By Austine Duru, MDiv, MA, BCC
In this issue of Vision, in lieu of publishing a research article, we present eight resources in hopes of assisting readers to sample a broad range of research and research related topics by chaplains and non-chaplain collaborators. Each resource is related to our current Vision theme, “Using Music and Art in Chaplaincy.” For each resource, a link to a safe, open access site has been included to aid in further detailed reading.
Stuckey, H. L. & Nobel, J. (2010). The connection between art, healing, and public health: A review of current literature. American Journal of Public Health, 100(2), 254-263. www.ncbi.nlm.nih.gov/pmc/articles/PMC2804629/
The definition of health and well-being has moved beyond mere absence of disease or infirmity to encompass the totality of physical, mental and social well-being that is congruent with the holistic view of the place of the human person within and in balance with the structure of the entire ecosystem. This robust view seems to capture the nuances of the review done by Stuckey and Nobel. The authors explored the relationship between engagement with the creative arts and health outcomes with specific focus on discovering the health impact of music, virtual art therapy, movement-based creative expression, and expressive writing. The team hoped to establish a foundation for ongoing investigation into the engagement of arts with health. The study looked at published articles from 1970-2007 focusing on the four areas of investigation above. The results showed that while creative expressions have been embraced by multiple cultures as a means of healing, “only in recent years have systematic and controlled studies examined the therapeutic effect and benefits of the arts and healing.” The authors insist that the “use of arts in healing does not contradict the medical view in bringing emotional, somatic, artistic, and spiritual dimensions to learning.” Instead, it complements the biomedical view by drawing attention beyond the symptoms to the “holistic nature of the person.” (104 references).
McCann, S. R. (2013). Can an art intervention influence quality of life in a hospitalized patient? haematologica, 98(1), 4-6. www.haematologica.it/content/98/1/4.full
Shaun McCann, professor emeritus of hematology and academic medicine at St. James Hospital and Trinity College, Dublin, was behind the “open window” study conducted at a stem cell transplant unit to assess the effect of multimedia art introduced in the facility. The author believed that art intervention should not be relegated only to pediatric wards; they have a place in adult units. The findings of this study suggest that exposure to art had significant impact on the patients when compared to those who were not exposed. “The reduction in anxiety and depression found in the study was significant, but what surprised us most was the positive difference in the experience of patients undergoing stem cell transplantation when exposed to ‘open window,’ versus those who were not exposed.” The author concludes with one caveat, “We do not suggest that an art intervention will necessarily influence the outcome of stem cell transplantation.” “Open window” is a paradigm that positively mediates the experience of the patients while in the hospital by making the hospital stay less difficult. (15 references).
Koen, B. D. (2013). “My Heart Opens and My Spirit Flies”: Musical Exemplars of Psychological Flexibility in Health and Healing. Ethos, 41(2), 174-198. onlinelibrary.wiley.com/doi/10.1111/etho.12014/full
The discussion of cultural sensitivity in a healthcare environment seldom takes on the subject of music as an aspect of culturally sensitive areas that chaplains and healthcare providers ought to be aware of. Various studies show the significance of music as a medium of culture and a mediating factor in health and wellness. In this case study, Benjamin D. Koen introduces us to ethnomusicology (an innovative field of integrative research and applied practice concerned with music, medicine, health, healing, and culture) as an aspect of psychological flexibility. This is a “conceptual framework for better understanding diverse cultural and clinical contexts of health and healing.” Koen’s work explores how a genre of Pamiri (Pamir Mountain region is in the eastern province of Tajikistan) devotional music popularly known as maddoh enhances psychological flexibility for the participants. He shows that engaging certain specific socio-cultural markers such as local belief system, poetry, prayer, and music, could generate enriching and multi-layered system of psychological flexibility that enhances wellness and healing. A key idea here is that health benefits derived from music and creative arts are not limited to a specific genre or culture. This study is laden with conceptual frameworks that are highly technical and might be boring to the reader who is not familiar with ethnography or psychological flexibility. But this discussion does not prevent the reader from grasping the key elements and ideas that the author is trying to communicate. (26 references)
Kelly, C. G., Cudney, S., & Weinert, C. (2012). Use of Creative Arts as a Complementary Therapy by Rural Women Coping With Chronic Illness. Journal of Holistic Nursing, 30(1), 48-54. jhn.sagepub.com/content/30/1/48.full
Access to healthcare, especially in rural parts of the United States, is fraught with significant challenges. The gender dimension of health disparities is also an important factor, for instance, when coping with chronic illness. In this research study, the authors set out to investigate the spontaneous use of creative arts as a complementary therapy by rural women in the western United States coping with chronic illness. This gender-based study was conducted over an 11-week period when women living with chronic pain conditions were exposed to a computer-based intervention that provided interactive health education. This was later examined to determine references to the use of creative arts and the influence this may have had on the management of chronic illness. The results were categorized in three areas of consideration: Coping with pain, relaxation/quality of life, and giving back to others. The findings suggest a positive correlation between the use of creative arts and increased overall well-being. The authors conclude that the already-marginalized rural populations could benefit significantly from creative art interventions. There is a need to discover new and better ways to implement these findings. (27 references).
Clair, A. A., Lyons, K. E., & Hamburg, J. (2011). A Feasibility Study of the Effects of Music and Movement on Physical Function, Quality of Life, Depression, and Anxiety in Patients with Parkinson Disease. Music and Medicine. mmd.sagepub.com/content/4/1/49.full.
This study explores the health benefits of an exercise program facilitated by auditory music cues on key “motor functions, balance, trunk flexibility, upper limb range of motion, self-perceived daily functioning, and self-perceived quality of life in persons living with Parkinson disease (PDs).” There were 24 seated exercises performed for 36 minutes each day for 10 weeks. Half of the participants studied (seven out of 17 participants) completed the study program in full. The results show preliminary evidence that music- and movement-based exercises have the potential to improve overall quality of life and movement in persons living with PD. It is perhaps obvious to add that further studies with a much larger cohort might be warranted here. However, this study has some potential for pastoral care of persons living with Parkinson’s disease based on some of the findings of this study. For instance, this study could be helpful in establishing an interdisciplinary support group or spirituality group for such a patient population in a hospital setting or in extended care facilities. (67 references).
DeMarco, J., Alexander, J. L., Nehrenz, G., & Gallagher, L. (2012). The benefit of music for the reduction of stress and anxiety in patients undergoing elective cosmetic surgery. Music and Medicine, 4(1), 44-48. mmd.sagepub.com/content/4/1/44.full
Care providers and especially chaplains who work in surgical units and outpatient surgery facilities are aware that pre-op anxiety can overwhelm patients and sometimes family members. It has been documented that stress and anxiety during surgery have unintended negative impact on expected health outcomes, leading to extended recovery periods and possible complications. This study was an attempt to explore the impact of music on patients in the pre-operative environment. Twenty-six patients were involved in this study. Fourteen were exposed to pre-selected music before their surgery. Twelve patients were among the control group. The results show that those patients who were exposed to music before surgery reported 18% less anxiety. This population of patients benefited emotionally from hearing music played to them before their surgery, leading to improved health outcomes. (25 references).
De Bruyn, L., Moelants, D., & Leman, M. (2012). An embodied approach to testing musical empathy in participants with an autism spectrum disorder. Music and Medicine, 4(1), 28-36. mmd.sagepub.com/content/4/1/28.full
The privilege of providing care to persons with Autism Spectrum Disorder (ASD) is both a humbling and rewarding experience. One of the key symptoms of ADS is the loss or disturbance of social empathy skills. This study, which involves 11 adult participants, explores the dynamics of empathy in artistic contexts. It examines the degree to which autistic participants can access the emotional content of music through listening. Four experiments targeted synchronization ability and implicit attuning effects of the music. The first involves tapping to the tune; the second involves drawing the tune from a broad selection of musical genres. The authors conclude that musical empathy is accessible to people with ASD when evaluated from a corporeal standpoint. However, when emotional processing of music is required, their response is significantly limited. This suggests that, “people with ASD seem to rely on disembodied cognitive process to attribute effects to music.” They do not have direct access to the emotional content of music. (26 references).
Janata, P. (2012). Effects of widespread and frequent personalized music programming on agitation and depression in assisted living facility residents with Alzheimer-type dementia. Music and Medicine, 4(1), 8-15. mmd.sagepub.com/content/4/1/8.full
Caregivers of patients living with Alzheimer’s-type dementia can attest to the unpleasantness of the agitation and depression that are common mood changes among this patient population. Studies have shown that a familiar voice or the presence of a loved one is sometimes helpful in calming such patients. This study aims to explore another dimension of this phenomenon by exploring the impact of familiar music on this patient population. The author studied 38 assisted living patients for 12 weeks. These were exposed to music for several hours in the course of the day. The result points to a significant and sustained reduction in agitation and depression when examined against two important protocols. This finding indicates that exposure to music in the immediate surroundings of persons with Alzheimer’s-type dementia has the potential to reduce average levels of agitation and depression. (20 references).
Austine Duru, a member of the NACC’s Editorial Advisory Panel, is staff chaplain at Franciscan St. Margaret Health in Dyer, IN. He is also adjunct professor of philosophy at Calumet College of St. Joseph in Whiting, IN.
