Comparing the effects of Western music and five-element music therapy on patients undergoing maintenance hemodialysis: A randomized controlled trial

Due to the intricate interplay between music and culture, the comparative effectiveness of Western music therapy and five-element music therapy for Chinese patients undergoing maintenance hemodialysis warrants further investigation. In this randomized controlled trial, 87 patients receiving maintenance hemodialysis were recruited and randomly assigned to the five-element music group (n = 29), Western music group (n = 29), and control group (n = 29) in a 1:1:1 ratio. Participants in the five-element music group and Western music group received eight weeks of five-element music therapy and Western music therapy, respectively, for 60min per session, three times per week. The primary outcome indicator was the Hospital Anxiety and Depression Scale score. The secondary outcome indicators were the Pittsburgh Sleep Quality Index, Dialysis Symptom Index, and Positive and Negative Emotions Scale scores. All outcome indicators were measured at baseline, on the day of the end of week 4 of the intervention, on the day of the end of week 8 of the intervention, and at the one-month follow-up after the end of the intervention. The results of the generalized estimating equations indicated that both five-element music therapy and Western music therapy were effective in alleviating anxiety, depression, sleep disturbances, and both positive and negative emotions among patients undergoing maintenance hemodialysis. However, patients in the five-element music group showed significantly greater relief from anxiety (mean difference = -1.76 ± 0.672, 95% CI: 3.37, -0.15, p = 0.027), depression (mean difference = -1.79 ± 0.647, 95% CI: -3.34, -0.24, p = 0.017), and both positive (mean difference = -3.00 ± 1.062, 95% CI: 0.46, 5.54, p = 0.014) and negative emotions (mean difference = -3.38 ± 1.084, 95% CI: -5.97, -0.78, p = 0.005) compared to those in the Western music group. Conversely, no significant differences were observed in sleep quality (mean difference = -1.07 ± 0.776, 95% CI: -2.93, 0.79, p = 0.505) or symptom-related distress (mean difference = 3.62 ± 3.124, 95% CI: -3.86, 11.10, p = 0.739) between the five-element music and Western music groups. The significant benefits of five-element music therapy in improving emotions in Chinese patients undergoing maintenance hemodialysis highlight the importance of culturally tailored interventions.