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Anxiety affects many hemodialysis patients. The response to treatment varies and often requires patients to take therapeutics for long periods; thus, many patients look for complementary approaches. There have been reports of music alleviating anxiety in hemodialysis patients. However, the efficacy of music needs to be evaluated. The objective of this study was to conduct a systematic review and meta-analysis to compare the effects of participation in standard care combined with music with standard care alone. This was a systematic review and meta-analysis of randomized controlled trials to determine the efficacy of music to lower anxiety in hemodialysis patients. Five studies were included in the review (290 patients). Listening to music resulted, on average, in an anxiety reduction that was -0.52 standard deviation units greater (95% confidence interval, -1.02 to -0.03 lower, P = .003) than in the standard care group. No adverse events were identified. All trials contained a risk of bias due to lack of blinding. The heterogeneity showed an I = 75%. The strength of evidence was very low. No adverse events were identified. Few trials were available for inclusion, with small sample sizes and significant heterogeneity. Within these considerable limitations there was a demonstrated decrease in anxiety for hemodialysis patients receiving standard care augmented with music. The effect size was moderate. Results were inconsistent across studies. We are uncertain about the estimate. The likelihood that effect will be substantially different is very high. Further research has a large potential for reducing uncertainty about the effects of the music interventions.

The following study is original respect to the scientific panorama in fact, through a literature review that uses a qualitative metasynthesis method and follows the aggregative or meta-aggregative approach of the Joanna Briggs Institute, it returns to the reader 3 main results: the Anguish for an imminent death, the relationship with the body, sexuality, pain and dimension of the person, and the Perception of time and existentialism. Reflecting on the “philosophical state or philosophy of the patient in dialysis treatment” through these 3 macro-themes means investigating in depth the words of the patients, extrapolating their feelings, fears and worries, so as to understand their overall view of life and illness even in the most veiled aspects. Finally, the reflection will be used to direct the care of professionals towards a real and meaningful appointment of the dialysis patient. All thanks to the philosophy that goes beyond the methodology of research and evaluation of data, through the interpretation, direction and demonstration of the concept of limit, as an intrinsic part of man, disease and science. (Humanization)

For some years now, the health care world has also been interested and influenced by issues related to immigration, integration, no integration, historical changes in our socio-anthropological field and cultural and linguistic differences; different worldviews and expectations, beliefs and non-evidence-based practices; prejudices and defense mechanisms for ethical and professional inability to care with patients with different cultures; scientific culture alongside a traditional and popular culture; little or no anthropological knowledge of many health professionals; improvised approaches to foreign patients, misunderstandings, tensions. The use of the cultural mediator is a very small part in the solution of the problem. Cross-cultural assistance represents the solution and it is a model, a discipline, a communication that allows an appropriate health care based on the cultural differences of the patients.

Following the pandemic state, produced by the infection with the new coronavirus SARS-CoV-2, and the consequent state of health emergency, it is considered scientifically important to propose an update on ongoing clinical pharmacological trials, the most advanced international projects in the innovation sector and the most important statistical mathematical approaches to use a model for predictive purposes. In Italy there are several experimental molecules subjected to rigorous RCT studies approved by AIFA. In the Research & Development sector, the CERN in Geneve with the “CERN against COVID-19 project” represents the most advanced innovation, while in predictive statistical techniques, the mathematical model with wavelet approach allows to predict variables such as the persistence of the virus or to calculate the probability of transmission, strategic information for health planning.

Narrative-based practice has been developed to bring the health care aspects of illness and treatment closer to the psychosocial and life experiences of a patient. It gives value to the lived experience by using writing tools, spoken words, poetry, drawing, and photography. Nephrology has become one of the first health care fields, likely due to its large patient burden of both critical and chronic disease, to use narrative-based practice. The use of narrative-based practice in renal care explores the lived experience through structured and semistructured interviews with patients, caregivers, and health care providers. The principle topics discussed are the lack of a "disease identity" that would allow patients to identify themselves with a specific state of illness, the "uncertainty" of living with an illness characterized by continuous progression and regression, and the living with the "unspeakable" looming specter of death. This review highlights the powerful significance of qualitative knowledge gained with the narrative method. Increased awareness of these aspects of patients' lived experiences can help nurses improve the quality and effectiveness of the therapeutic relationship between patient and health care professional and may offer a promising approach, within this relationship, to decreasing patient feelings of isolation.

Practical recommendations on nonpharmacologic non-device/surgical interventions in patients with heart failure (HF) are well known. Although complementary treatments may have beneficial effects, there is no evidence that these on their own improve mortality, morbidity, or quality of life. We examined the effects of listening to recorded classical music on HF-specific quality of life (QOL), generic QOL, sleep quality, anxiety, depression, and cognitive state in patients with HF in the home-care setting.Multicenter randomized controlled trial. One hundred fifty-nine patients with HF were randomized on a 1:1 basis in 2 groups: experimental (music) and control. Patients were evaluated after 30, 60, 90 days (experimental period) and at 6 months. Patients randomized to the music group listened to music from a large preselected playlist, at least 30 minutes per day, for 3 months on an MP3 player. Patients in the control group received standard care. HF-specific QOL, generic QOL, self-care, somatic perception of HF symptoms, sleep quality, anxiety and depression, and cognitive abilities were assessed throughout the use of specific scales. On average, patients in the music group showed greater improvements in terms of HF-specific QOL (P.001), generic-QOL (P = .005), quality of sleep (P = .007), anxiety and depression levels (P.001 for both), and cognitive performances (P = .003).Listening to recorded classical music is a feasible, noninvasive, safe, and inexpensive intervention, able to improve QOL in patients with HF in the home-care setting.

Dialysis is often considered slow, repetitive, and with programmed intervals. Patients often perceive it as time taken from their lives with a sense of ineluctability and emptiness, engendering a negative emotional and cognitive perception of the world and one's place in it. Today, it is possible to improve the quality of life of patients during hemodialysis using virtual reality (VR). This creation of a true multisensory experience may absorb the patient's perceptions during hemodialysis, improving his/her quality of life. An Italian multicenter, longitudinal experimental study will be conducted with a randomized, pre-post test design, with balanced allocation 1:1, in parallel groups with a control group in the standard care of patients diagnosed with chronic renal failure who are, undergoing hemodialysis treatment. A sample of 186 patients calculated with sample size (power = 80%, β = 0.2, α = 0.05) will be randomized into an experimental group exposed to VR, and a control group in standard care. The 2 groups will be studied over a period of 1 month, with 12 applications of VR and with measurements of the following outcomes: anxiety, fatigue, pruritus, arterial pressure, heart rate, respiration rate, and duration of the session at each hemodialysis session. This is the first international experimental protocol that examines the application of VR in patients undergoing hemodialysis. If the results show statistically and clinically significant differences, the VR could be an additional holistic intervention, which is evidence based, linked to the humanization of chronic, repetitive interventions, complementary to and synergistic with standard of care.

Background: Participation in music therapy is associated with improved psychological and physical indices among chronically ill patients. Listening to music during hemodialysis treatments positively affects patients’ hemodynamics, laboratory values, quality of life, and physical symptoms. The effect of live singing during hemodialysis treatments, however, has not previously been studied. Methods: A total of 24 participants with a diagnosis of end-stage kidney disease participated in the study. The vocalist was a musically trained dialysis nurse. Twelve of the patients listened to 15 min of live singing during 6 consecutive hemodialysis sessions, while the other 12 underwent standard hemodialysis. After a washout period of 2 days, the two groups were reversed. Results: Listening to live music was associated with improvements in systolic and diastolic blood pressure, better quality of sleep, fewer cramps, and reduced anxiety/depression, pain, and itching ( p < .05, all values). Conclusions: Listening to live music during hemodialysis is an effective and potentially low-cost therapy for the dialysis care team to employ during hemodialysis treatments.

Patients with heart failure have been traditionally treated with a pharmacology-based approach, diet, exercise, and rehabilitation for reducing symptoms, hospitalizations, and mortality. We have developed a solid conceptual framework for music listening-based protocols, showing how music may have a broad range of positive effects on cardiovascular health through psychoneuroimmunoendocrinological pathways.

Background: Few randomized controlled trial studies have focused on the effect of music in cancer patients, and there are no randomized controlled trials on the effects of live music with saxophone in cancer patients. Objectives: To determine the effects of live saxophone music on various physiological parameters, pain level, and mood level. Design: A randomized controlled trial study. Participants: 52 cancer patients were randomized to a control group (n = 26), an experimental group (n = 26) whose members received 30 minutes of live music therapy with saxophone. Measurements: Systolic and diastolic blood pressure, pulse rate, glycemia, oxygen saturation, pain level, and mood level were measured before and after the live music performance. Results: There was a statistical difference between the groups for oxygen saturation (0.003) and mood level (0.001). Conclusions: Live music performed with a saxophone could be introduced in oncology care to improve the oxygen saturation and mood in cancer patients. KEY WORDS: cancer patients, music therapy, nursing, research Holist Nurs Pract 2014;28(5):301–311

SUMMARYBackground Few studies have focused on the effect of music in patients undergoing haemodialysis. Objectives To determine the effects of live saxophone music on various physiological parameters and pain, mood and itching levels. Design A randomised controlled study with 114 patients undergoing haemodialysis with a control group (n = 57) and an experimental group (n = 57) who received 30 minutes of live saxophone music therapy. Measurements Systolic and diastolic blood pressure, pulse rate, glycaemia, oxygen saturation, pain, mood and itching levels were measured before and after the live music performance, resulting in baseline and post-test values for the patients in the experimental group. Results The experimental group showed a statistically significant reduction in pain level, and an improvement in mood and itching levels and in the oxygen saturation. Conclusion Live saxophone music could be introduced to improve clinical and quality-of-life measures in patients undergoing haemodialysis.

Few studies have focused on the effect of music in patients undergoing haemodialysis.To determine the effects of live saxophone music on various physiological parameters and pain, mood and itching levels.A randomised controlled study with 114 patients undergoing haemodialysis with a control group (n = 57) and an experimental group (n = 57) who received 30 minutes of live saxophone music therapy.Systolic and diastolic blood pressure, pulse rate, glycaemia, oxygen saturation, pain, mood and itching levels were measured before and after the live music performance, resulting in baseline and post-test values for the patients in the experimental group.The experimental group showed a statistically significant reduction in pain level, and an improvement in mood and itching levels and in the oxygen saturation.Live saxophone music could be introduced to improve clinical and quality-of-life measures in patients undergoing haemodialysis.