Bilgiç, Ş., & Acaroğlu, R. (2017). Effects of listening to music on the comfort of chemotherapy patients. Western Journal of Nursing Research, 39, 745–762.

To examine the effect of listening to music on comfort from chemotherapy symptoms (pain, tiredness, nausea, depression, anxiety, drowsiness, lack of appetite, not feeling well, and shortness of breath) for patients undergoing chemotherapy.

Intervention group: Each member was given a portable mp3 player (with double earphones) containing music prepared by Turkish Psychological Association (TPA) containing 30 minutes of relaxation wave sounds with harp and violin. Participants were asked to listen to the music in the chemotherapy unit before treatment. Instructions were to listen to the music at least three times weekly in keeping with recommendations from TPA. 

Summary: Participants were given a pre-loaded mp3 player with instructions to listen for 20 to 30 minutes once a day for a minimum of three days per week and to record specific observations: dates and times of symptom experiences and music listening.

• N = 70; 35 in each group   
• AGE: Mean = 54.51 years (SD = 10.35) 
• MALES: 47.1%  
• FEMALES: 52.9%
• CURRENT TREATMENT: Chemotherapy, other
• KEY DISEASE CHARACTERISTICS: Lung cancer, 31.4%; breast cancer, 32.9%; colon cancer, 12.8%; other cancer, 22.9%
• OTHER KEY SAMPLE CHARACTERISTICS: Sequential selection: First 35 to control group, next 35 to intervention group to avoid inter-group influence by association or talking.

• SITE: Single site   
• SETTING TYPE: Multiple settings, such as listening in clinic and at home
• LOCATION: Public hospital in Tekirdağ, Turkey

PHASE OF CARE: Active anti-tumor treatment

Quasi-experimental with two groups (intervention and control) using pre-/post-test measures

• Patient Information Form: Self-developed by researchers for demographics (age, sex, educational level, marital status, profession, and diagnosis). Delivered to each participant for completion at home. 
• Patient Observation Form: For the control group, a chart for recording chemotherapy symptoms, dates, and communication with the researcher. For the intervention group, a form for recording days of treatment, duration of treatment, dates and times of symptoms, and music listening. 
• Edmonton Symptom Assessment System (ESAS): Used to measure nine of the most commonly occurring chemotherapy symptoms (pain, tiredness, nausea, anxiety, drowsiness, lack of appetite, not feeling well, depression, and shortness of breath) using a number (scale not clear) to indicate severity. 
• General Comfort Questionnaire (GCQ): 48-item Likert-type scale with three levels and four dimensions of comfort, ranging from 1 (low comfort) to 4 (high comfort). Includes reverse coding for negative items. Scale was adapted to Turkish language and context 2008.

There was no significant between-group difference at baseline. The statistically significant differences in the intervention group related to music listening were for pain, exhaustion, nausea, anxiety, lethargy, lack of appetite, and not feeling well. However, no significant differences were found for depression or shortness of breath. 

There were statistically significant differences between groups for comfort measures: general comfort, physical comfort, psycho-spiritual comfort, and sociocultural comfort. All intra-group (within-group) differences were statistically significant for comfort measures.

Listening to specified music for specified time periods was positive for chemotherapy symptoms: pain, exhaustion (fatigue), nausea, anxiety, lethargy, lack of appetite, and not feeling well; and on measures of general comfort, physical comfort, psycho-spiritual comfort, and sociocultural comfort. 

There were no positive effects on depression or shortness of breath.

• Small sample (< 100)
• Measurement/methods not well described; unclear how numbers scale was used to indicate symptom levels for common symptoms of chemotherapy treatment.
• Findings not generalizable
• Other limitations/explanation: Self-report of symptoms and listening adherence by patients. Small sample in one site of one country with one type of music–suggesting application to just one small group.

Music listening may diminish symptom severity in patients undergoing chemotherapy. Music therapy should be considered as an important element of holistic treatment for patients who have a cancer diagnosis and chemotherapy.