Music Therapy for Traumatic Brain Injury (TBI) | Research

Music Therapy for traumatic wizard distress (TBI) Research CHAPTER IINTRODUCTION Music gives a soul to the universe, wings to the mind,flight to the imagination and liveness to e reallything PlatoHead tarnish (Traumatic Brain defacement) is defined as an insult to the maven, not a degenerative or cognitive nature, but caused by an external physical force, that produces a diminished or altered direct of consciousness which results in impair custodyt in cognitive abilities or physical dieing. (American Head Injury Foundation, 2012) Traumatic Brain Injury can result when the topic suddenly and violently hits an object, or when an object pierces the skull and enters outlook tissue. Approximately half of life-threateningly head injured patients forget need surgery to remove or repair hematomas or contusions. Some earthy disabilities include problems with cognition, sensory touch on, communication and problems with behaviour or psychogenic health. (Newman, 2003)Road Traffic Accidents (RTA) atomic number 18 the sixth leading cause of death in India with a greater sh are of hospitalizations, deaths, disabilities and socioeconomic losses in young and middle-age races. It also place a huge nub on the health sector in terms of pre hospital, acute cable superintend and rehabilitation. (WHO, 2012)Al well-nigh 10 billion head injuries occur annually, about 20 % of which are serious enough to cause understanding damage. Among men under 35 years, accidents, usually move vehicle collisions are the chief cause of death and 70 % of these involve head injury. Further more, minor head injuries are so common that almost all physicians go out be called upon to provide immediate vex or to see patients who are suffering from various sequels. (Allan H Ropper, 2011)The advancement in medicine and technology has increased the survival rate of patients with head injury and more of them do have various disabilities. When injury is severe or even minor it lead to vauntingly number of behavioural and cognitive problems with the physical disability. Each patient represents a unique disabilities which include physical, visual, cognitive and behavioural abnormalities. Sensory stimulant Programmes are usually started in the Neuro Intensive Care Unit and should be continued in rehabilitation. This may include tactile, olfactory, visual, gustatory and audile. (Ellen Barkers, 2002)Music is a magical medium and a very powerful tool. Music can delight all the senses and inspire every fiber of being. Its third-dimensional nature touches the individuals physical and psychological levels of consciousness suggested that symphony exerts its effect through and through the frolic of body rhythms. (Wilson Parsons, 2002)Music has been used as a healing force for centuries. Appolo is god of medicine and of medicine. Aesculapius was communicatoryise to cure diseases of the mind by using song and music. Aristotle taught that music tints the soul and described music as a force that purified the emotions. Aulus cornelius advocated the sound of cymbals and running water for the treatment of psychic disorders. Music therapy goes back to biblical times, when David played the harp to rid King Saul of a bad spirit. In the thirteenth century, Arab hospitals contained music-rooms for the return of the patients. Music therapy began in the later onmath of World Wars I and II. Musicians would travel to hospitals, particularly in the United kingdom and play music for soldiers suffering from war-related emotional and physical trauma. (Lee Mathew, 2000)Neurologic Music Therapy (NMT) is the therapeutic application of music to treat cognitive, sensory and motor dysfunctions that come from neurologic impairment. The treatment is based on stimulating music perception and production parts in the human top dog. The targeted neurologic disorders like Stroke, Autism, Huntingtons disease, Cerebral palsy, Alzheimers disease and other neurological disease affecting cognition, movement and communication (mild , moderate or severe traumatic conceiver injury). (Blosser DePompei, 1994)Need for the StudyEveryday men, women and children suffer head injuries. A fall, a car accident, a sports injury these everyday injuries can range in severity from concussion to coma. Traumatic Brain Injury can be fatal or, in survivors, can produce persistent problems that significantly affect the livelihood and well-being of millions around the globe. Ninety-five percent of trauma victims in India do not have optimal disquiet during the golden hour period after an injury is sustained, in which health deal out administration is critical. (Indian Head Injury Foundation, 2010)The annual global incidence rates of traumatic school principal injury ranges from 91 per 100,000 cosmoss to 546 per 100,000. The traumatic header injury constitutes 7090% of all head injuries, with rates of hospital treatment ranging from 100 to 300 per 100,000 popula tions per annum. This high variability in incidence is due to sampling of population ranging from only hospitalized patients to all the patients who visit emergency plane section. A large number of cases are not hardened at hospitals the actual rate is possibly in excess of 600 per 100,000 cases. There is bimodal distribution of pass injury with peaks at age conclave 1524 years and after 65 years. (Centre for affection Control and Prevention, 2010)The annual national incidence rates among 28 states of India, the mortality rate per million population due to road traffic accident. A varied from as low as 20 in Nagaland to as high as 216 in Tamil Nadu. States with rapid and high growth in motorisation had a higher number of deaths. Nearly half of the total road fatalities were in the 4 states of India, Tamil Nadu (14.5%), Andhra Pradesh (11.4%), Maharashtra (11.1%) and Uttar Pradesh (10.2%). (National Crime Records Bueareau, 2005)A combination of neurological and neuropsychologic al deficits seems to contribute to residual handicap in patients with head injury. Neurological deficits include motor deficit (55%), ataxia (49%) and anosmia (46 %) along with memory impairment, poor initiativeness and increasing irritability. Among them very least could return to their occupation and occupational and psychological rehabilitation may found to be more effective. (Zebenlozer and Oder, 1998)Over the past few decades major advancements have been made in the management of patients with traumatic judgment injury and significant improvements have been made in their care in the pre hospital and emergency department settings. Patients with complex, multisystem trauma are admitted to critical care unit and these patients require complex care. (Lind D Urden, 2010)Rehabilitation is an grand part of the recovery process for a traumatic brain injury patient. The patients with brain injury are completely dependent on health care providers to meet all their needs. Rehabilitation should begin as soon as possible after brain injury patient is stable, often with 24-48 hrs after resuscitation. The overall goal of rehabilitation after a traumatic brain injury is to improve the patients ability to function at home and in society. (Davis White, 1995)Music therapy benefits patients across the spectrum, from premature infants in neonatal intensive care units responding to lullabies to swing band numbers in elderly Alzheimers patients moods and appetites. Involving the primary care givers take care in auditive stimulation program will helps in continuity of care and also helps to humble cost of care. (German, 2003)Brocas area is important in processing the sequencing of physical movement and in tracking musical rhythms. It is critical for converting thought into spoken words. Scientists speculate, therefore, that Brocas area supports the appropriate timing, sequencing, and experience of rules that are common and essential to music, speech, and movement. The br ain areas involved in music are also active in processing language, auditory perception, attention, memory, executive control, and motor control. Music efficiently accesses and activates these systems and can drive complex patterns of interaction among them. (Michael Thaut Gerald Mclntosh, 2010) completing and secondary therapies are now the fastest growing areas of health care. Music therapy is one of the best and cheapest alternative methods. Teaching the care giver about the auditory stimulation helps to win care and satisfaction to the patient. For galore(postnominal) individuals, music is a source of pleasure and therefore more preferable. Hence the researcher believes that the use of auditory stimulation for patients with brain injury provides the rehabilitative as well as physical assistance with most cost effective manner.Statement of the ProblemA Study to Evaluate the Effectiveness of Auditory stimulant on Motor and literal Responses among Patients admitted in Intensi ve Care Unit with Traumatic Brain Injury at Selected Hospitals, Salem.ObjectivesTo assess the motor and verbal responses among patients with traumatic brain injury in experimental group and control group.To evaluate the effectiveness of auditory stimulation on motor and verbal responses among patients with traumatic brain injury in experimental group and control group.To associate motor and verbal responses among patients with traumatic brain injury with their selected demographic variables in experimental and control group.Operational DefinitionsEffectivenessImprovement of motor and verbal responses among patients with traumatic brain injury after implementing auditory stimulation along with routine nursing care as observed by Glasgow Coma Scale Score.Auditory StimulationIn this study it refers to auditory stimulation in which classical instrumental music therapy is given to patients with traumatic brain injury using I pod for twenty minutes for three times a day.Motor functionIn t his study it refers to patient actively moving upper extremities or lower extremities as response towards the auditory stimulation with best motor response 6 in G C S score.Verbal responseIn this study it refers to ability of the patient to respond orally towards the auditory stimulation with uttermost GCS Score of 5.Traumatic brain injuryIt refers to injury to the brain resulting from external mechanical force much(prenominal) as violent blow or jolt to the head. In this study it refers to patients diagnosed to have traumatic brain injury with GCS between 8 -12.AssumptionsSensory stimulation may increase the motor and verbal responses among patients with traumatic brain injury.Nurses can enroll music therapy as a simple nursing intervention to promote the well being among patients with traumatic brain injury.HypothesesH1There will be a significant disparity in the pre test and post test motor and verbal responses among patients with traumatic brain injury after administering aud itory stimulation in experimental group at P 0.05 level.H2There will be a significant association between pretest scores on motor and verbal responses among patients with traumatic brain injury with their selected demographic variables in experimental group and control group at P 0.05 level. delimitationStudy period is limited to 4 weeks.Projected OutcomeThis study would help the nurses to enlighten their knowledge regarding auditory stimulation.Nurses can utilize music therapy as an integral part of their routine care to the brain injury patients.Conceptual couchworkConceptual models are made up of concepts which are words describing the mental images of phenomena and proportions which are statements about concepts. It provides a schematic representation of some relationship among phenomenon.Ernestine Wiedenbach, (1964) proposed a prescriptive hypothesis for nursing which is described as conceiving of a in demand(p) situation and the ways to attain it. Prescriptive hypothesis directs action towards an explicit goal.The present study is based on the concept of providing auditory stimulation to patients with traumatic brain injury patients. The investigator adopted Wiedenbachs Helping Nursing Art Theory (1964). This possibleness, describes the desired situation and way to be attained. It directs action towards the explicit goals. This theory has three factorsCentral purpose prescription(prenominal)RealityCentral Purpose It refers to what a nurse wants to accomplish. It is an overall goal towards which a nurse strives. The primeval purpose of this study is to evaluate the effectiveness of auditory stimulation on motor and verbal responses among patients with traumatic brain injuryPrescriptionIt refers to the plan of action for the patient. It will specify the nature of the action that will fulfil the nurses central purpose. The prescription of this study is providing auditory stimulation to patients with traumatic brain injury .RealityIt refers to the ph ysical, psychological, emotional and spiritual factors that come into play in situation involving the nurses. The five realities set by Widenbachs are agent, recipient, goal, mean activities frame work.According to this theory, nursing practice consist of 3-steps, which are all guiding the researcher to attain the desired objectives.Step I Identifying the need for help.Step II Ministering the needed help.Step III Validating that the need for help was met.Step-IThis involves determining the need for help. The investigator assesses motor and verbal response among patients with traumatic brain injury by Glasgow Coma Scale score and demographic variables through the structured interview schedule.Step-IIAfter identification of the patients needs ,the researcher assuage the plan for care and implement it. In this study , the researcher provided auditory stimulation to the experimental group. Wiedenbach theory defines the five realitiesAgent Nurse Investigator.Recipient Patients with traumatic brain injury.Goal To determine the effectiveness of auditory stimulationon motor and verbal responses among patientswith traumatic brain injury.Means and activities Implementation of music therapy.Frame work and facilities Sri Gokulam Specialty Hospital andSri Gokulam HospitalStep-IIIThis is accomplished by means of validation of the prescription. It is done through the pretest and posttest assessment of the motor function and verbal response among patients with traumatic brain injury. If there are no significant changes in the perceived behaviour we need to reconstruct the experience to ascertain step I II. Not included in studyFigure-1.1 Conceptual Frame Work Based on modified Wiedenbachs Helping Art of Clinical Nursing Theory (1964) on Effectiveness of Auditory Stimulation on Motor and Verbal Responses among Patients with Traumatic Brain Injury. SummaryThis chapter dealt with introduction, need for the study, statement of the problem, objectives, operational defini tions, assumptions, delimitations, project outcome and conceptual framework