Sing a New Song: Community Songwriting and Singing to Enhance the Quality of Life and Health of Older Adults
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Sing a New Song: Community Songwriting and Singing to Enhance the Quality of Life and Health of Older Adults The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:37945125 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#LAA Sing A New Song: Community Songwriting and Singing to Enhance the Quality of Life and Health of Older Adults Robert Bergner A Thesis in the Field of Psychology for the Degree of Master of Liberal Arts in Extension Studies Harvard University May 2018 Copyright 2018 Robert Bergner Abstract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edication This thesis is dedicated to my community songwriting colleagues at Yale New Haven Hospital, Yale New Haven Psychiatric Hospital and Musical Intervention, and those at The Seabury Community whose enthusiastic creativity forms the basis of the research presented here. As well, I offer this work in memory of my mother, Marilyn Bergner, Ph.D., a pioneer in the measurement of quality of life and health. v Acknowledgements I am grateful for… The residents and staff of The Seabury Community for their support of my creative musical work while I served as Interfaith Chaplain there for several years. The encouragement and guidance of Shelley Carson, Ph.D., my thesis director. Her appreciation of the importance of creativity for healthful human living has been an inspiration and her matter-of-fact walk through of computerized statistical analysis saved me from a thousand time-wasting pitfalls. My father, Lawrence Bergner, M.D., and stepmother Shoshanna Sofaer, Ph.D., for their longstanding, engaged interest in my academic, pastoral and creative work. My brother, Daniel Bergner, for his unrelenting enthusiasm for what I do. Licia Sky for reminding me how powerful a heartfelt original song can be. Matt Hagen for keeping my scholar’s ship afloat when troubled waters threatened. Fernanda Clariana and the staff at Yale New Haven Hospital and Dr. Elizabeth Frates at Spaulding Rehabilitation Hospital for their enthusiastic embrace of my musical interactions with their patients. Adam, Rachel and everyone at Musical Intervention for their vision, passion, talent and positive attitude. I am grateful, most of all, for my wife, Pam, who has lived with this project and the lead up to it for more than half a decade. Thanks, Soleil, for your love and patience! iv Table of Contents Dedication……………………………………………………………………………….... v Acknowledgements……………………………………………………………………..... vi List of Tables…………………………………………………………………………..… ix List of Figures…………………………………………………………………………….. x I. Introduction.............................................................................................................. 1 Definition of Terms...................................................................................... 3 Background of the Problem......................................................................... 4 II. Method................................................................................................................... 15 Participants................................................................................................. 15 Measures………………………………...…………………………..……17 Quality of Life...................................................................................17 Positive and Negative Affect............................................................ 18 Perceived Self-Efficacy.................................................................... 19 Health Care Visits............................................................................. 20 Procedure…………….……………...………..…………………………..20 III. Results.................................................................................................................... 23 Effects of the Songwriting Intervention on QOL...................................... 24 Effects of the Songwriting Intervention on Positive and Negative Affect..................................................................... 27 Effects of the Songwriting Intervention on General Self-Efficacy................................................................................. 27 Effects of the Songwriting Intervention on Unscheduled Medical Visits....................................................................... 28 Qualitative Effects of the Songwriting Intervention.................................. 28 IV. Discussion.............................................................................................................. 30 Limitations................................................................................................. 32 Conclusion................................................................................................. 34 Appendix A........................................................................................................................ 36 Appendix B........................................................................................................................ 39 Appendix C........................................................................................................................ 46 References.......................................................................................................................... 54 List of Tables Table 1 Comparison of group pre- and post-test means on principle measures of QOL, affect and self-efficacy………………………………25 ix List of Figures Figure 1 Change in psychological QOL scores before and after songwriting intervention............................................................................26 x Chapter I Introduction America is aging. According to the U.S. Census Bureau, the number of older adults living in the United States will increase substantially over the next four and a half decades. In 2014, fewer than one in seven Americans was 65 years of age or older. By 2060, that ratio will increase to almost one in four, nearly 100 million people (Colby & Ortman, 2015). Meanwhile, the United Nations Department of Economic and Social Affairs (ECOSOC) predicts a similar global transformation. According to ECOSOC, the worldwide population of people over 60 years of age will double by 2050 and triple by 2100 (ECOSOC, 2015). Furthermore, adults living until 65 in the United States in 2014 could expect to live for an average of almost another two decades and those living until 75 could expect, on average, to live slightly more than an additional dozen years (United States Department of Health and Human Services, 2015). While enjoying the potential benefits of longevity, this burgeoning cohort of older adults faces the real threat of chronic illness. The United States Agency for Healthcare Research and Quality (AHRQ) reported in 2005 that more than 90% of Americans over 65 years of age were living with at least one chronic medical condition (AHRQ, 2005). In 2010, the AHRQ stated that 80% of Americans over 65 years of age live with Multiple Chronic Conditions, that is two or more chronic illnesses (AHRQ, 2010). The prevalence of chronic illness, in turn, places an important burden on the healthcare resources of the United States, where, according to the 2010 AHRQ report, more than two-thirds of ) 1 healthcare dollars are spent caring for people