INTRODUCTION:

Handling most cancers may be a less horrifying experience, while a holistic technique is incorporated into the primary scientific remedy.

- Foster Kennedy.

The world is emerging in the direction of diverse kinds of non-communicable sicknesses that are referred to as cutting-edge epidemics. Among this contemporary epidemic, one phrase that is even more daunting than the dying itself and eats up someone from internal is cancers.

Cancer is a big group of disorders with distinctive reasons, manifestations, remedies, and analysis. Because most cancers can contain any organ system, it is a disorder technique that starts off evolved while a cell is converted by the genetic mutations of the cell DNA. Genetic mutations may be inherited and/or acquired, leading to abnormal cell behavior.

Development of head and neck cancer is intently associated with private conduct, usually tobacco use, which includes the usage of cigarettes, cigars, chewing tobacco and snuff. Snuff dipping or the placement and retention of tobacco inside the cheek is common amongst younger humans. Long term snuff users and cigars smokers are at multiplied danger of oral cancer. Prolonged alcohol use has been implicated as a cause of head and neck most cancers (Lewis, 2004).

Complementary and alternate therapies are harmonious with a few of the values of nursing. These consist of a view of the human as holistic beings, and an emphasis on healing, reputation that the provider-patient relationship must be a partnership and a focal point on health promotion and illness prevention.

NEED OF THE STUDY:

The word cancers brings up many ideas for the individual tremendously they are afraid, no longer so much of demise however for themselves, the fear of pain or the cease of lifestyles as they comprehend it and for others, the fear of being a nuisance or even objectionable. The diagnosis of most cancers method an alternate within the lifestyle of the man or woman in whom the most cancers is observed, the degree and permanency of that modifications of course, dependent on the quantity of the ailment, the direction of remedy undertaken, and the ensuing disabilities all of which place the individual and his circle of relatives below notable stress.

Aanchal Satija, Sushma Bhatnagar found that the survival rate of cancer patients is rapidly increasing over the last decade due to the advent of multi- model-antic- cancer treatments. The usage of complementary/ alternative therapies to enhance health and QOLs is increasing among both the general population and cancer patients (5.6%). National Institute for clinical excellence describes (CTs) as the ones which are used along orthodox treatments with the intention of imparting mental and emotional support psychological and emotional support through the relief of symptoms.

STATEMENT OF THE PROBLEM:

A study to assess the effectiveness of music therapy on selected physiological and psychological symptoms among patients with head and neck cancer in selected hospital at Kanya kumari District, Tamil Nadu.

OBJECTIVES OF THE STUDY:

1. To assess the score of selected physiological and psychological symptoms among patients with head and neck cancer before the intervention.

2. To determine the effectiveness of music therapy on selected physiological and psychological symptoms among patients with head and neck cancer.

3. To find the correlation between selected physiological symptoms and psychological symptoms among patients with head and neck cancer in the experimental and control group.

4. To find out the association between pretest scores of selected physiological and psychological symptoms among patients with head and neck cancer with selected demographic and clinical variable.

REVIEW OF LITERATURE:

Madineh Jasemi, Sanaz Aazami and Roghaieh Esmaili Zabihi (2016) had accomplished a quasi-experimental look at in Urmia city to determine the effect of music therapy on anxiety and depression of cancer patients. A total of 60 patients with depression and anxiety have been recruited using random sampling technique and divided into two groups of control and intervention. Patients in the intervention group listened to mild song at the least 20 min per day for three days. Information has been analyzed through the usage of a t-test, Pearson and ANOVA checks. This study concluded that there was a significant decrease in the level of depression and anxiety among intervention group, and there have been extensive relationships among anxiety, depression, and sex (P<0.001, r=0.42) as well as education (P=0.003, r=0.37). This study revealed the positive effects of music therapy on decreasing the level of depression and anxiety in patients with cancer.

Digdem et al., (2015) conducted a study to investigate the effects of music on sleep quality in breast cancer patients with poor sleep. A randomized experimental design was used with two groups and 2 measurement times. Samples are randomly assigned. 60 patients with sleep complaints were recruited at a university in Gaziantep. The experimental group received intervention between 21.00 PM 1.00 AM at night for one week. The music intervention consisted of Turkish soft music and it was decided upon based on the opinion of academics of the conservatory of Turkish music of the University of Gaziantep. A central music system was used. The experimental group encouraged not to use other relaxation technique. The Pittsburg sleep quality Index questionnaire is used to measure self-reported sleep. Data were analyzed and found that the magnitude of the difference between groups was statistically significant after the second week. Improvement continued during the following week of the day. The study concluded that sleep quality can be improved by relaxing the body with sedative music which decreases circulating nor-adrenaline that is related to sleep onset.

RESEARCH METHODOLOGY:

RESEARCH APPROACH:

In this study, the effectiveness of music therapy on selected physiological and psychological symptoms among patients with Head and neck cancer was evaluated. Therefore the researcher has chosen a quantitative research approach to test the effectiveness of the intervention for this study.

RESEARCH DESIGN:

The research design used in this study is quasi experimental pre-test post-test control group time series design

SETTING OF THE STUDY:

The present study was conducted in International Cancer Center; CSI Medical Mission Hospital Neyyoor is a 600 bedded hospital in which 150-beds exclusively for cancer patients.

POPULATION OF THE STUDY:

Target Population:

The target population of this study was all Head and neck cancer patients who are admitted in International Cancer Centre CSI Medical Mission Hospital, Neyyoor, Kanyakumari District.

SAMPLE:

Head and neck cancer patients who fulfill the inclusion criteria were selected as a sample of the study.

SAMPLING TECHNIQUE:

Purposive Sampling Technique

DEVELOPMENT AND DESCRIPTION OF RESEARCH TOOL:

Tools of the Research used:

The strategy or system used to gather information from participants, programmes and other elements of evaluation.

The tool used for the study divided into 5 sections.

Section A: It consisted of demographic and clinical variables of patients with Head and neck cancer which include age, sex, education, occupation, monthly Income, place of residence, food pattern, habits, marital status, type of family, stages of cancer and type of treatment.

Section B:

Numerical pain Rating scale

Section C:

Bio-physiological Parameter Assessment Tool.

Section D:

Modified Hospital Anxiety and depression scale.

Section E:

Soft instrumental music selected from piano and flute.

DATA COLLECTION PROCEEDURE:

The study was conducted in International cancer center Neyoor. After getting the ethical clearance, the patients were explained to about the purpose of the study and consent was obtained from all patients. The patients were asked to rate their physiological and psychological symptoms. Instrumental music therapy was given. Post test was conducted by same tool. Data were analyzed by inferential and descriptive statistics.

RESULTS AND DISCUSSION:

The physiological and psychological symptoms of the control group patients were assessed in table 1. It shows that all patients had severe to moderate level of symptoms during pretest and the same represented in post test. While in the experimental group all patients reduced their symptoms in post test. It was represented in table 2

Table 1: Frequency and Percentage Distribution of physiological and psychological variables before and after music therapy in control group from pre-test to Post- 3-Test.

Variable	Category	Score	Pre-test		Post-test 1		Post-test 2		Post-test 3
Variable	Category	Score	No	%	No	%	No	%	No	%
Pain	No pain	0	0	0	0	0	0	0	0	0
	Mild	1-3	0	0.0	0	0.0	0	0.0	0	0.0
	Moderate	4-6	107	97.3	110	100.0	110	100.0	110	100.0
	Severe	7-10	3	2.7	0	0.0	0	0.0	0	0.0
SBP	Normal	120	2	1.8	3	2.7	2	1.8	2	1.8
SBP	Ab-normal	>120	108	98.2	107	97.3	108	98.2	108	98.2
DBP	Normal	80	60	54.5	60	54.5	63	57.3	73	66.4
DBP	Ab-normal	>80	50	45.5	50	45.5	47	42.7	37	33.6
Pulse	Normal	60-80	95	86.4	96	87.3	96	87.3	85	77.3
Pulse	Ab-normal	82-100	15	13.6	14	12.7	14	12.3	25	22.7
Sleep duration	Normal	4-6 hrs	2	1.8	5	4.5	3	2.7	3	2.7
Sleep duration	Ab-normal	<4 hrs	108	98.2	105	95.5	107	97.3	107	97.3
Anxiety	Normal	0-7	0	0.0	0	0.0	0	0.0	0	0.0
	Border	8-10	0	0.0	0	0.0	0	0.0	0	0.0
	Clinical	11-21	110	100.0	110	100.0	110	100.0	110	100.0
Depression	Normal	0-7	0	0.0	0	0.0	0	0.0	0	0.0
	Border	8-10	0	0.0	0	0.0	0	0.0	1	0.9
	Clinical	11-21	110	100.0	110	100.0	110	100.0	109	99.1

Table 2: Frequency and percentage distribution of physiological and psychological symptoms before and after music therapy in Experimental group from pre-test to post- 3-test.

Variable	Category	Score	Pre-test		Post-test 1		Post-test 2		Post-test 3
Variable	Category	Score	No	%	No	%	No	%	No	%
Pain	No	0	0	0	0	0	0	0	0	0
	Mild	1-3	0	0.0	0	0.0	0	0.0	31	28.2
	Mod-erate	4-6	110	100.0	110	100.0	110	100.0	79	71.8
	Severe	7-10	0	0.0	0	0.0	0	0.0	0	0.0
SBP	Normal	120	3	2.7	4	3.6	36	32.7	56	50.9
SBP	Ab-normal	>120	107	97.3	106	96.4	74	67.3	54	49.1
DBP	Normal	80	63	57.3	81	73.6	101	91.8	109	99.1
DBP	Ab-normal	>80	47	42.7	29	26.4	9	8.2	1	0.9
Pulse	Normal	60-80	96	87.3	110	100.0	110	100.0	110	100.0
Pulse	Ab-normal	82-100	14	12.7	0	0.0	0	0.0	0	0.0
Sleep duration	Normal	4-6	12	10.9	7	6.4	101	91.8	108	98.2
Sleep duration	Ab-normal	<4 hours	98	89.1	103	93.6	9	8.2	2	1.8
Anxiety	Normal	0-7	0	0.0	0	0.0	0	0.0	0	0.0
	Border	8-10	0	0.0	0	0.0	1	0.9	103	93.6
	Clinical	11-21	110	100.0	110	100.0	109	99.1	7	6.4
Depression	Normal	0-7	0	0.0	0	0.0	0	0.0	0	0.0
	Border	8-10	0	0.0	0	0.0	2	1.8	65	59.1
	Clinical	11-21	110	100.0	110	100.0	108	98.2	45	40.9

Table 3: Correlation between Selected Physiological and Psychological Symptoms among Patients with Head and Neck Cancer in Control Group and Experimental Group

Table 3: Correlation between Anxiety with pain and sleep of control group

Test	Variables		“r”	Sig	r²	%	% of Determination
Pre-test	Anxiety	Pain	-0.289	P=0.002	0.084	8.4	Anxiety determined pain 8.4
Pre-test	Anxiety	Sleep	-0.322	P=0.001	0.104	10.4	Anxiety determined sleep 10.4
Post-test 1	Anxiety	Pain	-0.208	P=0.030	0.043	4.3	Anxiety determined pain 4.3
Post-test 1	Anxiety	Sleep	-0.092	P=0.339	0.008	0.8	Anxiety determined sleep 0.8
Post-test 2	Anxiety	Pain	-0.067	P=0.487	0.004	0.4	Anxiety determined pain 0.4
Post-test 2	Anxiety	Sleep	-0.032	P=0.740	0.001	0.1	Anxiety determined sleep 0.1
Post-test 3	Anxiety	Pain	0.058	P=0.558	0.003	0.3	Anxiety determined pain 0.3
Post-test 3	Anxiety	Sleep	-0.140	P=0.144	0.020	2.0	Anxiety determined sleep 2.0

Table 4: Correlation between Anxiety with pain and sleep of experimental group

Test	Variables		“r”	Sig	r²	%	% of Determination
Pre-test	Anxiety	Pain	-0.170	P=0.076	0.029	2.9	Anxiety determined pain 2.9
Pre-test	Anxiety	Sleep	-0.052	P=0.583	0.003	0.3	Anxiety determined sleep 0.3
Post-test 1	Anxiety	Pain	0.654	P<0.001	0.428	42.8	Anxiety determined pain 42.8
Post-test 1	Anxiety	Sleep	-0.536	P<0.001	0.287	28.7	Anxiety determined sleep 28.7
Post-test 2	Anxiety	Pain	0.381	P<0.001	0.145	14.5	Anxiety determined pain 14.5
Post-test 2	Anxiety	Sleep	-0.758	P<0.001	0.575	57.5	Anxiety determined sleep 57.5
Post-test 3	Anxiety	Pain	0.820	P<0.001	0.672	67.2	Anxiety determined pain 67.2
Post-test 3	Anxiety	Sleep	-0.686	P<0.001	0.471	47.1	Anxiety determined sleep 47.1