The most often described subjective experiences of patients were relaxing and calming effects, sensations that the body feels lighter, and the provocation of peaceful images or visualizations. Family members enjoyed listening to the music and in doing so felt more connected with their sick family members. Seen in the context of the growing body of studies on music therapy in palliative and cancer care this study is the first to explore therapeutic experiences with the Body Tambura in a stationary hospice setting.
Patients included in this study suffered from cancer and were in a progressed stage of end of life care. They were not able to participate in the interviews for more than 5 to 15 minutes. Furthermore, the ability to explain experiences was limited, especially in those patients with brain metastasis. Although the verbal communication was restricted to a few minutes, the data was homogeneous enough to see a consistent picture that highlights that patients and their relatives felt more relaxed, experienced pleasant images and experienced a change of body sensations.
A clear limitation is the fact that the sample is relatively small and we did not use a control group for comparison. Therefore, our results must be interpreted with caution and should be used to develop hypotheses for a larger trial combining qualitative and quantitative research. The four themes “feeling of relaxation”, changes in body sensation”, “images and visualizations” and “connecting to family” could clearly be coded and summarized from the patients’ narrations. However, the data did not allow us to generate further hypotheses regarding other treatment experiences. We believe that our data covers the most important experiences, but of course, the inclusion of more patients in future trials might reveal additional relevant experiences.
It is important to understand, that the applied music therapy was fully passive and receptive. Active participation of the patient (e.g. singing, playing an instrument) was not necessary. Given the fact that the Body Tambura is easily applied, the therapy itself is very well suited for the needs of patients in hospice settings. The nursing staff of the Berlin hospice asked to be trained in playing the Body Tambura after completing the study and were taught how to apply the instrument in a weekend workshop. Treatments with the Body Tambura are now regularly offered in the hospice by nurses and are very popular.
From this qualitative data we were able to generate the following hypothesis: Music therapy with the Body Tambura might help end of life patients to relax, to feel positive body sensations, to have positive images or visualizations, and to connect with their families and friends while sharing the experience of the instruments’ sound. In future quantitative confirmatory studies, simple measurements assessing relaxation, stress, quality of life and well-being could be used and a routine therapy group or another active treatment group such as therapeutic touch or empathic listening could be used as a comparison.
It is worthy of note that the reported positive effects of the Body Tambura could have been a result of the music itself, the fact that someone was attending the patient, the therapeutic relationship or the expectations generated by the therapist’ explanations of the therapy , or most likely a combination of such aspects. However, what remains paramount and unique to the Body Tambura is the harmonic acoustic space created by the instrument and the vibrations felt on the patients’ body. Both, acoustic and sensory stimulation in combination with the suggestions of the music therapists might be able to induce a trance like state of relaxation comparable to hypnotic relaxation . This hypothesis is supported by the research of Zeigert  who reviewed the existing therapeutic evidence and experience with the Body Tambura. According to his research, the intervention could be understood as a form of vibroacoustic therapy that combines hearing (auditory perception) with the perception of vibrations (somatosensoric perception of pressure, touch and vibration) that may induce a state of kinesthetic trance and relaxation.
Although this was reported in other studies we were not able to determine if the Body Tambura had a positive influence on pain, as our patients did not suffer from pain at the time the intervention was delivered. One explanation for this phenomenon might be that the hospice staff selected only patients to participate who were not suffering from pain at the time of the study.