인간행동과 음악연구 (Journal of Music and Human Behavior)

  • 제16권1호
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  • Pages.25-46
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  • 2019
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  • 2288-2774(pISSN)
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  • 2799-9076(eISSN)
한국음악치료교육학회 (Korean Music Therapy Education Association)
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중환자 보호자의 불안 감소를 위한 단회기 노래중심 음악치료 적용 예비연구

Pilot Study of Single Session Song-Based Music Therapy for Decreasing ICU Caregiver Anxiety

  • 정유선 (소리울 치료상담센터) ;
  • 나성원 (연세대학교 의과대학 마취통증의학과)
  • Jung, Yu Sun (Soriul Therapy Counseling Center) ;
  • Na, Sungwon (Department of Anesthesiology and Pain Medicine Anesthesia and Pain Research Institute, Yonsei University College of Medicine)
  • 투고 : 2019.05.04
  • 심사 : 2019.05.20
  • 발행 : 2019.05.30
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초록

본 연구는 중환자 보호자의 불안 감소를 위해 단회기 노래중심 음악치료를 적용한 예비연구로, 총 6명의 중환자 보호자가 음악치료 세션에 참여하였다. 노래중심 음악치료 중재는 초반에 대상자의 현재 정서 상태를 확인하고, 신체적 이완촉진 및 심리적 저항감을 줄이기 위한 음악듣기 혹은 음악에 맞추어 악기(톤차임)를 연주하는 단계를 진행하였고, 이후 노래중심 활동에서는 노래 가사에 대해서 토의하고 실제로 노래를 부르는 과정이 진행되었다. 가사에 대해 토의하면서 대상자가 자신에게 의미 있는 메시지를 확인할 수 있도록 하였고, 노래부르기 동안에는 연구자가 대상자의 정서 상태에 따라 음악 요소(템포, 다이내믹, 리듬, 화성 등)를 조정하며 제공하는 반주에 맞춰 선택된 노래를 부르도록 하였다. 대상자의 변화를 확인하기 위해 참여 전후로 상태불안 척도(STAI) 및 정서 상태에 대한 VAS 척도를 측정하였으며, 중재 과정에서 관찰된 대상자의 언어 반응 역시 분석하였다. 연구 결과, 중재 후 대상자들의 STAI 점수가 유의하게 감소한 것으로 나타났다. 또한 대상자들이 지각하는 정적 정서상태는 유의하게 증가하였고, 단회기 치료과정에서의 심리적 변화에는 개인적 편차가 있는 것으로 나타났다. 결과적으로 단회기 노래중심 음악치료가 중환자 보호자의 불안을 포함한 심리정서적 필요에 효과적으로 개입할 수 있는 가능성을 확인할 수 있었다.

This pilot study involved a single session of song-based music therapy to relieve the anxiety of intensive care unit (ICU) caregivers. Six caregivers of ICU patients participated in the intervention session individually. During the initial stage of the intervention, the participants' current emotional states were identified. Then they listened to familiar songs and playing a tone chime, which was intended to help them relax their body and reduce their psychological resistance. During singing experiences as an essential part of the intervention, the participants discussed the lyrics of songs in an attempt to find the meaning related to them. Also, they sang the songs with a live accompaniment in which their emotional states were reflected with changes in musical elements (e.g., tempo, dynamics, rhythm, or chords). In the final stage, they identified personal application to their everyday lives. To analyze the results, the State-Trait Anxiety Inventory (STAI) and a visual analog scale on emotional states were completed by participants before and after the session, and participants' verbal responses during the session were also recorded. According to the results, STAI anxiety scores significantly declined following the session. Also, they showed significant increases in positive emotions and significant decreases in negative emotions. This suggests that short-term music therapy can be an effective intervention for relieving the psychological distress of ICU caregivers.

키워드

Demographic Information of Participants (N = 6)

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Changes in Level of Anxiety

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Changes in Level of Perceived Emotional States

HKOOBX_2019_v16n1_25_t0003.png 이미지

참고문헌

  1. Bak, H. G. (2014). A meta-analysis of the music therapy research to reduce stress (Unpublished master's thesis). Sookmyung Women's University, Seoul.
  2. Beesley, S. J., Hopkins, R. O., Holt-Lunstad, J., Wilson, E. L., Butler, J., Kuttler, K. G., ... Hirshberg, E. L. (2018). Acute physiologic stress and subsequent anxiety among family members of ICU patients. Critical Care Medicine, 46(2), 229-235. https://doi.org/10.1097/CCM.0000000000002835
  3. Bishop, S. M., Walker, M. D., & Spivak, I. M. (2013). Family presence in the adult burn intensive care unit during dressing changes. Critical Care Nurse, 33(1), 14-24. https://doi.org/10.4037/ccn2013116
  4. Chaboyer, W., Thalib, L., Alcorn, K., & Foster, M. (2007). The effect of an ICU liaison nurse on patients and family’s anxiety prior to transfer to the ward: An intervention study. Intensive & Critical Care Nursing, 23(6), 362-369. https://doi.org/10.1016/j.iccn.2007.04.005
  5. Choi, D. I. (2017). Review of music interventions for family caregivers of patients in medical settings. Journal of Music and Human Behavior, 14(1), 17-39. https://doi.org/10.21187/JMHB.2017.14.1.017
  6. Choi, K. W., Shaffer, K. M., Zale, E. L., Funes, C. J., Koenen, K. C., Tehan, T., ... Vranceanu, A. (2018). Early risk and resiliency factors predict chronic posttraumatic stress disorder in caregivers of patients admitted to a neuroscience ICU. Critical Care Medicine, 46(5), 713-719. https://doi.org/10.1097/CCM.0000000000002988
  7. Choi, Y. K. (2010). The effect of music and progressive muscle relaxation on anxiety, fatigue, and quality of life in family caregivers of hospice patients. Journal of Music Therapy, 47(1), 53-69. https://doi.org/10.1093/jmt/47.1.53
  8. Chong, H. J. (2011). Influence of music on human behavior. Seoul: Hakjisa.
  9. Chong, H. J. (2015). Music therapy: Understanding and application (2nd ed.). Seoul: Ewha Womans University Press.
  10. Chong, H. J., & Kim, D. M. (2010). Music psychotherapy. Seoul: Hakjisa.
  11. Daly, B. J., Douglas, S. L., O’Toole, E., Gordon, N. H., Hejal, R., Peerless, J., ... Hickman, R. (2010). Effectiveness trial of an intensive communication structure for families of long-stay ICU patients. Chest, 138(6), 1340-1348. https://doi.org/10.1378/chest.10-0292
  12. Gardstrom, S. C., & Hiller, J. (2010). Song discussion as music psychotherapy. Music Therapy Perspectives, 28(2), 147-156. https://doi.org/10.1093/mtp/28.2.147
  13. Halm, M. A. (1990). Effects of support groups on anxiety of family members during critical illness. Heart & Lung, 19(1), 62-71.
  14. Halm, M. A., Titler, M. G., Kleiber, C., Johnson, S. K., Montgomery, L. A., Craft, M. J., ... Megivern, K. (1993). Behavioral responses of family members during critical illness. Clinical Nursing Research, 2(4), 414-437. https://doi.org/10.1177/105477389300200405
  15. Kim, E. S., Park, J. S., & Park, C. J. (2002). A relation study on burden, health promotion behavior and health status of the family caregiver of intensive care unit patient. Journal of Korean Academy of Nursing, 32(5), 654-664. https://doi.org/10.4040/jkan.2002.32.5.654
  16. Kim, J. T., & Shin, D. K. (1978). A study based on the standardization of the STAI for Korea. The New Medical Journal, 21, 69-75.
  17. Kim, Y. J., & Seo, N. S. (2010). Effects of progressive muscle relaxation on nausea, vomiting, fatigue, anxiety, and depression in cancer patients undergoing chemotherapy. Journal of Korean Oncology Nursing, 10(2), 171-179. https://doi.org/10.5388/jkon.2010.10.2.171
  18. Kleiber, C., Halm, M., Titler, M., Montgomery, L. A., Johnson, S. K., Nicholson, A., ... Megivern, K. (1994). Emotional responses of family members during a critical care hospitalization. American Journal of Critical Care, 3(1), 70-76. https://doi.org/10.4037/ajcc1994.3.1.70
  19. Knight, W. E. J., & Rickard, N. S. (2001). Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females. Journal of Music Therapy, 38(4), 254-272. https://doi.org/10.1093/jmt/38.4.254
  20. Krout, R. E. (2001). The effects of single-session music therapy interventions on the observed and self-reported levels of pain control, physical comfort, and relaxation of hospice patients. American Journal of Hospice & Palliative Care, 18(6), 383-390. https://doi.org/10.1177/104990910101800607
  21. Kwon, S. B., & Lee, M. L. (1987). Factor analysis of the seriously-ill patient’s family needs. Journal of Korean Academy of Nursing, 17(2), 122-136.
  22. Lee, M. M., & Yi, M. S. (2017). Experiences of families in the intensive care unit: Interactions with health care providers. Korean Journal of Adult Nursing, 29(1), 76-86. https://doi.org/10.7475/kjan.2017.29.1.76
  23. Lim, D. B. (2017). Analysis on domestic research articles related to therapeutic use of songs (Unpublished master's thesis). Ewha Womans University, Seoul.
  24. McAdam, J. L., Dracup, K. A., White, D. B., Fontaine, D. K., & Puntillo, K. A. (2010). Symptom experiences of family members of intensive care unit patients at high risk for dying. Critical Care Medicine, 38(4), 1078-1085. https://doi.org/10.1097/CCM.0b013e3181cf6d94
  25. Menon, V., & Levitin, D. J. (2005). The rewards of music listening: Response and physiological connectivity of the mesolimbic system. NeuroImage, 28(1), 175-184. https://doi.org/10.1016/j.neuroimage.2005.05.053
  26. Montgomery, R. J., Gonyea, J. G., & Hooyman, N. R. (1985). Caregiving and the experience of subjective and objective burden. Family Relations, 34(1), 19-26. https://doi.org/10.2307/583753
  27. Oh, S. H. (2003). A relationship between burden and stress of family members of intensive care unit patient (Unpublished master's thesis). Ewha Womans University, Seoul.
  28. Okamoto, M. (2005). The effects of music therapy interventions on grief and spirituality of family members of patients in a hospice setting (Unpublished master's thesis). Florida State University, Florida.
  29. O’Kelly, J. (2008). Saying it in song: Music therapy as a carer support intervention. International Journal of Palliative Nursing, 14(6), 281-286. https://doi.org/10.12968/ijpn.2008.14.6.30023
  30. Park, M. J., Park, S. H., & Chung, M. Y. (2017). Factors affecting caregivers’ burnout caring for a family member in an intensive care unit. Korean Journal Adult Nursing, 29(5), 517-526. https://doi.org/10.7475/kjan.2017.29.5.517
  31. Pochard, F., Darmon, M., Fassier, T., Bollaert, P-E., Cheval, C., Coloigner, M., ... Azoulay, E. (2005). Symptoms of anxiety and depression in family members of intensive care unit patients before discharge or death: A prospective multicenter study. Journal of Critical Care, 20(1), 90-96. https://doi.org/10.1016/j.jcrc.2004.11.004
  32. Rim, J. H. (2009). The effects of song psychotherapy in decreasing adolescent test anxiety. Journal of Music and Human Behavior, 6(1), 81-109.
  33. Roh, E. S., Kim, K. H., & Kwon, H. J. (1997). A study on caring experiences of the families of the seriously ill patients. The Journal of Korean Academic Society of Adult Nursing, 9(2), 251-261.
  34. Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). STAI manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.
  35. Song, Y. M. (2003). A study on the effects of musical activities focused on lyric discussion on reducing the level of anxiety and depression of the patients suffering from spinal injuries (Unpublished master's thesis). Sookmyung Women's University, Seoul.
  36. Steenbarger, B. N. (2002). Brief therapy. In M. Hersen, & W. Sledge (Eds.), Encyclopedia of psychotherapy (pp. 349-358). San Diego, CA: Academic Press.
  37. Van Horn, E., & Tesh, A. (2000). The effect of critical care hospitalization on family members: Stress and responses. Dimensions of Critical Care Nursing, 19(4), 40-49. https://doi.org/10.1097/00003465-200019040-00014
  38. White, D. B., Martin Cua, S., Walk, R., Pollice, L., Weissfeld, L., Hong, S., ... Arnold, R. M. (2012). Nurse-led intervention to improve surrogate decision making for patients with advanced critical illness. American Journal of Critical Care, 21(6), 396-409. https://doi.org/10.4037/ajcc2012223