Emotional Responses of Nurses in Hospice Ward toward Korean ...

Emotional Responses of Nurses
in Hospice Ward
toward Korean Traditional Music*
Jo, Kae-Hwa 1 , An, Gyeong-Ju 2
1
College of Nursing, Catholic University of Daegu, Daegu, Korea,
2
Department of Nursing, Cheongu University, Cheongu, Korea
*This research was supported by Basic Science Research Program through the National Research Foundation
of Korea (NRF) funded by the Ministry of Education, Science and Technology (2012-0002473).

Introduction
1. Music help patients relax
2. Slow-tempo music is more favorable
3. Korean traditional music is based on Li-Yue thought of
Confucius
4. Korean traditional music emphasizes sounds of the
nature itself

Introduction
5. Nurse in hospice ward treats the patients who suffer
pains in the crisis of death.
6. Nurse in hospice ward should maintain his/her
psychological, cognitive, behavioral balances and
practice sympathy.
7. Study on stress and response for terminal care of nurse
in hospice ward is insufficient.

Purpose
1. To understand and explain how hospice nurse
experiences Korean traditional music.
2. The questions for this are
"what is emotion experienced by Korean traditional
music?"
"what is the meaning of emotion for Korean
traditional music that nurse in hospice ward
experiences?".
3. To develop artistry and sensibility based on
multidisciplinary approaches of nursing.

Study Design
1. Qualitative content analysis (Downe-Wamboldt, 1992)
2. Collects data from interview and summarizes
information after applying Korean traditional music

Participants
1. Six people who was extracted randomly
2. University hospital in D city
3. Nurses in hospice ward.
4. Interviews were recorded with participants’ consent

Application
of Korean Traditional Music
1. Instrumental and vocal musics
2. Total 56 hours,
two hours a day in four weeks
from April 16 to June 16, 2012,
3. Research assistant applied the songs of Table 1 in order
using a CD player
at the nurses’ station at 10-11 AM and 2-3 PM.
4. The researcher joined in the site to observe the
atmosphere and response of nurses.

Table 1. A List of Korean Traditional Music Applying Nurses working at Hospice W
No. Title Musical instrument Tempo
M1 Korean folk song Small-notched bamboo vertical flute Moderate
M2 A solo flute sound Large transverse bamboo flute Slow
M3
Pipe
music
Large transverse bamboo flute
yeongsanhoesang
Slow
M4 Piri sanjo Piri Slow-fast
M5 Haegeum sanjo Haegeum, changgo, & geomungo Slow
M6 Gayageum sanjo Gayageum & changgo
Slow, gradually
fast
M7 Ajaeng sanjo Ajaeng Moderate
M8
Korean traditional
Slow, gradually
music
Gayageum & buk
fast
sanjo collection
M9 Bicheon Saengwhang, earthenware-jar Moderate
Gayageum, small-notched bamboo vertical flute,
M10 Song-book sandokebee Large transverse bamboo flute, Piri Saengwhang, Slow
haegeum, & changgo
M11 Geomungo sanjo Geomungo
Slow, gradually
fast
M12 Gyeonggi folk songs Voice Slow-moderate
M13 Namdo minyo Voice Slow-moderate
M14 Classical court music Saengwhang & small-notched bamboo vertical flute Slow
M15
Korean traditional court Large transverse bamboo flute, Yang-geum, &
music
Small-notched bamboo vertical flute
Slow
Geomungo, gayageum,g, yang-geum, haegeum,
M16 Kazun-heosang
small-piri,
Slow
Large transverse bamboo flute, Small-notched
bamboo vertical flute, & Changgo

Data Collection
1. Interview with the participants from April to June in 2012,
2. First interview started 4 weeks after applying the traditional music.
3. The location for interview: selected within the hospital
4. The interview took 1-1.5 hours until the data was full.
5. The questions for interview were
1) "What do you experience through Korean traditional music?"
2) "What do you feel from Korean traditional music?"
3) "Which image dose Korean traditional music give you?"
4) "Which relations are there between Korean traditional music and
nursing?”

Data Analysis
1. The participant's interview data was analyzed using the traditional
qualitative content analysis of Downe-Wamboldt (1992) and
Graneheim & Lundman (2004).
1) Interview was transcribed was read repeatedly
2) Read again to check the semantic unit fit for the content of
emotion for Korean traditional music (ex, sorrowful, plaintive)
3) Word, sentence or phrase were extracted and describe and coded.
4) Classified into categories.
5) The categories continued to be compared while classifying.
6) The subjects classified were compacted abstractly.
7) The codes, categories and subjects were discussed with other
professors of nursing science to check validity.
8) The validity was verified by checking again to the participants.

Reliability and Validity
of the Study
1. Qualitative research audit of Morse and Field (1995)
2. The details were summarized, confirmed, consistent with the
facts.
3. The participants' statement, expression and attitude
were observed and recorded to increase reliability.
4. Through feedback between analyzers and in order to exclude
bias,
5. The analysis was submit to the participants and qualitative
research experts.

Results
General characteristics of participants
1. Two participants: 30 years old
2. Three participants: 40 years old
3. One participant: 50 years old
4. One participant: Charge nurse
5. Five participants: Staff

Table 2. Themes and Categories Identified
Themes
Mirror of inner feeling
Categories
Expression of feelings
Maintenance of sense of balance
Reflection of personal life
Connection to traditional music
Revival of memory
Opportunity of switch
Music as a therapeutic medium
Charm to traditional music
Sympathetic communication
Unfamiliar and barrier
Barrier to knowledge
Barrier to sensitivity
Barrier to attitude

1. Mirror of Inner Feeling
The subject, ‘Mirror of Inner feeling' is that the
participants show their experienced feeling through
Korean traditional music.
The traditional music aroused calm and
emotion to meditate and helped
cultivate sympathetic skills and
concentration in nursing of
hospice ward.

1) Expression of Feelings
‘Gentle, thrilling sound of the flute playing quite plaintively
saddened my heart, then the janggu beat lifted my mood
enough light as a feather and made me excited.
My steps became quicker through green trees in the garden
tuned on the sound of janggu. (Participant 1)

2) Maintenance of Sense of Balance
‘I feel relaxed when I listen to traditional music so, when I work alone at
night, I can attend to details without missing something important.
One day, when a patient asked to me, 'No many days left for me,
right?’…
Before, I would hesitate in speaking and be very embarrassed
though I responded frankly and calmly that day. Perhaps, I read the
minds of patients. That I‘d better not deny it.
After that, we stated to have open and honest
talks about our plans for the future.‘
(Participant 3)

2. Reflection of Personal Life
This subject explains how Korean traditional music acts
as a bridge between inner ego and life of the participants.
Furthermore, they express how the traditional music
reminds them of memories and converts their stress.

1) Connection with Traditional Music
‘While listening to music, I thought ‘Oh my, how
such sounds can be made?’ Like soothing my
heart… And I was enchanted unutterably.
The ebb and flow of the melody tender than
ever before,
something like stopping the moment and
at the same time going beyond it,
gave me the feeling that telling me don’t tie up
my mind in this world.
That the real world doesn’t mean everything …
I felt who is in the ward now, and both people and
things around me coming to me sweet and friendly.’

2) Revival of Memory
‘First, traditional music eases my mind.
Because its slow tempo in general
makes me feel like my body goes along
with my mind.
From afar, sounds of shaking bamboo trees are like somebody is
calling me.
I feel as if I am going back to the old days, as if I am going to the
mountain top or riverside in the evening and I am looking at myself
sitting quietly.
I can see myself, so pure without having many things.' (Participant 6)

3) Opportunity of Switch
‘I don’t usually listen to Korean classic music much,
then I got new impression about it this time.
Lasting echoes of the instruments ...
how should it be called, something like a spreading, resonance?
It reminded me of my hometown and I felt it
relaxes my body and mind.
As muscles are relaxed by music, I can
somewhat take it easier even
when I treat patients or their guardians.

3) Opportunity of Switch
‘Unlike Western music, I see no significant different
to dynamics and range in sijo and chang.
Staying in the same tune, sometimes it feels a bit
boring.
But, maybe, I will say it was calmness?
While I am listening to this kind of music,
I feel like I'm watching the sound rather than absorbing into it.
I’ve been thought it’s a song for the elderly, however, but it’s comforting for
someone like me still young with no sense of difference.
It’s a feeling like that I am getting a good energy.’ (Participant 5)

3. Music as a Therapeutic Medium
The participants felt that the traditional music could be
therapeutic for them.
While they listened to the traditional music, they
recognized the music as a bridge between themselves,
environment, patient and guardian.

1) charm of traditional music
‘Listening to Chungsong, the Song of Pine trees,
I got such feeling that I walk down slowly from
the high mountain and settle down deep inside
of me.
Buried myself in my work and everyday life, I’ve almost forgotten myself……
Since I first listened to traditional music,
I guess, I’ve became able to see myself from the outside and stay calm.
My impression on tradition music can’t be expressed in one word in one word,
but it’s really, really good.
Each time, it becomes more familiar and gives me new mood every other time,
you know? Yeah. Good thing takes your mind. For that, I once take it with me
and listened at home.' (Participant 2)

2) Sympathetic Communication
‘My lover who left without me will have a sore foot within a mile, as it
goes,
Korean folk song have the power to sooth deep regrets and sorrows of
the age. (……)
Even for experienced nurses, dealing with dying
patients will not be an easy task.
That’s why the nurses of the hospice ward need to
put an effort intentionally for themselves with
book, music, or art, whatever suit each taste...’

4. Unfamiliarity and Barrier
In spite of positive aspects, the participants explained that
the traditional music was strange and unfamiliar with
application.
The factors to bring strange response are barriers to
knowledge, sensitive and attitude for the traditional
music.

1) Barrier to Knowledge
‘If we talk about music in general, Western
classic music comes first, right?
Above all, I didn’t felt good about that we
are unfamiliar with the Korean raditional
music even though we are Koreans.
I need to admit my ignorance on music first and the anxiety
came next, of being asked about the song.’ ((Participant 5)

2) Barrier to Sensitivity
‘This song has a strong mood of Buddhism…
perhaps, is it a Buddhist song? Wooden gong is keep sounding,
feels like chanting some mantra.
It would be better turn down a little or change to a different
song.’ (Participant 2)

3) Barrier to Attitude
‘ I'm worried if a patient stuck in bed would get more depressed
with the melancholy sound of flute.
The dong of bumper year, this song is too exciting.
Patients might not like it for that.
It could give a shock to patients.’

Conclusion
1. This study that sheds new light on experience of Korean
traditional music from the cultural perspective
targeting in hospice nurse is of significance.
2. This improves the current negative image of the
traditional music and emphasizes therapeutic role of
the traditional music.
3. This study suggests basic data to establish multidisciplinary
system of nursing science that values of
artistry and slowness of nursing in the field.

Suggestions
1. This study proposes to develop treatment program
using the traditional music based on the findings.
2. This study proposes experimental research which
applies the traditional music to hospice target as
nursing intervention .
3. This study proposes to find multidisciplinary course of
nursing science using the traditional music.

Thank you !