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신생아집중치료실 고위험 신생아 대상 음악중재연구에 대한 체계적 문헌고찰 및 메타분석

The Effects of Music Interventions on High-risk Neonates in NICUs: Systematic Review and Meta-analysis

  • 김혜랑 (고신대학교 일반대학원 음악치료학) ;
  • 박혜영 (고신대학교 교회음악대학원 음악치료전공)
  • Kim, Hye Rang (Department of Music Therapy, Graduate School, Kosin University) ;
  • Park, Hye Young (Department of Music Therapy, Kosin University)
  • 투고 : 2023.10.11
  • 심사 : 2023.11.24
  • 발행 : 2023.11.30

초록

본 연구는 NICU 고위험 신생아를 대상으로 시행된 국내·외 음악중재연구의 효과를 심박동수, 호흡수, 산소포화도, 행동상태 등의 활력징후와 음악 유형, 음악제공자, 회기 수 등의 중재세부 사항에 따라 분석하고 평가하는 것을 목적으로 하였다. 이를 위해 국내·외 학술지 전자 데이터 베이스를 사용하여 음악중재와 NICU, 고위험 신생아, 활력징후 등을 검색어로 하여 2023년 3월까지 게재된 논문을 검색하였다. 검색 결과, 총 17편의 문헌이 최종 선정되었고 해당 연구에 포함된 음악에 대해 고찰 및 메타분석을 실시하였다. 연구 결과, NICU 고위험 신생아를 대상으로 한 음악중재에서 활력징후의 효과크기는 심박동수 0.433, 호흡수 효과크기는 0.568, 산소포화도 0.791, 행동상태 1.329의 중간 효과 또는 큰 효과로 확인되었다. 또한 주요 조절변수에 따라 효과크기를 비교 및 분석한 결과 음악 유형의 경우 라이브와 녹음을 혼합 방식으로 제공한 음악이, 음악제공자의 경우 심박동수는 음악치료사가, 그 외 산소포화도, 호흡수, 행동상태에서는 비음악치료사가 음악을 제공한 경우 효과적이었으며, 총회기는 1회기 이상 5회기 이하가 상대적으로 효과적인 것으로 나타났다. 본 연구 결과는 고위험 신생아를 대상으로 한 음악의 임상적 가치를 확인하고 신생아집중치료실 음악중재 시 음악 요소, 음악 전달 방식, 음악 중재자 등에 대한 고려점을 제시했다는 데 그 의의가 있다.

The purpose of this study was to analyze and evaluate music intervention research conducted with high-risk neonates in NICUs in both domestic and international settings. Seventeen music intervention studies were identified, and their characteristics, including type of music, music provider, and treatment frequency, and outcomes (i.e., neonatal vital signs) were reviewed and analyzed along with meta-analysis. For music interventions targeting high-risk neonates in NICUs, the effect sizes of the neonates' vital signs were classified as either medium or large. In addition, larger effect sizes were associated with a combination of live and recorded music, nonmusical therapists as the music providers, and treatment frequency of one to five sessions per week. These research findings verify the clinical value of music for high-risk neonates and provide insights into the selection of music elements, music delivery methods, and music providers in NICU music interventions.

키워드

참고문헌

  1. Anderson, D. E., & Patel, A. D. (2018). Infants born preterm, stress and neurodevelopment in the neonatal intensive care unit: Might music have an impact? Developmental Medicine and Child Neurology, 60(3), 256-266. https://doi.org/10.1111/dmcn.13663
  2. Anderson, G. C., Behnke, M., Gill, N. E., Conlon, M., Measel, C. P., & McDonie, T. E. (1990). Self-regulatory gavage-to-bottle feeding for preterm infants: Effects of behavioral state, energy expenditure, and weight gain. In S. G. Funk et al. (Eds.), Key aspects of recovery: Improving nutrition rest and mobility: Disseminating nursing research (pp. 83-97). New York: Springer.
  3. Arnon, S., Shapsa, A., Forman, L., Regev, R., Bauer, S., Litmanovitz, I., & Dolfin, T. (2006). Live music is beneficial to preterm infants in the neonatal intensive care unit environment. Birth, 33(2), 131-136. https://doi.org/10.1111/j.0730-7659.2006.00090.x
  4. Beevi, S. S. S., Premaletha, T., & Sona, P. S. (2017). Classical music therapy influences physiological parameters in preterm neonates. Asian Journal of Nursing Education and Research, 7(2), 155-157. https://doi.org/10.5958/2349-2996.2017.00031.3
  5. Bieleninik, L., Ghetti, C., & Gold, C. (2016). Music therapy for preterm infants and their parents: A meta-analysis. Pediatrics, 138(3), 20160971.
  6. Bingham, P. M. (2009). Deprivation and dysphagia in premature infants. Journal of Child Neurology, 24(6), 743-749. https://doi.org/10.1177/0883073808329530
  7. Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. West Sussex, Chichester: John Wiley & Sons.
  8. Bruscia, K. E. (2014). Defining music therapy. (3rd ed.). New Braunfels, Texas: Barcelona Publishers.
  9. Caparros-Gonzalez, R. A., de la Torre-Luque, A., Diaz-Piedra, C., Vico, F. J., Buela-Casal, G., Dowling, D., & Thibeau, S. (2018). Listening to relaxing music improves physiological responses in premature infants. Advances in Neonatal Care, 18(1), 58-69. https://doi.org/10.1097/ANC.0000000000000448
  10. Cevasco-Trotter, A. M., Evans, E. H., & Baird-Galloway, A. C. (2022). There is a lack of contraindications for live music listening for preterm and term infants in the neonatal intensive care unit. Journal of Perinatology, 42(4), 513-514. https://doi.org/10.1038/s41372-022-01342-4
  11. Cho, H. H. (2000). Effects of music therapy on body weight and vital signs in prematurity (Unpublished master's thesis). Korea University, Seoul.
  12. Chou, L. L., Wang, R. H., Chen, S. J., & Pai, L. (2003). Effects of music therapy on oxygen saturation in premature infants receiving endotracheal suctioning. Journal of Nursing Research, 11(3), 209-216.
  13. Chou, S. J., & Choi, S. H. (2006). The effect of music therapy on the heart rate and behavioral state of premature infants. Child Health Nursing Research, 12(1), 84-88.
  14. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.
  15. Cooper, H. (2015). Research synthesis and meta-analysis: A step-by-step approach (5th ed.). Thousand Oaks, CA: Sage publications.
  16. da Silva, C. M., Cacao, J. M. R., Silva, K. C. d. S., Marques, C. F., & Merey, L. S. F. (2013). Physiological responses of preterm newborn infants submitted to classical music therapy. Revista Paulista De Pediatria, 31(1), 30-36. https://doi.org/10.1590/S0103-05822013000100006
  17. Detmer, M. R., & Whelan, M. L. (2017). Music in the NICU: The role of nurses in neuroprotection. Neonatal Network, 36(4), 213-217. https://doi.org/10.1891/0730-0832.36.4.213
  18. Etzel, R. A., & Balk, S. J. (1997). Noise: A hazard for the fetus and newborn. Pediatric, 100(4), 724-727. https://doi.org/10.1542/peds.100.4.724
  19. Gholami, N., Borimnejad, L., Jafari, R., Rasouli, M., & Ranjbar, F. (2023). Effect of a noise reduction program on stress of premature neonates in neonatal intensive care unit. Journal of Neonatal Nursing, 29(1), 194-198. https://doi.org/10.1016/j.jnn.2022.05.011
  20. Giordano, V., Goeral, K., Schrage-Leitner, L., Berger, A., & Olischar, M. (2021). The effect of music on aEEG cyclicity in preterm neonates. Children, 8(3), 208.
  21. Haslbeck, F. B. (2012). Music therapy for premature infants and their parents: An integrative review. Nordic Journal of Music Therapy, 21(3), 203-226. https://doi.org/10.1080/08098131.2011.648653
  22. Higgins, J. P. T., & Green, S. (Eds.), (2022). Cochrane handbook for systematic reviews of interventions version 6.3 [updated Fabruary 2022]. The Cochrane Collaboration. www.hand book.cochrane.org.
  23. Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327(7414), 557-560. https://doi.org/10.1136/bmj.327.7414.557
  24. Jang, I. S. (2012). The basics of sound engineering. Seoul: SRMUSIC.
  25. Keith, D. R., Russell, K., & Weaver, B. S. (2009). The effects of music listening on inconsolable crying in premature infants. Journal of Music Therapy, 46(3), 191-203. https://doi.org/10.1093/jmt/46.3.191
  26. Kim, B. N., Son, M. S., & Kang, I. S. (2019). Effect of noise management education on noise perception, performance of noise management and noise level of nurses in neonatal intensive care unit. Global Health and Nursing, 9(2), 80-87.
  27. Kobus, S., Diezel, M., Dewan, M. V., Huening, B., Dathe, A. K., Felderhoff-Mueser, U., & Bruns, N. (2021). Music therapy is effective during sleep in preterm infants. International Journal of Environmental Research and Public Health, 18(16), 8245.
  28. Kyle, T., & Carman, S. (2022). Essentials of pediatric nursing (4th ed.) (G. E. Kim et al., Trans.). Seoul: Hyunmoon. (Original work published 2020)
  29. Loewy, J., Stewart, K., Dassler, A. M., Telsey, A., & Homel, P. (2013). The effects of music therapy on vital signs, feeding, and sleep in premature infants. Pediatrics, 131(5), 902-918. https://doi.org/10.1542/peds.2012-1367
  30. Marshall, J., & Raynor, M. (2016). Myles textbook for midwives (16th ed.). (Korean Midwives Association & Ilsin Christian Hospital, Trans.). Seoul: Elsevier Korea. (Original work published 2014)
  31. McCain, G. C. (1992). Facilitating inactive awake states in preterm infants: A study of three interventions. Nursing Research, 41(3), 157-160. https://doi.org/10.1097/00006199-199205000-00006
  32. Neal, D. O., & Lindeke, L. L. (2008). Music as a nursing intervention for preterm infants in the NICU. Neonatal Network, 27(5), 319-327. https://doi.org/10.1891/0730-0832.27.5.319
  33. Olejnik, B. K., & Lehman, I. (2018). Inadvertent noise in neonatal intensive care unit and its impact on prematurely born infants. Biomedical Journal of Scientific and Technical Research, 11(2), 8346-8350.
  34. Parga, J. J., Bhatt, R. R., Kesavan, K., Sim, M. S., Karp, H. N., Harper, R. M., & Zeltzer, L. (2018). A prospective observational cohort study of exposure to womb-like sounds to stabilize breathing and cardiovascular patterns in preterm neonates. The Journal of Maternal-Fetal and Neonatal Medicine, 31(17), 2245-2251. https://doi.org/10.1080/14767058.2017.1339269
  35. Park, J. S., Hong, K. J., & Bang, K. S. (2013). Effects of the 'intervention-mother's song' on physical response and behavioral state of low-birth weight infants in a neonatal intensive care unit. Child Health Nursing Research, 19(3), 198-206. https://doi.org/10.4094/CHNR.2013.19.3.198
  36. Park, S. S. (2002). The effects of the music therapy on the weight, vital sign, behavioral state of the premature infants (Unpublished master's thesis). Kyung Hee University, Seoul.
  37. Parra, J., de Suremain, A., Berne Audeoud, F., Ego, A., & Debillon, T. (2017). Sound levels in a neonatal intensive care unit significantly exceeded recommendations, especially inside incubators. Acta Paediatrica, 106(12), 1909-1914. https://doi.org/10.1111/apa.13906
  38. Rabiner, L. R., & Schafer, R. W. (2010). Theory and applications of digital speech processing. London: Pearson.
  39. Seo, B. M. (2010). Effects of music therapy on behavioral state, body weight and vital signs in prematurity (Unpublished master's thesis). Inje University, Gimhae.
  40. Seo, E. J., & Yoon, H. S. (2015). Comparison of the effect of music and noise blocking on postoperative pain, length of stay at post anesthetic care unit and satisfaction after a laparoscopic colectomy. Journal of Korean Biological Nursing Science, 17(4), 315-323. https://doi.org/10.7586/JKBNS.2015.17.4.315
  41. Standley, J. M. (2012). Music therapy research in the NICU: An updated meta-analysis. Neonatal Network, 31(5), 311-316. https://doi.org/10.1891/0730-0832.31.5.311
  42. Standley, J. M., Cassidy, J., Grant, R., Cevasco, A., Szuch, C., Nguyen, J., ... Adams, K. (2010). The effect of music reinforcement for non-nutritive sucking on nipple feeding of premature infants. Pediatric Nursing, 36(3), 138-145.
  43. Sun, J., Freeman, B. D., & Natanson, C. (2018). Meta-analysis of clinical trials. In J. I. Gallin, F. P. Ognibene, & L. L. Johnson (Eds.), Principles and practice of clinical research (4th ed.) (pp. 317-327). Boston, MA: Academic Press.
  44. Taheria, L., Kargar Jahromi, M., Abbasi, M., & Hojat, M. (2017). Effect of recorded male lullaby on physiologic response of neonates in NICU. Applied Nursing Research, 33, 127-130. https://doi.org/10.1016/j.apnr.2016.11.003
  45. Tonin, F. S., Rotta, I., Mendes, A. M., & Pontarolo, R. (2017). Network meta-analysis: A technique to gather evidence from direct and indirect comparisons. Pharmacy Practice, 15(1), 943.
  46. Wachman, E. M., & Lahav, A. (2011). The effects of noise on preterm infants in the NICU. Archives Disease in Childhood-Fetal and Neonatal Edition, 96(4), 305-309.
  47. Yoo, K. H. (2015). Effects of music therapy on the heart rate and respiration rate in premature infants. Journal of Korean Biological Nursing Science, 17(3), 271-276. https://doi.org/10.7586/JKBNS.2015.17.3.271
  48. Yun, J. Y, Kim, J. S., Shim, S. Y., Cho, S. J., Park, E. A., & Chong, H. J. (2020). Effects of music intervention techniques on very-low-birth-weight infants in neonatal intensive care unit: A preliminary study. Neonatal Medicine, 27(4), 174-180. https://doi.org/10.5385/nm.2020.27.4.174