Rhetorical Analysis of Musical Therapy for the Terminally Ill
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If music is food for the soul, could it also be an effective form of therapy for the terminally ill? The scientific review article “The Effectiveness of Musical Therapy for Terminally Ill Patients: A Meta-Analysis and Systematic Review” featured in the Journal of Pain and Symptom Management, explores how musical therapy can be used as a form of palliative care to improve the quality of life of terminally ill patients. The study is authored by Yinyan Gao, MM, Yanping Wei, MM, Wenjiao Yang, MM, Lili Jiang, MM, Xiuxia Li, PhD, Jie Ding, MM, and Guowu Ding, PhD, all of whom are affiliated with research at the School of Public Health in Lanzhou University, located in Gansu, China. This study was conducted by the American Academy of Hospice and Palliative Medicine, and was accepted by the Journal of Pain and Symptom Management on October 23, 2018, then later published online on October 30, 2018. The Journal of Pain and Symptom Management focuses on providing relief to patients with serious life-threatening illnesses through clinical trials and symptom control therapies. The American Academy of Hospice and Palliative care, is a society under the journal consisting of physicians working to enhance hospice and palliative care in seriously ill patients. The Journal of Pain and Symptom Management is under Elsevier, a Dutch publishing and analytics company focused on scientific content, with the mission of advancing healthcare (Elsevier, 2019). This rhetorical analysis is meant to inspect the structure, subject-matter and delivery of a peer-reviewed article about the effectiveness of the use of musical therapy on critical patients.
The purpose of this article is to showcase the capability of musical therapy, in reducing pain and improving the quality of life of terminally ill patients. Palliative care refers to a form of treatment for patients with end-of-stage diseases such as cancer, Alzheimer’s, and Parkinson’s disease. It is intended to alleviate pain and improve both their mental and physical quality of life. Musical therapy involves listening to or creating music, for the purpose of improving one’s health. Due to this paper’s focus on pain management of the terminally ill, it has an intended audience of musical therapists, hospice nurses, oncologists, psychologists, psychiatrists, palliative care consultants as well as occupational and physical therapists. All of the health-care workers listed interact with terminally ill patients with the goal of improving their health. Musical therapy is simply a tool they can use to achieve this goal. Musical therapy is an emerging form of palliative care that is unlike general nursing, breathing, and conversation, it is also growing in popularity (Gao,Y. et al, 2018).
This research paper is written in the IMRAD format consisting of an introduction, methods, results and discussion section, and the CARs model is used to perform the rhetorical analysis (Swales, J. 2019). As evident in the first move, the authors highlight the great importance and necessity of musical therapy as a form of palliative care for patients with both physical and psychological issues (Swales, J. 2019). They accomplish this by referring to former studies done on the subject. A pilot studies’ focus on musical therapies beneficial effects on 125 patients, and its ability to reduce stress, anxiety, and depression, indicates that musical therapy is becoming a widely accepted form of treatment. The authors also refer to two related systematic reviews which demonstrate the positive effects of musical therapy, and in turn its essential nature. The first review analysed musical therapies’ impact on pain, anxiety, depression, quality of life and social/spiritual well-being (Gao,Y. et al, 2018). The other review conducted research on the effectiveness of musical therapy as a nonpharmacological approach to managing distressing pain symptoms (Gao,Y. et al, 2018).
In the second move, the authors demonstrate the necessity of their research by specifying improvements that can be made, due to the short-comings of both previous research (Swales, J. 2019). Weaknesses in previous research include the small sample sizes of participants. When small sample sizes are utilized, randomized controlled trials are then required. Improvements to be made in future research include defining the traits of the music being played or listened to by patients. These traits include the music’s speed, genre, and whether it is live or recorded. Another way to enhance the research is by having patients choose their own music since it could improve the benefits of musical therapy. It is note-worthy to compare the cost-effectiveness of listening to recordings or sonic music, which is manipulated sounds. The most prevalent short-coming of previous research that the researchers in the School of Public Health in Lanzhou University address, is the fact that the effects of musical therapy on the terminally ill population has not been studied in depth (Gao,Y. et al, 2018).
The third move is then used to solve the most prominent issue of previous research, as the authors of the paper substantiate the fact that musical therapy does in fact lead to improved quality of life in people with critical illnesses (Swales, J. 2019). The researchers fill the gap in previous research that used other forms of palliative care on the terminally ill instead of musical therapy-based palliative care. The authors accomplish filling the gap by exhibiting results that indicate positive outcomes on the quality of life of terminally patients who receive musical therapy. After the introduction, the structure of the paper is as follows: methods, results, discussion, conclusion, disclosures, and acknowledgments and references. The paper’s findings not only demonstrate the advantages of musical therapy as a form of palliative care through improved quality of life, but also through its effectiveness in relieving depression, anxiety, and social function.
The authors of “The Effectiveness of Musical Therapy for Terminally Ill Patients…” use ethos and logos as rhetorical strategies in their method section to assure their audience that musical therapy is in fact an effective form of palliative care. The paper’s use of ethos is demonstrated through the referencing of established organizations such as the European Organization for Research and Treatment of Cancer (EORTC) and the Health-Related Quality of Life (HRQOL), which provide scales to measure palliative care. Since the authors refer to trustworthy institutions, it in turn indicates that the authors themselves are establishing their own credibility. Another example of ethos being established in the paper is through the referencing of medical professionals such as Dr. Joke Bradt, who specializes in musical therapy end-of-life care. Since the audience of this paper are likely medical professionals, it is reassuring that a respected member of their field is cited in this research paper. An example of logos as a rhetorical strategy that presents the logical reasoning behind the effectiveness of musical therapy is the use of statistical analysis. Statistical analysis is the science of collecting data and trends. The authors state, “meta-analysis was performed to integrate the outcomes of the RCTs. The primary outcomes included pain, QoL, and physical status”(Gao,Y. et al, 2018). By including the statistical analysis which is used to examine the data of the experiment, the authors demonstrate that their procedures are rational. They are rational because the analysis of the outcomes uses numbers and figures to reflect that musical therapy does statistically benefit patients.
The authors of this study illustrate the results through the use of subheadings, and visual components such as charts, tables, and graphs. The sub-headings in the results section are as follows: literature research, study characteristics, quality assessment, primary outcomes, and secondary outcomes. The use of the sub-headings makes the findings of this study easy to understand by the audience. The results of the primary and secondary outcomes demonstrate that pain management and quality of life were not the only outcomes that were improved, since musical therapy also relieved depression and anxiety. The most useful graphic in the results section is a color-coded table, entitled “The risk of bias included in the studies”. The purpose of this table is to categorize the potential biases that are present in the research of this paper. The dark green circles (which are the most prevalent) indicate that there is a low risk of bias, while the yellow circles indicate the unclear risk of bias, which is ultimately followed by the red circles that indicate explicit bias (Gao,Y. et al, 2018). This visual element is simple and effective due to the use of color-coding.
The way in which the authors interpret their discussion section about their findings is by thoroughly analysing the multiple facets of their research. They do this by separating the discussion section into several sub-headings: summary of results, overall completeness and applicability, and finally, strengths, limitations, and future research. The addition of the sub-headings show that the authors are thoroughly interpreting the results of their research since they provide several categories. The authors provide a summary of the results section to convey to the audience that their data from the meta-analysis suggests that musical therapy reduces pain significantly in terminally ill patients. Under the subheading “overall completeness and applicability of evidence”, they indicate that it is possible they excluded some relevant published or unpublished studies, since the previous studies on musical therapy used small sample sizes of subjects. Most importantly, the authors highlight the strengths of their research by stating that they had more experimental trials than previous studies, and that their studies analysed the effects of musical therapy more comprehensively than previous ones. The conclusion simply restated their main finding of the positive impact of musical therapy on alleviating the pain of terminally ill patients.
The process of writing this scientific rhetorical analysis has been a new experience for me, proving to be both taxing and educational. One of the writing habits that I utilized in writing this essay was outlining, since this assignment had a lot of specific organizational requirements and topics to address, due to the use of the CARs model (Swales, J. 2019). Reading the research article “The Effectiveness of Musical Therapy for Terminally Ill Patients: A Meta-Analysis and Systematic Review” was also challenging at times since I am not an expert on the topic. Re-reading the peer-reviewed article was a necessity because I had to summarize parts of it in this rhetorical analysis. Searching the definition of certain words and learning the statistical analysis methods used was also pivotal to my comprehension of the material. The course objective that this assignment helped me fulfill is using CCNY’s online database to locate a source appropriate for my writing project, since that is the method used to find the article. Overall, I am grateful to have learned about the topic of musical therapy and will consider using it in my future medical career.
References
1.Gao, Y., Wei, Y., Yang, W., Jiang, L., Li, X., Ding, J., & Ding, G. (2018, October 30). The Effectiveness of Music Therapy for Terminally Ill Patients: A Meta-Analysis and Systematic Review. https://www.sciencedirect.com/science/article/abs/pii/S0885392418310510
2.Science Direct, Journal of Pain and Symptom Management, March 2020, https://www.sciencedirect.com/journal/journal-of-pain-and-symptom-management
3.Swales, J.The Introduction Section. Helsinki University of Technology, 2005.
http://www.cs.tut.fi/kurssit?SGN-16006/academic_writing/cars_model_handout.pdf
4.Elsevier. “About.” About Elsevier, https:www.elsevier.com/about
