중환자 보호자의 불안 감소를 위한 단회기 노래중심 음악치료 적용 예비연구
Pilot Study of Single Session Song-Based Music Therapy for Decreasing ICU Caregiver Anxiety
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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.
Abstract
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.
참고문헌 (38)
- 박현경, "스트레스 감소를 위한 음악치료 연구 메타분석", 석사, 임상음악치료전공, pp.2014
- Beesley, S. J., "Acute physiologic stress and subsequent anxiety among family members of ICU patients", Critical Care Medicine, 46(2), pp.229~235 (2018)
- Bishop, S. M., "Family presence in the adult burn intensive care unit during dressing changes", Critical Care Nurse, 33(1), pp.14~24 (2013)
- Chaboyer, W., "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), pp.362~369 (2007)
- 최다인, "국내・외 의료 환경 내 가족 참여음악 중재 연구 고찰", 인간행동과 음악연구, 14(1), pp.17~39 (2017), 한국음악치료교육학회[DOI]
- Choi, K. W., "Early risk and resiliency factors predict chronic posttraumatic stress disorder in caregivers of patients admitted to a neuroscience ICU", Critical Care Medicine, 46(5), pp.713~719 (2018)
- Choi, Y. K., "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), pp.53~69 (2010)
- Chong, H. J., "Influence of music on human behavior" (2011), Hakjisa
- Chong, H. J., "Music therapy: Understanding and application" (2015), Ewha Womans University Press
- Chong, H. J., "Music psychotherapy" (2010), Hakjisa
- Daly, B. J., "Effectiveness trial of an intensive communication structure for families of long-stay ICU patients", Chest, 138(6), pp.1340~1348 (2010)
- Gardstrom, S. C., "Song discussion as music psychotherapy", Music Therapy Perspectives, 28(2), pp.147~156 (2010)
- Halm, M. A., "Effects of support groups on anxiety of family members during critical illness", Heart & Lung, 19(1), pp.62~71 (1990)
- Halm, M. A., "Behavioral responses of family members during critical illness", Clinical Nursing Research, 2(4), pp.414~437 (1993)
- 김은실, "중환자 가족의 부담감, 건강증진행위 및 건강상태에 관한 연구", Journal of Korean Academy of Nursing, 32(5), pp.654~664 (2002), 한국간호과학회
- Kim, J. T., "A study based on the standardization of the STAI for Korea", The New Medical Journal, 21, pp.69~75 (1978)
- 김영재, "점진적 근육이완요법이 항암화학요법환자의 오심과 구토, 피로, 불안 및 우울에 미치는 효과", Asian Oncology Nursing, 10(2), pp.171~179 (2010), 대한종양간호학회
- Kleiber, C., "Emotional responses of family members during a critical care hospitalization", American Journal of Critical Care, 3(1), pp.70~76 (1994)
- Knight, W. E. J., "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), pp.254~272 (2001)
- Krout, R. E., "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), pp.383~390 (2001)
- Kwon, S. B., "Factor analysis of the seriously-ill patient’s family needs", Journal of Korean Academy of Nursing, 17(2), pp.122~136 (1987)
- 이미미, "중환자실 환자 가족의 경험: 의료인들과의 상호작용", 성인간호학회지, 29(1), pp.76~86 (2017), 한국성인간호학회[DOI]
- Lim, D. B., "Analysis on domestic research articles related to therapeutic use of songs", master’s, pp.2017
- McAdam, J. L., "Symptom experiences of family members of intensive care unit patients at high risk for dying", Critical Care Medicine, 38(4), pp.1078~1085 (2010)
- Menon, V., "The rewards of music listening : Response and physiological connectivity of the mesolimbic system", NeuroImage, 28(1), pp.175~184 (2005)
- Montgomery, R. J., "Caregiving and the experience of subjective and objective burden", Family Relations, 34(1), pp.19~26 (1985)
- Oh, S. H., "A relationship between burden and stress of family members of intensive care unit patient", master’s, pp.2003
- Okamoto, M., "The effects of music therapy interventions on grief and spirituality of family members of patients in a hospice setting", master’s, pp.2005
- O’Kelly, J., "Saying it in song : Music therapy as a carer support intervention", International Journal of Palliative Nursing, 14(6), pp.281~286 (2008)
- 박민정, "중환자실 환자의 가족돌봄자의 소진에 미치는 영향요인", 성인간호학회지, 29(5), pp.517~526 (2017), 한국성인간호학회[DOI]
- Pochard, F., "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), pp.90~96 (2005)
- Rim, J. H., "The effects of song psychotherapy in decreasing adolescent test anxiety", Journal of Music and Human Behavior, 6(1), pp.81~109 (2009)
- Roh, E. S., "A study on caring experiences of the families of the seriously ill patients", The Journal of Korean Academic Society of Adult Nursing, 9(2), pp.251~261 (1997)
- Spielberger, C. D., "STAI manual for the state-trait anxiety inventory" (1970), Consulting Psychologists Press
- Song, Y. M., "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", master’s, pp.2003
- Steenbarger, B. N., "Encyclopedia of psychotherapy", pp.349~358 (2002), Academic Press
- Van Horn, E., "The effect of critical care hospitalization on family members : Stress and responses", Dimensions of Critical Care Nursing, 19(4), pp.40~49 (2000)
- White, D. B., "Nurse-led intervention to improve surrogate decision making for patients with advanced critical illness", American Journal of Critical Care, 21(6), pp.396~409 (2012)
