Questão 2184209

Directions: Read the text below and answer questions 33 to 48 according to it.

TEXT

Music therapy with cancer patients

Cancer is the second leading cause of death in the

United States, in Germany and in many other

industrialized countries. In 2007, about 12 million

people were diagnosed with cancer worldwide with a

5 mortality rate of 7.6 million (American Cancer Society,

2007). In the industrial countries, the most commonly

diagnosed cancers in men are prostate cancer, lung

cancer and colorectal cancer. Women are most

commonly diagnosed with breast cancer, gastric

10 cancer and lung cancer.

The symptoms of cancer depend on the type of the

disease, but there are common symptoms caused by

cancer and/or by its medical treatment (e.g.,

chemotherapy and radiation). Common physical

15 symptoms are pain, fatigue, sleep disturbances, loss of

appetite, nausea (feeling sick, vomiting), dizziness,

limited physical activity, hair loss, a sore mouth/throat

and bowel problems. Cancer also often causes

psychological problems such as depression, anxiety,

20 mood disturbances, stress, insecurity, grief and

decreased self-esteem. This, in turn, can implicate

social consequences. Social isolation can occur due to

physical or psychological symptoms (for example,

feeling too tired to meet friends, cutting oneself off due

25 to depressive complaints).

Besides conventional pharmacological treatments

of cancer, there are treatments to meet psychological

and physical needs of the patient. Psychological

consequences of cancer, such as depression, anxiety

30 or loss of control, can be counteracted by

psychotherapy. For example, within cognitive therapy

cancer patients may develop coping strategies to

handle the disease. Research indicates that music

therapy, which is a form of psychotherapy, can have

35 positive effects on both physiological and psychological

symptoms of cancer patients as well as in acute or

palliative situations.

There are several definitions of music therapy.

According to the World Federation of Music Therapy

40(WFMT, 1996), music therapy is: “the use of music

and/or its music elements (sound, rhythm, melody and

harmony) by a qualified music therapist, with a client or

group, in a process designed to facilitate and promote

communication, relationship, learning, mobilization,

45 expression, organization, and other relevant

therapeutic objectives, in order to meet physical,

The Dutch Music Therapy Association (NVCT,

1999) defines music therapy as “a methodological form

50 of assistance in which musical means are used within a

therapeutic relation to manage changes,

developments, stabilisation or acceptance on the

emotional, behavioural, cognitive, social or on the

physical field”.

55 The assumption is that the patient's musical

behaviour conforms to their general behaviour. The

starting points are the features of the patient's specific

disorder or disease pattern. There is an analogy

between psychological problems and musical

60behaviour, which means that emotions can be

expressed musically. For patients who have difficulties

in expressing emotions, music therapy can be a useful

medium. Music therapy might be a useful intervention

for breast cancer patients in order to facilitate and

65 enhance their emotional expressivity. Besides analogy,

there are further qualities of music that can be

beneficial within therapeutic treatment. One of these

qualities is symbolism: music can symbolize persons,

objects, incidents, experiences or memories of daily

70 life. Therefore, music is a reality, which represents

another reality. The symbolism of the musical reality

enables the patient to deal safely with the other reality

for it evokes memories about persons, objects or

incidents. These associations can be perceived as

75 positive or negative, so they release emotions in the

patient.

Music therapy both addresses physical and

psychological needs of the patient. Numerous studies

indicate that music therapy can be beneficial to both

80 acute cancer patients and palliative cancer patients in

the final stage of disease.

Most research with acute cancer patients receiving

chemotherapy, surgery or stem cell transplantation

examined the effectiveness of receptive music therapy.

85 Listening to music during chemotherapy, either played

live by the music therapist or from tape has a positive

effect on pain perception, relaxation, anxiety and mood.

There was also found a decrease in diastolic blood

pressure or heart rate and an improvement in fatigue;

90 insomnia and appetite loss could be significantly

decreased in patients older than 45 years. Further

improvements by receptive music therapy were found

for physical comfort, vitality, dizziness and tolerability of

the chemotherapy. A study with patients undergoing

95 surgery found that receptive music therapy led to

decreased anxiety, stress and relaxation levels before,

during and after surgery. Music therapy can also be

applied in palliative situations, for example to patients

with terminal cancer who live in hospices.

100 Studies indicate that music therapy may be

beneficial for cancer patients in acute and palliative

situations, but the benefits of music therapy for

convalescing cancer patients remain unclear. Whereas

music therapy interventions for acute and palliative

105 patients often focus on physiological and

psychosomatic symptoms, such as pain perception and

reducing medical side-effects, music therapy with post-

hospital curative treatment could have its main focus

on psychological aspects. A cancer patient is not free

110 from cancer until five years after the tumour ablation.

The patient fears that the cancer has not been

defeated. In this stage of the disease, patients

frequently feel insecure, depressive and are

emotionally unstable. How to handle irksome and

115 negative emotions is an important issue for many

oncology patients. After the difficult period of the

medical treatment, which they often have overcome in

a prosaic way by masking emotions, patients often

express the wish to become aware of themselves

120 again. They may wish to grapple with negative

emotions due to their disease. Other patients wish to

experience positive feelings, such as enjoyment and

vitality.

The results indicate that music therapy can also

125 have positive influences on well-being of cancer

patients in the post-hospital curative stage as well as

they offer valuable information about patients' needs in

this state of treatment and how effects can be dealt

with properly.

(Adapted from https://essay.utwente.nl/59115/1/scriptie_F_Teiwes.pdf - Access on 25/02/19)

According to the text, mark the option which contains the meaning for the word “hospice” (line 99).