately After Intervention (30-minute intervention period). |
| Measure | Description | Time Frame |
|---|---|---|
| Systolic Blood Pressure (mmHg) | Measured using standardized sphygmomanometer according to clinical standards at baseline and immediately post-intervention. | Baseline (Pre-Intervention) and Immediately Post-Intervention (30-minute intervention period). |
| Diastolic Blood Pressure (mmHg) |
Eligibility Criteria:
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Pınar Tekinsoy Kartın | https://sbf.erciyes.edu.tr/ | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yozgat city hospital | Yozgat | Merkez | 66000 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33176590 | Background | de Witte M, Pinho ADS, Stams GJ, Moonen X, Bos AER, van Hooren S. Music therapy for stress reduction: a systematic review and meta-analysis. Health Psychol Rev. 2022 Mar;16(1):134-159. doi: 10.1080/17437199.2020.1846580. Epub 2020 Nov 27. |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| SAP | No | Yes | No | Statistical Analysis Plan | Nov 1, 2022 | Nov 22, 2025 | SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Nov 1, 2022 | Nov 22, 2025 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D000072716 | Cancer Pain |
| D001008 | Anxiety Disorders |
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001523 | Mental Disorders |
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a quasi-experimental design
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| Procedures for the Control Group | Other | The control group followed the same two-phase data collection protocol as the intervention group (first follow-up). After baseline data collection, the control group was instructed to rest quietly in bed for 30 minutes without any other activity. Immediately after the rest period (second follow-up), the VAS, State Anxiety Inventory, and vital signs were measured and recorded. |
|
| Trait Anxiety (State-Trait Anxiety Inventory - Trait Subscale) | Developed by Spielberger et al. (1970) and validated for Turkish by Öner and Le Compte (1985). This inventory measures general (Trait) anxiety; higher scores indicate higher anxiety. Scores range from 20 to 80. Internal consistency (Cronbach's alpha) in this study was 0.76 for Trait Anxiety. | Baseline (Pre-Intervention) only. |
Measured using standardized sphygmomanometer according to clinical standards at baseline and immediately post-intervention. |
| Baseline (Pre-Intervention) and Immediately Post-Intervention (30-minute intervention period). |
| Heart Rate (beats per minute) | Measured using standardized pulse oximeter at baseline and immediately post-intervention. | Baseline (Pre-Intervention) and Immediately Post-Intervention (30-minute intervention period). |
| Respiratory Rate (breaths per minute) | Measured by observation according to clinical standards at baseline and immediately post-intervention. | Baseline (Pre-Intervention) and Immediately Post-Intervention (30-minute intervention period) |
| Body Temperature (degrees Celsius) | Measured using a digital thermometer at baseline and immediately post-intervention. | Baseline (Pre-Intervention) and Immediately Post-Intervention (30-minute intervention period). |
| Oxygen Saturation (SpO₂) (%) | Measured using standardized pulse oximeter at baseline and immediately post-intervention. | Baseline (Pre-Intervention) and Immediately Post-Intervention (30-minute intervention period). |