音樂的波形與精神分裂患者的不適切行為

Tone Color of Music and Inappropriative Behavior of Schizophrenic

施以諾(Yi-nuo Shih)

指導教授 ： 江漢聲

臺北醫學大學/醫學院/醫學科學研究所/碩士(2003年)

摘要

前言：近年來，音樂治療在健康照護領域開始被廣泛地運用。在研究者的工作領域中，心理疾病職能復健部門之病人參與靜態治療活動治療時，常會出現許多諸如肢體暴力、大聲喧嘩、離開團體、發呆、傻笑…等不適切行為，國外許多學者即建議可藉由古典樂來做為背景音樂，以音樂介入的方式來觀察老人失智症、精神分裂症..等腦部機制病變病人當下的行為改變，結果發現其諸如肢體暴力、躁動..等不適切行為大為降低。而許多職能治療的期刊也建議可在職能治療活動中配合介入音樂治療，以增加治療效應，其他諸如一些相關護理期刊，也對於在精神科病房使用音樂治療的正面成效多有描述。 目的：本研究的目的即為探討音樂可否降低台灣精神病患者的不適切行為，以實驗設計的方式進行觀察記錄，並選定台北市某醫學中心38位精神部日間留院病房之病人，以莫札特K448來做背景音樂，並用電腦合成音樂的方式來探討當不同音色（方形波、鋸齒形波、三角形波）的背景音樂介入時，那種波形的音樂對降低病人參與靜態職能治療活動時的不適切行為最為有效，以及音樂治療介入的成效跟腦認知功能間的相關性。 結果：結果發現三角形波最能普遍地降低病人的不適切行為，而三種波形介入時，病人不適切行為發生次數的變化，與認知功能呈負相關，意即認知功能越低的病人卻易受音樂介入的影響而使其在臨床上的不適切行為次數發生變化。 討論：若是本研究的數據，日後經重複實驗後也有類似的結果，則治療師則可考量在療程中適時、適當地介入背景音樂，以改善病人參與復健活動的情況，進而提升復健效率。

關鍵字

心理疾病職能治療 ； 音樂治療 ； 不適切行為 ； 精神分裂症 ； 方形波 ； 鋸齒形波 ； 三角形波 ； 大腦認知功能

並列摘要

Background： Treatment by music is quite a new attempt in the modern medical field. Its supplementary curing effects, particularly on alleviating inappropriate behaviors of patients suffering cerebral injuries such as schizophrenia, have been recognized by many studies. Aims： The goal of this research was to study how different types of background music affected the inappropriate behavior exhibited by patients, during static therapeutic activities organized by the Psychological Occupational Therapy Department. Should we judge from tone color, the music could be classified into three wave types, respectively, square, serrated and triangle wave types. Methods： Thirty-eight (38) schizophrenia patients from a day-care ward from a certain medical center in Taipei are selected as the subjects of the study. Conversion software is used to respectively convert a song into square, serrated and triangle wave types and played as background music in the occupational therapy activities. Frequencies of inappropriate behaviors by wave type are recorded to compare with that recorded with the absence of the music. Results： Findings indicate that with the intervention of triangle wave type, the most effective, and most comprehensive alleviation on frequencies of inappropriate behavior of the patients is observed while the patients are most vulnerable to be agitated by the square wave type of the music. Conclusions： Generally, square wave type of music comes from a clarinet; serrated wave type, violin; and triangle wave type, piano. Should the repeated experiments following the conclusion of this study prove that the music of triangle wave type is more efficient in control the symptoms of the schizophrenia patients during the curing process of rehabilitation, this finding not only will serve an important reference for the clinic therapists, but also is a major breakthrough in the development of therapy by music in the current clinical medicine.

並列關鍵字

Psychological Occupational therapy ； music therapy ； inappropriate behavior ； Schizophrenia ； square wave type ； serrated wave type ； triangle wave type ； cerebral cognition function

參考文獻

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