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  • Guideline Summary
  • NGC:008991
  • 2012 Feb 16

Best evidence statement (BESt). The effects of music therapy on well-being in pediatric inpatients.

Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). The effects of music therapy on well-being in pediatric inpatients. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2012 Feb 16. 6 p. [13 references]

View the original guideline documentation External Web Site Policy

This is the current release of the guideline.

Major Recommendations

The strength of the recommendation (strongly recommended, recommended, or no recommendation) and the quality of the evidence (1a‒5b) are defined at the end of the "Major Recommendations" field.

It is strongly recommended that both active and passive music interventions be facilitated by board-certified music therapists (and music medicine be made available by medical personnel) at the bedside for hospitalized pediatric patients to improve physical, emotional, and social well-being during their hospital stay (Treurnicht Naylor et al., 2011 [1a]; Klassen et al., 2008 [1a]; Mrazova & Celec, 2010 [1b]; Ngyuen et al., 2010 [2a]).

Definitions:

Table of Evidence Levels

Quality Level Definition
1a or 1b Systematic review, meta-analysis, or meta-synthesis of multiple studies
2a or 2b Best study design for domain
3a or 3b Fair study design for domain
4a or 4b Weak study design for domain
5a or 5b General review, expert opinion, case report, consensus report, or guideline
5 Local consensus

a = good quality study; b = lesser quality study

Table of Recommendation Strength

Strength Definition
It is strongly recommended that…
It is strongly recommended that… not…
There is consensus that benefits clearly outweigh risks and burdens (or vice versa for negative recommendations).
It is recommended that…
It is recommended that… not…
There is consensus that benefits are closely balanced with risks and burdens.
There is insufficient evidence and a lack of consensus to make a recommendation…

Note: See the original guideline document for the dimensions used for judging the strength of the recommendation.

Clinical Algorithm(s)

None provided

Disease/Condition(s)

Pediatric conditions requiring hospitalization

Guideline Category

Treatment

Clinical Specialty

Family Practice

Pediatrics

Intended Users

Advanced Practice Nurses

Allied Health Personnel

Nurses

Physician Assistants

Physicians

Guideline Objective(s)

To evaluate if pediatric inpatients who receive active and/or passive music therapy and music medicine (in addition to standard care) compared to standard medical care alone, experience improved emotional, social and physical well-being during their current hospitalization

Target Population

Hospitalized inpatients receiving care in a pediatric institution

Interventions and Practices Considered

  • Music therapy
    • Active
    • Passive
  • Music medicine

Major Outcomes Considered

Emotional, social and physical well-being

Methods Used to Collect/Select the Evidence

Searches of Electronic Databases

Description of Methods Used to Collect/Select the Evidence

Search Strategy

  • Terms: Music therapy, medical music therapy, pediatric music therapy, music therapy and: pediatrics, children, quality of life, mood, well-being, emotions, social state, anxiety, pediatrics, hospitalized children, pain, and inpatients
  • Databases: Medline/PubMed, CINAHL, PsycINFO, Cochrane Library, Alt Healthwatch, Google Scholar, & NACRHI
  • Last date of search: 4/19/2011
  • No filters or limits were used.

Number of Source Documents

Not stated

Methods Used to Assess the Quality and Strength of the Evidence

Weighting According to a Rating Scheme (Scheme Given)

Rating Scheme for the Strength of the Evidence

Table of Evidence Levels

Quality Level Definition
1a or 1b Systematic review, meta-analysis, or meta-synthesis of multiple studies
2a or 2b Best study design for domain
3a or 3b Fair study design for domain
4a or 4b Weak study design for domain
5a or 5b General review, expert opinion, case report, consensus report, or guideline
5 Local consensus

a = good quality study; b = lesser quality study

Methods Used to Analyze the Evidence

Systematic Review

Description of the Methods Used to Analyze the Evidence

Not stated

Methods Used to Formulate the Recommendations

Expert Consensus

Description of Methods Used to Formulate the Recommendations

Not stated

Rating Scheme for the Strength of the Recommendations

Table of Recommendation Strength

Strength Definition
It is strongly recommended that…
It is strongly recommended that… not…
There is consensus that benefits clearly outweigh risks and burdens (or vice versa for negative recommendations).
It is recommended that…
It is recommended that… not…
There is consensus that benefits are closely balanced with risks and burdens.
There is insufficient evidence and a lack of consensus to make a recommendation…

Note: See the original guideline document for the dimensions used for judging the strength of the recommendation.

Cost Analysis

  • In one study, music therapy had a significantly positive effect for level of sleep/sedation (p <.001) and length of sleep/sedation (p <.001) in comparison to the chloral hydrate group providing a safe, non-pharmacological and cost-effective alternative.
  • A cost-effective analysis for music therapy procedural support indicated success in eliminating patient sedation, reducing procedural time and in the number of medical professionals present during electrocardiograms (ECGs), computed tomography (CT) scans, intravenous (IV) starts, X-rays, ventilator extubations, and electroencephalograms (EEGs).

Method of Guideline Validation

Peer Review

Description of Method of Guideline Validation

This Best Evidence Statement has been reviewed against quality criteria by 2 independent reviewers from the Cincinnati Children's Hospital Medical Center (CCHMC) Evidence Collaboration.

References Supporting the Recommendations

Klassen JA, Liang Y, Tjosvold L, Klassen TP, Hartling L. Music for pain and anxiety in children undergoing medical procedures: a systematic review of randomized controlled trials. Ambul Pediatr. 2008 Mar-Apr;8(2):117-28. PubMed External Web Site Policy

Mrazova M, Celec P. A systematic review of randomized controlled trials using music therapy for children. J Altern Complement Med. 2010 Oct;16(10):1089-95. PubMed External Web Site Policy

Nguyen TN, Nilsson S, Hellstrom AL, Bengtson A. Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial. J Pediatr Oncol Nurs. 2010 May-Jun;27(3):146-55. PubMed External Web Site Policy

Treurnicht Naylor K, Kingsnorth S, Lamont A, McKeever P, Macarthur C. The effectiveness of music in pediatric healthcare: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med. 2011;2011:464759. PubMed External Web Site Policy

Type of Evidence Supporting the Recommendations

The type of supporting evidence is identified and graded for each recommendation (see the "Major Recommendations" field).

Potential Benefits

Improved emotional, social and physical well-being

Potential Harms

Not stated

Qualifying Statements

This Best Evidence Statement addresses only key points of care for the target population; it is not intended to be a comprehensive practice guideline. These recommendations result from review of literature and practices current at the time of their formulation. This Best Evidence Statement does not preclude using care modalities proven efficacious in studies published subsequent to the current revision of this document. This document is not intended to impose standards of care preventing selective variances from the recommendations to meet the specific and unique requirements of individual patients. Adherence to this Statement is voluntary. The clinician in light of the individual circumstances presented by the patient must make the ultimate judgment regarding the priority of any specific procedure.

Description of Implementation Strategy

An implementation strategy was not provided.

Implementation Tools

Audit Criteria/Indicators

For information about availability, see the Availability of Companion Documents and Patient Resources fields below.

IOM Care Need

Staying Healthy

IOM Domain

Effectiveness

Patient-centeredness

Bibliographic Source(s)

Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). The effects of music therapy on well-being in pediatric inpatients. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2012 Feb 16. 6 p. [13 references]

Adaptation

Not applicable: The guideline was not adapted from another source.

Date Released

2012 Feb 16

Guideline Developer(s)

Cincinnati Children's Hospital Medical Center - Hospital/Medical Center

Source(s) of Funding

Cincinnati Children's Hospital Medical Center

Guideline Committee

Not stated

Composition of Group That Authored the Guideline

Group/Team Members: Brian Schreck, MA, MT-BC, Coordinator/Music Therapist, Department of Child Life & Integrative Care; Mary Ellen Meier, MSN, RN, CPN, Evidence-Based Practice Mentor-Center for Professional Excellence & Business Integration Research & Evidence-Based Practice

Financial Disclosures/Conflicts of Interest

No financial conflicts of interest were found.

Guideline Status

This is the current release of the guideline.

Guideline Availability

Electronic copies: Available from the Cincinnati Children's Hospital Medical Center Web site External Web Site Policy.

Print copies: For information regarding the full-text guideline, print copies, or evidence-based practice support services contact the Cincinnati Children's Hospital Medical Center Health James M. Anderson Center for Health Systems Excellence at EBDMInfo@cchmc.org.

Availability of Companion Documents

The following are available:

Print copies: For information regarding the full-text guideline, print copies, or evidence-based practice support services contact the Cincinnati Children's Hospital Medical Center Health James M. Anderson Center for Health Systems Excellence at EBDMInfo@cchmc.org.

In addition, suggested process or outcome measures are available in the original guideline document External Web Site Policy.

Patient Resources

None available

NGC Status

This NGC summary was completed by ECRI Institute on May 8, 2012.

Copyright Statement

This NGC summary is based on the original full-text guideline, which is subject to the following copyright restrictions:

Copies of this Cincinnati Children's Hospital Medical Center (CCHMC) External Web Site Policy Best Evidence Statement (BESt) are available online and may be distributed by any organization for the global purpose of improving child health outcomes. Examples of approved uses of the BESt include the following:

  • Copies may be provided to anyone involved in the organization's process for developing and implementing evidence based care
  • Hyperlinks to the CCHMC website may be placed on the organization's website
  • The BESt may be adopted or adapted for use within the organization, provided that CCHMC receives appropriate attribution on all written or electronic documents
  • Copies may be provided to patients and the clinicians who manage their care

Notification of CCHMC at EBDMInfo@cchmc.org for any BESt adopted, adapted, implemented or hyperlinked by the organization is appreciated.

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