the significance of choral singing

7/25/2019 The Significance of Choral Singing

1/18

Article

MusicPerformance

Research

Copyright2010

RoyalNorthernCollegeofMusic

Vol3(1)SpecialIssueMusicandHealth:7996

ISSN17559219

The

significance

of

choral

singing

for

sustainingpsychological

wellbeing:

findings

from

a

survey

of

choristersinEngland,AustraliaandGermany

StephenClift

GrenvilleHancox

SidneyDeHaanResearchCentreforArtsandHealth

ABSTRACT:Previousresearchhashighlightedthepossiblebenefitsofactivepar

ticipation insingingforwellbeingandhealth. Shortcomings inthe literatureare

thelackofacommonunderstandingofwellbeingandhealth,andtheabsenceof

atheoreticalmodelofthecausalmechanismslinkingsingingwithwellbeing. The

presentstudyaimstoaddresstheseshortcomingsthroughalargecrossnational

survey of choral singers based on theWorldHealthOrganization definition of

healthandutilizingmeasuresdevelopedby theWHOQualityofLifeproject. A

totalof1124choralsingersdrawnfromchoirsinAustralia,EnglandandGermany

completedtheWHOQOLBREFquestionnairetomeasurephysical,psychological,

social and environmental wellbeing, and a 12item effects of choral singing

scale. Writtenaccountsoftheeffectsofchoralsingingonwellbeingandhealth

weregiveninresponsetoopenquestions. Ahighdegreeofconsensusemerged

onthepositivebenefitsofchoralsinging,withwomensignificantlymorelikelyto

endorsethevalueofsingingforwellbeingandhealthcomparedwithmen. Asig

nificantbut small correlationbetweenpsychologicalwellbeing andpositive ef

fectsofchoralsingingalsoemergedforwomen,butnotformen. Particularat

tentionisgiventoqualitativeaccountsoftheeffectsofchoralsingingonwellbe

ing from85participantswith relatively lowpsychologicalwellbeingasassessed

bytheWHOQOLBREF,andhighscoresonthesingingscale. Fourcategoriesof

significant personal and health challengeswere disclosed bymembers of this

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Article

group:enduringmentalhealthproblems; family/relationshipproblems;physical

health challenges and recent bereavement. Their accounts also suggested six

generativemechanismsbywhichsingingmay impactonwellbeingandhealth:

positive affect; focused attention; deep breathing; social support; cognitive

stimulationand

regular

commitment.

KEYWORDS: Choral singing, psychological wellbeing, WHOQOLBREF, survey,

crossnational,health

Arecentsystematicmappingoftheempiricalliteratureonsingingandwellbeingidentified

35papersforreview(Clift,Hancox,Staricoff&Whitmore,2008). Thestudiesvariedconsid

erablyintermsoffocus,method,samplecharacteristics,samplesize,natureofthesinging

investigated,datagatheredandapproachtoanalysis. Thestudiesaresodiversethataco

herent synthesis of the evidence on the value of singing forwellbeingwas not possible.

Rather,studieswerecategorisedaccordingtotheirdesignandthenatureofdatagathered

andtheevidencetheyprovidedcriticallyevaluated.

Qualitativestudiesofsingingandhealth

Anumberofqualitativestudiesonthebenefitsofcommunitysinginghavebeenundertaken

withdiverse samplesofsingers,and theseprovideevidence from subjective reportsona

rangeofsocial,psychological,andhealthbenefitsassociatedwithsinging. BaileyandDavid

son(2002,2005)forexample,interviewedchoirsingersfromarangeofsocialbackgrounds

inCanada;Silber (2005)explored the impactofasinginggroupestablished inawomens

prisonin

Israel,

and

Watanabe

(2005)

explored

the

experience

of

individual

engagement

withKaraokelessonsandperformanceinJapan.

TheworkofBaileyandDavidson isofparticularrelevancetothestudyreportedhere.

Intheirfirststudy(2002)theyinterviewedmembersofasmallchoirsetupinMontrealfor

homelessmenandfourthemesemergedrepeatedlyinthemensaccounts:

Groupsingingalleviateddepressionandenhancedemotionalandphysicalwellbe

ing.

Performing to an audienceencouraged a senseofpersonalworth andprovideda

meansofreengagingwithwidersocialnetworks.

Thechoir

provided

asupportive

context

for

the

men

in

which

they

could

develop

theirsocialskillsandachievecollectivegoals.

Singingismentallydemanding,andrequiredthementoconcentrateandlearnnew

materialinordertoperform. Suchconcentrationalsodirectedtheirattentionaway

frominternalpreoccupationwiththeirproblems.

Infurtherwork,BaileyandDavidson(2005)interviewedmembersofasinginggroupin

aneconomicallydisadvantagedarea, togetherwithmoresociallyadvantagedandaffluent

choralsingers. Thethemesidentifiedinthe2002paperareconsideredtobebroadlyappli

cable

to

singers

irrespective

of

social

context

and

the

character

of

the

repertoire

being

sung,

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Article

but some differences of emphasis did emerge. Both disadvantaged andmoreprivileged

singers,forexample,highlightedthebroadlytherapeuticvalueofparticipation insinging,

particularlyinrelationtocreatingenergy,positiveemotionalexperienceandrelaxation. For

otherthemes,some importantdifferencesemerged,particularlyinrelationtocognitivedi

mensionsandtheimpactofsinginginagroup. Forthemoremarginalisedparticipants,sing

ingprovidedastimulatingactivitywhichhelpedtopromoteconcentrationandanordering

oftheir innermentalspace. Forthemiddleclasssingers, incontrast,agreaterstresswas

placedondevelopingmusical knowledgeand skillwhichenabled them tomeet thechal

lengesofclassicalrepertoireandgainasenseofachievement.

Questionnairesurveysofsingingandhealth

Theideathatsingingcanbebeneficialforwellbeingandhealthisalsosupportedbysurveys

inwhichchoralsingershavebeenaskedtorespondtoarangeofstatementsabouttheef

fectsof

singing.

Beck,

Cesario,

Yousefi

and

Enamoto

(2000)

report

that

67

per

cent

of

semi

professionalchoralsingers intheirsurveyagreedorstronglyagreedthat Singinghascon

tributedtomypersonalwellbeing,andCliftandHancox(2001)reportthat71percentof

singers inauniversitychoralsocietyagreedorstronglyagreed thatsingingwasbeneficial

for their mentalwellbeing. CliftandHancox identifiedsixdimensionsofbenefitsassoci

atedwithchoralsingingfromaPrincipalComponentsAnalysisoftheirquestionnairedata.

Thesewere labelled (in order) as: benefits forwellbeing and relaxation, benefits for

breathingandposture,socialbenefits,spiritualbenefits,emotionalbenefitsandbene

fitsfortheheartandimmunesystem. Thereisalsoaclearlinkbetweenthesetofcompo

nents emerging from this analysis and the model of positive benefits of group singing

emergingfrom

the

work

of

Bailey

and

Davidson

(2002,

2005).

For

the

first

and

most

impor

tant factorof wellbeing and relaxation,Clift andHancox found thatwomen had higher

scoresthanmen,suggestingthatwomenexperienceorperceivegreaterwellbeingbenefits

fromsinging.

BaileyandDavidson (2003)alsoconductedaquestionnairestudytocomparetheper

ceivedbenefitsof activeparticipation inmusic (singing in a choir), passive listening to

musicwithothers,andpassivelisteningtomusicalone. Choristersfromthreechoirs(N=

121)participated inthesurveyandwere invitedtocompletea100itemquestionnairede

scribedasmeasuringattitudesrelatedtomusic. Included inthequestionnairewerethree

setsof22 itemsconcernedwiththe holistichealtheffectsofmusic inthethreeparticipa

tioncategories.

Additional

items

relating

to

choir

practices,

performances,

voice

quality

andconductingtechniqueswereincludedtocamouflagethepurposeofthequestionnaire.

BaileyandDavidson report thatanumberof thegroup singing items receivedhigher

ratings than equivalent listening items, and indicated that singing promotes heightened

arousalonavarietyofbehaviouraldimensions. Theseitemswere:improvesmood,isan

exhilaratingactivity,givesmeasenseofachievement,isacreativeexperienceandgives

meakindofhigh. Bycontrast,thelisteningaloneitemswhichreceivedhigherratingswere

indicativeofprocesseswhichpromotestress reductionand restorationofahomeostatic

state.These itemswere:reducesstress,releasessuppressedemotions,isphysicallyre

laxingandreleasestension. BaileyandDavidsonconcludefromtheirfindingsthatdiffer

entlevels

of

music

participation

can

have

differential

yet

beneficial

effects.

(p.

223).

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Article

Experimentalstudiesofsingingandhealth

Inaddition toqualitativestudiesandquestionnairesurveys,moreobjective,experimental

researchhasalsoassessedtheimpactofsingingonphysiologicalvariablesassumedtohave

wellbeingand

health

implications.

Several

studies,

for

example,

have

assayed

levels

of

im

munoglobulinAinsalivatakenfromparticipantsbeforeandaftersinging,andreportedsig

nificant increases, pointing to enhanced immune system activity (e.g. Beck et al., 2000;

Kuhn,2002;Kreutz,Bongard,Rohrmann,Grebe,Bastian,&Hodapp,2004).

Twoquasiexperimentalstudieshavealsoreportedpositivehealthbenefitsfromgroup

singingforelderlypeopleusingstandardisedmeasuresandobjectiveindicatorsofwellbeing

andhealth. Houston,McKee,CarrollandMarsh (1998) report improvements in levelsof

anxietyanddepressioninnursinghomeresidentsfollowingafourweekprogrammeofsing

ing,andCohen,Perlstein,Chapline,Kelly,FirthandSimmens(2006)foundimprovementsin

bothmentalandphysicalhealth inagroupofelderlypeopleparticipating inacommunity

choirfor

one

year.

Limitationsofexistingresearchandthepresentstudy

Theexistingresearchliteraturehassubstantiallimitations(seeClift,Hancox,Staricoff,etal.

2008). Manyofthestudiesaresmallscaleandessentiallyexploratoryandonlyonestudy

hasindependentlyreplicatedandimproveduponapreviousstudy(Kreutzetal.,2004repli

catingBecketal.,2000). Themainshortcomingsofthiscorpusofresearcharethelackofa

common conceptual understanding ofwellbeing and health, and the absence of a fully

elaborated theoreticalmodelof thecausalmechanisms linkingsingingwithwellbeingand

health.

Afurther limitationofparticular interestandrelevancetothestudyreportedbelow isthelackofattentiontothepotentialsignificanceofsexinrelationtochoralsingingandits

effects. Thesystematicreviewrevealedthat19ofthe35papersconsideredreportedre

searchongroupsinging. Threestudieswereconcernedwithsinglesexsinginggroups,and

therest includedbothsexes. However, fourstudies failedtoreport thenumbersofmen

andwomen intheirsamples. Inthe13studiesgivingdetailsofsexcompositionatotalof

763singerswereinvestigatedwith72percentwomenand28percentmen. Theonlystudy

toexaminesexasa factor in relation to their findings is the survey reportedbyCliftand

Hancox(2001). Asnotedabove,theyfoundevidencethatwomenreportedstrongerwell

beingbenefitsassociatedwithsingingthandidmen.

Thepresent

study

aims

to

address

these

limitations

in

the

previous

literature

through

a

largescalecrossnationalsurveyassessingtheviewsofchoralsingers inEngland,Germany

andAustraliaonthepossibleeffectsofsingingonwellbeingandhealth. Whiletheproject

was initiated by the SidneyDeHaan Research Centre in England, research colleagues in

Germany and Australia expressed an interest in using the same instruments in a cross

national collaboration. All three countries are affluent democracies, andmarked differ

encesbetweenthemwerenotexpected. Rather,thecrossnationaldimensiontothestudy

wasseenasprovidingabasisoftestingthegeneralityoffindingsacrossthreeindependent

nationalsamplesofsingers.

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ThestudyisbasedontheWorldHealthOrganizationsdefinitionofhealth(WHO,1946)

asastateofcompletephysical,mentalandsocialwellbeingandnotmerelyanabsenceof

illnessorinfirmity(p.100)(andusesacrossnationallyvalidatedqualityoflifeinstrument

theWHOQOLBREFdevelopedbytheWHOQualityofLifeproject(Power,Harper,Bullin

gerandtheWorldHealthOrganizationQualityofLifeGroup,1999). Foradetaileddescrip

tion of the study,methods and findings see Clift, Hancox,Morrison, Hess, Stewart and

Kreutz(2008).

Morespecifically, thepresentpaperpresents findings fromanewlyconstructedscale

assessingtheperceivedwellbeingeffectsofparticipatinginchoralsinging,andexploresthe

relationshipsbetween thisscaleand theWHOQOLBREFmeasureofpsychologicalwellbe

ing. Intheconstructionandanalysisofthisscale,carefulattentionisgiventothequestion

ofdifferencesattributabletosex. Itwasexpected,onthebasisofthefindingsreportedby

CliftandHancox (2001) thatwomenwouldendorse thewellbeingeffectsofsingingmore

stronglythanmen.

Inorder

to

explore

further

the

value

of

choral

singing

for

health,

some

illustrative

ex

amplesaregivenofwrittencommentsaboutsinginganditseffectsfromchoristerswhore

portstrongwellbeingbenefitsfromsingingbutwhosegeneralpsychologicalwellbeingap

pearsrelatively low. Attention isgiven to thechallengessomeof thesechoristers face in

theirliveswhichmayaccountfortheirrelativelylowerpsychologicalwellbeing. Theircom

ments also serve to highlight a range ofmechanisms, some ofwhich have already been

identified inpreviousresearch,throughwhichsingingcanacttopromotepersonalwellbe

ing.

METHOD

Participatingchoralsocietiesandchoirs

Thesampleconsistedof1124choralsingersdrawn from21choralsocietiesandchoirs in

England(N=633),Germany(N=325)andAustralia(N=166). InEngland,asampleofcho

risters involved in an ongoing community singing project for elderly people also partici

pated. Theoverallresponseratewas61percent.

MostofthechoirsinthesurveysingmajorchoralworksfromtheWesternclassicalrep

ertoirefromthefifteenthtotwentiethcentury. Somechoirssingamoreeclecticrepertoire

includingwellknownsongsfrommusicalshowsandfilms. Onlysixofthe21choirsareaudi

tionedandtheremainderareopentoallcomers.

Severalofthechoirshavebeenestablishedalongtime. TheStuttgarterLiederkranzin

Germanyistheoldestchoirinthesurvey,foundedin1824,followedbytheEnglishAshford

ChoralSocietyfoundedin1857,andTheQueenslandChoir inAustraliasetup in1872. So

cietiesthathavecontinuedinexistenceforthislengthoftimeindicatetheappealofchoral

singingfromthenineteenthtothetwentyfirstcenturies. Therearealsosomerecentlyes

tablishedchoralsocietiesandchoirsinthestudy:theGermanEnsembleadlibitumStuttgart

was formed in2002,andTheSilverSingers,Gateshead,EnglandandTheEsplanados,Bris

bane,Australiaweresetupin2005.

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Article

TheQuestionnaire

Thequestionnairewasstructuredinthreeparts. Thefirstpartaskedforpersonalinforma

tionanddetailsoftherespondents involvementwithmusicandsinging. Thesecondsec

tionfocused

specifically

on

the

effects

of

choral

singing

and

started

with

three

open

ques

tionsontheeffectsofsingingonqualityoflife,wellbeingandhealth:

1. Whateffects,ifany,doessinginginachoirhaveonyourqualityoflife?

2. Whateffects, ifany,does singing ina choirhaveon yourpsychologicaland social

wellbeing?

3. Whateffects,ifany,doessinginginachoirhaveonyourphysicalhealth?

Thesequestionswerewordedcarefullytoavoidbeing leading,andto indicatethatef

fectsmightbepositiveornegativeor that theremaybenoeffectsatall. Thequestions

werealso focusedon the respondentsownhealth, rather thanaskingaboutpossibleef

fectsofsingingonotherpeopleshealth.

Theseopenquestionswerethenfollowedby24statementsaboutchoralsingingusing

itemsdefining the firstmajor wellbeingand relaxationcomponent reportedbyCliftand

Hancox(2001)anditemsfromtheSingersEmotionalExperiencesScaledevisedbyBecket

al.(2000). The instrumentsdevisedbyCliftandHancox,andBecketal.couldbecriticised

forincludingonlypositivelywordeditems,whichcouldhelptoreinforceapositiveresponse

bias. In the present questionnaire, therefore, twelve itemswere positivelyworded and

twelve negativelyworded, and participants responded on a fivepoint Likert scale from

stronglydisagreeto stronglyagree. FollowingaPrincipalComponentsAnalysis (seebe

low)scoreson12oftheseitemsweresummedtoformasinglesingingandwellbeingscalewithahighdegreeofinternalconsistency. Scoresonthescalerangefrom1260(seebelow

fordetails).

ThethirdsectionofthequestionnairecontainedtheWHOQOLBREF. Thiswasdesigned

to assess fourmajor lifequality domains: physical (e.g.Howmuch do you needmedical

treatmenttofunctioninyourdailylife?),psychological(e.g.Howmuchdoyouenjoylife?),

social(e.g.Howsatisfiedareyouwiththesupportyougetfromyourfriends?)andenviron

mental(e.g.Howsatisfiedareyouwiththeconditionsofyourlivingplace?). Thequestion

nairehasbeenwidelyusedinternationallyandhashighlevelsofreliabilityandvalidity(e.g.

Skevington,Lofty,&OConnell,2004;Hawthorne,Herrman,&Murphy,2006). Itwascon

sideredespecially

suitable

for

across

national

survey

as

official

WHO

versions

of

the

ques

tionnaireareavailableforuseinAustralia,GermanyandtheUK. Attention inthispaperis

confinedtothepsychologicalwellbeingscale. Thisconsistsofsixstatementstowhichpar

ticipantsrespondusingfivepointLikertscales(thewordingvariesbyitem). Theitemscores

weresummed toprovide rawscoresonascaleranging from630,and thesewere trans

formedfollowingWHOQOLBREFguidelinestoascalerangingfrom420.

Questionnairesweredistributed tomembersofparticipating choirsduringMay2007

forcompletionathomeandreturninasealedenvelope.

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Ethics

Thestudyreceivedethicalapprovalthroughethicscommitteesinthecollaboratinguniversi

ties in each country. Participationwas entirely voluntary and questionnaireswere com

pletedanonymously.

It

was

assumed

that

singers

would

find

the

survey

of

interest

and

this

wasreflected inthecaretakentoprovideanswerstotheopenquestions. Areportbased

onapreliminaryanalysisofthedatagatheredwasmadeavailabletoallrespondentsafter

completionofthesurvey.

Analysis

NumericaldatafromthequestionnairewereanalysedusingSPSS16. PrincipalComponents

Analysiswasapplied to the24 singing items, for the totalsampleand forsixcountry/sex

groups. Theresultsforthefirstunrotatedcomponentprovidedjustificationforconstructing

a summed scale using 12 items to assess perceivedwellbeing effects of choral singing.

Comparisonsbetweenmenandwomenineachcountryandwithinthetotalsampleswere

madeusing independent ttests. Productmoment correlationswere computedbetween

thesingingscaleand theWHOQOLBREFpsychologicalwellbeingscale. Toexplorethe is

suesaddressedbythissurveymoreconcretely,attentionisgiventothecommentswritten

onthequestionnairebyrespondentswithrelativelylowscoresonthepsychologicalwellbe

ingscale,buthighscoresonthesingingscale. Asimplethematicapproachwasadoptedto

identifyexamplesof lifechallengeswhichmayexplain therelatively lowwellbeingscores,

togetherwithcommentsidentifyingpossiblemechanismswhichlinksingingwithbeneficial

outcomesforwellbeing.

Findings

Theaverageageofchoristerswasrelativelyhigh(M=57years(SD=15)withathirdaged

6069andafifthaged70andabove). Womensubstantiallyoutnumberedmen (72vs.28

percent). Choristersreportedengagementwithchoralsingingforameanof27years(SD=

11years);42percentreportedhavinghadsinginglessons;62percentplayedamusicalin

strumentandonly6percentweretoldaschildrenthattheycouldnotsing.

Withrespecttohealth,79percentwere satisfiedor verysatisfiedwiththeirhealth

(with21percentlessthansatisfied)and87percentdescribedtheirhealthasgood,very

goodorexcellent(with13percentdescribingtheirhealthaslessthangood). Justunder

halfof

the

sample

(N

=536,

49%)

reported

long

term

health

problems,

the

most

commonly

expressed issues being problemswith pain, emotional andmental health problems and

problemswithbreathing.

PrincipalComponentsAnalysis applied to the choral singing items identified a strong

first componentwith substantial loadings from 12 items (e.g. improvedmood,enhanced

qualityoflife,greaterhappiness,stressreduction,andemotionalwellbeing). Table1gives

the loadingsofthese items inseparateanalysesofdata fromsixcountryxsexsubgroups

anddemonstrates therobustnessofthispattern. It isstrikingthatasenseof happiness

producedbysingingistheitemwhichachievesthehighestloadingforthetotalsample,and

isalsothehighestloadingitemforfouroutofthesixsubgroups.

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Table1:Effectsofsingingquestionnaire:firstprincipalcomponentforsixcountryxsexgroups(12items)Totalsample

EnglishMen

English

Women

Australian

Men

Australian

Women

German

Men

German

Women

Makesmefeelalothappierafterwards .75 .74 .73 .66 .83 .72 .78

Singinggivesapositiveattitudetolife .74 .74 .74 .68 .78 .72 .74

Singinghasimprovedwellbeing/health .74 .68 .77 .76 .81 .71 .69

Singingreleasesnegativefeelings .73 .74 .75 .69 .82 .71 .73

Singinghelpsmakemeahappierperson .73 .72 .78 .78 .74 .69 .68

Singingdoesn'tgivemea'high' .70 .71 .71 .74 .61 .73 .67

Choirpositivelyaffectsqualityoflife .70 .66 .75 .64 .66 .74 .60

Relaxingand

helps

deal

with

stress

.69

.61

.70

.67

.70

.66

.74

Doesn'treleasenegativefeelingsinmylife .69 .72 .68 .65 .74 .67 .65

Singingmakesmoodmorepositive .69 .68 .71 .71 .71 .71 .60

Doesn'thelpgeneralemotionalwellbeing .67 .69 .68 .44 .75 .73 .62

Singinggivesnodeepsignificance .65 .65 .65 .68 .63 .66 .69

Varianceaccountedfor 50.1 48.4 51.9 46.2 53.8 49.5 46.7

Cronbachalpha 0.91 0.91 0.92 0.89 0.92 0.91 0.90

Theseitemswereusedtoconstructasinglesummedmeasureoftheperceivedeffects

ofsingingonwellbeing(Cronbachalpha=0.9forbothsexes). Ahighmeanscoreconfirmed

thata largemajorityofchoristers, ineachcountry,andamongmenandwomen,agreed

thatsinginghasapositiveimpactonpersonalwellbeing(seeTable2). Differencesbetween

thesexeswereapparent,however,andasexpectedwomengavehigherscoresthanmenin

eachcountryandinthetotalsample. FortheEnglishandGermansamplesandforthetotal

sample,thisdifferenceisstatisticallysignificant.

Table2:Singingscalestatisticsforcountryxsexsubgroups

England

Australia

Germany

Total

Men

N=134

Women

N=449

Men

N=51

Women

N=103

Men

N=100

Women

N=192

Men

N=285

Women

N=744

M SD M SD M SD M SD M SD M SD M SD M SD

48.1 6.8 50.2 6.7 49.5 5.6 50.7 6.9 47.0 7.0 49.5 6.6 48.0 6.7 50.1 6.7

t(584)=3.19,p=


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Article

OntheWHOpsychologicalscale,amajorityofrespondentsscoredwellabovethescale

midpointindicatinggoodtoexcellentselfassessedpsychologicalwellbeing(seeTable3).

A small proportion of choristers, however, gave low scores,which could indicatemental

healthdifficulties. For the frequencyofnegative feelings item forexample,justoversix

percentofparticipantsgaveratingswhich indicated that they veryoftenor alwaysex

periencednegativefeelingssuchasbluemood,despair,anxiety,depression.

Table3:WHOQOLBREFPsychologicalwellbeingpercentageresponsestoindividualitems(totalsample)

N 1

Low

2 3 4 5

High

Enjoylife 1112 0.2 1.3 15.1 67.2 16.3

Lifeismeaningful 1097 0.7 2.8 17.5 54.3 24.6

Abletoconcentrate 1111 0.1 1.9 31.6 56.9 9.5

Acceptbodilyappearance 1113 1.1 4.5 18.3 51.8 24.3

Satisfactionwithself 1108 0.9 4.7 21.1 60.3 13.0

Frequencyofnegativefeelings 1112 0.7 5.4 27.7 54.9 11.2

Itemsarescaledsuchthathighscoresreflecthighwellbeing. Forthefrequencyofnegativefeelingsitem,for

example,ahighscoremeansthatthefrequencyofnegativefeelingswaslow(1=always,2=veryoften,3=

quiteoften,4=seldom,5=never).

AsTable4indicates,womenintheEnglishandGermansamplesandthesampleoverall

scoredslightlyloweronthepsychologicalwellbeingscale. ThesedifferencesintheEnglish

andtotal

samples

were

statistically

significant.

Table4:WHOQOLBREFPsychologicalwellbeingscores

England Australia Germany Total

Men

N=139

Women

N=463

Men

N=54

Women

N=106

Men

N=101

Women

N=201

Men

N=294

Women

N=770

M SD M SD M SD M SD M SD M SD M SD M SD

15.7 1.8 15.3 2.0 15.5 2.2 15.1 1.8 15.6 2.1 15.7 2.1 15.7 2.0 15.4 2.0

t(603)=2.17,

p

=


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Article

geststhatallpossiblecombinationsofhighandlowscoresonbothscalesarerelativelysimi

larinfrequency.

Toexplore this finding further,data from theWHOQOLBREFpsychological scaleand

theeffectsofsingingscaleweredividedasneartothe33rd

and67th

percentilesaspossible

andthetworecodedscaleswerecrosstabulated. Respondents inthe lowestthirdonthe

psychologicalwellbeingscale,andthehighestthirdontheeffectsofsingingscalewerecon

sideredofparticularinterestforunderstandingthepotentialimpactofsingingonwellbeing.

Thesearepeoplewho report that theirgeneralpsychologicalwellbeingover theprevious

twoweekshadbeenrelativelylowcomparedwiththesampleoverall,butwhoalsoreporta

relativelyhighimpactonwellbeingfromsinging. Eightyfivepeopleinthetotalsamplefell

into thiscategory:15menand69women (onerespondentdidnotdisclose theirsex);51

English,19Germanand14Australian.

Justunder twothirds of this group (N = 55, 65%) reported longterm problemswith

theirhealth,comparedwith49percentinthetotalsample. Withrespecttopsychological

wellbeing,over

three

quarters

of

the

group

(N

=66,

78%)

gave

answers

of

quite

often,

veryoftenor always inresponsetothequestion Howoftendoyouhavenegativefeel

ingssuchasbluemood,despair,anxiety,depression? Thiscompareswith34percentof

thetotalsamplegivingthisrangeofanswers(seeTable3).

Writtencommentsfromchoristersrelativelylowinpsychologicalwellbeingbutstrongly

endorsingthewellbeingeffectsofsinging

Inanswerstotheopenquestionsdetailedabove,approximatelyonefifthofthisgroupgave

concreteinformationonsignificantchallengesintheirlivesimpactingontheirsenseofper

sonalwellbeing.

Respondents

comments

about

these

challenges

could

be

readily

catego

rised under the following headings:mental health problems, significant family problems,

physicalhealthdifficultiesandbereavement. Thefollowingexamplesare indicativeofthe

issues identified and also clearly express the benefits which the respondents felt they

gainedfromsinginginachoir.

EnduringmentalhealthproblemsThiswasthemostcommonlyexpressedchallenge,with

sixrespondentsdisclosingproblemswithclinicaldepressionoranxietyandafurthersixal

ludingtodifficultieswithdepression. Inthefollowingexamplessingingisdescribedasbeing

helpfulintheprocessofrecoveryorinthemanagementoftheseproblems:

Ihave

had

to

stop

working

due

to

an

on

going

medical

condition

(bi

polar

disorder).

I

havehadseveralepisodesofthis. Requiringvaryinglengthsoftimespentinhospital,fol

lowedbymonthsoftimeneedingsupportfordepressionandlackofselfconfidence. Be

ingamemberof thisparticularchoirhas liftedmyselfesteemagainand restoredself

belief.[Englishfemale54.]

Ihadafulltimepanicattack lastweek. Triedsomeswimmingexerciseswhichmade it

worsethensanginthecarforhalfanhour. Bytheendmyheartrateandbreathinghad

returned tonormal,neckand shoulders relaxed, stomachunknotted. Generally find it

unwindsandrelaxesme. Alwaysfeellooserafterrehearsals.[Australianmale,38.]

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Significantfamily/relationshipproblemsProblemswithinthefamilyorclosepersonalre

lationshipswerealsoasourceof significantstress for the following twoparticipants,and

singinghelpedthemtocopewiththesecontinuingchallenges:

Asacarer

of

two

relatives

stricken

with

schizophrenia,

Ihave

suffered

from

reactive

de

pression.()HavingapleasantstarttothedayknowingIshallmeetlikemindedpeople

andenjoymusicmaking,hopefullyhavingalaughalongtheway. Hearingtheharmonies

helpsmeforgetfamilyworries.[Englishfemale,70.]

AbletoenjoycompanionshipandmakesmefeelIamabletodosomething. Myhusband

isdepressedandthishelpsmetokeepgoing. Liftsmoodandhelpstoforgetproblems

inlife.[Englishfemale,65.]

Significantphysicalhealth issues/disabilityPhysical health problems can also result in

significantemotionalchallengesthatcanincreaserisksofmentalhealthdifficulties. Thefol

lowingparticipants

describe

the

consequences

of

stroke

and

insomnia,

with

the

first

indicat

inghowsinginghelpedhim:

Itplaysa significantpart inmyemotionalhealthandwellbeing. I findmusicuplifting.

Whenrecoveringfromamajorstroke,singingwasoneofthewaysofliftingmyspiritsout

ofdepression.[Englishmale,65.]

Severeinsomnia.Iwakeupbetween3and4am.MostofthetimeIcantgobacktosleep

oronlyshortlybeforeIgetupagain. Consequently,Iamextremelytiredintheevenings

andsuffermoodswings.[Germanfemale,67.]

RecentbereavementFinally,tworespondentsdisclosedrecentlossofclosefamilymem

bers.Bereavement

substantially

increases

risks

to

emotional

and

mental

health,

and

for

thesechoristerssingingclearlyhelpedthemtocopewithsignificantpersonalloss:

Myhusbanddiedthreemonthsagosoallthequestionsaboutnegativefeelingsetc.are

distortedbythisfact. Oneofthegreatestsupportsinmylifeatthisdifficulttime isthe

[choir Ibelong to]. I thinkchoralsinging is fantastic foremotionalhealth. [English fe

male,64.]

Intodaysworld,choralsingingofferspeopleoneoutletfromstressandworry. It isan

experiencenottobemissed,andhashelpedmethroughtherecentlossofmydaughter.

[Englishfemale,59.]

The

accounts

given

above

also

suggest

some

of

the

ways

in

which

singing

can

help

ad

dresschallengestopsychologicalwellbeing,andthisissuewasexploredfurtherbycodingall

examples inwhichrespondents themselvesofferedsomeexplanationofhowsingingpro

videdpsychologicalandemotionalbenefits. Thisanalysis identifieddescriptionsofatleast

sixgenerativemechanisms linkingchoralsingingwithwellbeingandhealth,mostofwhich

havebeenpreviously identified in the research literature (e.g.BaileyandDavidson,2003,

2005,refertoimprovementsinmoodandtheroleofdistraction). Thepurposehereisnot

to present a thoroughgoing documentation of the incidence of comments indicative of

thesemechanisms,butsimplytoprovideillustrationsoftheintuitivehypothesesemployed

bysingerstoexplainhowsingingcanbebeneficial.

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Agivenmechanismmayhavemorethanoneoutcomeforwellbeing,andtwoormore

mechanismsmayhaveasimilarimpact. Themechanismsareasfollows:positiveaffect,fo

cusedconcentration,controlleddeepbreathing, socialsupport,cognitivestimulation,and

regularcommitment. Eachof thesemechanismsserves tocounter factorsandprocesses

thatarepotentiallydetrimentaltowellbeingandhealth. Thegeneralprincipleatworkhere

appearstobeoneofrebalancingorcounteraction.

PositiveaffectRespondentsinthisgroupcommentedthatsingingmadethemfeelhappier

and improvedtheirmood. Inthefollowingcomments,thecapacityofsingingtogenerate

positivefeelingsislinkedtoaprocessofcounteractingfeelingsofsadness,anxietyandde

pressioninotherareasoftheirlives:

Whenyousing,youcannotbesad for long. It really liftsyourspirits. Being inachoir

meansyouare inateamyouallhelpeachotherwhichgivestremendoussatisfaction.

[Englishfemale,

52.]

Singingimprovesmymoodandmyhealth. Ihavetobeonguardconstantlyagainstmy

medicalcondition(anxietyanddepression).[Australianfemale,49.]

Focusedattention Inaddition to generatingpositive feelings, singing canbeaveryde

mandingactivity involvingfocusedconcentration. Thefollowingrespondentsexplicitlylink

this featureof singing as an activity toblockingpersonalpreoccupationswith sourcesof

worry,andpromotingrelaxationandthereliefofstress:

Singinginachoirputstroublesonhold,asconcentratingonthemusicrequiresallones

attention.[English

female,

65.]

Ithasgreateffects.Ithelpsmetoswitchoffeverydayconcernsandalsotoconcentrate.

Result:Icanrelax.[Germanfemale,56.]

ControlleddeepbreathingControlledbreathing isof course, intrinsic to the activityof

singing,andwaswidelyidentifiedasaphysicalbenefitassociatedwithbeingamemberofa

choir. Inaddition, the following respondentsweremoreexplicit in suggesting thatdeep

controlledbreathingcancounteractanxietyandstress,andalsogiveasenseoffitness:

Deepbreathing,essentialforsinging,isonemethodofhelpingwithsignsofanxietyand

stress.[English

female,

70.]

Ithinkthatyouarekeptfitbychoralsingingbecauseyoubreathecorrectlyandyouen

gage yourwholebody in theactivity, like youdowhenpractisingyogaorwhendoing

sports(walkingforfitness).[Germanfemale,50.]

Socialsupport Choralsinging isalsoan intrinsicallysocialactivity, involvingprocessesof

socialcooperationandcoordination. Thevalueofgroupmembershipand friendly rela

tionshipswithin thegroupwerewidelycommentedon. Inaddition the followingrespon

dents are explicit in suggesting that singing in a choir offers them social support,which

serves to ameliorate feelings of isolation and loneliness, and provides a sense ofwider

90


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Article

communityandsocialinclusion:

Theeffectofsingingwithagrouphelpstomakefriends,sothishaswidenedmyhorizons

quiteabit,andgetsmeoutandaboutmore. Thesupportyoureceivefromotherpeople

helpsingeneralwellbeing.[Englishfemale,78.]

The communityaspectofchoralsinging isparticularly significant. Achoir isacommu

nityofsingersdrawn fromallwalksof life, coming together tomakeaunified impact.

Thatteamworkanddisciplinedfocusonathinggreaterthanourselves(namelyachoral

work)isanexampleofhowtheworldmight/couldbe![Australianfemale,66.]

Cognitive stimulation Choral singing involves education and learning,which keeps the

mindactive,andgivesasenseofachievement. Thefollowingrespondentshighlightwaysin

whichchoralsingingcanofferachallengingandworthwhileactivityandpossiblyserve to

counteractagerelateddeclineofcognitivefunction:

[Choralsinging

is]

A

very

satisfying

activity

to

be

involved

in

at

any

age,

but

Ithink

espe

ciallyvaluabletopeopleintheirlateryearswhentheyhavetimeontheirhands. Ithink

choralsinging isaparticularlyvaluableandworthwhileactivity to fillsomeof this time

andgivearealsenseofachievementatatimewhenonemightbefeelingonesuseful

nessisdeclining.[Australianfemale,60.]

Apartfromtherelaxationbenefits,Ibelievethatforme,aged57,keepingthebrainactive

andhavingtoconcentrateforlongperiodswilldelayifnotcompletelypreventsenilede

mentia![Englishfemale,57.]

RegularcommitmentFinally, likeallworthwhileactivities,choralsingingrequiresregular

practiceand

so

involves

aregular

commitment

to

attend

rehearsal,

which

motivates

people

toavoidbeingphysicallyinactive:

Itmakesmegetupinthemorning[rehearsalsareduringtheday]andputsmeinagood

moodfortherestofthedayandmakesmemorealert.[Englishfemale,65.]

Makingtheefforttoattendchoirpracticeonwet,coldevenings insteadofwatchingTV

mustbebetterforhealth.[Englishfemale,69.]

DISCUSSION

AND

IMPLICATIONS

Thisstudycontributestoaprocessofaddressingtheshortcomingsofpreviousresearchby

undertakingalargescalecrossnationalsurveyofsingersinchoirsinEngland,Germanyand

Australia. ThestudyisbasedontheWHOdefinitionofhealth,andusesarigorouslydevel

oped crossnational instrument for assessinghealth relatedqualityof life, theWHOQOL

BREF. Inaddition,thestudyallowedfortheconstructionofanewscale forassessingthe

wellbeingeffectsof choral singing,whichdemonstrates substantial construct validityand

internalconsistency.

TheresultsconfirmpreviousfindingsfromCliftandHancox(2001)andBecketal.(2000)

thatamajorityofchoristersexperiencesingingasbeneficial forwellbeing. Nevertheless,

thereis

variation

in

the

extent

to

which

singers

endorse

the

idea

that

singing

has

benefits

91


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Article

for their wellbeing, and an important finding is that women are more likely to report

strongerbenefitscomparedwithmen. Thisconfirmstheearlierfindingofsuchasexdiffer

encereportedbyCliftandHancoxinasmallscalestudyofasinglechoir. Thecurrentfind

ingisparticularlystrong,giventhatthedifferencebetweenwomenandmenappearsinde

pendently ineachnationalsampleofchoristersstudied. Inspectionof individual items in

thescaleshowsthatwomenweremorelikelythanmentostronglyagreethatsingingmade

them feelhappier,madetheirmoodmorepositive,helped improvewellbeingandhealth,

andhelpedthemrelaxanddealwithstress. Similarly,theyweremorelikelytostronglydis

agreethatsingingdoesnthelptoreleasenegativefeelings.

Suchsexdifferencesareintriguing,andmeritfurtherstudy. Theymayreflectabroader

sexdifferenceinemotionalsensitivityandexpressiveness,withwomenandmenexperienc

ingsimilarbenefits,butwithwomenexpressing themselvesmorestrongly in thisrespect.

Thesedifferencesmayalsohelptowardsexplainingwhychoralsingingshouldbeanactivity

whichtendstoattractmorewomenthanmen. Certainly, inthepresentsampleofchoirs,

womenwere

in

the

majority.

On

the

other

hand,

the

men

in

the

sample

are

actively

in

volvedinchoralsinging,andwhiletheyendorsethewellbeingbenefitsoftheactivity,itmay

bethatotherfactors,suchasthevalueplacedonmusicortheopportunitytosocialise,are

strongermotivatorsfortheirinvolvement.

ThefindingsfromtheWHOQOLBREFalsodemonstratethatalargemajorityofsingers

ratetheirqualityoflifeandtheirhealthasgoodorbetter. Thisisanimpressivefinding,es

peciallygiven thehighaverageageof thesample,and the fact thata largeproportionof

peoplewereinretirement. Thismaypartlypointtothehealthpromotingbenefitsofchoral

singing,butitshouldalsoberecognisedthatastheparticipantsgetolder,thesamplemay

increasinglyrepresentthemoreactiveandhealthymembersoftheiragegroup,asindivid

ualchoristers

retire

due

to

health

and

mobility

problems

or

afading

voice.

It

is

notable,

however, thataminorityofparticipantsdogive lowscoreson theWHOQOLBREFscales,

whichindicatethattheyarenotsatisfiedwiththeirqualityoflifeandhealth. FortheWHO

psychologicalwellbeing scale,approximately10per centof the sample scoredbelow the

scalesmidpoint suggesting that theymay be copingwith significantmental health chal

lenges. Asmallsexdifferencealsoemergesonthisscalewithwomenreportingloweraver

agelevelsofwellbeing.

Afurtherfindingfromthissurveywhichhasnotbeenreportedsofarintheliteratureis

thesexdifferenceinthecorrelationbetweenperceptionsofthewellbeingbenefitsofsing

ing and selfassessed general psychologicalwellbeing. In the total sample and for each

countryindependently,

asignificant

positive

correlation

was

observed

between

the

two

scalesforwomen,butnotformen. Higherscoresonthesingingwellbeingscalewereasso

ciatedwithhighergeneralwellbeingscores. Correlationsareofcoursedifficulttointerpret

fromacausalperspective. Thisfindingmayindicatethatwomenwithhighergeneralwell

beingaremore likelytoexperiencewellbeingbenefitsfromsinging,or itmaysuggestthat

theexperienceofwellbeingbenefitsfromsingingcontributestoabroadersenseofpsycho

logicalwellbeing. Itisimportantnottomaketoomuchofthecorrelationfound,however,

as it represents nomore than five per cent of shared variance. What the findingmore

stronglyindicatesisthatforwomenperceptionsofthebenefitsofsingingaresubstantially

independentofgeneralpsychologicalwellbeingasmeasuredby theWHOQOLBREF. The

factthat

no

significant

correlation

emerged

for

the

men

further

underlines

this

point.

For

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Article

thisreason,attentionwasgiven inthispapertoasubgroupconsideredtobeofparticular

interest inexploring the valueof choral singing forwellbeing andhealthnamely those

choristerswithlowgeneralwellbeingwhohighlyendorsedthebenefitsofsinging.

Withinthissubgroup,manyparticipantsdisclosedpersonalchallengesintheirlivesthat

havecompromisedtheirsenseofpersonalwellbeing. Nevertheless,itisclearthatparticipa

tion insinginghasbeenofconsiderablebenefittothem. More importantly, fromatheo

reticalpointof view, the choristers accountsprovide valuable insights into a numberof

possiblecausalmechanismslinkingsingingwithimprovedwellbeingandhealth. Thesefind

ingsareconsistentwith insightscoming frompreviousqualitativeresearchonsingingand

wellbeing(seeClift,Hancox,Staricoffetal.,2008),andreflectsomeoftheprocesseshigh

lightedintheworkofBaileyandDavidson(2005),Becketal.(2000)andKreutzetal.(2004).

Thisstudybuildsonpreviousresearch,however, inhighlighting the fact that inanymain

streamchoirorchoralsociety, therewillbememberswithexistinghealthchallengesand

thatsinging isactivelyemployed inanumberofwaystohelp incopingwithoraddressing

thesechallenges.

The

specific

mechanisms

identified

should

also

be

the

focus

of

more

de

tailedresearchtoexploretheirsignificanceandinterconnectednesswithinarangeofsing

inggroups. Howforexample,dothemechanismsofcontrolleddeepbreathingandfocused

attention relate toone another and impact uponexperiencesofwellbeing? If singing is

widelyperceived tohavebenefits forbreathing,wouldsingingasanactivitybeuseful for

peoplewithcompromisedlungfunction(e.g.asthmaorchronicobstructivepulmonarydis

ease)? ResearchbyEngen (2005)andarecentstudyreportedbyBonilha,Onofre,Vieira,

Prado,andMartinez(2008)providesomeevidenceinsupportofthispossibility.

Theanalysisofthemesinthequalitativedatareportedhereispreliminaryandconsiders

onlyafractionoftheavailableaccountsprovidedbythetotalsampleofchoristers. Afuller,

moresophisticated

analysis

is

currently

in

progress

using

the

MAXQDA2007

qualitative

analysis software programme (http://www.maxqda.com), (see Clift, Hancox, Morrison,

Hess,Kreutz,&Stewart,2009forfindingsfromchoristersaccountsoftheeffectsofchoral

singingonphysicalhealth).Oncecompleted,thisanalysiswillallowforemergentthemesto

beorganisedintoamoredetailedmodelofmechanismsandbeneficialimpacts,andrelate

the informationprovided in response toopenquestions, to the structureddataavailable

fromtherestofthequestionnaire.

Inaddition to thisstudyhelping tohighlight thewellbeingandhealthbenefitsassoci

atedwithchoralsinging,italsohasanumberofimplicationsforthewiderissueofencour

agingmorepeopletoparticipateinchoralsingingforthepotentialbenefitsitcanbringfor

wellbeing.

Itisclearthatmanyparticipants inthestudyhavehad longexperienceofinvolvement

inchoralsinging,andmanyhavehadsinging lessonsandcanplayan instrument. Inaddi

tion,very fewoftherespondentsweretoldaschildren that theycouldnotsing. It isnot

difficulttoimagine,therefore,thattheabilityofpeople intheir lateryearstobenefitfrom

groupsingingderives inconsiderablepartfromtheskillandconfidencethatcomesfroma

lifetimeinvolvementwithmusicandsinging. Thissuggeststhatifsingingistobeapoten

tialresourceinlaterlifethattheearlyfoundationsarecrucial,asareopportunitiesthrough

outearlyandmidadulthoodtoengageincommunitysinging. Itisofinterestinthisrespect

that inboththeBaileyandDavidson (2005)andSilber (2005)studies, inwhichspecialef

fortswere

made

to

recruit

disadvantaged

adults

into

singing

projects,

those

most

ready

to

93
http://www.maxqda.com/http://www.maxqda.com/


16/18

Article

engagedidhavesomebackgroundinmusic. Theissueofhavingagoodfoundationinmusic

andpositiveencouragementtosingappearstobeparticularlyrelevantforboys,asthere

sultsofthisstudyunderlinethewellknownpatternthatmenarelesslikelytobeinvolvedin

choralsingingthanwomen.

Although this study strongly indicates the importance of a history of engagement in

singing,this isnottosaythatadultswith littleornopreviousexperienceofsingingmight

notfinditenjoyableandbeneficialiftheyweretohavetheopportunityandencouragement

toparticipate in their localcommunities. And indeed, thereweremembers in thechoirs

studiedwith relatively littlepreviousexperienceof choral singing. A further implication,

therefore, isthatmoreeffortsareneededtoexpandcommunityopportunitiesforinvolve

ment insinging,andtoeducateadultsaboutthevalueofsuchengagementonamusical,

personalandsociallevel,andalsoforthebenefitsitcanpotentiallybringforwellbeingand

health.

Thestudycontributestobuildinganevidencebasetosupportgreaterpublicinvestment

bylocal

government

and

health

authorities

in

community

music

and

singing

provision

in

the

interestsofpromotingwellbeingandhealth,especially frommidlifeonwards. Given that

throughout theworld, increased lifeexpectancyhasresulted inacontinuingdemographic

shifttowardslargerproportionsofelderlypeopleinnationalpopulations,thereisaneedto

lookafreshat theopportunitiesavailable tohelpencouragepeople to remainphysically,

sociallyandmentallyactivepostretirement. Itisarguedthatsingingisavaluableactivityin

alloftheserespectsanddeservestobemorewidelyrecognisedassuch.

ACKNOWLEDGEMENTS:OurthanksareduetotheRogerDeHaanFamilyTrustforfunding

thatmade

this

work

possible;

Canterbury

Christ

Church

University

for

supporting

the

work

oftheSidneyDeHaanResearchCentre forArtsandHealth;ourcolleaguesandcollabora

tors:Dr.IanMorrison,Ms.BrbelHess,Dr.GunterKreutz,Prof.DonaldStewart,Mrs.Isobel

Salisbury,andnot least,thechoralsingers inEngland,GermanyandAustraliawhoshared

theirexperiencesofchoralsingingwithus.

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Clift,S.,Hancox,G.,Morrison, I.,Hess,B.,Stewart,D.,&Kreutz,G. (2008).Choralsinging,

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centres/sidneydehaanresearch.

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singerssayabouttheeffectsonchoralsingingonphysicalhealth? Paperpresentedat

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UniversityofJyvskyl,Finland,August1216.

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Hancox,

G.,

Staricoff,

R.,

&

Whitmore,

C.

(2008).

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health:

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systematic

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University.Retrieved23June2009fromhttp://www.canterbury.ac.uk/centres/sidney

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ofprofessionallyconductedculturalprogramson thephysicalhealth,mentalhealth,

andsocialfunctioningofolderadults.TheGerontologist,46(6),726734.

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sema.JournalofMusicTherapy,42(1),2048.

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http://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/centres/sidney%20-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-researchhttp://www.canterbury.ac.uk/%20centres/sidney-de-haan-research


18/18

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Watanabe,H.(2005).ChangingadultlearninginJapan:Theshiftfromtraditionalsingingto

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ence,NewYork,1922June,1946;signedon22July1946bytherepresentativesof61

States(OfficialRecordsoftheWorldHealthOrganization,no.2,p.100)andentered

intoforceon7April1948.

ForfurtherinformationabouttheworkoftheSidneyDeHaanResearchCentreforArtsand

Health,see:http://www.canterbury.ac.uk/centres/sidneydehaanresearch/index.asp

STEPHENCLIFT,FRSPH,isProfessorofHealthEducationintheFacultyofHealthandSocial

Care,Canterbury

Christ

Church

University,

co

Director

of

the

Sidney

De

Haan

Research

Cen

treforArtsandHealthandDirectorofacharitablecompanySingForYourLifeLtdwhich

promotesopportunities forcommunitymusicandsingingamongelderlypeople. Contact:

SidneyDeHaanResearchCentre forArtsandHealth,UniversityCentreFolkestone,Folke

stone,KentCT201JG,UK. [Email:[email protected]]

GRENVILLEHANCOX,MBE,FRSA, isProfessorofMusic intheFacultyofArtsandHumani

ties,CanterburyChristChurchUniversity,UniversityDirectorofMusicandcoDirectorofthe

SidneyDeHaanResearchCentreforArtsandHealth. Heisachoralconductorandclarinet

player. Contact: SidneyDeHaanResearchCentre forArts andHealth,UniversityCentre

Folkestone,Folkestone,

Kent

CT20

1JG,

UK.

[E

mail:

[email protected]]

96
http://www.canterbury.ac.uk/centres/sidney-de-haan-research/index.asphttp://www.canterbury.ac.uk/centres/sidney-de-haan-research/index.asphttp://www.canterbury.ac.uk/centres/sidney-de-haan-research/index.asphttp://www.canterbury.ac.uk/centres/sidney-de-haan-research/index.asphttp://www.canterbury.ac.uk/centres/sidney-de-haan-research/index.asphttp://www.canterbury.ac.uk/centres/sidney-de-haan-research/index.asphttp://www.canterbury.ac.uk/centres/sidney-de-haan-research/index.aspmailto:[email protected]:[email protected]:[email protected]:[email protected]://www.canterbury.ac.uk/centres/sidney-de-haan-research/index.asp

the significance of choral singing

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