Abstract
Music playing is a non-invasive psychosocial intervention that received a renewed interest among mental health professionals, policy planners, and health scientists due to psychosocial stresses related to psychiatric disorders (Adiasto et al., 2022). The healing power of music has been acknowledged by almost all traditions of India. The music-playing intervention affected the sympathetic and parasympathetic systems and endocrine systems of the human body (Ellis & Thayer, 2010). Music playing has been found successful in various clinical settings like dental clinic settings, surgical settings, critical care settings, surgical operation room settings, and terminal care settings (Bekhuis, 2009; Bradt et al., 2016; Evans, 2002; Migneault et al., 2004). Its usefulness as an adjunct to normal care practices is reported in the literature (Leubner & Hinterberger, 2017; Migneault et al., 2004). Also, music has a significant role in improving the well-being of humans in alternative to traditional therapies. There is a huge research gap in this area in India and more work is needed so that persons with anxiety and depression, and psychosocial stress-related issues could take benefit from it.
A cross-sectional focused group discussion among health care professionals was conducted in a tertiary care center in north India. The procedural aspect of this project was conducted in multiple phases. In the first phase, a mental health team of a consultant psychiatrist and a nursing officer conducted this discussion. Fifty participants working in a tertiary care institution of national importance in North India constituted the sample for this discussion that were enlisted through interactive meeting sessions. The standardized tool of the Perceived Stress Scale was administered to record the stress levels among the participants before enrollment (Cohen et al., 1983). The participants with mild levels to moderate levels were included and participants with higher stress levels were referred for detailed psychiatric assessment and were excluded from this pilot survey. The mean levels of stress score were 17. Another tool a discussion guide was prepared after a review of the literature and validation from three experts. Total 45 participants completed the survey. Out of 45 participants, 11 were nursing officers and 34 were prefinal year medical students and provided consent for this discussion. The focused group discussion was conducted in English. A total of three focused group sessions with 15 participants for a 1-hr duration in each group were held in the department of psychiatry of a tertiary care institute. Briefly, the open-ended questions were as (1) please describe how you liked the music playing in the inpatient unit (2) What are the difficulties being faced during day-to-day music playing in the psychiatric inpatient Unit? (3) What are the modifications in the music-playing system that needs to be adopted for making it better for stress management? The participant’s responses were recorded by a team of two researchers independently and they prepared written notes. In the final third phase, after completion of the survey 6 weeks post assessments the participants were reassessed on the Perceived stress scale. There was significant reduction in stress levels scores among the participants after 6 weeks of assessments (p < .05).
After the completion of the surveys, the significant themes reported by the participants were analyzed. The participants emphasized that music playing during morning hours was feasible in the psychiatric unit. Among participants 88.8% liked the music playing in the indoor unit and reported the usefulness of it in decreasing worries, and anxieties and amelioration of stress among persons with psychiatric disorders. Another issue reported by them was the need for a music control system in the ward setting. Non-religious, low-pitch-melodious music use was suggested by most participants. Another issue highlighted by 12% of the participants was that it was monotonous and can cause distraction. Further 18% of the participants suggested regular feedback from persons with psychiatric disorders to improve the quality of music playing was needed in public hospitals. Music playing has been a part of a complementary and alternative form of medicine (Bekhuis, 2009; Chan et al., 2011; Evans, 2002; Migneault et al., 2004). This intervention benefits persons with anxiety and mood disorders (Leubner & Hinterberger, 2017). This pilot survey revealed some themes including usefulness in morning hours, the need for a music control system, and regular feedback from the users. This survey attempts to highlight the unique need of playing music in inpatients specific to day-to-day stresses so that clinicians can address them at the proper time. The present pilot survey endorses the finding of previous researchers (Bradt et al., 2016; Poulsen et al., 2019). Some previous researchers suggested the duration of music sessions and musical beats per minute in postoperative patients (Poulsen et al., 2019).
Understanding the experiences of healthcare professionals can help in guiding psychiatric patients and their caregivers to improve resilience with music playing. This can help in improving the well-being of the patient and it would also decrease their psychiatric morbidity and thus lead to a good outcome. Inadequate knowledge among clinicians about the benefits of music playing and brief training courses in these aspects would be helpful for mental health professionals and staff members working in psychiatry units. The unstructured pilot survey may discover richer, more in-depth information, adding useful and interesting responses to the research. As music-based interventions are a variety of psychosocial interventions and can be an effective adjunct modality for people with psychosocial problems related to anxiety and depression. Its effectiveness as stress levels lowering ability and as psychoeducation can engage and motivate persons with psychosocial problems to attend, and actively participate in treatment sessions. It has thus an important role in treating people with psychosocial problems. This psychosocial intervention, which is non-invasive, economic, and highly accepted by the participants needs further research at other tertiary care centers all over India for better patient care in the digital world of the 21st century.
