ターミナルケアと音楽療法(ターミナルケアと心身医学)(第33回日本心身医学会総会)
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概要
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In recent years, the use of music therapy in terminal care has become more prevalent, especially in Western countries. In trying to analyse the complexity of pain in cancer patients, Dr. Cicely Saunders coined the phrase "total pain", which she described as having physical, psychological, social and spiritual components. Finding ways to treat the total pain of the terminally ill is a very difficult task. Music therapy has been introduced in terminal care as an approach that aims to alleviate some of this "total pain" and to improve the "quality of life" of the terminally ill. The potential of music therapy in terminal care is outlined through our experience in our hospice. Music is indispensable for the patients and their families in our hospice. Concerts are sometimes held. Occasionally a patient performs on a musical instrument at a program attended by staff, patients and their families. Ambulatory patients, patients on wheelchair and even patients in beds can gather in the hospice lobby for such programs. Frequently our hospice staff visit the rooms to sing together the favorite songs of a patient. In addition cassette tape players or CD players are available for use by the bedside, and for this a library of music tapes and CD's are available. Two cases in which music therapy was useful and effective in our hospice were outstanding. In the first case, the patient had physical, psychological and social pain, and in the second case, spiritual pain. Music therapy has the potential for multidimensional influence on the physical, psychological, social and spiritual aspects of a patient's life. Physically it promotes muscular relaxation, helps to relieve pain and facilitates physical participation. Psychologically it can alter the patient's mood including the easing of anxiety and the lessening of depression. It provides a nonverbal means of expressing feelings. Music enhances communication and helps the patient to recall past significant events. Socially it provides an opportunity to participate in a group and to lessen isolation. It can be used as a bond promoting a sense of community with family members and others ; it can also promote healing during the family's grief process. Spiritually it provides an avenue to search for the meaning of life and helps the patient to accept the dying process by easing the fear of death. Music can inspire hope. Music therapy has a great deal of potential for meeting the needs of the terminally ill and their families. In the future, music therapy is expected to be used more widely and more effectively not only in terminal care but also in the field of psychosomatic medicine.
- 日本心身医学会の論文
- 1993-01-08
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