호스피스ㆍ완화의료 환자를 대상으로 한 국내ㆍ외 음악치료 연구 메타분석 = A Meta-analysis of the Effect of Music Therapy in Hospice and Palliative Care

다국어 초록 (Multilingual Abstract)

The purpose of this study was to analyze quantitative studies regarding the effect of music therapy program on hospice and palliative patients and provide a basis for more effective application in music therapy in hospice palliative care. A meta-analysis was conducted on 31 studies including domestic and international studies. The results of the study are as follows: First, the overall mean effect size was –0.579, which means a medium effect size according to Cohen’s interpretation criteria. Second, music therapy has a positive effect on physiological and psychological symptoms of hospice and palliative care patients. Third, recorded music therapy is more effective than live music or mixed music. Fourth, a total of 6 to 10 sessions were the most effective. Fifth, 20minutes is the most adequate as a session length. Sixth, when the patients engage in music therapy receptively, music therapy could be more helpful. Lastly, out-patient hospice service would increase the effect of music therapy. The above results show that music therapy can have a positive effect on hospice and palliative care patients and positively affect them.

국문 초록 (Abstract)

본 연구는 메타분석을 통해 호스피스ㆍ완화의료 환자를 대상으로 한 음악치료의 전체효과를 확인하였다. 국내ㆍ외 호스피스ㆍ완화의료 환자를 대상으로 음악치료를 중재한 연구 중 본 연구의 목적에 부합하는 31편의 연구를 채택하여 메타분석을 실시하였다. 연구결과는 다음과 같다. 첫째, 전체 평균 효과크기는 –0.579로 Cohen(1977)이 제시한 해석 기준에 의해 중간 수준의 전체효과 크기를 도출했다. 둘째, 음악치료는 호스피스ㆍ완화의료 환자의 생리적 증상 및 심리적 증상에 긍정적인 영향을 미치는 것으로 확인하였다. 셋째, 치료사가 녹음 음악을 사용하고 환자가 수용적 참여를 할 때 음악치료의 효과가 더 클 수 있는 것으로 나타났다. 넷째, 호스피스ㆍ완화의료 환자는 20분 미만, 6회 이상 10회기 미만의 음악치료 활동에 참여할 경우 더 큰 치료 효과를 경험하는 것으로 확인하였다. 마지막으로 자문형 호스피스ㆍ완화의료 서비스를 받는 환자에게 음악치료의 효과가 더 큰 것으로 나타났다. 위의 결과를 통해 음악치료는 호스피스ㆍ완화의료 환자에게 긍정적인 영향을 미칠 수 있으며 환자의 심리 및생리적 증상에 긍정적인 영향을 줄 수 있다는 것을 보여 주었다.

참고문헌 (Reference)

1 김현정, "효과적인 의학문헌검색" 한양대학교 의과대학 35 (35): 18-22, 2015

2 문지영, "호스피스에서의 음악치료" 한국호스피스완화의료학회 10 (10): 67-73, 2007

3 Ministry of Health and Welfare, "호스피스ㆍ완화의료 사업안내"

4 Noh, Y. J., "호스피스ㆍ완화의료" Hyunmoonsa Press 2018

5 Korean HospiceㆍPalliative care Association, "호스피스ㆍ완화의료" Kunja Press 2018

6 Korea Hospice Association, "호스피스 총론" Korea Hospice Association Press 2010

7 Hospice and Palliative Care, "호스피스 완화의료 서비스 유형"

8 Korean Hospice Nursing Society, "호스피스 완화 돌봄 학습 가이드" Sumunsa Press 2006

9 김은정, "한국의 호스피스 음악치료" 한국호스피스완화의료학회 21 (21): 109-114, 2018

10 황은영, "한국의 음악치료 미래변화와 그 전망: 음악치료 도입 20주년을 기념하며" 한국음악치료학회 18 (18): 1-20, 2016

11 김창곤, "한국의 예술치료와 호스피스 완화의료" 한국호스피스완화의료학회 18 (18): 85-96, 2015

12 이선자, "편지를 활용한 가족관계 증진 프로그램이 말기 암 환자의 가족기능, 죽음 불안, 우울에 미치는 영향" 한국재활간호학회 17 (17): 18-26, 2014

13 임채원, "치료적 음악 감상이 호스피스 말기 암환자의 불안에 미치는 영향" 명지대학교 사회교육대학원 2008

14 Davis, W. B., "음악치료학 개론" Kwon Hye Kyung Music Therapy Center 2002

15 Brucia, K. E., "음악치료의 즉흥연주 모델" Yangseowon 1998

16 김은정, "음악치료가 암환자 기분상태에 미치는 영향에 관한 연구" 한국음악치료학회 16 (16): 1-20, 2014

17 Jeong, H. J., "음악 치료의 이해와 적용" Ewha Woman’s University Press 2015

18 Jeong, H. J., "음악 심리치료" Hakjisa 2010

19 Ministry of Health and Welfare, "완화의료 팀원을 위한 호스피스ㆍ완화의료 개론"

20 전영희, "암환자의 불안, 스트레스, 재발 우려가 삶의 질에 미치는 영향과 사회적지지의 조절효과" 인제대학교 보건대학원 2010

21 이은해, "선호음악 감상이 항암화학요법을 받는 성인 유방암환자의 우울 및 수면에 미치는 효과" 대한의료커뮤니케이션학회 10 (10): 115-126, 2015

22 이은해, "선호음악 감상이 성인 말기 암 환자의 기분 및 스트레스 변화에 미치는 영향 : 통증인지 정도에 따른 분석" 명지대학교 사회교육대학원 2010

23 Kim, G. J., "모야모야병(Moyamoya disease) 내담자에게 뇌가소성원리(Neural plasticity)를 접목한 게슈탈트 음악치료 효과 검증: 인지, 정서, 운동" 6 (6): 1-17, 2007

24 Oh, S. S., "메타분석의 이론과 실제" Kunkuk University Press 2002

25 Kim, H. J., "말기 암 환자들의 심리적 필요에 대한 질적 연구" 2013 (2013): 297-298, 2013

26 Thaut, M. H., "리듬, 음악 그리고 뇌" Hakjisa 2005

27 김미희, "로고테라피(Logothearpy)를 활용한 기독교 Well-dying 교육 연구" 고신대학교 대학원 2013

28 Park, S. Y., "단일 회기 음악치료 참여 수준에 따른 호스피스 환자의 통증과 피로감 지각 차이" Ewha Woman’s University 2016

29 Im, S. R., "노래 회상 기법을 활용한 음악치료가 호스피스 환자의 불안과 삶의 질에 미치는 영향" Kosin University 2017

30 Ryu, H. S., "감상을 중심으로 한 음악 중재가 말기 암 환자의 불안 감소에 미치는 영향" Sookmyung Women’s University 2002

31 김정희, "가정호스피스기관의 활동에 관한 연구" 한국호스피스완화의료학회 3 (3): 28-38, 2000

32 Clark, M., "Use of preferred music to reduce emotional distress and symptom activity during radiation therapy" 43 (43): 247-265, 2006

33 Sue Duval, "Trim and Fill: A Simple Funnel-Plot-Based Method of Testing and Adjusting for Publication Bias in Meta-Analysis" Wiley 56 (56): 455-463, 2000

34 Joke Bradt, "The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: a mixed methods study" Springer Science and Business Media LLC 23 (23): 1261-1271, 2015

35 Cooper, H., "The handbook of research synthesis and meta-analysis" Russell Sage Foundation 2009

36 Robert E. Krout, "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" SAGE Publications 18 (18): 383-390, 2016

37 Hilliard, R. E., "The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer" 40 (40): 113-137, 2003

38 Evangelia D. S., "The effects of music on cancer patients submitted to chemotherapy treatment" 10 (10): 1465-1477, 2017

39 Bailey, L. M., "The effects of live music versus tape-recorded music on hospitalized cancer patients" 3 (3): 17-28, 1983

40 Shih-Tzu Huang, "The effectiveness of music in relieving pain in cancer patients: A randomized controlled trial" Elsevier BV 47 (47): 1354-1362, 2010

41 Polat, S., "The effect of therapeutic music on anxiety in children with acute lymphoblastic leukaemia" 1 (1): 43-46, 2016

42 Burns, D. S., "The effect of the Bonny method of guided imagery and music on the mood and life quality of cancer patients" 38 (38): 51-65, 2001

43 Nguyen, J. T., "The effect of music therapy on end-of-life patients' quality of life, emotional state, and family satisfaction as measured by self-report" Florida State University 2003

44 Ezgi Karadag, "The effect of music listening intervention applied during radiation therapy on the anxiety and comfort level in women with early-stage breast cancer: A randomized controlled trial" Elsevier BV 27 : 39-44, 2019

45 Lee, H. J., "The effect of live music via the ISO-principle on pain management in palliative care as measured by self-report using a Graphic Rating Scale(GRS) and pulse rate" Florida State University 2005

46 Ferrer, A. J., "The effect of live music on decreasing anxiety in patients undergoing chemotherapy treatment" 44 (44): 242-255, 2007

47 A. Liberati, "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration" BMJ 339 (339): b2700-b2700, 2009

48 Andrew Rossetti, "The Impact of Music Therapy on Anxiety in Cancer Patients Undergoing Simulation for Radiation Therapy" Elsevier BV 99 (99): 103-110, 2017

49 Alyssa Cadwalader, "The Effects of a Single Session of Music Therapy on the Agitated Behaviors of Patients Receiving Hospice Care" Mary Ann Liebert Inc 19 (19): 870-873, 2016

50 Anne Horne-Thompson, "The Effect of Music Therapy on Anxiety in Patients who are Terminally Ill" Mary Ann Liebert Inc 11 (11): 582-590, 2008

51 Jean-Jacques Georges, "Symptoms, treatment and “dying peacefully” in terminally ill cancer patients: a prospective study" Springer Science and Business Media LLC 13 (13): 160-168, 2005

52 Cohen, J., "Statistical power analysis for the behavioral science" Academic Press 1977

53 A. Bovero, "Spirituality, quality of life, psychological adjustment in terminal cancer patients in hospice" Wiley 25 (25): 961-969, 2016

54 Sheri L. Robb, "Randomized controlled trial of the active music engagement (AME) intervention on children with cancer" Wiley 17 (17): 957-957, 2008

55 Juan Liao, "Progressive Muscle Relaxation Combined with Chinese Medicine Five-Element Music on Depression for Cancer Patients: A Randomized Controlled Trial" Springer Science and Business Media LLC 24 (24): 343-347, 2018

56 GENE V GLASS, "Primary, Secondary, and Meta-Analysis of Research" American Educational Research Association (AERA) 5 (5): 3-8, 2016

57 Marco Warth, "Music therapy in palliative care: A randomized controlled trial to evaluate effects on relaxation" Deutscher Arzte-Verlag GmbH 2015

58 Hilliard, R. E., "Music therapy in hospice and palliative care : A review of the empirical data" 2 (2): 173-178, 2005

59 Bradt, J., "Music therapy for end-of-life care" 11 (11): 1-33, 2010

60 Gaston, E. T., "Music in therapy" Macmillan 1968

61 Thanh Nhan Nguyen, "Music Therapy to Reduce Pain and Anxiety in Children With Cancer Undergoing Lumbar Puncture: A Randomized Clinical Trial" SAGE Publications 27 (27): 146-155, 2010

62 Madineh Jasemi, "Music Therapy Reduces the Intensity of Pain Among Patients With Cancer" Kowsar Medical Institute 2 (2): 76-9, 2013

63 Kathy Jo Gutgsell, "Music Therapy Reduces Pain in Palliative Care Patients: A Randomized Controlled Trial" Elsevier BV 45 (45): 822-831, 2013

64 Michael, B., "Introduction to Meta-Analysis" Wiley Press 2009

65 Gonca Hanedan Uslu, "Influence of Music Therapy on the State of Anxiety During Radiotherapy" LookUs Bilisim A.S. 2017

66 Hua Liu, "Group singing improves depression and life quality in patients with stable COPD: a randomized community-based trial in China" Springer Science and Business Media LLC 28 (28): 725-735, 2019

67 Hwang, S. D., "Free Software를 활용한 메타분석" Kyungpook university press 2016

68 Lee-Chen Chen, "Fifteen-minute music intervention reduces pre-radiotherapy anxiety in oncology patients" Elsevier BV 17 (17): 436-441, 2013

69 Barbara, A., "Effects of music therapy on vital signs and anxiety : A study with terminally ill patients" 1 (1): 1-7, 2018

70 Chih-Yuan Chuang, "Effects of music therapy on subjective sensations and heart rate variability in treated cancer survivors: A pilot study" Elsevier BV 18 (18): 224-226, 2010

71 Hilary A. Fredenburg, "Effects of music therapy on positive and negative affect and pain with hospitalized patients recovering from a blood and marrow transplant: A randomized effectiveness study" Elsevier BV 41 (41): 174-180, 2014

72 Kate Gfeller, "Effects of frequency, instrumental family, and cochlear implant type on timbre recognition and appraisal" SAGE Publications 111 (111): 349-356, 2016

73 Şebnem Bilgiç, "Effects of Listening to Music on the Comfort of Chemotherapy Patients" SAGE Publications 39 (39): 745-762, 2017

74 Priyadharshini Krishnaswamy, "Effect of music therapy on pain and anxiety levels of cancer patients: A pilot study" Medknow 22 (22): 307-, 2016

75 Garunkstiene, R., "Controlled trial of live versus recorded lullabies in preterm infants" 23 (23): 71-88, 2014

76 Higgins, J. P. T., "Cochrane handbook for systematic reviews of interventions" Wiley-Blackwell 2008

77 Mei-Feng Lin, "A randomised controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety" Wiley 20 (20): 988-999, 2011

78 Kaina Zhou, "A clinical randomized controlled trial of music therapy and progressive muscle relaxation training in female breast cancer patients after radical mastectomy: Results on depression, anxiety and length of hospital stay" Elsevier BV 19 (19): 54-59, 2015