Music – a key to the Kingdom? A qualitative study of music and health in relation to men and women with long-term illnesses

Trygve Aasgaard

Abstract

There are few studies that have used music as tool in qualitative research by building trust and confidence or create a sympathetic link into the participant’s world of experience and knowledge. This article is based on an action oriented research project involving eight in-depth ethnographic interviews, and open narratives of nine men and thirteen women, aged 35-65 years old, with long-term illnesses. Using CDs as a useful tool in data collecting procedures, and as an introductory gift and participatory ingredient, supported a process of reflection for the participants, helping to evoke memories and establish ‘deep’ rapport between interviewer and participant. U sing CDs as a useful tool in the data collecting procedures, one might secure or achieve quality in qualitative research, by building up trustworthiness, which assists the evaluation of integrity of research evidence and process.

1. Introduction

Few studies have used music as a convenient or useful tool to aid the data collecting process in qualitative research as a way of building trust and confidence or create a sympathetic link into the participant’s world of experience and knowledge – thus facilitating communication and narratives. It is important to provide a safe environment in which the individual can discover the value of self-reflection in-depth interviewing. A few researchers (Plummer, 1983; Covington & Crosby, 1997; Bennet & Maas, 1988; Aldridge, 2003; Ridder, 2004) provide some leads for thinking about music, e.g. CDs as a tool in the data collecting process in fieldwork. T he amount of rich information one might uncover could open up for further probing and exploring in the chosen area of research, thus build up trustworthiness in the research process. Plummer (1983) describes how a record collection is a goldmine of biographical incidents and that many will narrate hugely complex stories. He focuses on how people send letters, take photos, shoot films, make music and try to record their personal dreams. These ‘documents of life’ are a whole battery of research tools, often widely ignored and neglected and which have potential for exploring concrete social experience.

Aldridge (2002) argues that stories are a way of perceiving, feeling, relating and existing. As he says, ‘Our task as researchers is not to impose meaning on to stories, but to allow meaning to become manifest in reality…our task in therapy is to facilitate telling; and then, in research to understand that telling’…(Aldridge, 2002; pp: 101). Ridder (2004) focuses on a clinical strategy for building music therapy sessions with persons who are gradually losing cognitive abilities and suffer from severe neurodegeneration. She points out how certain songs seem to be connected to life stories that represent a certain period in life and trigger memories.

Apart from the in-depth interviews, there are several strategies or tools to aid the data collection processes in qualitative research, i.e. biographies, diaries, records, photos, film, paintings, observations, memos, etc…. using CDs is thus one tool (Stanley, 1992, Charmaz, 2003).

Challenges in qualitative research

Music might be a key to encounter vital challenges in qualitative research. Building trust and confidence in field relations is vital and the quality of the data are linked to the quality of the developing relationship between the researcher and the participants (Bertaux, 1981; Schensul et al. 1999; Snape & Spencer, 2003). Eliciting rich data is a vital aim in qualitative research. The degree to which rich data can be collected is the gold standard for judging the integrity of research evidence and process (Freeman, 1993; Yardley, 2000; Ritchie & Lewis, 2003; Smith, 2003). A related issue is finding the right way into the interviewer situation, one that is sensitive or able to elicit participant-sensibilities. The aim of the life-story interview is to encourage the participants to provide an extended account of their lives and sometimes the participants may be wary and uncommunicative about their everyday experiences. (Stanley, 1992; Charmaz, 2003) Quite often it takes time and effort to win participants confidence, and researchers may strive to create a comfortable, caring, safe and pleasant setting, to facilitate talk about often private and sensitive thoughts, experiences, views and feelings (Miles & Huberman, 1984; Langenberg et al, 1996; Alvesson & Skøldberg, 2000).

In addition, researchers sometimes face the practical problem of sustaining patience and motivation throughout lengthy research process. Listening to the participant’s accounts even if it does not ‘fit’ into the topics of the day, by showing an open attitude and respect for participants being reflective, is part of high quality fieldwork skills ( Ritchie & Lewis, 2003). At the onset of fieldwork, the relationship between an interviewer/researcher and interviewee/participant may be characterized as fairly vulnerable, like having ‘china in ones hand’ – breakable at any moment or with fuss or bustle, precious data might be slipping through the fingers. Trying to connect at the right frequency and carefully treading through the jungle of ‘joint dreams’ might be a complex manoeuvre in social competence, and an extreme sport in social action. After all, producing a ‘story’ is a joint production, as Mishler (1986) observes. The interviewer’s presence and form of involvement – how she or he listens, attends, encourages, interrupts, digresses, initiates topics, and terminates responses – is integral to a respondent’s account. It is in this specific sense that a ‘story’ is a joint production’ (Mishler, 1986: pp 82). Altheide and Johnson (1994) describe criteria for assessing interpretive validity in qualitative research and the challenges posed by seeking to understanding and present various life worlds from participants. They point to how ethnographers must reflect on clarifying the nature, context, process, significance, and consequences of the ways in which human beings define their situations.

Focus of this article

The article discusses how the CD, ‘Keepsakes and Memories’ compiled by the researcher and distributed at the onset of fieldwork, acted as a device that motivated participants, provided a diversion, acted as an icebreaker, triggered memory work and consciousness,and contributed to achieving qualitatively rich information or thick descriptions. This article also discusses the potential benefits of musical narratives affecting the feeling of well-being, particularly when conducted in a safe and secure environment, allowing ventilation of feelings and emotions. Finally, the use of CD listening in conjunction with interviews and narratives may be a useful tool in the data collection procedure, which may be transferable or relevant to music therapists, health professionals or social scientists aiming at exploring connections between or issues covering music, health or illness, and include any topics, which may otherwise have remained inaccessible without reference to music. This may be a way of acquiring and gaining knowledge from a lay-perspective, contributing to an evidence-based knowledge in relation to qualitative research.

Objectives of the study

There are two main objectives of the study: 1. To increase general knowledge in the population as to if, how and why musicking in everyday life can improve quality of life and health situation for the long term ill. 2. What role and significance does music have in the life of long-term ill men and women with long-term illnesses? Further objectives of the study have been to explore connections and relations between music, health and quality of life, to promote health by promoting public participation in cultural activities and to increase knowledge of the ways individuals and groups might improve their health and well being via cultural and specifically musical participation. By the term, ‘increase knowledge’ we mean two things: First, we mean our own knowledge (as researchers) of how music listening and music exchange may foster health promotion. Second, we mean participants’ knowledge: how, through exposure to new musical materials and practices, participants may learn how to engage in self-monitoring and self-care. We have in mind here what might be thought of as a new and informal type of ‘music education’ or musical learning, as discussed by Green (2001). We mean a focus on how the provision and exchange of musical works, styles and genres may allow individuals and groups to develop skills and knowledge about how to use music in their daily lives for enrichment and coping, and as an instrument of change. A further objectives was to examine what type of music seems to be of benefit to whom and why. Our motivation here was not to devise a prescriptive typology of musical ‘cures’, but rather to explore the processes through which research participants come to associate some forms of music with some forms of benefits and to examine their accounts of ‘why’ certain forms of music or musical materials come to ‘work’ for them. We have also been interested in examining the more general question of how participants use music in their everyday lives, for example, what type of music they choose to hear and share and for what reasons.

2. Methodological approach

The study has an explorative approach and can be characterized as an action oriented research project (Smith 2003; Reason & Bradbury, 2001) involving eight in-depth ethnographic interviews, and open narratives of nine men and thirteen women, aged 35-65 years old, using a topic guide, two single albums and four double CDs. Grounded theory was chosen as the methodological approach, since the research questions attempted to explore and describe social processes of illness and health. The major benefit of using grounded theory was believed to be the flexibility of the approach, and its logic and context of discovery and this methodological approach is close to how Charmaz (2000) proposes a constructivist version of grounded theory by assuming that people create and maintain meaningful worlds through dialectical processes. Grounded theory offers a set of flexible strategies or guidelines for doing qualitative research in a systematic way, though grounded theory does not specify suitable data collection methods (Dellve et al, 2002). Rather, data in grounded theory study can come from multiple sources, e.g. participant observations, taped in-depth interviews or diaries. CDs has been used in this study in order to gather thick descriptions of connections between music, health and illness. New probing questions were introduced during the research process, in line with the tradition of grounded theory, in order to clarify and challenge earlier data, and in developing categories and concepts. The coding procedure included open, axial and selective coding, using a word processor to create core concepts and categories.

Participants were initially asked where they would like the interviews to be taken. Some of the participants actually insisted having the interviews in their homes, saying they would feel most comfortable being in a known environment The sample was recruited through four organizations and institutions in Norway; The Nature-Culture and Health Centre (NaCuHeal) in Asker, the Akershus University Hospital, department of Health Promotion, an Art Society in the county of Akershus and a folk Club in Oslo. Two participants were recruited through other participants, i.e. snow -ball effect.

The sample was constructed according to the following terms. Participants are or have been long-term ill due to different illnesses or diseases. The type of illnesses or diseases these men and women have or have had in the past are or have been diagnosed as follows: Two men and three women with muscular disease, one woman has neurological disease, four men and six women with anxiety or depression, three men and two women with chronic fatigue or ’burnt -out syndrome’ and one woman with breast cancer and relational problems. These illnesses represent the major categories of illness in modern societies and are the major contributors to the rising proportion of chronically disabled or long-term certified sick (Tellnes, 2003; Batt-Rawden & Tellnes, 2005).

Further, most of the participants were musically active prior to the start of the study, whether in private situations involving music listening or playing music for self or family, or public situations such as choir, folk-singing, playing in a band. Twelve participants play instruments like guitar, piano, accordion, flute, whistle, African drums and keyboard and sing actively, some also as professionals or semi-professionals. Ten participants are either members of a folk club, or choir, a band or they are active listeners or go regularly to concerts or music festivals.

The Ethics Committee at the University of Exeter in England approved this research in February 2004.

Motivational and empowering devices

Four CD compilations and two single albums were used as motivational and empowering devices and facilitated communication, which supported a process of reflection for the participants, helping to evoke memories. All CDs were given to participants as gifts or keepsakes from this project – a means of showing gratitude to the participants, which is an important component of fieldwork (Spradley, 1976; Whyte, 1984). The participants were asked to choose their own music to go on four CDs, themed ‘Music and its Significance for me’ (CD 2), ‘My Mood’ (CD 3), ‘Feeling at My Best’ (CD 4) and ‘All Time Best’ (CD 5). Each CD was related to their personal experiences, mood, life situations or implications. Who the participants and the mediators are, makes the track list on the CDs personal and individual each time. By making the participants choose their own music, one gets closer to the participants biography and life stories and one’s own musical biography and self-reflexivity (Ritchie & Lewis, 2002; Stige, 2003). The selecting process itself makes the participants reflect on their life situation and experiences.

CD 1: “Keepsakes and Memories”

The first CD compilation ‘Keepsake and memories’ was compiled by the researcher according to the following terms: Four tracks on the CD compilation were considered in relation to the researcher’s own musical childhood memories and events related to ‘happy moments’ through musical practice, the purpose of which was, in the spirit of reflexive research, to provide points of musical sharing and thus, perhaps, sympathetic entry into the participants’ musical worlds. Four main genre/styles were selected to secure a variety that might reflect general musical taste according to age, gender, identity, social background, status group, musical practices, tastes and social location. In general, these genres/styles might be folk/country, classical, popular music, jazz/blues. About two pieces of music from each category were chosen in this project representing different periods in time. Assuming that participants would relate to some of the pieces or genres or that they would remember them from past musical eras and trends, these tracks were included as potential triggers for memory work, and thus as potential prompts for discussion in interview. That said, no information about the content on this first CD was offered, so as to avoid setting up expectations or pre-formed opinions. Sixteen tracks were compiled and given to the participants at the first round of interviews, including questions on listening practices, which was part of the topic guide.

CD 1 ’Keepsakes and Memories’, which is discussed in this article and CD 6 ‘Parting Gift’ were compiled by the researcher. See appendix I

3. Methodological reflections – CD 1 ‘Keepsakes and Memories’

A diversion and an icebreaker?

Since the first CD is part of a practical task, it is a gift that generates the interrelation of giver-receiver. It provides a pretext for further talk, show-and-tell and starts to unfold participant’s interests, opinions, and values at a very early stage. It is believed that the possibility of getting valid and trustworthy data is referred to as the interviewer’s ability to interact in a trustworthy way with the participant (Charmaz, 2000; Dellve et al, 2002). Having a practical task to achieve between us was conducive to a comfortable first situation; the first CD ‘broke the ice’ and facilitated narrative accounting, even before they had listened to it. For example, the participants were asked whether he or she could tell about their musical taste and preferences. Knowing that the CDs would be part of the project, many were already eager to present their personal opinions and experiences with music and several expressed that they had looked forward to the first CD I. Many showed their favourite CDs or some participants asked whether they could play the CD straight away, which we sometimes did. This initiated a warm and personal atmosphere where the participants seemed relaxed, willing and motivated to contribute to the research process at the onset. In field situations where we did not listen to CDs, instruments they used to play were shown to me or sometimes instruments they played regularly were brought forth for inspection and even musical action. On some occasions, where we did not play the CD during the first interview, several of them said they were going to play the CD straight away afterwards and were looking forward to listen to it.

A device that motivates participants?

Meeting the participants in the second round of interviews, they showed an amazing interest in the CD I, which then was a central topic in the guide. It occurred during our discussions, that the way they had used it, liked and disliked some of it or totally fallen in love with pieces of it, had created a huge amount of enthusiasm and dedication to their task of describing their opinions, memories, highlights and experiences in life in general. The enthusiasm the participants had in digging out or searching for a CD on their shelves, or bringing their personal CD portfolio along with them to interviews conducted elsewhere, was also quite remarkable. Several expressed that they had enjoyed the interview, often described as a social – musical meeting, e.g. saying ‘I have not thought about music like this before’, referring to remembered ‘happy times’. One of several participants expressed ‘this has really started a process’ or ‘I am much more aware how I actually use music now’ and relating to why they were moved by certain pieces of music. A fifty-year-old male participant put it this way:

‘I have been quite inspired by this project both to seek out new music and to go and buy some new CDs …so I have bought a new CD now by an artist called Frank Britch, which was quite good and some songs of Sibelius which I think are good and also this CD which I would like to select as a piece to go on the CD 2 (showed a CD of Prokofiev) I just got hold of it, and that is heart music for me…’(we played the CD and we listened for a while).

Trigger memory work and consciousness?

The second round of fieldwork was also much easier to set up due to several factors. The first crucial contact was made. We had talked, laughed, listened and started on the process of building trust and confidence. We had something new to talk about; the CD 1. This made the interviews interactive and dynamic. Very often we listened to the CD again while participants made comments or sometimes we discussed it when we were not able to play the CD during our interview. Sometimes the participants themselves wanted me to get back to certain topics as they felt that their musical memory work had just started and many of them were quite sure that they had several more examples to fetch from their subconscious. Details from past experiences are typically evoked through listening to music and gave the participants strong associations:

‘This project has been so exciting. When I listen to music, particularly music that brings back good memories, I get closer to myself and then I think what I ought to do with my life and how to take care of myself. I think this is due to the fact that we have been talking about music and this has contributed to my process of rehabilitation…’(female, 60, breast cancer)

Another female participant described how her raised consciousness towards music had given her ideas on how to use music in different life situations, e.g. for people dealing with bereavement:

‘I have also been thinking that this project can be very good for people who are in grief or self-help groups dealing with loss or bereavement …perhaps one could initiate musical groups for people with such life crisis…through music they might gain a friend or music itself is also a friend, it is there to give you comfort, peace of mind, relaxation, you can retrieve memories, you can dance to it, well, there is so much to get hold of through music, and all this I would not have known without this consciousness towards music…’(female, age 52, on rehabilitation for about two years from a burn-out, just started to work part-time)

A method for achieving qualitatively rich information?

Ruud (1997, 2000, 2002, 2005) describes how music can be provider of vitality and help us to experience emotional nuance and to maintain precise concepts of feelings. This may be considered as having the ability to open oneself toward the world, to other people and to oneself. Vitality can imply our ways of activating a certain range of our feelings, how we integrate our experiences and express them clearly. To acquire these emotional resources is an important part of health, in sense of having a strong and resistant self. Ruud also claims that we can find narratives where people reveal several instances of music being used as a source of activation of feelings, of clarification and expression. In this way, music provides a means for achieving qualitatively rich information on the experiences of illness and reflections upon the way they live or have lived their life and deep thoughts and reflections about what the future might bring and how they might improve their experiences through music. The typical descriptions of the outcome of participation were substantiated in an increased self-awareness and consciousness towards life changing issues, events, memories and habits, where music had played a key role in their lives:

‘I have gained a better well-being by partaking in this project…I have become much more conscious about what music gives me…I feel I can enjoy music now at a different and more conscious level…’(female, age 50, long term certified sick for about two years due to anxiety and depression)

Through the intimate frame given by musical activity, researchers and participants are bound together through common musical experiences. By using music in a study of the narrative accounts one might start a process of reflection for both the participants and the researcher. Sloboda and O`Neill discusses the role of emotional ‘work’ in relation to music, which takes into account individual subjective experiences as they occur in everyday evolving situations:

Music becomes part of a construction of emotional feelings and displays that are both reflective and communicative ‘embodied’ judgements used to accomplish particular social acts. In other words, musical emotions are a form of social representation, which is negotiated as an interaction between cultural/ideological values of society, the values and believes operating in a social grouping or subculture in that society, and the individual’s own social and personal experiences (Sloboda and O`Neill, 2001: pp 427).

4. Discussion

In qualitative studies the role of the researcher is important to reflect and consider, even in action oriented research projects the observer effect, e.g. the researchers gender, age and personal characteristics need to be taken into account ( Schensul et al., 1999; Spradley, 1979; Reason & Bradbury, 2001; Smith et al. 1997). It is necessary to consider that one of the aims of this study was how music listening and music exchange might have fostered health promotion, thus the role of the researcher was an active participant, enforcing the interactive, dialectical and empowering elements throughout the yearlong research process. The interviews also generated emotions and feelings both from the researcher and the participants. The positive and beneficial results might be interpreted as the participants` own interest to create optimal results, for example ‘this has really been fun’, or ‘this has been so rewarding’ and ‘interesting’ as to please the researcher. From another point of view, we have an impression that the participant’s beliefs and opinions were genuine and real, particularly due to the fact that each participant was interviewed eight times, contributing to securing the trustworthiness of the study. Using CDs as a participatory ingredient might have contributed to continuous participation, i.e. no drop-outs, and supports a major finding that participants were all looking forward to each social-musical meeting, thus finding it worthwhile to participate. The positive outcome of participation could also be substantiated as being a buffer for loneliness and experiences of life complications, thus giving participants a predicative ritual to look forward to, as a substitute for close networks and relations with music as a salutogenetic way to promote their health and well-being (Antonovsky, 1987, 1996). See references: Batt-Rawden & Tellnes, 2005a.

Recruiting participants

A challenge in qualitative methods dealing with personal opinions and experiences is sometimes the difficulty of recruiting participants which represent characteristics that are relevant for research focus (Bertaux, 1988; Schensul et al., 1999). In this respect, criteria of selection has been to choose a strategic sample, i.e. that are both willing and motivated to spend time talking to you throughout a yearlong dedication. Another methodological implication is that we do not know how the participants ability or willingness to communicate would have progressed if we had not used CDs as a tool or gift to aid the data collecting process or procedures, thus facilitating communication by building trust and confidence. Another aspect is that we do not have any data on persons who did not participate in this study, thus important patterns and tendencies belong to this population in this research. On the other hand, this research design is transferable and relevant to other researches that might like to conduct or initiate similar projects on different populations in the future.

A comfortable and pleasant atmosphere?

The CD ‘Keepsakes and Memories’ seemed to act as an icebreaker and motivational device in this field setting. In addition, the CD created a comfortable and pleasant atmosphere, which seemed to build up trust and confidence, which is vital in qualitative research (Miles & Huberman 1984; Langenberg et al., 1996; Alvesson & Skøldberg, 2000).Referring to music may also create narratives that bring order and meaning into participant’s lives (Aldridge 2002) by constructing a sense of coherence (Antonovsky, 1987, 1996) providing self-reflexivity or structure the participants sense of selfhood, particularly in relation to illnesses and life complications (Radley, 1993, 1994; Wheeler, 1995, Yardely, 1997; Williams, 2003, Williams et al 2003; Charmaz, 1991, 1999). Bennet and Maas (1988) have described the usefulness of music-based life-review as a technique for improving personal adjustment in elderly people. They suggest that music-based life review is more effective in promoting life satisfaction than verbal life review. The willingness to participate in the life review programme was enhanced when they were offered music. Music can help establish a relaxed non-threatening environment conducive to the thinking through life events, changes and conflict. Bailey and Davidson (2004) have described how group singing appears positively to influence emotional, social and cognitive processes in ways that stimulate participants. The choristers perceived that singing in the choir offered an opportunity to explore emotions that had been buried for many years. This sense of well being may contribute to the subjective feeling of quality of life as defined by the participants themselves (Ruud, 1997, 2002, 2005).

Musical narratives – health promoting?

Musical narratives seemed to play a vital role in the participants’ everyday life relating to memories of happy times and meaningful moments, which created access routes into emotions and feelings, providing qualitatively rich information. Aasgaard (2004, 2005) argues how important it is to experience and look forward to occasional pleasurable and enjoyable moments for people being ill and a healthy environment is one that fosters growth and creativity. In this perspective, narratives in a comfortable and safe field setting, with music on the agenda, may promote health or well-being. Health may in this context be defined as having as little illness as possible while having the energy to cope with the tasks and challenges of everyday life (Tellnes, 2004). Radley ( 1994) focuses on how the maintenance of health and the successful alleviation of suffering, require that practitioners understand how these things are woven together in the lives of the people concerned. Aldridge describes how absence of symptoms, coupled with a zest for living appear to play a significant role in the subjective assessment of health: “ Music has a vast potential for pleasure…and a little bit of fun is a powerful medicine…” (Aldridge, 1996: pp 283).

The CD might have been a contributing factor in helping to uncover or explore new or hidden topics or issues on health and illness, through reference to their own personal music or musicking, thus increasing their consciousness and emotional competence. Several connections and patterns between music and health were detected and explored. Vital factors concerning how music seemed to work for different participants’ were described as strength, energy and comfort to carry on, in spite of their illnesses. In addition, the CD gave participants strong associations with other type of music that had been of great significance to them in their lives. Several reported feelings of recovering, when music acted as a strong medium to closer contact with their emotions, particularly through their own musicking, i.e. playing or singing. This illustrates how music is used to re-establish wholeness between mind and body, making them feel healed (Gouk, 2002; Bührman, 1986; Aldridge, 2002). Covington & Crosby (1997) discusses how music is a tool that facilitates exploration and ventilation of feelings. Music can serve as an avenue for determining issues for therapy that might otherwise remain closed. By using music as a therapeutic tool, the pschyciatric nurse can facilitate positive patient outcomes.

Music and its qualities

Music is universal. Humans can relate to music whatever their race, ethnic origin, culture, age, disability, class, religion, sexual orientation, education, experiences, opinions and beliefs (Aldridge, 2004). For centuries music has been recognized for its therapeutic properties in healing the body and mind (Gouk, 2002; Bührmann, 1986). Music interventions have been referred to as the marriage of science and art for the purpose of healing (White, 2001) Music is said to empower us by providing materials against or with which we find capacities and inclinations for feeling, doing and thinking (DeNora, 2000, 2002). DeNora discusses how music creates an emotional and cognitive context that is conductive to a feeling of well-being, a state of alertness or relaxation in accordance with the needs of the situation. Music is present in a variety of social and personal context where mood is regulated, attention focused, energy channelled:

Music can be used as a device for the reflexive process of remembering /constructing who one is, a technology for spinning the apparently continuous tale of who one is (DeNora: 2000: pp 63).

By using music in a study of the narrative accounts one might start a process of reflection for both the participants and the researcher (Stige, 2003). Music might then be a useful and constructive tool that connects to a more open, reflexive and interactive process that gently and carefully can build up the first vulnerable and susceptible field contact. Blacking (1973) argues that music is not only reflexive; it is also generative, both as a cultural system and as human capability. Music can also be a tool for developing agency and empowerment. An important goal in changing the life style of people leading to greater self-management of health has to be directed towards the individual and his sense of agency, of being responsible for his or hers actions. Through decoding the semiotics of music we gain social resources and increase our basic social competency (DeNora, 1999, 2000; Ruud, 2002, 2005).

Final comments

Since music, life and health seems to be so closely linked and interwoven, the use of music, i.e. CDs in conjunction with qualitative interviewing or narratives might also produce a musical identity (Ruud, 2000), which can be viewed as a social and cultural capital (Bourdieu, 1984; Shepard & Wicke, 1997) that enables participants to connect their lives to sequences of events and aspects that gives a salutogenetic effect (Antonovsky, 1987, 1996) and produce ontological security (Giddens, 1991). Using CD as a tool or gift did create sympathetic links into the participant’s world of experience and knowledge, which might inspire further research into topics on music, health and illness in different cultural or sub-cultural settings. Using the CD supported a process of reflection for the participants, helping to evoke memories associations. In this respect, one might argue for a possible heightened quality of the relationship between the researcher and the participant, contributing to establish ‘deep’ rapport or thick descriptions. (Morse, 1995; Charmaz, 1999; Murray, 2003). Perhaps by using CDs as a useful or convenient tool during the data collection process in fieldwork, one might secure or achieve quality in qualitative research, by building up trustworthiness or credibility, which is vital for the evaluation of integrity of research evidence and process.

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Appendix

CD 1 ‘Keepsakes and Memories’ (compiled by the researcher in following order:)

Max Bruch,: Violin concert in g-minor. (Classical)
Mary Black: Holy Ground (Traditional/folk)
Blues Brothers: Give me some lovin` (Blues)
Dire Straits/Mark Knopler: Brothers in Arms (Pop)
J.S Bach: Orchestra suite no. 3 in D-major. Air. (Classical)
Eva Cassidy: Fields of Gold (Pop)
George Bizet: Pearl fishers (Classical)
Garth Brooks: If tomorrow never comes (Country)
Loreena Mckenitt: Skellig (Folk)
Otis Reading: Sitting in the dock of the bay (Blues)
Moody Blues: Nights in White Satin (Pop)
G.F Händel: Xerxes: Largo (Classical)
Celtic Circle : Theme from Brave Heart (classical/folk)
Dolly Parton: Jolene (Country)
G. Verdi: Nebukanesar, Va pensiero (Classical)
Celtic Circle : An air from Brittany (traditional/folk)