團體遊戲治療介入在改變養護機構老人的衰弱、活力與快樂之成效

The effect of play therapy on the elder' s frailty, vitality and happiness in nursing home residents

潘姿玲(Tzu-Ling Pan)

指導教授 ： 林淑媛

高雄醫學大學/護理學院/護理學系研究所/碩士(2010年)

摘要

本研究旨在探討團體遊戲治療介入後，在養護機構老人衰弱、活力與快樂改變程度。研究採雙組前後測之類實驗設計，以高雄縣兩家養護機構老人共六十位，依個案意願分派實驗組與控制組各三十人，實驗組個案接受為期五週的團體遊戲治療，控制組則無接受團體遊戲治療。兩組老人均接受衰弱、活力及快樂量表之前測，五週後進行相同問卷之後測。研究資料以SPSS14.0中文版套裝軟體進行分析，以描述性統計、卡方檢定、費雪精確性檢定、無母數McNemar卡方檢定、無母數Wilconxon Z檢定、配對t檢定、獨立t檢定及重複量數單因子變異數分析進行統計檢定。
研究結果發現團體遊戲治療介入後，實驗組老人在衰弱前測與後測的改變有顯著差異(p<.01)，無接受團體遊戲治療之控制組老人在衰弱前測與後測的改變則無顯著差異，且實驗組老人較控制組老人在衰弱程度的改善有顯著差異(p<.01)；在活力方面，有無接受團體遊戲治療之實驗組、控制組老人在活力前測與後測的改變都有顯著差異(p<.01)，且實驗組老人較控制組老人在活力程度的改善有顯著差異(p<.01)；在快樂方面，有無接受團體遊戲治療之實驗組、控制組老人在快樂前測與後測的改變都有顯著差異(p<.01)，且實驗組老人較控制組老人在快樂程度的改善有顯著差異(p<.01)。研究結果顯示團體遊戲治療可降低老人衰弱程度，提升老人活力及快樂程度，建議未來能在長期照護機構推廣以老人的團體遊戲治療，並安排有關團體遊戲治療的在職教育課程，以瞭解團體遊戲治療的好處和活動方式，以促進機構老人的身心健康。

關鍵字

團體遊戲治療 ； 老人 ； 衰弱 ； 活力 ； 快樂

並列摘要

The purpose of this study is to understand the changes in frailty, vitality and happiness of nursing home residents after an intervention of group play therapy. This quasi-experimental study had been conducted in two nursing homes located in Kaohsiung County for five weeks. Sixty residents were equally assigned to either an experimental or a control group depending on their willingness. The residents in the experimental group had received 10 sessions of play therapy for five weeks; however, the control group had not received any intervention during this time period. The residents in these two groups both had measured by the same questionnaires before and after the five-week period. The data were analyzed by SPSS 14.0: descriptive statistics, chi-square tests, fisher’s exact test, nonparametric McNemar test, nonparametric Wilcoxon test, paired t-tests, independent t-tests and repeated measure ANOVA.
Result showed: in the experimental group, the difference between the pre- and post-intervention in frailty was significant (p<.01); however, in the control group, there was no significant change in frailty. Moreover, the change of the frailty in the experimental group (p<.01) was more significant than the control one. The difference between the pre- and post- intervention in vitality in the experimental group was significant (p<.01) as well as the control group ; however, the change of the vitality in the experimental group was more positive and significant (p<.01) than the control group. The difference between the pre- and post- intervention in happiness in the experimental group was significant (p<.01) as well as the control group, but the change in the experimental group was more significant than the control group. Consequently, the results show that the group play therapy can decrease the level of the frailty and increase the level of the vitality as well as the happiness in the nursing home residents. Thus, the intervention of the group play therapy for the elderly residents in long-term care institutions is recommended. Furthermore, in order to enhance the physical and mental health of nursing home residents, conducting a continuing educational course which is related to the group play therapy and to enhance providers’ understanding its advantages and methods is recommended.

並列關鍵字

play therapy ； elder ； frailty ； vitality ； happiness

參考文獻

內政部統計報告(2009a)•重要參考指標•2009年12月1日取自http://www.moi.gov.tw/stat/stat01.aspx

內政部統計報告(2009b)•九十八年第十一週內政統計通報-97年底老人長期照顧及安養機構概況•2009年12月1日取自http://www.moi.gov.tw/stat/news_content.aspx?sn=2197&page=3

內政部統計報告(2009c)•內政國際指標•2010年05月23日取自

http://sowf.moi.gov.tw/stat/national/list.htm

內政部統計報告(2005)•中華民國94年老人狀況調查報告•2009年12月1日取自http://www.moi.gov.tw/stat/survey.aspx