Wednesday, June 5, 2019

Music Therapy for Traumatic Brain Injury (TBI) | Research

Music Therapy for traumatic Brain Injury (TBI) Research CHAPTER I institution Music gives a soul to the universe, wings to the mind,flight to the imagination and life to all(prenominal)thing PlatoHead defect (Traumatic Brain Injury) is defined as an insult to the instinct, not a degenerative or cognitive nature, but fared by an external physical force, that produces a diminished or altered level of consciousness which results in prejudice in cognitive abilities or physical functioning. (American Head Injury Foundation, 2012) Traumatic Brain Injury can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. Approximately half of severely head injured patients will motif surgery to remove or repair hematomas or contusions. many common disabilities include problems with cognition, sensory serveing, communication and problems with behaviour or mental health. (Newman, 2003)Road Traffic Accidents (RTA) are the sixth leading cause of death in India with a greater share of hospitalizations, deaths, disabilities and socioeconomic losses in young and middle-age populations. It also place a huge burden on the health orbit in terms of pre hospital, acute care and rehabilitation. (WHO, 2012)Almost 10 million head injuries occur annually, about 20 % of which are serious enough to cause brain damage. Among men under 35 years, accidents, usually beat back vehicle collisions are the chief cause of death and 70 % of these involve head injury. Furthermore, venial head injuries are so common that almost all physicians will be called upon to provide immediate care or to see patients who are woeful from non-homogeneous sequels. (Allan H Ropper, 2011)The advancement in medicine and technology has increased the survival prescribe of patients with head injury and many of them do have various disabilities. When injury is severe or even minor it lead to large number of behavioural and cognitive problems wi th the physical disability. Each patient re largesss a unique(p) disabilities which include physical, visual, cognitive and behavioural abnormalities. Sensory Stimulation Programmes are usually started in the Neuro Intensive Care Unit and should be continued in rehabilitation. This may include tactile, olfactory, visual, gustatory and auditory. (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 multidimensional nature touches the individuals physical and psychological levels of consciousness suggested that music exerts its effect through the entertainment of body rhythms. (Wilson Parsons, 2002)Music has been apply as a healing force for centuries. Appolo is god of music and of medicine. Aesculapius was said to cure diseases of the mind by using song and music. Aristotle taught that music affects the soul and draw music as a force that purified the emotions. Aulus cornelius advocated the sound of cymbals and running water for the treatment of mental disorders. Music therapy goes back to biblical times, when David played the harp to liberate King Saul of a bad spirit. In the thirteenth century, Arab hospitals contained music-rooms for the benefit of the patients. Music therapy began in the afterwardwardmath 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 drive dysfunctions that come from neurologic impairment. The treatment is based on stimulating music perception and production parts in the human brain. The targeted neurologic disorders like Stroke, Autism, Huntingtons disease, Cerebral palsy, Alzheimers disease and other neurological disease affecting cognition, vogue and communication (mild , moderate or sev ere traumatic brain injury). (Blosser DePompei, 1994) desire 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 misfortune 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 near the globe. Ninety-five percent of trauma victims in India do not receive optimal care during the golden hour period after an injury is sustained, in which health care administration is critical. (Indian Head Injury Foundation, 2010)The annual global incidence rates of traumatic brain injury ranges from 91 per 100,000 populations to 546 per 100,000. The traumatic brain injury constitutes 7090% of all head injuries, with rates of hospital treatment ranging from 100 to 300 per 100,000 populations per annum. This high variability in incidence is ascribable to sampling of population ranging from only hospitalized patients to all the patients who visit emergency department. A large number of cases are not treated at hospitals the actual rate is possibly in excess of 600 per 100,000 cases. at that place is bimodal distribution of brain injury with peaks at age group 1524 years and after 65 years. (Centre for Disease Control and Prevention, 2010)The annual national incidence rates among 28 states of India, the mortality rate per million population due to road art accident. A varied from as low as 20 in Nagaland to as high as 216 in Tamil Nadu. States with rapid and high step-up in repelization 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 faction of neurological and neuropsychological deficits seems to contribute to residual handicap in patients with head injury. Neurological defic its include motor deficit (55%), ataxia (49%) and anosmia (46 %) along with memory impairment, silly 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 a few(prenominal) decades major advancements have been made in the management of patients with traumatic brain injury and significant improvements have been made in their care in the pre hospital and emergency department settings. Patients with coordination compound, multisystem trauma are admitted to critical care unit and these patients require complex care. (Lind D Urden, 2010) refilling is an important 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, of ten 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 auditory stimulant program will admirers in continuity of care and also helps to reduce 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 knowledge of rules that are common and essential to music, speech, and movement. The brain areas conglomerate in music are also active in processing language, aud itory 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)Complementary and alternative 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 foreplay helps to promote care and satisfaction to the patient. For many individuals, music is a source of pleasure and therefore more preferable. Hence the research worker 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. teaching of the ProblemA Study to Evaluate the Effectiveness of Auditory Stimulation on Motor and literal Responses among Patients admitted in Intensive Care Unit with Traumatic Brain Injury at Selected Hospitals, Salem.Objecti vesTo assess the motor and literal responses among patients with traumatic brain injury in experimental group and control group.To evaluate the military strength 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 nurse care as observed by Glasgow Coma Scale Score.Auditory StimulationIn this theme it refers to auditory stimulation in which classical instrumental music therapy is given to patients with traumatic brain injury using I pod for 20 minutes for three times a day.Motor functionIn this 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 maximum GCS Score of 5.Traumatic brain injuryIt refers to injury to the brain resulting from external robotic force such 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 difference in the pre test and suffer test motor and verbal responses among patients with traumatic brain injury after administering auditory stimulation in experimental group at P 0.05 level.H2There will be a significant a ssociation 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 exemplarConceptual 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 theory for nursing which is described as conceiving of a desired function and the ways to attain it. Prescriptive theory directs action towards an explicit goal.The present study is based on the concept of providing auditory s timulation to patients with traumatic brain injury patients. The investigator adopted Wiedenbachs Helping Nursing prowess Theory (1964). This theory, describes the desired situation and way to be attained. It directs action towards the explicit goals. This theory has three factorsCentral purposePrescriptionRealityCentral goal It refers to what a nurse wants to accomplish. It is an overall goal towards which a nurse strives. The central 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 physical, psychological, emotional and spiritual factors that come into play in situation involving the nurses. The five realit ies identified 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 tec 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 audience schedule.Step-IIAfter identification of the patients needs ,the researcher facilitate 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 patien tswith 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 verification 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 sensed behaviour we need to reconstruct the experience to ascertain step I II. Not included in studyFigure-1.1 Conceptual Frame Work base 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 definitions, assumptions, delimitations, projected outcome and conceptual framework

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