Connection musicians in hemodialysis: a starting point for training musicians and interdisciplinary practice oriented to hospital environment humanization

• Grant number: 12/20784-3
• Support Opportunities: Regular Research Grants
• Start date: April 01, 2013
• End date: March 31, 2015
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Fernando Antonio de Almeida
• Grantee: Fernando Antonio de Almeida
• Host Institution: Faculdade de Ciências Médicas e da Saúde (FCMS). Pontifícia Universidade Católica de São Paulo (PUC-SP). Sorocaba , SP, Brazil

Abstract

Chronic kidney disease (CKD) is a major public health problem in Brazil and worldwide. At end-stage kidney disease (ESKD) life can only be maintained by renal replacement therapy (hemodialysis, peritoneal dialysis or kidney transplant). CKD is accompanied by high morbidity and mortality, leading to substantial loss of productive years of life and enormous expenditures for the Unified Health System (SUS) and health insurance. Today there are more than 95,000 individuals on dialysis in Brazil, 90% undergo four-hour sessions, three times a week in hemodialysis centers. In addition to the symptoms of the disease, individuals with ESKD need many adjustments in their personal, familiar and social relationships, compromising their emotional state and quality of life. The perspective of an incurable disease and the proximity of death, produce complex psychological disorders in a cycle of negative events that permeate their lives and their families. The proposed work of Connection Musicians in hospital environments, a successful experience in various geriatrics, palliative care and pediatrics units of hospitals in Europe, meets the needs of hemodialysis patients. Exposing hemodialysis individuals to the presence of Connection Musicians and their music, we will rescue them from their condition of deep concern, anxiety and dependence on the dialysis machine. Involving them in the musical act we will rescue positive feelings and harmonious past experiences away from the worry and the shadow of death. Healthcare professionals from the center of hemodialysis and patient's family members are also targets of the acting musicians, creating a friendly and reliable working atmosphere. This humanizing action in the environment of hemodialysis will result in an improvement of psychological conditions, perception of health and quality of life for patients and their families. The work of the Connection Musicians differs from the approaches of other musicians who work in hospitals. It differs from those of music therapists, who seek to participate in the therapeutic process, but are also somewhat close as they aim at patient's psycho-affective well-being. Connection Musicians do not concentrate only on patients, but on the service as a whole, targeting their performances on all present persons, the "soundscape" in its relational dimension.Connection Musicians differ from musical entertainers because their work methodology incorporates various dimensions of nonverbal communication in the kinesics, proxemics and tacesics dimension, because it is known that only 7% of the thoughts and emotions are conveyed by words. They also differ from musicians doing shows or concerts in hospitals, because they consider themselves interlocutors, partners and not professionals who try to draw attention in order to show their musical abilities. Their musical interventions are built in a consistent, sophisticated, ethical and philosophical position whose propose is to rescue the centrality of each person present in the institutions, including their own! The Connection Musicians are experienced professionals who receive theoretical and practical training for a year. Prof. Flusser, created the first university degree for Connection Musicians in Europe at Strasbourg University. With his collaboration the Faculdade de Ciências Médicas e da Saúde - PUC/SP, campus of Sorocaba, may offer the first training course of Connection Musicians in Brazil, a pioneering of interdisciplinary work involving culture and health professionals in humanization projects.Thus, the central aim of the project is to train professionals (Connection Musicians) to intervene in the process of humanization of hemodialysis centers and other areas of hospital care and to spread this work regionally. Video documentaries will be instrumental for the dissemination of the work in national and international nephrology conferences and multidisciplinary meetings, amplifying the results. (AU)