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초고령 재가여성노인의 우울감 완화를 위한 노래 부르기 사례

Title
초고령 재가여성노인의 우울감 완화를 위한 노래 부르기 사례
Other Titles
Singing to alleviate of the depression symptoms in the oldest-old women living at home : Case studies
Authors
김유정
Issue Date
2018
Department/Major
대학원 음악치료학과
Publisher
이화여자대학교 대학원
Degree
Master
Advisors
김수지
Abstract
본 연구의 목적은 노래 부르기를 통한 신체적, 심리적 상태변화가 초고령 재가여성노인의 우울감 완화에 어떠한 변화를 도모하는지 알아보는 것이다. 총 4명의 정신적, 신체적 기능쇠퇴로 낮은 외부활동과 사회활동참여가 어려운 85세 이상의 여성노인들을 대상으로 6회기 중재를 시행한 사례연구이다. 연구결과를 살펴보면 첫째, 노인우울척도(GDS) 결과 전체 내담자 A, B, C, D 모두 감소되었는데 특히 내담자 A의 경우, 사전평가 점수 25점으로 중증 우울증 범주에 속하였으나 사후평가 점수가 11점으로 14점 감소하면서 경미한 우울 수준으로 완화되었다. 둘째, 세션 전·후 자가 기분평가 결과 세션이 진행됨에 따라 다양한 수준의 음악자극과 신체활동을 동반한 노래 부르기를 경험하며 신체 에너지 수준의 변화를 유발하여 부적 정서를 감소시키고 정적 각성을 유도하는 데 영향을 미쳤다. 셋째, 신체적, 언어적, 정서적, 음악적인 측면에서 분석하여 내담자의 반응과 태도 분석결과 회기가 진행됨에 따라 내담자가 언어적으로 본인의 호흡이나 목소리의 변화를 표현하며 노래 부르기 활동에 긍정적 태도로 참여하는 모습이 나타났다. 넷째, 노래 부르기 프로그램을 통한 심리정서적 변화를 살펴볼 때, 음악 안에서 자신이 알지 못했던 자신의 정체성이나 내 존재에 대한 확인을 통한 삶의 의미를 발견하는 것을 바탕으로 자신을 재해석하고 새로운 부분을 발견하며 자기 인식 변화가 나타났다. 추가적으로 음향학적 음성 측정(Praat)을 통해 분석결과 전체 내담자 모두 최대발성지속시간(MPT)이 최소 3.54초에서 최대 11.59초까지 증가되었으며 전반적인 음성의 질이 향상이 본인의 목소리 수용 및 우울감 완화에 긍정적 영향을 준 것으로 사료된다. 본 연구결과를 통해 노래 부르기 프로그램이 초고령 재가여성노인의 신체적 심리적 상태를 긍정적으로 변화시켜 우울감을 완화시킬 수 있는 치료적 중재임을 확인한 것에 연구 의의가 있다.;The purpose of the study is to examine the change of physical and psychological state through singing with physical activities to alleviate the depression symptoms in the oldest-old women living at home. The purpose of this case study is to describe the client’s mood and verbal (or non-verbal) responses in three different domains: physical, emotional, musical. The subjects of this study were four the oldest-old women aged 85 and over who had difficulties in participating in social activities due to mental, emotional, and physical decline with age. These participants, who had recommended by a general manager of the Y senior center and Y dementia support center participated in a total of six sessions, three times a week for two weeks. Each participant received 40 minutes of singing including breathing exercise, toning, and vocalizing with physical activities at one’s home. In the pre- and post-test, the Gereiatric Depression Scale(GDS) was measured. Additionally, the Maximum Phonation Time(MPT), pitch, and intensity via the Praat test were measured in order to clarify the current their voice before the first session, and any changes after the last session. Each participant’s mood by using a visual analogue scale was checked before and after the every session. The results of the study were as follows: First, the depression scores of the participants A, B, C, and D were remarkably lowered by using the Geriatric Depression Scale (GDS). Second, the client 's mood which was evaluated before and after the session was changed from negative to positive mood through the singing with physical activities. As the singing with physical activities progressed, the musical stimulation using various musical elements affected the change of the body energy level, thereby reducing the negative emotions and inducing the static awakening. Third, the participant 's responses to participation in the singing with physical activities was analyzed in terms of physical, emotional, and musical aspects. As the session progressed, the participants showed a positive attitude to the singing activities, expressing the change of their breath or voice in their words. Fifth, depression symptom is alleviated when they had positive self–awareness through experience of an insight into their emotion. Based on discovering the meaning of life through identification of one's identity in music, the expression of the verbal and the emotional with regard to all the participants transformed negative thought into positive beliefs about the self. Throughout this study, it presents that the singing program accompanied by physical activity is a therapeutic intervention for alleviating depression symptoms of the oldest-old women living at home. This study is significant in that it can be used as basic data for intervention on alleviating depression symptoms of the oldest-old than 85 years old women who had difficulties in participating in social activities due to mental, emotional, and physical decline with age.
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