Questão 2497974

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,

------emotional, mental, social and cognitive needs”.

------------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 musicalThe 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

60 --behaviour, 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 beStudies indicate that music therapy may be

------beneficial for cancer patients in acute and palliative

------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)

Read the statement based on paragraph 8 and mark the action that happened first.

A study discovered that receptive music therapy had decreased anxiety and stress levels before, during and after surgeries. Also, music therapy can be applied to different levels of the disease.