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치매 환자의 인지재활 음악치료 효과에 대한 체계적 문헌고찰 및 메타분석

The Effect of Music Therapy on Cognitive Rehabilitation for People with Dementia: A Systematic Review and Meta-Analysis

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초록

이 연구는 치매 환자들을 위한 인지재활 음악치료의 효과를 알아보기 위해 1986~2016년까지 출간된 국내외 연구들을 대상으로 체계적 문헌고찰과 메타분석을 실시한 연구이다. 8개의 국내외 검색 서비스(국회도서관, KISS, RISS, CINAHL, Cochrane Library, MEDLINE, Pubmed, SCOPUS)를 통해 총 20편의 연구들을 분석대상으로 선정하였다. 연구의 비뚤림 평가를 위해 연구들은 Cochrane Collaboration Risk of Bias 도구를 이용해 사정하였다. 연구결과, 전체 효과크기는 중간 효과크기(g=0.53)로 유의하였다. 이질성은 중간정도로 나타나 세부 영역별 분석을 하였다. 기억력(g=0.60), 언어기능(g=0.56), 전반적 인지기능(g=0.48), 주의집중능력(g=0.34)의 순서로 모두 중간 정도에 속하는 효과크기가 나타났고, 음악치료가 유의한 효과가 있는 것으로 나타났다. 한편, 전반적 인지기능과 언어기능에서 중간 정도의 이질성이 나타났다. 이질성 평가를 위해 하위분석 결과, 전반적 인지기능에서는 질병의 정도와 측정도구에서, 언어 기능에서는 질병의 정도가 이질성과 연관이 있는 조절변수인 것으로 나타났다. 이 연구에서는 중재효과를 과대 혹은 과소 추정할 수 있는 요소에 대한 연구 비뚤림(Risk of Bias)평가, 체계적 문헌고찰, 메타분석, 이질성 평가 등을 통해 치매환자의 인지재활 음악치료의 효과를 검증하고 종합적으로 분석한 정보를 제공하여 미래 연구의 바탕이 될 수 있는 임상적 근거와 기초자료를 마련하는 데 의의가 있다.

Abstract

This study is a systematic review & meta-analysis of music therapy research studies on cognitive rehabilitation for patients with dementia published from 1986~2016. The purpose of study is to evaluate the impact of music therapy on cognitive rehabilitation for patients with dementia. The authors retrieved quantitative studies from 8 data-bases(CINAHL, Cochrane Library, MEDLINE, National Library of Korea, KISS, Pubmed, RISS, SCOPUS). We selected 20 studies, including randomized controlled trials and controlled clinical trials. Studies were assessed using the Cochrane Collaboration Risk of Bias Tool. The result indicated that overall effect size was medium(g= 0.53) along with each outcomes were medium(memory: g=0.60, language: g=0.56, general cognitive function: 0.48, and attention: g=0.34). However, this study outcomes indicated heterogeneity on general cognitive function and language. Subgroup analysis results indicated that progression of illness and assessment tool were moderators. This study offers information and will guide in future music therapy studies on cognitive rehabilitation for people with dementia.

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