失智老人音樂介入團體之成效評估研究

Outcome Research on the Effectiveness of Group Music Intervention to Older Adult

林鴻鵬(Hung-Peng Lin) ； 高常豪(Chang-Hao Kao)

《臺灣老人保健學刊》 14卷1&2期 (2018/12) Pp. 83-99

摘要

研究目的：本結果研究旨在評估一個在臺北市某老人安養中心執行的音樂介入團體，對（疑似）失智老人的焦慮、憂鬱、孤獨感和躁動改善的成效。研究方法：運用選擇、最適化和補償的成功老化架構設計18週的音樂介入團體，以處理失智老人的情緒行為健康。團體成員（共19位，女性14位、男性5位）每週接受一次一小時的音樂團體介入。研究採用單一樣本連續測量設計，以「康乃爾失智者憂鬱觀察量表」（The Cornell Scale for Depression in Dementia, CSDD）、「失智者焦慮程度量表」（Rating for Anxiety in Dementia, RAID）、「De Jong Gierveld寂寞量表」（De Jong Gierveld Loneliness Scale, DJGLS）與「Cohen-Mansfield躁動情緒行為量表簡短版」（Cohen-Mansfield Agitation Inventory- Short Form, CMAI-SF）評估團體成員的心理健康和行為變化。研究結果：關聯樣本t檢定顯示團體成員的焦慮（t=-3.49, p=0.003）、憂鬱（t=-3.41, p=0.003）和躁動（t=-2.91, p=0.009）情形顯著減緩，分量表的統計分析顯示介入效果集中在於情緒、行為及認知面向的改善。結論：音樂介入團體能有效減緩老人的情緒行為困擾情形，證明是一項有證據基礎的實務。建議往後在處理老人的心理衛生議題，可提供具文化敏感的心理衛生教育、早期偵測與提供非醫療的心理行為介入，以有效提升老人的心理健康及生活品質。

關鍵字

老人 ； 音樂介入 ； 團體工作 ； 心理衛生 ； 介入研究

並列摘要

Objective: This outcome research aimed to evaluate the effectiveness of group music intervention on anxiety, depression, loneliness and agitation of older tenants in a senior home in Taipei City. Methods: A 18-week percussion music intervention group within a selection, optimization and compensation (SOC) framework was introduced to address older adults' emotional distress. A total of 19 participants (female=13, male=6) received intervention one hour weekly. With pre- and post-test design without a control group design, the Rating of Anxiety in Dementia scale, the Cornell Scale for Depression in Dementia, the De Jong Gierveld Loneliness Scale and the Cohen-Mansfield Agitation Inventory- Short Form were used to assess their behavioral and mental health changes. Semi-structural in-depth interviews were also conducted to explore their reflection on intervention group engagement and self-reported outcome after intervention. Results: Repeated measures t-test indicated that participants had a significantly lower score on anxiety (t=-3.49, p=0.003), depression (t=-3.41, p=0.003), and agitation (t=-2.91, p=0.009); further analysis on sub-scales showed that intervention effects centered around emotional, behavioral and cognitive domains. Qualitative data implied that engagement shall be articulated from a relational perspective, with which the perceived ＂cognitive enhancement＂ nature of intervention somehow interfered in the beginning, whilst the normalization leading style and cultural adaptation optimized their participation. The outcome was positively acknowledged in individual needs and reaffirmed by invited offspring audience at commencement performance. Conclusion: Group music intervention proves to be a well-researched and cost-effective evidence-based practice (EBP) to reduce older adults' emotional distress and to improve their quality of life. Culturally tailored mental health literacy education, monitoring and intervention are suggested to tackle with the emotional challenges in later life.

並列關鍵字

Older adults ； music intervention ； group work ； mental health ； intervention research