Musical Rounds: A multisite, mixed-methods feasibility study of a musical legacy session in palliative care.

OBJECTIVES

Patients hospitalized with a life-limiting illness, along with their loved ones, frequently experience anxiety, stress, and pain. Legacy building through storytelling and music may alleviate emotional strain and provide comfort. Musical Rounds is a novel music medicine program designed to reduce distress and support legacy building for adult patients receiving palliative care and their loved ones.

METHODS

This multisite, mixed-methods, pre-post feasibility study was conducted across 3 hospitals in California, USA. Participants engaged in live bedside recording sessions in which personal stories were shared with real-time musical improvisation provided by a clinician-musician. Afterward, participants received a personalized edited recording combining voice and improvised music. Pain, stress, anxiety, and comfort were assessed before and after each session using a 0-10 numeric rating scale. Perceived mood changes were assessed through directed qualitative content analysis.

RESULTS

We invited 100 adult patients hospitalized with a life-limiting illness and their loved ones to participate. If patients were unable to respond, loved ones participated on their behalf. Patients (n = 79) demonstrated statistically significant within-group differences between pre- and post-session assessments, including lower pain (-1.58, p < .001), stress (-2.89, p < .001), and anxiety (-2.73, p < .001), and higher comfort (+1.61, p < .001). Loved ones (n = 42) reported lower stress (-3.14, p < .001) and anxiety (-2.86, p < .001), and higher comfort (+1.83, p = .004). Directed content analysis indicated perceived mood improvement in 59% (47/80) of patients and 68% (30/44) of loved ones.

SIGNIFICANCE OF

RESULTS

Musical Rounds, a personalized music and storytelling session for hospitalized patients with life-limiting illness and their loved ones, was associated with lower self-reported stress, pain (patients only), and anxiety, and higher comfort and perceived mood across 3 hospitals. Findings demonstrate the feasibility and suggest potential benefits of music medicine-supported legacy building in palliative care. Controlled studies with independent assessors are needed to further evaluate efficacy.