Music Therapy
Music Therapy
Music Therapy
1, 2016
Down through the ages, music has been universally valued for its therapeutic properties based on the psychological and physiological responses in humans. However, the
underlying mechanisms of the psychological and physiological responses to music
have been poorly identified and defined. Without clarification, a concept can be
misused, thereby diminishing its importance for application to nursing research and
practice. The purpose of this article was for the clarification of the concept of music
therapy based on Walker and Avants concept analysis strategy. A review of recent
nursing and health-related literature covering the years 20072014 was performed
on the concepts of music, music therapy, preferred music, and individualized music.
As a result of the search, the attributes, antecedents, and consequences of music
therapy were identified, defined, and used to develop a conceptual model of music
therapy. The conceptual model of music therapy provides direction for developing
music interventions for nursing research and practice to be tested in various settings to improve various patient outcomes. Based on Walker and Avants concept
analysis strategy, model and contrary cases are included. Implications for future
nursing research and practice to use the psychological and physiological responses
to music therapy are discussed.
44
RTNP30-1_R2_A5_044-059.indd 44
http://dx.doi.org/10.1891/1541-6577.30.1.44
1/18/16 10:44 AM
Consequences
Antecedents
Vibration
Sound
Tone
Timbre
Intensity
Tempo
Attributes
Rhythm
Melody
Pitch
Harmony
Interval
Psychological responses
- Mood alteration
- Auditory distraction
- Memory
- Well-being
- Sleep quality
Physiological responses
- Blood pressure
- Respirations
- Heart rate
- Oxygen consumption
- Immune response
- Cognitive performance
- Gait and balance
RTNP30-1_R2_A5_044-059.indd 45
1/18/16 10:44 AM
46
In the literature, there are three different terms for using music to evoke the psychological and physiological responses. First, there is music therapy, defined as the
controlled use of music and its influence on the human being to aid in the physiological, psychological, and emotional integration of the individual during treatment of
illness or disability (Munro & Mount, 1978). In practice, music therapy is the clinical
and evidence-based use of music interventions to accomplish individualized goals
within a therapeutic relationship by a credentialed professional who has completed
an approved music therapy program (American Music Therapy Association, 2010).
Music therapy is used to improve, maintain, remediate, or prevent one or more clinical
issues for patient care (de Niet, Tiemens, Lendemeijer, & Hutschemaekers, 2009).
For example, music therapy has reduced postoperative pain (Comeaux & SteeleMoses, 2013), improved pain management (Kwan, Soek, & Seah, 2013), decrease
depression in older adults (Chan, Wong, Onishi, & Thayala, 2011), reduced anxiety
in adult patients (Li, Zhou, Yan, Wang, & Zhang, 2012) and in caregivers of patients
with cancer (Lai, Li, & Lee, 2011), reduced anxiety in ventilated patients (Korhan,
Khorshid, & Uyar, 2011), decreased nausea and vomiting in patients with cancer
(Karagozoglu, Tekyasar, & Yilmaz, 2012), and decreased posttraumatic stress in
adults (Carr et al., 2012). Other music therapy studies reported decreased agitation
in patients with dementia (Clare, 2014); decreased stress, anxiety, and depression
in older adults (Mohammadi, Shahabi, & Panah, 2011); improved mood in patients
with stroke (Kim et al., 2011); improved sleep quality and relaxation (Su et al., 2013);
and enhanced psychological well-being in patients with cancer (Foster, Wiseman,
& Pennert, 2014). Thus, there is empirical support for the conceptual model of
music therapy based on the psychological and physiological responses in various
adult populations.
A second term found in the literature is preferred music, which is defined as
systematic presentation of music selected based on personal music preferences
(Gerdner, 1997). Music can be used to introduce a sense of familiarity into a new
environment or to maximize familiarity in an existing environment. To facilitate
feelings of physical and mental relaxation, music can mask environmental noises
and refocus an individuals attention on a more pleasant emotional state (Gerdner,
1997). Listening to preferred music can induce pleasant and positive feelings with
activation of the limbic system (Menon & Levitin, 2005). Furthermore, listening to
relaxing music decreased cortisol, which can reduce anxiety and promote relaxation
(Menon & Levitin, 2005). As a result, preferred music can be a viable alternative to
chemical and physical restraints to decrease agitation in older adults with dementia
(Sung, Chang, & Lee, 2010). Listening to preferred music has also been associated
with improved mood and problem-solving skills in professional adults (Lesiuk,
2010). Thus, listening to preferred music can improve the psychological responses
to music therapy by impacting an individuals emotional state.
As an auditory time cue, music is also a stimulus for movement. Exercising to
preferred music has demonstrated beneficial effects on the psychological and physiological responses of the individual (Hutchinson & Sherman, 2014). Preferred music
enhances state motivation and arousal through the sympathetic branch of the ANS,
which increases heart, blood pressure, and respiration rate (Guyton & Hall, 2005).
RTNP30-1_R2_A5_044-059.indd 46
1/18/16 10:44 AM
RTNP30-1_R2_A5_044-059.indd 47
1/18/16 10:44 AM
48
To further extend the literature search, the following keywords were searched: concept
analysis, psychological responses to music, and physiological responses to music.
These concepts and keywords were used to search these databases: Cumulative
Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, ProQuest Nursing
& Allied Health Source, PsycINFO, and Cochrane Library. Inclusion criteria included
music history, music therapy, and music intervention studies in adult populations.
Only articles written in English or translated to English were reviewed. Articles of
music intervention studies in infants, children, adolescents, and meta-analyses
were excluded from the review. The search resulted in 158 articles, 4 books, and
3 book chapters and then limited to 75 articles, 4 books, and 3 book chapters that
met the inclusion criteria and were not duplicate citations.
Attributes of Music. The attributes of music consist of five elements: rhythm,
melody, pitch, harmony, and interval (Alvin, 1975; Bunt, 1994). These attributes are
closely related, interdependent, and nonhierarchical. As the first element, rhythm is
the pattern of repeated sounds and silences and is the most fundamental, essential,
structural, and organizational element (Tramo, 2001). Rhythm captures an individuals
attention and is the most important consideration when using music for specific
and therapeutic purposes. As an auditory time cue, rhythm influences motor control
and function based on its recurring patterns and predictable cues. Rhythmic cueing
leads to skeletal muscle synchronization and determines the timing, cadence, and
dynamics of physical movements (Thaut, 1997). Melody is the sequencing of musical pitch and intervals between musical notes. As the second element, melody is
structured by its length and intensity and expresses a mood or an emotion (Schneck
& Berger, 1999). As a form of nonverbal communication, melody can elicit emotions
from one extreme response (happy, calm, euphoric) to another (sad, anxious, angry).
Pitch, the third element, is the number of cycles that a particular sound vibrates per
second (Aldridge, 1996). Faster vibrations cause high-pitched tones often associated with cheerful or happy reactions. Conversely, slower vibrations cause lower
tones and typically denote bleakness or depression. The vibration rate influences
emotional response as rapid vibrations and are perceived as stimulating and slow
vibrations are deemed relaxing (Bunt, 1994). The fourth element, harmony, is the
result of blending pitches together to form a combination of sound. These blended
combinations can be characterized as consonant or dissonant (Bunt, 1994) and
form distinct patterns from the concurrent musical notes producing a musical chord.
Interval, the fifth and final element, is the distance between each note and it is the
integral component of the melody giving it its character and emotional response
(Schneck & Berger, 1999). As a result, the five elements of music play a significant
role in eliciting a broad spectrum of consequences such as emotional responses
(psychological) and as a stimulus for movement (physiological) that can improve
health outcomes in various patient populations.
Antecedents of Music. Antecedents are those events or incidences that come
before the particular concept (Walker & Avant, 2010). For music, the antecedents
are vibration, sound, tone, timbre, intensity, and tempo. To start, vibration is the
quivering or trembling motion of molecules resulting in sound. Without vibration,
nothing can be heard. To the human ear, sound ranges from the lowest audible
RTNP30-1_R2_A5_044-059.indd 48
1/18/16 10:44 AM
RTNP30-1_R2_A5_044-059.indd 49
1/18/16 10:44 AM
50
RTNP30-1_R2_A5_044-059.indd 50
1/18/16 10:44 AM
Model Case
The conceptual model of music therapy includes antecedents and attributes to
provide direction for developing interventions to influence the consequences.
Understanding the attributes of music is essential part of music therapy when
developing an intervention. Subsequently, the consequences of music therapy can
be used to evaluate the effectiveness of the music intervention. The model case
is an example of the conceptual model of music therapy that has all the defining
attributes of the concept (Walker & Avant, 2010).
J.H. is a 64-year-old female who recently had hip replacement surgery. In addition
to pain management after surgery, it is imperative for those who have undergone
hip replacement surgery to restore physical function. While ambulating with the
nurse from the bathroom to the chair, J.H. experiences moderate incision pain and
feels that her heart rate and breathing are faster than usual. The nurse notices J.H.
grimacing in pain and knows that she needs something in addition to pain medication so J.H. can walk to physical therapy. She complains to the nurse that she cannot
do physical therapy today and wants to go back to bed. To help alleviate J.H.s pain,
the nurse turns on the CD player at her bedside that plays big band music with a
tempo of 6080 beats per minute. As the musical composition begins, J.H. notices
the constant rhythm of the drums, melody of the trumpets, pitch of the high notes
of the flutes, harmony of the woodwinds, and the interval between each note in the
trumpets melody (attributes). The music starts out soft and slow with a tempo of 60
beats per minute and then becomes louder and increasing to a tempo of 80 beats
per minute. As the musical composition comes to an end, the volume becomes
soft again and the tempo returns to 60 beats per minute (antecedents). By the end
of the song, J.H. feels her pain is tolerable and agrees to go to physical therapy.
As a result, the music intervention shifted her attention away from the unpleasant
stimuli of pain to a more pleasant stimulus of music (psychological consequence).
Contrary Case
Contrary cases are constructed to understand what the concept is not (Walker &
Avant, 2010). For example, J.H. has returned from physical therapy and is complaining
of pain. It is not time for pain medication so she asks the nurse if she can listen to
music because it helped alleviate her pain prior to physical therapy. The nurse brings
her a CD of nature sounds and starts the CD while J.H. is in bed trying to relax. As
the CD begins, J.H. notices birds singing, a babbling brook, and other nature sounds.
J.H. notices the different pitches and sounds of the bird calls. However, the pitches
and sounds are not music and there is no rhythm, melody, or harmony of the bird
calls and other nature sounds. By the end of the CD, J.H. does not feel as if her pain
has decreased and asks the nurse if it is time for her pain medication. As a result,
the CD of nature sounds did not distract her attention away from the unpleasant
RTNP30-1_R2_A5_044-059.indd 51
1/18/16 10:44 AM
52
stimuli of pain. Even though the birds singing included the antecedents of sound,
tone, timbre, and intensity, it did not have the five attributes of music and did not
lead to consequence of reduced pain.
DISCUSSION
Concept analysis was used to clarify music therapy and provide a conceptual model
of its antecedents, attributes, and consequences. The definitions of music, music
therapy, preferred music, and individualized music are addressed as well as the
consequences of music therapy based on these definitions. However, few studies
mentioned the attributes of music therapy, which are the five elements that play
an instrumental role in capturing an individuals attention (rhythm), eliciting an
emotional response (melody), having high or low sounds (pitch), combining sound
(harmony), and altering the distance between notes (interval). Based on the literature, these attributes are vital when developing music interventions to elicit the
psychological and physiological responses to improve health outcomes. In addition,
few studies mention the antecedents of music therapy, which are the foundation for
the therapeutic properties of music. Only nine studies mentioned the therapeutic
properties of the attributes and antecedents when testing a music intervention that
resulted in the psychological and physiological responses of music therapy (Table 1).
Furthermore, the model and contrary cases of music therapy illustrated examples of
what the concept is and is not when using music therapy as an intervention to
alleviate pain. Thus, the conceptual model of music therapy can serve as a framework for music interventions that have practical application in nursing research
and practice to improve various health outcomes in various patient populations.
As a result of this concept analysis, the conceptual model of music therapy provides the underpinnings for other theories. For example, two middle-range nursing
theories focus on the psychological responses of music reduce pain and decrease
agitation. The theory of acute pain management (Good, 1998) uses music as a
nonpharmacological adjuvant to distract a patients attention away from a pain
stimulus. It has been tested in abdominal surgery (Good, 1995; Good & Chin, 1998)
and labor and delivery patients (Good et al., 1999) to reduce pain and pain medication usage. The other theory is the theory of individualized music intervention for
agitation (IMIA; Gerdner, 1997). This theory proposes that individualized music must
be familiar to the patient to have any impact on agitation. Music is proposed as a
nonpharmacological intervention to reduce agitation medication and the need for
restraints in patients with dementia (Gallagher, 2011b; Gerdner, 2000). However,
neither theory describes the therapeutic properties of the attributes or the antecedents of music therapy for the psychological responses.
As for physiological responses, the rhythmic auditory stimulation (RAS) technique (Thaut, Miltner, Lange, Hurt, & Hoemberg, 1999) uses music as a cue for
movement in neurologically impaired individuals. RAS is based on entrainment in
which rhythmic auditory cues help an individual synchronize movements of his or
her arms and legs. The attribute of rhythm serves as an anticipatory and continuous
RTNP30-1_R2_A5_044-059.indd 52
1/18/16 10:44 AM
Psychological
Responses
Melody (AT)
Tempo (AN)
Fast 5 happy/
slow 5 sad
Pitch (AT)
Gold et al.
(2012)
Decreased anxiety
and depression
in caregivers of
patients with cancer
Lai et al.
(2011)
Decreased
depression
Chan et al.
(2011)
Intensity (AN)
Rhythm (AT)
Tempo-slow (AN)
Tempo-slow (AN)
Physiological
Responses
References
Pereira et al.
(2011)
Rhythm (AT)
Increased heart
rate and improved
gait in patients with
Parkinsons disease
Thaut (1997)
Rhythm (AT)
Increased cognitive
function
Satoh et al.
(2014)
Tempo (AN)
Increased participation
in an exercise program
Johnson et al.
(2012)
Rhythm (AT)
No change in immune
markers
Lai et al.
(2013)
Su et al.
(2013)
Tempo (AN)
Melody (AT)
Melody (AT)
Rhythm (AT)
Tempo (AN)
time cue to keep an individuals walking cadence in time with the music. The
RAS has been tested in patients with Parkinsons disease (Thaut, 1997), patients
with Huntingtons disease (Thaut, Miltner, Lange, Hurt, & Hoemberg, 1999), and
patients with stroke (Thaut, McIntosh, & Rice, 1997) to improve gait and delay
the progression of the disease. Finally, the theory of music, mood, and movement
(Murrock & Higgins, 2009) combines the psychological and physiological responses
to music to promote the initiation and maintenance of physical activity to improve
health outcomes. It proposes that music alters mood, is a cue for movement, and
makes physical activity more enjoyable leading to improved health outcomes. It
has been tested in underserved adults to improve physical function, depression,
and disability (Murrock & Graor, 2014) and in older adults to decrease depression
(Chan et al., 2011).
RTNP30-1_R2_A5_044-059.indd 53
1/18/16 10:44 AM
54
CONCLUSION
Currently, few studies define the purpose of music therapy or discuss the significance of the attributes and antecedents when developing music interventions to
evoke certain psychological and physiological responses. Few studies identified a
theoretical or conceptual framework as the foundation for the development and
testing the music interventions. Thus, the conceptual model of music therapy should
help to fill this gap as the assessment and selection of music should be based on the
attributes and antecedents to evoke the psychological and physiological responses
to improve health outcomes.
RTNP30-1_R2_A5_044-059.indd 54
1/18/16 10:44 AM
REFERENCES
Aldridge, D. (1996). Music therapy research and practice in medicine: From out of the silence.
London, United Kingdom: Jessica Kingsley Publishers.
Alvin, J. (1975). Music therapy. New York, NY: Basic Books.
Amer, T., Kalender, B., Hasher, L., Trehub, S. E., & Wong, Y. (2013). Do older professional
musicians have cognitive advantages? PLoS One, 8(8), e71630.
American Music Therapy Association. (2010). What is music therapy? Retrieved from http://
www.musictherapy.org
Botez, M. I., Botez, T., & Aube, M. (1983). Neuromusicology: An integral part of neurophysiology. Union Medicine Canada, 112, 366372.
Bunt, L. (1994). Music therapy: An art beyond words. London, United Kingdom: Routledge.
Carr, C., dArdenne, P., Sloboda, A., Scott, C., Wang, D., & Priebe, S. (2012). Group music
therapy for patients with persistent post-traumatic stress disorderAn exploratory randomized controlled trial with mixed methods evaluation. Psychology and Psychotherapy,
85, 179202. http://dx.doi.org/10.1111/j.2044-8341.2011.02026.x
Chan, M. F., Wong, Z. Y., Onishi, H., & Thayala, N. V. (2011). Effects of music on depression
in older people: A randomised controlled trial. Journal of Clinical Nursing, 21, 776783.
http://dx.doi.org/10.1111/j.1365-2702.2011.03954.x
Chlan, L., & Halm, M. A. (2013). Does music ease pain and anxiety in the critically ill? American
Journal of Critical Care, 22(6), 528532. http://dx.doi.org/10.4037/ajcc2013998
Clare, M. (2014). Soothing sounds: Reducing agitation with music therapy. British Journal of
Healthcare Assistants, 8(4), 190195.
Comeaux, T., & Steele-Moses, S. (2013). The effect of complementary music therapy on the
patients postoperative state anxiety, pain control, and environmental noise satisfaction.
Medsurg Nursing, 22(5), 313318.
Creutzfeldt, O., & Ojemann, G. (1989). Neuronal activity in the human lateral temporal lobe III:
Activity changes during music. Experimental Brain Research, 77, 490498.
Curtis, S. M., Carroll, E. W., & Curtis, R. L. (1998). Control of special senses. In C. M. Porth (Ed.),
Pathophysiology: Concepts of altered health states (5th ed., pp. 9951024). Philadelphia,
PA: J.B. Lippincott.
de Niet, G., Tiemens, B., Lendemeijer, B., & Hutschemaekers, G. (2009). Music-assisted relaxation
to improve sleep quality: Meta-analysis. Journal of Advanced Nursing, 65(7), 13561364.
Foster, N., Wiseman, T., & Pennert, K. (2014). An assessment of the value of music therapy
for haemato-oncology patients. Cancer Nursing Practice, 13(5), 2228.
Gallagher, M. (2011a). Evaluating a protocol to train hospice staff in administering individualized music. International Journal of Palliative Nursing, 17(4), 195201.
Gallagher, M. (2011b). The role of music therapy in palliative medicine and supportive care.
Seminars in Oncology Nursing, 38, 403406.
RTNP30-1_R2_A5_044-059.indd 55
1/18/16 10:44 AM
56
Gerdner, L. (1997). An individualized music intervention for agitation. Journal of the American
Psychiatric Nurses Association, 3(6), 177184.
Gerdner, L. (2000). Effects of individualized versus classical relaxation music on the frequency of agitation in elderly persons with Alzheimers disease and related disorders.
International Psychogeriatrics, 12, 4965.
Gerdner, L., & Schoenfelder, D. P. (2010). Evidence-based guidelines: Individualized music for
elders with dementia. Journal of Gerontological Nursing, 36(6), 715.
Giovagnoli, A. R., Oliveri, S., Schifano, L., & Raglio, A. (2014). Active music therapy improves
cognition and behaviour in chronic vascular encephalopathy: A case report. Complementary
Therapies in Medicine, 22, 5762. http://dx.doi.org/10.1016/j.ctim.2013.11.001
Gold, R., Butler, P., Revheim, N., Leitman, D. I., Hansen, J. A., Gur, R. C., . . . Javitt, D. C. (2012).
Auditory emotion recognition impairments in schizophrenia: Relationship to acoustic
features and cognition. American Journal of Psychiatry, 169(4), 424432.
Good, M. (1995). A comparison of the effects of jaw relaxation and music on postoperative
pain. Nursing Research, 44(1), 5257.
Good, M. (1998). A middle-range theory of acute pain management: Use in research. Nursing
Outlook, 46(3), 120124.
Good, M., & Chin, C. (1998). The effects of western music on postoperative pain in Taiwan.
Kaoshiung Medical Journal, 14(2), 93103.
Good, M., Stanton-Hicks, M., Grass, J. M., Anderson, G. C., Choi, C. C., Schoolmeesters, L.,
& Salman, A. (1999). Relief of postoperative pain with jaw relaxation, music, and their
combination. Pain, 81(12), 163172.
Gooding, L. F., Abner, E. L., Jicha, G. A., Kryscio, R. J., & Schmitt, F. A. (2014). Musical training
and late-life cognition. American Journal of Alzheimers Disease & Other Dementias, 29(4),
333343. http://dx.doi.org/10.1177/1533317513517048
Guyton, A. C., & Hall, J. H. (2005). Textbook of medical physiology (10th ed.). Philadelphia, PA:
W.B. Saunders.
Guzzetta, C. E. (2000). Music therapy: Hearing the melody of the soul. In B. Dossey, L. Keegan,
& C. E. Guzzetta (Eds.), Holistic nursing (pp. 585610). Gaithersburg, MD: Aspen.
Hars, M., Herrmann, F. R., Gold, G., Rizzoli, R., & Trombetti, A. (2014). Effect of music-based
multitask training on cognition and mood in older adults. Age and Ageing, 43, 196200.
http://dx.doi.org/10.1093/ageing/aft163
Hart, J. (2009). Music therapy for children and adults with cancer. Alternative and Complementary
Therapies, 15, 221225.
Hutchinson, J. C., & Sherman, T. (2014). The relationship between exercise intensity and preferred music intensity. Sport, Exercise, and Performance Psychology, 3(3), 191202. http://
dx.doi.org/10.1037/spy0000008
Jeong, S., & Kim, M. T. (2007). Effects of a theory-driven music and movement program for
stroke survivors in a community setting. Applied Nursing Research, 20, 125131.
Johnson, L., Deatrick, E. J., & Oriel, K. (2012). The use of music to improve exercise participation in people with dementia: A pilot study. Physical & Occupational Therapy in Geriatrics,
30(2), 102108. http://dx.doi.org/10.3109/02703181.2012.680008
Jonas-Simpson, C. (1997). The Parse research method through music. Nursing Science Quarterly,
10(3), 112114.
Karageorghis, C. I., Jones, L., Priest, D. L., Akers, R. I., Clarke, A., Perry, J., & Lim, H. B. T.
(2011). Revisiting the exercise heart rate-music tempo preference relationship. Research
Quarterly for Exercise and Sport, 82, 274284.
Karageorghis, C. I., Jones, L., & Stuart, D. P. (2007). Psychological effects of music tempi
during exercise. International Journal of Sports Medicine, 29, 613619. http://dx.doi
.org/10.1055/s-2007-989266
RTNP30-1_R2_A5_044-059.indd 56
1/18/16 10:44 AM
RTNP30-1_R2_A5_044-059.indd 57
1/18/16 10:44 AM
58
Nightingale, F. (1992). Notes on nursing: What it is and what it is not. Philadelphia, PA: J.B.
Lippincott. (Original work published 1859)
OKonski, M., Bane, C., Hettinga, J., & Krull, K. (2010). Comparative effectiveness of exercise
with patterned sensory enhanced music and background music for long-term care residents. Journal of Music Therapy, 47(2), 120136.
Park, H., & Specht, J. K. (2009). Effect of individualized music on agitation in individuals with
dementia who live at home. Journal of Gerontological Nursing, 35(8), 4755.
Pereira, C. S., Teixeira, J., Figueiredo, P., Xavier, J., Castro, S. L., & Brattico, B. (2011). Music
and emotions in the brain: Familiarity matters. PLoS One, 6(11), e27241.
Srkm, T., Tervaniemi, M., Laitinen, S., Numminen, A., Kurki, M., Johnson, J. K., & Rantanen,
P. (2013). Cognitive, emotional, and social benefits of regular musical activities in early
dementia: Randomized controlled study. The Gerontologist, 54(4), 634650. http://dx.doi
.org/10.1093/geront/gnt100
Satoh, M., Ogawa, J., Tokita, T., Nakaguchi, N., Nakao, K., Hida, H., & Tomimoto, H. (2014). The
effects of physical exercise with music on cognitive function of elderly people: MihamaKiho project. PLoS One, 9(4), e95230.
Schneck, D. J., & Berger, D. S. (1999). The role of music in physiologic accommodation. IEEE
Engineering in Medicine and Biology, 18(2), 4453.
Seger, C. A., Spiering, B. J., Sares, A. G., Quraini, S. I., Alpeter, C., David, J., & Thaut, M. H.
(2013). Corticostriatal contributions to musical expectancy perception. Journal of Cognitive
Neuroscience, 25(7), 10621077. http://dx.doi.org/10.1162/jocn_a_00371
Su, C. P., Lai, H. L., Chang, E. T., Yiin, L. M., Perng, S. J., & Chen, P. W. (2013). A randomized
controlled trial of the effects of listening to non-commercial music on quality of nocturnal
sleep and relaxation indices in patients in medical intensive care unit. Journal of Advanced
Nursing, 69(6), 13771389. http://dx.doi.org/10.1111/j.1365-2648.2012.06130.x
Sung, H. C., Chang, A. M., & Lee, W. L. (2010). A preferred music listening intervention to
reduce anxiety in older adults with dementia in nursing homes. Journal of Clinical Nursing,
19, 10561064. http://dx.doi.org/10.1111/j.1365-2702.2009.03016.x
Thaut, M. H. (1989). Music therapy, affect modification, and therapeutic change: Towards an
integrative model. Music Therapy Perspectives, 7, 5572.
Thaut, M. H. (1997). Rhythmic auditory-motor facilitation of gait patterns in patients with
Parkinsons disease. Journal of Neurology, Neurosurgery and Psychiatry, 63(1), 2226.
Thaut, M. H., McIntosh, G. C., & Rice, R. R. (1997). Rhythmic facilitation of gait training in
hemiparetic stroke rehabilitation. Journal of Neurological Sciences, 151, 207212.
Thaut, M. H., Miltner, R., Lange, H. W., Hurt, C. P., & Hoemberg, V. (1999). Velocity modulation and rhythmic synchronization of gait in huntingtons disease. Movement Disorders,
14(5), 808819.
Tramo, M. J. (2001). Biology and music: Music of the hemispheres. Science, 291(5501), 5456.
Trombetti, A., Hars, M., Herrmann, F. R., Kressig, R. W., Ferrari, S., & Rizzoli, R. (2011).
Effect of music-based multitask training on gait, balance, and fall risk in elderly people:
A randomized controlled trial. Archives of Internal Medicine, 171(6), 525533. http://dx.doi
.org/10.1001/archinternmed.2010.446
Vaajoki, A., Kankkunen, P., Pietil, A. M., & Vehvilinen-Julkunen, K. (2011). Music as a nursing
intervention: Effects of music listening on blood pressure, heart rate, and respiratory rate
in abdominal surgery patients. Nursing and Health Sciences, 13, 412418. http://dx.doi
.org/10.1111/j.1442-2018.2011.00633.x
Vieillard, S., Roy, M., & Peretz, I. (2012). Expressiveness in musical emotions. Psychological
Research, 76, 641653. http://dx.doi.org/10.1007/s00426-011-0361-4
Villarreal, E. A. G., Brattico, E., Vase, L., stergaard, L., & Vuust, P. (2012). Superior analgesic
effect of an active distraction versus pleasant unfamiliar sounds and music: The influence
of emotion and cognitive style. PLoS One, 7(1), e29397.
RTNP30-1_R2_A5_044-059.indd 58
1/18/16 10:44 AM
RTNP30-1_R2_A5_044-059.indd 59
1/18/16 10:44 AM