A randomised controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety

Aims: To determine the effect of music therapy and verbal relaxation on state anxiety and anxiety-induced physiological manifestations among patients with cancer before and after chemotherapy.

Background: Cancer and its treatment provoke a series of changes in the emotional sphere of the patient's anxiety. Music therapy and verbal relaxation had reported the anxiety reduction effect on patients with cancer receiving chemotherapy. Few studies have been undertaken comparing music therapy and verbal relaxation in differentiating high-normal state anxiety subsample.

Design: A randomised controlled trial and permuted block design were used. Outpatient chemotherapy clinic operated by a University medical centre in southern Taiwan.

Methods: Ninety-eight patients were randomised into three groups: the music therapy group received one-hour single music session; the verbal relaxation group received 30 minutes of guided relaxation; the control group received usual care. Spielberger State-Trait Anxiety Instrument, Emotional Visual Analog Scale, three biobehavioural indicators: skin temperature, heart rate and consciousness level were measured during and after chemotherapy.

Result: Music therapy had a greater positive effect on postchemotherapy anxiety than verbal relaxation and control groups and a significantly increase in skin temperature. Patients with high state anxiety receiving music therapy had a greater drop in postchemotherapy anxiety than did the normal state anxiety subsample.

Conclusions: Both music and verbal relaxation therapy are effective in reducing chemotherapy-induced anxiety. Thirty minutes of intervention initiates anxiety reduction. Patients with high state anxiety receiving chemotherapy obtain the most benefit from music or verbal relaxation.

Relevance to clinical practice: Prior to chemotherapy, patients with high state anxiety must be sorted from all patients as they are more responsive to interventions. Oncology nurses can offer music and verbal relaxation as adjuvant interventions to reduce chemotherapy-induced anxiety and enhance the quality of care.