The Effect of Combination of Healthy Sleep Education and Music Therapy on the Functional Status of Children with Cancer


  • Syalvia Oresti Faculty of Applied Science, Lincoln University College, 47301 Petaling Jaya, Selangor, Malaysia ; Stikes Alifah Padang, West Sumatra, Kota Padang, Sumatera Barat 25134, Indonesia
  • Gusni Rahma Faculty of Applied Science, Lincoln University College, 47301 Petaling Jaya, Selangor, Malaysia
  • Fatmi Nirmala Sari Faculty of Applied Science, Lincoln University College, 47301 Petaling Jaya, Selangor, Malaysia
  • Asita Elengoe Faculty of Applied Science, Lincoln University College, 47301 Petaling Jaya, Selangor, Malaysia



Introduction: Cancer refers to the uncontrolled growth and reproduction of abnormal cells in the body as a whole. Sufferers will experience physical and psychological disorders in the form of feelings of sadness and depression, which cause a loss of ability to live daily life. The prevalence of cancer patients on chemotherapy at Dr. M. Djamil Padang Hospital has increased from 135 in 2019 to 170 in 2020 (21% increase). The side effects of chemotherapy are sleep disturbances, fatigue, and decreased functional status. Objective: This study aims to determine the effect of the combination of providing healthy sleep education and music therapy on the functional status of children with cancer to minimize the side effects of chemotherapy. Methods: The research design was a quasi-experimental pre-post-test with the control group. The sample consisted of 60 children, who were divided into a control group (n = 30) and an intervention group (n = 30). Three consecutive days were devoted to the intervention. Measurement of functional status scores using the Activity Daily Living Barthel Index questionnaire. Differences in functional status scores of each group were tested with a dependent T-test, and differences in functional status between the control and intervention groups were tested with independent T-tests used in this study. Results: The results of statistical tests showed that there was a significant difference in the mean score of functional status before and after giving sleep education and music therapy between the intervention group and the control group (p = 0.0005). Conclusion: Combining healthy sleep therapy and music therapy can be an option for independent nursing care for children with cancer as a way to combat the side effects of chemotherapy.


Cancer, Functional Status, Healthy Sleep Education, Music


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Allenidekania, A., Nurachmah, E., Rustina, Y., & Eryando, T. (2017). Implementation of fatigue management model to quality of life in children with cancer: Indonesia experience. Support Care Cancer, 25(2), 128-142.,%20MASCC%202017.pdf

Astuti, A., Yayah, Y., & Nurhaeni, N. (2021). Music Therapy on the Quality of Life of Sick Children: A Literature Review. Journal of Holistic Nursing Science, 8(1), 89-104.

Barrera, M. E., Rykov, M. H., & Doyle, S. L. (2002). The effects of interactive music therapy on hospitalized children with cancer: a pilot study. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 11(5), 379-388.

Barry, P., O'Callaghan, C., Wheeler, G., & Grocke, D. (2010). Music therapy CD creation for initial pediatric radiation therapy: A mixed methods analysis. Journal of Music Therapy, 47(3), 233-263.

Bilgiç, Ş., & Acaroğlu, R. (2017). Effects of listening to music on the comfort of chemotherapy patients. Western Journal of Nursing Research, 39(6), 745-762.

Cheung, A. T., Li, W. H. C., Ho, K. Y., Lam, K. K. W., Ho, L. L. K., Chiu, S. Y., ... & Chung, J. O. K. (2019). Efficacy of musical training on psychological outcomes and quality of life in Chinese pediatric brain tumor survivors. Psycho‐Oncology, 28(1), 174-180.

Cox, L. E., Kenney, A. E., Harman, J. L., Jurbergs, N., Molnar Jr, A. E., & Willard, V. W. (2019). Psychosocial functioning of young children treated for cancer: Findings from a clinical sample. Journal of Pediatric Oncology Nursing, 36(1), 17-23.

Ellul, J., Watkins, C., & Barer, D. (1998). Estimating total Barthel scores from just three items: the European Stroke Database ‘minimum dataset’for assessing functional status at discharge from hospital. Age and Ageing, 27(2), 115-122.

Eseadi, C., & Ngwu, M. O. (2023). Significance of music therapy in treating depression and anxiety disorders among people with cancer. World Journal of Clinical Oncology, 14(2), 69.

Fedhila, F., Hannachi, M. W., Jbebli, E., Selmi, I., Rhayem, S., Magouri, I., ... & Khemiri, M. (2023). Impact of music therapy on quality of life in children with cancer. Children, 10(9), 1486.

Ferguson, Y. L., & Sheldon, K. M. (2013). Trying to be happier really can work: Two experimental studies. The Journal of Positive Psychology, 8(1), 23-33.

Fernandes, A. (2020). Fatigue in Children with Acute Lymphoblastic Leukemia Undergoing Induction Phase Chemotherapy. Jurnal Kesehatan Perintis, 7(1), 69-74. . Accessed on 10th September 2022.

Fernandes, A., & Andriani, Y. (2021). Factors that Influence the Occurrence of Sleep Disorders in Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy. Jurnal Keperawatan Silampari, 5(1), 196-206.

Franco, J. H. M., Evangelista, C. B., Rodrigues, M. D. S. D., Cruz, R. A. D. O., Franco, I. D. S. M. F., & Freire, M. L. (2021). Music therapy in oncology: perceptions of children and adolescents in palliative care. Escola Anna Nery, 25.

González-Martín-Moreno, M., Garrido-Ardila, E. M., Jiménez-Palomares, M., Gonzalez-Medina, G., Oliva-Ruiz, P., & Rodríguez-Mansilla, J. (2021). Music-based interventions in paediatric and adolescents oncology patients: A systematic review. Children, 8(2), 73.

Götte, M., Taraks, S., & Boos, J. (2014). Sports in pediatric oncology: the role (s) of physical activity for children with cancer. Journal of Pediatric Hematology/Oncology, 36(2), 85-90.

Hatipoglu, Z., Gulec, E., Lafli, D., & Ozcengiz, D. (2018). Effects of auditory and audiovisual presentations on anxiety and behavioral changes in children undergoing elective surgery. Nigerian Journal of Clinical Practice, 21(6), 788-794.

Hendon, C., & Bohon, L. M. (2008). Hospitalized children's mood differences during play and music therapy. Child: Care, Health and Development, 34(2), 141-144.

Heryyanoor, H., Muhsinin, M., Rahmawati, R., Patarru, F., Secsaria Handini, F., & Yosepfus Weu, B. (2019). Music therapy and bibliotherapy to reduce child anxiety when given intravenous therapy. Jurnal Ners, 14(3si), 345-353.

Hooke, M. C., & Linder, L. A. (2019). Symptoms in children receiving treatment for cancer-Part I: Fatigue, sleep disturbance, and nausea/vomiting. Journal of Pediatric Oncology Nursing, 36(4), 244-261.

Indonesia Cancer Care Community (2022). Cancer in Children. Sekilas Kanker, 1. . Accessed on 11th September 2022.

Islaeli, I., Said, F. M., Nambiar, N., & Umar, N. S. (2023). Development and Validation of a Revised VAS-Anxiety Measurement Tools for Preschool Hospitalized Children. The Malaysian Journal of Nursing (MJN), 14(3), 46-54.

Jepsen, S. L., Haahr, A., Eg, M., & Jørgensen, L. B. (2019). Coping with the unfamiliar: How do children cope with hospitalization in relation to acute and/or critical illness? A qualitative meta synthesis. Journal of Child Health Care, 23(4), 534-550.

Johnson, A. A., Berry, A., Bradley, M., Daniell, J. A., Lugo, C., Schaum-Comegys, K., ... & Whalen, M. (2021). Examining the effects of music-based interventions on pain and anxiety in hospitalized children: An integrative review. Journal of Pediatric Nursing, 60, 71-76.

Medical Records Department of Dr. RSUP. M. Djamil (2021). Children's Cancer Medical Records Data. Padang: RSUP Dr. M. Djamil. Accessed on 12th December 2022.

Mofredj, A., Alaya, S., Tassaioust, K., Bahloul, H., & Mrabet, A. (2016). Music therapy, a review of the potential therapeutic benefits for the critically ill. Journal of Critical Care, 35, 195-199.

Nguyen, T. N., Nilsson, S., Hellström, A. L., & Bengtson, A. (2010). Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial. Journal of Pediatric Oncology Nursing, 27(3), 146-155.

Ningsih, E.W. (2015). The influence of play therapy on the anxiety of children undergoing chemotherapy. Coping Community of Publishing in Nursing, 3(1). Accessed on 12th December 2022.

P2PTM Republic of Indonesia Ministry of Health (2019). Ministry of Health. What is Cancer? Indonesian Ministry of Health (2019). . Accessed on 12th September 2022.

Polat, S., Gürol, A., Çelebioğlu, A., & Yildirim, Z. K. (2015). The effect of therapeutic music on anxiety in children with acute lymphoblastic leukaemia. Accessed on 10th September 2022.

Ramanda, S., Milyartini, R., & Latifah, D. (2022, June). The effect of music therapy on children with cancer patients. In 4th International Conference on Arts and Design Education (ICADE 2021) 270-281. Atlantis Press.

Raphael, J., Hester, J., Ahmedzai, S., Barrie, J., Farqhuar-Smith, P., Williams, J., ... & Sparkes, E. (2010). Cancer pain: part 2: physical, interventional and complimentary therapies; management in the community; acute, treatment-related and complex cancer pain: a perspective from the British Pain Society endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners. Pain Medicine, 11(6), 872-896.

Riskesdas. 2018 Basic Health Research Results (2018). Kementrian Kesehatan RI, 53(9), 1689-1699.

Rustam, J. S., Makmee, W., Jugjali, R., & Kongsuwan, W. (2018). Implementation of innovative nursing care program for relieving discomfort in mechanically ventilated patients: an exemplar in practice. The Malaysian Journal of Nursing (MJN), 9(3), 34-44. . Accessed on 30th April, 2017.

Sriasih, N. K, Allenidekania, Wanda, D., Agustini, N., & Nurhidayatun. (2018). The effectiveness of sleep hygiene education and music therapy combination on fatigue, sleep quality, and functional status on children with cancer in shelter homes. Fakultas Ilmu Keperawatan Universitas Indonesia. Accessed on 12th September 2022.

Standley, J. M., & Hanser, S. B. (1995). Music therapy research and applications in pediatric oncology treatment. Journal of Pediatric Oncology Nursing, 12(1), 3-8.

World Health Organization (WHO) (2020). WHO Global Initiative for Childhood Cancer. World Health Organization, 5(4), 145-50.

World Health Organization (WHO) (2022). Non-communicable Diseases. Accessed on 10th December 2022.

Yi, Y., Ding, L., Wen, H., Wu, J., Makimoto, K., & Liao, X. (2020). Is Barthel index suitable for assessing activities of daily living in patients with dementia? Frontiers in Psychiatry, 11, 282.

Yu, C. H. (2010). Exploratory data analysis in the context of data mining and resampling. International Journal of Psychological Research, 3(1), 9-22.

Zang, L., Cheng, C., Zhou, Y., & Liu, X. (2023). Music therapy effect on anxiety reduction among patients with cancer: A meta-analysis. Frontiers in Psychology, 13, 1028934.



How to Cite

Oresti, S., Rahma, G. ., Sari, F. N. ., & Elengoe, A. . . (2024). The Effect of Combination of Healthy Sleep Education and Music Therapy on the Functional Status of Children with Cancer. The Malaysian Journal of Nursing (MJN), 15(3), 81-89.