Music in Managing Pain

Laurie Scudder, DNP, NP


June 13, 2013

In This Article

Study Summary

The study was conducted at a single university-affiliated hospital. Patients with advanced, life-limiting conditions were referred for the study by members of the palliative care team. Patients invited to participate in the study were older than 18 years, had a pain score of 3 or greater on a numeric rating scale (NRS), were able to understand English, and were alert and oriented. Patients on scheduled pain medications were not excluded, although interventions were scheduled around administration of breakthrough pain medications and immediately before scheduled doses.

The intervention was a single 20-minute music therapy session using harp music played at a low volume and slow tempo. Patients were also given the option for the session to include an ocean drum component. The music intervention accompanied a relaxation exercise that began with placing a "do not disturb" sign on the patient's door, lowering light levels, offering a blanket, turning off cell phones, and guiding the patient through an autogenic relaxation exercise that included visualization of a safe place. Control patients received the relaxation exercises without the accompanying music.

A clinical nurse specialist evaluated all patients before the intervention using 3 different scales:

  • NRS -- a widely used self-report scale that asks patients to rate their pain on a scale of 0 (no pain) to 10 (worst possible pain).

  • The Face, Legs, Activity, Cry, Consolability (FLACC) Scale -- a behavioral pain assessment tool in which pain is rated on 5 criteria by a trained observer. Each of these criteria is assigned a score of 0 (no pain) to 2, and total scores range from 0 to 10.

  • Functional Pain Scale (FPS) -- a scale that allows assessment of a patient's subjective experience of pain by asking patients whether pain is tolerable or intolerable and about its effect on the ability to engage in daily activities. A score of 0 reflects no pain, and a maximum score of 5 indicates intolerable pain with a resultant inability to communicate or perform usual activities.

The clinical nurse specialist, who was blinded to the patient's assignment, left the room following the preintervention evaluation and returned after the intervention to complete a postintervention evaluation using the same 3 scales. Patients assigned to the control group were offered the music intervention following the postintervention evaluation.


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