探討身心機能活化方案之成效:以正向心理為基礎

Evaluation of the effects of Activity and Learning Program on the elderly in the community - based on Positive psychology

邱惠鈴(Hui-Ling Chiu)

指導教授 ： 謝佳容

臺北醫學大學/護理學院/護理學研究所/碩士(2011年)

https://doi.org/10.6831/TMU.2011.00102

摘要

研究背景：非藥物治療介入對老人的生活品質具有提升效果，但過去研究鮮以群體為導向的健康促進策略，且缺乏以正向心理學為基礎的觀察測量，本研究將採群體導向的身心機能活化方案為介入措施，期能使社區長者達到成功老化的目標。
研究目的：探討身心機能活化方案介入後，社區長者或有精神疾病的社區長者其快樂感、人際互動（淡漠感受）、憂鬱情緒、認知功能及注意力的成效。
研究方法：本研究方法分為兩階段，第一階段為橫斷式相關性設計，採立意取樣方式，以台北市信義區、大安區及士林區為主的社區關懷據點及社區精神康復機構的社區長者為對象，進行問卷施測及測試注意力，收案共62位。第二階段採類實驗性研究設計，以立意取樣方式將個案分為實驗組（n=27）及對照組(n=35)。實驗組進行每週一次共八次的身心機能活化方案，對照組則繼續參加常規的社區活動。
研究工具：1.中文版牛津快樂感問卷 2.淡漠評估量表 3.老人憂鬱量表 4.簡易智能量表、八次後測比較成效，統計分析以Wilcoxon、八次後測比較成效，統計分析以Wilcoxon Signed Ranks test檢定實驗組在進行第四、八週後於依變項改變的顯著性。
研究結果：1.社區長者平均女性較男性快樂得分為高，年齡越大，其快樂得分也越高（t=-2.16，p<0.05;r=0.29，p<0.05）。2.社區長者其年紀越大，人際互動越佳（淡漠感較低），有配偶者較無配偶者人際互動佳（淡漠感較低）（r=-0.36，p<0.05;t=-2.63，p<0.05）。3.健康的社區長者較有精神疾病的長者人際互動佳（淡漠感較低），定向感較佳，注意力測量得分也較高（t=3.52，p<0.05；t=-2.28，p<0.05；t=-2.86， p<0.01）。4.社區長者其教育程度較高者認知功
能得分較高（t=-3.93，p<0.01）。5.身心機能活化方案可使社區長者的認知功能提升（Z=-1.98，p<0.05）。研究建議：身心機能活化方案可增進社區長者的認知功能，建議未來能運用本方案於長者的介入活動，可促使長者增進良好的認知功能，避免發生認知功能障礙的情形。

關鍵字

長者 ； 身心機能活化 ； 快樂感 ； 淡漠感受 ； 注意力 ； 正向心理

並列摘要

Background: Non-medication intervention has an uplifting effect on the quality of life of the elderly; however, previous studies rarely used group oriented health promotion strategies, and lacked observational measurements based on positive psychology. This study uses a group-oriented Activity and Learning Program as an intervention to activate the physical and mental states of the elderly in the community, with the objective of assisting their successful aging.
Objective: This study aims to determine the happiness, interpersonal relationships (apathy), depression, cognitive functions, and focus of attention in community elders with or without mental illness, after the introduction of Activity and Learning Program.
Method: The methodology used in this study is comprised of two stages. In the
first stage, subjects selected by purposive sampling through
cross-sectional correlation design were elders from community care centers and local psychiatric rehabilitation centers in the Xinyi, Daan, and Shilin Districts in Taipei. Subjects were given questionnaires and attention tests, and a total of 62 cases were collected. Quasi-experimental research design was adopted in the second stage of study, in which subjects were divided into an experimental group (n = 27) and a control (n = 35) group. The experimental group participated in the Activity and Learning Program once a week for eight weeks, while the control group continued with their normal community activities.
Tools: The tools used included the Chinese version of Oxford Happiness Questionnaire, apathy evaluation scales, Geriatric Depression Scale, mini-mental state examinations, and the attention test of the Gordon diagnostic test. After the pre-test, and the fourth and eighth tests, results were compared . Descriptive analysis and Wilcoxon Signed Ranks test were used to analysis the data.
Results: 1.On average, the community female elderly are happier than males; the older they are, the higher they score in happiness (t = -2.16, p < 0.05; r = 0.29, p < 0.05).2.The older the community elderly, the better their interpersonal relationships (lower degree of apathy); and elderly with spouses have better interpersonal relationships (lower degree of apathy) than those without spouses（r=-0.36, p<0.05; t=-2.63, p<0.05）3.As compared to elderly with mental illnesses, those without mental illness have better interpersonal relationships (lower degree of apathy), better orientation, and also score higher in attention tests (t = -3.52, p < 0.05; t = -2.28, p < 0.05; t = -2.86, p < 0.01). 4.Those elderly with higher education levels also score high on recognition (t = -3.93, p < 0.01).5.The Activity and Learning Program can elevate the cognitive function of community elderly (Z = =1.98, p < 0.05).
Suggestions: The Activity and Learning Program can enhance the cognitive functions of the community elderly. It is recommended to incorporate this program into the activities of the elderly, so as to improve their cognitive functions and prevent cognition malfunctions.

並列關鍵字

elderly ； Activity and Learning Program ； happiness ； apathy ； attention ； positive psychology

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