Explorando la eficacia de la intervención con musicoterapia como parte de la evaluación y el tratamiento interdisciplinario de pacientes con trastornos prolongados de conciencia.
DOI:
https://doi.org/10.47513/mmd.v14i2.833Resumen
Veintinueve pacientes participaron en un estudio de 4 años en un hospital de rehabilitación en Irlanda, donde dos musicoterapeutas trabajaron como parte integrada de un equipo interdisciplinario (IDT) de trastornos prolongados de conciencia (PDOC). La investigación exploró el impacto de la musicoterapia como parte de la evaluación y el tratamiento de IDT para pacientes con PDOC y sus familias. El PDOC se define como una capacidad de respuesta y conciencia disminuida o ausente que persiste durante más de cuatro semanas después de una lesión cerebral catastrófica. Se llevó a cabo un enfoque de métodos mixtos que incorporó una serie de estudios de casos,la herramienta de evaluación the Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC), cuestionarios sobre las familias de los pacientes y miembros del IDT, y análisis de video. Se describen tres series de estudios de casos para ilustrar aspectos del trabajo clínico y abordar las preguntas de investigación. Los hallazgos sugieren que la musicoterapia puede mejorar un IDT y tener un impacto positivo en los miembros de la familia. Se estableció un servicio permanente de musicoterapia PDOC en el hospital que incorporó la evaluación de la musicoterapia y la vía de tratamiento que se desarrolló en este estudio.
Palabras clave: Musicoterapia, trabajo en equipo interdisciplinario, trastornos prolongados de conciencia, trabajo familiar.
Citas
Royal College of Physicians. Prolonged disorders of consciousness: National clinical guidelines. London, RCP, 2013
Magee, W.L., Siegert, R.J., Lenton-Smith, G; Daveson, B.A., Taylor, S.M. (2014). Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC): Standardisation of the principal subscale to assess awareness in patients with disorders of consciousness. Neuropsychological Rehabilitation, 24 (1), 101-124
Magee, W.L., O’Kelly, J. (2015) Music Therapy with Disorders of Consciousness: Current Evidence and Emergent Evidence-Based Practise. Annals of the New York Academy of Sciences, 1337, 256-262. Sciences, 1337, 256-262
Laureys, S., Celesia, G.G., Cohadon, F. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med 8, 68 (2010). https://doi.org/10.1186/1741-7015-8-68
Giacino, J.T., Kalmar, K., Whyte, J. (2004) The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil. 85(12) 2020-9
Giacino, J.T., Ashwal, S., Childs, N., Cranford, R., Jennett, B., Katz, D.I., Zasler , N.D. (2002) The minimally conscious state: Definition and diagnosis criteria. Neurology, 58(3), 349-353
Hirschberg, R., Giacino, J.T. (2011) The vegetative and minimally conscious states: Diagnosis, prognosis and treatment. Neurologic Clinics, 29(4) 773-786
Schnakers, C. (2012) Clinical assessment of patients with disorders of consciousness. Archieves Italiennes de Biologie, 150: 36-43
Vogl, J., Heine, A.M. Steinhoff, N., Weiss, K., Tucek, G. (2015) Neuroscientific and neuroanthropological perspectives in music therapy research and practice with patients with disorders of consciousness. Frontiers in NeuroScience, 9 (273) 1-6
Heine, L., Castro, M., Martial, C., Tillmann, B., Laureys, S., Perrin F. (2015) Exploration of functional connectivity during preferred music stimulation in patients with Disorders of Consciousness. Frontiers in Psychology, 6:1704. doi: 10.3389/fpsyg.2015.01704
O’Kelly, J., James, L., Palaniappan, R., Taborin, J., Fachner, J., Magee, W. L.(2013) Neurophysiological and behavioral responses to music therapy in vegetative and minimally conscious states. Frontiers in Human Neuroscience, 7, 884 doi:10.3389/fnhum.2013.00884
Gill-Thwaites H., Mundy, R. (2004) The Sensory Modality Assessment and Rehabilitation technique (SMART): A valid and reliable assessment for vegetative state and minimally conscious state patients. Brain Injury 18, 1255-1269
Gill-Thwaites H., Mundy R., Elliott K. Sensory modality assessment and rehabilitation technique manual. version 2. London: Royal Hospital for Neuro-disability; 2008
Shiels A., Horn S.A., Wilson B (2000) The Wessex Head Injury Matrix (WHIM) main scale: A preliminary report on a scale to assess and monitor patient recovery after severe head injury. Clinical Rehabilitation 14: 408–16 doi:10.1191/0269215500cr326oa
Giacino, J.T., Kalmar, K. Diagnostic and prognostic guidelines for the vegetative and minimally conscious states. Neuropsychol Rehabil. 2005;15(3–4):166–74. doi:10.1080/09602010443000498
Boeseler, K. (2012) Needs orientated, emotional-communicative dialogue in music therapy with unresponsive wakefulness syndrome patients in neurological early rehabilitaiton. In Jox, R.J., Kuehlmeyer, K., Marckmann, G., Racine, E. ( Eds.) Vegetative State - a paradigmate problem of modern societies: medical, ethical, legal and social perspectivies on chronic disorders of consciousness. Practical Ethics, Zurich: Literature. 80-94
Magee, W.L. Why include music therapy in a neurorehabilitation team? ACNR 2020;19(2): 10-12
Magee, W.L. Music in the diagnosis, treatment and prognosis of people with prolonged disorders of consciousness. Neuropsychological Rehabilitation, 2018;17;28(8):1331-9
Leonardi, M., Giovannetti, A.M., Pagani, M., Raggi, A., Sattin, D. (2012) Burden and needs of 487 caregivers of patients in vegetative state and in minimally conscious state: results from a national study. Brain Injury, 26(10) 1201-10
Tramonti, F., Bonfiglio, L., Di Bernardo, C., Ulivi, C., Virgillito, A., Rossi, B., Carboncini, M.C. (2015) Family functioning in severe brain injuries: correlations with caregivers’ burden, perceived social support and quality of life, Psychology, Health & Medicine, 20(8)1-7
Chiambretto, P., Rossi Ferrario, S., Zotti, A.M. (2001).Patients in a persistent vegetative state: Caregiver attitudes and reactions. Acta Neurologica Scandinavica,104(6), 364–369
Romaniello, C., Simoni, C., Farinelli, M., Bertoletti, E., Pedone, V., Northoff, G. (2016). Emotional Burden, Quality of Life, and Coping Styles in Care Givers of Patients with Disorders of Consciousness Living in Italy: Preliminary Data. Brain Impairment, 17(3), 254-264. doi:10.1017/BrImp.2016.26
Kennelly, J., Brien-Elliot, K. (2001) The role of music therapy in paediatric rehabilitation. Paediatric Rehabilitation, 4, 137-143
Magee, W.L. (2016) Validating the MATADOC Against Best Practice Standard External ReferenceStandard. IdentificationNo. NCT02959736.Retrieved from https://clinicaltrials.gov/ct2/show/NCT02959736
