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Live music therapy with lullaby singing as affective support during painful procedures: a case study with microanalysis
Örebro University, School of Music, Theatre and Art. Centre for Clinical Research, Värmland County Council, Karlstad, Sweden. (Musiken och Människan, PEARL- Pain in Early Life)ORCID iD: 0000-0002-4436-4258
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. (PEARL- Pain in Early Life)ORCID iD: 0000-0002-5996-2584
Centre for Clinical Research, Värmland County Council, Karlstad, Sweden.ORCID iD: 0000-0003-0534-4921
Örebro University, School of Music, Theatre and Art. (Musiken och Människan)ORCID iD: 0000-0002-5809-3575
2017 (English)In: Nordic Journal of Music Therapy, ISSN 0809-8131, Vol. 26, no 2, p. 142-166Article in journal (Refereed) Published
Abstract [en]

During the most vulnerable period in a child’s life, preterm and sick infants are exposed to a high number of painful procedures, sometimes without the comfort and affection of their parents. Since repeated pain and frequent use of analgesic drugs may have consequences for the neurological and behaviour-oriented development of the infant, it is vital to identify effective non-pharmacological interventions with regard to procedural pain. This paper reviews the use of live lullaby singing as an adjuvant to the control of premature infant pain. The objectives of this case study were to analyse the live lullaby singing for two premature infants during venipuncture in comparison to standard care only, and the infants’ physiological and affective responses emerging before, during and after this procedure. The empirical data stem from a quantitative clinical study. From this larger study, two premature infants were selected. Through microanalysis, with in-depth analysis of video footage, and pain assessment with Behavioral Indicators of Infant Pain (BIIP), painful standard care procedures with and without live lullaby singing, were analysed. The results show that live lullaby singing with premature infants is a communicative interaction which may optimize the homeostatic mechanisms of the infant during painful procedures. This case study shows the importance of predictability of the affective support, right from the start of the live singing intervention. It is important in a painful context that vocal interactions provide regular and comforting intensity, shape and temporal structures.

Place, publisher, year, edition, pages
Oxon, United Kingdom: Routledge, 2017. Vol. 26, no 2, p. 142-166
Keywords [en]
Pain management, premature infants, music therapy, infant directed singing, lullaby
National Category
Musicology
Research subject
Health and Medical Care Research
Identifiers
URN: urn:nbn:se:oru:diva-49326DOI: 10.1080/08098131.2015.1131187ISI: 000394440800004Scopus ID: 2-s2.0-84988566335OAI: oai:DiVA.org:oru-49326DiVA, id: diva2:911552
Note

Funding Agencies:

Värmland County Council, Sweden

Queen Silvia's Jubilee Fund, Sweden

Karin and Erik Gerdens Foundation, Sweden

Berit and Carl-Johan Wettergrens Foundation, Sweden

Available from: 2016-03-13 Created: 2016-03-13 Last updated: 2019-11-19Bibliographically approved
In thesis
1. Singing, sharing, soothing: Family-centred music therapy during painful procedures in neonatal care
Open this publication in new window or tab >>Singing, sharing, soothing: Family-centred music therapy during painful procedures in neonatal care
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

To sing is to communicate. The soothing, comforting and emotional regulating properties of a lullaby are well-known cross-culturally and historically. This doctoral thesis addresses neonatal pain management from a novel and groundbreaking perspective, studying the efficacy of live music therapy on infants’ pain responses during venepuncture. New research is needed to advance the non-pharmacological interventions in neonatal pain care, and neonatal music therapy (NICU MT) offers active methods to involve the parents in pain management. The doctoral thesis includes two empirical and two theoretical articles. In paper I, preterm and term infants (n=38) were subjected to venepuncture with and without live lullaby singing, in a randomised order with a crossover design. Parent-preferred lullabies were performed live by a music therapy student and standard care was provided for all infants. The results did not show any significant pain-alleviating effects, however, the live singing was not stressful for the infants.

In paper II, the microanalysis disclosed that live lullaby singing is a communicative reciprocal intervention that also applies to premature infants during painful procedures. Live lullaby singing is a tool suitable as a means to optimise the homeostatic mechanisms. The results from the theoretical papers III and IV are further developed and synthesised in the thesis into a theoretical strategy; The Nordic NICU MT pain management strategy, featuring the parents and their singing voices as mediators for pain relief. The role of the music therapist in neonatal pain management is as a facilitator and an educator for the parents. Coaching parents to better meet their infant’s attachment needs during a painful procedure may lead to more efficacious interventions. The biopsychosocial parental infant-directed singing is presumably an applicable parent-driven non-pharmacological intervention, which promotes pain relief and attachment formation during painful procedures. Neonatal music therapy is still in its infancy in the Nordic countries, but the societal and healthcare contexts afford important prerequisites to further develop NICU MT as a truly family-centred approach. This doctoral thesis will hopefully contribute to the important interdisciplinary endeavour worldwide of involving and integrating parents in neonatal pain management.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2019. p. 134
Series
Örebro Studies in Musicology ; 4
Keywords
music therapy, pain management, premature infants, family-centred, infant-directed singing, venepuncture, parents, dynamic forms of vitality
National Category
Musicology
Identifiers
urn:nbn:se:oru:diva-77285 (URN)978-91-7529-313-4 (ISBN)
Public defence
2019-12-13, Örebro universitet, Hörsalen, Musikhögskolan, Fakultetsgatan 1, Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2019-10-14 Created: 2019-10-14 Last updated: 2019-11-20Bibliographically approved

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Ullsten, AlexandraEriksson, MatsKlässbo, MariaVolgsten, Ulrik

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School of Music, Theatre and ArtSchool of Health and Medical Sciences, Örebro University, SwedenÖrebro University Hospital
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