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Journal of Korean Gerontological Nursing 2000;2(1):22-35.
치매노인의 음악요법 효과에 관한 연구
김부영
Abstract
At this moment when the increasing dementia old people become a social issue, it may well be important to approach in a variety of ways to its socio-environmental treatment or the nursing intervention in its secondary mental disorder. With such a basic conception in mind, this study was aimed at determining the effects of the musical therapy, one of the dementia treatment programs, on patients' behaviors and emotion, and thereby, suggesting the methods of nursing intervention to help them live a quality life. To this end, the test group was checked once before the therapy, and four times thereafter (first, second, third and fourth week). In short, this study was designed as pro- and post-test for a single test group. The test group consisting of 20 dementia old people were sampled from those who had visited an old people's welfare center in Seoul to be treated for their dementia symptom from July 30 to August 27, 1998. For this survey, the researcher developed a scale based on "the Behavioral and Emotional Scale invented by Wyatt & Kupfer(1968) after having consulted the experts and proven its validity. This tool consisted of 59 items. The tool or tape of the musical therapy was edited by selecting old people's favorite songs (changes, folk songs, old popular songs and children's songs). The test group was subject to 3 rounds of the musical therapy a day for a month. It would take half an hour to complete one round of the therapy which consisted of music listening, rhythmic instrument playing and following-up singing. The therapy was performed at the lounge of the center to which the sample people could get access conveniently. A nurse was asked to observe sample people's dementia behaviors or emotion and thereupon, evaluated them according to the checklist scale. The collected data were processed using the SPSS program for absolute values, percentiles, mean, SD and Paired T-Test, while such values as item-wise decrease ratio of dependent variables, decrease ratio by specific item and changes after the therapy were examined by means of percentiles. The items of scale and its reliability were analyzed with Cronbach alpha, which was found to be 8923. The results of this study can be summarized as follows : 1. As a result of analyzing dementia old people's behaviors and emotion before and after the therapy (once and four times, respectively), it was found that the disorder of perception functions was most outstanding. 2. After the therapy, the decrease was most apparent in "depression mood" out of the dementia behaviors and emotion. 3. After the therapy, the decrease was most outstanding in such specific items as "depression" and "overaction". 4. As a consequence of analyzing the changes caused by the therapy, it was disclosed that sample people's overall behaviors and emotions had been decreased, which suggests that the musical therapy may be an effective nursing intervention for the treatment of dementia. 5. Hypothesis Ⅰ : The hypothesis I that "dementia behaviors and emotion would be less after the musical treatment than before it" was supported. 6. Hypothesis Ⅱ : The hypothesis II that "the musical therapy would be more effective on light dementia than heavy one" was also supported. As discussed above, it has been proved through this study that the musical therapy consisting of such traditional songs favored by old people as changes, folk songs, old popular songs and children's songs has an effect on the treatment of dementia behaviors and emotion, and that light dementia may be better treated by the therapy than the heavy symptoms. Furthermore, it is deemed desirable to apply the musical therapy on a continual basis for 3- 4 weeks or longer rather than stop it in 1-2 weeks. After all, it may well be concluded that the musical therapy is an effective nursing intervention to provide the dementia old people with a quality service and thereby, reduce the problematic behaviors and emotion. Lastly, it is hoped that this study would be followed up by another similar studies, if we want to develop a longer-term and systematic musical therapy befitting our sentiment and thereby, contribute to the development of an independent nursing area under the circumstance of poor dementia treatments.
Key words: 음악요법, 노인성 치매, 치매행동 및 정서
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