A Study on the Effects of cognition, behavior and affection of the Music Therapy for Dementia Senile People

Kim, Hee Kyung; Lee, Ok Ran

Abstract

The purpose of this study was to determine the effects of the music therapy, one of the dementia treatment programs, on patients' cognition, behaviors and affection, and thereby, developing a nursing intervention to help them live a quality of life. The subjects of the study were 37 dementia senial people who admitted the mental hospital at K city in chungnam province. The study was designed as repeated measures design for a single test group. The subjects were received music therapy for 40 minutes 2 times a day during 6 weeks from February 16 to March 29, 2000. The tools of study were K-MMSE developed by Park, J. H. and Kuen, Y. C.(1989), Clinical Dementia Rating developed by Morris, J(1993) at Washington university, and A fourteen symptom behavior and mood rating scale developed by Wyatt and Kupfer(1968). For the tools of music therapy, elderly favorite songs (changs, folk songs, old popular songs and children's songs) were recorded. These tapes and other tools were edited according to experts' advices. The music therapy 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 cognition, dementia behaviors and affection, evaluated them according to the checklist scale. The collected data were processed using the SPSS WIN 7.5 program for absolute values, percentiles, mean, SD, ANOVA, GLM-repeated measure method. The items of scale and its reliability analyzed were Cronbach's alpha. The results of this study were as follows: 1. As a result of analyzing dementia elderly cognition, behaviors and affection before the music therapy, it was found that the disorder of cognition, behavior and affection was most outstanding. 2. After the therapy, the average scores of subjects' overall cognition, behavior and affection were lowered significantly. It was conceived that the music therapy should continue for 3-4 weeks. 3. Difference of cognition in test groups was significant statistically between pre-test and 2 weeks, 4 weeks, 6 weeks after test (df=3, F=6.39, p=.000), pretest and 4, 6 weeks after test (p=.01, p=.001), which suggests that a continued music therapy would be desirable to treat dementia. Difference of behaviors and affection in test groups was significant statistically between pre-test and 1-6 weeks after test (F=52.01, p = .000), pretest and 3-6 weeks after test (p=.000), which suggests that a continued music therapy would be desirable to treat dementia. 5. It was found that the music therapy was more effective in treating moderate dementia (MMSE-K score 16-23) than severe one (MMSE-K score 15 or lower), and vascular type of dementia than Alzheimer's type of one. After all, it may well be concluded that the musical therapy is an effective nursing intervention to provide the dementia elderly with a quality service and thereby, increase cognition and reduce the problematic behaviors and affection of dementia senile people.