Music for Waiting Rooms

By Jessica Duckworth

I am a final year medical student at the University of Manchester, whilst also being a keen musician and composer. I have always been fascinated in the effects of music on both the body and the mind, which led me to pursue this project integrating music and healthcare. This project was part of the Medical Humanities MSc at The University of Manchester.

The Waiting Room

Nobody thinks much about the waiting room, including those who sit and wait. But in fact, a waiting room often contains an amazing concentration of the full spectrum of human emotion, ranging from bone-numbing boredom to acute anxiety[1]

WaitingRoom2

Sitting in a medical waiting room is an accepted part of visiting a doctor. Waiting is an ingrained part of daily human life in the Western world. Whether this is waiting for public transport, waiting in traffic, waiting for the kettle to boil, waiting in a queue, or waiting for an appointment, it is ubiquitous in modern society. In terms of the medical waiting room, it is uncommon to attend a hospital or GP surgery without spending at least a few minutes waiting, often longer.

Medical waiting rooms are often uncomfortable, anxiety-filled spaces with little to stimulate or preoccupy patients’ minds other than medical posters littering the walls. The aim of my project, Music in the Waiting Room, was to fill this empty ‘space’ of the waiting room with music, with the intention of encouraging a calm and relaxing environment, positively distracting patients from their medical anxieties.

Anxiety has been associated with negative health outcomes, including slower recovery times, decreased pain thresholds and resistance to treatment.[2] In order to provide patient-centred care, one must consider the entire patient experience, not confining the care solely to the consultation room. Therefore, it is vital to consider the waiting room experience, and ways in which it can be optimised to encourage a relaxing and anxiety-relieving environment.

Research has provided evidence for the stress-relieving effects of music. Several studies have found that listening to music leads to reduced levels of the stress hormone ‘cortisol’, explaining the relaxing impact of ‘calming’ music.[3],[4] This project intended to use these stress-relieving effects of music to improve the patient experience of the waiting room.

The Project: Music in the Waiting Room

The project was part of my masters degree in Medical Humanities. I composed an album of music called ‘Music in the Waiting Room’. This included a selection of calming electronic ambient music and piano music. You can listen to this music by clicking on the links below:

WordCloudResearch was performed during the composition process of the album to explore the type of music that the public generally found relaxing and would like to hear in a waiting room. The word cloud displays the described responses.

Upon further research, it emerged that people generally preferred piano music to electronically generated music, which assisted in guiding the composition.

Results: Chelsea and Westminster Hospital Study

WaitingRoom1My album of music was installed in the fracture clinic waiting room at Chelsea and Westminster hospital, supported by the Arts charity Chelsea and Westminster Plus.

PieChart1The impact of the music was measured by evaluation questionnaires with patients in the waiting room. A total of 30 patients completed questionnaires

Patients were asked: ‘What do you think to the music playing in the waiting room?’ Results were positive, with 96% stating that they either like it or don’t mind (see pie chart).

When questioned about how patients were feeling while sitting in the waiting room with music, all but one patient reported positive feelings. The most frequently reported feeling in the waiting room was ‘calm’, closely followed by ‘at ease’ and ‘relaxed’. These were the feelings that I was aiming to capture and enhance in the waiting room via the music.

Patients were then asked how strongly they agreed/disagreed with the following statement: ‘music in the waiting room creates a relaxing environment’. Results were overwhelmingly positive, with 87% of patients selecting ‘agree’ or ‘strongly agree’, suggesting that the majority find music relaxing in the waiting room.

BarChart3Finally, patients were asked to what extent they agreed with the following statement: ‘I like to have music in the background in a waiting room’. Again, results were positive, with 90% of patients choosing either ‘agree’ or ‘strongly agree’, and 10% were undecided. No patients voted for ‘disagree’ or ‘strongly disagree’, revealing that music was preferred by the majority of patients in this waiting room.

Written feedback from patients on their thoughts of the music in the waiting room are displayed below.

QuotesConclusions

Waiting rooms are not often considered pleasant places to be in, yet they are a key component of the overall patient experience. If we can help the way patients feel in the waiting room, we can have a positive impact on their overall experience. Patients can enter the consultation room feeling less stressed, with a clearer mind, ready to take in information from the healthcare professional.

Results from this study at Chelsea and Westminster hospital suggest that music in the waiting room does encourage a more relaxing, calming environment, hence providing a more positive patient healthcare experience.

I thoroughly enjoyed the entire experience of undertaking this project. It provided me with the opportunity to combine my two passions in life: music and medicine, whilst making a positive impact on the patient experience of healthcare.

References

[1] Ian Cameron, “What’s Happening In Your Waiting Room?”, Canadian Family Physician, 64 (2018): 378.

[2] Elaine Biddiss, Tara Joy Knibbe and Amy McPherson, “The Effectiveness Of Interventions Aimed At Reducing Anxiety In Health Care Waiting Spaces”, Anesthesia & Analgesia, 119 (2014): 433

[3] Alexandra Linnemann, Jana Strahler and Urs M. Nater, “Assessing The Effects Of Music Listening On Psychobiological Stress In Daily Life”, Journal Of Visualized Experiments, 120 (2017)

[4] Barbara Miluk-Kolasa et al., “Effects Of Music Treatment On Salivary Cortisol In Patients Exposed To Pre-Surgical Stress”, Experimental And Clinical Endocrinology & Diabetes, 102 (2009): 118.

Copyright for Text, Music and Images: Jessica Duckworth 2018
Find out more about Jess’s creative journey in her online journal

 

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MedHums Creative Portfolio: Gemma Wilson

Next in our series introducing creative portfolios is Gemma Wilson, who graduated from the MSc in Medical Humanities in 2015. She is now a Lecturer in the School of Community Health and Midwifery at UCLan.

In what follows, Gemma reflects on select works and pages from her journal:

Hospital Gown

Gemma Wilson, Embroidered hospital gown (front)

Gemma Wilson, Embroidered hospital gown (front)

Gemma Wilson, Embroidered hospital gown (back)

Gemma Wilson, Embroidered hospital gown (back)

This piece was inspired by an article entitled ‘White Coat, Patient Gown (Wellbery and Chan, 2014), which discusses the fact that although a lot of attention has been paid to the symbolic power of the doctor’s white coat, very little has been written about the patient gown. Prior to this, I hadn’t given much thought to the gown, although it is something I had come across every day when practising as a midwife.

Gemma Wilson, Embroidered hospital gown (detail)

Gemma Wilson, Embroidered hospital gown (detail)

I began to consider the act of putting on the gown and becoming a patient, and the impact that might have on an individual. I started to think about the words we associate with being a patient and decided to embroider them onto a hospital gown. I was interested in making those unspoken assumptions, ideas and beliefs visible.

Gemma Wilson, Embroidered hospital gown (detail)

Gemma Wilson, Embroidered hospital gown (detail)

Overall, the process made me more aware of what we take for granted in terms of the power structures within health care and how these are reinforced. When a person wears a hospital gown, it transforms them from an individual (with specific needs, ideas, beliefs and wants) to the role of a patient whose identity and needs become determined by medical criteria.

Gemma Wilson, Embroidered hospital gown (detail)

Gemma Wilson, Embroidered hospital gown (detail)

There’s Much More To Me Than My Carotid Artery

I wrote this journal entry after a visit to the Manchester Museum, where I encountered an exhibit displaying the skeleton of an unknown woman next to the skeletons of apes and prehistoric humans. I found this both disturbing and baffling. Disturbing, as I hold the belief that human remains should be treated with respect – something that has been taught and reinforced to me through the values within our society. It was baffling to me that the woman’s remains could be treated as an object for education and entertainment, because her identity was unknown; whereas, if she had an identity – and possibly living ancestors – this would be completely objectionable. I couldn’t reconcile the reasoning or logic behind this, and it left me feeling quite angry and frustrated.

Gemma Wilson, There's much more to me than my carotid artery

Gemma Wilson, There’s much more to me than my carotid artery

I imagined my own skeleton in the museum years into the future – my experiences, successes, failures, triumphs and tragedies all forgotten and unknown to the strangers who peer at my bones from the other side of the glass. This experience taught me that we can think that we have fairly strong shared beliefs that link us as a society or a profession, but when we start to look closer at things, we see inconsistencies all around us.

Heart-Sink Patient

I wrote this story after a Medical Humanities session with a doctor who was discussing ‘heart-sink patients’. As soon as these patients step through the clinic door, the doctor’s heart will sink, because they are ‘difficult’ in some way.

Gemma Wilson, Heart-sink patient

Gemma Wilson, Heart-sink patient

I began to think of the experiences of an elderly relative of mine who had an unshakeable trust in medicine. She truly believed that doctors could work miracles to the extent that she would regularly make trips to the GP to see if they could cure her old age. When they told her there still was nothing they could do, her heart would sink, but she never gave up, and every month or so she would return to see if there was a new medicine or treatment that would help reverse the effects of time.

This inspired me to write a story around the idea of a ‘heart-sink doctor’: about a retired woman and her complex relationship with both medicine and her family.

I found that creative writing was a really effective way of exploring complex and interlinked ideas within a short space of time.

Books I Love

A journal entry about books Gemma read for leisure as she was studying medical humanities – but which influenced her thinking around health, wellbeing and medicine.

Gemma Wilson, Books I Love

Gemma Wilson, Books I Love

And finally, here are Gemma’s thoughts on assembling a creative portfolio for the course more generally:

Prior to the completion of this creative journal, I hadn’t done anything creative like this; however, I found this to be one of the most rewarding and important learning experiences I’ve had. It pushed me to move out of my comfort zone and to think of new ways of approaching, understanding and presenting a variety of content. The freedom we were given to explore our own ideas also meant that we had the opportunity to discover our passions and interests within medical humanities, which was so useful later in the course (and beyond).

All artwork and images © Gemma Wilson.

MedHums Creative Portfolio: Amina Kreusch

Next in our Students Reflect on MedHums series, in which we showcase creative portfolios assembled by students on the MSc in Medical Humanities, is Amina Kreusch, whose journal contains a range of fascinating visual and textual material.

Amina Kreusch, Introduction, 2013/14

Amina Kreusch, Introduction, 2013/14

Amina explains in her introduction how the journal became a space for reflection, exploration, discovery and experimentation. It covers historical, cultural and sociological topics – some of a very personal nature. According to Amina, the illness and passing of her grandfather on the one hand and the experience of spending a year in Manchester as an international student on the other made her aware of the fleeting nature of time, and the cycle of life and death more generally – themes that pervade the journal both explicitly and on a more subtle level.

Amina describes the process of creating a journal in the following terms:

Coming from a science-focused degree, assembling a creative portfolio seemed a daunting task at first. But in the course of the first semester looking for scraps of interesting stories and everyday encounters that related to reflecting on medicine and, more broadly, on health and disease, life and death, became a habit I would not want to miss anymore.

My favourite part was putting different sources of material and text types to work. I collected photographs, digital media, and drawings of my own while also experimenting with poems, short prose, and documenting oral history.

The journal contains exhibition and film reviews, poems, reflections on public perceptions of diseases such as diabetes and cancer, photographs, drawings, and more:

Amina Kreusch, Bee and Flower Photograph, 2013/14

Amina Kreusch, Brains, 2013/14

Amina Kreusch, Diabetes

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Amina Kreusch, Journal, 2013/14

Amina Kreusch, Journal, 2013/14

Amina reflects on the ways in which putting together a creative portfolio shaped her understanding of the Medical Humanities:

The journal played a significant part in how the MSc helped open up my perception of how thoroughly the medical humanities pervade our work as healthcare professionals as well as personal lives, all the while moving away from a purely medical gaze.

All artwork and images © Amina Kreusch.

MedHums Creative Portfolio: Alice Ryrie

Our new Students Reflect on MedHums series showcases creative portfolios assembled by students on the MSc in Medical Humanities during the academic years 2013/14 and 2014/15. The journals and portfolios were part of the assessment for the semester 1 module Major Themes in Medial Humanities, led by Sarah Collins and Carsten Timmermann.

We begin with Alice Ryrie, whose artwork, journal and comments demonstrate how creative coursework can lead to fascinating new insights and a deeper understanding of themes in Medical Humanities.

Alice Ryrie, Sanguine

Alice Ryrie, Sanguine, 2014/15

Alice Ryrie, Choleric

Alice Ryrie, Choleric, 2014/15

Alice Ryrie, Melancholic

Alice Ryrie, Melancholic, 2014/15

Alice Ryrie, Phlegmatic

Alice Ryrie, Phlegmatic, 2014/15

Alice shared her thoughts on writing a journal for the course:

Being given the opportunity to write a journal was for all of us an exciting, yet slightly daunting task. The journal was a chance to try something a bit different and document thoughts, inspirations and creative ideas with a clear set of aims and framework to focus on.

Some of the ideas I started putting together over Christmas break were articles inspired by newspaper stories or the lives of artists and patients, and others were drawings or pieces of creative writing. At first none of them seemed to fit together, but soon subtle themes began emerging that connected some of the pieces – for example, using metaphors or imagery to create comparisons or humour between medical and non-medical subjects. This really helped to reveal what interested me and went on to inform my dissertation that year.

However, there were challenging parts to creating the journal, too… and not just the mad rush cutting and gluing in things the night before the deadline! In other University assignments I have always felt anonymous: essays are handed in with only a student number marking my identity. But now, I was being assessed not only as myself, but by submitting a piece of work which had grown very personal to me.

This was most obvious on the day we showed each other our work. The six of us sat nervously with our journals, not wanting to be the first to open the cover. However, once we started sharing our ideas, we quickly began to enjoy talking about our journals and appreciating the different styles and themes. I found this day one of the most memorable of our course. We all learned a huge amount from each other, ranging from creative ideas and personal stories to academic papers and book recommendations.

Alice’s journal contains a wide variety of topics, photographs, clippings, reflections, poems, drawings, paintings, quotes, lists, re-writings, collages, illustrations, and analysis. While the examples below are visually compelling in themselves, they are also worth reading in more detail:

Alice Ryrie, Virus, 2014/15

Alice Ryrie, Virus, 2014/15

Alice Ryrie, Louise Bourgeois, Art Therapy and the Stream of Unconsciousness, 2014/15

Alice Ryrie, Louise Bourgeois, Art Therapy and the Stream of Unconsciousness, 2014/15

Alice Ryrie, Edvard Munch - Illness & Art, 2014/15

Alice Ryrie, Edvard Munch – Illness & Art, 2014/15

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Alice Ryrie, Facial Symmetry & Health, 2014/15

Alice Ryrie, Homophobia and Blood Donation, 2014/15

Alice Ryrie, Homophobia & Blood Donation, 2014/15

Alice Ryrie, 2014/15

Alice Ryrie, “I smoke for my mental health” – why David Hockney is fighting against anti-smoking campaigns, 2014/15

Alice Ryrie, Public Health Problems, 2014/15

Alice Ryrie, Public Health Problems, 2014/15

Alice Ryrie, Masectomy, Breast Cancer & Narratives, 2014/15

Alice Ryrie, Mastectomy, Breast Cancer & Narratives (1), 2014/15

Alice Ryrie, Mastectomy, Breast Cancer & Narratives (2), 2014/15

Alice Ryrie, Mastectomy, Breast Cancer & Narratives (2), 2014/15

Alice Ryrie, The Nightshade Alkaloids (1), 2014/15

Alice Ryrie, The Nightshade Alkaloids (1), 2014/15

Alice Ryrie, The Nightshade Alkaloids (2), 2014/15

Alice Ryrie, The Nightshade Alkaloids (2), 2014/15

Alice Ryrie, A Day in the Life of a Medical Student..., 2014/15

Alice Ryrie, A day in the life of a medical student…, 2014/15

The journal offered me a way to explore the diversity of medical humanities whilst discovering about my own interests along the way.

All artwork and images © Alice Ryrie.