Medical procedures and surgery impact people psychologically as well as physically, provoking feelings of fear and anxiety that may influence their experience of the procedure itself. Patients with elevated anxiety prior to medical procedures may require increased anxiolytic medication, which in turn may lead to greater medical costs and increased side effects. Anxiety and distress may contribute to an increased perception of pain, and inadequately managed pain in the post-operative period may complicate the recovery process. The supportive and flexible approach of music therapy can offer patients the possibility of improving positive affective states while decreasing distress in a way that positively impacts their experience of medical procedures. The evidence base supports the use of structured music listening approaches during and after surgery to reduce pain, and prior to procedures or surgery to reduce anxiety and distress. More flexible music therapy approaches that involve a music therapist interactively engaging with a patient may be best used during painful, and/or highly anxietyprovoking, procedures when the patient is awake. With live, interactive music therapy approaches, the trained music therapist modifies the music and therapeutic approach to meet the changing needs of the patient, which requires a high level of clinical competence. Music therapists, physicians, nurses and other members of the interdisciplinary team collaborate to assure that the therapeutic use of music is optimized at all levels of a patient’s hospitalization.

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Music and music therapy interventions with patients with coronary heart disease mainly focus on receptive approaches such as music listening with or without an attendant; music listening with guided relaxation, and guided imagery with music. In music therapy the therapeutic relationship is an important ground for change and improvement of health. Music is selected and compiled for its sedative potential and according to the patients’ needs for anxiety and stress reduction. The music interventions may support, comfort, divert the attention from discomfort and anxiety, and provide a space for the patients to process anxiety and other emotions in relation to their illness and treatment. Music and music therapy interventions are clinically relevant as complementary treatment in hospital and rehabilitation settings and in outpatient treatment.

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The death of a child is always tragic, regardless of expectation of death, length of illness, level of pain and suffering or traumatic event. While similarities exist in treatment goals during the final stages of life (e.g. symptom management), major differences exist in the way in which children and adults experience their own death. Music therapy is a vital component in the interdisciplinary management of children and their families at the end of life. Music therapy is a multifaceted experience that includes all family members and represents the healthy aspects of the child. Core concepts of music therapy work with children who are facing imminent death are reviewed, creating a theory from which to build practical approaches. This article reviews techniques and current research trends, including recommendations for future research directions. The purpose of this article is to demonstrate the need for increased music therapy presence at the end of a child’s life.

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It is difficult to show the efficiency of music therapy (MT) objectively, though it is apparent subjectively and empirically. But, the establishment of its evidence is indispensable in order to utilize the MT in the medical situation as one of the alternative or supplemental therapies. I discuss the objective indices which are suitable to show the efficacy of MT, and introduce some of my previous researches. It is generally accepted that, as the indices, easy, non-vulnerable, and cheap ones are recommended. From the results of reported literatures and my previous researches, I suppose that chromogranin A(CgA) , immunoglobulin A (IgA), and cortisol in the saliva might be useful to show the efficiency of MT. Further effort is needed to clearly show the efficiency of MT, scientifically.

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