Effect of Music on Pain and Anxiety in Palliative Cancer Patients

Advances in medicine have increased life expectancy, leading to a rise in chronic diseases like cancer, with 14 million new cases annually, projected to reach 22 million by 2030. Cancer patients often face intensive treatments and severe symptoms, including pain and anxiety, highlighting the need for palliative care.

Nurses play a key role in symptom management, using both pharmacological and non-pharmacological methods, including music therapy. Music can stimulate neuroendocrine responses by increasing dopamine and serotonin release, activating the limbic system, increasing endorphin release, and suppressing sympathetic nervous system activity, which contributes significantly to reducing pain and anxiety while also affecting the regulation of vital signs such as blood pressure, pulse, body temperature, respiratory rate, and oxygen saturation.

This study examined the effects of music on pain, anxiety, and vital signs in 32 palliative care cancer patients using a quasi-experimental design with a pretest-posttest control group. The study was conducted between February 2021 and June 2022 at Yozgat City Hospital Palliative Care Center and Karaman Training and Research Hospital Palliative Care Center.

Patients in the intervention group listened to 30 minutes of instrumental Turkish music in the maqams of Hicaz and Buselik; controls rested quietly. The music CD was prepared by experts from the Applied Music Therapy Association (UMTED) and consisted of 13 instrumental works designed to provide relaxation and have a sedative effect. The volume was kept low and the main melody was emphasized.

Data collection took approximately 60 minutes per participant. The intervention was performed between 10:00 AM and 5:00 PM after patients received their first daily analgesic dose. Headphones were used to maintain focus and block extraneous noise, with separate devices for each patient to ensure infection control standards. Further research should explore mechanisms, patient differences, and optimal implementation protocols.

Eligibility Criteria:

Inclusion criteria

• Diagnosed with cancer
• Receiving palliative care treatment at Yozgat City Hospital or Karaman Training and Research Hospital
• Hospitalized in the palliative care center for at least 7 days
• Aged 18 years or older
• Able to speak and understand Turkish
• Able to communicate verbally
• Oriented to place and time
• No psychiatric disease
• No vision or hearing problems
• Self-reported pain intensity of at least 3 on the Visual Analog Scale in the last 24 hours
• Voluntarily agreed to participate in the study
• Provided written informed consent

Exclusion criteria

• Underwent major surgical intervention within the last month
• Currently using another complementary and integrative treatment (e.g., aromatherapy, acupuncture)
• Cognitive impairment preventing questionnaire completion
• Not open to communication
• Died within seven days of hospital admission