{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:48:43Z","timestamp":1782272923637,"version":"3.54.5"},"reference-count":25,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"\n Background:<\/jats:title>\n Music therapy (MT) and virtual reality (VR) are increasingly being used in palliative care for symptom management, though evidence quality remains low.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n The aim of our study was to assess the effect of combined MT + VR on the main symptom in palliative cancer patients.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n This study employed an explanatory sequential mixed methods design based on a randomized controlled clinical trial, integrating quantitative outcomes with qualitative patient experiences.<\/jats:p>\n <\/jats:sec>\n \n Measurements:<\/jats:title>\n The main symptom was the symptom rated as most severe by the patient on the Edmonton Symptom Assessment System Revised (ESAS-r) scale. Secondary outcomes included the global ESAS-r score, anxiety (additionally measured with State-Trait Anxiety Inventory\u2014State [STAI-S]), emotional distress (DME scale), and heart rate. All variables were assessed at three time points: baseline (T1), post-intervention (T2), and 24 hours post-intervention (T3).<\/jats:p>\n <\/jats:sec>\n \n Patients and Settings:<\/jats:title>\n Adult patients attended by palliative care with advanced cancer at a university hospital in Argentina.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Sixty patients completed the protocol. Significant differences between baseline (T1) and immediate post-intervention (T2) were observed when comparing the MT + VR condition to the control group for the main symptom (1.5 vs. 0,\n p<\/jats:italic>\n < 0.001); global symptom score (9 vs. 0.5,\n p<\/jats:italic>\n < 0.001); and anxiety (0.2 vs. 0.1,\n p<\/jats:italic>\n < 0.001). No significant differences were found between groups at 24 hours post-intervention (T3) compared with baseline. Several categories of interest emerged: (a) affective states, (b) projections, and (c) transcendental experiences.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The combination of MT + VR improved the main symptom, as compared with the control group. Patient perceptions add valuable information about the factors that influenced this difference.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10966218251407902","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T15:46:57Z","timestamp":1767973617000},"page":"594-601","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Music Therapy Combined with Virtual Reality Reduces Prevalent Symptoms in Adult Patients with Advanced Cancer: Randomized Clinical Trial"],"prefix":"10.1177","volume":"29","author":[{"given":"Agustina","family":"Iturri","sequence":"first","affiliation":[{"name":"Palliative Care Unit, Austral University Hospital (HUA), Pilar, Argentina."},{"name":"Faculty of Biomedical Sciences, Austral University, Pilar, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adela","family":"Bertella","sequence":"additional","affiliation":[{"name":"Faculty of Biomedical Sciences, Austral University, Pilar, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Nicol\u00e1s","family":"D\u00f3vidas","sequence":"additional","affiliation":[{"name":"Delta Regional Faculty, National Technological University, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Spector","sequence":"additional","affiliation":[{"name":"Faculty of Engineering, Austral University, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Alonso Babarro","sequence":"additional","affiliation":[{"name":"Palliative Care Unit, La Paz University Hospital, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1404684"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-2016-003204"},{"key":"e_1_3_2_4_2","volume-title":"Fundamentos de cuidados paliativos y control de s\u00edntomas","author":"De Simone G","year":"2004","unstructured":"De Simone G, , Tripodoro V. Fundamentos de cuidados paliativos y control de s\u00edntomas. Buenos Aires: Pallium Latinoam\u00e9rica; 2004."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/082585979100700202"},{"key":"e_1_3_2_6_2","unstructured":"Dawidowicz N. National Palliative Care Program [Internet]. 2016. Available from: https:\/\/www.argentina.gob.ar\/salud\/instituto-nacional-del-cancer\/institucional\/programa-paliativos [Last accessed: Jul23 2019]."},{"key":"e_1_3_2_7_2","first-page":"265","volume-title":"Advances in virtual reality and anxiety disorders","author":"Riva G","year":"2014","unstructured":"Riva G, , Repetto C. Conclusions: The present and the future of virtual reality in the treatment of anxiety disorders. In: Wiederhold BK, , Bouchard S., editors. Advances in virtual reality and anxiety disorders. New York: Springer Science + Business Media; 2014. pp. 265\u2013283."},{"key":"e_1_3_2_8_2","first-page":"104990912199429","article-title":"The potential of personalized virtual reality in palliative care: A feasibility trial","volume":"38","author":"Perna L","year":"2021","unstructured":"Perna L, , Lund S, , Whit N, et al. The potential of personalized virtual reality in palliative care: A feasibility trial. Am J Hosp Palliat Care, 2021; 38:104990912199429.","journal-title":"Am J Hosp Palliat Care"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.29422"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2022.11.008"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13413"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jormas.2021.03.009"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2020.0403"},{"issue":"3","key":"e_1_3_2_14_2","first-page":"CD007169","article-title":"Music therapy for end-of-life care","volume":"2014","author":"Bradt J","year":"2014","unstructured":"Bradt J, , Dileo C. Music therapy for end-of-life care. Cochrane Database Syst Rev, 2014; 2014(3):CD007169.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2007.0193"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4103\/0973-1075.185042"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0481"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-023-02671-4"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163221099584"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.10.004"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1975.tb00927.x"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.47513\/mmd.v15i3.906"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-04713-4"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-018-0461-0"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/1029864917715061"},{"key":"e_1_3_2_26_2","volume-title":"Music Therapy and Medicine: Theoretical and Clinical Applications","author":"Saperston B","year":"1999","unstructured":"Saperston B. Music-based individualized relaxation training in medical setting. In: Dileo C., editor. Music Therapy and Medicine: Theoretical and Clinical Applications. 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