老年医学科开展个体音乐治疗模式初探  

The model of music therapy in department of geriatrics

作　　者：刘谦[1] 陈洛婷 杨琬 陈文艺 沈琦[1] 路蕊 于莉[1] Liu Qian;Chen Luoting;Yang Wan;Chen Wenyi;Shen Qi;Lu Rui;Yu Li(Department of Geriatrics,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;不详)

机构地区：[1]首都医科大学附属北京同仁医院老年医学科/干部医疗科,北京100730 [2]中央音乐学院音乐学系音乐治疗专业

出　　处：《中国临床保健杂志》2021年第4期538-541,共4页Chinese Journal of Clinical Healthcare

基　　金：国家重点研发计划项目(2018YFC2002100)。

摘　　要：目的探索个体音乐治疗在老年医学科的应用及开展模式。方法运用“筛选-评估-转介-制定计划-讨论-实施治疗-反馈-总结”的模式为住院患者进行个体音乐治疗;记录入选患者的临床特征、音乐治疗情况并进行分析。结果30位患者共进行音乐治疗43次,80岁及以上占80%,共病指数4(2.5,7.5)分,1年预后指数4(1,9)分,主要诊断分别是心脑疾病(n=12,40%)、恶性肿瘤(n=8,26.7%)、感染性疾病(n=4,13.3%)、消化系统良性疾病(n=4,13.3%)和糖尿病(n=2,6.7%),音乐治疗目标分别为焦虑抑郁(n=14,46.7%)、安宁缓和医疗(n=7,23.3%)、认知功能障碍(n=6,20.0%)、谵妄(n=2,6.7%)及丧亲哀伤(n=1,3.3%)。所有患者均使用被动式接受、主动式参与及谈话方式进行音乐治疗,其中26.7%的患者进行了音乐引导放松,10%的患者应用了绘画方式,90%的患者接受1~2次音乐治疗,共有8位患者的家属共同参与,音乐治疗过程中无患者及家属退出,均对音乐治疗效果表示满意。结论围绕音乐治疗目标筛选患者,将老年综合评估和音乐评估相结合,老年医学科人员与音乐治疗师密切配合有助于音乐治疗的顺利进行并取得良好效果。Objective To explore the application and the model of individual music therapy in department of geriatrics.Methods Individual music therapy was performed on inpatients with the model of“Screening-Evaluating-Referring-Making plans-Discussing-Implementing-Summing up”.The clinical characteristics and music therapy status were recorded and analysed.Results There were 43 sessions of music therapy in 30 patients.The proportion of aged 80 years and over was 80%.The Charlson Comorbidity Index was 4(2.5,7.5)and the one-year prognosis index was 4(1,9).The main diagnosis was cardio-brain disease(n=12,40%),cancer(n=8,26.7%),infectious diseases(n=4,13.3%),benign digestive diseases(n=4,13.3%)and diabetes mellitus(n=2,6.7%).The goals of music therapy were anxiety and depression(n=14,46.7%),hospice and palliative care(n=7,23.3%),cognitive impairment(n=6,20%),delirium(n=2,6.7%)and bereavement(n=1,13.3%),respectively.All the patients were treated with combined receptive music therapy,active music therapy and therapeutic conversation.Music-led imagination to relax was applied in 26.7%of the patients,while drawing was applied in 10%.90%of the patients had received 1 to 2 times of music therapy.A total of 8 patients′relatives participated in the music therapy.No patients and their relatives quited the music therapy and all of them were satisfied with the effect.Conclusion Screening the appropriate patients should be around the goal of music therapy.Comprehensive geriatric assessment should combine with music preference assessment before music therapy.The close collaboration between the geriatricians and the music therapists is beneficial to improve the effect of music therapy.

关 键 词：音乐疗法 处方 非药物 老年人 老年医学 诊疗模式 

分 类 号：R47[医药卫生—护理学]