[논문]미술요법이 노인의 인지, 우울 및 삶의 질에 미치는 효과

최연희; 전은영

doi:10.12799/jkachn.2013.24.3.323

미술요법이 노인의 인지, 우울 및 삶의 질에 미치는 효과
Effects of Art Therapy on Cognition, Depression, and Quality of Life in Elderly 원문보기

지역사회간호학회지 = Journal of korean academy of community health nursing, v.24 no.3, 2013년, pp.323 - 331

Abstract ▼ AI-Helper

Purpose: The study attempted to examine whether the group art therapy using a collage medium and reminiscence therapy prevented or reversed dementia, prevented depression, and improved the quality of life of elderly women at high risk for dementia in community public health centers. Methods: As a quasi-experimental study with a non-equivalent control group, this study used a pre-post design. The subjects consisted of a random sample of women over 65 years of age who had been registered as being at high-risk for dementia at the Public Health Center of the G City, and the Dementia Support Center. Of these elders, 30 were assigned to the experimental group and 33 to the control group. The intervention was conducted twice a week for 5 weeks. $x^2$-test, t-test, Wilcoxon test were used to analyze the data. Results: After the program, cognitive function, depression, and quality of life were significantly better in the experimental group than in the control group. Conclusion: The group art therapy can be utilized in community-based nursing practices by identifying and registering those who are at high risk for dementia. The results should prove useful when designing future intervention strategies targeting elderly individuals residing in communities.

주제어

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문제 정의

Group art therapy uses visual media such as painting, drawing, sculpting, collages, and other forms of art to assist in the integration of parts of one's personality (Rebecca & Magniant, 2004). In this study, the investigator designed a series of structured art activities according to the developmental stage of individuals. The program, which relied on therapeutic art activities using the medium of collage, met twice per week, yielding a total of 10 sessions over the course of 5 weeks.
Visiting nurses conducted individual interviews at the homes of members of the experimental group from April 5 to 9, 2010. These interviews collected data on the general characteristics, cognition, level of depression, and quality of life of participants. The same pretest was conducted from May 24 to 28, 2010, with members of the control group after all interventions with the experimental group were completed.
This study found significant improvement in the quality of life of the experimental group compared with that of the control group after the intervention. These results are consistent with those reported by Ko and Jung (2007), who provided 10 sessions of group art therapy to elderly patients in nursing homes with the aim of facilitating the use of the creative process to express repressed feelings and increase life satisfaction.

가설 설정

⦁ Hypothesis 1: Those participating in art therapy using a collage medium and engaging in a reminiscence group would differ in cognition from those in a control group.
⦁ Hypothesis 2: Those participating in art therapy using a collage medium and engaging in a reminiscence group would differ in terms of depression from those in a control group.
⦁ Hypothesis 3: Those participating in art therapy using a collage medium and engaging in a reminiscence group would differ in terms of their quality of life from those in a control group.

제안 방법

Because this study was conducted among a group of individuals who had registered in a public health center as being at high risk for dementia, the results cannot be generalized to all elderly people. Additionally, this study was limited by using only one follow-up visit to assess the effect of the intervention program rather than by continuously measuring cognition, depression, and quality of life.
After termination of the program, a post‐test on all study variables, with the exception of general characteristics, was conducted from May 17 to 21, 2010, by the same visiting nurse who had conducted the pre‐test. A post test was conducted with the control group in the same way from June 5 to 9, 2010.
The investigator facilitated open dialogue including the expression of sympathy, support, and so on. After the recollection phase, the investigator summarized all the memories of all participants and presented information about the next meeting and the challenges posed by remembering. After the termination of the experimental group, the same 5‐week program was offered to members of the control group in consideration of ethical issues.
In this study of elderly individuals at high risk for dementia, the intervention group engaged in 5 weeks of group art therapy using the medium of collage and participated in reminiscence therapy. After the intervention, they differed significantly from the control group in terms of cognition, depression, and quality of life.
The instrument addressing this domain consisted of eight items derived from the Visiting Health Service guidebook (MHW, 2008) that measured quality of life during the past month. It consists of two items that ask respondents to rate their health status and physical pain on a 6‐point scale and six items that ask respondents to use a 5‐point scale to rate limitations on their physical activity, limitations on their performance of everyday tasks, subjective feelings of energy, limitations on their social activity, pain caused by emotional problems, and limitations on their daily activities due to emotional problems. The scores ranged from 8 to 42 points, with higher scores indicating a lower quality of life.
Two graduate students served as group therapists, and two specially qualified nurses served as visiting nurses. The investigator and all assistants prepared the art materials to be used at each session and practiced all procedures before the actual interventions were initiated.
The experimental group participated in group art therapy using collages and reminiscence therapy. The program was conducted during the 5 weeks from April 12 to May 15, 2010, in twice‐weekly 1-hour sessions. The investigator and assistants conducted this program in the health education room of the public health center.
This therapeutic program was a revised version of the group art therapy program developed by Rebecca and Magniant (2004) and the reminiscence therapy program developed by Riiey and Malchlo (1994). The program, designed to meet the specific aims of this study, focused on the recollections arising during the creation of collages to facilitate interpersonal interactions and on structured activities involving the recall of a pleasant life experience to improve cognition by improving skills related to memorization and stimulus perception.
In this study, the investigator designed a series of structured art activities according to the developmental stage of individuals. The program, which relied on therapeutic art activities using the medium of collage, met twice per week, yielding a total of 10 sessions over the course of 5 weeks.
The purpose of the study was to examine whether group art therapy using a collage medium and reminiscence therapy prevented or reversed dementia, prevented depression, and improved the quality of life of elderly women at high risk for dementia in community public health centers.
This study offered group art therapy involving collages and reminiscence therapy to elderly individuals at high risk for dementia to determine the effects of these approaches on cognition, depression, and quality of life. We used a quasi‐experimental research design involving a nonequivalent control group and a pretest–posttest structure.
This study targeted elderly individuals at high risk for dementia and evaluated the effects of group art and reminiscence therapies.

대상 데이터

Data were collected from April 5 to June 9, 2010, with assistance of the Dementia Support Center of the Public Health Center in G city.
During the study, four subjects in the experimental group and one subject in the control group were eliminated due to hospitalization, moving, or for other reasons. The final analysis included 63 subjects (experimental group: 30, control group: 33).
The investigator attended courses in art therapy at the Continuing Education Academy of K University, became qualified as a certified art therapist, and has been an active member of the Korean Art Mental Healing Association. Two graduate students served as group therapists, and two specially qualified nurses served as visiting nurses.
The subjects consisted of women over 65 years of age who registered as being at high‐risk for dementia at the Public Health Center of the G City, Dementia Support Center. The target of study was selected the group using pre-prepared random number tables.
This group consisted of women older than 65 years who registered with the Dementia Support Center of the Public Health Center and who had normal intelligence and appropriate levels of knowledge in the absence of cognitive impairment before becoming ill. Members of this group obtained MMSE-KC scores between 16 and 24.
The investigator attended courses in art therapy at the Continuing Education Academy of K University, became qualified as a certified art therapist, and has been an active member of the Korean Art Mental Healing Association. Two graduate students served as group therapists, and two specially qualified nurses served as visiting nurses. The investigator and all assistants prepared the art materials to be used at each session and practiced all procedures before the actual interventions were initiated.

데이터처리

05, two-tailed). When the data did not satisfy conditions of normality required for a parametric paired t‐test, the non‐parametric Wilcoxon signed rank test was used.

이론/모형

Depression is an abnormal emotional state in which a person feels sad, discouraged, worthless, empty, despairing, and so on (KSBNS, 2002). To measure the degree of depression in elderly individuals, we used Kee (1996) modification of the Korean Geriatric Depression Scale‐Short Form, which was originally developed by Yesavage et al.,(1983).
To measure the degree of depression, we used the shortened Geriatric Depression Scale that Kee (1996) developed by modifying the Korean Geriatric Depression Scale‐Short Form, which was originally developed by Yesavage et al.,(1983). This instrument consists of the 15 dichotomous items (yes/no) that were most highly correlated with depression in a study of its validity.
05, two-tailed). When normality was not shown, the Wilcoxon rank‐sum test was used. Differences between scores before and after the intervention were tested with t‐tests (p<.

성능/효과

The scores on the quality of life measure (where higher scores indicated poorer quality of life) among members of the experimental group decreased by an average of 1.0 points, whereas those among members of the control group decreased by an average of 1.8 points, reflecting that the quality of life among the experimental group was significantly more improved than that among the control group (t=-2.39, p<.05).

후속연구

Second, additional studies using physiological parameters are needed to verify the clinical effects of group art and reminiscence therapies.

참고문헌 (23)

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원문보기 상세보기
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상세보기
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원문보기 상세보기
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상세보기
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