精神病者身體活動與生命療癒－－以太極拳為例

The Physical Activity and Life Healing in Psychiatric Patients: Taijiguan as an Example

背景：慢性精神病者易有認知與整體生活功能障礙，參與體能活動能增進他們健康及獨立能力，經常練習太極拳有助於改善情緒和生活壓力，促進身、心健康。目的：將太極拳應用於臨床精神醫療照護的學習活動，探討慢性精神病人學習十三週太極拳之過程及經驗，了解對其疾病與日常生活之影響、意義與體會。方法：以焦點團體及個別訪談進行資料收集，運用敘事分析進行資料整理及分析。結果：研究結果以：一、投身太極學功夫。二、揮動太極鬆束縛。三、學習太極造非凡等三大向度描述慢性精神病者的疾病、身體與人際生活觀；其中特別著重病者學習太極拳活動對其身體、生活與生命的潛在療癒和影響，描述學員「困境」、「突破與慣習」、「通達」三階段學習歷程。結論與臨床應用：太極拳對慢性精神病者身體活動的學習初期有其挑戰性，當熟習動作招式和拳術要領後，有助於身體的放鬆、感知和平衡，同時穩定病情、心緒和人際交往，藉以增進美好的生活經驗與疾病復元。當病者將太極拳融入日常活動時，能開創成為重要保健、療癒和復元的可能性，因此推薦將太極拳列入精神療癒項目之一。

Background: Chronic psychiatric patients tend to have cognitive and functional impairments. Participation in physical activity has been shown to improve their health and independence. Regular practice of Taijiquan may help improve mood and life stresses, promoting physical and mental health. Purpose: This research explores the effect of a 13-week Taijiquan learning program on the daily life experience of chronic psychiatric patients. The process and the essential meaning of the entire learning experiences are presented. Methods: Data were collected from a psychiatric daycare center at a Teaching Hospital in Taipei. The 6 patients who participated in this study included 3 with bipolar disorders and 3 with schizophrenia. Narrative inquiry and focus-group interviews were used for qualitative data collection and analysis. Results: The initial results of participant experiences were categorized into 3 themes: 1. Learning kung fu in the Taijiquan; 2. Releasing binding through the practice of Taijiquan; and 3. Pursuit of excellence through the learning of Taijiquan. The views of illness, body, and interpersonal interaction as well as the three stages of dilemma, transcendence/acclimation, and acquaintance for the psychiatric patients and their Taijiquan's learning world were described and the potential therapeutic effects on the body and daily life of these patients were explored. Conclusions/Implications for Practice: Learning Taijiquan is highly challenging for the novice, especially those with chronic psychiatric illnesses. However, after familiarization with the postural actions and key concepts of this exercise, Taijiquan facilitated body relaxation, heightened perception, and postural balance. Consequently, this exercise stabilized the mood, disease status, and capacity for handling interpersonal relationships of participants and consequently may enhance their long-term life quality and disease recovery status. Results of this study recommend strongly that Taijiquan be included as a therapeutic activity for psychiatric patients to improve their health, healing, and recovery.