複合式活動計畫介入延緩機構住民失能之研究：以新康福護理之家為例

The effect of a 12-week multicomponent activity intervention on delayed disability among institutional residents --an example of Shin-Kanfu nursing home

林碧玉(Pi-Yu Lin)

指導教授 ： 方進隆 ； 廖邕

國立臺灣師範大學/運動與休閒學院/樂活產業高階經理人企業管理碩士在職專班/碩士(2021年)

https://doi.org/10.6345/NTNU202101620

摘要

長照機構住民因「老化」、「慢性疾病」、「行動受限」等因素，加上長期坐臥姿生活型態導致活動量大幅減少，對於活動容易感到疲累，常會造成惡性循環致失能且失智。據此，本研究希望探討十二週的複合式活動課程介入對於機構住民日常生活功能及認知功能之成效。本研究自2020年10月到2020年12月底間，針對多重慢性疾病且輕、中、重度失能、失智之機構住民，執行為期十二週的複合式活動方案(每週5天；每天活動90分鐘)，活動內容包括緩和的肌力訓練、藝術輔療、懷舊輔療、音樂輔療及團體活動。研究對象的日常生活功能及認知功能，分別運用日常生活活動量表(ADL)及簡易智能量表(MMSE)進行評估。統計分析方法為描述性統計及成對樣本T檢定。本研究之研究對象共22人(男性12人，佔55%)，年齡在60歲以上的有16人(佔73%)，教育程度為國中以下有16人(佔73%)。經過十二週的複合式課程介入後，所有研究對象的ADL分數皆維持(72.73%)或增加(27.27%)，其MMSE分數也同樣是維持(68.18%)與增加(31.82%)，沒有任何的研究對象呈現退步的情形。而成對樣本T檢定顯示，經過十二週的複合式課程介入後，ADL的後測分數(56.59 ± 24.51)顯著高於前測分數(54.77 ± 23.88)，p值為0.028；而MMSE的後測分數(19.05 ± 6.62)顯著高於前測分數(18.32 ± 5.96)，p值為0.025。本研究發現十二週的複合式課程介入能有效「維持」或「提升」護理之家住民日常生活功能及認知功能，建議未來社區型的小型長照機構，可整合跨專業的團隊的人力資源，設計多元且創新有趣的複合式活動，來增加住民持續參與活動的動機，提升照護品質及達到延緩失能的目標。

關鍵字

長期照護 ； 八段錦 ； 藝術輔療 ； 懷舊輔療

並列摘要

Due to aging, diseases, lack of sports skills, mobility limitation and sedentary lifestyle, the residents of long-term care institution are at increased risk of developing dementia and disabilities. Therefore, this study aims to examine the effect of a 12-week multicomponent activity intervention on residents’ activities of daily living and cognitive function. During October to December 2020, residents with multiple chronic diseases, disability and dementia were recruited to attend a 12-week multicomponent activity program (5 days /week, 90 minutes /day). Multicomponent activity included muscle-strengthening activities, art therapy, reminiscence therapy, music therapy and group activities. Cognitive function and independence of daily activity were assessed by Mini-mental state examination (MMSE) and activities of daily living (ADL) scale. Descriptive statistics and paired-t test were performed. The results showed that among 22 participants, most of them were male (55%), aged over 60 years (73%) and had a degree under middle school. After a 12-week multicomponent activity intervention, ADL scores of all participants were maintained (72.73%) or increased (27.27%), whereas MMSE scores were also maintained (68.18%) or increased (31.82%). A paired t test showed that after a 12-week multicomponent activity intervention, the scores of ADL were significantly improved (56.59 ± 24.51 vs. 54.77 ± 23.88, p= 0.028), as well as the scores of MMSE were also significantly increased (19.05 ± 6.62 vs. 18.32 ± 5.96, p=0.025). This study revealed that a 12-week multicomponent activity intervention can maintain or improve residents’ activities of daily living and cognitive function. It is suggested that long-term care institution can integrate the professionals from interdisciplinary care team to design multiple and interesting multicomponent activities, to motivate residents’ participation, increase the care quality and achieve the goal of delayed disability.

並列關鍵字

long-term care ； baduanjin ； art supplementary therapy ； reminiscence therapy

參考文獻

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參考文獻

Baum, E. E., Jarjoura, D., Polen, A. E., Faur, D., & Rutecki, G. (2003). Effectiveness of a group exercise program in a long-term care facility: a randomized pilot trial. J Am Med Dir Assoc, 4(2), 74-80. doi:10.1097/01.Jam.0000053513.24044.6c

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