Environmental music therapy (EMT): Music’s contribution to changing hospital atmospheres and perceptions of environments

Authors

  • Andrew Rossetti MMT, MT-BC, LCAT, The Louis Armstrong Center for Music & Medicine Mount Sinai Healthcare System, United States of America

DOI:

https://doi.org/10.47513/mmd.v12i2.742

Abstract

 

Abstract

There are a myriad of sensory elements that contribute to the hospital sensory experience.

Environmental Music Therapy is a human-centered, trauma informed strategy that encompasses a process using the metaphoric and associative properties of live music that seeks to modulate patients’ and staff’s perception of the hospital milieu as hostile. While there have been a few studies that have measured EMT’s actual impact quantifiably [1-5], this is the first article to outline the steps and provide orientation, theoretical grounding, and training guidelines for its actual implementation. It is hoped that EMT can be instituted in hospital ICUs as a viable, accessible practice for music therapists whereby its institution will address the sound environment, and perhaps most particularly in those ICUs that are extremely noisy or eerily quiet.

 

Keywords:  Environmental Music Therapy, soundscape, soundtrack, ICU, milieu perception

Author Biography

Andrew Rossetti, MMT, MT-BC, LCAT, The Louis Armstrong Center for Music & Medicine Mount Sinai Healthcare System, United States of America

Andrew Rossetti MMT, LCAT, MT-BC is a music therapy clinician, researcher, and educator who supervises the multi-site music psychotherapy program in radiation oncology at the Mount Sinai/Beth Israel Healthcare system.

References

Canga B, Hahm C, Lucido, D, Grossbard M, Loewy, J. V. Environmental music therapy: A pilot study on the effects of music therapy in a chemotherapy infusion suite. Music Med 2012, 4(4), 221-230.

EMT (Environmental Music Therapy) based on the pilot of Schneider & Stewart, (2000), Stewart, K., & Schneider, S. (2000). The effect of music therapy on the sound environment in the neonatal intensive care unit: A pilot study. In J. V. Loewy (Eds.) Music therapy in the neonatal intensive care unit (pp. 85-100). New York: Satchnote Press: The Louis & Lucille Armstrong Music Therapy Program

Rossetti A, et al, The Effect of EMT on Anxiety Levels and Perception of Waiting Time in the Radiation Oncology Waiting Room, https://clinicaltrials.gov

Zhang J, Mahoney J, Environmental Music in a Hospital Setting considerations of music therapists and performing musicians Music Med 2018, Volume 10, Issue 2 pps. 71 – 79

Loewy J, et al, The Effects of Music Therapy on Adult Patients Requiring Mechanical Ventilation in the ICU, https://clinicaltrials.gov

Nightingale,F. Notes on nursing:what it is and what it is not. 1860 New York:D.Appleton And Company.

Craik, K. H. (2000). The lived day of an individual: A person–environment perspective. In W. B. Walsh, K. H. Craik, & R. H. Price (Eds.), Person–environment psychology: New directions and perspectives (pp. 233-266). Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers.

Schneider, B. A., & Pichora-Fuller, K. M. Implications of perceptual deterioration for cognitive aging research. In F. I. M. Craik & T. A. Salthouse (Eds.), The handbook of aging and cognition 2000. (pp. 155-220). Mahwah, NJ: Lawrence Erlbaum.

Gibson, J. J. (1966). Chapter XIV: The causes of deficient perception.

In J. J. Gibson, The senses considered as perceptual systems (pp. 287-318). Boston: Houghton Mifflin.

Hsu T, PhD, Ryherd E, Persson K, Ackerman J, Noise Pollution in Hospitals: Impact on Patients JCOM July 2012 Vol. 19, No. 7

Sendelbach S, Funk M, A Patient Safety Concern AACN Adv Crit Care

Volume 24, Number 4 , pp. 378 – 386 © 2013 AACN

Mazer S, Creating a Culture of Safety: Reducing Hospital Noise. Biomed Instrum Technol Sept./Oct. 2012, Vol. 46, No. 5, pp. 350-355.

Cunha M, Silva N, Hospital Noise and Patients’ Wellbeing, Procedia Soc Behav Sci Volume 171, 16 January 2015, Pages 246-251

Basner M, et al, Auditory and non-auditory effects of noise on health. Lancet volume 383, issue 9925, 12-18, April 2014, Pages 1325-1332

.

Anjali J, Mahbub R, The architecture of safety: hospital design Curr Opin Crit Care December 2007 - Volume 13 - Issue 6 - p 714–719

Choiniere DB, The effects of hospital noise. Nurs Adm Q. 2010 Oct-Dec;34(4):327-33. doi: 10.1097/NAQ.0b013e3181f563db.

Stewart K, PATTERNS--A Model for Evaluating Trauma in NICU Music Therapy: Part 1--Theory and Design, Music Med 2009 1: 29 DOI:10.1177/1943862109338370

Bharathan T, Glodan D, Ramesh A, Vardhini B, Baccash E, Kiselev P, Goldenberg G , What do patterns of noise in a teaching hospital and nursing home suggest? Noise Health. 2007 Apr-Jun;9(35):31-4.

Born G, ed. Broadcasting the Body: the public made private in hospital soundscapes’ in Music, Sound and Space: Transformations of Public and Private Experience. Cambridge: Cambridge University Press; 2013. doi:10.1017/CBO9780511675850

Kaur H, et al ,Comparison of staff and family perceptions of causes of noise pollution in the Pediatric Intensive Care Unit and suggested intervention strategies. Noise Health. 2016 Mar-Apr;18(81):78-84. doi: 10.4103/1463-1741.178480.

Xyrichis A, Wynne J, Mckrill J, Rafferty AM, Carlyle A, Noise pollution in hospitals. BMJ, 2018 363:k4808.

Baker C. Sensory overload and noise in the ICU: sources of environmental stress. Crit Care Quart 1984;6:66–80.

Freedman NS, Kotzer N, Schwab RJ. Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit. Am J Respir Crit Care Med 1999;159:1155–62

Dlin BM, Rosen H, Dickstein K, et al. The problem of sleep and rest in the intensive care unit. Psychosomatics 1971;12:155–63.

Baker CF, Garvin BJ, Kennedy CW, Polivka BJ. The effect of environmental sound and communication on CCU patients’ heart rate and blood pressure. Res Nurs Health 1993;16:415–21.

Cohen I. Stress and wound healing. Acta Anatomica 1979;103:134–41.

Toivanen P, Hulkko S, Naatanen E. Effect of psychic stress on certain hormone factors on the healing of wounds in rats. Ann Med Exp Biol Fenn 1960;38:343–9.

Mazer S, Music, Noise, and the Environment of Care: History, Theory, and Practice. Music Med 2(3) 182-191 2010

Akansel N. Effects of Intensive Care Unit Noise on Patients: a Study on Coronary Artery Bypass Graft Surgery Patients. J Clin Nurs. 2008; 17(12):1581–1590

HCAHPS. Centers for Medicare & Medicaid Services. Baltimore, MD.

Biley FC. Effects of Noise in Hospitals. Br J Nurs. 1994; 3(3):110–113

Welch S. Better Medicine: Tame Noise to Better Serve Patients. Modern Physician.com. Posted Aug. 3, 2011.

Gurses AP, Carayon P. Exploring Performance Obstacles of Intensive Care Nurses. Appl Ergon. 2009; 40(3):509–518

Orellana D , Busch-Vishniac IJ , West JE. Noise in the Adult Emergency Department of Johns Hopkins Hospital. J Acoust Soc Am. 2007; 121(4):1996–1999

Cropp AJ , Woods LA , Raney D , Bredle DL . Name that tone: the proliferation of alarms in the intensive care unit . Chest . 1994 ; 105 ( 4 ): 1217 – 1220 .

Chambrin MC , et al Multicentric study of monitoring alarms in the adult intensive care unit (ICU): a descriptive analysis . Intensive Care Med. 1999 ; 25 (12): 1360 –1366

Guski, R. Personal and social variables as co-determinants of

noise annoyance. Noise Health, 1999. 1(3), 45-56.

Holjlund M, Beyond insulation and Isolation – Towards an attuning approach to noise in hospitals, SoundEffects vol 6 no. 1, 2016

Loewy JV, (Eds.) Music therapy in the neonatal intensive care unit (pp. 85-100). New York, Satchnote Press: The Louis Armstrong Center for Music and Medicine 2000

Ulrich, R. S. Effects of healthcare environmental design on medical outcomes. Paper presented at the DHCP 2000

Rossetti A, Canga B. Environmental music therapy: Rationale for ‘multi-individual’ music psychotherapy in modulation of the pain experience. In: Mondanaro JF, Sara AG, ed. Music and Medicine: Integrative models in the treatment of pain. New York: Satchnote Press: The Louis Armstrong Center for Music and Medicine. 2013: 451-468

Cooke AL, Appell R, Suderman K, Fradette K, Latosinsky S. Radiation treatment waiting times for breast cancer patients in Manitoba, 2001 and 2005. Curr Oncol. 2009;16(5):58–64. doi:10.3747/co.v16i5.298

Cooke AL, Appell R, Suderman K, Fradette K, Latosinsky S. Radiation treatment waiting times for breast cancer patients in Manitoba, 2001 and 2005. Curr Oncol. 2009;16(5):58–64. doi:10.3747/co.v16i5.298

Ward PR, Rokkas P, Cenko C, et al. 'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia. BMC Health Serv Res. 2017;17(1):333. Published 2017 May 5. doi:10.1186/s12913-017-2281-5

Spechbach H, Rochat J, Gaspoz JM, Lovis C, Ehrler F. Patients' time perception in the waiting room of an ambulatory emergency unit: a cross-sectional study. BMC Emerg Med. 2019;19(1):41. Published 2019 Aug 1. doi:10.1186/s12873-019-0254-1

Rossetti, A, et al, (2017) The Impact of Music Therapy (MT) on Anxiety in Cancer Patients Undergoing Simulation for Radiation Therapy (RT), Int J Radiat Oncol Biol Phys (2017), doi 10.1016/.ijrobp.2017.05.003.

Rossetti A, et al, The Effect of EMT on Anxiety Levels and Perception of Waiting Time in the Radiation Oncology Waiting Room, https://clinicaltrials.gov

Eilers GM, Improving patient satisfaction with waiting time. J Am Coll Health. 2004 Jul-Aug;53(1):41-3.

Anderson RT, Camacho FT, Balkrishnan R, Willing to wait?: the influence of patient wait time on satisfaction with primary care. BMC Health Serv Res. 2007 Feb 28;7:31.

Leddy KM, Kaldenberg DO, Becker BW, Timeliness in ambulatory care treatment. An examination of patient satisfaction and wait times in medical practices and outpatient test and treatment facilities. Ambul Care Manage. 2003 Apr-Jun;26(2):138-49.

Florian N, Lang E, Distress in the radiology waiting room, Radiology 2011, jul; 260(1): 166-173

Horsburgh CR, Healing by design, N Engl J Med, 333, 1995, pp. 735-740

Martinsen K. Staying at the hospital and experience architecture. Chapter 7. In: Architecture, Body and Learning (ed. Larsen K.), pp. 131–157. Hans Reitzels forlag, København, Denmark

Corey LJ , Wallace MA, Harris SH, Casey B, Psychiatric ward atmosphere

J Psychosoc Nurs, 1984, 24 pp. 10-16

Davis C, Glick ID, Rosow I, The architectural design of a psychotherapeutic milieu Hosp Community Psychiatry, 1979. 30 pp. 453-460

Holahan CJ, Saegert S, Behavioral and attitudinal effects of large-scale variations in the physical environment of psychiatric wards J Abnorm Psychol, 82 (1973), pp. 454-462

Viegas L, Turrini R, da Silva Bastos Cerullo J. An analysis of nursing diagnoses for patients undergoing procedures in a Brazilian interventional radiology suite. AORN J 2010;91(5):544–547

Johnston M. Anxiety in surgical patients. Psychol Med 1980;10(1):145–152 [PubMed]

Bugbee ME, Wellisch DK, Arnott IM, et al. Breast core-needle biopsy: clinical trial of relaxation technique versus medication versus no intervention for anxiety reduction. Radiology 2005;234(1):73–78

Lang EV, Benotsch EG, Fick LJ, et al. Adjunctive non-pharmacological analgesia for invasive medical edical procedures: a randomised trial. Lancet 2000;355(9214):1486–1490

Lang EV, Berbaum KS, Faintuch S, et al. Adjunctive self-hypnotic relaxation for outpatient medical procedures: a prospective randomized trial with women undergoing large core breast biopsy. Pain 2006;126(1-3):155–164

Lang EV, Berbaum KS, Pauker SG, et al. Beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment: when being nice does not suffice. J VascInterv Radiol 2008;19(6):897–905

Schupp CJ, Berbaum K, Berbaum M, Lang EV. Pain and anxiety during interventional radiologic procedures: effect of patients’ state anxiety at baseline and modulation by nonpharmacologic analgesia adjuncts. J Vasc Interv Radiol 2005;16(12):1585–1592

Martin ML, Lennox PH, Buckley BT. Pain and anxiety: two problems, two solutions. 2005 J Vasc Interv

Krantz DS, Kop WJ, Santiago HT, Gottdiener JS. Mental stress as a trigger of myocardial ischemia and infarction. Cardiol Clin 1996;14(2):271–287 .

Auerbach SM, Martelli MF, Mercuri LG. Anxiety, information, interpersonal impacts, and

adjustment to a stressful health care situation. J Pers Soc Psychol 1983;44(6):1284–1296

Dirckinck-Homfield K, Heslet L, & Rigshospitalet. Sansernes hospital. Copenhagen, Denmark: Arkitektens Forlag in Holijund M

Shattell H, Hogan B, Thomas SP, It’s the People that Make the Environment Good or Bad: The Patient’s Experience of the Acute Care Hospital Environment, Adv Crit Care, 2005 16(2), 159-169

Rice, T. Hearing the hospital: sound, listening, knowledge and experience. 2013. Canon Pyon: Sean Kingston Press.

Porges, S.W.Music Therapy & Trauma:Insights from the Polyvagal Theory. K. Stewart (Ed.), Symposium on Music Therapy & Trauma: Bridging Theory and Clinical Practice. New York: Satchnote Press.

Porges SW, Carter S, The Polyvagal theory and the social engagement system Neurophysiological bridge between connectedness and health 2017 https://kinseyinstitute.org

Axelsson O, The ISO 12913 series on soundscape. Forum Acusticum 2011

Hauskeller M, Concepts and Perceptions of Atmospheres in Weidinger, Jürgen Designing Atmospheres Universitätsverlag der TU Berlin, Architecture, May 16, 2018 -

Douek J, Music and emotion – a composer’s perspective, Front Syst Neurosci 2013 doi: 10.3389/fnsys.2013.00082

Erkkilä, J., Punkanen, M., Fachner, J., Ala-Ruona, E., Pöntiö, I., Tervaniemi, M., Vanhala, M., & Gold, C. (2011). Individual music therapy for depression: randomised controlled trial. Br j Psychiatry, 199(2), 132-139.

Lindahl Jacobsen S, ‎Nygaard Pedersen I, ‎Ole Bonde L EDs. A comprehensive guide to music therapy: Theory, clinical practice, research, and training 2nd edition 2019 Jessica Kingsley Publishers

Entrainment https://sk.sagepub.com › reference › processes

Aasgaard T. A pied piper among white coats and infusion pumps: Community music therapy in a paediatric hospital setting. In: Andsell G, Pavlicevic M. ed. Community Music Therapy. London: Jessica Kingsley. 2004: 147-155.

Silva MJ, McKenzie K, Harpham T, Huttly SRA. Social Capital and mental illness: a systematic review. J Epidemiol Community Health. 2005;59:376-381.

Schneider, S. Environmental music therapy, life, death and the ICU. In C. Dileo & J. V. Loewy (Eds.), Music therapy at the end of life 2005(pp. 219-225). Cherry Hill, N. J.: Jeffrey Books.

WEBSTER https://www.merriam-webster.com/dictionary/music

Aasgaard T. Music therapy as milieu in hospice and paediatric oncology ward. In: Aldridge D, ed. Music Therapy in Palliative Care. London: Jessica Kingsley. 1999:29–43.

SAMHSA.gov. https://www.samhsa.gov/nctic/trauma-interventions. Updated April 27, 2018. Accessed May 18, 2018

Quinal , L. , Harford , S. , & Rutledge , D. N. ( 2009 ). Secondary traumatic

stress in oncology staff . Cancer Nurs 2009 , 32 , E1 – E7 .

Morrison , L. E. , & Joy , J. P. ( 2016 ). Secondary traumatic stress in the emergency department . J Adv Nurs . In press. doi:10.1111/jan.13030

Karanikola , M. N. , Giannakopoulou , M. , Mpouzika , M. , Kaite , C. P. , Tsiausis , G. Z. , & Papathanassoglou , E. D. ( 2015 ). Dysfunctional psychological responses among intensive care unit nurses: A systematic review of the literature . Rev Esc Enferm USP 49 ( 5 ), 847 – 57 . doi:10.1590/ S0080-623420150000500020.

Sendelbach S. Funk M, Alarm Fatigue: a Patient Safety Concern AACN Adv Crit Care, 2013 Volume 24, number 4 pp. 378-386 2013 DOI: 10.1097/NCI.0b013e3182a903f9

Atzema C , Schull MJ , Borgundvaag B , Slaughter GR , Lee CK . ALARMED: adverse events in low-risk patients with chest pain receiving continuous electrocardiographic monitoring in the emergency department . A pilot study . Am J Emerg Med . 2006 ; 24 ( 1 ): 62 – 67 .

Lawless ST . Crying wolf: false alarms in a pediatric intensive care unit . Crit Care Med . 1994 ; 22 ( 6 ): 981 – 985 .

Siebig S , Kuhls S , Imhoff M , Gather U , Scholmerich J , Wrede CE . Intensive care unit alarms—how many do we need? Crit Care Med . 2010 ; 38 ( 2 ): 451 – 456 .

Tsien CL , Fackler JC . Poor prognosis for existing monitors in the intensive care unit . Crit Care Med . 1997 ; 25 ( 4 ): 614 – 619 .

Mitchell L, McDonald A, Brodie E. A comparison of the effects of preferred music, arithmetic and humour on cold pressor pain. Eur J Pain 2006; 10: 242-351.

, Otte C, Lenoci M, Metzler T, Yehuda R, Marmar C, Neylan T. Hypothalamic Pituitary-Adrenal Axis Activity and Sleep in Posttraumatic Stress Disorder. Neuropsychopharmacology 2005. 30, 1173-1180.

Punkanen M, Eerolaa T, Erkkiläa J. Biased emotional recognition in depression: Perception of emotions in music by depressed patients. J Affect Disord. 2011 130(1-2), 118-126 .

Zentner M. Homer’s Prophecy: an essay on music’s primary emotions. Music Anal. 2010 29:102--125.

Scherer K, Zentner M. Emotional effects of music: production rules. In: Juslin PN, Sloboda J. editors. Music and emotion: theory and research. Oxford: Oxford University Press. 2001; 361--392.

Thayer JF, Lane RD. A model of neurovisceral integration in emotion regulation and dysregulation. J. Affective Dis. 2000; 61: 201–216.

Faith M, Thayer JF. A dynamical systems interpretation of a dimensional model of emotion. Scand. J. Psychol. 2001; 42 (2): 121–133.

Juslin PN, Sloboda JA. (Eds.) Handbook of music and emotion: Theory, research, applications. New York: Oxford University Press 2010

Rossetti A Towards Prescribed Music in Clinical Contexts: More Than Words, Music Med 2014 Volume 6 Issue 2 Pages 70 – 77

Loewy JV, NICU music therapy: song of kin as critical lullaby in research and practice Ann NY Acad Sci. 2015 Mar;1337:178-85. doi: 10.1111/nyas.12648.

Clark et al, Use of Preferred Music to Reduce Emotional Distress and Symptom Activity During Radiation Therapy J Music Ther, 2006 xii (3) 247-265

Wakim H, Smith S, Guinn C, The Efficacy of Music Therapy. J Perianesth Nurs

Volume 25, Issue 4, August 2010, Pages 226-232

Mitchell, L. A., & MacDonald, R. A. R. (2006). An experimental investigation of the effects of preferred and relaxing music listening on pain perception. J Music Ther, 43, 295–316. doi: 10.1093/jmt/43.4.295

Pelletier, C. L. The effect of music on decreasing arousal due to stress: A meta-analysis. J Music Ther, 2004 41, 192-214.

Loewy J, Hallan C, Friedman E, Martinez C, Sleep/sedation in children undergoing EEG testing: A comparison of chloral hydrate and music therapy J Perianesth Nurs 20 (5), 323-331

Published

2020-04-24

Issue

Section

Full Length Articles