DOI: 10.14457/tu.the.2018.1688
title: A randomized controlled trial examining the effects of a music and biofeedback program on Thai cancer patients receiving palliative care

description: Cancer can cause both physical and emotional symptoms, especially pain and stress. The relationship between stress and pain is complex. Stress can lead to physical effects which can increase pain. Intervention to decrease both physical and emotional symptoms is essential. The application of music together with biofeedback training for stress and pain in cancer patients is an interesting prospect. This research investigated the Effects of a Music and Biofeedback Program for Thai Cancer Patients within Palliative Care at Thammasat University Hospital. The sample size comprised 88 cancer patients by randomized controlled trial, divided into four groups with 22 cases in each group, and the total time period was 8 times. Experimental group 1 comprised cancer patients who were received music and received routine nursing care provided by Thammasat University Hospital (TUH). Experimental group 2 was a group of cancer patients who were received a biofeedback training program, and also received routine nursing care provided by TUH, Experimental group 3 was a group of cancer patients who were received music together with a biofeedback training program, and also received routine nursing care provided by TUH, and the control group comprised cancer patients who were received routine only nursing care provided by TUH.The instruments included: the Symptoms of Stress Inventory (SOSI), the pain score, biofeedback training, music relaxation, guidelines for stress and pain management, and a home music record. This study use advanced statistics, a repeated Measures between factors MANOVA, to determine whether there were statistically reliable mean differences among the groups. This research compared the average score of stress from the SOSI, pain score, VS, EEG, and EMG assessment of all groups. The results of comparative analysis of stress in each time period between the three experimental groups found that the 3rd experimental group (music and biofeedback) had the highest mean during the time before the experiment. Means continuously decreased, with lowest mean in the 3rd stress. The 1st experimental group (music) and the 2nd experimental group (biofeedback) gave decreasing means, while the control group recorded higher stress means in all measurement periods. However, stress was highest in the 3rd experimental group. Moreover, The results of comparative analysis for each time period between experimental groups showed that SOSI, EEG, and EMG were significantly different in mean scores between time1 to time2, and time2 to time3 in groups 1, 2 and 3. Group 4 was not significantly different. The limitations of this study were patients with breast cancer, colorectal cancer, and cervical cancer and did not represent all types of cancer and the most participants have a very less pain or no pain (level 0-1 of pain scale) which was tolerable without medicine taken, so it was not able to evaluate the changes of pain. Limitation of the experiment included practicing listening to music together with a biofeedback program. The researcher could not control the length of time for listening to the music and the patient’s practice at home. Principles of practicing through a biofeedback program involved 8 times of correct practice with the researcher until the patients were able to self-control stress and implement the technique of relaxation by listening to the music for controlling and reducing stress effectively without using the tools. However, this study can help patients manage their stress more effectively. In addition to reducing mortality rate, lowering costs, and providing useful guidance for the prevention and treatment of cancer and the care of patients, it may also prove useful as information to support its implementation and application in nursing.