靈性照護介入對憂鬱症病人在靈性需求與生活品質之成效

背景:在臺灣以憂鬱症病人為研究對象介入靈性照護之文獻有待開發。目的:探討靈性照護介入對憂鬱症病人憂鬱程度改善及提升靈性需求與生活品質之成效。方法:採實驗組-前後測設計，於南部某醫學中心之精神科病房及門診篩選經醫師診斷為憂鬱症、年滿20歲、同意參與研究者為收案條件。研究對象(n=19)接受四週八次之個別性靈性照護。於介入前、第二週與第四週使用中文版靈性需求量表、漢氏憂鬱量表及台灣簡明版世界衛生組織生活品質問卷來評估靈性照護介入後之成效。以描述性統計及重複測量變異數分析做統計。結果: (1)憂鬱程度呈現持續與顯著下降(p <.001)。(2)自覺靈性需求重要性只有在「積極的生活態度」構面，介入後兩週分數（Mean±SD=3.93±1.04，p<.05）明顯高於介入前的分數（Mean±SD=3.51±0.92）。(3)靈性需求滿足只有在「平靜的心靈」構面，介入後四週分數（Mean±SD =3.16±0.83，p=.029）顯著高於介入前的分數（Mean±SD=2.53±1.02）。(4)在生活品質分數部分，生理層面:介入後四週分數(Mean±SD =11.85±2.46, p=.04)顯著高於介入前的分數(Mean±SD=10.71±1.97)；心理層面:介入後兩週 (Mean±SD=9.43±3.15, p=0.045)及介入後四週(M± SD=9.75±3.40, p=0.018)的分數顯著高於介入前的分數(Mean±SD=8.17±2.79)；社會關係層面:介入後兩週 (Mean±SD=11.42±3.06，p<.01)與介入後四週(Mean±SD=12.11±2.62，p<.01)的分數顯著高於介入前的分數(Mean±SD=10.12±2.79)。結論:四週八次的靈性照護介入可以改善憂鬱症病人憂鬱程度並提升生活品質。

關鍵字

憂鬱症病人；憂鬱程度；靈性照護；靈性需求；靈性滿足；生活品質

並列摘要

Background: The research on the effects of spiritual care for patients with depression in Taiwan is scarce and yet to be developed. Objective: To examine the effects of spiritual care on the depression level, spiritual needs, and quality of life in patients with depression. Methods: The study was a pretest-posttest design, conducted at the psychiatric acute wards and outpatient clinics in a medical center in the southern Taiwan. Patients with a diagnosis of depression, over the age of 20, and agreed to participate in the study were recruited. A total of 19 patients were recruited and received individual spiritual care for eight times in 4-week span. The Chinese Version of Spiritual Interests Related to Illness Tool, the Hamilton Rating Scale for Depression, and the WHOQOL-BREF Questionnaire were assessed at baseline, the second and the fourth week. Descriptive statistics and repeated measures of variance analysis were used for analyses. Results: Significant findings were as follows. (1) Depression level significantly decreased overtime (p < .001). (2) The 2-week “positive attitudes toward life” domain had a higher score (Mean±SD=3.93±1.04) than those of baseline (Mean±SD=3.51±0.92, p< .05). (3)The 4-week “peaceful mind” domain had a higher score (Mean±SD=3.16±0.83) than those of baseline (Mean±SD=2.53±1.02, p=.029) (4) As for the quality of life, the 4-week “physical health” domain had a higher score (Mean±SD = 11.85±2.46) than those of baseline (Mean±SD = 10.71±1.97, p=.04); the 4-week (Mean±SD=9.43±3.15, p=.045) and 2- week (Mean±SD=9.75±3.40, p=.018) “psychological” domain had higher scores than those of and baseline (Mean±SD=8.17±2.79); the 2-week (Mean±SD=11.42±3.06, p<.01) and 4-week (Mean±SD=12.11±2.62, p<.01) “social relationships” domain had higher scores than those of baseline (Mean±SD=10.12±2.79). Conclusion: The eight times with 4 weeks of individualized spiritual care had a positive impact on depression level and quality of life in patients with depression.