- 學位論文
以音樂為媒介的短期團體治療於住院亞急性中風病患之成效探討
The Effectiveness of Short-Term Group Therapy Which is Mediated by Music for Inpatients with Subacute Stroke
摘要
本研究目的主要為探討以音樂為媒介的短期團體治療對住院亞急性中風病患其情緒、睡眠與日常生活功能相關症狀改善之成效。採實驗組與控制組前後測實驗設計，研究對象為台北某醫學中心的復健科病房之病人，篩選條件為年滿35歲以上的意識清楚、病情穩定及無語言感覺中樞受損者的腦中風病人，且簡易心智功能量表得分15分以上者、健側肢體或雙上肢肌肉力量達4分以上者。共招募參與者58人，經隨機分派後，實驗組為31位，控制組為27位。實驗組成員參與為期8次，每次1小時，持續8天的以音樂為媒介的團體治療，控制組則未參與，但維持一般常規治療與護理措施。以結構式問卷收集資料，包含、貝克憂鬱量表、貝克焦慮量表、正向意念與負向自殺意念量表、匹茲堡睡眠品質量表及日常生活活動功能量表。資料分析方法包括，描述性統計、獨立樣本t檢定、卡方檢定、Mann-Whitney U檢定、Wilcoxon配對組符號排序檢定及單一樣本t檢定。研究結果發現，於以音樂為媒介的團體治療介入實施後，實驗組於貝克憂鬱量表、貝克焦慮量表、睡眠品質及日常生活功能前後測達到統計上顯著的改善，且對以音樂為媒介的團體治療之團體成效感到滿意。研究結果顯示以音樂為媒介的團體治療可改善中老年中風後的身心影響症狀，建議可將以音樂為媒介的團體治療納入復健科病房常規治療中，協助中風患者舒緩情緒，達到減輕憂鬱、改善睡眠品質、促進日常生活活動功能及達成早日康復返家的目標。
並列摘要
The major purposees of this study were to investigate the effectiveness of short-term group therapy which is mediated by music on emotional, sleep, and daily living function related symptoms for patients with subacute stroke. Experimental study design with pre-test and post-test was used for this study. Subjects were recruited from the rehabilitation ward in a medical teaching hospital in Taipei. Subjects who are 35 years old and above, clear consciousness, stable condition, MMSE scales scores 15 and higher, and unaffected limbs or upper limbs muscle power scores 4 and higher were invited to participate in this study. Fifty-eight participants were recruited and randomly assigned to two groups, where 31 were in the experimental group and 28 were in the control group. The subjects in the experiment group received group therapy which is mediated by music for 2 hours and 3 times a week for 2 weeks, a total of 6 sessions. The subjects in the control group maintained usual care without group therapy which is mediated by music. A set of questionnaires was used to collect data. Study instruments included the Beck Depression Inventory II, Positive and Negative Suicide Ideation, Beck Anxiety Inventory, Activity of Daily Living, and Pittsburgh Sleep Quality Index. Data were collected before and after the group therapy. Statistic analyses included descriptive statistics, Chi-square test, Independent Sample t-test, Mann-Whitney U test, Wilcoxon match-pairs signed-ranks test, and One Sample t-test. Result revealed that group therapy which is mediated by music has positive effects on improving depressive symptoms, anxiety symptoms, sleep quality, and activity of daily living, except for suicidal ideation. Participants reported that they satisfied with the activities designed in group therapy which is mediated by music. Results suggested that group therapy which is mediated by music may be used as a regular activity in rehabilitation ward in order to improve depressive and anxiety symptoms, sleep quality and daily living function.