高齡者儀式化行為對其生活適應影響之研究

本研究目的在探討高齡者的日常儀式化行為對其生活適應的影響，並瞭解儀式化行為背後的認知信念與心理需求。研究者採用質性研究之立意取樣，選擇未失智失能之高齡者為對象，以半結構性深度訪談法蒐集七位研究參與者的文本資料，再以詮釋現象學取向進行綜合性主題分析。研究結果如下：一、高齡者日常儀式化行為可分成五大類別共26種儀式化行為，其中，健康維護之儀式化行為包含起床儀式、規律運動、對飲食與喝水的堅持、固定回診醫療與服藥、使用保健食品；生活安排之儀式化行為包含固定安排旅遊、投入音樂藝文活動、學習成為生活重心、隨手做紀錄、參與休閒娛樂、特定時間看新聞∕電視節目、刻意穿著打扮、經常反省自身；心情照顧之儀式化行為包含進入閱讀世界、個人情緒轉化儀式、宗教相關儀式、堅持穿戴幸運物品；特殊記憶之儀式化行為包含特殊食物的儀式記憶、特殊收藏物品的儀式記憶、個人化的特殊儀式；與人連結之儀式化行為則包含家庭聚餐、家族團聚活動、同學/同事/朋友聚會、使用fb/LINE視訊互動、參加社團交友、志工服務。二、高齡者日常儀式化行為的認知信念涵蓋五大類別共26種認知信念如下：健康最重要、持續規律運動是維持健康的關鍵、簡單清淡飲食避開負擔、固定醫療與服藥就能控制病情、保健食品補充營養與體力；旅遊可放鬆心情增廣見聞、唱歌讓我快樂又長壽、活到老就要學到老、做紀錄手腦並用可防失智、休閒娛樂增添生活樂趣、新聞∕電視節目不與社會脫節、合宜裝扮讓自己變年輕、反省自身不貳過；閱讀幫助想法和心情的轉換、轉換心情自己處理、宗教是重要的心靈寄託、戴了幸運物品就覺得有安全感；特殊食物瞬間回憶幸福的滋味、特殊收藏物品開啟連結之鑰、個人化特殊儀式可撫慰心靈；家庭聚餐聯繫家人感情、家族團聚活動凝聚家族的向心力、「老友」是退休生活的重要精神依靠、視訊讓彼此聯繫沒有距離、社團交友可拓展人際關係、志工服務貢獻社會讓生命更有意義。三、高齡者日常儀式化行為背後的心理需求依生理、心理和社會人際等三個面向總共有14種心理需求。生理面向包含健康維護與增進、醫療照顧等需求；心理面向包含控制與穩定、自主、休閒娛樂、知能學習、心情照顧、自信、安全感、宗教靈性、連結記憶與統整等需求；社會人際面向包含愛與隸屬、人際關係、自我實現和貢獻社會等需求。四、日常儀式化行為對高齡者生活適應之影響包含：有助於獲得控制，建立生活穩定感；維持健康、延緩老化；預防失智失能；提供生活重心與樂趣；增加自信；增加安全感；增廣見聞、自我賦能；轉化情緒、平靜心靈、瞭解生死之道；增進情感交流；對家族向心力有凝聚效應；增進社會人際關係；提升生命意義與價值；傳承經驗精神與文化；協助統整與回顧等共十三種影響。研究結果顯示高齡者日常儀式化行為，對其在生理、心理或社會人際層面上的生活適應，均具有正向功能與影響。最後依據上述研究結果進行討論並提出建議，以做為未來研究及實務工作者之參考。

關鍵字

儀式化行為；生活適應；認知信念；心理需求

並列摘要

This study aims to explore the effects of the daily ritualized behaviors of the elderly on their life adaptation, and to understand the cognitive beliefs and psychological needs behind the ritualized behaviors. The researcher adopted a purposive sampling of qualitative method to select the elderly who are not demented and disabled as the objects, collected the text data of seven research participants by semi-structured in-depth interview method, and then conducted the synthetic theme analysis with the hermeneutic phenomenological approach. The results showed as the following: First, the daily ritualized behaviors of the elderly can be divided into five categories and a total of 26 ritualized behaviors. Among them, the ritualized behaviors of health maintenance include wake-up rituals, regular exercise, adherence to eating and drinking, regular follow-up medical treatment and medication, and use of healthy food; the ritualized behaviors of living arrangements include fixed arrangements for travel, participation in music and art activities, learning becomes the focus of life, making records at hand, participating in leisure and entertainment, watching news/TV programs at specific times, deliberately dressing up, and often self-reflection; the ritualized behaviors of mood care include entering the reading world, personal emotional transformed rituals, religious-related rituals, and insisting on wearing lucky items; the ritualized behaviors of special memory include ritual memory of special food, ritual memory of special collection items, and specially personalized rituals; the ritualized behaviors of connecting people include family dinners, family reunion activities, gatherings of classmates/colleagues/friends, using fb/LINE video interaction, participating in social activities, and volunteer services. Second, the cognitive beliefs of daily ritualized behaviors of the elderly that cover five categories and a total of 26 cognitive beliefs are as follows: health is the most important, continuous regular exercise is the key to maintaining health; simple and light diet to avoid the burden; fixed medical treatment and medication can control the disease; healthy food supplements nutrition and physical strength; traveling can relax and increase our knowledge; singing makes us happy and long-lived; never too late to learn; recording by using both hands and brains can prevent dementia; leisure and entertainment increase the joy of life; News/TV programs keep us not out of touch with the society; dressing appropriately let us become younger; reflect on yourself and no more mistakes; reading helps you to change your thoughts and moods, change my mood and deal with it by myself; religion is an important spiritual sustenance; feeling safe after wearing lucky items; special food instantly recalls the taste and specialness of happiness; collection is the key to open the connection; personalized special rituals can soothe the soul; family dinners connect family feelings; family reunion activities unite the centripetal force of the family; "old friends" are the important spiritual support of retirement life; video makes contact with each other without distance; making friends in social activities can expand interpersonal relationships; and volunteer services can contribute to society and make life more meaningful. Third, the psychological needs behind the daily ritualized behaviors of the elderly have a total of 14 psychological needs based on the three aspects of physiology, psychology and social interpersonal. The physiological aspect includes the needs of health maintenance and improvement, and medical care. The psychological aspect includes the needs of control and stability, autonomy, leisure and entertainment, knowledge learning, mood care, self-confidence, security, religious spirituality, and linking memory and integration. The social and interpersonal aspect includes the needs of love and affiliation, interpersonal relationships, self-realization and contribution to society. Forth, the effects of daily ritualized behaviors of the elderly on the life adaptation include a total of 13 kinds of effects. Such as helping to gain control in order to establish a sense of life stability; to maintain health and delay aging; to prevent dementia and disability; to provide life focus and fun; to increase self-confidence; to increase a sense of security; to enhance knowledge and self-empowerment; to transform emotions, to calm the mind, and understand the way of life and death; to enhance emotional communication; to have a cohesive effect on family centripetal force; to enhance social interpersonal relationships; to enhance the meaning and value of life; to inherit experience, spirit and culture; and to assist in integration and review. The research results show that the daily ritualized behaviors of the elderly have positive functions and effects on their life adaptation on the physical, psychological, or social interpersonal level. Based on the research results, further discussions were made, and specific suggestions were proposed for future research and practical workers.