Music Therapy for Schizophrenic Patients’ Quality of Life Coursework

Problem Statement

Schizophrenic patients’ impaired social functioning and strategies to reduce this chronic symptom present critical issues in inpatient psychiatric settings. The problem that the study will focus on is that music therapy (MT) interventions are not widely used to care for schizophrenic patients despite the existence of scientific evidence to support its benefits for those in inpatient facilities. Multiple researchers, including Volpe et al. (2018), Lee et al. (2020), Jeon et al. (2017), Tseng et al. (2016), Paul et al. (2020), and He et al. (2018), report that active and passive MT interventions, including playing music/singing, listening to the music, and self-reflection, can strengthen schizophrenic patients’ social functioning and interaction abilities. As per the systematic review by Geretsegger et al. (2017), MT can influence social functioning positively even when delivered by nurses and psychiatrists with limited training in MT provision. In qualitative research, MT has been shown to offer valuable social experiences to schizophrenia patients (Lotter & Van Staden, 2019).

Concerning schizophrenic inpatients’ perceived life quality, the evidence is more heterogeneous. Relatively recent studies by Jia et al. (2020) and Pinar and Tel (2020) demonstrate adjunct MT’s ability to increase adult schizophrenic patients’ quality of life even when it comes to unstructured passive listening activities, whereas Jeon et al. (2017) report a 12-session active MT program’s insignificant effects on life quality. Considering MT’s widely demonstrated positive impacts and the absence of side-effects, developing guidelines for its implementation could take psychiatric care quality to the next level.

Practice-Focused Question(s)

One practice-focused question can be formulated to address the aforementioned practice gap and summarize the benefits of implementing MT to support hospitalized patients with schizophrenia. What are the research-based recommendations regarding the use of adjunct music therapy in inpatient psychiatric facilities for increasing schizophrenic patients’ quality of life and social functioning? Consequently, the purpose of the project will be to review the existing literature and prepare a document with recommendations regarding MT in the discussed population, including psychiatric nurses’ acceptable role in delivering such interventions.

Social Change

The EBP project can promote positive social change by evaluating the ways to transform schizophrenic patients with poor social cognition into individuals that live a satisfactory social life. The project will support the exploration of easy-to-implement, non-costly, and non-pharmacological interventions, such as music therapy, in psychiatric populations with impaired social problem-solving abilities and interpersonal communication skills. These efforts will shed light on effective adjunctive treatments for schizophrenia that could supplement the effects of standard care for hospitalized patients with this diagnosis without significant risks and expensive equipment. The project will facilitate the expansion of knowledge regarding therapies that support social skills in those diagnosed with schizophrenia, thus promoting positive social change by facilitating this population’s rehabilitation after hospitalization and reintegration into society. The proposal aligns with the university’s mission statement in that it will involve exploring safe interventions that have the potential of improving the vulnerable population’s perceived quality of life and skills required to contribute to society. This experience will enable the implementation of the practitioner-scholar model into my everyday practice by transforming research-based knowledge into opportunities for promoting patient well-being.

The Context for the Doctoral Project

My current workplace serves as the intended setting for the project, and the document will be developed for this organization. It is an inpatient psychiatric facility that cares for adult and geriatric patients with diverse mood and chronic brain disorders that affect a person’s social activity and functioning and create obstacles to role fulfillment, ranging from relatively mild issues to social dangerousness. The facility specializes in the treatment of individuals with anxiety, depressive and bipolar disorders, schizophrenia spectrum disorders, and other less common diagnoses. Accomplishing the project in this setting will be feasible due to several reasons. Firstly, the facility’s employees are experienced in treating schizophrenia patients and have access to equipment, resources, and medications that these healthcare consumers need, so the developed guidelines will be easy to implement. Secondly, music therapy activities, especially receptive ones, do not require expensive equipment, which will also add to the ease of implementation.

Sources of Evidence

The evidence that supports the need for the broader implementation of MT, including nurses’ participation in MT delivery, to support schizophrenia inpatients’ mental health stabilization and social skills can be found in both single research projects and reviews. In their systematic review, Geretsegger et al. (2017) offer level I evidence in favor of the safety and effectiveness of MT interventions for schizophrenic patients’ life quality and social functioning, including programs delivered by psychiatric nurses with minimal training in MT. Geretsegger et al. (2017) conclude that the existing evidence supports the need for making MT programs more available for those with schizophrenia. In their source of level III evidence, Lee et al. (2020) demonstrate experienced psychiatric nurses’ ability to deliver safe and effective MT programs. As per their study, a 15-session MT program developed and implemented by a psychiatric nurse with some assistance from professionals in MT promotes significant increases in schizophrenia patients’ interpersonal relationship functioning without any risks for participants (Lee et al., 2020). Based on the results, Lee et al. (2020) suggest that non-pharmacological nursing interventions with MT elements would be helpful in supporting schizophrenic patients’ social reintegration.

Approach or Procedural Steps

The possible procedural steps for the project include searching for evidence related to MT in schizophrenia and conducting a systematic review of studies with particular attention to MT interventions’ types, effects, duration, and providers’ qualifications. The results will then be converted into a comprehensive document for my current workplace, specifying the best MT interventions for schizophrenic inpatients, including dosage, indications and contraindications, nurses’ roles in delivering MT programs, and other critical aspects. To obtain relevant data and resources, it will be possible to use academic databases and collaborate with local music therapy professionals. The proposed project is among the possible project types specified in the guide. It will not involve experiments in actual patient groups and can be classified as the third acceptable option – clinical practice guidelines development.

Ethical

Due to its focus on guideline creation, the project will not involve interventions in actual patient groups, so protections for human subjects will not be relevant. Regarding ethical issues, it is unlikely that they will emerge and create obstacles for the project’s completion. However, existing ethical concerns associated with currently used MT treatments will be discussed in the final document to promote the informed use of MT in schizophrenia inpatients.

Alignment

The selected research problem aligns with the remaining components of the initial proposal and the clinical question related to the absence of clear guidelines regarding MT in schizophrenia. MT interventions’ positive effects are cited ubiquitously in recent literature, and the authors of meta-analytical and systematic review studies cited above agree that this promising treatment can be helpful for schizophrenia patients’ social competence, at least in the short to medium term, which makes it a safe option to consider (Geretsegger et al., 2017; Jia et al., 2020). The drafted steps will help to contribute to the problem’s resolution by summarizing the currently available evidence and translating it into recommendations regarding improving the discussed group’s outcomes and chronic symptoms.

References

Geretsegger, M., Mössler, K. A., Bieleninik, Ł., Chen, X. J., Heldal, T. O., & Gold, C. (2017). Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database of Systematic Reviews, (5), 1-85.

He, H., Yang, M., Duan, M., Chen, X., Lai, Y., Xia, Y., Shao, J., Biswal, B. B., Luo, C., & Yao, D. (2018). Music intervention leads to increased insular connectivity and improved clinical symptoms in schizophrenia. Frontiers in Neuroscience, 11, 1-15.

Jeon, G. S., Gang, M., & Oh, K. (2017). The effectiveness of the Nanta-program on psychiatric symptoms, interpersonal relationships, and quality of life in forensic inpatients with schizophrenia. Archives of Psychiatric Nursing, 31(1), 93-98.

Jia, R., Liang, D., Yu, J., Lu, G., Wang, Z., Wu, Z., Huang, H., & Chen, C. (2020). The effectiveness of adjunct music therapy for patients with schizophrenia: A meta-analysis. Psychiatry Research, 293, 1-10.

Lee, K., Lee, K. J., & Cho, J. M. (2020). Effect of Korean folk music intervention on schizophrenia inpatients’ emotional behavior and interpersonal relationship functioning. Archives of Psychiatric Nursing. 1-23.

Lotter, C., & Van Staden, W. (2019). Verbal affordances of active and receptive music therapy methods in major depressive disorder and schizophrenia-spectrum disorder. The Arts in Psychotherapy, 64, 1-22.

Paul, N., Lotter, C., & Van Staden, W. (2020). Patient reflections on individual music therapy for a major depressive disorder or acute phase schizophrenia spectrum disorder. Journal of Music Therapy. 1-25.

Pinar, S. E., & Tel, H. (2019). The effect of music on auditory hallucination and quality of life in schizophrenic patients: A randomised controlled trial. Issues in Mental Health Nursing, 40(1), 50-57.

Tseng, P. T., Chen, Y. W., Lin, P. Y., Tu, K. Y., Wang, H. Y., Cheng, Y. S., Chang, Y. C., Chang, C. H., Chung, W., & Wu, C. K. (2016). Significant treatment effect of adjunct music therapy to standard treatment on the positive, negative, and mood symptoms of schizophrenic patients: A meta-analysis. BMC Psychiatry, 16(1), 1-11.

Volpe, U., Gianoglio, C., Autiero, L., Marino, M.L., Facchini, D., Mucci, A., & Galderisi, S. (2018). Acute effects of music therapy in subjects with psychosis during inpatient treatment. Psychiatry MMC, 81(3), 218–227.