Ann Skingley

Effectiveness and cost-effectiveness of community singing on mental health-related quality of life of older people: randomised controlled trial

BACKGROUND As the population ages, older people account for a greater proportion of the health and social care budget. Whereas some research has been conducted on the use of music therapy for specific clinical populations, little rigorous research has been conducted looking at the value of community singing on the mental health-related quality of life of older people. AIMS To evaluate the effectiveness and cost-effectiveness of community group singing for a population of older people in England. METHOD A pilot pragmatic individual randomised controlled trial comparing group singing with usual activities in those aged 60 years or more. RESULTS A total of 258 participants were recruited across five centres in East Kent. At 6 months post-randomisation, significant differences were observed in terms of mental health-related quality of life measured using the SF12 (mean difference = 2.35; 95% CI = 0.06-4.76) in favour of group singing. In addition, the intervention was found to be marginally more cost-effective than usual activities. At 3 months, significant differences were observed for the mental health components of quality of life (mean difference = 4.77; 2.53-7.01), anxiety (mean difference = -1.78; -2.5 to -1.06) and depression (mean difference = -1.52; -2.13 to -0.92). CONCLUSIONS Community group singing appears to have a significant effect on mental health-related quality of life, anxiety and depression, and it may be a useful intervention to maintain and enhance the mental health of older people.

The effectiveness and cost-effectiveness of a participative community singing programme as a health promotion initiative for older people: protocol for a randomised controlled trial

BackgroundThe growth in numbers of older people represents a considerable cost to health and social care services in the United Kingdom. There is an acknowledged need to address issues of social exclusion and both the physical and mental health of this age group. In recent years there has been much interest in the potential contribution of the arts to the health of communities and individuals. There is some evidence that participative singing may be of benefit to older people, however studies to date are limited in number and have lacked rigour. There is therefore a need to build on this knowledge base to provide more quantifiable evidence of both effectiveness and cost effectiveness of singing as a health intervention for this population group.MethodsThe proposed study is a pragmatic randomised controlled trial with two parallel arms. The primary hypothesis is that singing groups for older people improve both physical and mental aspects of quality of life when compared to usual activities. Potential participants will be volunteers over 60 years living in the community and recruited through publicity. Eligible and consenting participants will be randomized to either a singing group or a control group. Singing groups will take part in a twelve week planned programme of singing and control groups will continue with usual activities. The primary outcome measure will be the York SF-12, a health related quality of life measure which will be administered at baseline, three and six months after baseline. The study will evaluate both effectiveness and cost-effectiveness.DiscussionThis study proposes to add to the existing body of evidence on the value of singing for older people by using a rigorous methodological design, which includes a power calculation, a standardised intervention and assessment of cost-effectiveness. It should be regarded as a stage in a progressive programme of studies in this area. If group singing is found to be effective and cost-effective it may offer an alternative means to maintaining the health of people in later life.Trial RegistrationISRCTN62404401

“Singing for Breathing”: Participants' perceptions of a group singing programme for people with COPD

Background: Chronic obstructive airways disease (COPD) is a long term respiratory condition with a high prevalence rate and associated with considerable physical and psychological morbidity. This research aims to examine the perceptions of people with COPD taking part in regular group singing, in terms of feasibility, acceptability and effectiveness. Methods: The overall approach was a pre-test, post-test feasibility element and a nested qualitative component. Measures of respiratory function and self-reported quality of life were collected from participants engaged in a 36 week singing programme. Written comments from 97 individuals, reported here, were collected at baseline, mid-point and end-point. Data were analysed using content and thematic analysis. Results: Participants noted limitations due to their respiratory condition but a large number expressed beliefs that singing had led to improvement and this appeared to be incremental over the time of the project. Other comments related to positive effects on physical health more broadly, on psychological wellbeing and on the social support gained through meeting others with COPD. Comments relating to the overall programme and the research itself were overwhelmingly positive. Conclusions: Findings suggest that singing is perceived as both acceptable and beneficial to people with COPD. Evidence from participants served as a useful supplement to the quantitative findings.

The contribution of community singing groups to the well-being of older people: participant perspectives from the United Kingdom

Current evidence suggests that participatory arts activities, and particularly group singing, may contribute to the well-being of older people. However, there is currently a paucity of prospective research from the participant perspective. This qualitative study nested within a randomized controlled trial aimed to assess participants’ perspectives of the acceptability and effect on health and well-being of a community singing program for older people. Volunteers recruited to the intervention arm (n = 131) were invited to write comments on their experiences over three data collection points of a 14-week singing program. A subsample (n = 19) participated in a retrospective semi-structured interview. Data were subjected to content and thematic analysis. Comments and interviews from 128 individuals suggested that the singing groups led to specific, incremental benefits to physical, psychological, social, and community well-being. Benefits tended to tail off after the program ended. Suggestions were made for the future running of such groups.

Experiences of being a control group: lessons from a UK-based randomized controlled trial of group singing as a health promotion initiative for older people

Existing randomized controlled trials within the health field suggest that the concept of randomization is not always well understood and that feelings of disappointment may occur when participants are not placed in their preferred arm. This may affect a studys rigour and ethical integrity if not addressed. We aimed to test whether these issues apply to a healthy volunteer sample within a health promotion trial of singing for older people. Written comments from control group participants at two points during the trial were analysed, together with individual semi-structured interviews with a small sample (n = 11) of this group. We found that motivation to participate in the trial was largely due to the appeal of singing and disappointment resulted from allocation to the control group. Understanding of randomization was generally good and feelings of disappointment lessened over time and with a post-research opportunity to sing. Findings suggest that measures should be put in place to minimize the potential negative impacts of randomized controlled trials in health promotion research.

Community singing groups for people with chronic obstructive pulmonary disease: participant perspectives:

Aim: Chronic obstructive pulmonary disease (COPD) is a major public health issue which is irreversible and progressive, but previous research suggests that singing may have beneficial effects. The aim of this study was to establish the views of participants with COPD taking part in a singing for better breathing programme. Methods: This was a descriptive qualitative study nested within a single-cohort feasibility study which included measures of lung function and wellbeing. Participants (n = 37) were interviewed following a community singing programme that ran over 10 months in South East England. Results: Findings support those from previous studies regarding the impact of singing on respiratory wellbeing. These included the teaching on breath control, relaxation and the breathing exercises, singing as a means to deflect attention away from breathing problems, leading to increased activity levels and the mutual support for respiratory problems. Beyond the impact on breathing, the singing was also seen as fun, and provided friendship and a ‘feel-good’ factor which led to motivation to participate in further activities. For some, it was the highlight of the week, and singing together in a group was felt to be central to the benefits experienced. Findings are compared with the quantitative measures within the same study. Conclusion: The majority of participants reported improvements in respiratory symptoms as well as mental and social wellbeing following the programme. The study contributes to the evidence base in supporting and highlighting the consistently positive experiences of a large sample of participants, despite variable outcomes in clinical measures.

Evaluation of edna: arts and dance for older people

Purpose – The purpose of this paper is to evaluate the impact on health and well-being of participation in dance and arts activities by older people living in the community. Design/methodology/approach – A small-scale, mixed methods research design comprising pretest-posttest evaluation of a three month dance and arts programme. Two groups of older people underwent physical measures and completed a self-report quality of life questionnaire. Written comments and interview data were also gathered. Findings – Physical tests (n=14) demonstrated improvements in posture, shoulder mobility and balance in both groups following the intervention, with some measures reaching statistical significance. Quality of life evaluations (n=21) also showed improvement, with the mental health subscale reaching statistical significance. Qualitative data showed that participants enjoyed the programme and felt physical, psychological and social benefits. Research limitations/implications – The research involved only a small sampl...