Table of Contents
- Need for the Study
- Patients with Mental Illness
- Criteria for Sample Selection
- Reliability of the Tool
Stress is a natural stimulus or response to any kind of situation whether it is a good or bad situation. Stress can be classified into good or bad stress. So, if the person is feeling the latter, it then develops into a feeling of anxiety. The level of stress we feel actually depends much on how we think and respond to the things and events that surround us. These factors may be from a past experience, or present situation, and what may happen in the future.
Indian classical ‘Ragas’ have been acclaimed by Vedic science to have healing effects. Music has frequently been used as a therapeutic agent from the ancient times. In India, music is a kind of yoga system through the medium of sonorous sound, which acts upon the human organism and awakens and develops their proper functions to the extent of self-realization, which is the ultimate goal of Hindu Philosophy and religion. Melody is the keynote of Indian Music. The ‘Raga’ is the basis of melody.
Need for the Study
The word stress is now as common as global warming and cell phones. Stress, like a virus has infected the entire population and symptoms appear everywhere. Stress; it has no age, race, gender, religion and nationality and for this purpose it is called as an “equal opportunity destroyer”. When left unresolved, stress can undermine all aspect of one’s life. One way to combat stress is using music therapy. A music therapist views the particular needs of their client. The client and the therapist both are involved in the therapy. Music heightens mental functioning, promotes healing and helps you feel calm and relaxed. It is considered a creative art therapy. Experts propose that it is the rhythm of the music that has a calming effect on us. A therapist encourages the use of different kinds of instruments. One way listening to music can manage the degree of your stress is it relaxes tense muscles. When you feel relaxed, your worries float into the background. Music activates our minds, integrates our attention, and seems to help regulate some body functions. “A study to assess the effectiveness of music therapy on reduction of stress among mentally ill patients addmited in selected hospitals of jabalpur city”.
- Assess the level of stress among the mentally ill patient.
- Determine the effectiveness of music therapy on level of stress among mentally ill patient.
- Evaluate the effectiveness of music therapy by comparing pre-test and post-test stress level.
- Associate level of stress with selected demographic variables.
It is organised, systematic and continuous process of collecting data from the patients with anxiety disorders.
It refers to the outcome of music therapy on stress and anxiety as measured by Stress Scale.
It refers to administering recorded Indian vocal and instrumental music, rendered by experts in the field and especially diverts the patient’s attention from the stress and anxiety.
It is a situation perceived to be taxing beyond the normal ability of a person to cope, which is threatening to a person’s wellbeing.
Patients with Mental Illness
A mental condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual — called also mental disorder.
H1: There will be significant difference between pre- test and post- test on the level of stress among patients with mental illness.
H2: There will be significant association between the progress of stress with selected socio demographic variables.
Modified Imogene king goal attainment model is used for developing the conceptual frame work of the present study. According to the model the goals of nursing is to help individual to maintain mental health.
Perception – It is a process of organizing, interpreting, and transforming information from sense data memory that meaning to one’s experience, represent one’s image of reality, and influences one’s behavior.
In this study, investigator perceived the need to assess the level of stress and provide the music therapy among mentally ill patient.
Goal Setting – After perception investigator set goal assess the level of stress among mental ill patients.
Action – According to king’s model, action is defined as a sequence of behavior’s involving mental and physical action. During the action phase, the investigators administer the music therapy for assess the level of stress in the experimental group.
Interaction – According to kings theory interaction is defined as a process of perception and communication between person and environment, present by verbal behaviors that are goal directed. In this study during interaction the investigator administers music therapy to mentally ill patients. Goal attainment – In this present study either there is reduce the stress or there is overcome the stress of mentally ill patients. If there is reduce stress level of mentally ill patients hence the goal will be attained in the study.
The use of music therapy (M.T.) shows promising benefits in many areas but is just ones subset of creative art therapy, sometimes known as expressive therapy or creative therapy dance, movement, drama, writing, sand, art, music, play and horticulture all fall under the purview of creative art therapy. Music research has existed since the early 20th century with over 100 years of practice and research (MacDonald, 2013). Music can reduce stress and tension, improving coping with physical and emotional stress, improve empathy and compassion, and reduce pain and anxiety (Jurcau & Jurcau, 2012). We have access to music as often as we want with phones, ipods, radios in our cars, homes, workplaces, public places, and institutions. Music affects emotion and may be able to manage and regulate it, as well as stress, in day to day life (MacDonald, 2013). Recently there has been an increase in the use of (MT) in China, Japan, Australia, Canada, Europe and the United States as will be evidenced in the review of the literature.
This study conducted by the Susan E. Mazer,(2010) Historical review of the theories Music and noise would seem to be polar opposites: One is thought to be disruptive, whereas the other is assumed to have pleasant, positive influences. The two are, however, conjoined in the ear of the listener, often begging the question of whether a sound is music or noise. The historical background and sources of music and noise as environmental influences have changed as sound levels have increased. This article is a historical review of the theories and science of noise and music in relationship to patient outcomes, considers the ways patients make meaning from what they hear, and provides a critique of research and practices with consideration to optimizing the auditory environment for hospitalized patients.
This study conducted by Mrazova, Celec, and Ing (2010) As stated earlier in this paper, listening to preferred music can be a coping skill for adolescents. Mrazova, Celec, and Ing (2010) shared research that proves this to be effective, as listening to self-chosen music for 30 minutes was seen to decrease stress hormone levels, specifically the hormone cortisol. The resulting decrease in stress would be the desired effect of a coping skill, making this an effective way for one to regulate mood when experiencing stress.
The study conducted by Horne-Thompson & Grocke (2008) was confined to individuals with end stage terminal illnesses in an inpatient hospice setting. There were 25 participants that ranged in age from 18 to 90 years old selected from individuals referred to MT for anxiety. The participants were randomly assigned to an experimental group that received a single &T session or a control group that received a volunteer visit. The ESAS and a pulse oximeter were used in pre-test , post-test design. The results of the measures indicate that 8 of the 18 participants in the experimental group had a significant decrease in anxiety compared to only 1 of the 12 individuals in the control group.
This study done by Jurcău and Jurcău (2012) conducted a study with 44 individuals, 22 men and 22 women, evenly split and placed into an experimental and control group. The mean age of each group was 26.2 ± 2 for the experimental group and 21.6 ± 4 for the control group with each made up of 11 women and 11 men. Mozart’s Concert no. 21 was played by headphones to the experimental group while both groups went through short term exercise on cycle ergometers. The purpose of the study was to the effect of MT on anxiety and cortisol levels while exercising. Results showed that anxiety and salivary cortisol were reduced after MT.
This study conducted by the Pérez . (2012) compared music therapy and psychotherapy for patients suffering from depression and found a significant effect for the music therapy. Patients who were administered music therapy demonstrated a better improvement than those receiving psychotherapy. The study pointed out that depression is caused by low dopamine levels and low numbers of dopamine receptors in the brain. The research also stated that since music helps stimulate the areas of the brain involved with reward as well as emotion it can provide intense pleasure in these areas. In the end, this increases positive affect which helps reduce depression
For the achievement of stated objectives and testing the hypothesis the following research approach, research design and methods will be used. It includes the research approach, research design, population, study setting, sample and sampling technique, data collection method, development of tool, inclusion and exclusion criteria, validity, reliability, and plan of data analysis and description of tools.
Evaluative approach was adopted in the study to evaluate the effectiveness of music as a psychotherapy therapy on reduction of stress.
Criteria for Sample Selection
Inclusion Patients with mild & moderate mental illness.
- Patients willing to participate in the study.
- Both male and female.
- Patients with age group 20-50 years. Familiar with English and Hindi language. Exclusion Patients with severe psychiatric illness.
- Patients who are not willing to participate in the study.
Reliability of the Tool
The reliability was determined by inter-rater method . Reliability of the tool was done on 06 samples. Statistical coefficient of correlation (Karl Pearson’s correlation coefficient formula) is use to find out reliability. The reliability coefficient of the test was found to be r=0.94, which made the tool reliable.
This study aimed to evaluate the effectiveness of music therapy in reduction of stress among the mentally ill patients. The conclusions drawn from the findings of the study are as follows: From the study findings it was concluded that there was significant differences in post test stress level of subjects. The reduction in the stress level was because of the intervention (music therapy) provided to the subjects.
Music therapy is one of the internationally recognized interventions, used in the care setting, and helps in the treatment of modern aliments both physical and mental. It reduces the psycho physiological stress, pain, anxiety, isolation to modulation of mood and behavior modification. A nurse needs to consult the individual institutional/agency policies and procedures about implementation of non-pharmacologic interventions and the need for physician’s orders or the necessity to involve a more skilled practitioner. Nurses who are working in psychiatric areas are encouraged to take up the challenge in making stress management a treatment priority. It is important to develop effective strategies to recovery of the clients.
Nursing practice: Music and music therapy may benefit patients directly: physiologically, psychologically, and socio emotionally. Music may also affect patients indirectly through its effects on caregiver attitudes and behaviors. With regard to direct physiologic effects, in animals, music changes neuronal activity with entrainment to musical rhythms in the lateral temporal lobe and in cortical areas devoted to movement. Steady rhythms entrain respiratory patterns. Listening to classical music increases heart rate variability, a measure of cardiac autonomic balance (in which increased levels reflect less stress and greater resilience), whereas listening to noise or rock music decreases heart rate variability (reflecting greater stress).
Nursing administrator can make use of the facilities or educate with the existing hospital setting together with the nurses to utilize the central music system every morning and evening with the selected music items to provide soothing effect.
Nursing students should be made aware to evaluate the physical and psychological causes of the pain and about the various nursing interventions. The student nurses while planning care to the patients should focus on stress reduction by diversion therapy. They should be aware of the fact, that severe pain has depressing effect on a person’s quality of life and emphasize the use of music to limit anxiety, lessen fear and to reduce pain. The music selected for the study also is used to nursing students, so that they will experience relaxation and reduction in anxiety. This would motivate them in turn to help patients while working with them.
This study was an attempt, to study the problem and the use of music therapy as reduction from stress, leading to reduction in actual stress level. Similarly other than stress several other problems such as anxiety, pain, depression for which nursing intervention such as relaxation, teaching, counselling etc. can be effectively researched. Thus in the management of stress complementary health practices can be researched.
- The study was conducted for the representative sample of the whole population in a particular setting; hence generalization is limited to the population of mentally ill patients of N.S.C.B. Medical college and hospital Jabalpur.
- The music therapy was effective only for a short time. It had no permanent effect on stress relief.
- The study is time consuming.
- The study is difficult to use on severe patients.
- Nurses should implement music therapy in their respective unit to those patients admitted in psychiatric unit, as an alternative pain management measures etc.
- Every psychiatric hospitals can implement music on all mentally ill patients those who have experienced with mild to moderate psychiatric disorders, and other specialties also.
Based on the study findings, the following recommendations were made for the future study.
- A similar study may be replicated on a larger sample.
- A similar study could be done on other psychiatric conditions, depression etc.
- A similar study can be undertaken at different setting.
- A comparative study can be conducted with play therapy and music therapy.
- A study may conducted to assess the knowledge and practice of staff nurses regarding stress management.