Li, X.M., Zhou, K.N., Yan, H., Wang, D.L., & Zhang, Y.P. (2012). Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: A randomized clinical trial. Journal of Advanced Nursing, 68, 1145–1155.

To evaluate the effects of music therapy on anxiety in women undergoing breast cancer surgery

Patients admitted to the hospital for mastectomy were randomly assigned to receive either music therapy or usual care. Patients in the intervention group listened to music they selected through a headphone connected to an MP3 player during their hospital stay. Music was provided twice daily for 30 minutes per session. The total time in the hospital receiving therapy was an average of 13.6 days following radical mastectomy and 18.9 days for chemotherapy. Assessments were done at baseline on the day before surgery, the day before hospital discharge, on second hospital admission for chemotherapy, and on a third hospital admission for chemotherapy.

• The study reported on a sample of 120 female patients with breast cancer.
• Mean patient age was 45 years.
• Most patients (93%) had modified radical mastectomy, and the rest had radical mastectomy.
• Approximately 20% of patients had some college education.

• Single site
• Inpatient setting
• China

Patients were undergoing active antitumor treatment.

A randomized controlled trial design was used.

State Anxiety Inventory

Pretest results showed that patients had moderate to severe anxiety levels prior to surgery. Mean post-test anxiety scores were lower in the experimental group, on the first post-test 4.57 points, and increasing across time to 9.69 points lower at the final post-test (p < 0.0001). Mean anxiety scores declined over time in all patients.

Findings suggest that listening to music can be beneficial in reducing anxiety during treatment for breast cancer.

• The study had baseline sample/group differences of import.
• The study had risk of bias due to no blinding, no appropriate attentional control condition, and sample characteristics.
• Control patients had higher anxiety levels at baseline.
• Usual care was not described. It is not known if all patients received the same type and schedule of chemotherapy, which could have influenced results. Data reported shows that more patients in the control group did not receive as many courses of chemotherapy, so it would appear that some of these patients did not complete all follow-up self reports. Actual sample sizes contributing to the data at all time points were not reported.
• The sample consisted of lower economic group patients in China and may not be generalizable to other cultures.

Listening to music is a simple and low-cost intervention that may be helpful for some patients in reducing anxiety associated with cancer treatment.