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Storytelling through music to facilitate meaning reconstruction and address psychosocial stress in oncology nurses

Carolyn S. Phillips, Deborah L. Volker & Barbara L. Jones

Frontline healthcare workers are exposed to significant suffering and loss. Recent studies have shown increased rates of depression among nurses and physicians [1], and increased rates of suicide in nurses compared to the general population [2]. Few clinician well-being interventions focus on increasing the awareness and expression of clinician’s emotions to improve psychosocial well-being. In particular, nurses are at the forefront of cancer care, and studies indicate that they cope with work-related emotions in isolation. Storytelling Through Music is a 6-week intervention that combines storytelling, reflective writing, songwriting, and stress management skills. The parent study was a quasi-experimental design, with 43 oncology nurses in either the intervention group or a non-randomized comparison group. This study evaluates the post-intervention qualitative data from participants in the intervention group (n=22). Content analysis was used for analysis, which revealed the following themes: belonging, finding meaning, and emotional transformation. Participants reported learning they were not alone in the emotional experience, that they were reminded of why they work in oncology, and that hearing their story in song transformed their feelings from sadness to something beautiful. Further, they described that hearing their story reflected back to them in song was deeply moving and provided them with emotional insight. 

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Can you provide an overview of the article and the topics it explores? 

This article explores the qualitative findings from a larger pilot study that evaluated the feasibility and effect of the intervention, Storytelling Through Music, to help oncology nurses cope with their work-related emotions. In this study we found the following themes: belonging, finding meaning, and emotional transformation. Participants reported learning they were not alone in the emotional experience, they were reminded of why they work in oncology, and hearing their story in song transformed their feelings from sadness to something beautiful. They also described that hearing their story reflected back to them in song was deeply moving and provided them with emotional insight. 

What was the impetus for writing this article?

Prior to the pandemic, there were rising rates of burnout and compassion fatigue among healthcare works. Research indicates that healthcare workers are not taught to cope with their work-related emotions and this results in their coping in isolation or avoidance of their emotions all together. The COVID-19 pandemic has had a significant negative impact on the mental well-being of many frontline healthcare workers and the need to help healthcare workers cope with work-related emotions is even greater. Yet, most interventions available do not provide an avenue for them to become more aware of their emotions, examine them, and release them. The impetus for this article was to describe and distribute the findings we learned when asking oncology nurses to describe the emotional experience of participating in an intervention aimed at increasing awareness and expression of emotions to improve psychosocial well-being.

What future research or areas of exploration would benefit the field and application of what was discussed in this article?

As far as we are aware, this type of intervention has not been conducted with other healthcare workers. This study was conducted with only oncology nurses. Future studies should be done with other specialties and disciplines to understand the generalizability. In addition, a next step that our lab is undertaking is to scale the intervention for greater distribution and accessibility. In general, it is difficult for healthcare workers to explore their work-related emotions. Music-based interventions have broad appeal and are a unique opportunity for emotional expression.

How do you think this article impacts the current understanding of music and medicine?

We believe that this study contributes to the music and medicine literature in two ways. First, healthcare workers have not been the priority population for well-being interventions until recently. This study contributes to the understanding of applying music interventions with this population. Second, we believe this study contributes another layer of knowledge about the depth of emotions experienced with music interventions. Music interventions that address deeply held emotions must be delivered with caution and in a safe space. In our work, we have learned that it is essential to teach self-care skills (breathing exercises, mindfulness, and self-compassion) during the writing sessions to help participants cope with their emotions as they tell their stories. At times, emotions were intense during the writing and sharing of stories. To prevent secondary trauma in the group setting, we defused the emotions with the self-care skill we learned that session. These “in the moment” experiences provided good opportunities for the participants to practice self-care skills in intensely emotional settings. In those moments, we helped them learn to feel their emotion and actively cope with them through breathing, mindfulness, and self-compassionate thoughts, instead of avoiding their emotions.

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Table of Contents

Editorial – Chaos and order… Our world at a crossroads

Ralph Spintge, Joanne V. Loewy

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Storytelling through music to facilitate meaning reconstruction and address psychosocial stress in oncology nurses

Carolyn S. Phillips, Deborah L. Volker & Barbara L. Jones

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Understanding the impact of the “Fountains of Uke” intergenerational music program on long-term care residents

Jenna Schlorff, Brandon Ruan, Tiffany Got & Chelsea Mackinnon

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Care, compassion, & controversy: Supporting children in a Covid-19 vaccine pod through music therapy & child life

John Mondanaro & Jessica Sturgeon

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Perspectives on dementia from a speech-language pathologist: An interdisciplinary focus

Linda Carozza

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Neglect, virtual reality and music therapy: A clinical report

Andrew Danso, Mikaela Leandertz, Esa Ala-Ruona & Rebekah Rousi

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An International Discourse on ‘Music and Medicine’

Efthymios Papatzikis

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Book Review – Relationship completion in palliative care music therapy. Authors: Amy Clements-Cortes & Joyce Yip

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