笑笑功對於長期照護機構住民心理健康促進的實證研究

An empirical study of the influence of Laughing Qigong on the mental health of residents in long-term care institutions.

巫秀鳳(Hsiu-Feng Wu)

指導教授 ： 謝佳容助理教授

臺北醫學大學/護理學院/護理學研究所/碩士(2011年)

https://doi.org/10.6831/TMU.2011.00152

摘要

研究背景:
高齡照護是全球重要的發展趨勢，目前在機構中的長者文獻顯示活動較缺乏，容易導致長者功能加速退化，有鑑於正向心理促進的介入，對於心理健康的促進已有實證成效；然而，國內卻鮮見以機構住民為對象的介入方案。
研究目的:
探討機構中的老年住民參加「笑笑功」的介入方案後，在情緒感受、憂鬱情緒與壓力生理指標（可體松濃度值和心率變異）的成效。
研究方法：
本研究方法分為兩階段，第一階段為橫斷式相關性設計，以北區某所長照機構，年滿65歲以上長者為研究對象，完成收案共285位，第二階段採類實驗性研究法，立意取樣，實際收案共78位，以隨機分配為實驗組及對照組。實驗組介入措施為四週每週2次，每次進行50~60分鐘的「笑笑功」方案，共進行八次。對照組依機構平日一般例行常規照護模式與活動安排。
研究工具：
運用主觀自陳情緒感受狀態臉譜、老人憂鬱量表簡明中文版、壓力生理指標唾液中可體松(Cortisol)濃度值及自律神經心率變異(HRV)儀器的評估與測量。資料以SPSS17.0套裝軟體進行描述性及推論性統計分析。
研究結果：
本研究對象以女性居多，年齡平均為84.04±7.00歲。透過笑笑功方案介入後實驗組的成效，呈現正向心理情緒感受狀態(Z = -3.93, p= .001)與憂鬱情緒改善(Z = -2.07, p= .04)，均達統計顯著水準；在可體松濃度值上，雖未達統計顯著水準，但其濃度值有下降的趨勢；而在心率變異量則未達統計顯著差異。對照組資料分析結果顯示：其情緒感受狀態會趨於不快樂，且達統計顯著差異(Z = -2.56, p= .01)；在憂鬱情緒雖未達統計顯著水準，但個體有趨於負向情緒發展的現象；另在壓力生理指標則見可體松濃度值上升(Z = -2.51, p= .01)，且達統計上顯著水準。
結論：本研究初步證實笑笑功對於機構住民於情緒改善與壓力調節的促進成效，此方案可做為長期照護機構的工作人員執行心理健康促進活動時的參考。

關鍵字

機構住民 ； 笑笑功 ； 正向心理健康促進

並列摘要

Title: An empirical study of the influence of Laughing Qigong on the mental health of residents in long-term care institutions.
Institute: Graduate Institute of Nursing, Taipei Medical University
Student name: Hsiu Feng, Wu
Graduation time: Spring Semester of 2010
Advisor: Chia Jung, Hsieh assistant professor, School of Geriatric Nursing and Care Management, Taipei Medical University
Research background:
The significance of senior care development is increasing globally. Literature has indicated that elderly people living in institutions have insufficient amounts of exercise, which leads to their accelerated functional degeneration. The intervention of positive mental health promotion has been shown to effectively promote mental health; however, intervention programs that take institutional residents as subjects are rare in Taiwan.
Purpose:
The purpose of this study is to investigate the impact of “Laughing Qigong” (a health practice that combines laughing and Qigong) on the physiological indicators of emotion, depression, and stress (the concentration of cortisol and heart rate variability) in elderly institutional residents.
Methodology:
This study was comprised of two stages. The first stage took a cross-sectional correlation design and the subjects were elderly people above 65 years of age in a particular long-term care institution in the northern region of Taiwan. A total of 285 elderly persons were included. The second stage used a quasi-experimental research method and purposive sampling; 78 cases were included in practice, and were randomly assigned to experimental or control groups. For the experimental groups, the “Laughing Qigong” program was introduced as the intervention process for 50 to 60 minutes twice a week for four weeks, for a total of eight interventions. The care and activity arrangements for the control group were conducted as usual.
Tools:
This study used subjective self-reporting of facial expressions for emotional experience; the Chinese version of Geriatric Depression Scale short form; and physiological indicators for stress, such as cortisol concentrations in saliva and heart rate variability (HRV) for measurement and evaluation. The information was analyzed using SPSS 17.0 software to perform descriptive and deductive analysis.
Results:
The majority of the subjects in this study were females, and the average age was 84.04 ± 7.00 years. After the intervention of Laughing Qigong, the experimental group displayed a statistically significant improvement in both positive emotional state (Z = -3.93, p = 0.001) and feelings of depression (Z = - 2.07, p = 0.04). Although both the change in cortisol concentration and HRV were not statistically significant, the value for concentration of cortisol tended to decrease. The data of the control group showed that the emotional experiences of elderly in the control group were inclined towards unhappiness, and was statistically significant (Z = -2.56, p = 0.01); and although depression was not statistically significant, each subject tended to develop negative emotions. In addition, cortisol concentration, the physiological indicator for stress, was significantly elevated (Z = -2.51, p = 0.01).
Conclusions:
This study preliminarily verifies the positive effects of Laughing Qigong on improving the emotion and regulating the stress of institutional residents. This study may serve as a reference for the implementation of psychological health-promoting activities for staff in long-term care institutions.

並列關鍵字

institutional residents ； Laughing Qigong ； positive mental health promotion.

參考文獻

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