Application of receptive music therapy in patients involved in outpatient cardiovascular rehabilitation: initial experience

    Authors

    Abstract

    **Introduction:** Since symptoms of anxiety have been recorded in 23% of patients upon admission to the outpatient cardiovascular rehabilitation program (OCVR) and depression symptoms have been recorded in 29% of patients (1), the implementation of the program in the Cardiovascular Disease Prevention and Rehabilitation Institute in Zagreb (Institute) (2) has been recently improved by occupational therapy (3), consulting procedures by psychiatrists (examination and lecture) (4) and music therapist (lecture and receptive music therapy) (5). The aim of this paper is to present initial experience in applying the receptive music therapy in patients involved in the OCVR program. **Patients and Methods:** The implementation of the OCVR program in the Polyclinic has already been described. (2) Hospital Anxiety and Depression Scale (HAD) has been used for assessment of anxiety and depression at the beginning and end of the OCVR program. All of the patients are involved in the psychodiagnostics of a clinical psychologist, and according to the indication of a psychologist and/or a cardiologist, a psychiatric examination has also been performed. The patients with borderline or pathological finding for HAD were involved in the program of receptive music therapy after applying additional diagnostic instruments (5). **Results:** During the period from 30th June 2017 to 25th October 2018, receptive music therapy was applied in a total of 17 patients (10 men and 7 women), in whom the OCVR program was indicated for 14 of them after acute myocardial infarction, for one of them after coronary artery bypass grafting, and for two of them after unstable angina pectoris. Median time that elapsed from the acute cardiovascular event until the start of applying the receptive music therapy was 90 days. The evaluation by a psychologist was done in all 17, and an examination by a psychiatrist was done in 11 patients. Out of 190 music therapy services, there were altogether 170 music therapy sessions. The desired threshold of 8 or more music therapy sessions was achieved in 13 out of 17 patients. The self-assessment result by applying Hospital Anxiety and Depression Scale upon admission to the OCVR program was borderline or pathological in 15 and in 3 patients upon discharge. The mean values ​​when doing the self-assessment on anxiety and depression particles by applying HAD were significantly higher at the beginning compared to those at the end of the OCVR program (anxiety 10 to 6, depression 7 to 4). The results on the Scale of the self-assessment of health condition at the end of music therapy are lower than those at the beginning (11.5 to 10). **Conclusion:** The treatment by receptive music therapy in patients involved in the OCVR program additionally contributes to reducing anxiety and depression. The effect of this procedure should be considered as part of the benefit of the entire OCVR program and in a larger group of patients.

    Keywords

    outpatient cardiovascular rehabilitation, anxiety, depression, music therapy

    DOI

    https://doi.org/10.15836/ccar2018.420

    Literature

    1. Tuzla M, Ivanuša M, Muminović Ž, Kruhek Leontić D. Screening for anxiety and depression using a hospital anxiety and depression scale in outpatient cardiovascular rehabilitation. Cardiol Croat. 2016;11(10-11):550–1. https://doi.org/10.15836/ccar2016.550
    2. Ivanuša M, Narančić Skorić K, Glavaš Vražić S, Kruhek Leontić D, Heinrich K, Mažuran Brkljačić L, et al. Outpatient Cardiovascular Rehabilitation in Croatia. Cardiol Croat. 2015;10(1-2):28–42. https://doi.org/10.15836/ccar.2015.28
    3. Ćurić G, Heinrich M, Ivanuša M. What is the role of occupational therapy in a cardiovascular rehabilitation program? Cardiol Croat. 2016;11(10-11):546–7. https://doi.org/10.15836/ccar2016.546
    4. Kruhek Leontić D, Ivanuša M. Complete psychological care for cardiovascular patients undergoing outpatient rehabilitation. Cardiol Croat. 2016;11(10-11):498. https://doi.org/10.15836/ccar2016.498
    5. Web portal Adiva. Ana Katušić, Mario Ivanuša, Ksenija Burić, Gabrijela Ćurić. Novo u Hrvatskoj: Blagotvorna terapija notama u Srčanoj stanici. Available at: (October 25, 2018). https://www.adiva.hr/zdravlje/zdrav-zivot/novo-u-hrvatskoj-blagotvorna-terapija-notama-u-srcanoj-stanici-381/
    Cardiologia Croatica
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    Application of receptive music therapy in patients involved in outpatient cardiovascular rehabilitation: initial experience

    Extended Abstract
    Issue11-12
    Published
    Pages420-421
    PDF via DOIhttps://doi.org/10.15836/ccar2018.420
    outpatient cardiovascular rehabilitation
    anxiety
    depression
    music therapy

    Authors

    Mario Ivanuša*ORCIDPoliklinika za prevenciju kardiovaskularnih bolesti i rehabilitaciju, Zagreb, Hrvatska
    Gabrijela ĆurićORCIDPoliklinika za prevenciju kardiovaskularnih bolesti i rehabilitaciju, Zagreb, Hrvatska
    Dubravka Kruhek LeontićORCIDPoliklinika za prevenciju kardiovaskularnih bolesti i rehabilitaciju, Zagreb, Hrvatska
    Ana KatušićORCIDHrvatska udruga muzikoterapeuta, Hrvatska
    Stipe DrmićORCIDKlinička bolnica Dubrava, Zagreb, Hrvatska

    *Correspondence email: mivanusa@gmail.com

    Abstract

    **Introduction:** Since symptoms of anxiety have been recorded in 23% of patients upon admission to the outpatient cardiovascular rehabilitation program (OCVR) and depression symptoms have been recorded in 29% of patients (1), the implementation of the program in the Cardiovascular Disease Prevention and Rehabilitation Institute in Zagreb (Institute) (2) has been recently improved by occupational therapy (3), consulting procedures by psychiatrists (examination and lecture) (4) and music therapist (lecture and receptive music therapy) (5). The aim of this paper is to present initial experience in applying the receptive music therapy in patients involved in the OCVR program. **Patients and Methods:** The implementation of the OCVR program in the Polyclinic has already been described. (2) Hospital Anxiety and Depression Scale (HAD) has been used for assessment of anxiety and depression at the beginning and end of the OCVR program. All of the patients are involved in the psychodiagnostics of a clinical psychologist, and according to the indication of a psychologist and/or a cardiologist, a psychiatric examination has also been performed. The patients with borderline or pathological finding for HAD were involved in the program of receptive music therapy after applying additional diagnostic instruments (5). **Results:** During the period from 30th June 2017 to 25th October 2018, receptive music therapy was applied in a total of 17 patients (10 men and 7 women), in whom the OCVR program was indicated for 14 of them after acute myocardial infarction, for one of them after coronary artery bypass grafting, and for two of them after unstable angina pectoris. Median time that elapsed from the acute cardiovascular event until the start of applying the receptive music therapy was 90 days. The evaluation by a psychologist was done in all 17, and an examination by a psychiatrist was done in 11 patients. Out of 190 music therapy services, there were altogether 170 music therapy sessions. The desired threshold of 8 or more music therapy sessions was achieved in 13 out of 17 patients. The self-assessment result by applying Hospital Anxiety and Depression Scale upon admission to the OCVR program was borderline or pathological in 15 and in 3 patients upon discharge. The mean values ​​when doing the self-assessment on anxiety and depression particles by applying HAD were significantly higher at the beginning compared to those at the end of the OCVR program (anxiety 10 to 6, depression 7 to 4). The results on the Scale of the self-assessment of health condition at the end of music therapy are lower than those at the beginning (11.5 to 10). **Conclusion:** The treatment by receptive music therapy in patients involved in the OCVR program additionally contributes to reducing anxiety and depression. The effect of this procedure should be considered as part of the benefit of the entire OCVR program and in a larger group of patients.

    Literature

    1. 1.
      Tuzla M, Ivanuša M, Muminović Ž, Kruhek Leontić D. Screening for anxiety and depression using a hospital anxiety and depression scale in outpatient cardiovascular rehabilitation. Cardiol Croat. 2016;11(10-11):550–1.DOI
    2. 2.
      Ivanuša M, Narančić Skorić K, Glavaš Vražić S, Kruhek Leontić D, Heinrich K, Mažuran Brkljačić L, et al. Outpatient Cardiovascular Rehabilitation in Croatia. Cardiol Croat. 2015;10(1-2):28–42.DOI
    3. 3.
      Ćurić G, Heinrich M, Ivanuša M. What is the role of occupational therapy in a cardiovascular rehabilitation program? Cardiol Croat. 2016;11(10-11):546–7.DOI
    4. 4.
      Kruhek Leontić D, Ivanuša M. Complete psychological care for cardiovascular patients undergoing outpatient rehabilitation. Cardiol Croat. 2016;11(10-11):498.DOI
    5. 5.
      Web portal Adiva. Ana Katušić, Mario Ivanuša, Ksenija Burić, Gabrijela Ćurić. Novo u Hrvatskoj: Blagotvorna terapija notama u Srčanoj stanici. Available at: (October 25, 2018).Link