Browsing by Author "Bartel, Lee R"
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Item Exit Music: The Experience of Music Therapy within Medical Assistance in Dying(2020-06) Black, SarahRose Mary; Bartel, Lee R; Rodin, Gary M; MusicSince the 2015 legalization of medical assistance in dying (MAiD), healthcare professionals across the interdisciplinary spectrum have been exploring their roles within this practice, and a number of professions have created guidelines and policies to define their role(s). Many Canadian music therapists also found themselves implicated in care for those requesting MAiD. No prior research has been done to gain insight into the role of music therapy within the context of MAiD. This qualitative hermeneutic phenomenological study, the first of its kind, examines the experience of music therapy within medically assisted dying from three perspectives: the patient, their primary caregiver, and the music therapist/researcher. Ten cases that vary in duration of involvement of the music therapist, demographic, characteristics, and nature of the music therapy are presented through a hermeneutic phenomenological methodology lens. A total of 24 music therapy sessions and seven caregiver interviews were transcribed and analyzed. A total 28 researcher reflections were analyzed. The analysis of data revealed thematic trends of life reflection activated by the musical interaction (wherein the music functioned as a narrator and a trigger), control (over musical and ritualistic choices), communication and connectedness (with the self and others through music), and aesthetic pleasure (as a catalyst for therapeutic outcomes such as pain and symptom management). Caregiver participant results revealed trends of immediacy of access to emotion through music, reflection (on personal narratives within music), witnessing (of patients’ emotional and narrative expressions), and unexpected opportunities (for life review through music). Researcher reflection data analyses revealed thematic trends of trusting (in the midst of uncertainty), witnessing (of the unfolding of narratives through music), therapeutic relationship creation (with a sense of immediacy), and support for patients and caregivers in their navigation of their MAiD processes. These results may have implications as to how music therapy is offered, standardized, and implemented in settings where MAiD is provided, as the overarching thematic findings show therapeutically beneficial outcomes in terms of quality of life, life review, and symptom management. Further research is merited to continue to explore the role of music therapy in the context of assisted dying.Item Music as a Sleep Aid in Fibromyalgia(2014-01-01) Picard, Larry M; Bartel, Lee R; Gordon, Allan S; Cepo, Davor; Wu, Qi; Pink, Leah RBACKGROUND: Interventions to improve sleep in fibromyalgia may generalize to improvements in multiple symptom domains. Delta-embedded music, pulsating regularly within the 0.25 Hz to 4 Hz frequency band of brain wave activity, has the potential to induce sleep.OBJECTIVES: To assess the effects of a delta-embedded music program over four weeks for sleep induction in patients with fibromyalgia.METHODS: The present unblinded, investigator-led pilot study used a within-subject design. Analysis was based on 20 individuals with fibromyalgia who completed the study, of the 24 recruited into the study. The primary outcome variables were the change from baseline in Fibromyalgia Impact Questionnaire (FIQ) and Jenkins Sleep Scale scores. A patient global impression of change was measured on a seven-point Likert scale. Secondary outcome measures, comprised of items 5, 6 and 7 of the FIQ, were used as indicators of pain, tiredness and being tired on awakening.RESULTS: The FIQ median score of 76.4 (95% CI 61.3 to 82.1) at baseline improved to 60.3 (95% CI 53.1 to 72.0; P=0.004). The Jenkins Sleep Scale median value of 17.5 (95% CI 15.5 to 18.5) at baseline fell to 12.5 (95% CI 8.5 to 14.5; P=0.001) at study completion. The outcomes of the patient global impression of change ratings were mostly positive (P=0.001). Being tired on awakening declined significantly from a median of 9.0 (95% CI 8.0 to 10.0) to 8.0 (95% CI 5.5 to 9.0; P=0.021). However, there was no significant improvement in pain level (baseline median 7.5 [95% CI 7.0 to 8.5] versus study completion median 7.0 [95% CI 6.5 to 8.0]; P=0.335) or tiredness (baseline median 9.0 [95% CI 8.0 to 9.5] versus study completion median 8.0 [95% CI 6.0 to 8.5]; P=0.061). There were no serious adverse events.CONCLUSIONS: Delta-embedded music is a potential alternative therapy for fibromyalgia.Item Synchronized personalized music audio-playlists to improve adherence to physical activity among patients participating in a structured exercise program: a proof-of-principle feasibility study(2015-05-08) Alter, David A; O’Sullivan, Mary; Oh, Paul I; Redelmeier, Donald A; Marzolini, Susan; Liu, Richard; Forhan, Mary; Silver, Michael; Goodman, Jack M; Bartel, Lee RAbstract Background Preference-based tempo-pace synchronized music has been shown to reduce perceived physical activity exertion and improve exercise performance. The extent to which such strategies can improve adherence to physical activity remains unknown. The objective of the study is to explore the feasibility and efficacy of tempo-pace synchronized preference-based music audio-playlists on adherence to physical activity among cardiovascular disease patients participating in a cardiac rehabilitation. Methods Thirty-four cardiac rehabilitation patients were randomly allocated to one of two strategies: (1) no music usual-care control and (2) tempo-pace synchronized audio-devices with personalized music playlists + usual-care. All songs uploaded onto audio-playlist devices took into account patient personal music genre and artist preferences. However, actual song selection was restricted to music whose tempos approximated patients’ prescribed exercise walking/running pace (steps per minute) to achieve tempo-pace synchrony. Patients allocated to audio-music playlists underwent further randomization in which half of the patients received songs that were sonically enhanced with rhythmic auditory stimulation (RAS) to accentuate tempo-pace synchrony, whereas the other half did not. RAS was achieved through blinded rhythmic sonic-enhancements undertaken manually to songs within individuals’ music playlists. The primary outcome consisted of the weekly volume of physical activity undertaken over 3 months as determined by tri-axial accelerometers. Statistical methods employed an intention to treat and repeated-measures design. Results Patients randomized to personalized audio-playlists with tempo-pace synchrony achieved higher weekly volumes of physical activity than did their non-music usual-care comparators (475.6 min vs. 370.2 min, P < 0.001). Improvements in weekly physical activity volumes among audio-playlist recipients were driven by those randomized to the RAS group which attained weekly exercise volumes that were nearly twofold greater than either of the two other groups (average weekly minutes of physical activity of 631.3 min vs. 320 min vs. 370.2 min, personalized audio-playlists with RAS vs. personalized audio-playlists without RAS vs. non-music usual-care controls, respectively, P < 0.001). Patients randomized to music with RAS utilized their audio-playlist devices more frequently than did non-RAS music counterparts (P < 0.001). Conclusions The use of tempo-pace synchronized preference-based audio-playlists was feasibly implemented into a structured exercise program and efficacious in improving adherence to physical activity beyond the evidence-based non-music usual standard of care. Larger clinical trials are required to validate these findings. Trial registration ClinicalTrials.gov ID ( NCT01752595 )Item Teaching Music with Keyboard Improvisation: A Pedagogical Journey Involving Four Older Adults(2015-11) Tahara, Lisa; Koga, Midori; Bartel, Lee R; MusicThe life expectancy of individuals has risen in the twentieth-century, due largely to improvements in health, technology, and nutrition. Accordingly, the older adult population has been increasing rapidly and, as a result, there is a need for greater attention and emphasis to be placed on their wellbeing. Research has shown that the older adult population is interested in music learning programs where they may be given the opportunity to actively create music in group settings. However, music programs have traditionally been based on notation and reading, and this approach may not be optimal for a student entering a music learning program later in life. This research study began as an exploration of how music instruction with improvisation may impact the wellbeing, enjoyment, and confidence levels of older adults. Four older adults between the ages of 83 and 90 participated in a music learning program involving a basic curriculum and improvisation over a period of three months. Qualitative data was collected in the form of audiovisual materials, individual interviews, and through focus group sessions. Quantitative data was gathered using pre and post-test surveys to examine differences in quality of life, musical aptitude, and mood. The researcher kept a personal journal including observations of the class and reflections on the videotapes to construct a personal narrative on her experiences in a reflective approach. At the end of the study, participants showed higher levels of confidence, and demonstrated improvement in musical and improvisational achievement. Further, their levels of enjoyment during music lessons were reported at their post-study individual interviews. The results suggest that a music curriculum involving improvisation may be an effective way for older adults to engage in spontaneous creativity while enhancing their musical learning experience.