Features

Singing their way to better health

Three practice nurses with a passion for singing started a group for people with COPD – with astonishing results.
Cheyne Gang Choir

Three practice nurses with a passion for singing started a group for people with COPD with astonishing results

Theres a good reason why I Can Breathe Clearly Now is the signature tune of Edinburgh-based singing group The Cheyne Gang.

The group adapted the 1972 Johnny Nash classic I Can See Clearly Now to reflect the fact that its members have breathing problems and that taking part is proving beneficial for their breathing and overall health.

The Cheyne Gang was the brainchild of three practice nurses Pauline Waugh, Sarah Marshall and Anne Ritchie who decided to set up a small trial to see if singing in a group would benefit their patients with chronic obstructive pulmonary disease (COPD).

Having won funding from the Queens Nursing Institute in Scotland, the nurses recruited eight patients

...

Three practice nurses with a passion for singing started a group for people with COPD – with astonishing results

sing1
The Cheyne Gang. Picture: Colin Hattersley

There’s a good reason why I Can Breathe Clearly Now is the signature tune of Edinburgh-based singing group The Cheyne Gang.

The group adapted the 1972 Johnny Nash classic I Can See Clearly Now to reflect the fact that its members have breathing problems – and that taking part is proving beneficial for their breathing and overall health.

The Cheyne Gang was the brainchild of three practice nurses – Pauline Waugh, Sarah Marshall and Anne Ritchie – who decided to set up a small trial to see if singing in a group would benefit their patients with chronic obstructive pulmonary disease (COPD).

Having won funding from the Queen’s Nursing Institute in Scotland, the nurses recruited eight patients via their annual COPD review at their GP practice to take part in a ten-month feasibility study.

Performing for audiences

The results were so positive – and the patients so enthusiastic – that the singing group has now become established and expanded. It has performed for a variety of audiences from a conference of practice nurses last year to a pop-up concert in August on the margins of the Edinburgh Festival Fringe, accompanied by the Ricciotti Ensemble, a youth orchestra from the Netherlands.

The three nurses were all interested in singing and sang in community choirs, explains Ms Marshall, who now works in Armadale, West Lothian, so were keen to be involved. ‘After the research went so well, the patients were interested in keeping it going, so we managed to find some funding and we’re now a charity, able to fundraise.’

The original group of eight patient members has now grown to around 60, who meet in three groups once every two weeks in different locations in Edinburgh. A fourth group is due to start next year. Led by a professional voice coach, the groups undertake around 20 to 30 minutes of breathing exercises, followed by singing, and then a cup of tea and a chat.

‘People with COPD can feel isolated by their breathlessness, so improving their breathing means they can go out more’

Sarah Marshall

There is always a nurse present, says Ms Marshall – if she, Ms Waugh or Ms Ritchie, who is now retired, are unable to attend, there are two retired nurses who go along to ensure that clinical expertise is there if needed.

Ms Waugh was inspired to explore the issue after reading about research conducted in Canterbury that showed singing groups were beneficial for COPD.

The Edinburgh study collected data to determine physical, mental and social benefits that the participants achieved over ten months, attending two sessions per month. The results were positive. Five of the eight participants reported improved quality of life, while one stayed the same. The two whose score worsened had developed other medical problems not attributed to their COPD.

The main themes that emerged were that participants' sleep improved, they appreciated the companionship, experienced improvement in mood and their physical health got better too. One said: ‘Normally I’d be up at the health centre three or four times in the winter. I’ve not been once since starting the choir.’

Social benefits

There were also unexpected benefits, says Ms Marshall, such as choir members supporting each other with smoking cessation, anxiety management and family issues.

‘We were looking for physical benefits, such as people needing to use their inhalers less, fewer hospital admissions and fewer exacerbations. We gained all that, but there were also huge psychological benefits.

‘People with COPD can feel isolated by their breathlessness, so improving their breathing means they can go out more – and of course the social dimension of the choir practices is also important.’

Mags Laurence, a retired data processor, was one of the original members. Since joining, she has stopped smoking and seen her lung capacity improve from 69% to 84%. ‘It gives you a real life – you invariably come out of the choir practice smiling and laughing,’ she says.

‘Singing for lung health helps to increase lung capacity and strengthens the muscles, resulting in more confident and controlled breathing’

Irene Johnstone

These emotional benefits come as no surprise to Lynne Paterson, a keen member of the Forth Valley Nurses Choir, who recommends singing in groups for nurses as well as patients.

‘We all work full-time, or nearly full-time, and it can be hard to go to choir practice after a busy day. But at the end of the evening, our stress levels are down and we feel so much better – singing in a choir really gives you a lift. Reaction from audiences is also really positive.’

The Cheyne Gang also appreciates audience response. At the recent Edinburgh performance with the Ricciotti Ensemble, one enthusiastic listener was Scotland’s chief medical officer Catherine Calderwood, who later tweeted that ‘their singing was fantastic and they told me how much their breathing had improved – they have data – as well as making new friends’.

The Cheyne Gang also won the ‘accessibility’ category in the inaugural Chorus Community Music Awards 2017.

sing
The Cheyne Gang in concert in Edinburgh with Dutch youth
orchestra Ricciotti Ensemble. Picture: Colin Hattersley

Word about the benefits of singing is spreading. ‘There is increasing evidence that singing regularly, as part of a group, can help people with lung conditions physically, psychologically and socially,’ says Irene Johnstone, head of British Lung Foundation Scotland.

‘Singing helps with deeper and more controlled breathing. Someone with an obstructive airways disease, such as COPD, will often need to take constant top-up breaths from their upper chest.

‘Singing for lung health helps to increase lung capacity and strengthens the muscles, resulting in more confident and controlled breathing. Patients consistently report singing for breathing helps them cope with their lung condition better.’

Ms Waugh says: ‘I feel very proud of what we’ve achieved, and what The Cheyne Gang has achieved,’ she says. ‘Just to see the smiles on people’s faces after performances and practices is wonderful.’

‘Everyone should do it’

When Lenny Love was asked if he’d like to take part in a study to help fellow patients with breathing difficulties, his response was ‘why not?’. Some four years later, he remains a central member of the Cheyne Gang singing group – and is keen to extol the benefits.

‘I have COPD, and my lung capacity is around 60%,’ he explains. ‘I have breathing difficulties – I get breathless very quickly.

‘When my practice nurse, Pauline Waugh, asked me if I’d help with the experiment, I thought I’d give it a try, and I’m very glad I did.’

Mr Love, from Edinburgh, was one of the first eight members of the singing group, and has nothing but thanks and praise for the practice nurses who set it up.

‘I have seen definite benefits. My latest check showed that my lung capacity hadn’t deteriorated, which is fantastic, and I’m not using my inhalers as much.’

Great fun

He admits he was sceptical at first about learning breathing exercises. ‘I thought that I knew how to breathe – breathe in, breathe out,’ he laughs. ‘But I learned it was more complicated than that. Now I do the breathing exercises all the time, when I’m on my motorcycle sitting at traffic lights, or at home watching television.’

Mr Love, who won a Sony award as a DJ (his Sunday night programme on Radio Forth in the 1990s was called The Love Groove) says the social aspects of the group are also beneficial. ‘I’m not saying we’re in and out of each other’s houses, but we look out for each other,’ he says.

‘And the performances are great fun. We don’t do anything left field – there’s no Ramones or Sex Pistols, although I would love that. We get together and sing popular songs, and it benefits our health and our breathing. I think everyone should do it.’


Jennifer Trueland is a freelance health journalist

For further information about the British Lung Foundation’s singing for lung health groups click here

Want to read more?

Subscribe for unlimited access

Enjoy 1 month's access for £1 and get:

  • Full access to nursing standard.com and the Nursing Standard app
  • Monthly digital edition
  • RCNi Portfolio and interactive CPD quizzes
  • RCNi Learning with 200+ evidence-based modules
  • 10 articles a month from any other RCNi journal

This article is not available as part of an institutional subscription. Why is this?

Jobs